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.
Tanuma and Zubair formations are known as the most problematic intervals in Zubair Oilfield, and they cause wellbore instability due to possible shale-fluid interaction. It causes a vast loss of time dealing with various downhole problems (e.g., stuck pipe) which leads to an increase in overall well cost for the consequences (e.g., fishing and sidetrack). This paper aims to test shale samples with various laboratory tests for shale evaluation and drilling muds development. Shale's physical properties are described by using a stereomicroscope and the structures are observed with Scanning Electron Microscope. The shale reactivity and behavior are analyzed by using the cation exchange capacity testing and the capillary suction test is
... Show MoreThe friendly-environment geophysical methods are commonly used in various engineering and near-surface environmental investigations. Electrical Resistivity Imaging technique was used to investigate the subsurface rocks, sediments properties of a proposed industrial site to characterize the lateral and vertical lithological changes. via the electrical resistivity, to give an overview about the karst, weak and robust subsoil zones. Nineteen 2D ERI profiles using Wenner array with 2 m electrode spacing have been applied to investigate the specific industry area. One of these profiles has been conducted with one-meter electrode spacing. The surveyed profiles are divided into a number of blocks, each block consists of several parallel pr
... Show MoreShear wave velocity is an important feature in the seismic exploration that could be utilized in reservoir development strategy and characterization. Its vital applications in petrophysics, seismic, and geomechanics to predict rock elastic and inelastic properties are essential elements of good stability and fracturing orientation, identification of matrix mineral and gas-bearing formations. However, the shear wave velocity that is usually obtained from core analysis which is an expensive and time-consuming process and dipole sonic imager tool is not commonly available in all wells. In this study, a statistical method is presented to predict shear wave velocity from wireline log data. The model concentrated to predict shear wave velocity fr
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Woman is the first target of social advertising, because most of these advertisements are primarily belong to them. This paper which is entitled "Social Responsibility for the Employment of Woman in Sustainable Development Declarations, An Analytical Study of Road Advertising in Baghdad" focuses on the use of woman in advertising. This aspect shows that some people see that advertisement is a mirror to what’s found in society such as woman’s behaviors in her everyday life and so on, while other people see that as long as the public wants those advertisings, they are free to choose what they prefer. They think that the shameful advertisements are natural and unavoidable. These vie |
This research set to indicate the role of the opportunity cost in the overall economic development (human and social development) by selecting the most appropriate alternative for the growth of the country in exchange for sacrificing profit limits to achieve this growth and development of the country, especially in the present circumstances of the country and after studying the reality of the economic case for him, as the problem lies with don't selecting the best alternative that enhances the gross domestic product, which extends to promote overall economic development and revive the industrial and agricultural sectors, productivity is more like Impotent, versus sacrifice alternative consumption may bring more financially lucrative than
... Show MoreThis research tests the relationship linkage and effect between the Employees Empowerment Strategy and Organizational Innovation, The research problem is how to understand the Employees Empowerment Strategy role in the achievement Organizational Innovation in Diyala Public Company For Electrical Industrial. A questionnaire was used in data collection depending on the distribution of (32) forms to the research sample. Data were analyzed Using (SPSS)program. Using a number of statistical tools for tests the research hypothesis. The research found set of conclusions, one of the most important thinks was, that there is a linkage and impact relation between Employees Empowerment Strategy, its variables, and Organizational Innovation a
... Show MoreBelgium is one of the countries that headed towards federalism through a peaceful transition, and over a few decades the country has witnessed deep transformations in its institutions, from a unified and central state in the early nineteenth century to a federal union, regional operations began since 1970 up and constitutionally established its diversity Linguistic and regional, the so -called "state reforms" have been implemented, which led to the emergence of political repercussions. The country has suffered about two decades ago, which caused many national governments that are considered to be among the Luxor in the modern political history of Belgium, However, institutional reforms to achieve the stability of the political system began,
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