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
The current research aims to reveal the extent to which all scoring rubrics data for the electronic work file conform to the partial estimation model according to the number of assumed dimensions. The study sample consisted of (356) female students. The study concluded that the list with the one-dimensional assumption is more appropriate than the multi-dimensional assumption, The current research recommends preparing unified correction rules for the different methods of performance evaluation in the basic courses. It also suggests the importance of conducting studies aimed at examining the appropriateness of different evaluation methods for models of response theory to the
... Show MoreThe study included 200 samples were collected from children under two years included (50 samples from each of Cerebrospinal fluid, Blood, Stool and Urine) from, (Central Children Hospital and Children's Protections Educational Hospital) The Iraqi Ministry of Health, the Department of Health Baghdad .the period from the first of 2015 September to the first of December 2015, Were obtained isolates bacterial subjected to the cultural, microscopic and biochemical examination and diagnosed to the species by using vitek2 system .The results showed there were contamination in 6.5% of clinical samples. The diagnosed colonies which gave pink color on the MacConkey agar, golden yellow color on the Trypton Soy agar and green color on t
... Show MoreBiomass has been extensively investigated, because of its presence as clean energy source. Tars and particulates formation problems are still the major challenges in development especially in the implementation of gasification technologies into nowadays energy supply systems. Laser Induced Fluorescence spectroscopy (LIF) method is incorporated for determining aromatic and Polycyclic Aromatic Hydrocarbons (PAH) produced at high temperature gasification technology. The effect of tars deposition when the gases are cooled has been highly reduced by introducing a new concept of measurement cell. The samples of PAH components have been prepared with the standard constrictions of measured PAHs by using gas chromatograph (GC). OPO laser with tun
... Show MoreIn this investigation , borax (B) (additive I) and chlorinated paraffin (CP.) (additive II) ,were used as flame retardants for each of epoxy and unsaturated polyester resins in the weight ratios of 2,4,6, & 8% by preparing films of (130×130×3) mm dimensions. Also films of these resins with a mixture of [50%(B.)+50%(CP.)] (additive III) in the same weight ratios were prepared in order to study the synergistic effect of these additives on the flammability of the two resins . Three standard test methods were used to measure the flame retardation which are : 1-ASTM : D-2863 2-ASTM : D-635 3-ASTM : D-3014
... Show MorePhotonic crystal fiber interferometers (PCFIs) are widely used for sensing applications. This work presented solid core-PCFs based on Mach-Zehnder modal interferometer for sensing refractive index. The general structure of sensor was applied by splicing short lengths of PCF in both sides with conventional single mode fiber (SMF-28).To apply modal interferometer theory collapsing technique based on fusion splicing used to excite higher order modes (LP01 and LP11). A high sensitive optical spectrum analyzer (OSA) was used to monitor and record the transmitted wavelength. This work studied a Mach-Zahnder interferometer refractive index sensor based on splicing point tapered SMF-PCF-SMF. Relation between refractive index sensitivity and tape
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The optimum balance values for different coefficient of spherical aberration (third and fifth degree also focal shift) were studied, the optical system includes different apertures (circle, ellipse, square and triangle) using point spread function (PSF). By using (Marechal) method; the minimum value of mean square of variance in wave front was founded, so we can get the maximum of central intensity according to (Strehl) criterion.
A particle swarm optimization algorithm and neural network like self-tuning PID controller for CSTR system is presented. The scheme of the discrete-time PID control structure is based on neural network and tuned the parameters of the PID controller by using a particle swarm optimization PSO technique as a simple and fast training algorithm. The proposed method has advantage that it is not necessary to use a combined structure of identification and decision because it used PSO. Simulation results show the effectiveness of the proposed adaptive PID neural control algorithm in terms of minimum tracking error and smoothness control signal obtained for non-linear dynamical CSTR system.
Grass trimming operation is widely done in Malaysia for the purpose of maintaining highways. Large number of operators engaged in this work encounters high level of noise generated by back pack type grass trimmer used for this purpose. High level of noise exposure gives different kinds of ill effect on human operators. Exact nature of deteriorated work performance is not known. For predicting the work efficiency deterioration, fuzzy tool has been used in present research. It has been established that a fuzzy computing system will help in identification and analysis of fuzzy models fuzzy system offers a convenient way of representing the relationships between the inputs and outputs of a system in the form of IF-THEN rules. The paper presents
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