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.
Abstract
The current research aims to reveal the extent to which all scoring rubrics data for the electronic work file conform to the partial estimation model according to the number of assumed dimensions. The study sample consisted of (356) female students. The study concluded that the list with the one-dimensional assumption is more appropriate than the multi-dimensional assumption, The current research recommends preparing unified correction rules for the different methods of performance evaluation in the basic courses. It also suggests the importance of conducting studies aimed at examining the appropriateness of different evaluation methods for models of response theory to the
... Show MoreBacteria strain H8, which produces high amount of exopolysaccharide (EPS), was isolated from soil, and identified as strain of Azotobacter chrococcum by its biochemical /physiological characteristics, EPS was extracted, partially purified and used as bioflocculant. The biochemical analysis of the partially purified EPS revealed that it was an alginate. analysis of EPS by Fourier transform infrared spectrometry (FTIR) show that the -OH groups present in bioflocculant are clearly seen at 3433.06 cm-1, the peaks attributed to the -CH3 groups present at 2916.17 cm-1 , and some distinct peaks such as carboxyl group showed strong absorption bands at 1604.66 cm-1, 1411.80 cm-1 and 1303.79 cm-1 indicate the chemical structure of alginate. The effe
... Show MoreA novel fractal design scheme has been introduced in this paper to generate microstrip bandpass filter designs with miniaturized sizes for wireless applications. The presented fractal scheme is based on Minkowski-like prefractal geometry. The space-filling property and self-similarity of this fractal geometry has found to produce reduced size symmetrical structures corresponding to the successive iteration levels. The resulting filter designs are with sizes suitable for use in modern wireless communication systems. The performance of each of the generated bandpass filter structures up to the 2nd iteration has been analyzed using a method of moments (MoM) based software IE3D, which is widely adopted in microwave research and in
... Show MoreThe prevalence of using the applications for the internet of things (IoT) in many human life fields such as economy, social life, and healthcare made IoT devices targets for many cyber-attacks. Besides, the resource limitation of IoT devices such as tiny battery power, small storage capacity, and low calculation speed made its security a big challenge for the researchers. Therefore, in this study, a new technique is proposed called intrusion detection system based on spike neural network and decision tree (IDS-SNNDT). In this method, the DT is used to select the optimal samples that will be hired as input to the SNN, while SNN utilized the non-leaky integrate neurons fire (NLIF) model in order to reduce latency and minimize devices
... Show MoreThe cost of pile foundations is part of the super structure cost, and it became necessary to reduce this cost by studying the pile types then decision-making in the selection of the optimal pile type in terms of cost and time of production and quality .So The main objective of this study is to solve the time–cost–quality trade-off (TCQT) problem by finding an optimal pile type with the target of "minimizing" cost and time while "maximizing" quality. There are many types In the world of piles but in this paper, the researcher proposed five pile types, one of them is not a traditional, and developed a model for the problem and then employed particle swarm optimization (PSO) algorithm, as one of evolutionary algorithms with t
... Show MoreThe purpose of this research was to prepare, characterize, and evaluate the new antimicrobial peptide KSL peptide encapsulated in poly(D,L-lactide-co-glycolide) (PLGA)composite microspheres. KSL was loaded in poly(acryloyl hydroxyethyl) starch (acHES) micropar-ticles, and then the peptide-containing microparticles were encapsulated in the PLGA matrix by a solvent extraction /evaporation method.
KSL-loaded PLGA microspheres were also prepared without the starch hydrogel microparticle microspheres for comparison study. KSL peptide microspheres were characterized for drug content, surface morphology, microspheres size determination, polymers stability , in vitro microspheres degradation and in vitro release. KSL peptide
... Show MoreThe esterification of oleic acid with 2-ethylhexanol in presence of sulfuric acid as homogeneous catalyst was investigated in this work to produce 2-ethylhexyl oleate (biodiesel) by using semi batch reactive distillation. The effect of reaction temperature (100 to 130°C), 2-ethylhexanol:oleic acid molar ratio (1:1 to 1:3) and catalysts concentration (0.2 to 1wt%) were studied. Higher conversion of 97% was achieved with operating conditions of reaction temperature of 130°C, molar ratio of free fatty acid to alcohol of 1:2 and catalyst concentration of 1wt%. A simulation was adopted from basic principles of the reactive distillation using MATLAB to describe the process. Good agreement was achieved.
This paper deals with the preparation of new monomers and polymers which including heterocyclic unit. The diacid chlorides compounds [1-3] were prepared from the reaction of glutaric acid, adipic acid, terephthalic acid with thionyl chloride. Succinic acid reacted with ethanol to produce compound [4]. Compound [4] reacted with hydrazine hydrate to obtain succinic hydrazide [5].Compound [5] reaction with CS2 and KOH in absolute ethanol to produce compound [6].The polymers [7-12] have been created by reacting diacid chlorides compounds [1-3] with compound[5] or [6] in dry pyridine with some drops of DMF. The topology of produced compounds has characterized through their spectral and analytical data as in FT-IR spectra, Thermal analysis [DSC,
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