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.
Low grade crude palm oil (LGCPO) presents as an attractive option as feedstock for biodiesel production due to its low cost and non-competition with food resources. Typically, LGCPO contains high contents of free fatty acids (FFA), rendering it impossible in direct trans-esterification processes due to the saponification reaction. Esterification is the typical pre-treatment process to reduce the FFA content and to produce fatty acid methyl ester (FAME). The pre-treatment of LGCPO using two different acid catalysts, such as titanium oxysulphate sulphuric acid complex hydrate (TiOSH) and 5-sulfosalicylic acid dihydrate (5-SOCAH) was investigated for the first time in this study. The optimum conditions for the homogenous catalyst (5-SOCAH) wer
... Show MoreThree plants extracts of Eucalyptus, Pomegranate and Oolong tea leaves have been used to synthesize iron oxide nanoparticles. The structure and particle size of the nanoparticles have been investigated by XRD spectrum. The results exhibit the polycrystalline nature of the material with a size around (17-19 nm). FESEM analysis showed that using different extracts as a reduction and capping agent might affect the shape of nanoparticles such as forming of round, polygon and irregular shapes under the same conditions. The photo catalyst activity of the prepared NPs in the degradation of MB dye has been investigated. the results showed a good efficiency reached to 91%, 88% and 80%.
Prodigiosin is a ‘natural red pigment produced by Serratia marcescens which exhibits immunosuppressive and anticancer properties in addition to antimicrobial activities. This work presents an attempt to maximize the production of prodigiosin by two different strategies: one factor at time (OFAT) and statistical optimization. The result of OFAT revealed that sucrose and peptone were the best carbon and nitrogen sources for pigment production with concentration of prodigiosin of about 135 mg/ L. This value was increased to 331.6mg/ L with an optimized ratio of C/N (60:40) and reached 356.8 with pH 6 and 2% inoculum size at end of classical optimization. Statistical experimental design based on Response surface methodology was co
... Show MoreAchieving reliable operation under the influence of deep-submicrometer noise sources including crosstalk noise at low voltage operation is a major challenge for network on chip links. In this paper, we propose a coding scheme that simultaneously addresses crosstalk effects on signal delay and detects up to seven random errors through wire duplication and simple parity checks calculated over the rows and columns of the two-dimensional data. This high error detection capability enables the reduction of operating voltage on the wire leading to energy saving. The results show that the proposed scheme reduces the energy consumption up to 53% as compared to other schemes at iso-reliability performance despite the increase in the overhead number o
... Show MoreThis paper describes a new proposed structure of the Proportional Integral Derivative (PID) controller based on modified Elman neural network for the DC-DC buck converter system which is used in battery operation of the portable devices. The Dolphin Echolocation Optimization (DEO) algorithm is considered as a perfect on-line tuning technique therefore, it was used for tuning and obtaining the parameters of the modified Elman neural-PID controller to avoid the local minimum problem during learning the proposed controller. Simulation results show that the best weight parameters of the proposed controller, which are taken from the DEO, lead to find the best action and unsaturated state that will stabilize the Buck converter system performan
... Show MoreEnvironmental pollution is experiencing an alarming surge within the global ecosystem, warranting urgent attention. Among the significant challenges that demand immediate resolution, effective treatment of industrial pollutants stands out prominently, which for decades has been the focus of most researchers for sustainable industrial development aiming to remove those pollutants and recover some of them. The liquid membrane (LM) method, specifically electromembrane extraction (EME), offers promise. EME deploys an electric field, reducing extraction time and energy use while staying eco-friendly. However, there's a crucial knowledge gap. Despite strides in understanding and applying EME, optimizing it for diverse industrial pollutant
... Show MoreThe current research examines the employment of indicators of stereotypes and the dimensions of organizational clarification to achieve planned organizational behaviour on a sample of employees in a number of departments of the Faculties of Engineering, University of Kufa, for a sample of (122) teaching staff. This research proposes the use of positive indicators of stereotypes for both the organization and employees and their awareness of what they want to obtain and what should be done for both parties and the removal of organizational clarity represented by the functional dimension that explores to what degree the employee's understanding of the internal strategy of the organization and the strategic dimension that searches fo
... Show MoreAn in-depth experimental study of the matrix effect of antifreeze (ethylene glycol) and water contamination of engine oil through FT-IR spectroscopy. With a comparison of the percent by volume concentration of contaminated fresh 15W-40 engine oil, there appeared to be a noticeable reduction in the O–H stretching signal in the infrared spectrum when ethylene glycol based antifreeze was included as a contaminant. The contaminants of distilled water, a 50/50 mixture of water and commercial ethylene glycol antifreeze, and straight ethylene glycol antifreeze were compared and a signal reduction in the O–H stretch was clearly evident when glycol was present. Doubling the volume of the 50/50 mixture as compared to water alone still res
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