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.
Any 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,
... Show MoreA field experiment was carried out during the seasons 2016 and 2017 in the farm of the Department of Field Crops Science, College of Agricultural Engineering Sciences-University of Baghdad to evaluate the effect of(Aminopyralid + Flurasulam, Coldinafop-propargyl and Flucarbazone-sodium) herbicides and seeding rate (100, 125 and 150) Kg.ha-1 and the interaction between them in growth characteristics, grain and yield components in wheat (Var. IPA99). The results showed that herbicides used were significantly efficient in studied characteristics compared to weedy treatment. Herbicide Flucarbazone-sodium gave higher weed control after 60 and 90 days of spraying the he
Incremental Sheet Metal Forming (ISMF) is a modern sheet metal forming technology which offers the possibility of manufacturing 3D complex parts of thin sheet metals using the CNC milling machine. The surface quality is a very important aspect in any manufacturing process. Therefore, this study focuses on the resultant residual stresses by forming parameters, namely; (tool shape, step over, feed rate, and slope angle) using Taguchi method for the products formed by single point incremental forming process (SPIF). For evaluating the surface quality, practical experiments to produce pyramid like shape have been implemented on aluminum sheets (AA1050) for thickness (0.9) mm. Three types of tool shape used in this work, the spherical tool ga
... Show MoreDenture bases are fabricated routinely using Poly(methyl methacrylate) (PMMA) acrylic resin. Yet, it is commonly known for its major drawbacks such as insufficient strength and ductility. The purpose of this study was to improve the performance of PMMA acrylic resin as a denture base material by reinforcement with surface treated lithium disilicate glass ceramic powder. The ceramic powder was prepared by grinding and sieving IPS e.max CAD MT blocks. Then, the powder was surface treated with an organosilane coupling agent (TMSPM) and added to PMMA in amount of 1%, 3%, 5% and 7% by weight. Characterizations of the powder was done by particle size analysis, XRD and FTIR. Transverse strength, Impact strength, Shore D hardness and surface roughn
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