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 objective of the research is to evaluate the risk management practices of the variables (risk management structure, risk management methods, key components of risk management) and their relation to the principled behavior of managers behavior(innovation, proactive, risk acceptance) By adopting the questionnaire as a main tool in collecting data from managers in the National and raq insurance companies of (50) officials Department manager, department administrator, unit administrator, and analyzed their answers using the SPSS In calculating arithmetic mean, standard deviation, percentage weight and simple correlation coefficient. The most prominent conclusions were:1.There is a positive trend in the sample in both companies and a high
... Show MoreSimple, rapid and sensitive spectrophotometric method was proposed for the analysis of metoclopramide hydrochloride (MPH) in pure form as well as in pharmaceutical tablets. The method is based on the diazotization reaction of MPH with sodium nitrite in hydrochloric acid medium to form diazonium salt, which is coupled with 1-naphthol in sodium hydroxide medium to form azo dye, showing absorption maxima at 550 nm. Beer’s law is obeyed in the concentration range of 0.4 – 18 µg mL-1 of MPH with detection limit 0.5448 µg mL-1. The molar absorptivity and Sandell’s sensitivity are 3.4969 × 104 L mol-1 cm-1 and 0.0101 µg cm-2, respectively. The method was successfully applied to the determination of MPH in pharmaceutical tablets with
... Show MoreBackground: Antioxidant, sedative, anticancer, and antibacterial properties are among the numerous pharmacological characteristics of Galium verum. Aim: The primary goal of this research was to investigate the therapeutic effects of G. verum extract against folic acid-induced acute kidney injury (AKI). Materials and methods: 18 male rats were assigned into three groups: Control, AKI, and G. verum. AKI was induced by a dose of folic acid (250 mg/kg, i.p.) while G. verum (250 mg/kg) was administrated for 7 consecutive days. Results: G. verum methanol extract contains flavonoids, anthraquinones, tannins, iridoids, triterpen
... Show MoreThis study deals with the corrosion inhibition of metal corrosion process of medium carbon steel using 1M HCl for kinetic studies and rate reaction determination. The weight loss method is applied to pieces of Medium carbon steel divided to Cubans with dimensions (0.4*2*2.4) cm , and use Tafel Extrapolation Method, the samples were polished using carbide silicon paper with dimensions of (180,200,400,600,800,1000). The samples were immersed in the alcoholic medium ethanol at a temperature 293K for 3hr. Natural inhibitor Kujarat Tea (Hibiscus sabdarriffa L.) is used which is extracted in aqueous and alcoholic medium, different concentrations (1000،2000, 3000) ppm have been used ; The best concentration found through the results is a conce
... Show MoreThe objective of this research was to study the effect of physical exertion training on bio-kinetic abilities in weightlifting among students of Physical Education and Sports Sciences. The present study had a pre-posttest experimental design in which participants were recruited in two groups: experimental group and control group. A total of 30 students of Physical Education and Sports Sciences constituted the sample of the study. The sample selection was done by a comprehensive inventory method. Participants were equally allocated into two groups with n=15 in each group. Participants of experimental group were made to perform special physical exercises with three training units per week during eight weeks. The statisti
... Show MoreIn this study, we investigate the behavior of the estimated spectral density function of stationary time series in the case of missing values, which are generated by the second order Autoregressive (AR (2)) model, when the error term for the AR(2) model has many of continuous distributions. The Classical and Lomb periodograms used to study the behavior of the estimated spectral density function by using the simulation.
A field experiment was carried out to test the efficiency of potassium silicate and wild eggplant
Anodic electrodeposition was used to synthesize a composite electrode of nanostructured manganese dioxide/carbon fiber (CF) galvanostatically. Different characterization results of the nanostructured MnO2 were obtained by varying the H2SO4 concentration and the current density. Field emission scanning electron microscopy, X‐ray diffraction, and atomic force microscopy were utilized to characterize the prepared composite electrodes. The best conditions were: 0.3 mA cm−2 current density and 0.64 M H2SO4 concentration. The electrosorption performance of the MnO
Background: Breast lump is one of the most common prevalent complaint of patients attending breast clinics.
Objective: To determine if there is any change in the pattern of common breast, diseases presenting as breast lumps between pregnant and non-pregnant women among patients attending Al-Elwiya Breast Clinic.
Methods: This is a cross – sectional study, with convent's patient sampling setting in AL-Elwiya Breast Cancer Early Detection Clinic from 1st Feb. to 1st May 2018, we collected data from patients with breast lumps including the age groups, pregnancy status, parity status, previous breast diseases, hormonal drugs, menstrual cycle, breast fe
... Show MoreWater samples from a variety of sources in Kelantan, Malaysia (lakes, ponds, rivers, ditches, fish farms, and sewage) were screened for the presence of bacteriophages infecting