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.
COVID-19 is a pandemic disease that has a wide spectrum of symptoms from asymptomatic to severe fatal cases due to hyperactivation of the immune system and secretion of pro-inflammatory cytokines. This study aimed to assess the level and impact of interleukin (IL)-13, IL-33, and tumor necrosis factor (TNF)-α cytokines on immune responses in mild and moderate COVID-19-infected Iraqi patients. A prospective case-control study was conducted from January 2023 to January 2024; it included 80 patients infected with moderate COVID-19 infection who consulted in different private clinics and 40 healthy controls. The serum of both groups was tested for quantification of serum IL-13, IL-33, and TNF-α using the human enzyme-linked immunosorbe
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This recearch is about studying the novel (doorstep’s women) by the Iraqi
narrator Hadia Hussian, and I choose Semiolog as a Curriculum for this
critical approach, because I think that this Semiotic curriculum has the ability
to read the Subjects and the narrative constructions. Which form the structure
of the novel starting from the little to the characters.
The focus is on many narrative constructions in the novel we have
studied the semiology of the tittle, the semiology of the cover, of the color, the
names of the characters and the semiology of the female characters.
First the focus of the novel is on the women’s characters because most
of it’s characters are women. Secondly because these
Some 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 implementation of the concept of project scheduling in the organizations generally requires a set of procedures and requirements, So, most important of all is the understanding and knowledge of the tools and techniques which are called the methods of scheduling projects. Consequently, the projects of the municipality administration in the holy governorate of Karbala suffer from the problem of delaying their projects and chaos in the ways of implementation. To provide assistance to this directorate and to demonstrate how to schedule projects using one of the advanced scientific methods that proved their ability to schedule any project and its potential to accelerate the time of completion, as well as ease of use and effectiven
... Show MoreUnder aerobic and anaerobic conditions, two laboratory-scale reactors were operated. Each reactor
was packed with 8.5 kg of shredded synthetic solid waste (less than 5 cm) that was prepared according to an
average composition of domestic solid waste in the city of Kirkuk. Using an air compressor, aerobic
conditions were created in the aerobic reactor. This study shows that the aerobic reactor was more efficient in
COD and BOD5 removal which were 97.88% and 91.25% while in case of anaerobic reactor, they were
66.53%and 19.11%, respectively.
the researchers Sought to determine the impact of the customer contact (Within a client contact there are two times, first is the total time required to create a service and within it there is contact time while the second time is the time of client contact ؛ where means a time that records the physical presence of the customer during the process of service) on operations performance by concentrate attention on the cost (labor productivity) and quality (patient ratio to the doctor) and speed (cycle time) and flexibility (the flexibility range) , as well as ruling out variable of innovation because of impossibility to measure this variable in the Specialty Center for Dental in al-alwia due to the center is lacking of mechanisms t
... Show MoreThis research reveals the treatment mechanisms followed in the media for covering the topic of displacement and captivity of Yazidi in the Iraqi press, through studying all the publishing in one of the Iraqi newspapers concerning the research subject. The research problem is in the following questions:
- What are the journalistic arts that are tackled by the newspaper concerning the subject of the Yazidi women?
- What are the editing forms for the model of the press subjects that have been employed about the event and what are its sources?
- What are the highlighting means used in presenting the subjects within the journalistic arts?
- What are the i
Background: Ulcerative colitis (UC) is an inflammatory bowel disease restricted to the large intestine, characterized by superficial ulceration. It is a progressive and chronic disease requiring long-term treatment. Although its etiology remains unknown, it is suggested that environmental factors influence genetically susceptible individuals, leading to the onset of the disease. (C-X-C) ligand 9 is a chemokine that belongs to the CXC chemokine family, it plays a role in the differentiation of immune cells such as cytotoxic lymphocytes, natural killer T cells, and macrophages. Its interaction with its corresponding receptor CXCR3 which is expressed by a variety of cells such as effector T cells, CD8+ cytotoxic T cells, and macrophage
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