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.
This study designed to evaluate the deleterious effects of iron overloaded on organs weights , enzyme activity of liver and bilirubin, iron concentration, total iron binding capacity in serum and on bone marrow cells proliferation in mice.
The obtained results showed non significant differences in organ weights (spleen and kidney) in group 1 that treated with three parts extracts of pomegranate except the decreasing in spleen weight subgroup 1-4 , significant increasing in liver and kidney weight in all animals treated with iron dextran (group 2) in comparison with their weights of organs in negative control (group 1). While significant increasing in iron concentrations in serum of animal administrated peel and juice in comparison wit
The research aims at identifying the importance of scientific research for researchers and in creating new knowledge، development and utilization of mental and cognitive energies and developed them with the ability to research، extrapolation، meditation and then conclusion. The information was collected by interviewing the Secretary-General of the Central Library and by distributing questionnaire forms to the (33) teaching staff of the College of Higher Education. The responses of the society were analyzed the result and the recommendations were the most important 1. Information specialist and all employees of the administrators and technicians in the centers of information sources (libraries) and in the field are considered scientific r
... Show MoreBackground: Verrucous carcinoma (VSCC) is considered as a rare well differentiated carcinoma variant of SCC with no metastatic potential. The aim of this study is to evaluate the Immunohistochemical expression MMP-2, VEGF and D2-40 expression in OSCC and VSCC. Materials and methods: Thirty formalin fixed paraffin embedded tissue blocks of OSCC and another twelve VSCC were collected and Four micrometer thick sections were cut from each block and mounted on positively charged slides and stained immunohistochemically with monoclonal antibodies to MMP-2, VEGF and D2-40. Results: there is no statistical difference between SCC and VSCC regarding the immunoexpression of MMP-2 and VEGF. While the lymphatic vessels density were higher in SCC than V
... Show MoreTranslation is a dynamic and living process that cannot be considered equal to the original text and requires the appropriate structure, language, thought and culture of the target language, and the translator's intellectual, linguistic and cultural influences inadvertently penetrate into the translated text. It causes heterogeneity of the destination text with the source text.
Admiral's theory is trying to help by providing components and suggested approaches to resolve these inconsistencies. In the meantime, in addition to the mission of putting words together, the translator must sometimes sit in the position of the reader and judge and evaluate the translated text in order to understand its shortcomings and try to correct it a
... Show MoreThis research aims to identify the impact of Daniel's model on the development of critical thinking. In order to achieve this objective, the following hypotheses are formulated: 1. There is no statistically significant difference at the significance level (0.05) between the average differences in the posttest scores of the experimental group taught according to Daniel's model and the control group taught according to the traditional method in the measure of critical thinking. 2. There is no statistically significant difference at the significance level (0.05) between the average differences in the preand post-tests scores of the experimental group taught according to Daniel's model in the measure of critical thinking. The current research i
... Show MoreField experiment was carried out during 2013- 2014 at the research field of the
Department of Biology, College of Science, Baghdad University, to study the
effect of bio-chemical fertilizers and chemical fertilizers on some agronomic traits
and yield components of two wheat cultivars (IPA99 and Rabyaa) under drought
stress conditions. The bio-chemical fertilizers were mixture of (Azotobacter
chroococcum. Azospirillum brasilense. and Pseudomonas fluorescens.) with
chemical fertilizers (only 50% of the recommended dosage of N and P), while the
chemical fertilizers was 100% of recommended dosage of N and P. Field plots
(1×1 m) were randomly made in the field equipped with rainfall shelter to avoid
rains. Grains o
Characterization 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 MorePurpose: To use the balanced measurement approach as a strategic link for increasing the effectiveness of strategic planning in the direction of achieving satisfaction rates at Bisha University in Saudi Arabia
Design / methodology / approach –The questionnaire survey was used to collect the data of the study from the faculty members at University of Bisha.
Findings –Prove the assumption that the use of the balanced measurement approach - as a strategic planning tool - leads to maximize the satisfaction rates among faculty members at the University of Bisha.
Research limitations/implications- adopt effective strategic planning in order to achieve
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