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.
Each organization struggles to exploit each possible opportunity for gaining success and continuing with its work carrier. In this field, organization success can be concluded by fulfilling end user requirements combined with optimizing available resources usage within a specified time and acceptable quality level to gain maximum profit. The project ranking process is governed by the multi-criteria environment, which is more difficult for the governmental organization because other organizations' main target is maximizing profit constrained with available resources. The governmental organization should consider human, social, economic and many more factors. This paper focused on building a multi-criteria optimizing proje
... Show MoreIn this study used three methods such as Williamson-hall, size-strain Plot, and Halder-Wagner to analysis x-ray diffraction lines to determine the crystallite size and the lattice strain of the nickel oxide nanoparticles and then compare the results of these methods with two other methods. The results were calculated for each of these methods to the crystallite size are (0.42554) nm, (1.04462) nm, and (3.60880) nm, and lattice strain are (0.56603), (1.11978), and (0.64606) respectively were compared with the result of Scherrer method (0.29598) nm,(0.34245),and the Modified Scherrer (0.97497). The difference in calculated results Observed for each of these methods in this study.
Sewer sediment deposition is an important aspect as it relates to several operational and environmental problems. It concerns municipalities as it affects the sewer system and contributes to sewer failure which has a catastrophic effect if happened in trunks or interceptors. Sewer rehabilitation is a costly process and complex in terms of choosing the method of rehabilitation and individual sewers to be rehabilitated. For such a complex process, inspection techniques assist in the decision-making process; though, it may add to the total expenditure of the project as it requires special tools and trained personnel. For developing countries, Inspection could prohibit the rehabilitation proceeds. In this study, the researchers propos
... Show MoreStorage of rainwater within the root depth zone is one of the modern ways to increase plant production. Subsurface water retention technology was applied to assess improving values of crop yield and crop water use efficiency, applying a membrane made of low-density polyethylene trough installed below the crop root zone. The goal of this paper is to assess that the retention of rainwater above the membrane can improve the crop yield and crop water use efficiency values for winter wheat. The experiment was conducted in open field, within Joeybeh Township, located in east of the Ramadi City, in Anbar Province, in winter growing season 2018-2019. Two plots T1 (with membrane trough) and T2 (without membrane) were used for the
... Show MoreNew microphotometer was constructed in our Laboratory Which deals with the determination of Molybdenum (VI) through its Catalysis effect on Hydrogen peroxide and potasum iodide Reaction in acid medium H2SO4 0.01 mM. Linearity of 97.3% for the range 5- 100 ppm. The repeatability of result was better than 0.8 % 0.5 ppm was obtanined as L.U. (The method applied for the determination of Molybdenum (VI) in medicinal Sample (centrum). The determination was compared well with the developed method the conventional method.
A novel demountable shear connector for precast steel-concrete composite bridges is presented. The connector uses high-strength steel bolts, which are fastened to the top flange of the steel beam with the aid of a special locking nut configuration that prevents bolts from slipping within their holes. Moreover, the connector promotes accelerated construction and overcomes the typical construction tolerance issues of precast structures. Most importantly, the connector allows bridge disassembly. Therefore, it can address different bridge deterioration scenarios with minimum disturbance to traffic flow including the following: (1) precast deck panels can be rapidly uplifted and replaced; (2) connectors can be rapidly removed and replaced; and (
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Abstract
The miraculous of al-Quran has been surrounded by the attention of scholars, as it is the one that has astonished the rhetoricians with its eloquence. So , they paid attention to every part of it and hugely they studied it with accuracy in respect to its Surah ad Ayahs. It is considered the most important source from which Arab scholars and early grammarians drew, given their unanimity that it is the highest degree of eloquence and the best record of the common literary language.
Among these sciences is the science of Grammar, and without Qur’an, this science would not have emerged, which later had control over every science of Arabic
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