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.
Every cultural achievement is a creative text, and every text is a group of signs. The Winged Bull sculpture is a sort of text that is not confined to some signs; indeed, its cultural signs go far beyond as they are open-ended, everlasting and it lends itself to various horizons of interpretation. The recipient has to combine the signs of this sculpture, which belong to different patterns, in the pursuit for perfection so that he can decode its media message.
I have tackled this sculpture by adopting a semiotic approach. The semiotic approach is a modern critical approach which is as wide as culture and as rich as knowledge. It has been linked to modernism, which in turn has been linked to modern critical approaches, because it can
Trickle irrigation is one of the most conservative irrigation techniques since it implies supplying water directly on the soil through emitters. Emitters dissipate energy of water at the end of the trickle irrigation system and provide water at emission points. The area wetted by an emitter depends upon the discharge of emitter, soil texture, initial soil water content, and soil permeability. The objectives of this research were to predict water distribution profiles through different soils for different conditions and quantify the distribution profiles in terms of main characteristics of soil and emitter. The wetting patterns were simulated at the end of each hour for a total time of application of 12 hrs, emitter disch
... Show MoreClinicians and investigators consider the normal range of bowel habit and frequency as between 3 to 21 motions per week. Stool frequency outside the normal range may be unusual but may not be abnormal in the sense of a disease, and according to the consistency, the normal stool ranges from porridge like to hard and pellety.
Objectives: To establish a basic data about the bowel habits (consistency and frequency) in a sample of healthy Iraqi population; in addition to learn about their definition of constipation and diarrhea.
Methods: Prospective study from Jan 2000- Jun 2000 at Al-Yarmouk teaching hospital, Baghdad. Questionnaires were distributed to 950 healthy persons of different age group .The questionnaire included: Detailed hi
Developing an efficient algorithm for automated Magnetic Resonance Imaging (MRI) segmentation to characterize tumor abnormalities in an accurate and reproducible manner is ever demanding. This paper presents an overview of the recent development and challenges of the energy minimizing active contour segmentation model called snake for the MRI. This model is successfully used in contour detection for object recognition, computer vision and graphics as well as biomedical image processing including X-ray, MRI and Ultrasound images. Snakes being deformable well-defined curves in the image domain can move under the influence of internal forces and external forces are subsequently derived from the image data. We underscore a critical appraisal
... Show MoreThe rate of gas induction was measured in gas-inducing type mechanically agitated contactors provided with two impellers. A reactor of 0.5 m i.d. was used with a working capacity of 60 liters of liquid. Tap water was used as the liquid phase, and air was used as the gas phase. The bioreactor mixing system consists of two equal diameter stirrers; the top impeller is shrouded-disk/curved-blade turbine with six evacuated bending blades, while the bottom impeller was disk turbine. The impeller speed was varied in the range of 50 to 800 rpm. The ratio of impeller diameter to tank diameter (D/T) and the submergence (S) of upper impeller from the top were varied. The effects of clearance of lower impeller from the tank bottom (C2) an
... Show MoreObjectives: The demand for orthodontic treatment is nowadays increasing significantly for aesthetic improvement and to correct various kinds of malocclusion, yet the prolonged treatment time remains the main obstacle. This review aimed to demonstrate various orthodontic techniques and highlight the evidence-based successful approaches used for acceleration of orthodontic tooth movement. Materials and Methods: Data and sources of information pertaining to accelerated orthodontic tooth movement premised on English-written articles were searched using electronic databases including Google Scholar, Scopus, PubMed and MEDLINE. Results: This review demonstrated the availability of different surgical and non-surgical methods to enhance tooth movem
... Show MoreThe problem of frequency estimation of a single sinusoid observed in colored noise is addressed. Our estimator is based on the operation of the sinusoidal digital phase-locked loop (SDPLL) which carries the frequency information in its phase error after the noisy sinusoid has been acquired by the SDPLL. We show by computer simulations that this frequency estimator beats the Cramer-Rao bound (CRB) on the frequency error variance for moderate and high SNRs when the colored noise has a general low-pass filtered (LPF) characteristic, thereby outperforming, in terms of frequency error variance, several existing techniques some of which are, in addition, computationally demanding. Moreover, the present approach generalizes on existing work tha
... Show MoreThe Messengers and the Imam of the God-fearing, Muhammad is God, his family, and all of his companions. As for what comes after... Fainting is one of the involuntary symptoms and states that occur to a person when carrying out his life’s tasks suddenly due to his loss of sense and movement, so he loses consciousness for a period of time that is short or may be long, and the person is held accountable and responsible for every moment of his life. He is required to perform duties specified by Sharia law, such as prayer, fasting, and Hajj...and fainting prevents him from performing these actions. We must consider the opinions of jurists and know the legal implications resulting from it. It was said that a person has a capacity that enable
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