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 presented work shows a preliminary analytic method for estimation of load and pressure distributions on low speed wings with flow separation and wake rollup phenomena’s. A higher order vortex panel method is coupled with the numerical lifting line theory by means of iterative procedure including models of separation and wake rollup. The computer programs are written in FORTRAN which are stable and efficient.
The capability of the present method is investigated through a number of test cases with different types of wing sections (NACA 0012 and GA(W)-1) for different aspect ratios and angles of attack, the results include the lift and drag curves, lift and pressure distributions along the wing s
... Show MoreA load flow program is developed using MATLAB and based on the Newton–Raphson method,which shows very fast and efficient rate of convergence as well as computationally the proposed method is very efficient and it requires less computer memory through the use of sparsing method and other methods in programming to accelerate the run speed to be near the real time.
The designed program computes the voltage magnitudes and phase angles at each bus of the network under steady–state operating conditions. It also computes the power flow and power losses for all equipment, including transformers and transmission lines taking into consideration the effects of off–nominal, tap and phase shift transformers, generators, shunt capacitors, sh
In this paper, we will illustrate a gamma regression model assuming that the dependent variable (Y) is a gamma distribution and that it's mean ( ) is related through a linear predictor with link function which is identity link function g(μ) = μ. It also contains the shape parameter which is not constant and depends on the linear predictor and with link function which is the log link and we will estimate the parameters of gamma regression by using two estimation methods which are The Maximum Likelihood and the Bayesian and a comparison between these methods by using the standard comparison of average squares of error (MSE), where the two methods were applied to real da
... Show More3D models delivered from digital photogrammetric techniques have massively increased and developed to meet the requirements of many applications. The reliability of these models is basically dependent on the data processing cycle and the adopted tool solution in addition to data quality. Agisoft PhotoScan is a professional image-based 3D modelling software, which seeks to create orderly, precise n 3D content from fixed images. It works with arbitrary images those qualified in both controlled and uncontrolled conditions. Following the recommendations of many users all around the globe, Agisoft PhotoScan, has become an important source to generate precise 3D data for different applications. How reliable is this data for accurate 3D mo
... Show MoreThe primary components of successful engineering projects are time, cost, and quality. The use of the ring footing ensures the presence of these elements. This investigation aims to find the optimum number of geogrid reinforcement layers under ring footing subjected to inclined loading. For this purpose, experimental models were used. The parameters were studied to find the optimum geogrid layers number, including the optimum geogrid layers spacing and the optimum geogrid layers number. The optimum geogrid layers spacing value is 0.5B. And as the load inclination angle increased, the tilting and the tilting improvement percent for the load inclination angles (5°,10°,15°) are (40%,28%, and 5%) respectively. The reduction percent o
... Show MoreFourier Transform-Infrared (FT-IR) spectroscopy was used to analyze gasoline engine oil (SAE 5W20) samples that were exposed to seven different oxidation times (0 h, 24 h, 48 h, 72 h, 96 h, 120 h, and 144 h) to determine the best wavenumbers and wavenumber ranges for the discrimination of the oxidation times. The thermal oxidation process generated oil samples with varying total base number (TBN) levels. Each wavenumber (400–3900 cm−1) and wavenumber ranges identified from the literature and this study were statistically analyzed to determine which wavenumbers and wavenumber ranges could discriminate among all oxidation times. Linear regression was used with the best wavenumbers and wavenumber ranges to predict oxidation time.
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