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.
Electronic properties including (bond length, energy gap, HOMO, LUMO and density of state) as well as spectroscopic properties such like infrared, Raman scattering, force constant, reduced mass and longitu- dinal optical mode as a function of frequency are based on size and concentration of the molecular and nanostructures of aluminum nitride ALN, boron nitride BN and AlxB7-XN7 as nanotubes has calculated using Ab –initio approximation method dependent on density functional theory and generalized gradient approximation. The geometrical structure are calculated by using Gauss view 05 as a complementary program. Shows the energy gap of ALN, BN and AlxB7-XN7 as a function of the total number of atoms , start from smallest molecule to reached
... Show MoreBackground: Hyperplastic polyps account for 30–93% of gastric polyps. Recently, there have been studies about the development of dysplasia in this type of polyp. Every cell in the body contains the p53 gene, which has anti-cancer properties. Objective: The sensitivity of immunohistochemical expression of p53 is evaluated among gastric hyperplastic polyps with and without dysplasia and gastric adenomatous polyps to know its usefulness as a diagnostic marker. Methods: A retrospective cross-sectional study was done on fifty formalin-fixed paraffin-embedded blocks of gastric polyps (44 hyperplastic polyps without dysplasia, 3 hyperplastic polyps with dysplasia, and 3 adenomas). Cases were collected from the archives of the pathology d
... Show MoreInvestigating the thermal and electrical gains and efficiencies influence the designed photovoltaic thermal hybrid collector (PVT) under different weather conditions. The designed system was manufactured by attaching a fabricated cooling system made of serpentine tubes to a single PV panel and connecting it to an automatic controlling system for measuring, monitoring, and simultaneously collecting the required data. A removable glass cover had been used to study the effects of glazed and unglazed PVT panel situations. The research was conducted in February (winter) and July (summer), and March for daily solar radiation effects on efficiencies. The results indicated that electrical and thermal gains increased by the incre
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The purpose of our study was to develop Dabigatran Etexilate loaded nanostructured lipid carriers (DE-NLCs) using Glyceryl monostearate and Oleic acid as lipid matrix, and to estimate the potential of the developed delivery system to improve oral absorption of low bioavailability drug, different Oleic acid ratios effect on particle size, zeta potential, entrapment efficiency and loading capacity were studied, the optimized DE-NLCs shows a particle size within the nanorange, the zeta potential (ZP) was 33.81±0.73mV with drug entrapment efficiency (EE%) of 92.42±2.31% and a loading capacity (DL%) of 7.69±0.17%. about 92% of drug was released in 24hr in a controlled manner, the ex-vivo intestinal p
... Show MoreThis study aims to investigate the degree of practicing the motivated classroom evaluation environment for learning and its relationship to different feedback patterns. To achieve the objectives of the study, the correlational descriptive research design was employed. A questionnaire was constructed consisting of two parts: the classroom evaluation environment (13) items, and feedback patterns (24) items on a five-point scale. The psychometric properties of the questionnaire were verified in terms of validity and reliability. The questionnaire was applied to a sample of (265) male and female teachers who work in the second cycle schools for grades (5-10) of basic education in all academic majors in the Governorate of Muscat in the Sultan
... Show MoreThe research aims to find out the effect of Cognitive Acceleration strategy and random excitement strategy in achievement of geography material and developing the reflective thinking for students of literary fifth class .
the researcher depended a partial control experimental design with the three groups(the competence groups of the pre & post tests), The sample is deliberately selected from first AL-Rusafah Directorate General of Education in Baghdad. AL.fardoos Interme
... Show MoreAn experiment was carried out in the vegetables field of Horticulture Department / College of Agriculture / Baghdad University , for the three seasons : spring and Autumn of 2005 , and spring of 2007 , to study the type of gene action in some traits of yield and its components in summer squash crosses (4 x 3 = cross 1 , 3 x 7 = cross 2 , 3 x 4 = cross 3 , 3 x 5 = cross 4 , 5 x 1 = cross 5 , 5 x 2 = cross 6). The study followed generation mean analysis method which included to each cross (P1 , P2 , F1 , F2 , Bc1P1 , Bc1P2) , and those populations obtained by hybridization during the first and second seasons. Experimental comparison was performed in the second (Two crosses only) and third seasons , (four crosses) by using RCBD with three repl
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