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.
B aa cc kk gg r oo uu nn dd : Very low birth weight (VLBW) neonates constitute approximately 4–7 percent of all live births and their mortality is very high. O bb j ee cc t i vv ee: to find out if there is a relationship between Very Low Birth Weight Neonates and increased neonatal mortality for age 0 to 7 days. M ee t hh oo dd ss A retrospective study of VLBW neonates admitted to NICU at Ibn Al- Baladi Pediatrics and Maternity hospital over one year (2012)were studied, 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.
... Show MoreThe increase globally fossil fuel consumption as it represents the main source of energy around the world, and the sources of heavy oil more than light, different techniques were used to reduce the viscosity and increase mobility of heavy crude oil. this study focusing on the experimental tests and modeling with Back Feed Forward Artificial Neural Network (BFF-ANN) of the dilution technique to reduce a heavy oil viscosity that was collected from the south- Iraq oil fields using organic solvents, organic diluents with different weight percentage (5, 10 and 20 wt.% ) of (n-heptane, toluene, and a mixture of different ratio
... Show MoreThe complexity and partially defined nature of jet grouting make it hard to predict the performance of grouted piles. So the trials of cement injection at a location with similar soil properties as the erecting site are necessary to assess the performance of the grouted piles. Nevertheless, instead of executing trial-injected piles at the pilot site, which wastes money, time, and effort, the laboratory cement injection devices are essential alternatives for evaluating soil injection ability. This study assesses the performance of a low-pressure laboratory grouting device by improving loose sandy soil injected using binders formed of Silica Fume (SF) as a chemical admixture (10% of Ordinary Portland Cement OPC mass) to di
... Show MoreError control schemes became a necessity in network-on-chip (NoC) to improve reliability as the on-chip interconnect errors increase with the continuous shrinking of geometry. Accordingly, many researchers are trying to present multi-bit error correction coding schemes that perform a high error correction capability with the simplest design possible to minimize area and power consumption. A recent work, Multi-bit Error Correcting Coding with Reduced Link Bandwidth (MECCRLB), showed a huge reduction in area and power consumption compared to a well-known scheme, namely, Hamming product code (HPC) with Type-II HARQ. Moreover, the authors showed that the proposed scheme can correct 11 random errors which is considered a high
... Show MoreThe faujasite type Y zeolite catalyst was prepared from locally available kaolin. For prepared faujasite type NaY zeolite X-ray, FT-IR, BET pore volume and surface area, and silica/ alumina were determined. The Xray and FT-IR show the compatibility of prepared catalyst with the general structure of standard zeolite Y. BET test shows that the surface area and pore volume of prepared catalyst were 360 m2 /g and 0.39 cm3 /g respectively.
The prepared faujasite type NaY zeolite modified by exchanging sodium ion with ammonium ion using ammonium nitrate and then ammonium ion converted to hydrogen ion. The maximum sodium ion exchange with ammonium ion was 53.6%. The catalytic activity of prepared faujasite type NaY, NaNH4Y and NaHY zeolites
This paper is concerned with pre-test single and double stage shrunken estimators for the mean (?) of normal distribution when a prior estimate (?0) of the actule value (?) is available, using specifying shrinkage weight factors ?(?) as well as pre-test region (R). Expressions for the Bias [B(?)], mean squared error [MSE(?)], Efficiency [EFF(?)] and Expected sample size [E(n/?)] of proposed estimators are derived. Numerical results and conclusions are drawn about selection different constants included in these expressions. Comparisons between suggested estimators, with respect to classical estimators in the sense of Bias and Relative Efficiency, are given. Furthermore, comparisons with the earlier existing works are drawn.
