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 focuses on the impact of technology on creating a dystopian world as presented by the English playwright Caryl Churchill in her play A Number (2002). This dramatic work came as a reaction to the most crucial and valuable turning point in the scientific achievements of human engineering, namely, the cloning of the sheep called Dolly. Therefore, A Number is a play that presents an analytical stage for imagining the biotechnological and scientific future. This dramatic vignette captures the playwright’s fears towards the abnormal progress of technology and science and how far such technological progress affects human relationships and identity. It also portrays how technological progress results in the feeling of a lack of
... Show MoreThe air flow pattern in a co-current pilot plant spray dryer fitted with a rotary disk atomizer was determined experimentally and modelled numerically using Computational Fluid Dynamics (CFD) (ANSYS Fluent ) software. The CFD simulation used a three dimensions system, Reynolds-Average Navier-Stokes equations (RANS), closed via the RNG k −ε turbulence model. Measurements were carried out at a rotation of the atomizer (3000 rpm) and when there is no rotation using a drying air at 25 oC and air velocity at the inlet of 5 m/s without swirl. The air flow pattern was predicted experimentally using cotton tufts and digital anemometer. The CFD simulation predicted a downward central flowing air core surrounded by a slow
... Show MoreA mathematical eco-epidemiological model consisting of harvested prey–predator system involving fear and disease in the prey population is formulated and studied. The prey population is supposed to be separated into two groups: susceptible and infected. The susceptible prey grows logistically, whereas the infected prey cannot reproduce and instead competes for the environment’s carrying capacity. Furthermore, the disease is transferred through contact from infected to susceptible individuals, and there is no inherited transmission. The existence, positivity, and boundedness of the model’s solution are discussed. The local stability analysis is carried out. The persistence requirements are established. The global behavior of th
... Show MoreThis study was aimed to determine the mutations and single nucleotide polymorphisms (SNPs) in exon 3 and 7 of estrogen receptor beta (ESR2) gene in women with breast cancer from Iraq. Different samples (blood, fresh tissue with blood from same patient, and formalin fixed paraffin embedded, FFPE) were collected from women with breast cancer. Molecular analysis exon 3 and 7 in ESR2 has been studied by using PCR. It was found exon 3 and 7 in ESR2 were revealed as a single band with size 151 and 157 bp, respectively. There was no SNP in exon 3 has been identified. While three novel polymorphisms (ACT, AGG and GCA) were detected in exon 7, the type of those polymorphisms deletion for ACT and AGG while substitution polymorphism for GCA. From this
... Show MoreAbstract:
the current research aims at analyzing the efficiency of the private university teaching that recently expanded after 2003 ,;besides , the commitment of the private colleges ,definitely Al-Maamun and Al-Mansour colleges with strategy of the ministry of higher education and scientific research. This could be done through many indications that measure the efficiency of the private university teaching , including ( the indication of the efficiency of using human resources and efficiency in using the materialistic indications. But the human efficiency in these colleges , including the sample of the research ( Maamun
... Show MoreThis study was achieved to investigate the accumulation of some heavy metals included: Cadmium, Lead and Nickel in the tissues (gill, intestine, liver, muscles and skin) of Silurus triostegus Heckel, 1843 (Siluriformes, Siluridae) and its larval stage of the nematode Contracaecum sp. (Rhabditida, Anisakidae). As well as to assess the infection patterns of Contracaecum among S. triostegus specimens which were purchased fresh from the local market in Baghdad. One hundred and nine nematodes specimens in larval stage were recovered from the fish host; the overall prevalence of Contracaecum sp. was 38.6%. The sex of the host was not significantly (P ˃ 0.05) associated with the infection of this nematode.
Results showed that the overall me
This study was achieved to investigate the accumulation of some heavy metals included: Cadmium, Lead and Nickel in the tissues (gill, intestine, liver, muscles and skin) of Silurus triostegus Heckel, 1843 (Siluriformes, Siluridae) and its larval stage of the nematode Contracaecum sp. (Rhabditida, Anisakidae). As well as to assess the infection patterns of Contracaecum among S. triostegus specimens which were purchased fresh from the local market in Baghdad. One hundred and nine nematodes specimens in larval stage were recovered from the fish host; the overall prevalence of Contracaecum sp. was 38.6%. The sex of the host was not significantly (P ˃ 0.05) associated with the infection of this nematode. Results showed that the ov
... Show MoreObjectives: to assess chronic diseases patients’ knowledge toward stroke risk factors and warning signs, besides
determining the relationship between chronic diseases patients’ knowledge and their sociodemographical
characteristics.
Methodology: A descriptive study was carried out at public medical clinics which has started from December
2
nd, 2008 to August 8th, 2009. A purposive "non-probability" sample of (300) chronic diseases individuals who
were clients of Public Medical Clinics who have one or more of the following chronic diseases (hypertension,
diabetes mellitus, heart diseases, and previous stroke), in Baghdad city. The data were collected through the use
of a constructed questionnaire which consists
Background: obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific low back pain (LBP). However, the relationship between obesity and LBP remain to date unsupported by an objective measurement of the mechanical behavior of spine and it is morphology in obese subjects. . Objectives: To identify the relationship between obesity and LBP regarding (height, weight, sleeping, chronic diseases, smoking, and steroid). Method: A cross-sectional study was conducted from the first of January 2016 to January 2018 in obe
... Show MorePatients with renal failure in the final stages undergo the treatment by hemodialysis. Hemodialysis is used to reinstate the intracellular and extracellular fluid environment, by propagation of molecules in solution through a semipermeable membrane along an electrochemical concentration gradient. Blood catching in the dialysis machine and the recurrent phlebotomy may lead to losing about 1-3 g of iron per year. Prohepcidin hormone is an acute phase protein (type II) that plays a major role in the systemic iron irregularities as it is a mediator of anemia in inflammation and regulator of iron metabolism. This study aims to evaluate the effect of hemodialysis on iron hemostasis and its relationship with prohepcidin as an inflammatory mark
... Show More