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 audit profession today gets an increasing interest by the financial , economic and legal contemporary societies , because of the importance of the technical & neutral auditor’s opinion to the financial reports beneficiaries in order to enable them making their investment decisions , but some of them whom suffered damage or loss when they made that decisions according to the mentioned financial statements which consolidated with auditor’s report , exposed the function to a responsibility and credibility crisis in addition to missing the trust especially at the latest years. They always ask why or what is the reason that cause the auditor didn’t giving us any warning signs about the economic mater for that companies.
Background: This research identified Streptococci spp. depending on culture, biochemistry, the VITEK technique, ability to produce biofilms, and antibiotic resistance. Aim: The goal of this study was to perform microbiological procedures to evaluate the qualitative qualities of mozzarella cheese against infective Streptococci using microbiological care. Methods: Sixty (60) mozzarella cheese samples were brought from diverse markets in Baghdad from October 2023 to December 2023 at the Zoonoses Research Unit and Veterinary Public Health Department, Veterinary Medicine College, University of Baghdad. Culture of samples on agar (MacConkey and blood) and aerobically incubated at 37°C for 48 hours. Gram staining purified colonies to
... Show MoreThis study aimed to manufacture an innovative device that enables the player to walk after the operation and improves the functional efficiency through the improvement in the range of motion as well as the improvement in the size of the muscles working on the knee joint. The research, the study population consisted of players with severing the anterior cruciate ligament of the advanced soccer players, and the number of the research sample was (5) injured for the control sample and (5) for the experimental sample in Abu Ghraib Hospital and some rehabilitation centers for a period of six months, and the pre-tests were conducted after two weeks of The cruciate ligament surgery was performed, and the innovative device was used for the e
... 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 MoreThis research aims to find out the phonemic, dialect and semantic ailments that were interrogated by the book of the parsing of thirty surahs of the Noble Qur’an by Ibn Khalawiyeh, by examining some phonemic phenomena of Qur’anic expressions and their explanatory relationships that resulted in their occurrence, such as substitution and compression, as the sounds in a word are affected by one another, especially during performance and composition. This influence and influence is the tendency of the human being to the law of ease, facilitation, and the reduction of muscular effort in speech often, all for the purpose of obtaining phonemic harmony for the compound letters; To facilitate pronunciation; And get rid of the muscular effort
... 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
... Show MoreEquilrium, kinetic and mechanistic studies for thcoordination of
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... Show MoreNo country in the world has an ancient heritage of its own. It represents the product of the civilizations left behind by previous eras. It represents the development of urban life and its capital of the interest of its people in the field of construction and reconstruction. The urban heritage and its associated arts may seem to be a material heritage at first glance, but it is not free from the spiritual side. Therefore, the nations in different parts of the earth cherish it and care for it with all due diligence, because it mixes with its history, memories and emotions.
This research discusses the use of local environment materials in the production of urban fabric constituents. I