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.
This study attempts to address the importance of communicative digitization in the field of various arts for the sake of continuity of shopping and aesthetic, artistic and intellectual appreciation of artistic achievements by the recipient on various places of their residence in light of the COVID 19 crisis, and to highlight the importance of the plastic arts of the Iraqi painter exclusively and how it expresses in a contemporary way the environment or life reality in Iraq in light of this crisis. With all its implications affecting the life reality from various aspects and methods of its negative and positive employment. As for the research procedures, the researcher reviewed the research methodology represented by the descriptive ana
... Show MoreSome major pollutants of polycyclic aromatic hydrocarbons (PAH) those discharged as water produced (WP) from the AlAhdab oil field (AOF) in the ponds close to it may leak to the water resources around and eventually reaches the marshes which will affect its ecosystem. Thus, this work aims to track the availability of PAH in the water resources and the Main Outfall Drain (MOD) nearby. The determination of PAH was evaluated using “High-Performance Liquid Chromatography (HPLC)”. The mean concentration of sixteen PAH in the produced water within the field was relatively high (0.01 to 10.89 g/ml) with standard deviations of (0.10.9). While, PAH outside the field were gradually diminishes down to (0.01-0.039) x10-2 g/ml which exceeds th
... Show MoreThe present study aims at assessing the status of heavy metals such as nickel, cadmium and lead to pollute some areas of Baghdad city. In this study the spectral absorption device and the program ArcGIS 10.2 will using. The soil samples were taken from five different locations in Baghdad, including Ameriya, Kadhimiya, Palestine Street, Jadiriyah and Taji for the 5cm depth layer on both sides of the road. This work on soil samples has been completed in two :phases 1 - Preparation of samples: For the purpose of converting solid material into a extract containing elements in the form of single ions can be estimated by the device 2-Determination of elements: Samples prepared to the device
Porosity is important because it reflects the presence of oil reserves. Hence, the number of underground reserves and a direct influence on the essential petrophysical parameters, such as permeability and saturation, are related to connected pores. Also, the selection of perforation interval and recommended drilling additional infill wells. For the estimation two distinct methods are used to obtain the results: the first method is based on conventional equations that utilize porosity logs. In contrast, the second approach relies on statistical methods based on making matrices dependent on rock and fluid composition and solving the equations (matrices) instantaneously. In which records have entered as equations, and the matrix is sol
... Show Moreresearch objectives to:
1. identify the social, economic and cultural factors affecting consumption.
2. detect the consumption culture among the population in the city of Erbil.
3. Identify the GATT consumer protection and rights.
The most important results:
1. that there is variation in the answers of respondents about keep up with modernity in the basic consumption (necessary), it swallowed the proportion of yes answers about keep up with modernity in food consumption (72%), and is an indication of growing consumer awareness of the individual in the side of nutrition. The clothing on the side of the proportion of yes answers amounted to (85%), in the health field note that the percentage of yes answers (83%), who are abr
Cardiovascular disorders are refer to the class of diseases that involve the heart or blood vessels (arteries and veins). While the term technically refers to any disease that affects the cardiovascular system. Cholesterol is classified as a sterol (a contraction of steroid and
... Show MoreApplications of quantitative methods, which had been explicit attention during previous period (the last two centuries) is the method of application sales man or traveling salesman method. According to this interest by the actual need for a lot of the production sectors and companies that distribute their products, whether locally made or the imported for customers or other industry sectors where most of the productive sectors and companies distributed always aspired to (increase profits, imports, the production quantity, quantity of exports. etc. ...) this is the part of the other hand, want to behave during the process of distribution routes that achieve the best or the least or most appropriate.
... Show MorePraise be to God who created the soul, perfected it, and inspired it with its immorality and piety. He says in His Noble Book: ﭤ Fajr: 27-30 Glory be to You, O God! O Lord, on whom I have chosen for You as a beloved from myself and the soul of the two worlds, may our master Muhammad be sacrificed for him, who enlightened the horizons with his introduction to enlightenment. It soon ends with the end of pleasure, which is the opposite of the pleasure of thought and meaning, as it is permanent and continuous, and from here we see that the Messenger of God, may God’s prayers and peace be upon him, urges us in various places to seek knowledge and fortify the soul and thought in a way that raises one’s status and protects him from the st
... Show MoreThis research aims to studying and analyzing the theoretical
framework of the environmental auditing in industrial environment to its a broad and danger environmental effects . It aims to contribute in setting and testing a proposed procedure framework for environmental auditing in that vital activity .The practical aspect focused on testing a proposed framework within practice it in a one Iraqi industrial company that has a huge effect on environmental activity, represented by Iraqi state company
Land use change, particularly the expansion of urban areas and associated human activities at the expense of natural and semi-natural areas, is a major ecological issue in urban areas around the world. Climate change being a very strong additional driver for changing the temperature and habitat in the cities. This also applies to Baghdad, Iraq, where urbanisation and climate change exerts a major pressure on the natural habitats of the city, and thus may affect the ability of city planners to adapt to future climate change scenarios. Here we present evidence of substantial growth in urban areas, increases in temperature, and degradation of natural vegetation within Baghdad city by using Remote Sensing techniques and an assessment for the
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