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.
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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Artificial Intelligence Algorithms have been used in recent years in many scientific fields. We suggest employing flower pollination algorithm in the environmental field to find the best estimate of the semi-parametric regression function with measurement errors in the explanatory variables and the dependent variable, where measurement errors appear frequently in fields such as chemistry, biological sciences, medicine, and epidemiological studies, rather than an exact measurement. We estimate the regression function of the semi-parametric model by estimating the parametric model and estimating the non-parametric model, the parametric model is estimated by using an instrumental variables method (Wald method, Bartlett’s method, and Durbin
... 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
... Show More'Steganography is the science of hiding information in the cover media', a force in the context of information sec, IJSR, Call for Papers, Online Journal
Non 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 MoreThis work investigates the effect of the gas nitriding process on the surface layer microstructure and mechanical properties for steel 37, tool steel X155CrVMo12-1 and stainless steel 316L. Nitriding was conducted at a temperature of 550 °C for 2 hours during the first stage and at 750 °C for 4 hours during the second stage. SEM and X-ray diffraction tests were performed to evaluate the microstructural features and the major phases formed after surface treatment. SEM and X-ray diffraction tests were performed to assess the microstructural features and the primary phases formed after surface treatment. The new secondary precipitates were identified as γ′-Fe4N, ε (Fe2–3N), and α-Fe, exhibiting an uneven chain-like pattern wit
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