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 function of internal auditing has become an important function that aims at achieving objectives that are compatible with these developments and changes that have occurred in many countries in the world, which required the emergence of professional associations and institutes in the profession of internal auditing. Improve the guideline of the internal audit units issued by the Federal Audit Bureau to enhance the efficiency of internal audit performance in Iraqi government units. The researchers adopted the statistical method of proving the hypothesis by constructing a questionnaire that included three main axes: supporting the senior management in adopting the current guide, and the second being the importance of improving t
... Show MoreIn this paper investigate the influences of dissolved CO2/H2S gases, crude oil velocity and temperature on the rate of corrosion of crude oil transmission pipelines of Maysan oil fields southern Iraq. The Potentiostatic corrosion test technique was conducted into two types of carbon steel pipeline (materials API 5L X60 and API 5L X80). The computer software ECE electronic corrosion engineer was used to predict the influences of CO2 partial pressure, the composition of crude oil, flow velocity of crude oil and percentage of material elements of carbon steel on the rate of corrosion. As a result, the carbon steel API 5L X80 indicates good and appropriate resistance to corrosion compared to carbon steel API
... 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 aim of the current research is to identify the effect of the active thinking model in the achievement of students of the fifth grade applied science of physics, and their pivotal thinking by verifying the two zero hypotheses, where there is no significant difference at the level of significance (0.05) between the average scores of the experimental group who studied physics using the active thinking model and the average scores of the control group students who studied the same material in the usual way in the achievement test, as well as in the pivotal thinking test. The research sample consisted of (77) students of the applied fifth grade students in two divisions (a) and (b), randomly selected (a) to be the experimental group, and (b)
... Show MoreBackground: Lung cancer is a common disease for patients over the age of 50 years, especially males due to smoking habits. This study aimed to compare the modulation complexity score (MCS) for the advanced treatment planning techniques which the intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). Materials and Methods: Thirty patients who had non-small lung cancerous tumors on their left side participated in this study. The range ages were 68 to 98 years, the heights were between 151 and 182cm and they having weights from 46 to 79 kg. For Each patient will create two plans dial using two different techniques, which will be Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy
... Show MoreSix house-hold Abyssinian pumps distributed in different villages of Mansoura (Mans-I, Mans-II and Mans-III) and Talkha (Talk-I, Talk-II and Talk-III) cities, Egypt, have been selected for regular seasonal water quality assessment during 2017. Water samples have been collected within the mid-periods of four seasons Standard assessment tools were employed for the integrated water quality assessment including Water Quality Index (WQI) and ISO standard algal toxicity test. WQI displayed remarkable local and seasonal variations with excellent (≥ 90) and good (70 - 89) only recorded for water samples collected from Mans-I pump located in sparsely populated area and far 50 meters only from the eastern (Damietta) branch of Nile River. WQI of
... Show MoreWith the increase in competition between insurance companies in addition to the increasing numbers in the number of insurance companies, whose number decreased to (32) private companies until the end of the year (2020). The blue ocean at the level and its effects on increasing the market share. Therefore, the two researchers tested the hypothesis and the research concluded that there is a relationship A .Also the researcher put some recommendations the most prominent is that the invention is considered one of the successful strategies an d the company has to encourage the employees according to inventive thoughts
In this paper we study the selection of cognitive elements and criteria of the inflectional structure of the Russian and Arabic languages in the process of speech communication. Phonetic-physiological principle is the main parameter by which the elements and criteria of cognitive activity in the presented study are distinguished. On the basis of the above mentioned parameter, we select the investigated criteria and elements. The first criterion is semantic, reflects the accordance of the elements of thinking to sound combinations in the studied languages, and allows us to distinguish the second criterion – morphonological. The second criterion depends on the phonetic changes of these combinations occurring in the process of speech activit
... Show MoreThe world and the business environment are constantly witnessing many economic changes that have led to the expansion of the business' volume due to mergers and the increase in an investments volume and the complexity of business and the transformation of some systems, which was reflected on the size of the risk and uncertainty which led to necessity of a presence of transparent and objective accounting information In the way that reflects the financial performance of the economic units to be available to all users of that information, therefore, The need for the existence of indicators for transparency in the disclosure of accounting information that these units adhere to. Standards & Poor's indicators, which included items
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