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 importance of this research comes from the possibility of achieving positive interaction between accounting and tax through the interest in setting accounting standards and adapting them to local tax legislation, as the adoption of the application of the international standard (IAS 12) for income taxes helps to measure and determine the base for income tax and may lead to an increase in the tax outcome. Through the reliance of enterprises on many accounting bases, and that the tax administration in Iraq depends on the element of personal judgment in determining the tax base, which leads to lack of objectivity in determining the tax outcome, as the impact of the accounting standard (IAS 12) on the tax base and tax outcome is one of th
... Show MoreThe article considers semantic and stylistic motivations for using obsolete lexicon (historicisms) in the text of a work of art. The specifics of the functioning of this process are presented against the background of the features of the contemporary Russian literary language. Attention is focused on the fact that the layer of obsolete lexical units belongs to a number of nationally specific vocabulary, the development of which forms an understanding of the nature of the actualized language. In addition, it should be noted that the semantics of historicisms is culturally commensurate: the latter is explained by the fact that the deactuation of linguistic units is positioned as parallel to the sociocultural and political changes.
... Show MoreCharacterization of the heterogonous reservoir is complex representation and evaluation of petrophysical properties and application of the relationships between porosity-permeability within the framework of hydraulic flow units is used to estimate permeability in un-cored wells. Techniques of flow unit or hydraulic flow unit (HFU) divided the reservoir into zones laterally and vertically which can be managed and control fluid flow within flow unit and considerably is entirely different with other flow units through reservoir. Each flow unit can be distinguished by applying the relationships of flow zone indicator (FZI) method. Supporting the relationship between porosity and permeability by using flow zone indictor is ca
... Show MoreThe path and its nodal purposes
Abstract
This study has come to indicate the doctrinal purposes of faith in this path، It was composed of an introduction and four demands، as follows:
The first requirement: the intentions of distinguishing between the ranks of people according to divine justice، as those who pass by him are different. Some of them are safe by his work، surviving from the fire، and some of them are not peace، he falls into the fire of Hell، and all of them are different in their ranks in a manner consistent with the justice of God Almighty and the works they have given themselves.
The second requirement: the purposes of divine mercy in honoring the Prophet and his nation on the path and embodying their
François Mauriac’s novel The Desert of Love (1949) puts the reader before an experienced sociologist who is skillfully able to analyze the most mysterious human emotions and feelings. The writer's starting point is that people are similar in feelings but different in behavior. He severely criticized the aristocratic class and uncovered its defects and faults.
The novelist presents Courege's family as an example of the aristocratic class. It is a family torn by hatred, selfishness and disagreements due to absence of intimacy and love. This poisoned environment pushes the father and his son, Raymond, to search away for emotional ventures and banned relations
... Show MoreIn the tenth century, Turks began to convert into Islam and adopted for official and literary use the Arabic language to study the teachings of the new religion they believed in. The use of many of the loanwords have become absolute in the Ottoman period, but even in Modern Turkish a large number of loanwords from Arabic can be often recognized because they are not subject to the strict rules of Turkish. Yet, some of these words lost its original meaning and acquired new different Turkish meaning. Moreover, some of the Arabic nouns of singular form in Turkish, modified the plural Turkish form. The present study entitled “the adaptation and the different modifications of borrowed Arabic Plurals in Modern Turkish” sheds light on
... Show MoreThe study aimed to identify the relationship between the speed and direction of the ball's rotation in the accuracy of the front and rear side longitudinal blow in wheelchair tennis players. The descriptive approach wasused in the manner of correlations to suit the nature of the problem to be studied. The research community identified the 32 players aged18 and over, and the search sample was selected from players with a local classification registered with the 2020 Wheelchair Ground Tennis Federation (2020) in the intentional manner of 8 players, using Smart Tennis Sensor technology to measure the speed and direction of the ball and test the accuracy of the front and rear side longitudinalstraightstrike. She conducted the reconnaissance exp
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