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.
The behavior of AC conductivity (σac), loss tangent (tan δ), and relative permittivity (ε′) for composites of PVC-P/graphite electrode waste (GEW) was investigated, and a qualitative explanation was provided as a function of PVC-P weight fractions (0, 5, 10, 15, 20, and 25) wt. percent, temperature (30-90) °C, and frequency (100Hz-2MHz). The behaviors of the composites' ac. conductivity and impedance as a frequency function and temperature have been examined. The permittivity was shown to rise with increasing temperature (Tg). The relative permittivity increased as the GEW filler concentration increased and was highest in the low-frequency range; nevertheless decreased as the frequency increased.
The effectiveness of (200 m) of the events of extreme intensity and this is characterized by training in the anaerobic energy system prevailing in the result of this privacy as these are based on the physical abilities and functional indicators identified in this direction and hence the importance of research in the evaluation of training programs on the basis of physical abilities and some indicators of the functionality of the hostile 200 m . The study aimed to: 1. Evaluation of training programs according to physical abilities and some functional indicators of hostile men.The researchers used the descriptive analytical method to suit the nature of the research. The researchers selected them research sample by the deliberate method of the
... Show MoreThe financial analysis of the published financial statements is the means that enables businessmen, financial institutions, financial analysts and others to conduct their studies and conclusions to obtain information that helps them in the decision-making process, including decisions related to investment. National in making the decision on the investment activity, for the period from 2012 to 2018, through the information provided by the annual financial statements, by selecting a set of indicators provided by the financial statements, namely (liquidity ratio, activity percentage, profitability ratios) to measure the extent of this ability Indicators in determining their role in making an investment decision.
Conditional logistic regression is often used to study the relationship between event outcomes and specific prognostic factors in order to application of logistic regression and utilizing its predictive capabilities into environmental studies. This research seeks to demonstrate a novel approach of implementing conditional logistic regression in environmental research through inference methods predicated on longitudinal data. Thus, statistical analysis of longitudinal data requires methods that can properly take into account the interdependence within-subjects for the response measurements. If this correlation ignored then inferences such as statistical tests and confidence intervals can be invalid largely.
G-system composed of three isolates G3 ( Bacillus),G12 ( Arthrobacter )and G27 ( Brevibacterium) was used to detect the mutagenicity of the anticancer drug, cyclophosphamide (CP) under conditions similar to that used for standard mutagen, Nitrosoguanidine (NTG). The CP effected the survival fraction of isolates after treatment for 15 mins using gradual increasing concentrations, but at less extent comparing to NTG. The mutagenic effect of CP was at higher level than that of NTG when using streptomycin as a genetic marker, but the situation was reversed when using rifampicin resistant as a report marker. The latter effect appeared upon recording the mutagen efficiency (ie., number of induced mutants/microgram of mutagen). Measuring the R
... Show MoreRecent research looking for acknowledgment of strategically influence of Robinson and self question at progressing the reading comprehension for students of sixth class .
To achieve research goal so the researcher mentally chose primary sixth class at the school (Tashti the primary) that followed education directorate of province (Jamjamal)/Suliymania for the scholastic year 2012-2013 as application field for their experiment of boys' number reached to (95) (female and male)students in reality (32) of the first experimental group and (31) student (female and male) from controlled group, the researcher rewarded between of three variable groups (timing period, intelligence ,Kurdish language degr
... Show MoreThe kindergarten teacher play a role in fixing the children behavior so she must plant the value and the habits that make a positive behavior and accepted by the society so the teacher must know all the right educational psychological styles to fix the children behavior and make them accepted psychologically and socially so the problem of the research start from knowing the relation between the methods of dealing with the kindergarten’s teachers and the non right behavior appearance for the kindergarten children. The current research aims to measure the negative behavior appearance of the children of kindergarten and distinguish it according to (sex and levels) and to distinguish the most using styles by the teachers of kinderg
... Show MoreEnvironmental pollution is experiencing an alarming surge within the global ecosystem, warranting urgent attention. Among the significant challenges that demand immediate resolution, effective treatment of industrial pollutants stands out prominently, which for decades has been the focus of most researchers for sustainable industrial development aiming to remove those pollutants and recover some of them. The liquid membrane (LM) method, specifically electromembrane extraction (EME), offers promise. EME deploys an electric field, reducing extraction time and energy use while staying eco-friendly. However, there's a crucial knowledge gap. Despite strides in understanding and applying EME, optimizing it for diverse industrial pollutant
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