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.
Future generations of wireless communications systems are expected to evolve toward allowing massive ubiquitous connectivity and achieving ultra-reliable and low-latency communications (URLLC) with extremely high data rates. Massive multiple-input multiple-output (m-MIMO) is a crucial transmission technique to fulfill the demands of high data rates in the upcoming wireless systems. However, obtaining a downlink (DL) training sequence (TS) that is feasible for fast channel estimation, i.e., meeting the low-latency communications required by future generations of wireless systems, in m-MIMO with frequency-division-duplex (FDD) when users have different channel correlations is very challenging. Therefore, a low-complexity solution for
... Show MoreThe experiences in the life are considered important for many fields, such as industry, medical and others. In literature, researchers are focused on flexible lifetime distribution.
In this paper, some Bayesian estimators for the unknown scale parameter of Inverse Rayleigh Distribution have been obtained, of different two loss functions, represented by Suggested and Generalized loss function based on Non-Informative prior using Jeffery's and informative prior represented by Exponential distribution. The performance of estimators is compared empirically with Maximum Likelihood estimator, Using Monte Carlo Simulation depending on the Mean Square Error (MSE). Generally, the preference of Bayesian method of Suggeste
... Show MoreThe current research discusses “The impact of the critical factors for the transfer of knowledge on opportunities and strategic success ", the attention have been increased on knowledge transfer and strategic success subjects because on being one of the important and contemporary issues, which have a significant impact on the existence of organizations and its future. The research aims to identify the critical factors for knowledge transfer in private high education environment which enables (the college community surveyed) to achieve strategic success, also the research sought to answer questions related to research problem by testing a number of major and minor hypothes in impact, in order to test the hypotheses I used a fiel
... Show MoreA new synthesis of Schiff (K) 6 and Mannich bases (Q) 7 had formed compound (Q) 7 by reacting compound (K) with N-methylaniline at the presence of formalin 35% to given Mannich base (Q). Additionally, new complexes were formed by reacting Schiff base (K) with metal salts CuCl2·2H2O, PdCl2·2H2O, and PtCl6·6H2O by 2:1 of M:L ratio. New ligands and their complexes were characterized, exanimated, and confirmed through several techniques, including FTIR, UV-visible, 1H-NMR, 13C-NMR spectroscopy, CHN analysis, FAA, TG, molar conductivity, and magnetic susceptibility. These compounds and their complexes were screened against breast cancer cells. It was determined that several of these compounds had a significant anti-breast cancer effec
... Show MoreThe purpose of the current article lies in determining the impact of the suggestive exercises on the development of the mental capabilities of children. The researchers used the experimental method with a single-group design, which was appropriate for the core of the current article . The study samble has been specified as children aged 4-6 years in Umm Al-Rabi'een Kindergarten, with a total of 95 children. The study samble (15 children) was randomly selected. . After the exercises were completed, the post-tests have been carried out on the sample with similar circumstances as that of pre-tests. Researchers used statistical methods in the SPSS program. After the results were presented, analyzed, and discussed, The resear
... Show MoreBackground: Although various imaging modalities are available for evaluating suspicious breast lesions, ultrasound-based Shear-Wave Elastography (SWE) is an advanced, non-invasive technique complementary to grayscale sonography. This technique evaluates the elasticity of a specific tissue by applying sonic pressure to that tissue.
Objective: The aim is to assess the role of SWE in evaluating solid breast masses in correlation to histopathological study results.
Subjects and Methods: This prospective study was done in a tertiary care teaching hospital from September 2019 to August 2020. A study population of 50 women aged 18 years or above with an
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