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.
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 MoreIn this paper, we present multiple bit error correction coding scheme based on extended Hamming product code combined with type II HARQ using shared resources for on chip interconnect. The shared resources reduce the hardware complexity of the encoder and decoder compared to the existing three stages iterative decoding method for on chip interconnects. The proposed method of decoding achieves 20% and 28% reduction in area and power consumption respectively, with only small increase in decoder delay compared to the existing three stage iterative decoding scheme for multiple bit error correction. The proposed code also achieves excellent improvement in residual flit error rate and up to 58% of total power consumption compared to the other err
... Show MoreTax state institution regards as one of the largest state institutions implementing the tax rules issuing be legislative body and achieving the goals of tax (financial, economic, social and political). So, the tax management should pay attention to the procedures enabling it to achieve those rules starting from the procedures of tax restrict and ending by tax allocation where the process of assessment the taxation must relaxing on modern methods. The problem of the study raising from that in spite of there is a low obliging the taxable person (registered or not) to submit a declaration about his income and the achieved profit to be the base of taxation˒ where the other ways are secondary ways helping in rejection of t
... Show MoreThe 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
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Anaerobic digestion process of organic materials is biochemical decomposition process done by two types of digestion bacteria in the absence of oxygen resulting in the biogas production, which is produced as a waste product of digestion. The first type of bacteria is known as acidogenic which converts organic waste to fatty acids. The second type of bacteria is called methane creators or methanogenic which transforms the fatty acids to biogas (CH4 and CO2). The considerable amounts of biodegradable constitutes such as carbohydrates, lipids and proteins present in the microalgae biomass make it a suitable substrate for the anaerobic digestion or even c
... Show MoreBimetallic Au –Pt catalysts supporting TiO2 were synthesised using two methods; sol immobilization and impregnation methods. The prepared catalyst underwent a thermal treatment process at 400◦ C, while the reduction reaction under the same condition was done and the obtained catalysts were identified with transmission electron microscopy (TEM) and energy-dispersive spectroscopy (EDS). It has been found that the prepared catalysts have a dimension around 2.5 nm and the particles have uniform orders leading to high dispersion of platinum molecules .The prepared catalysts have been examined as efficient photocatalysts to degrade the Crystal violet dye under UV-light. The optimum values of Bimetallic Au –
... Show MoreThese days, it is crucial to discern between different types of human behavior, and artificial intelligence techniques play a big part in that. The characteristics of the feedforward artificial neural network (FANN) algorithm and the genetic algorithm have been combined to create an important working mechanism that aids in this field. The proposed system can be used for essential tasks in life, such as analysis, automation, control, recognition, and other tasks. Crossover and mutation are the two primary mechanisms used by the genetic algorithm in the proposed system to replace the back propagation process in ANN. While the feedforward artificial neural network technique is focused on input processing, this should be based on the proce
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