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.
The 3-parameter Weibull distribution is used as a model for failure since this distribution is proper when the failure rate somewhat high in starting operation and these rates will be decreased with increasing time .
In practical side a comparison was made between (Shrinkage and Maximum likelihood) Estimators for parameter and reliability function using simulation , we conclude that the Shrinkage estimators for parameters are better than maximum likelihood estimators but the maximum likelihood estimator for reliability function is the better using statistical measures (MAPE)and (MSE) and for different sample sizes.
Note:- ns : small sample ; nm=median sample
... Show Moreتم استخدام خرائط ضبط الجودة الإحصائية لتقييم جودة الخدمة التعليمية في جامعة الباحة، ويهدف هذا البحث إلى استخدام خرائط ضبط الجودة الإحصائية لقياس مستوى الجودة وفجوة الجودة بين توقعات الطلبة وإدراكاتهم لمستوى الخدمة الذي تقدمه جامعة الباحة. حيث تم اختيار عينة من 200 طالب وطالبة عشوائيا باستخدام العشوائية العنقودية من 4 كليات خلال الفترة 01 – 30/2015م، وجمعت البيانات من خلال استبيان جودة الخدمة الذي يقيس ت
... Show MoreThe purpose of this research is to design a list of the scientific and moral values that should be found in the content of the computer textbook for the second intermediate grade, as well as to analyze the content of the above- mentioned book by answering the following question:
What is the percentage of availability of scientific and moral values in the content of the computer textbook for Second Intermediate grade issued by the Iraqi Ministry of Education / the general directorate of the curriculum, for the academic year (2017-2018)?
In order to achieve the research objectives, the descriptive method (content analysis method) was adopted. The research community has been iden
... Show MoreThe aim of the research is to identify the imaginative thinking skills included in the content of the chemistry textbook for fifth-grade students in biological sciences at the preparatory stage, which is approved by the Ministry of Education, General Directorate of Curricula in the academic year 2020-2021. To achieve the objective of the study, the researcher depends on the previous studies in the field and content of imaginative thinking skills for preparing a list of skills that includes (3) essential skills and (11) sub-skills and (28) items related to all skills. The researcher adopted the analytical descriptive approach because of its appropriation of the goals of the research. Then the researcher analyzed the content of the book de
... Show Moren this paper, we formulate three mathematical models using spline functions, such as linear, quadratic and cubic functions to approximate the mathematical model for incoming water to some dams. We will implement this model on dams of both rivers; dams on the Tigris are Mosul and Amara while dams on the Euphrates are Hadetha and Al-Hindya.
One of the important units in Sharq Dijla Water Treatment Plant (WTP) first and second extensions are the alum solution preparation and dosing unit. The existing operation of this unit accomplished manually starting from unloading the powder alum in the preparation basin and ending by controlling the alum dosage addition through the dosing pumps to the flash mix chambers. Because of the modern trend of monitoring and control the automatic operation of WTPs due to the great benefits that could be gain from optimum equipment operation, reducing the operating costs and human errors. This study deals with how to transform the conventional operation to an automatic monitoring and controlling system depending on a Programmable
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The aim of the research is to identify the level of awareness and emotional experience among university students and to identify the effect of the educational program based on (Guttmann) model for developing awareness and emotional experience among university students by verifying the validity of the following zero hypotheses: 1) There are no statistically significant differences in the development of awareness and emotional experience among university students at the level of (0.05) between the mean scores of the experimental group in the pre and post-tests. 2) There are no statistically significant differences in the development of awareness and emotional experience among university students at the lev
... Show Moreان تصنيع رمال مطلية بأوكسيد الحديد من خلال ترسيب الجزيئات النانوية لذلك الاوكسيد على سطوح الرمال واستخدامها في الحاجز التفاعلي النفاذ لإزالة ايونات الكادميوم والنحاس من المياه الجوفية الملوثة الهدف الرئيسي للدراسة الحالية. تم توصيف بيانات الامتزاز نتيجة تفاعل المادة المازة مع المادة الممتزة قيد الدراسة بشكل جيد من خلال نموذج لانكمير والذي كان أفضل من نموذج فراندلش. لقد وجد ان اعلى قيم لقابلية الامتزاز با
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