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.
Low grade crude palm oil (LGCPO) presents as an attractive option as feedstock for biodiesel production due to its low cost and non-competition with food resources. Typically, LGCPO contains high contents of free fatty acids (FFA), rendering it impossible in direct trans-esterification processes due to the saponification reaction. Esterification is the typical pre-treatment process to reduce the FFA content and to produce fatty acid methyl ester (FAME). The pre-treatment of LGCPO using two different acid catalysts, such as titanium oxysulphate sulphuric acid complex hydrate (TiOSH) and 5-sulfosalicylic acid dihydrate (5-SOCAH) was investigated for the first time in this study. The optimum conditions for the homogenous catalyst (5-SOCAH) wer
... Show MoreThe current study aims to identify the level of adaptation of the curriculum for visually handicapped pupils from the point of view of their teachers as well as to identify the level of adaptation of the educational programs offered to visually handicapped pupils from the point of view of their teachers. In order to achieve the goals of the research, the researcher developed two tools to measure the adaptation of curricula and educational programs for pupils with visual handicapped from the point of view of teachers. The sample included (60) teachers from Al Noor Institute for Blinders in Baghdad, the two tools were applied to them, and then the Reliability and Validity coefficients were extracted. The results sh
... Show MoreThe objective of the current research is to identify the degree of awareness of the teachers of Arabic language with the requirements of sustainable development. The research sample consisted of (100) male and female teachers of the Arabic language. A 3-likert scale of (71) items grouped into practical and cognitive aspects, five trends for each aspect was designed by the researcher to explore the required data. The results showed that the level of awareness of teachers of the Arabic language was moderate of both the cognitive and practical aspects of sustainable education with means (1.69) and (1.48) respectively. The researcher presented a set of recommendations and suggestions.
The researcher is one of the workers in university sports student activities, as he noticed that there is a diversity in the use of leadership patterns among managers of student activities in Iraqi universities between one director and another, which leads to the impact of these leadership styles on performance, positive or negative, in the level of human relations and the achievement of results. The researcher adopted the descriptive method in the survey method with relational relationships. The research sample consisted of (184) sports coaches who represent (27) universities and governmental and private colleges. To achieve the research objectives, the researcher used the Statistical Package for Social Sciences (Spss). To extract.statisti
... Show MoreBackground: Radiologic evaluation of breast lesions is being achieved through several imaging modalities. Mammography has an established role in breast cancer screening and diagnosis. Still however, it shows some limitations particulary in dense breast.
Methods : Magnetic resonance imaging is an attractive tool for the diagnosis of breast tumors1 and the use of magnetic resonance imaging of the breast is rapidly increasing as this technique becomes more widely available.1 As an adjunct to mammography and ultrasound, MRI can be a valuable addition to the work-up of a breast abnormality. MRI has the advantages of providing a three-dimensional view of the breast, performing wit
... Show MoreProdigiosin is a ‘natural red pigment produced by Serratia marcescens which exhibits immunosuppressive and anticancer properties in addition to antimicrobial activities. This work presents an attempt to maximize the production of prodigiosin by two different strategies: one factor at time (OFAT) and statistical optimization. The result of OFAT revealed that sucrose and peptone were the best carbon and nitrogen sources for pigment production with concentration of prodigiosin of about 135 mg/ L. This value was increased to 331.6mg/ L with an optimized ratio of C/N (60:40) and reached 356.8 with pH 6 and 2% inoculum size at end of classical optimization. Statistical experimental design based on Response surface methodology was co
... Show MoreThe faujasite type Y zeolite catalyst was prepared from locally available kaolin. For prepared faujasite type NaY zeolite X-ray, FT-IR, BET pore volume and surface area, and silica/ alumina were determined. The Xray and FT-IR show the compatibility of prepared catalyst with the general structure of standard zeolite Y. BET test shows that the surface area and pore volume of prepared catalyst were 360 m2 /g and 0.39 cm3 /g respectively.
The prepared faujasite type NaY zeolite modified by exchanging sodium ion with ammonium ion using ammonium nitrate and then ammonium ion converted to hydrogen ion. The maximum sodium ion exchange with ammonium ion was 53.6%. The catalytic activity of prepared faujasite type NaY, NaNH4Y and NaHY zeolites
Car drivers hear many kinds of noise inside their vehicles' cabins, and the most annoying ones are the noise generated by tires, engines, and outside winds. Noise affects the comfort of the passengers inside the cabin, and it’s sad to say that modern cars are noisier in many kinds of noise signals due to using a lot of plastic materials in new budget cars. For expensive and luxury cars, the problem is solved by using better sound insulation materials, but for the budget ones, the approach used here is effective. It is called Active Noise Cancellation and can be done using analog or digital electronics. An operational amplifier and filters are used for the analog one, and in the digital one, signal processor chips are used. In engineeri
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