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.
Three cultivars of the crop Almash (Green Indian VC6089A10, Green Indian VC6173B1319, and Black Indian Gold Star) were tested in a field experiment during the 2022 growing season in Ramadi, Anbar province, to determine the impact of spraying levels of zinc (0, 25, and 50) mg Zn L-1 and manganese (0, 30, and 60) mg Mn L-1 on some growth characteristics. The experiment was conducted using a randomized complete block design (RCBD) with three replicates, with each treatment being tested in a separate split plot. The study found that there were statistically significant differences between zinc levels, with the level giving 50 mg Zn L-1
The purpose of the study is to identify the need to improve health services in Iraq by determining the efficiency of service in health care centres and working on exploiting limited resources through choosing the most efficient technological art represented by using precast concrete technology to fill the shortfall in the establishment health centres for primary care and to explain the impact of this on saving resources, time, and increasing production efficiency. To achieve this, the quantitative analysis adopted as a methodology in the study by determining the size of the deficit in the infrastructure of health centres for primary care according to the standard of a he
... Show MoreABSTRACT Purpose: The determination of standard scores and levels for some mental skills by researchers is of great importance, especially if it matches the target research sample, Method: as the researchers used the descriptive approach in the survey method, and the researchers chose the sample of youth players for clubs for the season (2022-2021), numbering (127) players, and the researchers identified the scale and procedures and applied it to the research sample, Results: obtained the results that were processed, extracted grades and standard levels, and then interpreted them and obtained conclusions, Conclusion: the most important of which are: The standard levels of mental skills reached the results of the sample studied within the
... Show MoreThe possibility of using activated carbon developed from date palm seeds wastes as a permeable reactive barrier (PRB) to remove copper from polluted shallow groundwater was investigated. The activated carbon has been developed from date palm seeds by dehydrating methods using concentrated sulfuric acid. Batch tests were performed to characterize the equilibrium sorption properties of new activated carbon in copper-containing aqueous solutions, while the sandy soil (aquifer) was assumed to be inert. Under the studied conditions, the Langmuir isotherm model gives a better fit for the sorption data of copper by activated carbon than other models. At a pilot scale, One-dimensional column experiments were performed, and an integrated model ba
... Show MoreIn this paper, a procedure to establish the different performance measures in terms of crisp value is proposed for two classes of arrivals and multiple channel queueing models, where both arrival and service rate are fuzzy numbers. The main idea is to convert the arrival rates and service rates under fuzzy queues into crisp queues by using graded mean integration approach, which can be represented as median rule number. Hence, we apply the crisp values obtained to establish the performance measure of conventional multiple queueing models. This procedure has shown its effectiveness when incorporated with many types of membership functions in solving queuing problems. Two numerical illustrations are presented to determine the validity of the
... Show MoreThis research seeks to shed light on what you add intangible assets of benefit to the company and this antagonize pause for consideration because it makes the company in a good competitive position stimulates the rest of the companies to acquire those assets.
That many companies have achieved competitive advantages in the market do not even achieved monopolies increased the value and reaped extraordinary profits as a result of those assets which requires the need to be measured to determine the extent to which contribution in the emergence of the value added to the value of the company on the one hand and to make the presentatio
... Show MoreZeolite Y nanoparticles were synthesized by sol - gel method. Dffirent samples using two silica sources were prepared.
Sodium metasilicate (Na2SiO3) (48% silica) and silicic acid silica (H2SiO3) (75% silica) were employed as silica
source and aluminum nitrate (Al(NO3)3.9H2O) was the aluminum source with tetrapropylammonium hydroxide
(TPAOH) as templating agent.
The synihesized-samples were characterized by X-ray diffraction, showed the requirement of diffirent aging time for
complete crystallization to be achieved. Transmission Electronic Microscope (TEM) images, showed the particles were
in the same range of 30 - 75 nm. FT-IR spectroscory, showed the synthesized samples having the zeolite Y crystal
properties. The i
In this research , we study the inverse Gompertz distribution (IG) and estimate the survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes