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.
I started writing the research because of the linguistic and rhetorical methods in the Holy Quran.
This Sura included in all its verses the plural form such as the word planets graves and seas except the word sky was singular as the name of a genus, and this Sura showed the horrors of the Day of Judgment at the world level Included another science is the science of the interview and also came in the repetition and deletion and other linguistic and rhetorical things and concluded this Sura that the goal of breaking the sky and scattering planets and scatter graves is the human himself.
The Koran is a miracle immortal and science is still drawn from him each according to his specialty.
AL- Shaam Bathrooms in the later Abbasyat Ages
Abstract
What the research come to:
1- The presentation of the image of the proud person in this
mortal life appeared in several styles such as (conversation)
arousing the insert once and convincing in other time,
(confirmation) in all its types، (argument) scolding with the
gradual progress of time of the discourse .Interview and
parallelism are two of these styles with the presences of the
repetition style especially in the topics that has a reference to
the theme of (pride) being implied not directly stated. The
Koran discourse varied in its reference to the theme of pride
according to the context which is mentioned directly
(eighteen times) which formed one third of the number of
Surface water flow samples were collected with distances downstream over Saqlawiya main drain whose stretch of about 24.5 km. The drain travels through different land use pattern, before, flowing into Tigris River. Eight sampling points were carefully
selected downstream the channel during dry season. The examined water parameters were pH, NH3, NO3, PO= 4, BOD5, COD, TDS, S.S, Cl-, SO= 4, Na+ , Ca+2, Mg+2, and Oil and Grease. Descriptive and inferential methods through finding the best curve fit correlation were employed in the study to test the strength of the association between water chemical characteristics and distance downstream the channel. A comparison of the values of chemical parameters at the Al-Saqlawiya Drain-Tigris Riv
وظَّفَ الشاعرُ مجد الدين النُّشَّابي الصورة الاستعارية التي شكلت سمةً جمالية بارزة من سماتِ التشكيل الشعري عنده, وأحد المكونات الأساسية في بنية قصائده الشعرية وهي جوهر الإبداع ومحط التذوق عند المتلقي, إذ يشكل الشاعر صوره الاستعارية المتنوعة متولدة من خياله وعواطفه ومتوافقة مع الموضوع لتصبح الصورة الاستعارية ركنًّا من أركان التشكيل الفني الشعري عند الشاعر .
والتصوير الاستعاري له القدرة بالتشكيل ا
... Show MoreThis research is a comparative jurisprudential study that focuses on Imam Al-Bayhaqi’s preferred opinions in his book Al-Khilafiyat (The Disagreements), the part of Al-Rida’a (Breastfeeding). It is considered one of the most important familial topics that is concerned with organizing the social relations in Islam, strengthens the family ties and that prevents the family disintegration due to the ignorance and lack in comprehending Sharia laws (Islam law) in all aspects. The study follows the inductive and descriptive method. It aims at examining the prohibition of marriage when breastfeeding takes place at the time of woman’s conversion to Islam or during her infidelity period. It further aims at verifying the prohibition
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