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 objective review is to inspect the involvement of Interleukin-6 (IL-6) in rheumatoid arthritis (RA) and to highlight the role of IL-6 and its variants in the pathogenesis of RA and response to anti-IL-6 agents. Several genetic and environmental risk factors and infectious agents contributed to the development of RA. Interleukin-6 is engaged in self-targeted immunity by modifying the equilibrium between T regulatory (T-reg) and T helper-17 (Th-17) cells. The evidences reported that IL-6 parti
The power generation of solar photovoltaic (PV) technology is being implemented in every nation worldwide due to its environmentally clean characteristics. Therefore, PV technology is significantly growing in the present applications and usage of PV power systems. Despite the strength of the PV arrays in power systems, the arrays remain susceptible to certain faults. An effective supply requires economic returns, the security of the equipment and humans, precise fault identification, diagnosis, and interruption tools. Meanwhile, the faults in unidentified arc lead to serious fire hazards to commercial, residential, and utility-scale PV systems. To ensure secure and dependable distribution of electricity, the detection of such ha
... Show MoreCatalytic wet air oxidation of aqueous phenol solution was studied in a pilot plant trickle bed reactor using copperoxide catalyst supported on alumina and silica. Catalysts were prepared by impregnating method. Effect of feed solutionpH (5.9, 7.3, and 9.2), gas flow rate (20%, 50%, 80%, and 100%), WHSV (1, 2, and 3 h-1), temperature (120°C, 140°C,and 160°C), oxygen partial pressure (6, 9, 12 bar), and initial phenol concentration (1, 2, and 4 g/l).Generally, theperformance of the catalysts was better when the pH of feed solution was increased. The catalysts deactivation is relatedto the dissolution of the metal oxides from the catalyst surface due to the acidic conditions. Phenol oxidation reactionwas strongly affected by WHSV,
... Show MoreGroundwater modelling is particularly challenging in arid regions where limited water recharge is available. A fault zone will add a significant challenge to the modelling process. The Western Desert in Iraq has been chosen to implement the modelling concept and calculate the model sensitivity to the changes in aquifer hydraulic properties and calibration by researching 102 observations and irrigation wells. MODFLOW-NWT, which is a Newtonian formulation for MODFLOW-2005 approaches, have been used in this study. Further, the simulation run has been implemented using the Upstream-Weighting package (UPW) to treat the dry cells. The results show sensitivity to the change of the Kx value for the major groundwater discharge flow. Only abo
... Show MoreThis review is concluded of 8-Hydroxyquinline (8HQ) compound and derivatives which has a very significant interests with a strong fluorescence , furthermore the relationship between divalent metal ions and characteristic of chelating . In the same way coordinated features have increase of its organic action and inorganic behavior by giving many samples of compounds which are a good chelating agents ligands with more capable of forming very stable complexes.Therefore, the role of (8HQ) is not limited on complexes only but its applications in different fields so this review will focus on demonstration preparation methods and properties of (8HQ) derivatives with their complexes and applications, hopefully that we will cover a part of scientifi
... Show MoreIn recent days, the escalating need to seamlessly transfer data traffic without discontinuities across the Internet network has exerted immense pressure on the capacity of these networks. Consequently, this surge in demand has resulted in the disruption of traffic flow continuity. Despite the emergence of intelligent networking technologies such as software-defined networking, network cloudification, and network function virtualization, they still need to improve their performance. Our proposal provides a novel solution to tackle traffic flow continuity by controlling the selected packet header bits (Differentiated Services Code Point (DSCP)) that govern the traffic flow priority. By setting the DSCP bits, we can determine the appropriate p
... Show MoreThe paper attempts to find out the elements of picaresque novel in selected English and Iraqi novels. It studies these elements in Henry Fielding’s Joseph Andrews and Adil Abduljabbar’s Arzal Hamad Al-Salim. The paper is divided into four sections. The first is an introduction to the picaresque novel. It gives a definition, a historical background, and the elements of the genre. The second section studies Fielding’s novel focusing on the elements of this type of novel and how it affects the story itself. The paper follows the novel from the beginning to the end showing these elements. The third is dedicated to Abduljabbar’s novel and how the elements of picaresque genre appear in the novel and play an important role in its developm
... Show MoreThe topic of context is one of the important topics, which was mentioned as a concept in several fields and different fields, and there were many points of view that defined that concept.
He specified the title of the research (design contexts in the design of the interior space), as the research sought to identify the concept of context in the interior design of the spaces of sewing workshops. The research was divided into four chapters:
The first chapter, which consists of the methodological framework, the problem of research and the need for it, the importance of research, the goal and limits of research for sewing workshops for vocational schools from (2020-2021).
The second chapter: consists of previous studies and the theo
The general crisis of research methods in the social sciences
Research methodology: philosophy and techniques, founded by philosophers and applied by scientists, and no accurate application of techniques except with a deep understanding of philosophy, as a prerequisite. This fact is almost completely absent from the Iraqi and Arab academic mentality. This constituted one of the dimensions of the double crisis - theoretical and applied - of research methods in the social sciences. As first, there is no philosophy of science, neither as an independent material nor as an introductory subject, but not even an oral confirmation. Secondly, the advancement of quantitative research methods are presented without a background philosophy, as sol