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.
One of the main element in the network is the intersection which consider as the critical points because there are many conflict in this element. The capability and quality of operation of an intersection was assessed to provide a better understanding of the network's traffic efficiency. In Baghdad city, the capital of/Iraq the majority of the intersections are operated under the congestion status and with level of service F, therefore theses intersection are consider as high spot point of delay in the network of Baghdad city. In this study we selected Al-Ameria signalized intersection as a case study to represent the delay problem in the intersections in Baghdad. The intersection is located in the w
Sheikh Hanafi was born in one of the popular shops of Baghdad with interlocking social relations, and had a profound impact this camp where his talents in the first Venco loving to Mahalah and Baghdad and was born with this development since his days looked forward to the folklore and folk. In the middle of his youth, including authoring loves the heritage of folk legacies began in motion, from Baghdad, books, articles, research has brought him wide acclaim were not possible without the seriousness and diligence, independence and self-Asamath that mushroom on them
The trip was one of his tools in the scientific fame has gone to many Eastern and Asian countries and visited religious and literary institutes and delivered the lectures an
Asset management involves efficient planning of economic and technical performance characteristics of infrastructure systems. Managing a sewer network requires various types of activities so the network can be able to achieve a certain level of performance. During the lifetime of the network various components will start to deteriorate leading to bad performance and can damage the infrastructure. The main objective of this research is to develop deterioration models to provide an assessment tool for determining the serviceability of the sewer networks in Baghdad city the Zeppelin line was selected as a case study, as well as to give top management authorities the appropriate decision making. Different modeling techniques
... Show MoreThe research addresses the importance of reading and writing for sura Al-alaq and Al-qalam as they represent the main sources for all the sciences as well as ethical values. The researcher seeks to define the educational and ethical values in these two texts which related to reading and writing. To do this, the author went through different relevant literature to show the similarities and related points between them, she also shows the significant of reading and writing and the learning and teaching worth to be consider. The result revealed that the both texts assert on the educational and ethical values, and the vital role of reading and writing.
The )Resalat Al-Gofran) which means to Abi Ala Al-Ma'arri is included in the studies of prose in Arabic literature. The study of the "Message of Forgiveness" was passed in two stages. The first is the traditional linguistic study, specifically the rhetorical one. The second study, which took place in the sixties of the last century, was conducted in the light of comparative literary studies, after Dr. Taha Hussein summarized this letter and rid it of its complex language and after Dr. Bent Shati achieved it. Dr. Lewis Awad relied on her study in the light of comparative studies, Which appeared in Europe in the modern era and was able to discover similarities between them and the old texts that dealt with the subject of "literature of the
... Show MoreUnter Exilliteratur versteht man „die literarische Produktion von Autoren, die wegen politischer, religiöser oder rassistischer Verfolgung gezwungen sind, sich an einem anderen als dem von ihnen gewünschten Lebens- und Arbeitsort aufzuhalten.“[1] Deswegen unterscheidet sich „Migration“ von „Exil“ dadurch, dass sie freiwillige Auswanderung ist. Bereits in der Antike und auch im Mittelalter gab es Schriftsteller, die vor Zensur oder politischer Verfolgung ins Exil geflohen sind, wie zum Beispiel der griechische Satiriker des
... Show MoreIt is from the greatness of God Almighty and from him that he facilitated for me to delve into the immersion of the hadith of the Prophet in my doctoral dissertation, then I found it a fertile ground for the cultivation of scientific results.
Through this work, I chose the topic (Replies of Al-Aini to Ibn Malik in his book Umdat Al-Qari Sharh Sahih Al-Bukhari) because of its scientific impact, as such topics inspire in the soul of the follower and the student a lot of contemplation and great care to understand the texts and then come up with a result that is almost close. It is correct, and my current situation in this research is the condition of many scholars, not without errors and omissions. Whatever was correct is by the grace of
Visual pollution is one of the major obstacles that affect the process of urban development. This study addressed one of the environmental pollutants that humans feel and live with and has become part of their daily lives. In 2003, this research aims to identify the manifestations of visual pollution and its causes and effective solutions to reduce them. for the city dwellers. One of the most common causes of visual pollution in the city of Al-Dura (Abu Dashir) is the spread of waste and garbage due to the lack of environmental awareness, and the abundance of billboards and the difference in the colors of building covers and their design, which means the marginalization of the additional environmental aspect. for the course city as well as
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