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 steady state laminar mixed convection and radiation through inclined rectangular duct with an interior circular tube is investigated numerically for a thermally and hydrodynamicaly fully developed flow. The two heat transfer mechanisms of convection and radiation are treated independently and simultaneously. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function and the Body Fitted Coordinates (B.F.C) methods. The finite difference approach with the Line Successive Over-Relaxation (LSOR) method is used to obtain all the computational results. The (B.F.C) method is used to generate the grid of the problem. A computer program (Fortran
... Show MoreThis study was conducted to investigate activity and some kinetic
and thermodynamic parameters of adenosine deaminnse (ADA)in
serum in patient affected with P-thalassaemia and compared with that of healthy individuals .Serum AD levels were found to be significantly higher in patient with P-thalassaemia (98±9.15 IU/L) than in healthy individuals (22± 2.04 IUIL)the study was carried in optimum pH value 6.5 and 37c by which the enzyme possess highest activity .The study was concentrated to comprehensive determina
... Show MoreThis study aims to evaluate the performance of emergency departments according to international standards through studying the performance in some of Iraqi public hospitals, where the evaluation performance is considered one of the important topics that take a great deal of officials' attention, especially decision makers in health organizations.
The researcher has derived the research idea from the importance of work in emergency department in hospitals and to what it provides of medical services and quick and immediate nursing care that help in patients' lifesaving, and it is the mirror that reflects the real image for the hospital
... Show MoreIn this study, the flow and heat transfer characteristics of Al2O3-water nanofluids for a range of the Reynolds number of 3000, 4500, 6000 and 7500 with a range of volume concentration of 1%, 2%, 3% and 4% are studied numerically. The test rig consists of cold liquid loop, hot liquid loop and the test section which is counter flow double pipe heat exchanger with 1m length. The inner tube is made of smooth copper with diameter of 15mm. The outer tube is made of smooth copper with diameter of 50mm. The hot liquid flows through the outer tube and the cold liquid (or nanofluid) flow through the inner tube. The boundary condition of this study is thermally insulated the outer wall with uniform velocity a
... Show MoreBackground: The bond strength of the root canal sealers to dentin seems to be a very important property for maintaining the integrity and the seal of root canal filling. The aim of this study was to evaluate the shear bond strength of four different obturation systems using push-out test. Materials and methods: Forty straight palatal roots of the maxillary first molars teeth were used in this study, these roots were instrumented using crown down technique and ProTaper system, instrumentation were done with copious irrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilled water, roots were randomly divided into four groups according to the obturation system (ten teeth for each g
... Show MoreBackground: Lymphomas are a group of diseases caused by malignant lymphocytes that accumulate in lymph nodes and cause the characteristic clinical features of lymphadenopathy. Intercellular adhesion molecule-1 (ICAM-1) (CD54) is a transmembrane glycoprotein belonging to the immunoglobulin superfamily of adhesion molecules. Cortactin was first identified as one of the major substrates for src kinase. because it localized to Cortical actin structures, The aims of this study was to evaluate and compare the immunohistochemical of ICAM-1 expression as cell adhesion molecule marker and Cortactin expression as invasive marker. Material and Methods: This study was performed on (68) formalin-fixed, paraffin-embedded blocks, histopathologically diagn
... Show MoreBackground: Accurate detection of thyroid autoantibodies by enzyme linked immunosorbant assay technique namely thyroglobulin antibody, thyroid peroxides antibody is crucial in the differentiation of autoimmune thyroid disorders from other form of thyroid diseases.
Objective: Evaluation of the detection of thyroglobulin antibody and thyroid peroxides antibody in different thyroid diseases using enzyme linked immunosorbant assay technique.
Methods: - Seventy-five patients admitted to Surgical Units of Baghdad Medical City Hospital for the period between "October 2010 to June 2011" they were waiting to do thyroidectomy. They were chosen nonselectively for serological evaluation of above autoantibodies , and correlation of the results
Background: Acute appendicitis is regarded as one of the most common inflammation that needs surgical intervention. Different scoring systems have been used for diagnosing of acute appendicitis. ALVARADO score is one of the most widely used score in diagnosing of acute appendicitis, but the accuracy of the latter is insufficiently low in Middle-East patients. Thus a new scoring system called RIPASA score has been designed for diagnosing of acute appendicitis in those patients. The aim of this study is to use RIPASA score and compare its result with ALVARADO score in diagnosing of acute appendicitis.
Subjects and Methods: The study includes 200 patients with symptoms and signs of
... Show More