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 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 MoreThis paper aims to find new analytical closed-forms to the solutions of the nonhomogeneous functional differential equations of the nth order with finite and constants delays and various initial delay conditions in terms of elementary functions using Laplace transform method. As well as, the definition of dynamical systems for ordinary differential equations is used to introduce the definition of dynamical systems for delay differential equations which contain multiple delays with a discussion of their dynamical properties: The exponential stability and strong stability
The present study reports the effect of temperature and liquid hourly space velocity (LHSV) on the cumene cracking reaction rate and selectivity by using a laboratory continuous flow unit with fixed bed reactor operating at atmospheric pressure. The prepared HX zeolite was made from Iraqi kaolin with good crystallinity .The activity and selectivity of prepared HX-zeolite was compared with standard HY zeolite and HX zeolite catalysts in the temperature range of 673-823K and LHSV of 0.7-2.5 h-1 . It was found that the cumene conversion increases with increasing temperature and decreasing LHSV at 823K and LHSV of 0.7 h-1 the conversions 65.32, 42.88 and 59.42 mol% for HY, HX and prepared HX catalysts respectively and at LHSV of 2.5 h-1 and th
... Show MoreThe current research aims to know the effect of teaching using multiple intelligences theory on academic achievement for students of primary school. The sample search of pupils . The research sample was divided into two groups where the first group represented the experimental group which studied the use of multiple intelligences and the second group represented the control group which studied the use of the traditional way . The search tool consisted of achievement test. Showed search results, there are statistically significant differences(0.05) between the average scores of students who have studied according to multiple intelligences between the average scores of students who have studied in accordance with the tradition way in the p
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growth and development in the Arab and Islamic worlds, and both material and moral support
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A reduced-order extended state observer (RESO) based a continuous sliding mode control (SMC) is proposed in this paper for the tracking problem of high order Brunovsky systems with the existence of external perturbations and system uncertainties. For this purpose, a composite control is constituted by two consecutive steps. First, the reduced-order ESO (RESO) technique is designed to estimate unknown system states and total disturbance without estimating an available state. Second, the continuous SMC law is designed based on the estimations supplied by the RESO estimator in order to govern the nominal system part. More importantly, the robustness performance is well achieved by compensating not only the lumped disturbance, but also its esti
... Show MoreThree N-(hydroxylphenyl) dimethylmaleimides were directly prepared in good yields (81-86)% from the reaction of dimethylmaleic anhydride with amino phenols. The prepared imides were esterified to the corresponding benzoates, methacrylates and cinnamates via their reaction with different acid chlorides in the presence of triethylamine. The prepared esters were tested as plasticizers for PVC via preparing of thirty six samples of PVC with the prepared esters in certain weight ratio followed by recording their softening points. Comparison the results with the universal plasticizers for PVC (DOP) and (DBP) indicated that the prepared esters in general have high plasticizing efficiency.
Pure Cu (CZTSe) and Ag dopant CZTSe (CAZTSe) thin films with Ag content of 0.1 and 0.2 were fabricated on coring glass substrate at R.T with thickness of 800nm by thermal evaporation method. Comparison between the optical characteristics of pure Cu and Ag alloying thin films was done by measuring and analyzing the absorbance and transmittance spectra in the range of (400-1100)nm. Also, the effect of annealing temperature at 373K and 473K on these characteristics was studied. The results indicated that all films had high absorbance and low transmittance in visible region, and the direct bang gap of films decreases with increasing Ag content and annealing temperature. Optical parameters like extinction coefficientrefractive index, and
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