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.
Tax state institution regards as one of the largest state institutions implementing the tax rules issuing be legislative body and achieving the goals of tax (financial, economic, social and political). So, the tax management should pay attention to the procedures enabling it to achieve those rules starting from the procedures of tax restrict and ending by tax allocation where the process of assessment the taxation must relaxing on modern methods. The problem of the study raising from that in spite of there is a low obliging the taxable person (registered or not) to submit a declaration about his income and the achieved profit to be the base of taxation˒ where the other ways are secondary ways helping in rejection of t
... Show MoreObjective: This study aims to examine how implementing Extensible Business Reporting Language (XBRL) enhances the efficiency and quality of environmental audits and sustainability reporting in eco-friendly universities. Aligned with Sustainable Development Goal 12 (Responsible Consumption and Production), the study emphasizes promoting transparency and precision in sustainability reporting to encourage responsible management of resources within academic institutions. Theoretical Framework: The importance of our study is evident in the importance of accurate and transparent reports in the development of environmental performance with theories of sustainable reporting and environmental auditing. One of the most important digital
... Show MoreBy- products of corn starch industry were used to prepare media for propagation the lactic acid bacteria as a natural auxotroph. The by- products used were the corn steep water (S) and gluten extract (G) after a proper treatment to get them ready for media preparation. The results showed that it was possible to replace the peptone and meat extract by gluten extract in MRS medium. The growth was approximately similar to that obtained in standard MRS media. Corn steep water (S) was used as well and the growth enhanced by including Tween – 80 at 1% level. The later media named MZ, which was superior for growing standard and local strains and starters. The MZ medium modified by adding acetate and glacial acetic acid similarly to
... Show MoreThis paper proposes an on-line adaptive digital Proportional Integral Derivative (PID) control algorithm based on Field Programmable Gate Array (FPGA) for Proton Exchange Membrane Fuel Cell (PEMFC) Model. This research aims to design and implement Neural Network like a digital PID using FPGA in order to generate the best value of the hydrogen partial pressure action (PH2) to control the stack terminal output voltage of the (PEMFC) model during a variable load current applied. The on-line Particle Swarm Optimization (PSO) algorithm is used for finding and tuning the optimal value of the digital PID-NN controller (kp, ki, and kd) parameters that improve the dynamic behavior of the closed-loop digital control fue
... Show MoreThe synthesized ligand [4-chloro-5-(N-(5,5-dimethyl-3-oxocyclohex-1-en-1-yl)sulfamoyl)-2-((furan-2-ylmethyl)amino)benzoic acid] (H2L1) was identified utilizing Fourier transform infrared spectroscopy (FT-IR), 1 H, 13 C – NMR, (C.H.N), Mass spectra, UVVis methods based on spectroscopy. To detect mixed ligand complexes, analytical and spectroscopic approaches such as micro-analysis, conductance, UV-Visible, magnetic susceptibility, and FT-IR spectra were utilized. Its mixed ligand complexes [M(L1)(Q)Cl2] [ where M= Co(II), Ni(II) , and Cd(II)] and complexes [Pd(L1)(Q)] and [Pt(L1)(Q)Cl2]; [H2L1] =β-enaminone ligand =L1 and Q= 8-Hydroxyquinoline = L2]. The results showed that the complexes were synthesised utilizing the molar ratio M: L1
... Show MoreIn this paper, we present multiple bit error correction coding scheme based on extended Hamming product code combined with type II HARQ using shared resources for on chip interconnect. The shared resources reduce the hardware complexity of the encoder and decoder compared to the existing three stages iterative decoding method for on chip interconnects. The proposed method of decoding achieves 20% and 28% reduction in area and power consumption respectively, with only small increase in decoder delay compared to the existing three stage iterative decoding scheme for multiple bit error correction. The proposed code also achieves excellent improvement in residual flit error rate and up to 58% of total power consumption compared to the other err
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