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 adsorption of copper ions onto produced activated carbon from banana peels (with particle size 250 µm) in a single component system with applying magnetic field has been studied using fixed bed adsorber. The fixed bed breakthrough curves for the copper ions were investigated. The adsorption capacity for Cu (II) was investigated. It was found that 1) the exposure distance (E.D) and strength of magnetic field (B), affected the degree of adsorption; and 2) experiments showed that removal of Cu ions and accumulative adsorption capacity of adsorbent increase as the exposure distance and strength of magnetic field increase.
In this paper, the proposed phase fitted and amplification fitted of the Runge-Kutta-Fehlberg method were derived on the basis of existing method of 4(5) order to solve ordinary differential equations with oscillatory solutions. The recent method has null phase-lag and zero dissipation properties. The phase-lag or dispersion error is the angle between the real solution and the approximate solution. While the dissipation is the distance of the numerical solution from the basic periodic solution. Many of problems are tested over a long interval, and the numerical results have shown that the present method is more precise than the 4(5) Runge-Kutta-Fehlberg method.
The problem in the design of a cam is the analyzing of the mechanisms and dynamic forces that effect on the family of parametric polynomials for describing the motion curve. In present method, two ways have been taken for optimization of the cam size, first the high dynamic loading (such that impact and elastic stress waves propagation) from marine machine tool which translate by the roller follower to the cam surface and varies with time causes large contact loads and second it must include the factors of kinematics features including the acceleration, velocity, boundary condition and the unsymmetrical curvature of the cam profile for the motion curve.
In the theoretical solution
... Show MoreBimetallic Au –Pt catalysts supporting TiO2 were synthesised using two methods; sol immobilization and impregnation methods. The prepared catalyst underwent a thermal treatment process at 400◦ C, while the reduction reaction under the same condition was done and the obtained catalysts were identified with transmission electron microscopy (TEM) and energy-dispersive spectroscopy (EDS). It has been found that the prepared catalysts have a dimension around 2.5 nm and the particles have uniform orders leading to high dispersion of platinum molecules .The prepared catalysts have been examined as efficient photocatalysts to degrade the Crystal violet dye under UV-light. The optimum values of Bimetallic Au –
... Show MoreThese days, it is crucial to discern between different types of human behavior, and artificial intelligence techniques play a big part in that. The characteristics of the feedforward artificial neural network (FANN) algorithm and the genetic algorithm have been combined to create an important working mechanism that aids in this field. The proposed system can be used for essential tasks in life, such as analysis, automation, control, recognition, and other tasks. Crossover and mutation are the two primary mechanisms used by the genetic algorithm in the proposed system to replace the back propagation process in ANN. While the feedforward artificial neural network technique is focused on input processing, this should be based on the proce
... Show MoreNanomaterials, including nanoparticles such as iron oxide nanoparticles, have received great attention from researchers due to their unique properties and applications. There are several diverse methods, including chemical, physical, and green biological methods, to prepare iron oxide nanoparticles. The green method was chosen because it is safer, purer, and less toxic compared to other methods. Therefore, the green method is a promising and environmentally friendly method in the near future. The aqueous extract of Iraqi orange leaves was used to prepare nano iron oxide, it was examined structurally and spectrally by several techniques (X-ray diffraction- XRD, Fourier transform infrared - FT-IR, field emission scanning electron micr
... Show MoreAny design subject to a set of forces contributing to the establishment of relations working to strengthen the internal elements of the design; any imbalance in these elements can make a fragmented and weak design, thus preventing it from achieving the goal or performance. Poor performance can be attributed to various factors: the extent and function of the elements and principles in the design, realization of the idea, especially in fashion design.
Moreover, there are many aspects of a design that go into achieving the realization of the designer’s idea. The design utilizes a lot of stimulants by drawing attention to its design, which is consistent with the need for psychological and material individuals. In this research, we will