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 Al-Shishtary is considered one of the well-known Andalus poets. His poetry represents a flood of kind emotions, springs from the sincere sources of Divine Love, and this is what we felt in his life and his literary prestige. He was a poet who was familiar withthe art of his timeknowsthe oldand popularintellectual assets ofIslamicSciencesof Sharee'a. This wide culture, which he had, is available to him through his many travels between the coasts of Syria, Egypt and others ... to become Imam of the religion way known as(Al-Shishtariyah)resonatedin the hearts ofthe general publicespecially the poor people. This showshis smoothand influential styleand his humanitarian andsimple words which resonate in the hearts of his followers, therefo
... Show MoreThe study focuses on the causes of minaret tilting as well as possible solutions. The major aims of this study are to improve knowledge of historical tall structure stability and rehabilitation operations using the finite element approach to model the soil and minaret (PLAXIS 3D 2020), a platform for computational soil investigation and modeling. The numerical analysis aims to identify stresses, settlement, and deformation of the soil and minaret in various scenarios like Earthquakes, explosions, and winds. The simulation of the problem by the PLAXIS 3D revealed that the greatest lateral displacement computed at the Top Minaret is 5.5 cm, and the greatest vertical movement is calculated to be 3 cm. Seismic settlement is the effect of ear
... Show MoreThe current research aims to analyze the role of participatory budgeting in improving performance, especially during crises such as the Covid-19 crisis. The research used the descriptive analytical method to reach the results by distributing 100 questionnaires to a number of employees in Iraqi joint stock companies and at multiple administrative levels. The research came to several important conclusions, the most important of which is that the bottom-up approach to budgeting produces more achievable budgets than the top-down approach, which is imposed on the company by senior management with much less employee participation. Additionally, there is a better information flow from the lower levels of the organization to the upper management
... 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.
In this paper, a compartmental differential epidemic model of COVID-19 pandemic transmission is constructed and analyzed that accounts for the effects of media coverage. The model can be categorized into eight distinct divisions: susceptible individuals, exposed individuals, quarantine class, infected individuals, isolated class, infectious material in the environment, media coverage, and recovered individuals. The qualitative analysis of the model indicates that the disease-free equilibrium point is asymptotically stable when the basic reproduction number R0 is less than one. Conversely, the endemic equilibrium is globally asymptotically stable when R0 is bigger than one. In addition, a sensitivity analysis is conducted to determine which
... Show MoreMarketing is one of the most important pillars on which most industrial and commercial sectors depend on evaluating their performance, improving their financial position, development and economic growth. The presence of effective marketing activities in any industrial or commercial organization (which works to meet the requirements of customers in order to ensure the integration of trading and handling rings with consumers and to ensure the growth of the marketing process regularly and not to retreat) effectively contributes to maintaining the company's position between its competitors and its customers. It is necessary to have these marketing activities in order to meet the requirements of the organization on the one hand and to
... Show MoreObjectives: To determine the effectiveness of the instructional program on patients’ knowledge about home safety while receiving anti-cancer treatment at Al- Karama Teaching Hospital in Al-Kut City.
Methodology: A quasi-experimental design is conducted through the application of a pre-test and post-test approach for the study and control groups from February 5th, 2020 to April 25th, 2020. A non–probability (purposive) sample of (50) patients treated at the Blood Disease and Oncology Center is selected and divided into two groups. Each group contains (25) patients as control and study groups. An instrument is constructed that is comprised of two parts; t
... Show MoreThis study aims to assess the removal efficiency andestablish the BOD5 and COD statisticalcorrelation of the sewage flowing in Al-Diwaniyah wastewater treatment plant in Iraq during the study period (2005-2016). The strength of the influent wastewater entering the plant varied from medium to high in strength. High concentrations of BOD5 and COD in the effluent were obtained due to the poor performance of the plant. This was observed from the BOD5 /COD ratios that did not confirm with the typical ratios for the treated sewage. To improve the performance of this plant, regression equations for BOD5 and COD removal percentages were suggested which can be used to facilitate evaluation of liquid waste and optimal control process. The equations
... Show MoreThe educational service industry is one of the most negatively affected industries by the spread of the COVID-19 pandemic. Government agencies have taken many measures to slow its spread, and then restrict movement and gatherings and stop recreational activities. Furthermore, the repercussions of the curfew had a significant impact due to the interruption in actual attendance for students and employees, and the severity of the Covid-19 crisis and its (economic, social, security, humanitarian and behavioral) effects on all societies and work sectors is no secret to anyone. Iraq, like other countries, was also affected by the negative impact of Covid-19 pandemic in all fields of institutional work, especially public fields, and specifically t
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