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.
Clinicians 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
The modern stylistic lesson has become more committed to the scientific limits in which it believed, and more confident in itself, and it is no longer just a scientific procedure that helps other curricula and sciences that preceded it.
Based on this, our modest research ((a stylistic vision of the objection in the Quranic discourse)) arose to explore an artistic rhetorical phenomenon that was included in the Holy Quran text. ; Because analysis is a situation that allows us to see a lot and absorb the stranger more clearly.
And since the horizontal arrangement of the linguistic elements in which stylistically undistinguished elements meet with distinct ones, the other trend has emerged that believes that the stylistic dis
... Show MoreThe theory of Pilgrims in the Magra is based on Dekru's view that the mgha is considered a pilgrim, and that the pilgrims are pilgrims
Tujia purely exposes the abstract temptation structure, and that the discharge of the Mfezouz Mfarouz is through factors
This theory tends to highlight the role of pilgrim function as a language
There is no preservation unless directed towards a particular outcome. Gemma can include morphine blindness
Or formulas that allow for the presentation of a pilgrimage to a writer in addition to the content of the news, and the guidance of the recipient
In one direction or another.
The orbital masses are one of these morphines and functional components that achieve function
The Togolese
The current research aims through its chapters to verify the relationship and impact of strategic leadership as an independent variable in the marketing performance as a respondent variable, in a leap cement plant, and try to come up with a set of recommendations that contribute to enhancing the practice and adoption of the two variables in the organization under discussion. And based on the importance of the research topic to the community, and to the researched organization and its members, the analytical and analytical approach was adopted in the completion of this research, and the research community included a leap cement plant in Anbar Governorate, while the research sample was represented by (department heads, and people o
... 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 MoreReducing the drag force has become one of the most important concerns in the automotive industry. This study concentrated on reducing drag through use of some external modifications of passive flow control, such as vortex generators, rear under body diffuser slices and a rear wing spoiler. The study was performed at inlet velocity (V=10,20,30,40 m/s) which correspond to an incompressible car model length Reynolds numbers (Re=2.62×105, 5.23×105, 7.85×105 and 10.46×105), respectively and we studied their effect on the drag force. We also present a theoretical study finite volume method (FVM) of solvi
One of the troublesome duties in chemical industrial units is determining the instantaneous drop size distribution, which is created between two immiscible liquids within such units. In this work a complete system for measuring instantaneous droplet size is constructed. It consists of laser detection system (1mW He-Ne laser), drop generation system (turbine mixer unit), and microphotography system. Two immiscible liquids, water and kerosene were mixed together with different low volume fractions (0.0025, 0.02) of kerosene (as a dispersed phase) in water (as a continuous phase). The experiments were carried out at different rotational speed (1180- 2090 r.p.m) of the turbine mixer. The Sauter mean diameter of the drops was determined by la
... 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 MoreFluorescence excitation by Nd:YAG pumped dye laser and single vibrational level fluorescence
spectra of 1,3 benzodioxole in a supersonic jet have been obtained and interpreted. The previous assignment of
the 0 0
0 band was incorrect. In addition, many other bands involving n20 and n19 vibrations of a2 symmetry were
confirmed. As far as a1 totally symmetric vibration is concerned. The n14 was assigned to be located in the fivemembered
ring whereas n13 seem to be located in the benzene ring as a result of the electronic transition in the
benzene ring which affects n13 and not n14 wavenumber.