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 work, silicon nitride (Si3N4) thin films were deposited on metallic substrates (aluminium and titanium sheets) by the DC reactive sputtering technique using two different silicon targets (n-type and p-type Si wafers) as well as two Ar:N2 gas mixing ratios (50:50 and 70:30). The electrical conductivity of the metallic (aluminium and titanium) substrates was measured before and after the deposition of silicon nitride thin films on both surfaces of the substrates. The results obtained from this work showed that the deposited films, in general, reduced the electrical conductivity of the substrates, and the thin films prepared from n-type silicon targets using a 50:50 mixing ratio and deposited on both
... Show MoreThe removal of commercial orange G dye from its aqueous solution by adsorption on tobacco leaves (TL) was studied in respect to different factor that affected the adsorption process. These factors including the tobacco leaves does, period of orange G adsorption, pH, and initial orange G dye concentration .Different types of isotherm models were used to describe the orange G dye adsorption onto the tobacco leaves. The experimental results were compared using Langmuir, and frundlich adsorption isotherm, the constants for these two isotherm models was determined. The results fitted frundlich model with value of correlation coefficient equal to (0.981). The capacity of adsorption for the orange G dye was carried out using various kinetic models
... Show MoreThe role of teacher of kindergarten plays an important role in the educational institution for kindergarten role in the educational institution for kindergarten and the failure of its role in the development of the mental processes of children kindergarten means failing in this institution .and hence the importance and effectiveness of the role of the student applied section kindergarten application period it is there fore necessary to be aware of the importance of learning. in preschool and good professional setting and enjoy a significant level of psychological and social systems and mental qualities and study is the urgent need to find generations hare systematic thinker's mind so stay away from memorization and trad
... Show MoreThe economical and highly performed anode material is the critical factor affecting the efficiency of electro-oxidation toward organics. The present study aimed to detect the best conditions to prepare Mn-Co oxide composite anode for the electro-oxidation of phenol. Deposition of Mn-Co oxide onto graphite substrate was investigated at 25, 30, and 35 mA/cm2 to detect the best conditions for deposition. The structure and the crystal size of the Mn-Co oxide composite electrode were examined by using an X-Ray diffractometer (XRD), the morphological properties of the prepared electrode were studied by scanning electron microscopy (SEM) and Atomic force microscopy (AFM) techniques, and the chemical composition of the various
... Show MoreLet G be a graph with p vertices and q edges and be an injective function, where k is a positive integer. If the induced edge labeling defined by for each is a bijection, then the labeling f is called an odd Fibonacci edge irregular labeling of G. A graph which admits an odd Fibonacci edge irregular labeling is called an odd Fibonacci edge irregular graph. The odd Fibonacci edge irregularity strength ofes(G) is the minimum k for which G admits an odd Fibonacci edge irregular labeling. In this paper, the odd Fibonacci edge irregularity strength for some subdivision graphs and graphs obtained from vertex identification is determined.
In the present work, the focusing was on the study of the x-ray diffraction, dielectric constant, loses dielectric coefficient, tangent angle, alter- natively conductivity and morphology of PET/BaTio3. The PET/BaTio3 composite was prepared for polyethylene terephthalate PET polymer composite containing 0, 10, 20, 30, 40, 50, and 60 wt. % from Barium titanate BaTi03 powder. The composite of two materials leads to form mixing solution and hot-pressing method. The effect of BaTio3 on the structure and dielectric properties with morphology was studied on PET matrix polymer using XRD, LCR meter and SEM.
The present work aims to study the removal of dyes from wastewater by reverse osmosis process. Two dyes were used direct blue 6, and direct yellow. Experiments were performed with feed concentration (75 – 450 ppm), operation temperature (30 – 50 oC) and time (0.2 – 2.0 hr). The membrane used is thin film composite membrane (TFC). It was found that modal permeate concentration decreases with increasing feed concentration and time operating, while permeate concentration increases with increasing feed temperature. Also it was found that product rate increase with increasing temperature, but it decrease with increasing feed concentration and time. The concentration of reject solution showed an increase with increasing feed concentratio
... Show MoreWellbore instability is one of the most common issues encountered during drilling operations. This problem becomes enormous when drilling deep wells that are passing through many different formations. The purpose of this study is to evaluate wellbore failure criteria by constructing a one-dimensional mechanical earth model (1D-MEM) that will help to predict a safe mud-weight window for deep wells. An integrated log measurement has been used to compute MEM components for nine formations along the studied well. Repeated formation pressure and laboratory core testing are used to validate the calculated results. The prediction of mud weight along the nine studied formations shows that for Ahmadi, Nahr Umr, Shuaiba, and Zubair formations
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