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.
Education specialists have differed about determining the best ways to detect the
talented. Since the appearance of the mental and psychological measurement movement, some
scholars adopted intelligence ratios as a criterion to identify the talented and others went to
rely on the degree of academic achievement. Each of these two methods has its own flaws and
mistakes and a large number of talented children were victims of these two methods.
Therefore the need to use other scales for the purpose of detection of talented children
appeared because they provide valuable information which may not be obtained easily
through objective tests and these scales are derived from consecutive studies of gifted andtalented children
Background: Bone defect healing is a multidimensional procedure with an overlapping timeline that involves the regeneration of bone tissue. Due to bone's ability to regenerate, the vast majority of bone abnormalities can be restored intuitively under the right physiological conditions. The goal of this study is to examine the immunohistochemistry of bone sialoprotein in order to determine the effect of local application of bone sialoprotein on the healing of a rat tibia generated bone defect. Materials and Methods: In this experiment, 48 albino male rats weighing 300-400 grams and aged 6-8 months will be employed under controlled temperature, drinking, and food consumption settings. The animals will be subjected to a surgical procedure o
... Show MoreThere are many diseases that affect the arteries, especially those related to their elasticity and stiffness, and they can be guessed by estimating and calculating the modulus of elasticity. Hence, the accurate calculation of the elastic modulus leads to an accurate assessment of these diseases, especially in their early stages, which can contribute to the treatment of these diseases early. Most of the calculations used the one-dimensional (1D) modulus of elasticity. From a mechanical point of view, the stresses to which the artery is subjected are not one-dimensional, but three-dimensional. Therefore, estimating at least a two-dimensional (2D) modulus of elasticity will necessarily be more accurate. To the knowledge of researchers, there i
... Show MoreThe objective of the research is to uncover the effect of the strategy of Quranic verses in the collection of science and systemic intelligence for second-grade students. The research sample consisted of (48) students of second grade students in the middle of Al Rasheed Boys School of the second Karkh Directorate, Distribution in the two divisions, Division of (b) and experimental group that studied strategy of Quranic verses, and the Division (a) control group which studied the regular way, and results indicated a statistically significant differences for the experimental group students studied using the strategy Verses in systemic intelligence collection.
In information security, fingerprint verification is one of the most common recent approaches for verifying human identity through a distinctive pattern. The verification process works by comparing a pair of fingerprint templates and identifying the similarity/matching among them. Several research studies have utilized different techniques for the matching process such as fuzzy vault and image filtering approaches. Yet, these approaches are still suffering from the imprecise articulation of the biometrics’ interesting patterns. The emergence of deep learning architectures such as the Convolutional Neural Network (CNN) has been extensively used for image processing and object detection tasks and showed an outstanding performance compare
... Show MoreNew microphotometer was constructed in our Laboratory Which deals with the determination of Molybdenum (VI) through its Catalysis effect on Hydrogen peroxide and potasum iodide Reaction in acid medium H2SO4 0.01 mM. Linearity of 97.3% for the range 5- 100 ppm. The repeatability of result was better than 0.8 % 0.5 ppm was obtanined as L.U. (The method applied for the determination of Molybdenum (VI) in medicinal Sample (centrum). The determination was compared well with the developed method the conventional method.
Tight oil reservoirs have been a concerned of the oil industry due to their substantial influence on oil production. Due to their poor permeability, numerous problems are encountered while producing from tight reservoirs. Petrophysical and geomechanical rock properties are essential for understanding and assessing the fracability of reservoirs, especially tight reservoirs, to enhance permeability. In this study, Saadi B reservoir in Halfaya Iraqi oil field is considered as the main tight reservoir. Petrophysical and geomechanical properties have been estimated using full-set well logs for a vertical well that penetrates Saadi reservoir and validated with support of diagnostic fracture injection test data employing standard equations
... Show MoreIn this paper, Bayes estimators of the parameter of Maxwell distribution have been derived along with maximum likelihood estimator. The non-informative priors; Jeffreys and the extension of Jeffreys prior information has been considered under two different loss functions, the squared error loss function and the modified squared error loss function for comparison purpose. A simulation study has been developed in order to gain an insight into the performance on small, moderate and large samples. The performance of these estimators has been explored numerically under different conditions. The efficiency for the estimators was compared according to the mean square error MSE. The results of comparison by MSE show that the efficiency of B
... Show MoreA reduced-order extended state observer (RESO) based a continuous sliding mode control (SMC) is proposed in this paper for the tracking problem of high order Brunovsky systems with the existence of external perturbations and system uncertainties. For this purpose, a composite control is constituted by two consecutive steps. First, the reduced-order ESO (RESO) technique is designed to estimate unknown system states and total disturbance without estimating an available state. Second, the continuous SMC law is designed based on the estimations supplied by the RESO estimator in order to govern the nominal system part. More importantly, the robustness performance is well achieved by compensating not only the lumped disturbance, but also its esti
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