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 research Aim is to provide support to small enterprises by providing tools that enable measurement and test their performance and identifying weaknesses and work on them is determined by the problem of searching using traditional assessment methods for small projects with only financial performance measurement standards that do not provide a complete picture of the performance of these projects so use the balanced scorecard the four pillars (financial, customer, learning and growth, and internal processes) and identify deviations and work on them through the use of the outputs of the programme (probe), PROmoting Business Excellence-PROBE), which It is a model of performance evaluation, with which you can deve
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Abstract
This research studies Abu Baker Al-Siddiq’s commandments to the leaders of his armies. The research is organized into an Introduction, three sections, and a Conclusion.
The Introduction presents a definition of Style and Commandment terminologies. It also presents a brief biography of Abu Baker Al-Siddiq may Allah be pleased with him.
The first section explains the characteristics of the Composition and its rhetorical significance. In this Section, I study the types of predicate and the methods of construction in Abu Baker’s commandments and the rhetoric in using the connection and disconnection modifiers in his expressions.
The second section e
... Show MoreThe availability of low- cost adsorbent namely Al-Khriet ( a substance found in the legs of Typha Domingensis) as an agricultural waste material, for the removal of lead and cadmium from aqueous solution was investigated. In the batch tests experimental parameters were studied, including adsorbent dosage between (0.2-1) g, initial metal ions concentration between (50-200) ppm (single and binary) and contact time (1/2-6) h. The removal percentage of each ion onto Al-Khriet reached equilibrium in about 4 hours. The highest adsorption capacity was for lead (96%) while for cadmium it was (90%) with 50 ppm ions concentration, 1 g dosage of adsorbent and pH 5.5. Adsorption capacity in the binary mixture were reduce at about 8% for lead a
... Show MoreThe Al-Kindy College Medical Journal (KCMJ) is an Iraqi scholarly journal published by the Al-Kindy College of Medicine, University of Baghdad. It was officially founded in 2004. It is a peer-reviewed journal, published in both online and printed forms. It has a mission to offer a publication platform that mirrors recent knowledge and findings in the field of medicine and medical sciences. It publishes various types of articles, including editorial, review article, research article, brief report, case report, and letter to editor. It accepts articles in the English language. It was biannually published till 2021 when it started to launch three issues per year. The journal is registered with numerous partners, including Iraqi Academi
... Show MoreUnder cyclic loading, aluminum alloys exhibit less fatigue life than steel alloys of similar strength and this is considered as Achilles's heel of such alloys. A nanosecond fiber laser was used to apply high speed laser shock peening process on thin aluminum plates in order to enhance the fatigue life by introducing compressive residual stresses. The effect of three working parameters namely the pulse repetition rate (PRR), spot size (ω) and scanning speed (v) on limiting the fatigue failure was investigated. The optimum results, represented by the longer fatigue life, were at PRR of 22.5 kHz, ω of 0.04 mm and at both v's of 200 and 500 mm/sec. The research yielded significant results represented by a maximum percentage increase in the fa
... Show MoreBacterial contamination of AL-Habania and AL-Tharthar reservoirs were studied during the period from February 2001 to January 2002, samples were collected from four stations in AL-Habania reservoir (AL-Warrar, AL-Theban regulator, middle of the reservoir and the fourth was towards AL-Razzaza reservoir) and from two stations at AL-Tharthar reservoir (Ein AL-Hilwa and the middle of the reservoir). Coliform bacteria, faecal Coliforms, Streptococci, faecal Streptococci and total count of bacteria were used as parameters of bacterial contamination in waters of both reservoirs through calculating the most probable number. Highest count of Coliform bacteria (15000 cell/100ml) was recorded at Ein AL-Hilwa and lowest count at AL-Theban regulator
... Show MoreThe skin temperature of the earth’s surface is referred to as the Land Surface Temperature (LST). the availability of long-term and high-quality temperature records is important for various uses that affect people’s lives and livelihoods. Much valid information was provided to this research from remote sensing technology by using Landsat 8 (L8) imagery to estimate LST for Al-Ahdab oil field in Wasit city in Iraq. The aim of this research is to analyze LST variations based on Landsat 8 data for 2022 (January, April, July, and October). ArcMap 10.8 was used to estimate LST results. The results values ranged from (about 10 C in January to about 46 C in July). The results show that LS
Existing leachate models over–or underestimates leachate generation by up to three orders of magnitude. Practical experiments show that channeled flow in waste leads to rapid discharge of large leachate volumes and heterogeneous moisture distribution. In order to more accurately predict leachate generation, leachate models must be improved. To predict moisture movement through waste, the two–domain PREFLO, are tested. Experimental waste and leachate flow values are compared with model predictions. When calibrated with experimental parameters, the PREFLO provides estimates of breakthrough time. In the short term, field capacity has to be reduced to 0.12 and effective storage and hydraulic conductivity of the waste must be increased to
... Show MoreBrachytherapy treatment is primarily used for the certain handling kinds of cancerous tumors. Using radionuclides for the study of tumors has been studied for a very long time, but the introduction of mathematical models or radiobiological models has made treatment planning easy. Using mathematical models helps to compute the survival probabilities of irradiated tissues and cancer cells. With the expansion of using HDR-High dose rate Brachytherapy and LDR-low dose rate Brachytherapy for the treatment of cancer, it requires fractionated does treatment plan to irradiate the tumor. In this paper, authors have discussed dose calculation algorithms that are used in Brachytherapy treatment planning. Precise and less time-consuming calculations
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