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 paper deals with the language of Russian folklore. Folklore is a unique sphere of existence of the language, the most vivid expression of the national mentality. The folklore word embodied the perception and evaluation of the surrounding world. “What did the word in general mean for the life of the people? The word was equated ... with life itself. The word generated and explained life, it was ... the keeper of memory and the guarantee of the infinity of the future. The folklore text is studied by literary critics, ethnographers, historians, culturologists, and art historians. In the twentieth century, a new science emerged - linguo-folkloristics, the goals and objectives of which were formulated by A.T. Khrolenko only in the seven
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The underlying objective of the international standard No. (6) to assist in accounting applications for the extractive industries, taking into consideration the goals and objectives contained in the sixteenth of the private International Accounting Standards criterion accounting for land, machinery and equipment, as well as Standard No. axes (38) relating to intangible assets, and in order to create a vision of a comprehensive development needs oil in order to exact evaluation of policies related to the particular needs and draw a comprehensive frameworks with respect to treatment of expenditures and revenues in the oil production industry, is also interested in Standard No. (6) within the primary objectiv
... Show MoreIn this paper we proposed the method of X-ray fluorescence (XRF) determination of some essential trace elements in medicinal herbs and vitamin-mineral complexes at the level of 100-101 mg/ml. To increase sensitivity and selectivity of the determination we simple and effective approach based on the extraction of metal ions from aqueous solutions with chemically modified polyurethane foam sorbents followed by direct XRF analysis. The conditions of sorption preconcentration of Co(II), Ni(II) and Zn(II) ions with modified sorbents were optimized. The proposed approach is used for the determination of trace elements in several kinds of medicinal herbs (coltsfoot leaves, nettle leaves and yarrow herb) and vitamin-mineral
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Style of Dostoevsky - it is a style that clearly emerges the desire for stimulating thought reader stage. It's a style calculated to provoke the reader to their findings, conclusions and reflections. Dostoevsky hints, expressed as like inaccurate and at the same time with some startling sophistication. It makes the readers think and draw their own conclusions.
Аннотация
Стиль Достоевского - этостиль, в которомясноотмечаетсястремлениек стимулированиюзаконченного мыслячитателя
... Show MoreThe philosopher and social psychologist Erich Fromm (1900-1980), in his book "Escape from Freedom" highlighted the distinction between the "I" of the authoritarian personality and the "I" of the destructive personality based on their stance towards "the other." The former (the authoritarian self) relies on a submissive, enslaving formula, where the "I" is the master/dominator/controller/strong, while "the other" is the servant/submissive/controlled/weak, essential for perpetuating this formula. In contrast, the latter (the destructive self) relies on an annihilating, negating formula, where the "I" is existence/killer/destroyer/pe
... Show MoreThe Psychologists have noticed, not long ago, that the man’s success and happiness in life do not only depend on his degree and education, which express on his mental intelligence but also they need another kind of intelligence called emotional intelligence. The research aims at identifying the emotional intelligence level of the top and administrative leaderships in the Federal Board of Supreme Audit by evaluating their emotional intelligence when the administrative and audit leaderships face emotional interactions by dealing with administrative and audit stuffs in the Board. The research problem is focused on the following question “Is the emotional intelligence of the top and administrative leaderships in the Fede
... Show MoreThe studies on the antiviral compound chalcone in vitro in both tissue and organ culture systems against rubella virus glass that this compound relatively non toxic to the cell culture and organ culture of the concentration of 8 ug/ml or less, chalcone have significantly antiviral activity against rubella virus in tissue culture and organ culture. We find that a concentration of 0.03ug/ml or more inhibit the IOOTCID50 of rubella virus. The therapeutic index (TI) used in this study to evaluate the drug, the (TI) which is the ratio of the dose of drug which is just toxic (Maximum tolerated dose) to the dose which is just effective (Minimum effective dose). If this index is one or less it not possible to use the drug under the conditions outli
... Show MoreThis study aimed to show the extent of compliance with the income taxpayer to provide tax returns and increase the speed of collection of these taxes in addition to increasing confidence in Income Tax department and reduce the number of cases transferred to the courts and promote taxpayer awareness in charge of the importance of self-assessment system, and study sought to investigate the effect of the existence of records documents, technical audit, and computational audit and documentary audit on income tax collections in Jordan, from the point of viewof Jordanian income tax auditors ,results shows there's a strong relation between these variables and Income Tax collections.