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.
This paper presents an enhancement technique for tracking and regulating the blood glucose level for diabetic patients using an intelligent auto-tuning Proportional-Integral-Derivative PID controller. The proposed controller aims to generate the best insulin control action responsible for regulating the blood glucose level precisely, accurately, and quickly. The tuning control algorithm used the Dolphin Echolocation Optimization (DEO) algorithm for obtaining the near-optimal PID controller parameters with a proposed time domain specification performance index. The MATLAB simulation results for three different patients showed that the effectiveness and the robustness of the proposed control algorithm in terms of fast gene
... Show MoreThis work aims to investigate the tensile and compression strengths of heat- cured acrylic resin denture base material by adding styrene-butadiene (S- B) to polymethyl methacrylate (PMMA). The most well- known issue in prosthodontic practice is fracture of a denture base. All samples were a blend of (90%, 80%) PMMA and (10%, 20%) S- B powder melted in Oxolane (Tetra hydro furan). These samples were chopped down into specimens of dimensions 100x10x2.5mm to carry out the requirements of tensile tests. The compression strength test specimens were shaped into a cylinder with dimensions of 12.7mm in diameter and 20mm in length. The experimental results show a significant increase in both tensile and compression strengths when compared to cont
... Show MoreSoil water use and water storage vary by vegetative management practices, and these practices affect land productivity and hydrologic processes. This study investigated the effects of agroforestry buffers (AB), grass buffers (GB), and biofuel crops (BC), relative to row crops (RC) on soil water use for a claypan soil in northern Missouri, USA. The experiment located at the Greenley Memorial Research Center included RC, AB, GB, and BC established in 1991, 1997, 1997, and 2012, respectively. Soil water reflectometer sensors installed at 5‐, 10‐, 20‐, and 40‐cm depths monitored soil water from April to November in 2017 and 2018. Results showed significant differences in weekly volumetric water content (VWC) among treatments for all fou
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I wanted to address this topic because of creedal purposes importance,and its r le in regulating lives of individuals and society, and to talk about purposes of Almighty's saying:{It is easy for me},to simplify its meanings for general educated person to obtain the believe of the Creator’s power and his oneness.
Therefore,this research came,whichincludes:an introduction and topics, first :concept of creedal objectives and their divisions,second: creedal purposes in Almighty’s saying:{It is easy for me},and conclusion:in where most important results were included:
... Show MoreThe high carbon dioxide emission levels due to the increased consumption of fossil fuels has led to various environmental problems. Efficient strategies for the capture and storage of greenhouse gases, such as carbon dioxide are crucial in reducing their concentrations in the environment. Considering this, herein, three novel heteroatom-doped porous-organic polymers (POPs) containing phosphate units were synthesized in high yields from the coupling reactions of phosphate esters and 1,4-diaminobenzene (three mole equivalents) in boiling ethanol using a simple, efficient, and general procedure. The structures and physicochemical properties of the synthesized POPs were established using various techniques. Field emission scanning elect
... Show MoreNon Uniform Illumination biological image often leads to diminish structures and inhomogeneous intensities of the image. Algorithm has been proposed using Morphological Operations different types of structuring elements including (dick, line, square and ball) with the same parameters of (15).To correct the non-uniform illumination and enhancement biological images, the non-uniform background illumination have been removed from image, using (contrast adjustment, histogram equalization and adaptive histogram equalization). The used basic approach to extract the statistical features values from gray level of co-occurrence matrices (GLCM) can show the typical values for features content of biological images that can be in form of shape or sp
... Show MoreLipase was extracted by Sodium acetate buffer (pH=6; 0.05M) Containing 0.1M NaCl. Enzyme content of crude extract was concentrated by gradual addition of ammonium sulfate at 30-60% saturation. The dialyzed extract was purified on ion-exchange chromatography through DEAE–Cellulose and gel-filtration chromatography through sephacryl S-200 column. The specific activity, enzyme yield and fold purification were 54.06 unit/mg, 42.6% and 10.88 respectively. The molecular weight of the Lipase was 43.651 KDa as determined by gel-filtration chromatography through sephacryl S-200 column. Partial purified lipase used for the improvement of the flavor of butter fat after 12 hours for storage.
We report a new theranostic device based on lead sulfide quantum dots (PbS QDs) with optical emission in the near infrared wavelength range decorated with affibodies (small 6.5 kDa protein-based antibody replacements) specific to the cancer biomarker human epidermal growth factor receptor 2 (HER2), and zinc(II) protoporphyrin IX (ZnPP) to combine imaging, targeting and therapy within one nanostructure. Colloidal PbS QDs were synthesized in aqueous solution with a nanocrystal diameter of ∼5 nm and photoluminescence emission in the near infrared wavelength range. The ZHER2:432 affibody, mutated through the introduction of two cysteine residues at the C-terminus (