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.
Obesity is an escalating health problem in developing countries. One to ten children worldwide are overweight in a report showed by the International Obesity Task Force. Ghrelin, orexigenic peptide, has 28 amino acids, it is considered the greatest remarkable promotion in the last two decades for understanding the physiological changes of action regulating food intake and hunger. Obestatin is a 23-amino acid peptide nearly connected to ghrelin that secures from substitutio
... Show MoreOxidative stress plays a crucial role in the pathogenesis of peripheral artery disease (PAD). This study aimed to investigate the effect of clopidogrel on oxidative stress in PAD patients. Seventy subjects were divided into three groups: PAD patients before treatment (B-PAD), PAD patients after treatment with clopidogrel (A-PAD), and healthy controls. Serum levels of superoxide dismutase (SOD), copper (Cu), zinc (Zn), manganese (Mn), and oxidized protein were measured. SOD activities were also determined. The results showed that SOD activities, and SOD specific activities were significantly decreased in PAD patients compared to healthy individuals. After treatment with clopidogrel, SOD activities, and SOD specific activities were continuous
... Show MoreReverse shoulder arthroplasty is an increasingly common surgical intervention. However there are concerns and known limitations in relation to such joint replacement, while novel designs of reverse shoulder prostheses continue to appear on the market. Many claim to offer improvements over older designs but such assertions are difficult to validate when there is no consensus as to how such implants should be tested in vitro or even if such testing is necessary. In order to permit appropriate in vitro testing of reverse shoulder prostheses a unique, multi-station test rig was designed which was capable of applying motion in three axes to test prostheses. The shoulder simulator can apply up to 110° of motion in the flexion–extension and abd
... Show MorePoliteness strategies are of significant importance to maintain the face of the addressee. Senders of formal congratulatory letters seek to create a positive image in the minds of their addresses by performing particular illocutionary acts and face-saving acts (FSAs) in the form of written texts. To the best knowledge of the researcher, this topic received little attention from linguistic researchers, especially on the pragma-stylistic level. The importance of this study arises from the fact that congratulatory formal letters are an effective tool in the successful performance of foreign relations and thus deserve investigation. The current study investigates the pragmastylistic aspects of illocutionary acts and FSA Politeness Stra
... Show MoreIn context of this paper we prepare high purity powder ZnO nanostructures by chemical method at low temperature solution and study the effect off annealing at high temperature, ZnO nanoparticles have been successfully synthesized by chemical method at 0Cᵒ solution. In this method, suddenly reaction is occurred between zinc acetate solution and sodium hydroxide solution at 0Cᵒ, annealing temperature of powder product surfactant plays an important role in morphological changes. The nanostructures have been characterized by X-ray diffraction (XRD), Scanning Electron Microscope (SEM), differential scanning calorimetry(DSC) and UV-visible .analysis Effect of annealing temperatures on the morphology , structure and optical properties is di
... Show MoreBackground: Visfatin is a novel adipokine that mainly secreted by visceral adipose tissue, had an important role in inflammation and immune system. Creatine Kinase (CK) which is an enzyme that is involved in energy metabolism, found in large amounts in myocardium, brain and skeletal tissues. This study is carried out To evaluate the periodontal health status of the study groups (chronic periodontitis and chronic periodontitis with coronary atherosclerosis) and control groups, to measure the salivary levels of visfatin and Creatine Kinase in these groups and compare between them, and to determine the correlations between salivary visfatin and Creatine Kinase levels with the periodontal parameters in the three groups. Materials and Methods: e
... Show MoreBackground: Chronic myeloid leukemia is a cancer of the white blood cells characterized by the increased and unregulated growth of predominantly myeloid cells in the bone marrow. This study aimed to determine the effect of chronic myeloid leukemia on Dental caries and Oral health status including Gingivitis, Loss of attachment, Plaque index and Calculus index as well as evaluation of salivary flow rate and salivary interleukins-6 and tumor necrosis factor-?. Material and methods: Study group consisted of (75) subjects, (25) were newly diagnosed with chronic myeloid leukemia, (25) were taking medications (Glevic), and (25) were control subjects, all ag
... Show More<span lang="EN-US">In the last years, the self-balancing platform has become one of the most common candidates to use in many applications such as flight, biomedical fields, and industry. In this paper, the physical prototype of a proposed self-balancing platform that described the self-balancing attitude in the (X-axis, Y-axis, or biaxial) under the influence of road disturbance has been introduced. In the physical prototype, the inertial measurement unit (IMU) sensor will sense the disturbance in (X-axis, Y-axis, and biaxial). With the determined error, the corresponding electronic circuit, DC servo motors, and the Arduino software, the platform overcame the tilt angle(disturbance). Optimization of the proportional-integral-
... Show MoreWe consider the outflow of water from the peak of a triangular ridge into a channel of finite depth. Solutions are computed for different flow rates and bottom angles. A numerical method is used to compute the flow from the source for small values of flow rate and it is found that there is a maximum flow rate beyond which steady solutions do not seem to exist. Limiting flows are computed for each geometrical configuration. One application of this work is as a model of saline water being returned to the ocean after desalination. References Craya, A. ''Theoretical research on the flow of nonhomogeneous fluids''. La Houille Blanche, (1):22–55, 1949. doi:10.1051/lhb/1949017 Dun, C. R. and Hocking, G. C. ''Withdrawal of fluid through
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