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.
In recent days, the escalating need to seamlessly transfer data traffic without discontinuities across the Internet network has exerted immense pressure on the capacity of these networks. Consequently, this surge in demand has resulted in the disruption of traffic flow continuity. Despite the emergence of intelligent networking technologies such as software-defined networking, network cloudification, and network function virtualization, they still need to improve their performance. Our proposal provides a novel solution to tackle traffic flow continuity by controlling the selected packet header bits (Differentiated Services Code Point (DSCP)) that govern the traffic flow priority. By setting the DSCP bits, we can determine the appropriate p
... Show MoreGroundwater modelling is particularly challenging in arid regions where limited water recharge is available. A fault zone will add a significant challenge to the modelling process. The Western Desert in Iraq has been chosen to implement the modelling concept and calculate the model sensitivity to the changes in aquifer hydraulic properties and calibration by researching 102 observations and irrigation wells. MODFLOW-NWT, which is a Newtonian formulation for MODFLOW-2005 approaches, have been used in this study. Further, the simulation run has been implemented using the Upstream-Weighting package (UPW) to treat the dry cells. The results show sensitivity to the change of the Kx value for the major groundwater discharge flow. Only abo
... Show MoreThis review is concluded of 8-Hydroxyquinline (8HQ) compound and derivatives which has a very significant interests with a strong fluorescence , furthermore the relationship between divalent metal ions and characteristic of chelating . In the same way coordinated features have increase of its organic action and inorganic behavior by giving many samples of compounds which are a good chelating agents ligands with more capable of forming very stable complexes.Therefore, the role of (8HQ) is not limited on complexes only but its applications in different fields so this review will focus on demonstration preparation methods and properties of (8HQ) derivatives with their complexes and applications, hopefully that we will cover a part of scientifi
... Show MoreIn this work, a simulated study was carried out for designing a novel spiral rectangular patch of microstrip antenna that is used in ultra-wideband applications by using a high frequency structure simulator software (HFSS). A substrate with dielectric constant of 4.4 and height 2.10 mm (commercial substrate height available is about 0.8-1.575 mm) has been used for the design of the proposed antenna. The design basis for enhancing bandwidth in the frequency range 6.63 - 10.93 GHz is based on increasing the edge areas that positively affect the antenna's efficiency. This design makes the designed antenna cost less by reducing the area of the patch. It has been noticed that the bandwidth of the antenna under this study is increasing to 4.30
... Show MoreThis study explores the language used in reporting political headlines conducting a rhetorical stylistic analysis. It is based on showing the effect of the rhetorical stylistic relations in news reporting. The aim is to investigate the structure adopted in reporting political news. It argues that the rhetorical stylistic devices are necessary and applicable to non-literary texts, i.e. political headlines to evaluate language use in the representation of non-literary texts. The analysis was carried out on data selected from the British broadsheet The Guardian and the American New York Times newspaper headlines. The data were examined and subjected to a contrastive analysis incorporating rhetorical and stylistic tools to discern h
... Show MoreAbstract The research investigates in detail the fascinating story of its title character, which may work as an allegory for Africa itself in its past. Ama Ata Aidoo is miscellaneous writers who wrote in different literary genre like drama , short stories novel and , poetry and criticism . She is also an active feminist. Aidoo is against the colonial practice and its influence on African minds. Aidoo's play Anowa confronts painful issues in Africa's past, mostly those of the slave trade. She goes further to tackle issues of patriarchal domination and African feminism, like the relationships between individuals and society, women and motherhood, men and women, husbands and wives, mothers and daughters, and above all the future invasion
... Show MoreThis paper aims to add to the growing body of cognitive translation studies that deal with the translation of emotions and the factors of evaluating the translation process-oriented. Cognitive appraisal is one of the tokens that includes three paradigms of assessing the performance of translation, it can be addressed from the perspective of emotions, intuitions, and individual styles of the SL and the method of transfer into TL. The study hypothesized that translators create a similar emotional charge due to their mental capability to build the same emotional effect in the TL audience. The study also proposed that the applicability of cognitive appraisal is a valuable method of evaluating the translation process, as pertinent to TPR. The
... Show MoreHarold Pinter’s The Caretaker(1959) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Harold Pinter to use a lot of pauses and silences in all the plays he wrote instead of words. Samuel Beckett preceded Pinter in doing so in his plays and one way to express the bewilderment of modern man during the 20th century is through the use of no language in the dramatic works. Language is no more important to modern man; instead, he uses silence to express his feelings. Silence is more powerful than the words themselves. That’s why long and short pauses can be seen throughout all Pinter’s plays.
In this play, th
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People are supposed to use language harmoniously and compatibly. However, aggression may characterize much of human communication. Aggression has long been recognized as a negative anti-social issue that prevails in most personal interactions. If it abounds in familial communications, it is more dangerous due to its harmful effects on individuals, and consequently on societies. Aggression refers to all the instances in which we try to get our way without any consideration for others. Moriarty’s novel (2014), Big Little Lies, is argued to represent the patterns of aggressive communications. This study aims to find out the motivations behind aggressive language in familial communication in this
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