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 use of artificial intelligence (AI) technology is rapidly expanding in nursing and society. However, its use in healthcare comes with a number of challenges and concerns. The authors of this article use the sociotechnical model to consider the expanding use of AI in nursing and healthcare from a global perspective. Select references from the literature are used to support this important discussion for nurses and other healthcare professionals. Artificial intelligence is a major innovation that, if used properly, can reduce errors and improve efficiency and healthcare quality. It has also been shown to increase patient support, healthcare access and patient care. Here the authors address some of the limitations and challenges of
... Show MoreThis study deals with the concepts of Colonialism and Civilization in Aimé Cesaire’s A Tempest. The concern of this study is to discuss how postcolonial writers are continually re-writing the Western canonical works as a reaction to the European cultural hegemony. The Western representations of the black are products of specific moments and developments in history and culture. A Tempest reflects a certain historical moment in the decolonization process.
A Tempest is analysed to reveal the counter literary strategy used by Aimé Cesaire, and to disclose the reasons why re-writing and writing back are considered as vital and inescapable tasks. Shakespeare’s The Tempest, which deals with the
... Show MoreIn the current paradigms of information technology, cloud computing is the most essential kind of computer service. It satisfies the need for high-volume customers, flexible computing capabilities for a range of applications like as database archiving and business analytics, and the requirement for extra computer resources to provide a financial value for cloud providers. The purpose of this investigation is to assess the viability of doing data audits remotely inside a cloud computing setting. There includes discussion of the theory behind cloud computing and distributed storage systems, as well as the method of remote data auditing. In this research, it is mentioned to safeguard the data that is outsourced and stored in cloud serv
... Show MoreThe lack of active 2019 coronavirus disease (COVID-19) pandemic treatment creates a challenge for researchers and scientists to find the most appropriate treatment for this disease. Dexamethasone, according to the findings of the RECOVERY clinical trial, declared mid-June 2020 in print media was one of those therapies. Although the results from retrospective studies are not strongly supportive of corticosteroid routine use in COVID-19 despite the signals for some benefits, the dedicated RECOVERY trial found a significant reduction in death with dexamethasone only in severe cases on a ventilator or moderate cases on supplemental oxygen therapy nevertheless, no benefit observed in mild to moderate cases requiring no oxygen. More studi
... Show MoreThe main aim of this research is to introduce financing cost optimization and different financing alternatives. There are many studies about financing cost optimization. All previous studies considering the cost of financing have many shortcomings, some considered only one source of financing as a credit line without taking into account different financing alternatives. Having only one funding alternative powers, restricts contractors and leads to a very specific financing model. Although it is beneficial for the contractor to use a long-term loan to minimize interest charges and prevent a substantial withdrawal from his credit line, none of the existing financial-based planning models have considered long-term loans in
... Show MoreIn this study multi objective optimization is utilized to optimize a turning operation to reveal the appropriate level of process features. The goal of this work is to evaluate the optimal combination of cutting parameters like feed, spindle speed, inclination angle and workpiece material to have a best surface quality Taguchi technique L9 mixed orthogonal array, has been adopted to optimize the roughness of surface. Three rods of length around (200 mm) for the three metals are used for this work. Each rod is divided into three parts with 50 mm length. For brass the optimum parametric mix for minimum Ra is A1, B1 and C3, i.e., at tool inclination angle (5), feedrate of 0.01, spindle speed of 120
... Show MoreUndoubtedly, rutting in asphalt concrete pavement is considered a major dilemma in terms of pavement performance and safety faced by road users as well as the road authorities. Rutting is a bowl-shaped depression in the wheel paths that develop gradually with the increasing number of load applications. Heavy axle loadings besides the high pavement summer temperature enhance the problem of rutting. According to the AASHTO design equation for flexible pavements, a 1.1 in rut depth will reduce the present serviceability index of relatively new pavement, having no other distress, from 4.2 to 2.5. With this amount of drop in serviceability, the entire life of the pavement in effect has been lost. Therefore, it is crucial to look at the mechani
... Show MoreObjective: The aim of the research is to prepare skilled mental exercises according to spatial and temporal perceptions and the awareness of the strength of young pole-vaulters, and to recognize the impact of these exercises on improving the indicators of electrical activity of working muscles and some special physical abilities and accomplishing this effectiveness Research methodology: The researcher used the experimental curriculum (one experimental group), and included the sample of research on (5) two joint jumpers in the Iraqi club championship, all from the center of talent in athletics, the sample is trained on the same curriculum prepared by the coach himself but accompanied by a mental training approach that Prepared by the
... Show MoreThis research deals with the risks of non-compliance and its impact on the profitability of Islamic banks. Research variables were measured and analyzed as the risk of non-compliance as an independent variableand profitability as a dependent variable. The profitability was measured by three indicators ((rate of return on assets, rate of return on equity and rate of return on Total deposits)) The results of the research showed a significant relationship between the risk of non-compliance and the rate of return on assets and rate of return on total deposits, while there was no relationship between the risk of non-compliance and rate of return on ownership. The research recommended that the senior management of the Islamic Investment Bank s
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