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.
Abstract:
The study focused on the application of smart tourism as one of the applications of electronic commerce in the form of (B2C) to attract tourists to Saudi Arabia, where the tourism sector is one of the important sectors on which the Kingdom depends on the diversity of its economy.
The purpose of the research: With the issuance of tourist visas for the first time the study noted a deterioration in the case of Saudi tourist sites over the Internet, which do not live up to this great interest by the Saudi government for this sector, which became vital to them. The study tried to identify the reality of the Saudi tourist sites through the Internet in order to identify the sui
... Show MoreIn this paper, the effect of changes in bank deposits on the money supply in Iraq was studied by estimating the error correction model (ECM) for monthly time series data for the period (2010-2015) . The Philips Perron was used to test the stationarity and also we used Engle and Granger to test the cointegration . we used cubic spline and local polynomial estimator to estimate regression function .The result show that local polynomial was better than cubic spline with the first level of cointegration.
Objective: Evaluation of women's knowledge about risk factors and early detection of breast cancer at
Ibn Rushd college of education in Baghdad University.
Methodology: The study sample included (184) women in the Ibn Rushd College / University of
Baghdad, whose age ranged between (17-58) years. Data were collected through a structured
questionnaire prepared by the National Cancer Research Center which were answered during a scientific
symposium about breast cancer. The score was calculated by correcting the results of the answer, giving
one score for each correct answer and then estimating the level of knowledge and inputting all data in a
statistical program.
Results: The results showed limited level of women's
The aim of the research is to diagnose and analyze the gap between the actual reality and the application of the eighth requirement (operation) in the National Insurance Company in accordance with the international standard specification for the quality management system (ISO 9001:2015), which is related to the planning, implementation and control of operations, which would raise the level of performance of employees and be reflected in the provision of An appropriate service for the faithful, as the reality of the condition of the requirement was studied by identifying the strengths and weaknesses of the system to diagnose the gap and find ways to address it. A workshop was held with company officials, through which questions were raise
... Show MoreThe research aims to shed light on the importance of forensic accounting and its role in winning compensation claims against the company because of the ability of the forensic accountant (the judicial expert) to interpret and analyze the data. The research community represents the insurance companies in Iraq. The research sample was represented by the National Insurance Company. Coverage of the theoretical and deductive approach in covering the practical side, based on the financial records of the National Insurance Company for years of research.One of the most important conclusions reached by the researchers was that forensic accounting has a role
... Show MoreIn this research, we tackled the idea of absence and what companies it of interpretations and human, textual, philosophical and explanatory concerns. We also tackled the features and drawing them and identifying and lighting them by Ali Abdunnabi Az-Zaidi and how he read them as an Iraqi who writes in order to express a social, intellectual, political and religious reality in some of its aspects. The idea of absence and what accompanies it of pain or heartbreak or human change was a rich subject for all the writers and authors in the Iraqi theatre, and Ali Abdunnabi Az-Zaidi was one of them and the closest and most affected by it, who deserves discussion, explanation and briefing. The research problem was looking for the nature of absenc
... Show MoreThis search is field research, which aims to explore the trends of students in media department toward specialized Satellite Channels and identify the knowledge capacity and its role in the development of their knowledge’s, represented by watching those channels as well as media students' habits exposed by those channels. As to the public is a key element in the process and substantive communication, the Sociological studies information on that article information is not complete its work, but that he was receiving from before receiving, and send every piece of information content in order to achieve a certain goal, therefore, is the future of receiving such information in order to achieve a particular goal, which is
... Show MoreThe article reflects the results of the analysis of the use of metaphors as one of the main means used by Lyudmila Ulitskaya when writing the novel “Sincerely Yours Shurik” to form the image of the main hero in the novel. The main purpose of the article is to consider metaphors, which helped the author to form the image of the main character Shurik in the text space through the stages of his life path, closely related to the people around him, who is always happy to be useful (hence the title "Sincerely Yours"), among which the female images of his relatives, girlfriends and others stand out as a special layer in the narrative. And in the course of the study, the following tasks were solved: the metaphors that make up the image of the
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