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.
The life insurance companies need a sound system to use it in selecting Insurable risks so they can avoid or reduce possible losses that may be insured to a minimum levels , But the application within IRAQI INSURANCE COMPANY reflects that it still depends on a traditional ways in the procedures used to select that risks .
This research represents an attempt to put acceptable suggestions about developing a system for selecting insurable risks which used now by iraqi insurance company by recognizing the risks of life insurance , determining kinds of risks which can difined as normal and upnormal risks , rectification of the
... Show MoreThe aim of the research is to design a test with cognitive achievement through the use of the inverted class strategy for some basic soccer skills for gyms for first-average students, within the curriculum of the Ministry of Education, where the researcher used the experimental approach. For the same division (B) and the number of each group (10) students, i.e. the total total of the research sample (20) students, and the pre-test for the research sample was applied through the design of the test prepared by the research after which the educational program with the strategy was applied to the research sample and continued (8) weeks after Completion of the tutorial has been post-tested for the research sample, In it, he reached significant r
... Show MoreMale reproductive health is intricately regulated by molecular and physiological processes, with the aryl hydrocarbon receptor (AhR) playing a crucial role. AhR is activated by various ligands and influences the onset and progression of diseases. The aim of this study was to evaluate the role of AhR on spermatogenesis in adult male rats were affected by resveratrol (RES) and CH223191, an AhR antagonist. The study include forty rats were randomly divided into four equal groups: Control group, DMSO group, RES group and AhR‾ group, the rats received respective treatments intraperitoneally twice weekly for 60 days, and various parameters related to male reproductive health were evaluated. The AhR that activation by the RES treatment w
... Show MoreIn this paper activated carbon adsorbents produced from waste tires by chemical activation methods and application of microwave assisted KOH activation. The influence of radiation time, radiation power, and impregnation ratio on the yield and oil removal which is one of the major environmental issues nowadays and considered persistent environmental contaminants and many of them are suspected of being carcinogenic. Based on Box-Wilson central composite design, polynomial models were developed to correlate the process variables to the two responses. From the analysis of variance the significant variables on each response were identified. Optimum conditions of 4 min radiation time, 700 W radiation power and 0.5 g/g impregnation ratio
... Show MoreDeep learning (DL) plays a significant role in several tasks, especially classification and prediction. Classification tasks can be efficiently achieved via convolutional neural networks (CNN) with a huge dataset, while recurrent neural networks (RNN) can perform prediction tasks due to their ability to remember time series data. In this paper, three models have been proposed to certify the evaluation track for classification and prediction tasks associated with four datasets (two for each task). These models are CNN and RNN, which include two models (Long Short Term Memory (LSTM)) and GRU (Gated Recurrent Unit). Each model is employed to work consequently over the two mentioned tasks to draw a road map of deep learning mod
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In this study, optical fibers were designed and implemented as a chemical sensor based on surface plasmon resonance (SPR) to estimate the age of the oil used in electrical transformers. The study depends on the refractive indices of the oil. The sensor was created by embedding the center portion of the optical fiber in a resin block, followed by polishing, and tapering to create the optical fiber sensor. The tapering time was 50 min. The multi-mode optical fiber was coated with 60 nm thickness gold metal. The deposition length was 4 cm. The sensor's resonance wavelength was 415 nm. The primary sensor parameters were calculated, including sensitivity (6.25), signal-to-noise ratio (2.38), figure of merit (4.88), and accuracy (3.2)
... Show MoreA step to net-zero of carbon dioxide losses in the microalgae cultivation process was targeted in the current study. This research was carried out by using pre-dissolved inorganic carbon (DIC) as a source of carbon with two doses of twenty-five and fifty millilitres.
Mixed-effects conditional logistic regression is evidently more effective in the study of qualitative differences in longitudinal pollution data as well as their implications on heterogeneous subgroups. This study seeks that conditional logistic regression is a robust evaluation method for environmental studies, thru the analysis of environment pollution as a function of oil production and environmental factors. Consequently, it has been established theoretically that the primary objective of model selection in this research is to identify the candidate model that is optimal for the conditional design. The candidate model should achieve generalizability, goodness-of-fit, parsimony and establish equilibrium between bias and variab
... Show MoreThis paper reports a comprehensive study on the behavior of concavely curved soffit reinforced concrete (RC) beams strengthened in flexure with carbon fiber-reinforced polymer (CFRP) composites under static loading. The main objective of this paper is to explore the effect of surface concavity on the bond performance of externally bonded wet layup CFRP sheets and laminates. An experimental program consisting of flexural strengthening of 24 RC beams with concavely curved soffits was carried out. All specimens were simply supported RC beams tested under three-point bending. Of the 24 beams, 6 beams were flat soffit RC beams, and the remainder were fabricated with concavely curved soffits with a degree of curvature that is ranging from 5 mm/m
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