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.
الضاد والظاء موطن تفرد العربية وفخرها ، الفت فيهما العشرات والعشرات من المصنفات الثرّة لكثرة ذرائع تلابسهما والخلط بينهما ، فهما متشابهان في هيكل البناء ، وإخراجهما متداخل على اللسان ، وألفاظهما متناظرة برحابة في الإملاء ، فضلاعن اشكالهما إلى حدّ الآن ، مما حثني على التفكير في وسائل تسهل المطروح وتمد جسراً بين أجزائه عسى أن تدنو قطافه في دفع الشبهة ومواراتها ، فتحصلت لي امور ادرتها بكلمتين مف
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Abstract
The research discusses the biography of Imam Al-Qanuji, his syllabus in his book “ Raudha Al- Nadia , and Public, particular, edition definition. Then it mentions the types of matters and the Imam Al-Qanuji’s opinion in it, and it mentions the early and contemporary scholars’ opinions and simplifies their logical and unwritten proofs. It also discusses and librates the place of dispute, then it swages reliable based on the power of the proof and interest without any contravention which the orthodox law orders. Furthermore, the research discusses matters like, whether there is any particular formula for public, or whether the public considers the Quraan as i
... Show MoreGeotechnical characterization of the sites has been investigated with the collection of borehole data from different sources. Using the data, grain size distribution curves have been developed to understand the particle size distribution of the alluvium present. These curves were further used for preliminary assessment of liquefiable areas. From geotechnical characterization, it has been observed that the soil profile in the two sites is dominated by sand and silty sand.Seed and Idriss (1971) approachhas been usedevaluatethe liquefaction potentialbydeterminationof the relation between the maximum ground acceleration (a max/g) valuesdue to an earthquake and the relative density of a sand deposit in the field. The results reveal that
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The importance of studying the political trends of caricature in Al-Sharq Al-Awsat Newspaper comes from the importance of this magical and satirical journalistic art, as it addresses various trends with satirical criticism that exposes the negative sides and affects the reader’s consciousness in a way or another by contributing to the public opinion about these issues and topics that affect people's lives and their future. Therefore, this art is no less important than the other arts, on the contrary, it complements the other arts and also contributes to the importance of Journalism. Also, the choice of Al-Sharq Al-Awsat Newspaper as being one of the most widely circulated and prominent Arab newspapers, t
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The study aimed to identify what (isis) (Daesh) have been touched in the opening article of Al-Nabaa newspaper This objective is organized for asset of sub-targets it is the knowledge of media discourse and for those who are directed and methods of employing the strong content debt organization and we used the survay method to monitor and understand the content of opening anticale and the researcher took the numbers of the newspaper for years 2015-2018 consist of 157 The results of this study are :
* Use religious texts from (Holly qoran) (Abbreission of the prophetic) Remove from its context and empby them in justifying in what use of vio |
The current study included, studying the ability of eight genera of plants belong to Brassicaceae family, Brassica tournifortii, Cakile Arabica, Capsella bursa – pastoris,Carrichtera annua, Diplotaxis acris, Diplotaxis haru , Eruca sativa and Erucaria hispanica to accumulate ten heavy metals Cadmium, Chromium , Copper, Mercury, Manganese ,Nickel ,Lead ,and Zinc . Plant leaves samples were collected from Al-Tib area during spring of 2021.The data demonstrated that, the highest conc. of Cd was 2.7 mg/kg in Diplotaxis acris leaves and lower value was 0.3 mg/kg in Cakile Arabica leaves. For Co, the highest conc.was 1.3 mg/kg in Capsella bursa – pastoris leaves, whereas the lower value was 0.5 mg/kg in Cakile arabica leaves. As for Cr ele
... Show MoreIn this research an Artificial Neural Network (ANN) technique was applied for the prediction of Ryznar Index (RI) of the flowing water from WTPs in Al-Karakh side (left side) in Baghdad city for year 2013. Three models (ANN1, ANN2 and ANN3) have been developed and tested using data from Baghdad Mayoralty (Amanat Baghdad) including drinking water quality for the period 2004 to 2013. The results indicate that it is quite possible to use an artificial neural networks in predicting the stability index (RI) with a good degree of accuracy. Where ANN 2 model could be used to predict RI for the effluents from Al-Karakh, Al-Qadisiya and Al-Karama WTPs as the highest correlation coefficient were obtained 92.4, 82.9 and 79.1% respe
... Show MoreEuphrates River extends about 125 km within the study area located in Annassiriyah City, Dhi Qar Governorate, Iraq. The impact of the seven hydraulic structures on the discharge capacity of the Euphrates River needs to be considered. The main objectives of this research are to increase the discharge capacity of Euphrates River within Annassiriyah City during flood seasons and study the impact of these hydraulic structures on the river capacity by using HEC-RAS 5.0.3 software. Five scenarios were simulated to study the different current condition of Euphrates River within Annassiriyah City. Other additional four scenarios were implemented through river training to increase the river capacity to 1300 m³/s; it is the flood
... Show MoreThe emerge of capitalism beside appearing modern and contemporary political systems which had become hold out it is semi-domination on more vital space of human community life, it is through some vital apparatus, which the free market apparatus had make important one which depend on achieve the privileges of the capitalism elite whom standing on it, especially the finance elite. Thus the achievement of the profit had become the main podcasted of those elite which whom the really advancer of the Globalization system, this is which incarnated by the appears and extend of the (COVID-19) fatality pandemic in the end of last year, whereas reveals widespread of it in more than one states in the world, especially the developed coun
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