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.
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 MoreIndexes of topological play a crucial role in mathematical chemistry and network theory, providing valuable insights into the structural properties of graphs. In this study, we investigate the Resize graph of G2(3), a significant algebraic structure arising from the exceptional Lie group (G2) over the finite field F3. We compute several well-known topological indices, including the Zagreb indices, Wiener index, and Randić index, to analyze the graph's connectivity and complexity. Our results reveal intricate relationships between the algebraic structure of G2(3) and its graphical properties, offering a deeper understanding of its combinatorial and spectral characteristics. These findings contribute to the broader study of algebraic graph t
... Show MoreThis paper considers approximate solution of the hyperbolic one-dimensional wave equation with nonlocal mixed boundary conditions by improved methods based on the assumption that the solution is a double power series based on orthogonal polynomials, such as Bernstein, Legendre, and Chebyshev. The solution is ultimately compared with the original method that is based on standard polynomials by calculating the absolute error to verify the validity and accuracy of the performance.
The primary objective of the current paper is to suggest and implement effective computational methods (DECMs) to calculate analytic and approximate solutions to the nonlocal one-dimensional parabolic equation which is utilized to model specific real-world applications. The powerful and elegant methods that are used orthogonal basis functions to describe the solution as a double power series have been developed, namely the Bernstein, Legendre, Chebyshev, Hermite, and Bernoulli polynomials. Hence, a specified partial differential equation is reduced to a system of linear algebraic equations that can be solved by using Mathematica®12. The techniques of effective computational methods (DECMs) have been applied to solve some s
... Show MoreTight 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 MoreSewer sediment deposition is an important aspect as it relates to several operational and environmental problems. It concerns municipalities as it affects the sewer system and contributes to sewer failure which has a catastrophic effect if happened in trunks or interceptors. Sewer rehabilitation is a costly process and complex in terms of choosing the method of rehabilitation and individual sewers to be rehabilitated. For such a complex process, inspection techniques assist in the decision-making process; though, it may add to the total expenditure of the project as it requires special tools and trained personnel. For developing countries, Inspection could prohibit the rehabilitation proceeds. In this study, the researchers propos
... Show MoreMagnetic Abrasive Finishing (MAF) is an advanced finishing method, which improves the quality of surfaces and performance of the products. The finishing technology for flat surfaces by MAF method is very economical in manufacturing fields an electromagnetic inductor was designed and manufactured for flat surface finishing formed in vertical milling machine. Magnetic abrasive powder was also produced under controlled condition. There are various parameters, such as the coil current, working gap, the volume of powder portion and feed rate, that are known to have a large impact on surface quality. This paper describes how Taguchi design of experiments is applied to find out important parameters influencing the surface quality generated during
... Show MoreElectrodeposition of metal oxides on graphite electrodes can improve their ability to remove organic substances. In this work, multicomponent oxides of Mn, Co, and Ni were electrochemically deposited on both the anode and cathode of graphite electrodes to enhance their performance in removing phenol. Formation of the deposit was achieved within 2 h in current densities of 20, 25, 30, and 35 mA/cm2 for better composite properties. The deposited layer was characterized by testing the surface structure, morphology, composition, and roughness. X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray (EDX), and Atomic force microscopy (AFM) techniques facilitated these tests. The composite electrodes have synthesized
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