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 evolution of the Internet of things (IoT) led to connect billions of heterogeneous physical devices together to improve the quality of human life by collecting data from their environment. However, there is a need to store huge data in big storage and high computational capabilities. Cloud computing can be used to store big data. The data of IoT devices is transferred using two types of protocols: Message Queuing Telemetry Transport (MQTT) and Hypertext Transfer Protocol (HTTP). This paper aims to make a high performance and more reliable system through efficient use of resources. Thus, load balancing in cloud computing is used to dynamically distribute the workload across nodes to avoid overloading any individual r
... Show MoreIn this research, analytical study for simulating a Fabry-Perot bistable etalon (F-P cavity) filled with a dispersive optimized nonlinear optical material (Kerr type) such as semiconductors Indium Antimonide (InSb). An optimization procedure using reflective (~85%) InSb etalon (~50µm) thick is described. For this etalon with a (50 µm) spot diameter beam, the minimum switching power is (~0.078 mW) and switching time is (~150 ns), leading to a switching energy of (~11.77 pJ) for this device. Also, the main role played by the temperature to change the etalon characteristic from nonlinear to linear dynamics.
This 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.
Utilizing the modern technologies in agriculture such as subsurface water retention techniques were developed to improve water storage capacities in the root zone depth. Moreover, this technique was maximizing the reduction in irrigation losses and increasing the water use efficiency. In this paper, a polyethylene membrane was installed within the root zone of okra crop through the spring growing season 2017 inside the greenhouse to improve water use efficiency and water productivity of okra crop. The research work was conducted in the field located in the north of Babylon Governorate in Sadat Al Hindiya Township seventy-eight kilometers from Baghdad city. Three treatments plots were used for the comparison using surface
... Show MoreAbstract The study aims to clarify the value of auditing economic units and how it can be measured, which is one of the most important challenges to matching the Value Relevance of Accounting Information. The problem of the study was identified with questions that revolve around the extent to which it is possible to measure the value of auditing in Iraqi economic units and the extent to which the value of auditing affects the adequacy of accounting information. Through reviewing the studies discussing this topic, it was found that auditing can provide value through the performance of the auditor and adding value to the economic unit subject to audit. The study recommended the need to study the situational factors of auditing, whether exter
... 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.
Electrodeposition 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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