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.
Background: The immunogenetic predisposition
may be considered as an important factor for the
development of Type 1 Diabetes Mellitus (T1DM)
in association with the HLA antigens.
Objective:This study was designed to investigate
the role of HLA-class II antigens in the etiology of
type T1DM and in prediction of this disease in
siblings, and its effect on expression of glutamic
acid decarboxylase autoantibodies (GADA).
methods:Sixty children who were newly diagnosed
type 1 diabetes (diagnosed less than five months)
were selected. Their age ranged from 3-17 years.
Another 50 healthy siblings were available for this
study, their ages range from 3-16 years. Eighty
apparently healthy control subjects,
The aim of this research is to construct a cognitive behavior program based on the theory of Meichenbaum in reducing the emotional sensitivity among Intermediate school students. To achieve the aims of the research, two hypotheses were formulated and the experimental design with equal groups was chosen. The population of research and its sample are determined. The test of negative emotional sensitivity, which is constructed by the researcher, was adopted. The test contains (20) items proved validity and reliability as a reliable test by presenting it to a group of arbitrators and experts in education and psychology. An educational program is constructed based on the theory of Meichenbaum. The test was applied to a sample of (60) second i
... Show MoreThe purpose of this research is to identify
the effect of the translation of poetic poem into an artistic picture in the achievement of retention among fifth grade students.
In order to verify the research goal, the first two hypotheses were determined. There are no statistically significant differences between the average scores of the experimental group who study (according to the technical picture) ) And the control group (according to the traditional method of art education) at the level of significance (0,05). The second is that there are no statistically significant differences between the average of the experimental group who study (according to the technical picture) and the control group who study (On According to the trad
She noted most of the results of research conducted on the use of computers and the Internet in the areas of administrative, economic, agricultural and educational to a significant improvement in learning outcomes of these groups in the development of mechanisms of action, has increased rates of computer use and applications in various spheres of life at very fast pace so that the computer and the Internet is a vital part of any activity, whether administrative or research or the media, hence it can be said that the use of computers and the Internet in the management of public relations activities in any organization can accelerate the pace of echo positive goals and purposes of public relations, this study comes to looking at us
... Show MoreFootball has progressed from being a ritual and a celebration to become an amateur sport, a professional sport, and now, increasingly, a commercial sport. In the analysis of football business model, the systemic approach should be adopted. If sport is regarded as one of the business sectors, then the application of business system methodology can be fully justified. The interest to create strong football business system calls for the search of the ways of popularizing football business model and boosting the economic potential of its participants. In the research literature tend to ignore the business processes within the sports business. Besides, the systemic approach in football business is usually limited to p
... Show MoreIntroduction: Due to the high prevalence of diseases associated with obesity. There are several factors, including the genetic factors, it is known that the genes Fat mass and obesity-associated FTO rs9939609, the lipoprotein lipase (LPL) Ser447Ter, and the chymase 1 (CMA1) -1903A > G are associated with lipoprotein metabolism. The aim of the present investigation was to study the association of the FTO, LPL, and CMA1 genes with obesity in the children and adolescents population of the Rostov region, Russia. Methods: In a case-control study involving 500 children and adolescents aged from 3 to 17 years, the association between the genetic polymorphisms of the FTO rs9939609, LPL Ser447Ter (rs328) and CMA1 -1903A > G (rs1800875) with the obes
... Show MoreThe optical detectors which had been used in medical applications, and especially in radioactive treatments, need to be modified studied for the effects of radiations on them. This study included preparation of the MnS thin films in a way that vacuum thermal evaporation process at room temperature 27°C with thickness (400+-10nm) nm and a sedimentation rate of 0.39nm/sec on glass floors. The thin films prepared as a detector and had to be treated with neutron irradiation to examine the results gained from this process. The results decay X-ray (XRD) showed that all the prepared thin films have a multi-crystalline structure with the dominance of the direction (111), the two samples were irradiated with a neutron irradiation source (241Am-9Be)
... Show MoreThe current research aimed to study the effect of an exercise program on physical-kinetic intelligence and the skills of dribbling and shooting in basketball among female students. The research community was composed of 102 female students in the second stage of the Physical Education and Sports Sciences College for Girls of Baghdad University, in the academic year 2021-2022. A total of 40 female students were the sample of the study: 20 female students in the control group and 20 female students in the experimental group. After the implementation of the exercise program, there were significant improvements from pre-tests to post tests in the two groups (control and experimental groups), in physical-kinetic intelligenc
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