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.
Current search aims to identify the creative thinking of the kindergarten teachers and
solving professional problems among kindergarten teachers skills, and whether the level of
creative thinking in solving professional problems, according on marital status years of
service academic achievement of teachers as well as to identify the correlation between the
two variables the current sample consisted of (300) teachers to achieve the objectives of the
stndy , the researcher used two measures, one to measure creative thinking and the other to
measure the solution to the problems of professional kindergarten teachers skills. It has been
shown. validity and reliability of the two measures. The present stndy aims to identif
KA Hadi, AH Asma’a, IJONS, 2018 - Cited by 1
Objectives: To assess the coping strategies of parents of children with autism and the relationship of
different strategies with their educational level.
Methodology: A descriptive analytical study was carried out from Feb. 14th, 2013 through April, 10th
, 2013 in
several private rehabilitation centers of autism in Baghdad city. A non- probability (purposive) sample of 100
autistic children and 100 of their parents (father or mother) was assessed by a questionnaire which consisted of
two parts; the first part is concerned with the demographic characteristics of the child and demographic
characteristics of the parents; the second part consisted of 50 questions about coping strategies that were
distributed on 8 doma
The Necessity of College of Education for Woman from the Point of view of Students
The life insurance companies need a sound system to use it in selecting Insurable risks so they can avoid or reduce possible losses that may be insured to a minimum levels , But the application within IRAQI INSURANCE COMPANY reflects that it still depends on a traditional ways in the procedures used to select that risks .
This research represents an attempt to put acceptable suggestions about developing a system for selecting insurable risks which used now by iraqi insurance company by recognizing the risks of life insurance , determining kinds of risks which can difined as normal and upnormal risks , rectification of the
... Show MoreCatalytic reduction is considered an effective approach for the reduction of toxic organic pollutants from the environment, but finding an active catalyst is still a big challenge. Herein, Ag decorated CeO2 catalyst was synthesized through polyol reduction method and applied for catalytic reduction (conversion) of 4-nitrophenol (4-NP) to 4-aminophenol (4-AP). The Ag decorated CeO2 catalyst displayed an outstanding reduction activity with 99% conversion of 4-NP in 5 min with a 0.61 min−1 reaction rate (k). A number of structural characterization techniques were executed to investigate the influence of Ag on CeO2 and its effect on the catalytic conversion of 4-NP. The outstanding catalytic performances of the Ag-CeO2 catalyst can be assigne
... Show MoreThe economical and highly performed anode material is the critical factor affecting the efficiency of electro-oxidation toward organics. The present study aimed to detect the best conditions to prepare Mn-Co oxide composite anode for the electro-oxidation of phenol. Deposition of Mn-Co oxide onto graphite substrate was investigated at 25, 30, and 35 mA/cm2 to detect the best conditions for deposition. The structure and the crystal size of the Mn-Co oxide composite electrode were examined by using an X-Ray diffractometer (XRD), the morphological properties of the prepared electrode were studied by scanning electron microscopy (SEM) and Atomic force microscopy (AFM) techniques, and the chemical composition of the various
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