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.
ABSTRACT
The simulation of groundwater movement has been carried out by using MODFLOW model
in order to show the impact of change of water surface elevation of the Tigris river on layers of
the aquifer system for Nuclear Research Center at Al-Tuwaitha area, in addition to evaluate the
ability of the proposed pumping well to collect groundwater and change the direction of flow at
steady-state. The results of the study indicated that there is a good match between the values of
groundwater levels that calculated in the model and measured in the field, where mean error is
0.09 m.
The study also showed that the increasing of water surface elevation of the
The current research aims to find out the extent to which students of the Faculty of Education for Pure Sciences\/Ibn al-Haitham have owned laboratory academic skills, the researcher adopted a descriptive research approach to conform to the goal of the research, the research sample the consisted of 140 students from the Department of Chemistry Phase II, The research tool, which consisted of a measure of laboratory academic skills, which consisted of seven skills and consisted of 28 paragraphs (four paragraphs per field), was prepared and the pent-up scale was chosen because the selected sample were university students, and the results showed the ownership of students' skills of laboratory academic skills other than skill The use of the libr
... Show MoreThe research presents the "theory of happiness according to Junaid al-Baghdadi" and the theory's most significant characteristics.
The reasons for happiness, include knowledge, love, and providence, and happiness itself is the return of man or spirit to the source from which it originated.
A Geographic Information System (GIS) is a computerized database management system for accumulating, storage, retrieval, analysis, and display spatial data. In general, GIS contains two broad categories of information, geo-referenced spatial data and attribute data. Geo-referenced spatial data define objects that have an orientation and relationship in two or three-dimensional space, while attribute data is qualitative data that can be counted for recording and analysis. The main aim of this research is to reveal the role of GIS technology in the enhancement of bridge maintenance management system components such as the output results, and make it more interpretable through dynamic colour coding and more sophisticated visualization
... Show MoreUrban Balance is one of the important indicators that leads to an assessment of the urbanization process in a particular country , province or even a city that is multi-centered. By examining the data related to Anba province, it was found that the value of this indicator is equal to 0.96, which is less than the absolute one, and therefore the urbanization in the province is distributed collectively
The development of a mathematical or statistical model for estimating urban growth is a complex process due to the overlap between indicators or variables that can be adopted to calculate estimate growth rates Al-Qaim city has been considered as an example to develop a statistical method by which changes
... Show MoreThis study aims to identify the impact of social support on breast cancer patients’ psychological rigidity using a sample in Ramallah and al-Bireh. A descriptive correlative approach was adopted to fulfill the goals of the study and a questionnaire consisted of two criteria: social support and psychological rigidity, which was adopted as a tool for data collection for the study. In order to achieve the goals of the study, the researcher selected a convenient sample that consisted of 123 female breast cancer patients in Ramallah and al-Bireh. This sample represented 50% of the original patient population. The study showed that the average estimated percentage of social support and psychological rigidity for women with breast cancer, in
... Show MoreA water resources management for earthen canal/stream is introduced through creating a combination procedure between a field study and the scientific analytical concepts that distinguish the hydraulic problems on this type of stream with using the facilities that are available in HECRAS software; aiming to point the solutions of these problems. Al Mahawil stream is an earthen canal which is subjected to periodic changes in cross sections due to scour, deposition, and incorrect periodic dredging processes due to growth of the Ceratophyllum plants and weeds on the bed and banks of the stream; which affect the characteristics of the flow. This research aims to present a strategy of water resources management through a field study that conducte
... Show MoreAn evaluation the performance of the irrigation system for the Al-Ishaqi irrigation project for the Eastern Canal was conducted to identify management strategies that can be used to improve the operation and performance of the irrigation system. The study area is located in Salah al-Din G.0overnorate, Iraq. The field work included determining the moisture content of the soil before and after irrigation, measuring the inflow of the field to find the depth of the applied water, field monitoring, and measuring the depth of the root zone for each irrigation process. Field measurements showed that the average efficiency of water application for the two fields (A, and B) are 59.81% and 38.6%, respectively. The results of the efficiency of
... Show MoreAbstract---The aim of the current research is to identify the level of logical reasoning skills in chemistry students at the Faculty of Education for Pure Sciences/ Ibn Al-Haytham for the academic year (2021-2022). The differences in their level of skills according to the gender variable (males and females) and the academic stages (first- second - third - fourth). The descriptive approach was adopted because it corresponds to the nature of the research objectives. The research sample consisted of (400 )students selected in a relatively random stratified way. The researcher constructed a logical reasoning test, which includes (6) sub-skills , which is (proportional - probabilistic- synthetic- deductive- logic- variable adjustment). The psych
... Show MoreUltraviolet spectrophotometric studies for antibiotic (amino glycoside) derivatives including, Neomycin, Streptomycin, Gentamycin and Kanamycin with special reagents, which are benzoyl chloride; benzene sulfonyl chloride, toluenesulfonyl chloride and phthalic anhydride were made. Amino glycosides derivatives were followed through measurements of the ultraviolet absorbance (A) from which the absorptivity (ε) of the complexes was deduced and molar absorbances using Ultraviolet for products and calculate the number of reagents molecule that combine to amino glycosides.