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.
Bacteria strain H8, which produces high amount of exopolysaccharide (EPS), was isolated from soil, and identified as strain of Azotobacter chrococcum by its biochemical /physiological characteristics, EPS was extracted, partially purified and used as bioflocculant. The biochemical analysis of the partially purified EPS revealed that it was an alginate. analysis of EPS by Fourier transform infrared spectrometry (FTIR) show that the -OH groups present in bioflocculant are clearly seen at 3433.06 cm-1, the peaks attributed to the -CH3 groups present at 2916.17 cm-1 , and some distinct peaks such as carboxyl group showed strong absorption bands at 1604.66 cm-1, 1411.80 cm-1 and 1303.79 cm-1 indicate the chemical structure of alginate. The effe
... Show MoreABSTRACT:In this paper, Cd10–xZnxS (x = 0.1, 0.3, 0.5) films were deposited by using chemical spray pyrolysis technique, the molar concentration precursor solution was 0.15 M/L. Depositions were done at 350°C on cleaned glass substrates. X-ray dif- fraction technique (XRD) studies for all the prepared film; all the films are crystalline with hexagonal structure .The optical properties of the prepared films were studied using measurements from VIS-UV-IR spectrophotometer at wave- length with the range 300 - 900 nm; the average transmission of the minimum doping ratio (Zn at 0.1%) was about 55% in the VIS region, it was decrease at the increasing of Zn concentration in the CdS films, The band gap of the doped CdS films was varied as 3.7, 3
... Show MoreConditional logistic regression is often used to study the relationship between event outcomes and specific prognostic factors in order to application of logistic regression and utilizing its predictive capabilities into environmental studies. This research seeks to demonstrate a novel approach of implementing conditional logistic regression in environmental research through inference methods predicated on longitudinal data. Thus, statistical analysis of longitudinal data requires methods that can properly take into account the interdependence within-subjects for the response measurements. If this correlation ignored then inferences such as statistical tests and confidence intervals can be invalid largely.
The importance of this study stems from the importance of preserving the environment and creating a clean sustainable environment from waste and emissions and all the operations of industrial companies in general and cement companies in particular by activating sustainability accounting standards. The research aims to identify and diagnose deviations in violation of sustainability standards by employing the non-renewable resources standard (NR0401) For the construction industries to create a sustainable audit environment, the deductive approach was followed in the theoretical side and the inductive and descriptive approach to the practical side. The most important results of the research were the possibility of applying sustainab
... Show MoreBackground: Radiologic evaluation of breast lesions is being achieved through several imaging modalities. Mammography has an established role in breast cancer screening and diagnosis. Still however, it shows some limitations particulary in dense breast.
Methods : Magnetic resonance imaging is an attractive tool for the diagnosis of breast tumors1 and the use of magnetic resonance imaging of the breast is rapidly increasing as this technique becomes more widely available.1 As an adjunct to mammography and ultrasound, MRI can be a valuable addition to the work-up of a breast abnormality. MRI has the advantages of providing a three-dimensional view of the breast, performing wit
... Show MoreIn this paper, we use the repeated corrected Simpson's 3/8 quadrature method for obtaining the numerical solutions of Fredholm linear integral equations of the second kind. This method is more accurately than the repeated corrected Trapezoidal method and the repeated Simpson's 3/8 method. To illustrate the accuracy of this method, we give a numerical example
This study was conducted to evaluate the efficacy of different techniques for extraction and purification of Tomato yellow leaf curl virus (TYLCV). An isolate of the virus free of possible contamination with other viruses infecting the same host and transmitted by the same vector Bemisia tabaci Genn. was obtained. This was realized by indicator plants and incubation period in the vector. Results obtained revealed that the virus infect Nicotiana glutinosa without visible symptoms, while Nicotiana tabaccum var. White Burley was not susceptible to the virus. The incubation period of the virus in the vector was found to be 21 hrs. These results indicate that the virus is TYLCV. Results showed that Butanol was more effective in clarification the
... Show MoreThis research includes the study of dual data models with mixed random parameters, which contain two types of parameters, the first is random and the other is fixed. For the random parameter, it is obtained as a result of differences in the marginal tendencies of the cross sections, and for the fixed parameter, it is obtained as a result of differences in fixed limits, and random errors for each section. Accidental bearing the characteristic of heterogeneity of variance in addition to the presence of serial correlation of the first degree, and the main objective in this research is the use of efficient methods commensurate with the paired data in the case of small samples, and to achieve this goal, the feasible general least squa
... Show MoreCar drivers hear many kinds of noise inside their vehicles' cabins, and the most annoying ones are the noise generated by tires, engines, and outside winds. Noise affects the comfort of the passengers inside the cabin, and it’s sad to say that modern cars are noisier in many kinds of noise signals due to using a lot of plastic materials in new budget cars. For expensive and luxury cars, the problem is solved by using better sound insulation materials, but for the budget ones, the approach used here is effective. It is called Active Noise Cancellation and can be done using analog or digital electronics. An operational amplifier and filters are used for the analog one, and in the digital one, signal processor chips are used. In engineeri
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