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.
Theoretical 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 MoreThe cyanobacterial neurotoxin
The work in this paper focuses on the experimental confirming of the losses in photonic crystal fibers (PCF) on the transmission of Q-switched Nd:YAG laser. First HC-PCF was evacuated to 0.1 mbar then the microstructure fiber (PCF) was filled with He gas & gas. Second the input power and output power of Q-switched Nd:YAG laser was measured in hollow core photonic bandgap fiber (HCPCF). In this work loss was calculated in the hollow core photonic crystal fiber (HCPCF) filled with air then N2, and He gases respectively. It has bean observed that the minimum loss obtained in case of filling (HC-PCF) with He gas and its equal to 15.070 dB/km at operating wavelength (1040-1090) nm.
The paper attempts to find out the elements of picaresque novel in selected English and Iraqi novels. It studies these elements in Henry Fielding’s Joseph Andrews and Adil Abduljabbar’s Arzal Hamad Al-Salim. The paper is divided into four sections. The first is an introduction to the picaresque novel. It gives a definition, a historical background, and the elements of the genre. The second section studies Fielding’s novel focusing on the elements of this type of novel and how it affects the story itself. The paper follows the novel from the beginning to the end showing these elements. The third is dedicated to Abduljabbar’s novel and how the elements of picaresque genre appear in the novel and play an important role in its developm
... Show MorePragmatics of translation is mainly concerned with how social contexts have their own influence on both the source text (ST) initiator's linguistic choices and the translator's interpretation of the meanings intended in the target text (TT). In translation, socio-pragmatic failure(SPF), as part of cross-cultural failure, generally refers to a translator's misuse or misunderstanding of the social conditions placed on language in use. In addition, this paper aims to illustrate the importance of SPF in cross-cultural translation via identifying that such kind of failure most likely leads to cross-cultural communication breakdown. Besides, this paper attempts to answer the question of whether translators from English into Arabic or vice versa h
... Show MoreCatalytic wet air oxidation of aqueous phenol solution was studied in a pilot plant trickle bed reactor using copper
oxide catalyst supported on alumina and silica. Catalysts were prepared by impregnating method. Effect of feed solution
pH (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, the
performance of the catalysts was better when the pH of feed solution was increased. The catalysts deactivation is related
to the dissolution of the metal oxides from the catalyst surface due to the acidic conditions. Phenol oxidation reaction
was strongly
In 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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