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.
Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber.
Objective: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. in Eye Specialty Private Hospital, Baghdad, Iraq.
Type of the Study: a prospective non randomize intervention study.
Methods: 60 eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design).Mean spherical refraction was ₋11.32 diopter
... Show MoreThe investigation of determining solutions for the Diophantine equation over the Gaussian integer ring for the specific case of is discussed. The discussion includes various preliminary results later used to build the resolvent theory of the Diophantine equation studied. Our findings show the existence of infinitely many solutions. Since the analytical method used here is based on simple algebraic properties, it can be easily generalized to study the behavior and the conditions for the existence of solutions to other Diophantine equations, allowing a deeper understanding, even when no general solution is known.
In this paper, the Monte-Carlo simulation method was used to compare the robust circular S estimator with the circular Least squares method in the case of no outlier data and in the case of the presence of an outlier in the data through two trends, the first is contaminant with high inflection points that represents contaminant in the circular independent variable, and the second the contaminant in the vertical variable that represents the circular dependent variable using three comparison criteria, the median standard error (Median SE), the median of the mean squares of error (Median MSE), and the median of the mean cosines of the circular residuals (Median A(k)). It was concluded that the method of least squares is better than the
... Show MoreThis paper aims to find new analytical closed-forms to the solutions of the nonhomogeneous functional differential equations of the nth order with finite and constants delays and various initial delay conditions in terms of elementary functions using Laplace transform method. As well as, the definition of dynamical systems for ordinary differential equations is used to introduce the definition of dynamical systems for delay differential equations which contain multiple delays with a discussion of their dynamical properties: The exponential stability and strong stability
The current research aims to know the effect of teaching using multiple intelligences theory on academic achievement for students of primary school. The sample search of pupils . The research sample was divided into two groups where the first group represented the experimental group which studied the use of multiple intelligences and the second group represented the control group which studied the use of the traditional way . The search tool consisted of achievement test. Showed search results, there are statistically significant differences(0.05) between the average scores of students who have studied according to multiple intelligences between the average scores of students who have studied in accordance with the tradition way in the p
... Show MoreThe primary objective of the current paper is to suggest and implement effective computational methods (DECMs) to calculate analytic and approximate solutions to the nonlocal one-dimensional parabolic equation which is utilized to model specific real-world applications. The powerful and elegant methods that are used orthogonal basis functions to describe the solution as a double power series have been developed, namely the Bernstein, Legendre, Chebyshev, Hermite, and Bernoulli polynomials. Hence, a specified partial differential equation is reduced to a system of linear algebraic equations that can be solved by using Mathematica®12. The techniques of effective computational methods (DECMs) have been applied to solve some s
... Show MoreIn the present work we prepared heterojunction not homogenous CdS/:In/Cu2S) by spray and displacement methods on glass substrate , CdS:In films prepared by different impurities constration. Cu2S prepared by chemical displacement method to improve the junction properties , structural and optical properties of the deposited films was achieved . The study shows that the film polycrystalline by XRD result for all film and the energy gap was direct to 2.38 eV with no effect on this value by impurities at this constration .
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