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 efforts embedded in this paper have been devoted to designing, preparing, and testing warm mix asphalt (WMA) mixtures and comparing their behavior against traditional hot mix asphalt mixtures. For WMA preparation, the Sasobit wax additive has been added to a 40/50 asphalt binder with a concentration of 3%. An experimental evaluation has been performed by conducting the Marshall together with volumetric properties, indirect tensile strength, and wheel tracking tests to acquire the tensile strength ratio (TSR), retained stability index (RSI), and rut depth. It was found that the gained benefit of reduction in mixing and compaction temperatures was reversely associated with a noticeable decline in Marshall properties and moisture s
... Show MoreAbstract: Aluminum alloys grade 6061-T6 are characterized by their excellent properties and processing characteristics which make them ideal for varieties of industrial applications under cyclic loading, aluminum alloys show less fatigue life than steel alloys of similar strength. In the current study, a nanosecond fiber laser of maximum pulse energy up to 9.9 mJ was used to apply laser shock peening process (LSP) on aluminum thin sheets to introduce residual stresses in order to enhance fatigue life under cyclic loading Box-Behnken design (BBD) based on the design of experiments (DOE) was employed in this study for experimental design data analysis, model building and optimization The effect of working parameters spot size (ω), scannin
... Show MoreThe study focused on the treatment of real oilfield produced water from the East Baghdad field affiliated to the Midland Oil Company (Iraq) using an oil skimming process followed by a coagulation/flocculation process for zero liquid discharge system applications. Belt type oil skimmer was utilized for evaluating the process efficiency with various operating conditions such as temperature (17-40 °C) and time (0.5-2.5 hr.). Polyaluminum chloride (PAC) coagulant and polyacrylamide (PAM) flocculant was used to investigate the performance of the coagulation/flocculation process with PAC dosage (5-90 ppm) and pH (5-10) as operating conditions. In the skimming process, the oil content, COD, turbidity, and TSS decreased with an increase in tempera
... Show MoreIn the present work, leaching process studiedusing organic acids (acetic acid and lactic acid) to extract phosphate from the Iraqi Akashat phosphate ore by separation of calcareous materials (mainly calcite). This approach characterized by energy conservation, environmental enhancement by recovery of calcite as calcium sulfate (gypsum), keeping the physical and chemical properties of apatite. Samples were analyzed using X-ray diffraction and FTIR spectrophotometer. From the obtained experimental data it was found that using the two organic acids yields closed purity values of the produced apatite at the optimum conditions, while at different acid concentrations, it was found that the efficiency of acetic acid is higher at the low acid co
... Show MoreIn the last few decades, growing interest has been shown in the development of new solar selective coatings based on transition metal nitride and/or oxinitride for solar absorbing applications. Solar thermal collectors are well thought out to be the most effective process of converting and harvesting solar radiation. In this investigation, Cu/TiON/CrO2 multilayered solar selective absorber coatings have been coated onto Al substrates using the dip-coating process followed by an annealing process at (400, 450, 500, 550, and 600 °C. The XRD analysis showed excellent crystalline quality for the prepared thin films along with enhanced surface features as proved by FESEM images, and the grains are in the range of (27–81) nm. The optical in
... Show MoreAny design subject to a set of forces contributing to the establishment of relations working to strengthen the internal elements of the design; any imbalance in these elements can make a fragmented and weak design, thus preventing it from achieving the goal or performance. Poor performance can be attributed to various factors: the extent and function of the elements and principles in the design, realization of the idea, especially in fashion design.
Moreover, there are many aspects of a design that go into achieving the realization of the designer’s idea. The design utilizes a lot of stimulants by drawing attention to its design, which is consistent with the need for psychological and material individuals. In this research, we will
The adsorption of copper ions onto produced activated carbon from banana peels (with particle size 250 µm) in a single component system with applying magnetic field has been studied using fixed bed adsorber. The fixed bed breakthrough curves for the copper ions were investigated. The adsorption capacity for Cu (II) was investigated. It was found that 1) the exposure distance (E.D) and strength of magnetic field (B), affected the degree of adsorption; and 2) experiments showed that removal of Cu ions and accumulative adsorption capacity of adsorbent increase as the exposure distance and strength of magnetic field increase.
The efficiency evaluation of the railway lines performance is done through a set of indicators and criteria, the most important are transport density, the productivity of enrollee, passenger vehicle production, the productivity of freight wagon, and the productivity of locomotives. This study includes an attempt to calculate the most important of these indicators which transport density index from productivity during the four indicators, using artificial neural network technology. Two neural networks software are used in this study, (Simulnet) and (Neuframe), the results of second program has been adopted. Training results and test to the neural network data used in the study, which are obtained from the international in
... Show More