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 stress(Y) – strength(X) model reliability Bayesian estimation which defines life of a component with strength X and stress Y (the component fails if and only if at any time the applied stress is greater than its strength) has been studied, then the reliability; R=P(Y<X), can be considered as a measure of the component performance. In this paper, a Bayesian analysis has been considered for R when the two variables X and Y are independent Weibull random variables with common parameter α in order to study the effect of each of the two different scale parameters β and λ; respectively, using three different [weighted, quadratic and entropy] loss functions under two different prior functions [Gamma and extension of Jeffery
... Show MoreThe present study utilised date palm fibre (DPF) waste residues to adsorb Congo red (CR) dye from aqueous solutions. The features of the adsorbent, such as its surface shape, pore size, and chemical properties, were assessed with X-ray diffraction (XRD), BET, Fourier-transform infrared (FTIR), X-ray fluorescence (XRF), and field emission scanning electron microscope (FESEM). The current study employed the batch system to investigate the ideal pH to adsorb the CR dye and found that acidic pH decolourised the dye best. Extending the dye-DPF waste mixing period at 25°C reportedly removed more dye. Consequently, the influence of the starting dye and DPF waste quantity on dye removal was explored in this study. At 5 g/L dye concentration, 48% d
... Show MoreCar 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
... Show MoreBasketball is a popular game in many parts of the world and many developed countries are making continuous efforts to prepare and develop their emerging players on scientific and clear bases as the basis for reaching high levels The researchers used the descriptive approach in the method of correlative studies to suit the nature of the study The readymade software (IBM SPSS Statistics Version24) was used to perform statistical treatments The researchers concluded that there was a significant relationship between body size indicators (height and weight) with the fitness elements of the emerging basketball players The researchers recommended conducting a similar study to determine the type of relationship to the indicators of the physical str
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... Show MoreThe cost of pile foundations is part of the super structure cost, and it became necessary to reduce this cost by studying the pile types then decision-making in the selection of the optimal pile type in terms of cost and time of production and quality .So The main objective of this study is to solve the time–cost–quality trade-off (TCQT) problem by finding an optimal pile type with the target of "minimizing" cost and time while "maximizing" quality. There are many types In the world of piles but in this paper, the researcher proposed five pile types, one of them is not a traditional, and developed a model for the problem and then employed particle swarm optimization (PSO) algorithm, as one of evolutionary algorithms with t
... Show MoreThe importance of this study stems from the importance of preserving the environment and creating a clean sustainable environment from waste and emissions and all the operations of industrial companies in general and cement companies in particular by activating sustainability accounting standards. The research aims to identify and diagnose deviations in violation of sustainability standards by employing the non-renewable resources standard (NR0401) For the construction industries to create a sustainable audit environment, the deductive approach was followed in the theoretical side and the inductive and descriptive approach to the practical side. The most important results of the research were the possibility of applying sustainab
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