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 of this study was to develop neural network algorithm, (Multilayer Perceptron), based correlations for the prediction overall volumetric mass-transfer coefficient (kLa), in slurry bubble column for gas-liquid-solid systems. The Multilayer Perceptron is a novel technique based on the feature generation approach using back propagation neural network. Measurements of overall volumetric mass transfer coefficient were made with the air - Water, air - Glycerin and air - Alcohol systems as the liquid phase in bubble column of 0.15 m diameter. For operation with gas velocity in the range 0-20 cm/sec, the overall volumetric mass transfer coefficient was found to decrease w
... Show MoreInflammasome is a multiprotein oligomer complex which is the precursor procaspase-1 and is a component of the innate immune system so that this study aimed to determine the serum levels of interleukin-1? and 18 in patients with T2D and simple obesity in an attempt to clarify the role of inflammasome in these disorders.Twenty five known cases of T2D, twenty four patients with simple obesity and twenty healthy subjects were randomly recruited from AL-Kindy Teaching Hospital in Baghdad to enroll in this study. All the data about the demographic characteristics and anthropometric measurements were determined in all patients, also the C-reactive protein and serum interleukin (IL)-1? and IL-18 levels were obtained from each patient. The results s
... Show Moren this study, 25 clinical isolates of Proteus spp. were collected from urine, wounds and burns specimens from different hospitals in Baghdad city, all isolates were identified by using different bacteriological media, biochemical assays and Vitek-2 system. It was found that 15 (60%) isolates were identifies as Proteus mirabilis and 10 (40 %) isolates were Proteus vulgaris. The susceptibility of P. mirabilis and P. vulgaris isolates towards cefotaxime was (66.6 %) and (44.4 %) respectively; while the susceptibility of P. mirabilis and P. vulgaris isolates towards ceftazidime was (20%). Extended spectrum β-lactamses producing Proteus was (30.7 %). DNA of 10 isolates of P. mirabilis and 4 isolates of P. vulgaris were extracted and de
... Show More(January 25, 2011) represented a real opportunity to bring about fundamental changes in Egyptian foreign policy and to start a new phase that would cut off all the negative and problematic aspects of Egyptian politics in the period before the revolution. Through the employment of Egypt's huge balance and the role of historical is a civilization rooted in the roots of thousands of years and Islamic reference represented over more than a thousand years the Islamic medium of religion in the start of vision and tools to achieve the Egyptian national interest, and safeguarding Egyptian national security in its comprehensive sense. The research attempts to answer a central question: Is there a role for Egyptian soft power in the Islamic world
... Show MoreThe research aims to identify the degree of the availability of knowledge, skill and ability as components of human capital, in addition to stand at the level of strategic agility upon tourism and travel agencies company of Jordan, the impact of human capital on strategic agility has been tested through distribution of a questionnaire on a Randomly Sample from Workers in Jordan tourist Companies of (349),a number of statistics techinces have been used simple liner Regrision and Multiplayer regession, it has shown that the degree of knowledge, ability and skill availability was high, and the same applies on strategic agility components, and shown out that there is a statistically significant impact between human capital and strate
... Show MoreBackground: The study aimed to investigate the effect of different techniques of en masse retraction on the vertical and sagittal position, axial inclination, rate of space closure, and type of movement of maxillary central incisor. Materials and methods: A typodont simulation system was used (CL II division 2 malocclusion). Three groups were used group 1(N=10, T-loop), group 2(N=10, Time-Saving loop), and group 3(N=10, Microimplant). Photographs were taken before and after retraction and measurements were made using Autodesk AutoCAD© software 2010. Kruskal-Wallis one-way analyses of variance and Mann-Whitney U test (p?0.05) were used. Results: The rate of space closure showed no significant difference among the three groups (p?0.05), whi
... Show MoreFlaxseed from the flax plant (Linum usitatissimum), which has been cultivated for domestic use since prehistoric times. This study aims to investigate presence of antibacterial effect of flaxseed extract against selected oral pathogen in-vitro.
ABSTRACT— In primary teeth, root canal treatment is a time consuming and challenging procedure, particularly during the most important step in endodontic treatment which is the preparation of the canal. Pulpectomy is the treatment of choice in all the necrotic primary teeth. For better treatment protocol, advancing technology brought the rotary system to reduce the manual dexterity and improve the quality of treatment for pulpectomy. This study aimed to compare and assess the efficacy of cleaning and the time required for the instrumentation during the preparation of root canals of the primary molars using the rotary and the manual (conventional) systems. Thirty root canals of primary teeth were selected. These teeth submitted to a
... Show MoreCO2 laser (10.6 μm) is the most often used laser in the oral surgery due to its high absorption by water of the oral tissues. Several benefits of the use of CO2 laser have been reported for oral surgical procedures. This study aims to evaluate the effect of CO2 laser on soft and hard oral tissues (in vitro study). This study was done on fresh tissues from sheep’s head. CO2Surgical Laser with different operation modes was used; 0.2 mm spot size using different laser parameters on the tongue, and bone making holes, incisions and cutting. The depths and widths of holes and incisions were measured using endodontic file under magnification. The speed of incisions was calculated and the required time for cutting was measured using sport clo
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