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 present study has examined the spatiotemporal varieties of the demographics of the Shatt Al-Arab River fishes and their relation to some ecological components. The aim is to forecast these groups in the unexplored parts of the waterway with an emphasis on environmental indices of diversity. Three sites in the river were selected as an observation and study of these species, which lasted from March 2019 to February 2020, the study dealt with factors affecting fishes, as Water Temperature (WT), Dissolved Oxygen (DO), Potential Hydrogen Ion (pH), Salinity (Sal), and Transparency (Tra). Gill nets, cast nets, hooks, and hand nets were adopted to collecting fish. The results indicated that the fish population comprises 60 species represent
... Show MoreThe current study aims to apply the methods of evaluating investment decisions to extract the highest value and reduce the economic and environmental costs of the health sector according to the strategy.In order to achieve the objectives of the study, the researcher relied on the deductive approach in the theoretical aspect by collecting sources and previous studies. He also used the applied practical approach, relying on the data and reports of Amir almuminin Hospital for the period (2017-2031) for the purpose of evaluating investment decisions in the hospital. A set of conclusions, the most important of which is: The failure to apply
... Show MoreThis study aims to simulate and assess the hydraulic characteristics and residual chlorine in the water supply network of a selected area in Al-Najaf City using WaterGEMS software. Field and laboratory work were conducted to measure the pressure heads and velocities, and water was sampled from different sites in the network and then tested to estimate chlorine residual. Records and field measurements were utilized to validate WaterGEMS software. Good agreement was obtained between the observed and predicted values of pressure with RMSE range between 0.09–0.17 and 0.08–0.09 for chlorine residual. The results of the analysis of water distribution systems (WDS) during maximum demand
Wisdom in the era before Islam is soo famous and so mature And Wisdom in the age of Islam {the holy quran and AI Hadeeth AI shareef }is dealt with by different meanings that agree with the contexts in which it occurs its contacs One of meanings is wisesaying that occuars in the Halal and Haram .As to the wisdom of the Amawy age ,it was some times absent since it was not dealt with by the great Poets of that age .In the Poetry of AL-FARAZDAK , Wisdom was little and it expressed religious and phsycological meanings because wisdom is amessage that has along –rang .
research aims: 1- Demonstrating an aspect of the rhetorical miracle of the Qur’an represented in the accuracy of its verses and the consistency of its topics. 2- Clarifying the intent of Surat Al-Ghashiya, and clarifying the link between the topics of the surah and its purpose. 3- Studying the topics included in Surat Al-Gashiya, and highlighting their consistency among them. 4- Referring to the gifts contained in the noble verses.Research Methodology: In preparing this study, I followed the inductive-analytical approach, according to the procedures outlined in the introduction.From the search results: 1- The purpose of Surat Al-Gashiya: Reminding the Hereafter and its scenes of reward
... Show MoreExamining the pictures of the scientific miracles in Surat Al-Ra’d revealed to us - as all other verses of miracles revealed - the truth of the prophecy of our noble Messenger (may God bless him and his family and grant him peace) in receiving the verses of the Qur’an from God Almighty through revelation. It is not possible to talk about cosmic phenomena and their secrets in this way. Fourteen centuries ago, when scientific techniques, observational devices, space surveys, and means of science were non-existent, except for what is related to eye observation, transmitted experiences, and even observation is unable to explain many phenomena near as well as distant ones. The interpretations that are tainted by myth in the books
... Show MoreErbil city is located in the northern Iraq with a population of over one million people. Due to water crises farmers usually use wastewater and well water for the agricultural production. In this study six stations were designed to sample waste water and three from well water to define waste water and ground water characteristics. In this study, Residual Na+ Carbonate, Mg++ hazard, salinity hazard, Kelley index, %sodium, total hardness, permeability index, potential salinity, sodium adsorption ratio, and Irrigation Water Quality Index (IWQI) were determined. The order of average cation concentrations in water was Mg2+> Ca2+ > Na+ > K+. While the proportion of main
... Show MoreCommunity pharmacists faced more complex challenges in meeting patients’ medication needs during the pandemic than previously reported in the literature. Objectives To explore the perception and abilities of community pharmacists in managing patients’ needs in terms of medication dispensing during the pandemic, and to examine its effect on improving the patients’ situations. Materials and Methods A cross-sectional study design, validated by 30 experts, was conducted using an electronic survey (Google Form) to assess the effect of the dispensing practice of Iraqi community pharmacists on the patient’s clinical outcomes during the pandemic. The survey was distributed on professional pharmacist’s social media platforms from December
... Show MoreContext has a significant impact on the interpretation of Qur'anic and literary texts, especially in ancient Arabic poetry since that language is no longer considered as a contemporary understandable language. Hence this research is entitled: (the impact of context on the morphological semantics in the Diwan of Abi Al-Aswad Al-Dau’ali) and the morphological meanings indicated by the morphological formula which lack the combination of other contextual clues. The researcher depended on the analytical approach to show the impact of pairing occurring between the contextual elements on determining the morphological meaning.
The most important findings reached at:
1- Context has a great impact in dispelling the possibilities arising fr