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.
Abstract
The current research aims to reveal the extent to which all scoring rubrics data for the electronic work file conform to the partial estimation model according to the number of assumed dimensions. The study sample consisted of (356) female students. The study concluded that the list with the one-dimensional assumption is more appropriate than the multi-dimensional assumption, The current research recommends preparing unified correction rules for the different methods of performance evaluation in the basic courses. It also suggests the importance of conducting studies aimed at examining the appropriateness of different evaluation methods for models of response theory to the
... 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 MoreIn order to obtain a mixed model with high significance and accurate alertness, it is necessary to search for the method that performs the task of selecting the most important variables to be included in the model, especially when the data under study suffers from the problem of multicollinearity as well as the problem of high dimensions. The research aims to compare some methods of choosing the explanatory variables and the estimation of the parameters of the regression model, which are Bayesian Ridge Regression (unbiased) and the adaptive Lasso regression model, using simulation. MSE was used to compare the methods.
One of the recent significant but challenging research studies in computational biology and bioinformatics is to unveil protein complexes from protein-protein interaction networks (PPINs). However, the development of a reliable algorithm to detect more complexes with high quality is still ongoing in many studies. The main contribution of this paper is to improve the effectiveness of the well-known modularity density ( ) model when used as a single objective optimization function in the framework of the canonical evolutionary algorithm (EA). To this end, the design of the EA is modified with a gene ontology-based mutation operator, where the aim is to make a positive collaboration between the modularity density model and the proposed
... Show MoreBacteria strain H8, which produces high amount of exopolysaccharide (EPS), was isolated from soil, and identified as strain of Azotobacter chrococcum by its biochemical /physiological characteristics, EPS was extracted, partially purified and used as bioflocculant. The biochemical analysis of the partially purified EPS revealed that it was an alginate. analysis of EPS by Fourier transform infrared spectrometry (FTIR) show that the -OH groups present in bioflocculant are clearly seen at 3433.06 cm-1, the peaks attributed to the -CH3 groups present at 2916.17 cm-1 , and some distinct peaks such as carboxyl group showed strong absorption bands at 1604.66 cm-1, 1411.80 cm-1 and 1303.79 cm-1 indicate the chemical structure of alginate. The effe
... Show MoreAbstract This study investigated the treatment of textile wastewater contaminated with Acid Black 210 dye (AB210) using zinc oxide nanoparticles (ZnO NPs) through adsorption and photocatalytic techniques. ZnO NPs were synthesized using a green synthesis process involving eucalyptus leaves as reducing and capping agents. The synthesized ZnO NPs were characterized using UV-Vis spectroscopy, SEM, EDAX, XRD, BET, Zeta potential, and FTIR techniques. The BET analysis revealed a specific surface area and total pore volume of 26.318 m2/g. SEM images confirmed the crystalline and spherical nature of the particles, with a particle size of 73.4 nm. A photoreactor was designed to facilitate the photo-degradation process. The study investigated the inf
... Show MoreThis study is conducted to investigate the validity of using different levels of Rustumiya sewage water for irrigation and their effects on corn growth and some of the chemical properties of the soil such as electrical conductivity and soil pH in extract soil paste , the micro nutrient content in soil and plant which are ( Fe , Mn , Zn , Cu , Cd , Pb ). Three levels of sewage water ( 0 , 50 , 100 )% in two stages were used ,the three levels of wastewater ( without soil fertilization ) were used in the first stage , Where 80 Kg N /D+50Kg P2O5 /D was added to the soil as fertilizer in the control (0%) treatment and 40 Kg N/D+25Kg P2O5/D were added to 50 and 100% levels in the second stage .Corn seeds were planted in 12kg plastic pots in Com
... Show MoreConditional logistic regression is often used to study the relationship between event outcomes and specific prognostic factors in order to application of logistic regression and utilizing its predictive capabilities into environmental studies. This research seeks to demonstrate a novel approach of implementing conditional logistic regression in environmental research through inference methods predicated on longitudinal data. Thus, statistical analysis of longitudinal data requires methods that can properly take into account the interdependence within-subjects for the response measurements. If this correlation ignored then inferences such as statistical tests and confidence intervals can be invalid largely.