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 aims to evaluate the performance of the sewage treatment plant in Al-Diwaniya, one of cities in the southern part in Iraq. This evaluation could be used to facilitate effluent quality assessment or optimal process control of the plant. The influent reaching the plant is considered a medium to strong in strength with BOD5/COD ratio in the range 0.23 and 0.69 which can be considered an easily degradable sewage by the biological processes performed by the activated sludge unit. The quality of the effluent was found to be higher than the Iraqi standards for disposal to water bodies. The BOD5/COD ratios of the treated sewage varied over a wide range as low of 0.13 to 1.48 indicating operational problems in the plant. Regression ana
... Show MoreThis study aims to evaluate the performance of the sewage treatment plant in Al- Diwaniya, one of cities in the southern part in Iraq. This evaluation could be used to facilitate effluent quality assessment or optimal process control of the plant. The influent reaching the plant is considered a medium to strong in strength with BOD5/COD ratio in the range 0.23 and 0.69 which can be considered an easily degradable sewage by the biological processes performed by the activated sludge unit. The quality of the effluent was found to be higher than the Iraqi standards for disposal to water bodies. The BOD5/COD ratios of the treated sewage varied over a wide range as low of 0.13 to 1.48 indicating operational problems in the plant. Regressio
... Show MoreAbstract
Epidemics that afflict humankind are descending renewed, plaguing them in the place and time they spread.
- The epidemic affects individuals and the movement of societies, and its treatment requires dealing with it according to Sharia, taking into account the current data and developments.
- Integrative jurisprudence: it is intended to know the practical legal rulings deduced from the combination of evidence of two or more sciences related to one topic related to it, and among these calamities is the Corona Covid-19 pandemic.
- It is permissible to use sterile materials that contain a percentage of alcohol in sterilizing hands and fogging places, including mosques.
T
... Show MoreCox regression model have been used to estimate proportion hazard model for patients with hepatitis disease recorded in Gastrointestinal and Hepatic diseases Hospital in Iraq for (2002 -2005). Data consists of (age, gender, survival time terminal stat). A Kaplan-Meier method has been applied to estimate survival function and hazerd function.
Almost human societies are not void of poverty, as the latter accompanied the emergence of humanity, and it, thus, represents an eternal problem. To advance an individual's reality and raise the level of the poor social classes, social security networks have been established. Such networks operate in society following social systems and laws to provide food, and material support. Besides, such networks help to rehabilitate the individual academically and vocationally. They empower vulnerable groups through the establishment of courses and workshop, provide (conditional) subsidies related to the health and educational aspects in order to achieve the sustainable development goals of (2030), and apply developmental roles of social safety ne
... Show MoreBack ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI
Villages in most rural areas of the developing world, including Iraq, suffer from a deterioration in the urban structure in its various aspects, both in the lack of internal planning in terms of residential unit design which is not commensurate with the sustainable health life, in addition to the lack of infrastructure and community services networks As well as road networks linking them to neighboring urban centers, which was accompanied by the emergence of other problems, including the desire of the population to migrate to neighboring cities and the deterioration of economic activities due to lack of activation of economic development plans (Rural villages suffer from a lack of interest in urban development within the regional spatial
... Show MoreIA Ali, FK Emran, DF Salloom, Annals of the Romanian Society for Cell Biology, 2021