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 reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual
... Show MoreThe current paper proposes a new estimator for the linear regression model parameters under Big Data circumstances. From the diversity of Big Data variables comes many challenges that can be interesting to the researchers who try their best to find new and novel methods to estimate the parameters of linear regression model. Data has been collected by Central Statistical Organization IRAQ, and the child labor in Iraq has been chosen as data. Child labor is the most vital phenomena that both society and education are suffering from and it affects the future of our next generation. Two methods have been selected to estimate the parameter
... Show MoreFormed leadership skills and organizational trust Based on intellectual that underpinned the current research, as represented leadership skills variable interpretative represented in organizational trust-response variable.
The research aims to test the relationship and the impact of leadership skills dimensions in organizational trust dimensions for the purpose of achieving its objectives were formulated hypotheses main relate to test the effect and the relationship between the variables of research for the purpose of testing those hypotheses applied research on a sample of heads of departments and officials of the people at the center of the Ministry of Higher Education and Scientific Research, where th
... Show MoreOil pollution of the soil due to a leakage in oil tubes, transportation of products, or during oil excavations can change the soil physical and mechanical, chemical, and biological properties. Consequently, the soil may or may not be eligible for engineering construction projects and it may need a significant treatment. Therefore, it is required to have a better understanding of the general behavior and the corresponding geotechnical properties upon pollution particularly for those areas associated with oil explorations and industry like Thi-Qar Governorate. Fine and coarse soils from two sites at the University of Thi-Qar are artificially contaminated with oil products ranging from 0% to 10% of their dry weight. Testing programs have been
... Show MoreSocial responsibility has achieved tremendous attention by academicians and practitioners to focus on social responsibility accounting. However, many studies around the globe have been conduct to measure the outcomes of social responsibility accounting. This paper presents the impact of applying the supply chain strategy (SCS) on the agribusiness field to optimize productivity and decreasing cost which will have a direct impact on the net income of the organization. The inconclusive results of earlier studies stimulated this research to social responsibility accounting-financial performance. The equivocal results of this phenomenon urge this study to investigate the role of other factors in the relationship of social responsibility accounti
... Show MoreSalmonellosis in poultry is one of the most significant bacterial infections causing mortality, reduced production, and serious economic losses. This study aimed to study the molecular diversity among Salmonella isolates and investigate the epidemiological spread of these bacteria in broiler and layer chicken flocks in five different farms in Karbala, Iraq, using random amplified polymorphic DNA (RAPD) polymerase chain reaction (PCR). In total, 217 cloac a swabs were collected from the farms, out of which 129 and 88 swabs were taken from broiler and layer chickens. The samples were screened by PCR for S. enterica subsp. enterica using primers specific for the invA gene. Afterward, RAPD-PCR with uniplex or multiplex octamer primers was appli
... Show MoreGeodiversity is the variety within abiotic natural elements that include: rocks, minerals, landforms, soil types, and water resources. Recently ecologists and naturalists recognized that there is close relationship between geodiversity and ecosystems. Huwaiza marsh is located south eastern Iraq within Lower Mesopotamian plain. The main rock bed units which crop out north east of the studied area comprises many types of rocks: conglomerate, sandstone, mudstone, siltstone and claystone belong to Bai Hassan, Mukdadiya and Injana Formations. The general elevation of the area ranges around 5 meters (a. s. l.) near the marsh and increase northeast to more than 100 meters (a. s. l.) and the Land forms are: cuesta, oxbow lakes
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