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.
Iranian stories have been one of the most important aspects of Iranian society's culture and have reflected us as a mirror of all its cultural, societal and political dimensions.Among the important elements of the story can be the creation of space and the movement and the creation of characters and conflict and content and the angle of vision and landscape, language and subject. Studying the elements of the story leads to more understanding and determining the strength and skill of the author by studying the elements of his story. The story of Rustom and Suhrab is also one of the many stories in which the elements of the story are often noticed and show the skill of the great professor Al-Fardousi to benefit from these eleme
... Show MoreBackground: Malignant lymphoma is a term that describes primary tumors of the lymphoreticular system, almost all of which arise from lymphocytes.MMP-1 is the most ubiquitously expressed interstitial collagenase, a subfamily of MMPs that cleaves stromal collagens. It is also called collagenase-1.TIMPs which inhibits MMP activity and thereby restrict extracellular matrix breakdown, TIMP-1 is a stromal factor that has a wide spectrum of functions in different tissues. Material and Methods: This study was performed on (68) formalin-fixed, paraffin-embedded blocks, histopathologically diagnosed as lymphoma (head and neck lesions). Immunohistochemical staining of MMP1and TIMP1 was performed on each case of the study sample. Results: The expressio
... Show MoreThis study examined the problematic of the ambiguous relationship between the media and terrorism and the problems that result from press coverage of terroristic incidents. The paper sought to show the classification and confrontation of such incidents had been established from the point of view of a sample of media professionals, researchers and writers who are frequenters of Al-Mutanabi Street in Baghdad. The media outlets that carry this coverage would not give up their media mission as well as the terrorists would not be given an opportunity to take advantage of this coverage in achieving their goals and objectives. Furthermore, the terrorist organizations would have no chance to exploit these means to deliver their terroristic messa
... Show MoreThe process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
... Show MoreAbstract:
The research aims to achieve the basis of tax justice by making a comparison between the tax accounting process according to the application of the International Financial Reporting Standard IFRS15 and the tax accounting procedures currently used in the General Authority for Taxes to determine the annual and total tax differences, to give credibility and enhance transparency in the reports and financial statements of companies Long-term contracts when prepared in accordance with the requirements of applying the international standard IFRS15 “Revenue from Contracts with Customers”, which increases the possibility of relying on them when calculating taxes. Thus, the resea
... Show MoreAbstract
It is clear to everyone how important it is to implement transactions electronically, as it facilitates the provision of services to beneficiaries, whether individuals or institutions, to achieve many benefits that are not exclusive to the beneficiary or the applicant, but extends to the governmental and international bodies. And the number of users has reached millions since its emergence in 1995, because the concepts of electronic transactions have great advantages for the economy in general and the banking sector in particular, so cooperation in various fields with the aim of becoming an information society has become paramount, It allows customers to pay money to any company they want t
... Show MoreThe aim of the present study is to provide the adequate knowledge about the role of time management in facilitate the work requirements for employees of the administrative department at the Ministry of Higher Education and Scientific Research. The research depend on studying four important dimensions which are (time planning, time organization, time direction and time observation). In addition to study other five dimensions which are (new procedures, clear procedures, short procedures, the available information and the simplicity of the methods
used).Questionnaire sheets consist of (38 questions) distributed to (170) employees and (146) sheets only were considered in the study. SPSS program was used
... Show MoreThe research aimed to use HIIT exercises, and to know the effect of HIIT exercises on some physiological and physical indicators of the young badminton players, and to identify the degree of competition anxiety and the performance of some offense skills among the young badminton players. The research community (the young badminton players), the research sample and its selection method (the research sample was chosen by the intentional method (8) badminton player from the Athwari Club), the scientific method (the experimental method with pre and post tests), measurement tools: physiological tests (high and low blood pressure) , pulse, and physical exams (explosive force of arms and legs) and the offense skills and the scale of competit
... Show Moreهدفت الدراسة الى الاهتمام واستغلال ماهو جديد من تقنيات واجهزة حديثة في تعليم السباحة الحرة عن طريق توجيه الاطفال على تطوير مداركهم واستيعابهم بالتطور التكنولوجي الذي يتناوله العالم ،قامت الباحثتان باعداد منهج تعليمي باستخدام نظارة الواقع الافتراضي وذالك بتوفير بيئة مشابهة للبيئة الحقيقية تحاكي مدارك عقول الاطفال في عالم افتراضي لتتكون صورة كاملة عن مهارات السباحة الحرة ،ومن هنا اتت المشكلة نتيجة تعل
... Show MoreObjective(s): To assess mothers’ knowledge about their children with sickle cell anemia and non-Pharmacological approaches to pain management and found some relationship between mothers knowledge and their demographic data of age, level of education, and occupation.
Methodology: A descriptive design used in the present study established was for a period from September 19th, 2020 to March 30th, 2021. The study was conducted on a non-probability (purposive) sample of (30) mother their children with sickle cell anemia was chosen. The data were analyzed through the application of descriptive and inferential statistical approaches which are applied by using SPSS version 22.0.
Results: The findings of the study indicated that moderate