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.
Although the number of implants has increased gradually and consistently over the years to around one million per year globally, there is still far more potential for advancement in the field of dental implantology which is typically growing quickly. This study investigates the effect of nanofiller reinforcement high-performance polymer matrix to enhance mechanical and physical characteristics. Calcium silicate (CS)/Polyetherketoneketone (PEKK) biomedical composite (G0 as a control group) is reinforced with different weight percentages (G1-G4) of tellurium dioxide nanoparticles (TeO2NPs) ( n = 5). This research uses ethanol as a binder for mixing various weight percentages (wt%) of TeO2NPs w
... Show MoreThe sol-gel preparation technique of transparent silica monoliths containing up to 0.5 M of samarium have been described. The sol-gel processing parameters are: acid catalyzed hydrolysis and controlled drying. The prepared monoliths are analyzed by X-ray diffraction, pycnometer measurements, Fourier transformation infrared spectroscopy and optical spectroscopy. The oscillator strengths of the Sm3+ ions in the silica monoliths are calculated. The results show a linear concentration dependence of some Sm3+ transitions in UV/Vis absorption spectra and formation of Sm3+ clusters inside the pores structure of silica monoliths at high Sm3+ concentration
The picture has taken a place that sometimes enables it to take precedence over media analysis، psychology، and political communication.
The image has the ability to influence to obtain persuasion، not only emotionally or
dramatically، but also on the level of commercial and political persuasion. In every
image، the intention of that persuasion is hidden.
It can be identified by a set of underlying dimensions such as vitality، social dominance، and confidence، for which a group of specific suggestions or movements، such
as a smile، the movement of hands، or the nature and way of looking with the eyes، is
established. The visual image often precedes its verbal counterpart in the proce
The fouling depositions of crude oil stream were studied theoretically in a shell and tube heat exchanger to investigate the effect of depositions on the heat transfer process. The employed heat exchanger was with steam flowing in the inner tubes and crude oil in the shell at different velocities and bulk temperatures. It is assumed that fouling occurs only on the heated stream side (crude oil). The analysis was carried out for turbulent flow heat transfer conditions with wide range of Reynolds number, bulk temperature and time. Many previously proposed models for fouling resistance were employed to estimate a new model for fouling rate. It is found that the fouling rate and consequently the heat transfer coefficient were affected by Rey
... Show MoreGestational Diabetes Mellitus (GDM) is the most common metabolic disorder that found during gestation and is define as hyperglycemia of variable severity with onset or first recognition during gestation that does not clearly characterize any form of the preexisting diabetes (American Diabetes Association [1]). It affects approximately 16.5% of pregnancies worldwide (Plows, et al.[2]). The placenta is an organ that connects the mother and her fetus during pregnancy (Gul, et al.[3]). In the placenta, glucose can be transformed into glycogen for storage by either glycogen synthase or using glycogenin as a prime. However, the function of glycogen deposition stays a matter of debate, it may be the source of fuel for placenta itself or the storag
... Show MoreCompetencies topic in general , and Administrative competencies in specific, are considered as important subject in the contemporary administrative literature in all countries as well as in public and privet Organizations. For this reason, we have need to study those competencies in many Iraqi Organizations.
Two Organizations wer chosen for this research one of them is the Institution of taxation, and the other is the General company of Electric the data and information related to the research have been collected by desined questioner which has been given to a sample of (50) persions divided eqully between the two maintioned organizations.
The results of the study had differences
... Show MoreBackground: Cross contamination of dental appliances in the dental clinics and laboratories may potentially be a health hazard to the dental team and the patient. This study aimed to evaluate bacterial contamination of acrylic complete denture as received from dental laboratory before delivery to the patient, and then to evaluate the effectiveness of disinfection with 2% chlorhexidine and Kin denture cleaner tablet. Materials and methods: 45 newly made upper complete dentures undergone biaacterial examination for contamination before delivered to the patient. Samples were examined in two stages, first after finishing and polishing; when collected from the laboratory and before inserting to the patient mouth, second; after the samples were
... Show MoreLogic is one of the sciences that have receded and regressed in the field of Islamic sciences. This regression is the result of several factors, the most important of which are:
1- The Aristotelian logic, concerned with the seemingly essential shape and the underlying truth in the text, which has been translated into Arabic, is no longer able to keep pace with scientific revelations and epistemological spaces of our time.
2- The existence of logic in the curricula of Islamic studies was not subject to a study linking logic and Islamic sciences. Therefore, we find that the student studies logic as if it were a strange subject that has nothing to do with the subjects of Islamic studies and even Islamic philosophy.
3- Logic is