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 upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider
... Show MoreA study of non-diatom algal species composition in twelve sites from Greater Zab River path within
Erbil Province, was carried out from April 2021 to January 2022 with monthly sample collection in twelve studied sites. Among them site 4,5,6,7 and 9 are the first for algal study in this area. The 112 different species of algae belong to 33 genera, 25 families, 13 orders and 4 divisions have been identified. The predominant genera included Spirogyra and Cosmarium 17, 8 taxa respectively. 13 taxa were new recorded to Iraqi
Kurdistan algal flora and 9 of them were new recorded to Iraqi algal flora: Botryosphaerella sudetica, Muriella magna, Gloeotaenium loitlesbergianum, Apiocystis brauniana, Anabaena oscillarioides, C. distentum
هدفت الدراسة إلى التعرف على مستوى تقييم الإعلاميين العراقيين المقيمين في الأردن لتغطية الإصلاحات السياسية و الاقتصادية في العراق من قبل الفضائيات العراقية. و هدفت كذلك إلى التعرف على الف
s The study aims to identify the fairness in the distribution of municipal services between municipal districts and areas, from point of view of municipal chamber staff and from the point of view of the citizen. It also aims to identify factors affecting the fairness of the distribution of municipal services. Municipal services were being studied : hygiene and waste, water supply, sewer, creating gardens, and street paving .Factors which examined its impact on municipal services are: resources available to municipal chamber, the managerial process at municipal chamber, and factors in the external environment surrounding municipal chamber.The results of the study showed that level of the e
... Show MoreThis study aimed identify the teachers of sociology. In the development of creative thinking. I have students in middle school .llvra literary. In schools. Second Karkh From the perspective of the teachers and the students themselves numbered (41), a teacher and a school. As The study population encompassed of some students the fourth and fifth preparatory stage in the Karkh II schools, totaling 200 male and female students. As the study sample were consisted of (7) and a teacher (34) and accented (85) of male students (115) were female student The researcher the questionnaire which consisted of (39) items And to achieve the objectives of the study it was ascertained sincerity And stability. And
... Show MoreIn the present study, five derivatives have been designed to be synthesized as possible mutual prodrugs for 5-Fluorouracil (5-FU) and non steroidal anti-inflammatory drugs (NSAIDs) to selectively deliver the drugs into the cancer cells. The synthesis of the target compounds were accomplished following multistep reaction procedures, the chemical reaction followed up and the purity of the products were checked by TLC. The structure of the final compounds and their intermediates were confirmed by their melting points, infrared spectroscopy and elemental microanalysis, the hydrolysis of compound III was studied using HPLC technique. According to the results mentioned above, compounds (I−V) can be good candidates as possible mutual prod
... Show MoreA particle swarm optimization algorithm and neural network like self-tuning PID controller for CSTR system is presented. The scheme of the discrete-time PID control structure is based on neural network and tuned the parameters of the PID controller by using a particle swarm optimization PSO technique as a simple and fast training algorithm. The proposed method has advantage that it is not necessary to use a combined structure of identification and decision because it used PSO. Simulation results show the effectiveness of the proposed adaptive PID neural control algorithm in terms of minimum tracking error and smoothness control signal obtained for non-linear dynamical CSTR system.
One of the recent significant but challenging research studies in computational biology and bioinformatics is to unveil protein complexes from protein-protein interaction networks (PPINs). However, the development of a reliable algorithm to detect more complexes with high quality is still ongoing in many studies. The main contribution of this paper is to improve the effectiveness of the well-known modularity density ( ) model when used as a single objective optimization function in the framework of the canonical evolutionary algorithm (EA). To this end, the design of the EA is modified with a gene ontology-based mutation operator, where the aim is to make a positive collaboration between the modularity density model and the proposed
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Magnetic abrasive finishing (MAF) is one of the advanced finishing processes, which produces a high level of surface quality and is primarily controlled by a magnetic field. This paper study the effect of the magnetic abrasive finishing system on the material removal rate (MRR) and surface roughness (Ra) in terms of magnetic abrasive finishing system for eight of input parameters, and three levels according to Taguchi array (L27) and using the regression model to analysis the output (results). These parameters are the (Poles geometry angle, Gap between the two magnetic poles, Grain size powder, Doze of the ferromagnetic abrasive powder, DC current, Workpiece velocity, Magnetic poles velocity, and Finishi
... Show MoreThe research dealt with the topic ' the aesthetics of design shape of interior spaces for the syndicate of physicians' as it reflects visions evolving to the level of tasting and positive interpretation for the space of work to be on a high design level.The research consisting of four chapters as follow; The first chapter examined the problem of the research contracted in the following question: Have the design shapes any role in achieving and showing the aesthetic side for the syndicate of physicians? so the goal of the research was showing the aesthetics of design shape of interior spaces for the syndicate of physicians, The chapter also included the objective spatial and temporal limits of research .Finally the terms were specified. T
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