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 present study took up the different ways to cultivate the species Epipremnum aureum by two habitat water and soil and comber the anatomical features of the root, stem, and leaf. The results showed amazing significant anatomical features to the ecosystem. The root and stem anatomy showing decrease in all characters that studied but the leaf anatomy showing increase of palisade, spongy tissue thickness, midrib thickness, number of vessels in the xylem also the long and width of stomata of the soilless plants than soil ones. The upper epidermis empty from the stomata for the two treatment and the stoma diffuse in the lower epidermis, the type of it paracytic type. Also the total of flavonoids in the plant that were growth in soil reached 1
... Show MoreThis paper presents a comparative study between different oil production enhancement scenarios in the Saadi tight oil reservoir located in the Halfaya Iraqi oil field. The reservoir exhibits poor petrophysical characteristics, including medium pore size, low permeability (reaching zero in some areas), and high porosity of up to 25%. Previous stimulation techniques such as acid fracturing and matrix acidizing have yielded low oil production in this reservoir. Therefore, the feasibility of hydraulic fracturing stimulation and/or horizontal well drilling scenarios was assessed to increase the production rate. While horizontal drilling and hydraulic fracturing can improve well performance, they come with high costs, often accounting for up t
... Show MoreTransient three-dimensional natural convection heat transfer due to the influences of heating from one side of an enclosure filled with a saturated porous media, whereas the opposite side is maintained at a constant cold temperature, and the other four sides are adiabatic, were investigated in the present work experimentally. Silica sand was used as a porous media saturated with distilled water filled in a cubic enclosure heated from the side,using six electrical controlled heaters, at constant temperatures of (60, 70, 80, 90, and 100oC). The inverse side cooled at a constant temperature of (24oC) using an aluminum heat exchanger, consisted of 15 channels feeded with constant temperature water. Eighty thermocouples were used to control t
... Show Moren this study, 25 clinical isolates of Proteus spp. were collected from urine, wounds and burns specimens from different hospitals in Baghdad city, all isolates were identified by using different bacteriological media, biochemical assays and Vitek-2 system. It was found that 15 (60%) isolates were identifies as Proteus mirabilis and 10 (40 %) isolates were Proteus vulgaris. The susceptibility of P. mirabilis and P. vulgaris isolates towards cefotaxime was (66.6 %) and (44.4 %) respectively; while the susceptibility of P. mirabilis and P. vulgaris isolates towards ceftazidime was (20%). Extended spectrum β-lactamses producing Proteus was (30.7 %). DNA of 10 isolates of P. mirabilis and 4 isolates of P. vulgaris were extracted and de
... Show More(January 25, 2011) represented a real opportunity to bring about fundamental changes in Egyptian foreign policy and to start a new phase that would cut off all the negative and problematic aspects of Egyptian politics in the period before the revolution. Through the employment of Egypt's huge balance and the role of historical is a civilization rooted in the roots of thousands of years and Islamic reference represented over more than a thousand years the Islamic medium of religion in the start of vision and tools to achieve the Egyptian national interest, and safeguarding Egyptian national security in its comprehensive sense. The research attempts to answer a central question: Is there a role for Egyptian soft power in the Islamic world
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The objective of this study was to develop neural network algorithm, (Multilayer Perceptron), based correlations for the prediction overall volumetric mass-transfer coefficient (kLa), in slurry bubble column for gas-liquid-solid systems. The Multilayer Perceptron is a novel technique based on the feature generation approach using back propagation neural network. Measurements of overall volumetric mass transfer coefficient were made with the air - Water, air - Glycerin and air - Alcohol systems as the liquid phase in bubble column of 0.15 m diameter. For operation with gas velocity in the range 0-20 cm/sec, the overall volumetric mass transfer coefficient was found to decrease w
... Show MoreThe research aims to identify the degree of the availability of knowledge, skill and ability as components of human capital, in addition to stand at the level of strategic agility upon tourism and travel agencies company of Jordan, the impact of human capital on strategic agility has been tested through distribution of a questionnaire on a Randomly Sample from Workers in Jordan tourist Companies of (349),a number of statistics techinces have been used simple liner Regrision and Multiplayer regession, it has shown that the degree of knowledge, ability and skill availability was high, and the same applies on strategic agility components, and shown out that there is a statistically significant impact between human capital and strate
... Show MoreCO2 laser (10.6 μm) is the most often used laser in the oral surgery due to its high absorption by water of the oral tissues. Several benefits of the use of CO2 laser have been reported for oral surgical procedures. This study aims to evaluate the effect of CO2 laser on soft and hard oral tissues (in vitro study). This study was done on fresh tissues from sheep’s head. CO2Surgical Laser with different operation modes was used; 0.2 mm spot size using different laser parameters on the tongue, and bone making holes, incisions and cutting. The depths and widths of holes and incisions were measured using endodontic file under magnification. The speed of incisions was calculated and the required time for cutting was measured using sport clo
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