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.
A 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 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 MoreThe Iraqi-Kuwaiti relations represent a great issue for the Arab-Arab relations. This relation is characterized by specificity for the tension since the foundation of the State of Kuwait until late. There are many factors that prevented the fulfillment of the aspiration towards the development of the relations, perhaps the most important of which is the issue of Mubarak Great Port which is a difficult issue as far as the relation between the two states is concerned. One year after Iraq put the cornerstone of the Great Faw Port. This is considered as the most important hurdle in front of constructing the relations with the neighbor Kuwait
The survey and checklist of invasive species of the insects in some different localities of Iraq are revised; 24 invasive species were documented until December 2018 during the current investigations. The species distributions, common names and synonyms are given.
The current investigation included all of exotic species in Iraq, which are not collected during this study.
The most important recommendations of this research are:-
1.The benefit of the other countries experiences about the transparency of the government performance, without depending on the transparency that imitating the other experiences; that may not fit with the Iraqi government units.
2.The Ministry of Finance has to prepare the citizen guidebook about the government performance which is considered an essential document, it should be simple and available for all the parties of relation; and for not specialized citizen for the purpose of simplifying the understanding of government performance details.
3.The benefit of the government units websites of inte
... Show More