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.
It is a moral presumption that includes the object for its sake, and it is called the object for it or the object for its sake, which is the present tense after (lam, ki, fa, willn, and then), and it is not an excuse for the occurrence of the matter (1), and it requires a connection between the two sides of (a cause with a cause) united by a reason for a specific purpose (2). The object has a reason or an excuse, because it is an explanation of what came before it, of the cause. The reason for the occurrence of the action, being the motive for causing the action and the bearer of it (3), indicates that the infinitive is restricted to a special reason. So if I said: (I came to you with the hope of honoring you), then I attributed the coming
... Show MoreThe aim of the research is to measure the change in the impact of the factors of the Corona pandemic on psychological sensitivity and COVID-19 phobia in a sample of Bisha University students and to detect the differences in the phobia (phobia) Covid-19 among the sample members in the measurement before the ban and after the ban was opened, in addition to the differences in psychological sensitivity of The sample has between sizes before and after the spread of the Corona pandemic, as well as the differences in them according to the gender variable (male, female). The researcher relied on the comparative approach. The scale of psychological sensitivity and COVID-19 phobia was applied to a sample of (62) male and female respondents.
... Show MoreObjective(s): The study aims to evaluate the information of the elderly about personal hygiene , and to find out the relationship between residents of geriatric-care homes knowledge and their demographic characteristics .
Methodology: A quasi-experimental design study is conducted at geriatric home in Al Cyelakh Geriatric Care Home. The study was started at between November 20, 2021, and March 1, 2023. randomly sample of (30) elderly in geriatric home were studied . Data were collected throughout the utilization of the adopted questionnaire and interview technique. The questionnaire was consists of (40) items related to concerned personal hygiene geriatrics persons, t
... Show MoreThe game theory has been applied to all situations where agents’ (people or companies) actions are utility-maximizing, and the collaborative offshoot of game theory has proven to be a robust tool for creating effective collaboration strategies in a broad range of applications. In this paper first, we employ the Banzhaf values to show the potential cost to waste producers in the case of a cooperation and to reduce the overall costs of processing non-recyclable waste during cooperation between producers. Secondly, we propose an application of the methodology to study a case for five waste producers' waste management in the Al-Mahmudiya factory with the aim of displaying the potential cost to waste producers in case of cooperatio
... Show MoreThe nuclear structure of 38Ar, 59Co, 124Sn, 146Nd, 153Eu and 203Tl target nuclei used in technology for nuclear batteries have been investigation, in order that, these nuclei are very interesting for radioisotope thermo-electric generator (RTG) space studies and for betavoltaic battery microelectronic systems. The single particle radial density distribution, the corresponding root mean square radii (rms), neutron skin thicknesses and binding energies have been investigated within the framework of Hartree-Fock Approximation with Skyrme interaction. The bremsstrahlung spectrums produced by absorption of beta particles in betavoltaic process and backscattered p
... Show MoreThe problem of the tagged research (experimentation in the works of the artist Muhammad al-Kinani is an analytical study) dealt with the nature of the concept of experimentation and its work in the works of Muhammad al-Kinani. Which adopts the removal of the concept of style and artistic style and takes the experience away from the pattern of repetition The importance of the research comes through the identification of the materials founding the artistic work. The current research benefits the specialists in the field of arts from the students of studies with a new and renewed formulation of creativity. The research objectives shed light on the contemporary experiences of the artist Muhammad Al-Kinani and its importance in benefiting res
... Show MoreThis study was conducted on a sample of commercial banks in Iraq, chosen according number of considerations for twenty banks, contained two public banks and eighteen private banks. &
... Show MoreThe optimal combination of aluminum quality, sufficient strength, high stress to weight ratio and clean finish make it a good choice in driveshafts fabrication. This study has been devoted to experimentally investigate the effect of applying laser shock peening (LSP) on the fatigue performance for 6061-T6 aluminum alloy rotary shafts. Q-switched pulsed Nd:YAG laser was used with operating parameters of 500 mJ and 600 mJ pulse energies, 12 ns pulse duration and 10 Hz pulse repetition rate. The LSP is applied at the waist of the prepared samples for the cyclic fatigue test. The results show that applying 500 mJ pulse energy yields a noticeable effect on enhancing the fatigue strength by increasing the required number of cycles to fracture the
... Show MoreThe present study aims to establish an empirical correlation between biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) of the sewage flowing in Al-Diwaniyah wastewater treatment plant. The strength of the wastewater entering the plant varied from medium to high. High concentrations of BOD5 and COD in the effluent were obtained due to the poor performance of the plant. This was observed from the BOD5 /COD ratios that did not confirm with the typical ratios for the treated sewage. Regression equations for BOD5 and COD removal percentages were suggested which can be used to evaluate rapid effluent assessment after the treatment processes or optimal process control to improve the performance of wastewater treatment plants.
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