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.
This study aimed to identify the attitudes of school teachers and principals at basic government schools in Ajloun governorate towards the inclusion of disabled students at basic schools, and investigate how they will accept the merger. To achieve the purpose of this study, a questionnaire containing 35 items was administered to school teachers and principals to measure their attitudes toward the inclusion of disabled students in regular schools. The sample of this study consisted of 43 male teachers and (74) female teachers and principals. The frequency, normal distribution, arithmetic means and t-test were used to analyze the data of present study. The findings showed that there
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The aim of the research is to identify the effect of using the self-questioning strategy on the achievement of fourth-grade students in science and the development of their reflective thinking in physics in the city of Baghdad. The research sample was divided into two groups: an experimental group of (20) students and a control group of (20) students. The researchers developed two tools: a test of (40) multiple-choice questions. The second tool is a test to measure the reflective thinking skills of fourth-grade students. It consists of (25) multiple-choice questions distributed on skills as follow: reflection and observation, detection of inaccuracies, reaching conclusions, giving clear explanations, an
... Show MoreGeneration of new clones of multidrug resistant infectious foci of environmental, zoonotic and reverse zoonotic Enterococcus faecalis & faecium strains from cases of mastitis in cows privileged in Baghdad ecosystem reveal unsafe tricks. Medically important plants Blackcurrant, London Plane and Pine Buds are widely used for resolving these public health threats and hazards as powerful antimicrobial preparations. Totally sixty pooled milk samples were collected from apparently healthy (30 units) and infected (30 units) Cows from different regions of Abu-Ghraib during March until July (2019). Integrated units were checked by California mastitis test and a designed scheme was dependent for recovery of pathogenic Enterococci. Gram staining and c
... Show MoreNew simple and sensitive spectrophotometric methods for the determination of paracetamol in aqueous medium were developed. The first method is based on coupling of paracetamol with p-amino-2-hydroxy sodium benzoate (AHB) in the presence of sodium periodate, as oxidizing agent, to form a brownish-orange compound which shows a λmax at 470 nm. The molar absorptivity (εmax) of the colored product was found to be (3371) l.mole1.cm-1 and Sandel’s index 0.0449 μg.cm-2. The method follows Beer’s law in the concentration range of 12.5-500.0 μg of paracetamol in a final volume of 25 ml (0.5-20.0) μg.ml-1 with relative standard deviation percent (R.S.D%) ranged between 0.26-4.71% and accuracy, expressed by recover
... Show MoreHerein, a cost-effective bio approach using extract derived from desert truffles (Tirmania nivea) is utilized to synthesize gold nanoparticles (AuNPs). AuNPs were thoroughly investigated using UV–vis, XRD, SEM, and TEM analyses. It was shown that nanoparticles had an fcc structure with a smooth spherical surface, an average diameter of 9.44 ± 0.26 nm, and an SPR band observed at 548 nm. Investigations were conducted on AuNPs' antibacterial and anti-cancer properties of prostate cancer cells. The findings suggest that AuNPs showed better antibacterial effects against S. aureus compared to E. coli, P. aeruginosa, and K. pneumoniae. AuNPs’ combination with antibiotics demonstrated a synergistic effect with significant antibacterial activi
... Show MoreOrganizations nowadays, whether public or private organizations, productive or service (such as banks), face major challenges as a result of rapid and continuous changes, and in front of these challenges traditional management operations and tools become unable to make the organization able to work, which makes it imperative for these organizations to follow the methods and management practices, including the proposed knowledge risk management and strategic direction so that it can elevate its actions at the level of developments in reality, in the sense that these organizations and in the light of environmental developments to characterize their strategic direction as an intellectual approach characterized by mo
... Show MoreThe field efficacy of Actellic (organophosphate), Neporex (insect growth regulator) and
Ficam (carbamate), at the application rates of 2-4, 0.4-0.8 and 0.1-0.2 g AI/m2 respectively,
was studied against the larvae of Musca domestica L. Results of treatments involving horse
manure indicated that Actellic and Neporex produced sharp decrease of larval numbers (close
to zero) for 21d. But there was a slight recovery in larval numbers 14 d following treatment
with Ficam. The populations of predator mites were not affected due to insecticidal
applications.
The aim of the study was extraction of arial part of Euphorbia cyathophora constituents with methanol and evaluate its effect on mitotic index and total chromosomal aberration bone marrow cell and spleen cell in mice 200 gm of E. cyathophora fine powder was defatted then extracted by cold maceration 80% ethanol for seven days. The extract was filtered and dried in a rotary evaporator then the dried extract was suspended with water and consecutively extracted using chloroform, ethyl acetate for each. The aqueous layer was then mixed with 100ml methanol. These fractions are dried under reduced pressure to obtain the dry extract. Twenty-four Albino mice were used for the experiment. The animals were divided into four groups: Gr
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