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 aim of the study is to reveal the effect of the constructivist learning Model on the achievement and reflective thinking of the fifth grade literary Preparatory students in History subject. A random sample was chosen which consisted of 64 students divided into experimental and control groups, each group consisted of 32 students. The experimental group was taught via the constructivist learning model, and the control group was taught via the traditional method. The experiment was lasted for Eight weeks, each week taught two lessons. The researcher adopted the experimental design with partial control. The two groups were equalized statistically. The researcher used two instruments, the achievement test and the reflective thinking test.
... Show MoreThis research presents a numerical study to simulate the heat transfer by forced convection as a result of fluid flow inside channel’s with one-sided semicircular sections and fully filled with porous media. The study assumes that the fluid were Laminar , Steady , Incompressible and inlet Temperature was less than Isotherm temperature of a Semicircular sections .Finite difference techniques were used to present the governing equations (Momentum, Energy and Continuity). Elliptical Grid is Generated using Poisson’s equations . The Algebraic equations were solved numerically by using (LSOR (.This research studied the effect of changing the channel shapes on fluid flow and heat transfer in two cases ,the first: cha
... Show MoreThe research aims to achieve a set of the most important objectives of the review of the role of creative administrative leadership in achieving aspects of economic reform in various government institutions and indicate the role of supervisory awareness of administrative leadership in the revitalization of the role of the internal control system to achieve the best use of available resources. This paper deals with three problems is the loss of financial resources of the state as a result of the growing phenomenon of administrative and financial corruption in the majority of government institutions, and the weakness of the role of the internal control system in the province on the resources available and to achieve the best use of these reso
... Show MoreThe aim of the research is to present and discuss the subject of the budgeting estimates and how to activate the role of the Federal board of supreme audit in examining these estimates through reference to Articles 6 and 10 of the Federal board of supreme Law, which did not restrict Federal board of supreme in Preventive control on examination process for planning which is prepared from the government units, as the result of a large amount of government units Provisions and the weakness of estimates in most of its items, which rely on personal assessment and not based on scientific and logical basis of the estimate, which leads to the emergence of a deficit is not true in the general budget and this seems clear in most Iraq
... Show MoreThe study examines Julia Alvarez's role as a Dominican American author, poet, and essayist. Despite being born in New York City in 1950, she was raised in the Dominican Republic by a family with Dominican heritage. Her residence in her ancestral homeland significantly influenced her subsequent literary works. Upon her father's implication in a conspiracy against Dominican President, he departed from the Dominican Republic. Alvarez encountered the challenge of the English language. They were compelled to acquire proficiency in English due to the prevailing perception that anyone who spoke a language other than English were deemed "un-American" during that period. Alvarez recounted her initial encounters in the United States and the subseque
... Show MoreThe goal of the study is to discover the best model for forecasting the exchange rate of the US dollar against the Iraqi dinar by analyzing time series using the Box Jenkis approach, which is one of the most significant subjects in the statistical sciences employed in the analysis. The exchange rate of the dollar is considered one of the most important determinants of the relative level of the health of the country's economy. It is considered the most watched, analyzed and manipulated measure by the government. There are factors affecting in determining the exchange rate, the most important of which are the amount of money, interest rate and local inflation global balance of payments. The data for the research that represents the exchange r
... Show MoreThe aim of the current research is to reveal the effect of using brain-based learning theory strategies on the achievement of Art Education students in the subject of Teaching Methods. The experimental design with two equal experimental and control groups was used. The experimental design with two independent and equal groups was used, and the total of the research sample was (60) male and female students, (30) male and female students represented the experimental group, and (30) male and female students represented the control group. The researcher prepared the research tool represented by the cognitive achievement test consisting of (20) questions, and it was characterized by honesty and reliability, and the experiment lasted (6) weeks
... Show MoreThe research addresses the questioning of political loads in a cinematic model from the films of the author (David Abdel Sayed), who has been busy throughout his films in criticizing political power, where he presented protests visions her body the artistic composition of cinematic means of expression through artistic treatments that facilitate the representations of modernity in contemporary cinematic trends, and by this Several contemporary cinematic criticism is an example of a thinker cinematographer who presents his critical thesis on power politics through the composition of the film (material - form - expression). The research consisted of four chapters. The first was a methodological framework that included the research problem o
... Show MoreThis study was conducted to investigate the relationship between corticosterone hormone in the blood of local Iraqi white chicken mothers and the sexual ratio of the hatching chicks. A field experiment located at the Poultry Research Station, Livestock Department, Agricultural Research Department, Ministry of Agriculture for the period from 16 of September 2018 to 25 of December 2018. One hundred and forty birds of Iraqi local chicken mothers (100 females+ 40 males) at the age of 28 weeks were provided from the poultry research station. The birds were raised in individual cages and distributed sequentially to the cages after the numbering of the females. Data were recorded in three periods, each period was of 28 days, and then the general a
... Show MoreThe constructivist learning model is one of the models of constructivist theory in learning, as it generally emphasizes the active role of the learner during learning, in addition to that the intellectual and actual participation in the various activities to help students gain the skills of analyzing artistic works. The current research aims to know the effectiveness of the constructivist learning model in the acquisition of the skills of the Institute of Fine Arts for the skills of (technical work analysis). To achieve the goal, the researcher formulated the following hypothesis: There are no statistically significant differences between the average scores of the experimental group students in the skill test for analyzing artworks befor
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