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.
Design and build a center basins new p-type four mirrors were studied its effect on all parameters evaluating the performance of the solar cell silicon in the absence of a cooling system is switched on and noted that the efficiency of the performance Hzzh cell increased from 11.94 to 21 without cooling either with cooling has increased the efficiency of the
The paper is devoted to solve nth order linear delay integro-differential equations of convolution type (DIDE's-CT) using collocation method with the aid of B-spline functions. A new algorithm with the aid of Matlab language is derived to treat numerically three types (retarded, neutral and mixed) of nth order linear DIDE's-CT using B-spline functions and Weddle rule for calculating the required integrals for these equations. Comparison between approximated and exact results has been given in test examples with suitable graphing for every example for solving three types of linear DIDE's-CT of different orders for conciliated the accuracy of the results of the proposed method.
This research discusses one of the largest and most important issues of a doctrinal and philosophical dimension at the same time, which is the issue of man’s freedom to choose his actions, and thus his responsibility for those actions, by looking at the nature of these acts, their being and the origin of their creation. He showed that they were created in man by force, and that he was their original creator, and that they were among the creatures of the God Almighty God like others, but they are attributed to man through acquisition. So to the first saying went Jahmiyya or Jabariyya, and to the second saying went to fatalism in the past, and the existentialists shared with them in the modern era, and to the third saying went to the Sun
... Show MoreThe purpose of this research work is to synthesize conjugates of some NSAIDs with sulfamethoxazole as possible mutual prodrugs to overcome the local gastric irritation of NSAID with free carboxyl group by formation of ester linkage that supposed to remain intact in stomach and may hydrolyze in intestine chemically or enzymatically; in addition to that attempting to target the synthesized derivative to the colon by formation of azo group that undergo reduction only by colonic bacterial azo reductaze enzyme to liberate the parent compound to act locally (treatment of inflammation and infections in colon)
In order to advance the education process and raise the educational level of the players, it became necessary to introduce new educational aids, programmed education in the education process, through which the basic skills to be learned are explained and clarified, and immediate feedback is provided that would enhance the information of the learner, and Reaching the goal to be achieved, taking into account the individual differences between the players, and thus it is possible to move away from the educational methods used in learning skills, which requires great effort and time, in addition to that the open playground may not perform the skill accurately and the player looks from one side, while when using the computer you look from severa
... Show MoreIt is very known how great is the role of the Jewish writers in the system of the Zionist movement. The movement relied on writers and writers to carry out their programs, especially those pertaining to the creation of a "national homeland" for Jews. Most Jewish writers sang of Palestine even though they were not born there.
On such a basis, we have followed closely the writings of writers, critics and others by the end of the nineteenth century and the beginning of the twentieth century. We found that these writings are based on one common question: What is the fate of the Jewish people?
Most of these writings were accompanied by Theodor Herzl's proj
... Show MoreThe objective of this study was to investigate the drought stress and plant density possibility on water productivity and grain yield of maize (Zea mays L.) (Planting Baghdad 3 synthetic varieties), Field experiment was conducted at Abu Ghraib Research Station (Baghdad) during spring and Autumn seasons of 2016 using a randomized complete block design arranged in split plot with three replications. Three irrigation treatment included: irrigation after depletion 50% of available water (T1), irrigation after depletion 75% of available water (T2) and irrigation after depletion 90% of available water (T3) in the main plots and three plant density which were: 1 seeds hill-1 (D1) giving a uniform plant density of 66666 plants ha-1 , 2 seeds hill1
... Show MoreAphid Aphis spp (Hemiptera:Aphididae) and Thrips Thrips spp (Thysanoptera: Thripidae) an economically important pests on several crops in the world and Iraq, that transfer many viruses diseases to it. Field studies were conducted to assessment the population density of these insects and susceptibility of six varieties (Barin, Revera, Divela, Rudlph, Alazata and Pleny) to infestation during 2013 spring season. The results were showed that all Potato varieties were infested by Aphis and Thrips on spring plantation but with different percentage. The Divela variety was higher percentage of infestation and high population density of aphid which averaged 1.47 insect/ leaf while in Alazata was the lower population density which averaged 1.02 in
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