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 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.
Abstract
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 MoreThis paper presents the Taguchi approach for optimization of hardness for shape memory alloy (Cu-Al-Ni) . The influence of powder metallurgy parameters on hardness has been investigated. Taguchi technique and ANOVA were used for analysis. Nine experimental runs based on Taguchi’s L9 orthogonal array were performed (OA),for two parameters was study (Pressure and sintering temperature) for three different levels (300 ,500 and 700) MPa ,(700 ,800 and 900)oC respectively . Main effect, signal-to-noise (S/N) ratio was study, and analysis of variance (ANOVA) using to investigate the micro-hardness characteristics of the shape memory alloy .after application the result of study shown the hei
... Show MoreOne of the important differences between multiwavelets and scalar wavelets is that each channel in the filter bank has a vector-valued input and a vector-valued output. A scalar-valued input signal must somehow be converted into a suitable vector-valued signal. This conversion is called preprocessing. Preprocessing is a mapping process which is done by a prefilter. A postfilter just does the opposite.
The most obvious way to get two input rows from a given signal is to repeat the signal. Two rows go into the multifilter bank. This procedure is called “Repeated Row” which introduces oversampling of the data by a factor of 2.
For data compression, where one is trying to find compact transform representations for a
... Show MoreGrapes and grape seeds are important samples employed for environmental medical studies . The air of this work was to identify and concentration calculation of the elements in grapes fruit and thier seeds by using X-Ray fluoresces technique (XRF) . Samples were collected from Abo Ghraib of Baghdad city ,the grape seeds were obtained from those samples . Both samples were taken under experimental procedure to obtain the sample which were ready for analysis . The samples were then submitted to experimental conditions using a radiation source and then samples were applied for counting analysis shows the elements Na , Mg , Al , Si , P , S , Cl , K , Ca , and Sr as major components of the samples. Fe , Sr , I , Ba and V were
... Show MoreBased on the theoretical ideas of E. Cassirer, a methodology is developed and an analysis of the painting work by J. Saleem, a representative of modern Iraqi painting, is carried out. While comparing the artistic programme of J. Saleem and the views of E. Cassirer, the methodological potential of the theory of the symbol for the art criticism analysis of the regional painting is clarified. Comparative analysis with the inclusion of the works of B. Buffet, B. Turetsky, J. Miro helps to see the multiple meanings of the same cultural symbol in thematically similar works of different years, created in different socio-cultural circumstances. The article shows that for regions with a shorter history (France, Russia, Spain, etc.), which have lo
... 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 More