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.
The purpose of this research work is to synthesize conjugates of some NSAIDs with sulfamethoxazole as possible mutual prodrugs to overcome the local gastric irritation of NSAID with free carboxyl group by formation of ester linkage that supposed to remain intact in stomach and may hydrolyze in intestine chemically or enzymatically; in addition to that attempting to target the synthesized derivative to the colon by formation of azo group that undergo reduction only by colonic bacterial azo reductaze enzyme to liberate the parent compound to act locally (treatment of inflammation and infections in colon)
The proposed method is sensitive, simple , fast for the determination of mebeverine hydrochloride in pure form or in pharmaceutical dosage . Using Homemade instrument fluorimeter continuous flow injection analyser with solid state laser (405 nm) as a source. Where it is based upon the fluorescence of fluorescein sodium salt and quenching effect of fluorescence by mebeverine in aqueous medium. The calibration graph was linear in the concentration range 0.05 to10 mMol.L-1 (r= 0.9629) with relative standard deviation (RSD%) for 1 mMol.L-1mebeverine solution was lower than 3% (n=6). Three pharmaceutical drugs were used as an application for the determination of mebeverine. A comparison was made between the newly developed method of analysis wit
... Show MoreThe method of analysis is one of the tools the coach to identify strengths andweaknesses of each player, and how to avoid mistakes that in the course ofperformance on the other hand, Voslob analysis is important for the player, as throughthe analysis will determine the capacity enjoyed by both the coach and player, as wellas being the possibility of progress in a scientific manner thoughtful, and also helps inthe evaluation of physical and skill level and tactical, psychological and trainingcapacity of the coach in order to avoid obstacles and make the coach is movingtowards the right track to improve the good level, and then an investigation tocomplete higher education.Hence the importance of research in the analysis of simple attack and n
... Show MoreIn order to advance the education process and raise the educational level of the players, it became necessary to introduce new educational aids, programmed education in the education process, through which the basic skills to be learned are explained and clarified, and immediate feedback is provided that would enhance the information of the learner, and Reaching the goal to be achieved, taking into account the individual differences between the players, and thus it is possible to move away from the educational methods used in learning skills, which requires great effort and time, in addition to that the open playground may not perform the skill accurately and the player looks from one side, while when using the computer you look from severa
... Show MoreThe research aims to identify the effect of teaching according to the augmented reality on the technique of the visual thinking skills among scientific fifth-grade students in a biology course. In order to achieve the goal of the research, the researcher adopted the experimental approach with the partial set of the two equal groups with the dimensional test of visual thinking skills, The research population represented all the scientific students of the fifth grade for morning government schools affiliated to the General Directorate of Education of Baghdad / Karkh II, alshakerin preparatory for boys was chosen intentionally, in which two groups were chosen for this study, one group is chosen randomly as the control group via lottery, whe
... Show Moreالمستخلص:
في هذا البحث , استعملنا طرائق مختلفة لتقدير معلمة القياس للتوزيع الاسي كمقدر الإمكان الأعظم ومقدر العزوم ومقدر بيز في ستة أنواع مختلفة عندما يكون التوزيع الأولي لمعلمة القياس : توزيع لافي (Levy) وتوزيع كامبل من النوع الثاني وتوزيع معكوس مربع كاي وتوزيع معكوس كاما وتوزيع غير الملائم (Improper) وتوزيع
... Show MoreCrystalline silicon (c-Si) has low optical absorption due to its high surface reflection of incident light. Nanotexturing of c-Si which produces black silicon (b-Si) offers a promising solution. In this work, effect of H2O2 concentrations towards surface morphological and optical properties of b-Si fabricated by two-step silver-assisted wet chemical etching (Ag-based two-step MACE) for potential photovoltaic (PV) applications is presented. The method involves a 30 s deposition of silver nanoparticles (Ag NPs) in an aqueous solution of AgNO3:HF (5:6) and an optimized etching in HF:H2O2:DI H2O solution under 0.62 M, 1.85 M, 2.47 M, and 3.7 M concentrations of H2O<
... Show MoreThe research aims to identify the relationship between spatial ability and the physical structure of concepts to the students of the Faculty of Education for Pure Sciences / Ibn al-Haitham، research involved students from the third class / morning study for the year 2011/2012 totaling (98) male and female students ،distributed into three groups which were selected randomly . The number of students (26 males and females) represented research sample after excluding repeaters and absentees، the research included two tests ; one test of spatial ability، which included (20) items and other test the physical structure of concepts، which included (12) items distributed into four domains ، the first (linking b
... Show MoreNanoparticles of humic acid and iron oxide were impregnated on the inert sand to produce sorbent for treating groundwater contained of cadmium and copper ions by technology of permeable reactive barrier (PRB). Sewage sludge was the source of the humic acid to prepare the coated sand by humic acid—iron oxide (CSHAIO) sorbent; so, this work is consistent with sustainable development. For 10 mg/L metal concentration, batch tests at speed of 200 rpm signified that the removal efficiencies are greater than 90% at sorbent dosage 0.25 g/ 50 mL, pH 6 and contact time 1 h. The kinetic data was well described by the Pseudo first-order model indicating that physicosorption is the predominant mechanism. The maximum adsorption capacities (qmax) were c
... Show Moreملخص البحث
تبحث الدراسھ عن تنفیذ افضل لمفھوم التعلم مدى الحیاة كھیكل موجھ للسیاسة التربویة في العراق بشكل عام وفي
التعلیم العالي بشكل خاص. تحدد الدراسة استراتجیات التعلم مدى الحیاة وتناقش اھمیتھ وسماتھ الرئیسیة لتسھیل
الوصول الى فرص تعلم متمیز و ملائم لحاجات الطلبة مدى الحیاة، كما تناقش دور الجامعة في تحقیق ھذا الھدف.