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 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 Neutron Fermi Age, t, and the neutron slowing down density, q (r, t) , have been measured for some materials such as Graphite and Iron by using gamma spectrometry system UCS-30 with NaI (Tl) detector. This technique was applied for Graphite and Iron materials by using Indium foils covered by Cadmium and the measurements done at the Indium resonance of 1.46 eV. These materials are exposed to a plane 241Am/Be neutron source with recent activity 38 mCi. The measurements of the Fermi Age were found to be t = 297 ± 21 cm2 for Graphite, t = 400 ± 28 cm2 for Iron. Neutron slowing down density was also calculated depending on the recent experimental t value and distance.
The current study investigated the stability and the extraction efficiency of emulsion liquid membrane (ELM) for Abamectin pesticide removal from aqueous solution. The stability was investigated in terms of droplet emulsion size distribution and emulsion breakage percent. The proposed ELM included a mixture of corn oil and kerosene (1:1) as a diluent, Span 80 (sorbitan monooleate) as a surfactant and hydrochloric acid (HCl) as a stripping agent without utilizing a carrier agent. Parameters such as homogenizer speed, surfactant concentration, emulsification time and internal to organic volume ratio (I/O) were evaluated. Results show that the lower droplet size of 0.9 µm and higher stable emulsion in terms of breakage percent of 1.12 % were
... Show MoreCharge transfer complex formation method has been applied for the spectrophotometric determination of erythromycin ethylsuccinate, in bulk sample and dosage form. The method was accurate, simple, rapid, inexpensive and sensitive depending on the formed charge- transfer complex between cited drug and, 2,3- Dichloro-5,6-dicyano-p- benzoquinone (DDQ) as a chromogenic reagent. The formed complex shows absorbance maxima at 587 nm against reagent blank. The calibration graph is linear in the ranges of (10 - 110) μg.mL-1 with detection limit of 0.351μg.mL-1. The results show the absence of interferences from the excipients on the determination of the drug. Therefore the proposed method has been successfully applied for the determination of eryth
... Show MoreEach phenomenon contains several variables. Studying these variables, we find mathematical formula to get the joint distribution and the copula that are a useful and good tool to find the amount of correlation, where the survival function was used to measure the relationship of age with the level of cretonne in the remaining blood of the person. The Spss program was also used to extract the influencing variables from a group of variables using factor analysis and then using the Clayton copula function that is used to find the shared binary distributions using multivariate distributions, where the bivariate distribution was calculated, and then the survival function value was calculated for a sample size (50) drawn from Yarmouk Ho
... Show MorePostcolonial reading for any text aroused a great controversy that deserves to be studied it give more dimensions with the awareness that it can be interpreted in numerous ways. Postcolonialism is a challenging field as it covers variety of political, psychological, cultural, and economical activities often called ‘postcolonial’. The concept of culture worked effectively in shaping and mapping postcolonial struggles, which have so profoundly reshaped our world. Man's sense of cultural displacement is the core of this project. Man's quest for cultural adaptation forms a kind of equilibrium and compromise to the vision of human liberation. It is very important to minimize disadvantages and to internalize the logic of Western colonization.
... Show MoreBackground: Very low birth weight (VLBW) neonates constitute approximately 4–7 percent of all live births and their mortality is very high.
Objective: to find out if there is a relationship between Very Low Birth Weight Neonates and increased neonatal mortality for age 0 to 7 days.
Methods: A retrospective study of VLBW neonates admitted to NICU at Ibn Al- Baladi Pediatrics and Maternity hospital over one year (2012)were studied, The study period was from April till August 2013. Exclusion criteria were: (1) neonates weighing less than 700 g and with gestational age less than 24 weeks (abortion) (2) death in the delivery room (3) neonates weighing more than 1500 g. (4) Postnatal age more than 7 days. The outcome measure was in-hos
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.
The 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 More