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 pseudo-slug flow is a type of intermittent flow characterized by short, frothy, chaotic slugs that have a structure velocity lower than the mixture velocity and are not fully formed. It is essential to accurately estimate the transition from conventional slug (SL) flow to pseudo-slug (PSL) flow, and from SL to churn (CH), by precisely predicting the pressure losses. Recent research has showed that PSL and CH flows comprise a significant portion of the conventional flow pattern maps. This is particularly true in wellbores and pipelines with highly deviated large-diameter gas-condensate wellbores and pipelines. Several theoretical and experimental works studied the behavior of PSL and CH flows; however, few models have been suggested to pre
... Show MoreIn this work, a fiber-optic biomedical sensor was manufactured to detect hemoglobin percentages in the blood. SPR-based coreless optical fibers were developed and implemented using single and multiple optical fibers. It was also used to calculate refractive indices and concentrations of hemoglobin in blood samples. An optical fiber, with a thickness of 40 nanometers, was deposited on gold metal for the sensing area to increase the sensitivity of the sensor. The optical fiber used in this work has a diameter of 125μm, no core, and is made up of a pure silica glass rod and an acrylate coating. The length of the fiber was 4cm removed buffer and the splicing process was done. It is found in practice that when the sensitive refractive i
... Show MoreIn this paper, some estimators for the unknown shape parameter and reliability function of Basic Gompertz distribution have been obtained, such as Maximum likelihood estimator and Bayesian estimators under Precautionary loss function using Gamma prior and Jefferys prior. Monte-Carlo simulation is conducted to compare mean squared errors (MSE) for all these estimators for the shape parameter and integrated mean squared error (IMSE's) for comparing the performance of the Reliability estimators. Finally, the discussion is provided to illustrate the results that summarized in tables.
In 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 Bayes est
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Abstract
The miraculous of al-Quran has been surrounded by the attention of scholars, as it is the one that has astonished the rhetoricians with its eloquence. So , they paid attention to every part of it and hugely they studied it with accuracy in respect to its Surah ad Ayahs. It is considered the most important source from which Arab scholars and early grammarians drew, given their unanimity that it is the highest degree of eloquence and the best record of the common literary language.
Among these sciences is the science of Grammar, and without Qur’an, this science would not have emerged, which later had control over every science of Arabic
... Show MoreThe research aims to measure the sustainability of the Iraqi economy for the period 1990-2018 as well as to show the impact of fluctuations in the level of GDP on financial sustainability, where financial sustainability is the necessary and sufficient condition for achieving economic and financial balance in the country, as financial sustainability reflects the movement of the state budget and its relationship to GDP through the indicators of deficit, fiscal surplus and public debt internal and external, as well as reflecting the art of managing public debt, and the more managed public debt is achieved, the more the management of public debt is achieved financial sustainability. for the state in the sense that there is a reciprocal
... Show MoreThe effect of different doping ratio (0.3, 0.5, and 0.7) with thickness in the range 300nmand annealed at different temp.(Ta=RT, 473, 573, 673) K on the electrical conductivity and hall effect measurements of AgInTe2thin film have and been investigated AgAlxIn(1-x) Te2 (AAIT) at RT, using thermal evaporation technique all the films were prepared on glass substrates from the alloy of the compound. Electrical conductivity (σ), the activation energies (Ea1, Ea2), Hall mobility and the carrier concentration are investigated as a function of doping. All films consist of two types of transport mechanisms for free carriers. The activation energy (Ea) decreased whereas electrical conductivity increases with increased doping. Results of Hall Effect
... Show Morerop simulation models play a pivotal role in evaluating irrigation management strategies to improve water use in agriculture. The aim of this study is to verify the validity of the Aquacrop model of maize under the surface and sprinkler irrigation systems, and a cultivation system, borders and furrows, and for two varieties of Maze (Fajr and Drakma) At two different sites in Iraq, Babylon and Al-Qadisiyah governorates. An experiment was conducted to evaluate the performance of the Aquacrop model in simulating canopy cover (CC), biomass (B), dry yield, harvest index (HI), and water productivity (WP). The results of RMSE, R2, MAE, d, NSE, CC, Pe indicated good results and high compatibility between measured and simulated values. The highest a
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