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, excess properties (eg excess molar volume (VE), excess viscosity (ȠE), excess Gibbs free energy of activation of viscos flow (ΔG* E) and molar refraction changes (ΔnD) of binary solvent mixtures of tetrahydrofurfuryl alcohol (THFA) with aromatic hydrocarbons (benzene, toluene and p-xylene) have been calculated. This was achieved by determining the physical properties including density ρ, viscosity Ƞ and refraction index nD of liquid mixtures at 298.15 K. Results of the excess parameters and deviation functions for the binary solvent mixtures at 298.15 K have been discussed by molecular interactions that occur in these mixtures. Generally, parameters showed negative values and have been found to fit well to Redlich-Kister
... Show MoreA simulation study is used to examine the robustness of some estimators on a multiple linear regression model with problems of multicollinearity and non-normal errors, the Ordinary least Squares (LS) ,Ridge Regression, Ridge Least Absolute Value (RLAV), Weighted Ridge (WRID), MM and a robust ridge regression estimator MM estimator, which denoted as RMM this is the modification of the Ridge regression by incorporating robust MM estimator . finialy, we show that RMM is the best among the other estimators
There has been a growing interest in the use of chaotic techniques for enabling secure communication in recent years. This need has been motivated by the emergence of a number of wireless services which require the channel to provide low bit error rates (BER) along with information security. The aim of such activity is to steal or distort the information being conveyed. Optical Wireless Systems (basically Free Space Optic Systems, FSO) are no exception to this trend. Thus, there is an urgent necessity to design techniques that can secure privileged information against unauthorized eavesdroppers while simultaneously protecting information against channel-induced perturbations and errors. Conventional cryptographic techniques are not designed
... Show MoreThe current research aims to identify the extent to which cognitive economics skills are included in the content of the chemistry textbook for the third intermediate grade, and the research sample was represented in the chemistry textbook for the third intermediate grade. A list of knowledge economy skills was prepared (6) main skills (basic skills, communication skills, thinking skills, work skills Group, information-gathering skill, behavioral skills (and (20) sub-skills) (reading, writing, operations, computer skills and employability, oral expression and written communication, dialogue, persuasion, influence and arousal, analysis, problem-solving, decision-making, suggestions and hypotheses and employing them. Controlling, directing
... Show MoreThe present study aimed to investigate the effects of alcohol and hot aqueous extracts for leaves of Adhatoda vasica on, first larval instars Musca domestica. They were exposed to the suggested concentrations of alcoholic extract which were (500, 1000, 1500, 2000) PPM while the suggested concentrations of the hot aqueous extracts (500, 1000, 1500, 2000, 2500)PPM. The alcoholic (Methanol) extract of leaves was much effective on to killing the first larval instars of the M. domestica than hot aqueous extract.
Objectives: To determine the impact of an educational program on nurses’ knowledge
and practices concerning neurogenic bladder rehabilitation for spinal cord injured persons
through a follow-up approach each two months post program implementation for six
months.
Methodology: "Follow-up" longitudinal design by using time series approach of data
analysis and the application of pre-post tests approach for the study and the control
groups. The study was carried out at Ibn Al-Kuff hospital for (SCI) in Baghdad governorate
from 5th of July 2010 to 15th of October 2011. To achieve the objectives of the study, a
non-probability (purposive) sample of (60) nurses (males and females) were working in SCI
units were selec
The current research discusses the topic of the formal data within the methodological framework through defining the research problem, limits and objectives and defining the most important terms mentioned in this research. The theoretical framework in the first section addressed (the concept of the Bauhaus school, the philosophy of the Bauhaus school and the logical bases of this school). The second section dealt with (the most important elements and structural bases of the Bauhaus school) which are considered the most important formal data of this school and their implications on the fabrics and costumes design. The research came up with the most important indicators resulting from the theoretical framework.
Chapter three defined the
The study included isolate and diagnose fungus Fusarium solani of the local soil and purified and development in the PDB medium and the filtrate extracted using a solvent (Ethyl acetate) to obtain the fungal secondary metabolites extract. This extract has shown bioactivity against both reference isolates (E.coli (ATCC25922) and S.aureus(NCTC6571)) and pathogenic isolates S.pyogenes, K. pneumonia and S.typhimurium using agar disk diffusion technique , The diameters of the inhibition zones of fungal secondary metabolites24.0 mm against E.coli and 31.5 mm against S.aureus,and 34.0 mm against K.pneumoniae and 18.0 mm against S.pyogenes and 33.5mm against S.typhimurium. The test revealed the minimum inhibitory concentration (MIC) of the fungal
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