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.
Grass trimming operation is widely done in Malaysia for the purpose of maintaining highways. Large number of operators engaged in this work encounters high level of noise generated by back pack type grass trimmer used for this purpose. High level of noise exposure gives different kinds of ill effect on human operators. Exact nature of deteriorated work performance is not known. For predicting the work efficiency deterioration, fuzzy tool has been used in present research. It has been established that a fuzzy computing system will help in identification and analysis of fuzzy models fuzzy system offers a convenient way of representing the relationships between the inputs and outputs of a system in the form of IF-THEN rules. The paper presents
... Show MorePermanent deformation, fatigue and thermal cracking are the three typical distresses of flexible pavement. Using hydrated lime (HL) into the conventional limestone mineral additive has been widely practiced, including in Europe, to improve the mechanical properties of hot mix asphalt (HMA) concrete and as the result the durability of the constructed pavement. Large number of experimental studies have been reported to find the optimum addition of HL for the improvement on HMA concrete mechanical properties, moisture susceptibility and fatigue resistance. Pavement in service is under complex thermomechanical stress-strain conditions due to coupled atmospheric and surrounding environment temperature variation and the traffic loading. To predic
... Show MoreThis work was conducted to study the ability of locally prepared Zeolite NaY for the reduction of sulfur compounds from Iraqi natural gas by a continuous mode adsorption unit. Zeolite Y was hydrothermally synthesized using abundant kaolin clay as aluminum precursor. Characterization was made using chemical analysis, XRD and BET surface area. Results of the adsorption experiments showed that zeolite Y is an active adsorbent for removal H2S from natural gas and other gas streams. The effect of temperature was found inversely related to the removal efficiency. Increasing bed height was found to increase the removal efficiency at constant flow rate of natural gas. The adsorption capacity was evaluated and its maximum uptake was 5.345 mg H2S/g z
... Show MoreWith the development of cloud computing during the latest years, data center networks have become a great topic in both industrial and academic societies. Nevertheless, traditional methods based on manual and hardware devices are burdensome, expensive, and cannot completely utilize the ability of physical network infrastructure. Thus, Software-Defined Networking (SDN) has been hyped as one of the best encouraging solutions for future Internet performance. SDN notable by two features; the separation of control plane from the data plane, and providing the network development by programmable capabilities instead of hardware solutions. Current paper introduces an SDN-based optimized Resch
Biomass has been extensively investigated, because of its presence as clean energy source. Tars and particulates formation problems are still the major challenges in development especially in the implementation of gasification technologies into nowadays energy supply systems. Laser Induced Fluorescence spectroscopy (LIF) method is incorporated for determining aromatic and Polycyclic Aromatic Hydrocarbons (PAH) produced at high temperature gasification technology. The effect of tars deposition when the gases are cooled has been highly reduced by introducing a new concept of measurement cell. The samples of PAH components have been prepared with the standard constrictions of measured PAHs by using gas chromatograph (GC). OPO laser with tun
... Show MoreTight reservoirs have attracted the interest of the oil industry in recent years according to its significant impact on the global oil product. Several challenges are present when producing from these reservoirs due to its low to extra low permeability and very narrow pore throat radius. Development strategy selection for these reservoirs such as horizontal well placement, hydraulic fracture design, well completion, and smart production program, wellbore stability all need accurate characterizations of geomechanical parameters for these reservoirs. Geomechanical properties, including uniaxial compressive strength (UCS), static Young’s modulus (Es), and Poisson’s ratio (υs), were measured experimentally using both static and dynamic met
... Show MoreThe importance of this study stems from the importance of preserving the environment and creating a clean sustainable environment from waste and emissions and all the operations of industrial companies in general and cement companies in particular by activating sustainability accounting standards. The research aims to identify and diagnose deviations in violation of sustainability standards by employing the non-renewable resources standard (NR0401) For the construction industries to create a sustainable audit environment, the deductive approach was followed in the theoretical side and the inductive and descriptive approach to the practical side. The most important results of the research were the possibility of applying sustainab
... Show MoreThe objective of the current research is to identify the degree of awareness of the teachers of Arabic language with the requirements of sustainable development. The research sample consisted of (100) male and female teachers of the Arabic language. A 3-likert scale of (71) items grouped into practical and cognitive aspects, five trends for each aspect was designed by the researcher to explore the required data. The results showed that the level of awareness of teachers of the Arabic language was moderate of both the cognitive and practical aspects of sustainable education with means (1.69) and (1.48) respectively. The researcher presented a set of recommendations and suggestions.