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.
Zeolite Y nanoparticles were synthesized by sol - gel method. Dffirent samples using two silica sources were prepared.
Sodium metasilicate (Na2SiO3) (48% silica) and silicic acid silica (H2SiO3) (75% silica) were employed as silica
source and aluminum nitrate (Al(NO3)3.9H2O) was the aluminum source with tetrapropylammonium hydroxide
(TPAOH) as templating agent.
The synihesized-samples were characterized by X-ray diffraction, showed the requirement of diffirent aging time for
complete crystallization to be achieved. Transmission Electronic Microscope (TEM) images, showed the particles were
in the same range of 30 - 75 nm. FT-IR spectroscory, showed the synthesized samples having the zeolite Y crystal
properties. The i
The researcher focused on the importance of the physical abilities of the tennis game, as this game is one of the games that are characterized by its specificity in performance as this game is characterized by continuous movement and dealing with different elements, so this game requires the development of muscle strength, which plays an important role in Performance skills in the game of tennis. There are several methods to develop strength, including flat hierarchical technique, which is one of the most common forms of training in the development of muscle strength. As for the research problem, the researcher found a method that has an effect on the development of force. Therefore, the researcher tried to diversify a
... Show MoreAuthentic materials are the most important tools that the teacher could use in class in order to make teaching go smoothly and effectively in transmitting the necessary knowledge to all students. This research has investigated experimentally the effect of using authentic materials in teaching English as a foreign Language, because a number of studies point out that the use of authentic materials is regarded a useful means to motivate learners, arouse their interest and expose them to the real language they will face in real life situations.
It is hypothesis that there is no statistical significance difference between the experimental group who taught English as a foreign language by using the authentic materials with those
... Show MoreABSTRACT Purpose: The determination of standard scores and levels for some mental skills by researchers is of great importance, especially if it matches the target research sample, Method: as the researchers used the descriptive approach in the survey method, and the researchers chose the sample of youth players for clubs for the season (2022-2021), numbering (127) players, and the researchers identified the scale and procedures and applied it to the research sample, Results: obtained the results that were processed, extracted grades and standard levels, and then interpreted them and obtained conclusions, Conclusion: the most important of which are: The standard levels of mental skills reached the results of the sample studied within the
... Show MoreThe compound 2,2'-(((1H-benzo(d)imidazol-2-yl)methyl)azanediyl)bis(ethan-1-ol) was reacted with benzyl bromide to afford compound (1) which used as row material to prepare a series of compounds through condensation reaction, the starting compound were reacted with tosyl chloride to protect the OH group to afford compound 2, then reacted benzyl bromide to produce compound (2), then the compound (2) treated with three compounds ( 2-mercaptobenzthiazole, 2-mercaptobenimidazol and 2-chloromethyl benzimidazole) to form compounds 3a,b, 4a,b and 5a,b respectively. In the another step the click reaction of compound 2,2'-(((1H-benzo(d)imidazol-2-yl)methyl)azanediyl)bis(ethan-1-ol) with Propargyl bromide produce compound 6 which reacted
... Show MoreThe removal of congo red (CR) is a critical issue in contemporary textile industry wastewater treatment. The current study introduces a combined electrochemical process of electrocoagulation (EC) and electro-oxidation (EO) to address the elimination of this dye. Moreover, it discusses the formation of a triple composite of Co, Mn, and Ni oxides by depositing fixed salt ratios (1:1:1) of these oxides in an electrolysis cell at a constant current density of 25 mA/cm2. The deposition ended within 3 hours at room temperature. X-ray diffractometer (XRD), field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), and energy dispersive X-ray (EDX) characterized the structural and surface morphology of the multi-oxide sedim
... Show MoreThe purpose of this study is to investigate the biostimulation effect of 532 nm CW laser on the metabolism of Saccharomyces cerevisiae yeast. Cells were irradiated by 532 nm Nd:YAG laser using 0.153 W/cm2 power density at 30, 45, 60,180 and 300 seconds exposure times in their respective orders. Intrafluorescence parameters were measured by detection the autofluorescence intensity, proliferation rate and Imaging the fluorescent mitochondria using confocal laser scanning microscope. The results showed that the 30 and 45 second exposure times seem to have stimulated changes in the cells that led to increase proliferation, viability and mitochondrial activity. Autofluorescence of cells increased after 45 and 60 seconds exposure time. After 3
... Show MoreIn this paper, a procedure to establish the different performance measures in terms of crisp value is proposed for two classes of arrivals and multiple channel queueing models, where both arrival and service rate are fuzzy numbers. The main idea is to convert the arrival rates and service rates under fuzzy queues into crisp queues by using graded mean integration approach, which can be represented as median rule number. Hence, we apply the crisp values obtained to establish the performance measure of conventional multiple queueing models. This procedure has shown its effectiveness when incorporated with many types of membership functions in solving queuing problems. Two numerical illustrations are presented to determine the validity of the
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