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.
Background: The purposes of this study were to determine the photogrammetric soft tissue facial profile measurements for Iraqi adults sample with class I normal occlusion using Standardized photographic techniques and to verify the existence of possible gender differences. Materials and methods: Eighty Iraqi adult subjects (40 males and 40 females) with an age ranged between 18-25 years having class I normal occlusion were chosen for this study. Each individual was subjected to clinical examination and digital standardized right side photographic records were taken in the natural head position which is mirror position which the patient looking straight into his eyes into the mirror mounted on the stand. The photographs were analyzed using A
... Show MoreThe primary goal of in-situ load testing is to evaluate the safety and performance of a structural system under particular loading conditions. Advancements in building techniques, analytical tools, and monitoring instruments are prompting the evaluation of the appropriate loading value, loading process, and examination criteria. The procedure for testing reinforced concrete (RC) structures on-site, as outlined in the ACI Building Code, involves conducting a 24-h load test and applying specific evaluation criteria. This article detailed a retrofitting project for an RC slab-beams system by utilizing carbon fiber-reinforced polymer (CFRP) sheets to strengthen the structure following a fire incident. The RC structure showed indicators of deter
... Show MoreIn this paper, the dynamics of scavenger species predation of both susceptible and infected prey at different rates with prey refuge is mathematically proposed and studied. It is supposed that the disease was spread by direct contact between susceptible prey with infected prey described by Holling type-II infection function. The existence, uniqueness, and boundedness of the solution are investigated. The stability constraints of all equilibrium points are determined. In addition to establishing some sufficient conditions for global stability of them by using suitable Lyapunov functions. Finally, these theoretical results are shown and verified with numerical simulations.
In this work, the effect of variation of semi-angle of the conical part on the vibration characteristics of cylindrical-conical coupled structure is investigated. The shell is made of polyester resin reinforced by continuous E-glass fibers. The case is analyzed experimentally and numerically for orthotropic shell structures. The experimental program is conducted by exciting the fabricated structure by an impact hammer and monitoring the response using an attached accelerometer for different semi-angles of the conical part.
Software named SIGVIEW is used to perform the signal processing on the acquired signal in order to measure the natural frequencies and the corresponding mode shapes. The numerical investigation is achieved using ANS
Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and
... Show MoreThe study aims to identify the mechanical and electrical activities of the heart according to the energy systems of advanced players and to detect the differences between the energy systems in terms of the mechanical and electrical activities of the heart for advanced players. It was clear from the results of the significance of the differences between the three groups according to the energy systems of the advanced players in all research variables that (the non-oxygenic system "Lactic"), which represents the advanced players in the arches (800 m, 1500 m) was the first in most tests of mechanical and electrical activities of the heart, which is (Margaria-Kalamen, Wingate, systolic muscle strength of the heart FC, Stroke Volume SV
... Show MoreThe study was preformed for investigating of Salmonella from meat, and compared Vidas UP Salmonella (SPT) with the traditional methods of isolation for Salmonella , were examined 42 meat samples (Beef and Chicken) from the Local and Imported From local markets in the city of Baghdad from period December 2013 -February 2014 the samples were cultured on enrichment and differential media and examined samples Vidas, and confirmed of isolates by cultivation chromgenic agar, biochemical tests ,Api20 E systeme , In addition serological tests , and the serotypes determinate in the Central Public Health Laboratory / National Institute of Salmonella The results showed the contamination in imported meat was more than in the local meat 11.9% and 2
... Show MoreA novel series of liquid crystalline compounds containing 2,4-thiazolidinedione units with varying terminal alkyl chain lengths was successfully synthesized and characterized. The chemical structures of the synthesized compounds were confirmed by FT-IR, ¹H-NMR, and mass spectrometry. The mesomorphic behavior was investigated using polarized optical microscopy (POM) and differential scanning calorimetry (DSC). Compounds [V]₄, [V]₅, and [V]₆ exhibited enantiotropic nematic phases, while compound [V]₈ displayed a smectic A (SmA) phase. No liquid crystalline behavior was observed for compound [V]₃. The liquid crystalline properties were found to depend on the terminal-to-lateral chain length ratio, molecular geometry, and the nature
... Show MoreBackground: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and compa
... Show MoreBackground: Medication reconciliation can include medication reviewing and providing counseling and a list of all the medications during every transition of care. Objectives: to explore in-depth the perspectives of Iraqi physicians and pharmacists regarding the necessity of medication reconciliation at hospital discharge and identify the possible benefits and challenges that could face its implementation. Subjects and Methods: A qualitative study included semi-structured interviews with pharmacists and physicians working at a public teaching hospital in Iraq. The interviews were conducted face-to-face from February to March 2023. Thematic analysis was used to analyze the qualitative data generated from the interviews. Results: In th
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