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. In this paper, a high order extended state observer (HOESO) based a sliding mode control (SMC) is proposed for a flexible joint robot (FJR) system in the presence of time varying external disturbance. A composite controller is integrated the merits of both HOESO and SMC to enhance the tracking performance of FJR system under the time varying and fast lumped disturbance. First, the HOESO estimator is constructed based on only one measured state to precisely estimate unknown system states and lumped disturbance with its high order derivatives in the FJR system. Second, the SMC scheme is designed based on such accurate estimations to govern the nominal FJR system by well compensating the estimation errors in the states and the lumped
... Show MoreThe study is aimed at social support to the students of the College of Education for women (The research sample) and measuring the quality of life at students of the College of Education for women (The research sample) And to identify the relationship between social support and quality of life of students of the College Education for Women and research sample consisted of 200 students The adoption of the resolution as a tool for data collection and the most important results of the search results that the students of the College Education for Women have social support. In other words, parents and friends are supporting the students. The students have the quality of life any positive meaning to life and that when a person has a quality of
... Show MoreThis work deals with preparation of zeolite 5A from Dewekhala kaolin clay in Al-Anbar region for drying and desulphurization of liquefied petroleum gas. The preparation of zeolite 5A includes treating kaolin clay with dilute hydrochloric acid 1N, treating metakaolin with NaOH solution to prepare 4A zeolite, ion exchange, and formation. For preparation of zeolite 4A, metakaolin treated at different temperatures (40, 60, 80, 90, and 100 °C) with different concentrations of sodium hydroxide solution (1, 2, 3, and 4 N) for 2 hours. The zeolite samples give the best relative crystallinity of zeolite prepared at 80 °C with NaOH concentration 3N (199%), and at 90 and 100°C with NaOH concentration solution 2N (184% and 189%, respectively). Ze
... Show MoreThe problem in the design of a cam is the analyzing of the mechanisms and dynamic forces that effect on the family of parametric polynomials for describing the motion curve. In present method, two ways have been taken for optimization of the cam size, first the high dynamic loading (such that impact and elastic stress waves propagation) from marine machine tool which translate by the roller follower to the cam surface and varies with time causes large contact loads and second it must include the factors of kinematics features including the acceleration, velocity, boundary condition and the unsymmetrical curvature of the cam profile for the motion curve.
In the theoretical solution
... Show MoreIn the present work, leaching process studiedusing organic acids (acetic acid and lactic acid) to extract phosphate from the Iraqi Akashat phosphate ore by separation of calcareous materials (mainly calcite). This approach characterized by energy conservation, environmental enhancement by recovery of calcite as calcium sulfate (gypsum), keeping the physical and chemical properties of apatite. Samples were analyzed using X-ray diffraction and FTIR spectrophotometer. From the obtained experimental data it was found that using the two organic acids yields closed purity values of the produced apatite at the optimum conditions, while at different acid concentrations, it was found that the efficiency of acetic acid is higher at the low acid co
... Show MoreAny design subject to a set of forces contributing to the establishment of relations working to strengthen the internal elements of the design; any imbalance in these elements can make a fragmented and weak design, thus preventing it from achieving the goal or performance. Poor performance can be attributed to various factors: the extent and function of the elements and principles in the design, realization of the idea, especially in fashion design.
Moreover, there are many aspects of a design that go into achieving the realization of the designer’s idea. The design utilizes a lot of stimulants by drawing attention to its design, which is consistent with the need for psychological and material individuals. In this research, we will
Co+2, Ni+2, Cu+2 as well Zn+2 compounds mixed ligand from 8-hydroxyquinoline(8-HQ) also tributylphosphine (PBu3) have been attended at aquatic ethyl alcohol for (1:2:2) (M:8-HQ:PBu3). Produced complexes have been identified by utilizing atomic absorption flame, FT-IR as well UV-Vis spectrum manners also magnetic susceptibility as well as conductivity methods. At addendum antibacterial efficiency from the ligands as well complexes oboist three species about bacteria have been as well examined. Ligands and their complexes show good bacterial efficiencies. Of the gained datum the octahedral geometry was proposed into whole prepared complexes
Herein, the interfacial polymerization method has been used for the synthesis of PPy/NaVO3 composites with different compositions of NaVO3 (10 %, 20 %, 30 %, 40 % and 50 %) as an efficient electrode material for supercapacitors. The successful formation and composition of the as-prepared composites (PV1-PV5) were confirmed by FTIR, XRD, EDX, and SEM analysis. The electrochemical properties were investigated by cyclic voltammetry (CV), galvanometric charge–discharge measurement (GCD), and electrochemical impedance spectroscopy (EIS) in 0.5 M H2SO4 electrolyte. As compared to other, the PV4 composite exhibit excellent specific capacitance of 391 F g−1 at a current density of 0.75 A/g with good cycling stability of ∼59 % after 1000 cycle
... Show MoreE-learning applications according to the levels of enlightenment (STEM Literacy) for physics teachers in the secondary stage. The sample consists of (400) teachers, at a rate of (200) males (50%), and (200)females (50%), distributed over (6) directorates of education in Baghdad governorate on both sides of Rusafa and Karkh. To verify the research goals, the researcher built a scale of e-learning applications according to the levels of STEM Literacy, which consists of (50) items distributed over (5) levels. The face validity of the scale and its stability were verified by extracting the stability coefficient through the internal consistency method “Alf-Cronbach”. The following statistical means were used: Pearson correlation coefficient,
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