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.
Acrylic polymer/cement nanocomposites in dark and light colors have been developed for coating floors and swimming pools. This work aims to emphasize the effect of cement filling on the mechanical parameters, thermal stability, and wettability of acrylic polymer. The preparation was carried out using the casting method from acrylic polymer coating solution, which was added to cement nanoparticles (65 nm) with weight concentrations of (0, 1, 2, 4, and 8 wt%) to achieve high-quality specifications and good adhesion. Maximum impact strength and Hardness shore A were observed at cement ratios of 2 wt% and 4 wt%, respectively. Changing the filling ratio has a significant effect on the strain of the nanocomposites. The contact angle was i
... Show MoreNanoparticles (NPs) based techniques have shown great promises in all fields of science and industry. Nanofluid-flooding, as a replacement for water-flooding, has been suggested as an applicable application for enhanced oil recovery (EOR). The subsequent presence of these NPs and its potential aggregations in the porous media; however, can dramatically intensify the complexity of subsequent CO2 storage projects in the depleted hydrocarbon reservoir. Typically, CO2 from major emitters is injected into the low-productivity oil reservoir for storage and incremental oil recovery, as the last EOR stage. In this work, An extensive serious of experiments have been conducted using a high-pressure temperature vessel to apply a wide range of CO2-pres
... Show MoreThe problem of Bi-level programming is to reduce or maximize the function of the target by having another target function within the constraints. This problem has received a great deal of attention in the programming community due to the proliferation of applications and the use of evolutionary algorithms in addressing this kind of problem. Two non-linear bi-level programming methods are used in this paper. The goal is to achieve the optimal solution through the simulation method using the Monte Carlo method using different small and large sample sizes. The research reached the Branch Bound algorithm was preferred in solving the problem of non-linear two-level programming this is because the results were better.
In this work, microbubble dispersed air flotation technique was applied for cadmium ions removal from wastewater aqueous solution. Experiments parameters such as pH (3, 4, 5, and 6), initial Cd(II) ions concentration (40, 80, and 120 mg/l) contact time( 2, 5, 10 , 15, and 20min), and surfactant (10, 20and 40mg/l) were studied in order to optimize the best conditions .The experimental results indicate that microbubbles were quite effective in removing cadmium ions and the anionic surfactant SDS was found to be more efficient than cationic CTAB in flotation process. 92.3% maximum removal efficiency achieved through 15min at pH 5, SDS surfactant concentration 20mg/l, flow rate250 cm3/min and at 40mg/l Cd(II) ions initial co
... Show MoreThe progress of science in all its branches and levels made great civilized changes of
our societies in the present day, it's a result of the huge amount of knowledge, the increase of
number of students, and the increase of community awareness proportion of the importance of
education in schools and universities, it became necessary for us as educators to look at
science from another point of view based on the idea of scientific development of curricula
and teaching methods and means of education, and for the studying class environment as a
whole, by computer and internet use in education to the emergence of the term education
technology, which relies on the use of modern technology to provide educational content to<
The current research aims to analyze the mathematics book for the first intermediate grade according to the dimensions of mathematical power by answering the following question: What is the percentage of the availability of the dimensions of mathematical power included in the content of the mathematics textbook for first-grade students, average, in its first, and second parts for the academic year 2020-2021, approved by the Iraqi Ministry of Education / General Directorate of Curricula? The research community was determined by middle school mathematics books, and middle school students for middle ,and high school day schools affiliated to the Directorate of Education in Dhi Qar, and by the intentional test, the research sample was s
... Show MoreE-learning applications according to the levels of enlightenment (STEM Literacy) for physics teachers in the secondary stage. The sample consists of (400) teachers, at a rate of (200) males (50%), and (200)females (50%), distributed over (6) directorates of education in Baghdad governorate on both sides of Rusafa and Karkh. To verify the research goals, the researcher built a scale of e-learning applications according to the levels of STEM Literacy, which consists of (50) items distributed over (5) levels. The face validity of the scale and its stability were verified by extracting the stability coefficient through the internal consistency method “Alf-Cronbach”. The following statistical means were used: Pearson correlation coefficient,
... Show MoreThe paper presents the results of the research on the influence of the adjuvant concentration on the size of the drops produced by the spray nozzles of agricultural sprayers. For the tests, adjuvant Normaton with the composition of total nitrogen, amide nitrogen (N-NH2) and phosphorus pentoxide (P2O5) was used. The adjuvant was added to the water taken from the municipal water supply system of the city of Lublin. The tests were carried out for three concentrations, i.e. 75%, 100%, and 125% of the adjuvant concentration recommended by the manufacturer, and water without the adjuvant. The surface tension of water with adjuva