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.
Catalytic wet air oxidation of aqueous phenol solution was studied in a pilot plant trickle bed reactor using copperoxide catalyst supported on alumina and silica. Catalysts were prepared by impregnating method. Effect of feed solutionpH (5.9, 7.3, and 9.2), gas flow rate (20%, 50%, 80%, and 100%), WHSV (1, 2, and 3 h-1), temperature (120°C, 140°C,and 160°C), oxygen partial pressure (6, 9, 12 bar), and initial phenol concentration (1, 2, and 4 g/l).Generally, theperformance of the catalysts was better when the pH of feed solution was increased. The catalysts deactivation is relatedto the dissolution of the metal oxides from the catalyst surface due to the acidic conditions. Phenol oxidation reactionwas strongly affected by WHSV,
... Show MoreTheoretical trends have appeared Which posed the concept of biological structures in contemporary architecture concept, Spread through the emergence of architectural production that reflect and indicate the nature of the construction structures based on the ideas and principles of biological structures in biological science: Despite the emergence of many architectural proposals that tried to explain the concept in the field of architecture, but it is not dealt with in depth and not given a comprehensive definition: So there was need to search for the concept and its beginning in the biological field as a general framework down to the field of architecture for the purpose of reducing the limits of their search framework T
... Show MoreThis paper signifies the contradictory point of view in John Clare’s poetry. Clare (1794-1864) is an English romantic poetry in the nineteenth century, who writes more than ten volumes about nature. So, this study highlights the concept of Psychoanalytic theory which is ‘ambivalence’ and how through this theory can interpret any literary text on the basis of utilizing psychoanalytic methods to literary texts in order to reveal the author's inner emotions such as motives, dreams, as well as wishes. Consequently, the concept of ‘ambivalence’ has a lot in common with the human psyche and its struggles. Sometimes the reader finds the author/poet talking about something real or a notion with pleasant sentiments
... Show MoreAnimation is an industry that is expanding more quickly than ever. Every child’s favorite activity is watching cartoons. Therefore, it is essential to be cautious of the kinds of cartoon films children and teenagers tend. Because children and teenagers are the target audience for these films. This study aims at exposing a hidden enactment, namely racism, in a well-known cartoon film, Lion King, which has been selected accurately by the researchers because it shapes a set of ideas about black people and constructs prejudiced beliefs in their minds. This study is to answer the inquiry ‘Is the ideology of racism imposed in Lion King? And how?’ The significance of the present paper lies in highlighting the educational function of
... Show MoreIn the field of implantology, peri-implantitis is still a common complication of implant failure. Similar to periodontal disease, this kind of pathological condition is characterized by inflammation of the tissues surrounding dental implants or fillings. The sources of infection have been shown to be chronic periodontitis and poor maintenance of the communion. A thorough examination of the intricate components of peri-implantitis was sought in this review in order to identify common characteristics of the disease with regard to bacteria, biofilm formation, host immunological responses, diagnostic tools, and therapeutic treatments. The aim of this study was to provide a detailed overview of the different bacterial species associated
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The researcher seeks, through different aspects of the search, to reach a set of objective concerning in content creation a clear vision about conceptual and practical dimension of relation and effects between (Leader-Member Exchange, and Organizational Commitment) to construct a framework of a pragmatic model as a solution to research problem and it questions. The theoretical problem is derived basically from the scarcity of Arab studies and researches that deal by study and analyses for such important of The two variables blend. The practical problem depends in deriving from reality of every day work in the Iraqi ministry of defense.
On this basis, a formula of research problem for pur
... Show MoreThe present study addresses adopting the organic and nutritious materials in dairy wastewater as media for cultivation of microalgae, which represent an important source of renewable energy. This study was carried out through cultivation of three types of microalgae; Chlorella sp., Synechococcus, and Anabaena. The results shows the success the cultivation of the Synechococcus and Chlorella Sp, while the Anabaena microalgae were in low-growth level. The highest growth was in the Synechococcus farm, followed by Chlorella and Anabaena. However, the growth of Synechococcus required 10 days to achieve this increase that re
... Show MoreThis paper discusses the role of Auditors' Technological Maturity in reinforcing the quality of auditing profession, through focusing on the concepts of Technological Maturity and quality of auditing profession, as well as designing a proposed model for Technological Maturity which includes five evolutionary and sequential stages, and this proposed model would contribute to reinforce the quality of auditing. This proposed model will be employed in the field of auditing profession because the importance of the development and investment in this profession and the importance of the need for specialized knowledge in Information Technology, and the result of a proposed model is development of technological knowledge for the auditor to reach
... Show MoreThis study uses load factor and loss factor to determine the power losses of the electrical feeders. An approach is presented to calculate the power losses in the distribution system. The feeder’s technical data and daily operation recorded data are used to calculate and analyze power losses.
This paper presents more realistic method for calculating the power losses based on load and loss factors instead of the traditional methods of calculating the power losses that uses the RMS value of the load current which not consider the load varying with respect to the time. Eight 11kV feeders are taken as a case study for our work to calculate load factor, loss factor and power losses. Four of them (F40, F42, F43 and F
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