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.
During the period 1970-2006 the Marshes-land region was exposed to several change into many sides of vanishing steeling and growth as follow :
1- Drying this region after 1991,and re-flooded again during 2003. Many other large Marsh-land, like al-Hawaisa was dried by cutting off inlet-water fed from Iran sources .As asqunance there are transferred to different kinds of swamps ,followed by major change in the structure of the region as the rural settlement concerned. Rural settlement in this area starts new push of migration. The research did not take that in consideration in this thesis because some others took it in details in some thesis and researches. The situation of Marsh-land is getting anew face after those major changes which
During the 1970s, communicative view of language teaching began to be incorporated into syllabus design. The central question for the proponents of this view was: what does the learner want/need to do with the target language? This lead to the emergence of a teaching method (or approach) called communicative language teaching (CLT) during the late 1970s and early 1980s focusing on the functions that must be incorporated into a classroom. According to Brown (2001:43) CLT is a unified but broadly based, theoretically well informed set of tenets about the nature of language and of language learning and teaching. Harmer (2001:84) states that the communicative approach is the name which was given to a set of beliefs which included not only a
... Show MoreCholesteryl ester transfer protein gene contains some single nucleotide polymorphisms, which have been associated with serum high-density lipoprotein concentration and other lipoproteins. This study is done for determining of cholesteryl ester transfer protein polymorphism and evaluate its effect on serum lipid profile concentrations in some hyperlipidemic patients compared with healthy subjects in Salah Al-din governorate-Iraq. Blood samples were taken from (90) patients suffering from hyperlipidemia, and (70) samples that were apparently healthy controls. Serum lipid concentrations were measured by enzymatic assays. The polymorphism was genotyped using polymerase chain reaction restriction fragment length polymorphism analysis.&n
... Show MorePraise be to God, and may blessings and peace be upon our master and Prophet Muhammad and those who follow him, and may God be pleased with him
Taha is my guardian and whoever follows their path until the Day of Judgment. And after... The book (The Treasure in the Ten Recitations), written by Abu Muhammad Abdullah bin Abd al-Wasiti, who died in the year 710 AH, is considered one of the important books in recitations: because it included the universal custom that it contained in the books Al-Taysir by Al-Dani and Al-Irshad by Al-Falanisi, as the first of them was specialized.
Satisfy the second with the ten readings
May God bless my time, through His grace and generosity, to achieve this treasure and to publish it
... Show MoreThe work reported in this study focusing on the abrasive wear behavior for three types of pipes used in oil industries (Carbone steel, Alloy steel and Stainless steel) using a wear apparatus for dry and wet tests, manufactured according to ASTM G65. Silica sand with
hardness (1000-1100) HV was used as abrasive material. The abrasive wear of these pipes has been measured experimentally by measuring the wear rate for each case under different sliding speeds, applied loads, and sand conditions (dry or wet). All tests have been conducted using sand of particle size (200-425) µm, ambient temperature of 34.5 °C and humidity 22% (Lab conditions).
The results show that the material loss due to abrasive wear increased monotonically with
The Umm Al-Naaj Marsh was chosen in Maysan province, and it is one of the sections of Mar Al-Hawza, which is one of the most prominent Iraqi marshes in the south. The marshes are located between latitudes 30 35 and 32 45 latitudes and longitudes 13 46 and 48 00. The area of the study area is 76479.432142 hectares to evaluate soil quality and health index and their spatial distribution based on measuring physical, chemical, biological and fertility traits and calculating the total quality index for those characteristics. Using an auger drilling machine, we collected 50 randomly selected surface samples, evenly distributed across the study region, from Al-Aq 0.0–0.30 m, noting their precise locations along the way. Soil health and quality w
... Show MoreThe Electric Discharge (EDM) method is a novel thermoelectric manufacturing technique in which materials are removed by a controlled spark erosion process between two electrodes immersed in a dielectric medium. Because of the difficulties of EDM, determining the optimum cutting parameters to improve cutting performance is extremely tough. As a result, optimizing operating parameters is a critical processing step, particularly for non-traditional machining process like EDM. Adequate selection of processing parameters for the EDM process does not provide ideal conditions, due to the unpredictable processing time required for a given function. Models of Multiple Regression and Genetic Algorithm are considered as effective methods for determ
... Show MoreThe aim of the research is to identify an appropriate training method that raises the levels of immune globulins (IgA, IgM, IgG) and white blood cells and the effect of training by (HIT) method using resistance (weights) as a training curriculum that increases immunity and ensures the continuation of the pills after the return of activity from the stone The response to the Covid-19 epidemic among amateur weightlifters, the researchers relied on the method of trace analysis in an experimental way by conducting a pre-, medial and post-test with the same experimental one agroup on a sample of amateur weightlifters in the Fury private hall for weightlifting and body building in Adhamiya, the number of sample members reached (15 players) who int
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