Abstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. Objective: compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection. Patients and method: The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021). The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis. The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups. Results and discussion: two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin. COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05). Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day. Conclusion: Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.
The aim of this research is to find the impact of the efficiency of Management information systems (MIS) on the effectiveness of governmental organizations performance.
To achieve the objective of the research, the analytical descriptive method was adopted. A questionnaire was designed consisting of (35) paragraphs, and the sample consisted of (200) individual. The research attemped to answer the following question: To achieve the objective of the research, the analytical descriptive method was adopted. A questionnaire was designed consisting of (35) paragraphs, and the sample consisted of (200) individual. The research tried to answer the following question: What is the actual utilization of modern admi
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This study aimed to identify the business risks using the approach of the client strategy analysis in order to improve the efficiency and effectiveness of the audit process. A study of business risks and their impact on the efficiency and effectiveness of the audit process has been performed to establish a cognitive framework of the main objective of this study, in which the descriptive analytical method has been adopted. A survey questionnaire has been developed and distributed to the targeted group of audit firms which have profession license from the Auditors Association in the Gaza Strip (63 offices). A hundred questionnaires have been distributed to the study sample of which, a total of 84 where answered and
... Show MoreThe study aims at explaining the extent to which the principles of educational management reform contribute to Ibn Ashour in achieving educational management reform and the extent to which the pillars of the Kingdom's Vision 2030 in the field of Education in achieving the educational management reform. The study also aims to provide a future vision of what the educational administrative reform and its results should be in the Kingdom during the next ten years. To achieve the goals of the study, the researcher followed two approaches: on the theoretical side, he relied on applying the content analysis method. As for the applied side, the researcher adopted the Delphi method by two questionnaires to ask (36) participants from the experts a
... Show MoreThe art of batik is one of the ancient arts that has a long history in East Asian countries, especially in Indonesia, where it was considered a traditional craft with which many Indonesian tribes lived. This art began to move to other continents and develops and progresses due to the artist’s connection to the surrounding technological and intellectual development, as art became more outgoing and liberated, it helped the artist to create and innovate in his designs. In this research, he focuses on modern performance methods through which print paintings can be produced through design elements, especially calligraphy, to create aesthetic and creative effects in the productive work. The current research aims to identify the various perfo
... Show MoreShallow foundations are usually used for structures with light to moderate loads where the soil underneath can carry them. In some cases, soil strength and/or other properties are not adequate and require improvement using one of the ground improvement techniques. Stone column is one of the common improvement techniques in which a column of stone is installed vertically in clayey soils. Stone columns are usually used to increase soil strength and to accelerate soil consolidation by acting as vertical drains. Many researches have been done to estimate the behavior of the improved soil. However, none of them considered the effect of stone column geometry on the behavior of the circular footing. In this research, finite ele
... Show MoreThe Significance of this research comes as a result of the development occurring in various life fields including the field of technical and technological development in the domain of industrial products which are in direct touch with the receiver, and because the study of deletion and addition mechanism didn't Find the Scientific space through researches and Studies. On this basis , the aim of this study is defining the forms of deletion and addition mechanism in designing the industrial product in a way that fits the functional presser . As to the limitations of this study, they involve examples of readymade Turkish House furniture, which is available in Iraqi local markets in Baghdad city 2013. The study included four chapters. The fi
... Show MoreForensic accounting (FA) is an important tool in exposing financial manipulation and corruption within institutions, making the role of FA essential in the Iraqi judicial system (IJS). This role suffers from limited implementation due to the lack of specialized legislation and insufficient awareness of its importance. The role of FA in the IJS can be enhanced by enhancing professional training, amending university curricula to include FA, and developing legislation regulating this field. Furthermore, cooperation between courts and the FA should be strengthened to ensure adequate financial evidence (FE) in judicial cases. For example, the experiences of developed countries, such as the United States and the United Kingdom, demonstrate how FA
... Show MoreObjective: Per-implantitis is one of the implant treatment complications. Dentists have failed to restore damaged periodontium by using conventional therapies. Tissue engineering (stem cells, scaffold and growth factors) aims to reconstruct natural tissues. The paper aimed to isolate both periodontal ligament stem cells (PDLSCs) and bone marrow mesenchymal stem cells (BMMSCs) and use them in a co-culture method to create three-layered cell sheets for reconstructing natural periodontal ligament (PDL) tissue. Materials and methods: BMMSCs were isolated from rabbit tibia and femur, and PDLSC culture was established from the lower right incisor. The cells were co-cultured to induce BMMSC differentiation into PDL cells. Cell morphology, stem cel
... Show MoreThis study aimed to investigate the effect of total suspended solids (TSS) on the performance of a continuously operated dual-chamber microbial fuel cell (MFC) proceeded by primary clarifier to treat actual potato chips processing wastewater. The system was also tested in the absence of the primary clarifier and the results demonstrated a significant effect of TSS on the polarization curve of the MFC which was obtained by operating the graphite anodic electrode against Ag/AgCl reference electrode. The maximum observed power and current densities were decreased form 102.42 mW/m2 and 447.26 mA/m2 to 80.16 mW/m2 and 299.10 mA/m2, respectively due to the adverse effect of TSS. Also
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