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 article reflects the results of the analysis of the use of metaphors when creating the image of the main character of the story by D. Rubina "You and me under the peach clouds" - a pet, a dog named Kondraty. Through metaphorization, the image of the dog is filled by the author with purely human qualities, thus passing into the category of a full member of the family. The article is a continuation of the study of the work of D. I. Rubina.
Evolution has become a feature of this era because of the speed that makes it open multiple horizons and many to identify everything that is new in different areas and also characterized by the competitive position of emotional attitudes changing depending on the positions of winning and defeat, and the use of training methods are the most important pillars of the game of wrestling, The methods contribute to raising the level of the wrestler and refining his physical and skill potential. The problem of the research is that the shooting exercises from above the chest are very important in Roman wrestling and can be terminated by the player. Through very personal interviews for coaches and concluded that there is a weakness in the level of fl
... Show MoreBackground: Cardiopulmonary resuscitation (CPR) is a technique or procedure that combined chest compression and rescue breathing to maintain enough circulation that prevents brain damage until other essential steps are taken to control the main cause of cardiac and respiratory arrest. The health care personnel should be qualified in the performing of cardiopulmonary resuscitation (CPR) to improve the survival rate of the victims. Therefore; it is necessary to use new methods for learning [1]. Objectives: the study aims to compare the effectiveness of self-instructional teaching strategy and traditional teaching approach on student’s knowledge toward cardiopulmonary resuscitation. Methods: A randomized comparative trial (RCT) design was ca
... Show MoreThis research aimed to evaluate the level of readiness to teach science in the light of the information, media, and technology skills among undergraduate students at the Faculty of Edu-cation, King Khalid University. To achieve this goal, a descriptive and analytical approach was used. A list of readiness to teach science was prepared in the light of Information, media, and technology skills, and in the light of this list, a cognitive test, observation sheet, and attitude scale were prepared to assess readiness to teach science in its three aspects, cognitive, behavioral, and emotional. The sample of the research consisted of (42) students enrolled in field training courses at the sixth, seventh and eighth levels. Research tools were app
... Show MoreTwo field experiments were performed to study the response of two species , Nigella sativa L. and Nigella arvensis L. within different sowing dates at spring and autumn seasons which included 1st and 20th March, 10th April and 1st May for spring season, while the sowing dates for the autumn season were, 2nd November, 21st November, 11th December, 31stDecember and 20thJanuary. Both experiments conducted according to the Completely Randomized Block Design (CRBD) within three replications at hallabja/Kurdistan Region, located [35°12'48.7"N; 45°57'34.4"
... Show MoreVorwort:
Die Übersetzung gilt in der Vergangenheit als Brücke zwischen verschiedenen Gesellschaften. Sie spielt eine große Rolle im Bereich Kulturaustausch der Länder. Die Araber haben das früh betrachtet, und die Übersetzung als Wissenschaft wird eine der wichtigsten Lehren. Viele griechische Wissenschaften waren durch Übersetzung in den arabischen Ländern bekannt.
In dieser Forschung findet man einen Überblick über die Wichtigkeit der Sprichwörterübersetzung und welche Rolle spielt diese Übersetzung im Z
... Show MoreThe acceptance sampling plans for generalized exponential distribution, when life time experiment is truncated at a pre-determined time are provided in this article. The two parameters (α, λ), (Scale parameters and Shape parameters) are estimated by LSE, WLSE and the Best Estimator’s for various samples sizes are used to find the ratio of true mean time to a pre-determined, and are used to find the smallest possible sample size required to ensure the producer’s risks, with a pre-fixed probability (1 - P*). The result of estimations and of sampling plans is provided in tables.
Key words: Generalized Exponential Distribution, Acceptance Sampling Plan, and Consumer’s and Producer Risks
... Show MoreA newly developed FIA-merging zones spectrophotometric system, the method is rapid, accurate and sensitive for metformin hydrochloride determination through the oxidation of 1- naphthol by sodium hypochlorite and coupling with metformin.HCl in the presence of sodium hydroxide to form a blue soluble ion pair and this product was determined using homemade CFIA-Merging zones techniques , at 580 nm. Data treatment shows that linear range is (0.5-35) µg/ ml. The optimization conditions for various chemical and physical conditions of [MTF- NaOCl-α-naphthol-NaOH] system were investigated. The LOD was 0.01µg / ml and LOQ 0.1µg/ml from the lowest concentration of the calibration graph with r2% 99.18 and RSD% did
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