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 Islamic architectural heritage constitutes a civilized fortune that has to be preserved and protected and work should be done to maintain its development to be more convenient for the circumstances of the age and the civilization transformations. Due to the fact that architecture represents the civilization pot and cultural identity, its originality has to be preserved and work has to be done to prevent the strange architectural invasion that changes its character and make it lose the identity and the character and detached from its roots and environment.
Decoration, in the interior design, as a concept is connected to ornamentation process of interior spaces, which is a process of adding certain items
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The research aims to determine the nature of the Iraqi market in terms of banking financial stability and the extent impact of the operational efficiency on it, Accordingly, chosen 15 relational banks were chosen as an intentional sample that could represent the Iraqi banking system for the period 2010-2020. The operational efficiency variable was measured according to the data envelope model, and banking financial stability used CAMELS model which includes five indicators (capital adequacy, asset quality, management quality, profitability, and liquidity), so for testing the research hypotheses used the random regression model by adopting the S
... Show MoreEchinococcosis is a zoonotic disease caused by the larval stage of the tapeworm Echinococcus granulosus. This disease is an important public health and a significant economic issue in Iraq, where the lungs and livers are the popular places of infection. The aim of the current study focused on using the molecular techniques in the detection of an E. granulosus strain that causes cystic echinococcosis to human, sheep and cattle in Thi-Qar province, Iraq. In the current study, thirty isolates of E. granulosus were collected from 10 human hydatid cysts through surgery done at Al-Hussein Imam Teaching Hospital in Thi-Qar province and 10 sheep with 10 cattle hydatid cysts were obtained from the slaughterhouse in Thi-
... Show MorePurpose: The research aims to determine the relationship between E-Learning and Total Quality Management (TQM) in Educational institutions in Nineveh Governorates.
Methodology / Design: The researchers distributed (30) questionnaires to employees (teachers and administrators) of Nineveh Governorate education who represent the community of the research sample, as they were analyzed using the SPSS V.20
The importance of research: The importance of the research in the fact that it focuses on one of the educational methods represented in integrating the traditional method and relying on modern technologies using computers and the Internet in the field of education to improve the reali
... Show MoreThe parametric programming considered as type of sensitivity analysis. In this research concerning to study the effect of the variations on linear programming model (objective function coefficients and right hand side) on the optimal solution. To determine the parameter (θ) value (-5≤ θ ≤5).Whereas the result، the objective function equal zero and the decision variables are non basic، when the parameter (θ = -5).The objective function value increases when the parameter (θ= 5) and the decision variables are basic، with the except of X24, X34.Whenever the parameter value increase, the objectiv
... Show MoreTo develop a petrol engine so that it works under the bi-engine pattern (producer gas-petrol) without any additional engine modifications, a single-point injection method inside the intake manifold is a simple and inexpensive method. Still, it leads to poor mixing performance between the air and producer gas. This deficiency can cause unsatisfactory engine performance and high exhaust emissions. In order to improve the mixing inside the intake manifold, nine separate cases were modelled to evaluate the impact of the position and angle orientation inside the intake manifold on the uniformity and spread of the mixture under AFR=2.07. A petrol engine (1.6 L), the maximum engine speed (8000 rpm), and bi-engine mode (petrol-producer ga
... Show MoreThe research aims to get acquainted with the evaluation of the reality of the application of the curriculum axis from among the eight Iraqi academic accreditation standards in a sample of governmental and private universities and colleges in Iraq and to identify the main and secondary reasons for it as well as to provide proposed mechanisms and procedures to help reduce gaps, If the research problem is represented in the weak availability of the requirements of the curriculum axis in universities and colleges (the study sample) due to the weak documentation and successful implementation of them and interest in them is still below the level of ambition, In order to arrive at scientific facts, the researchers adopted the comparativ
... Show MoreThe research aims to achieve a set of objectives, the most important of which is determining the extent to which the auditors of the research sample in the Federal Bureau of Financial Supervision adhere to the requirements of the quality control system according to the Iraqi Audit Manual No. The federal financial / research sample with the quality control system according to the Iraqi audit guide No. 7), and the researcher seeks to test the main research hypothesis and sub-hypotheses, and to achieve this, a questionnaire was designed by (Google Form) and distributed electronically to the elements of the research sample, Through the statistical package program (SPSS), the results of the questionnaire were analysed. In light of the applied
... Show MoreDecision-makers in each country work to define a list of internal and external interests, goals and threats to their countries according to the nature of their awareness of these interests, goals and threats.
Hence, Iraq is not an exception to this rule, and the process of evaluating its interests and the objectives of its foreign policy is subject to the pattern of awareness of decision-makers and the influencing forces in defining its basic interests, which often witness some kind of difference in defining them, evaluating their importance and determining the size of the threats they face. And among these interests and threats that have witnessed a difference in the assessment of their
... Show MoreThe research attempts to diagnose the level of the effect of human resources flexibility (employees skills flexibility, employees behaviors flexibility, and human resource practice flexibility) in the south al-rusafa directorate of a power station one of the formations and the Ministry of Electricity, and impact of a range of variables related to the performance operational, namely, (efficiency, effectiveness)recognizing the importance of the subjects studied,& because of the importance of expected results of the field under consideration,researcher selected a sample of size (121) engineers and technicians of workers in the directorate. Was my hypotheses the major search of a relationship and impact between human resources flex
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