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 unsteady state laminar mixed convection and radiation through inclined
cylindrical annulus is investigated numerically. The two heat transfer mechanisms of
convection and radiation are treated independently and simultaneously. The outer
cylinder was kept at a constant temperature while the inner cylinder was heated with
constant heat flux. The study involved numerical solution of the governing equations
which are continuity, momentum and energy equations using finite difference method
(FDM), where the body fitted coordinate system (BFC) was used to generate the grid
mesh for computational plane. A computer program (Fortran 90) was built to calculate
the bulk Nusselt number (Nub) after reaching steady state con
Iraqi EFL students face difficulties in writing composition, especially academic writing, which affects negatively their exam results. This study has been conducted in the Department of English at College of Education for Women, University of Baghdad, in order to identify first year EFL students’ incompetence in writing. This may enhance their achievement by some weekly writing activities. It deals with Iraqi EFL students’ difficulties in writing paragraphs such as descriptive, process, opinion, and factual paragraphs. The study aims to identify these difficulties and to suggest suitable solutions for them. The researcher perceives that it is necessary to enhance students’ skills in writing because it i
... Show MoreComputer modeling has been used to investing the Coulomb coupling parameter ?. The effects of the structure parameter K, grain charge Z, plasma density N, temperature dust grain Td, on the Coulomb coupling parameter had been studied. It was seen that the ? was increasing with increasing Z and N, and decrease with increasing K and T. Also the critical value of ? that the phase transfer of the plasma state from liquid to solid was studied.
The results of the current study showed that the thyroid gland in an adult domestic cat (Felis catus) is located in the neck area on both sides of the trachea at rings 1–5. The gland consists of two lobes (right and left), and it is surrounded by a capsule of connective tissue consisting of two outer and inner layers, and a layer of fatty tissue overlaps with the outer layer of the capsule. In addition, the results of this study found that the histological structure of the thyroid gland is composed of several follicles that appear in different sizes and shapes. The follicles are lined with simple cuboidal epithelial tissue and sometimes appear lined with high and low simple cuboidal epithelial tissue. The gland is histological
... Show MoreIn this paper, we study flow of photons rate production in a quark-gluon QG plasma. General theory of this study is based on the field theory for hard interaction. The kinetic of photons production from hard interaction in charm with anti-top to production photons with gluon due to plasma phase at high temperatures (150, 200,250,300 and 350 MeV) .It has been investigated and studied using the postulate of quantum chromodynamic theory QCD .The photons production rate of hard photons with( GeV) are insensitive to strength coupling and depend mainly on the temperature of system T . Despite the different critical temperature (150 and 190MeV) comes, we ï¬nd that same order of flow rate photons magnitude in both cases. In both cases, the f
... Show MoreKE Sharquie, AA Noaimi, ER Shwail, J Clin Exp Dermatol Res, 2012 - Cited by 41
Bilastine (BL) is a novel non-sedating second-generation antihistamine, and its bioavailability is about 60%. Objective: To compare the bioavailability of prepared oral self-nanoemulsions of BL (BL-SNE) with that of pure BL and marketed tablets. Methods: Four groups of Wistar rats were used in this study, each with six rats weighing between 200 and 250 g. They were treated orally using a a gavage tube. The groups were fed either with conventional tablets ("Alerbix®") after being ground and dispersed with deionized water (DIW), treated with BL-SNE or fed with pure BL powder suspension. The fourth group did not receive any medication. The concentration of BL in the rat’s plasma was measured using HPLC. We used Trandolapril as an an interna
... Show MoreBackground: With the increasing demand on esthetic orthodontic appliances, discoloration of clear elastomeric chains and modules remains an issue which concerns both orthodontics and patients. This in vitro study was conducted to evaluate the effect of exposing stretched clear elastomeric chains from six different companies (Ortho Technology, Ormco, Ortho Organizer, American Orthodontics, Opal and G&H companies) to three types of dietary media (tea, coffee and turmeric). Materials and methods: A total of 960 lengths of six modules were cut from short type elastomeric chain; 160 pieces from each brand. The specimens were stretched 50%, placed on plastic boards, and incubated in water at 37°C for 1 day, 7 days, 14 days and 28 days. Once a
... Show MoreScorpions and spiders belong to the class Arachnida in phylum Arthropoda. Scorpions are easily distinguished by median eyes on obvious the center of the carapace and have one pair, and lateral eyes have 2-8 in some species. Scorpions do not have good eyesight so the median eyes have always been simple and they are more sensitive than the lateral pairs. They have anterior median eyes (AME) with narrow field of view and pairs of lateral eyes (LE) with more sensitivity and response to light. Family Buthidae have 2-6 lateral eyes in Compsobuthus Mesobuthus, Hottentotta, while Vaejovidae, Chactidae and Chaerilidae have 2 pairs of lateral eyes. In addition, 3 pairs are found in Orthochirus and Androctonus. Spiders have six eyes in family Pholicid
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