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.
Tira is a custom known to the Arabs since the pre-Islamic era. in the occurrence of good or evil. And from the pessimism: that the Arabs in the pre-Islamic era depended on birds, so if one of them went out for a matter, If he sees a bird flying to the right, he will believe in him and go on his journey and his need. The research aims to introduce Imam Al-Manawi and explain his saying in Al-Tira through his book Fayd Al-Qadeer.
Abstract
The space occupied by the dialogic imperative in the language is a very wide range, as it is present in most of the speeches received by the recipient, and this is not limited to dialogues. That the literary discourse is a dialogical and fulfillment imperative, as the implication is related to the implicit connotations, as if the implication covers the indirect actions of the speech act theory.
The present study is an attempt to show how the three Umayyad poets ; Jarir , Al-
Farazdaq and Al-Akhtal have consciously and skillfully employed in their poetry som ancient
Arab legends ,historical events and wars as they provide atrue image of the values and
customs of the peoples who lived before them .
Their employed , how ever, takes avarying degrees depending, to alarge extent , an the
vast but personal knowledge of each poet the past tradition , and practices . Jarir ,in many
respects out , stands the first , Al-Farazdaq , the second and Al-Akhtal , the third .
The 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 MoreWith the development of communication technologies, the use of wireless systems in biomedical implanted devices has become very useful. Bio-implantable devices are electronic devices which are used for treatment and monitoring brain implants, pacemakers, cochlear implants, retinal implants and so on. The inductive coupling link is used to transmit power and data between the primary and secondary sides of the biomedical implanted system, in which efficient power amplifier is very much needed to ensure the best data transmission rates and low power losses. However, the efficiency of the implanted devices depends on the circuit design, controller, load variation, changes of radio frequency coil’s mutual displacement and coupling coef
... Show MoreThe 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 aim of the present research is to illustrate γ-ray levels emitting from soil and bitumen producing from 238U, 232Th, and 40K along Abu-Jir Fault Zone. in the area extended from Al-Marj valley to Abu-Jir village using scintillometer device. Such study is important in environmental assessment to buildup data base about radioactivity. The concentration of natural radionuclides in the study area was determined to be occurring mostly in the clay minerals and organic matter. A high purity germanium spectrometer was used to detect the activity of these elements which ranged between 00.6±18.1- 1526±102, 0- 8.4±1.4, and 70.1±10.9- 328.2±73 in soil, and 28.2±5.6- 94±22.1, 0- 2.2±0.5, and 38.4±7.9- 70.1±10.9 in bitumen for 226Ra
... 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
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