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.
Proxy-based sliding mode control PSMC is an improved version of PID control that combines the features of PID and sliding mode control SMC with continuously dynamic behaviour. However, the stability of the control architecture maybe not well addressed. Consequently, this work is focused on modification of the original version of the proxy-based sliding mode control PSMC by adding an adaptive approximation compensator AAC term for vibration control of an Euler-Bernoulli beam. The role of the AAC term is to compensate for unmodelled dynamics and make the stability proof more easily. The stability of the proposed control algorithm is systematically proved using Lyapunov theory. Multi-modal equation of motion is derived using the Galerkin metho
... Show MoreBackground: Although various imaging modalities are available for evaluating suspicious breast lesions, ultrasound-based Shear-Wave Elastography (SWE) is an advanced, non-invasive technique complementary to grayscale sonography. This technique evaluates the elasticity of a specific tissue by applying sonic pressure to that tissue.
Objective: The aim is to assess the role of SWE in evaluating solid breast masses in correlation to histopathological study results.
Subjects and Methods: This prospective study was done in a tertiary care teaching hospital from September 2019 to August 2020. A study population of 50 women aged 18 years or above with an
... Show MoreIn this study used three methods such as Williamson-hall, size-strain Plot, and Halder-Wagner to analysis x-ray diffraction lines to determine the crystallite size and the lattice strain of the nickel oxide nanoparticles and then compare the results of these methods with two other methods. The results were calculated for each of these methods to the crystallite size are (0.42554) nm, (1.04462) nm, and (3.60880) nm, and lattice strain are (0.56603), (1.11978), and (0.64606) respectively were compared with the result of Scherrer method (0.29598) nm,(0.34245),and the Modified Scherrer (0.97497). The difference in calculated results Observed for each of these methods in this study.
A pseudo-slug flow is a type of intermittent flow characterized by short, frothy, chaotic slugs that have a structure velocity lower than the mixture velocity and are not fully formed. It is essential to accurately estimate the transition from conventional slug (SL) flow to pseudo-slug (PSL) flow, and from SL to churn (CH), by precisely predicting the pressure losses. Recent research has showed that PSL and CH flows comprise a significant portion of the conventional flow pattern maps. This is particularly true in wellbores and pipelines with highly deviated large-diameter gas-condensate wellbores and pipelines. Several theoretical and experimental works studied the behavior of PSL and CH flows; however, few models have been suggested to pre
... Show MoreBackground: Frovatriptan succinate (FVT) is an effective medication used to treat migraines; however, available oral formulations suffer from low permeability; accordingly, several formulations of FVT were prepared. Objective: Prepare, optimize, and evaluate FVT-BE formulation to develop enhanced intranasal binary nano-ethosome gel. Methods: Binary ethosomes were prepared using different concentrations of phospholipid PLH90, ethanol, propylene glycol, and cholesterol by thin film hydration and characterized by particle size, zeta potential, and entrapment efficiency. Furthermore, in-vitro, in-vivo, ex-vivo, pharmacokinetics, and histopathological studies were done. Results: Regarding FVT-loaded BE, formula (F9) demonstrated the best paramet
... Show MoreFire incidences are classed as catastrophic events, which mean that persons may experience mental distress and trauma. The development of a robotic vehicle specifically designed for fire extinguishing purposes has significant implications, as it not only addresses the issue of fire but also aims to safeguard human lives and minimize the extent of damage caused by indoor fire occurrences. The primary goal of the AFRC is to undergo a metamorphosis, allowing it to operate autonomously as a specialized support vehicle designed exclusively for the task of identifying and extinguishing fires. Researchers have undertaken the tasks of constructing an autonomous vehicle with robotic capabilities, devising a universal algorithm to be employed
... Show MoreObjective This study evaluated the effects of adding titanium oxide (TiO2) nanofillers on the tear strength, tensile strength, elongation percentage, and hardness of room-temperature-vulcanized (RTV) VST50F and high-temperature-vulcanized (HTV) Cosmesil M511 maxillofacial silicone elastomers. Methods Two types of maxillofacial elastomers, VST50F RTV and Cosmesil M511 HTV, were used. Nano-TiO2 powder was applied as a nanofiller. A total of 120 specimens were fabricated, 60 each of VST50F and Cosmesil M511. The specimens of each type of elastomer were divided into three equal groups on which tests were conducted for tear strength, tensile strength, and hardness i.e., 20 specimens were used for each test. Each group of 20 specimens was further
... Show MoreIn this work, a fiber-optic biomedical sensor was manufactured to detect hemoglobin percentages in the blood. SPR-based coreless optical fibers were developed and implemented using single and multiple optical fibers. It was also used to calculate refractive indices and concentrations of hemoglobin in blood samples. An optical fiber, with a thickness of 40 nanometers, was deposited on gold metal for the sensing area to increase the sensitivity of the sensor. The optical fiber used in this work has a diameter of 125μm, no core, and is made up of a pure silica glass rod and an acrylate coating. The length of the fiber was 4cm removed buffer and the splicing process was done. It is found in practice that when the sensitive refractive i
... Show More