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 Aluminium (Al) material emerged as a plasmonic material in the wavelength ranges from the ultraviolet to the visible bands in different on-chip plasmonic applications. In this paper, we demonstrate the effect of using Al on the electromagnetic (EM) field distribution of a compact hybrid plasmonic waveguide (HPW) acting as a polarization rotator. We compare the performance of Al with other familiar metals that are widely used as plasmonic materials, which are Silver (Ag) and Gold (Au). Furthermore, we study the effect of reducing the geometrical dimensions of the used materials on the EM field distributions inside the HPW and, consequently, on the efficiency of the polarization rotation. We perform the study based o
... Show MoreThe purpose of this research is to find the estimator of the average proportion of defectives based on attribute samples. That have been curtailed either with rejection of a lot finding the kth defective or with acceptance on finding the kth non defective.
The MLE (Maximum likelihood estimator) is derived. And also the ASN in Single Curtailed Sampling has been derived and we obtain a simplified Formula All the Notations needed are explained.
Two‐dimensional buoyancy‐induced flow and heat transfer inside a square enclosure partially occupied by copper metallic foam subjected to a symmetric side cooling and constant heat flux bottom heating was tested numerically. Finite Element Method was employed to solve the governing partial differential equations of the flow field and the Local Thermal Equilibrium model was used for the energy equation. The system boundaries were defined as lower heated wall by constant heat flux, cooled lateral walls, and insulated top wall. The three parameters elected to conduct the study are heater length (7 ≤
Land Transport regards a main element in the In Fra – structure of the national economy where distance and time shortness, open new opportunities of work, develop the different regions and rise the standard of living….
It is necessary to emphasize that the circumastances surrounding Iraq such as wars, economic sanctions, blockade occupation effected negatively upon economic Indicators of land Transportion including Value of output Value added contraction of Investment allocation and Investment expend tuer and the period of implementation and fulfillment of the projects of Land Transport to be ready to offer their service in underdeveloped country Like Iraq aiming to satisfy Fast and acomprehensi
... Show MoreMunicipal solid waste is one of the most important environmental problems in the world and is an important source of environmental pollution and contributes significantly to the pollution of the basic environmental elements of soil, water and air. The management of municipal waste in general is a process of monitoring, collection, treatment or recycling if possible or disposal of waste. This term is used for waste produced by some human activities. States provide this process to mitigate the negative effects of waste on the environment, health and appearance of the city. It is possible to find solutions to the problem of solid waste and make it an important source of income and contribute to securing employment oppor
... Show MoreThis paper suggesting a new modern method to evaluate the performance of hotel industry at Jordan instead of the classical method used by the industry and that is Bench Marking , this method can be done by comparing the performance of hotel industry at two serial years which helps in calculating a standard performance .
The industry can use this standard to identify the variance, which make the evaluation of performance easier and support the efforts to develop the hotel industry at all levels and enable to give high quality services to customers.
The study believed that this situation would not be achieved unless the hotel industry will app
... Show MoreEmployee Stealing or internal theft is considered from the passive practices that can’t be denied or be hidden, In spite of the hospital privacy as a serving organization that works 24\7 and deleing with human lives, they weren’t infallible from that kind of practice. To prevent or reduce this practice, it was important to search for the organizational and behavioral factors influencing internal thefts. The study problem briefly is to reach the most organizational and behavioral factors influencing internal theft, in governmental hospitals in Baghdad Rusafa Health district, this was done by analyzing (20) administrative cases of thefts occurred in the District, also a sample of (60) specialist Doctor’s opinion work, in (3) hospital
... Show MoreThe letter is defined as a message directed by the sender to another party, the future. The aim is to convey, clarify or explain a particular point or subject, and in the form of direct oral communication through speech that contains a set of words and words, The future can discuss the sender directly to exchange ideas with each other, or it may be written and in this case does not require direct interaction between the matchmaker and the recipient. As a result of the different sources and topics of the discourse, and the different types of categories addressed to the speech, and the number, it has been divided into several types.
And schools of discourse analysis emerged in the early eighties of the last century and has spread and ha
The physicochemical behaviour of dodecyltrimethylammonium bromide (DTAB) in water and ethanol-water mixture in the presence and absence of ZnSO4 were studied by measuring the conductivity at 298.15 K. The pre-micellar (S1) and post-micellar slopes (S2) were obtained and calculated the degree of dissociation (α) and the critical micelle concentration (cmc). With an increase in ethanol content, the cmc and α of DTAB increased whereas, in the presence of ZnSO4, the cmc and α decreased. By using cmc and α, thermodynamic properties as the standard free energy of micellization ( ) were evaluated. With an increase in ethanol content, the negative values of are decreased indicating less spont
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