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.
Background: The potential use of zinc oxide and other metal oxide nanoparticles in biomedical are gaining interest in the scientific and medical communities, largely due to the physical and chemical properties of these nanomaterials. The present work revealed the effect of zinc oxide nanoparticles (ZnONPs) on the total salivary peroxidase enzyme activity of human saliva in comparison to de-ionized water. Materials and methods: Forty eight unstimulated saliva samples were collected from dental students/University of Baghdad 18-22 years. Then measure the total salivary peroxidase activity first without any addition to human saliva as a control, second with dilution the saliva with de-ionized water, and third with zinc oxide nanoparticles in c
... Show MoreWet granulation method was used instead of conventional pan coating or fluidized –bed coating technique to prepare enteric-coated diclofenac sodium granules, using ethanolic solution of EudragitTM L100 as coating, binding and granulating agent .Addition of PEG400 or di-n-butyl phthalate as a plasticizer was found to improve the enteric property of the coat.
Part of the resulted granules was filled in hard gelatin capsules (size 0), while the other part was compressed into tablets with and without disintegrant.
The release profile of these two dosage forms in 0.1N HCl (pH 1.2)for 2 hours, and in phosphate buffer (pH 6.8) for 45 minutes as well as the release kinetic were compared with that of the en
... Show MoreBackground: Recurrent aphthous ulceration (RAU) is an inflammatory condition of unknown etiology characterized by painful recurrent (single or multiple) ulcerations of the oral mucosa. It is one of the most common and poorly understood mucosal disorders. It occurs more frequently in times of stress. Local and systemic conditions, genetic, immunologic, microbial factors, and oxidative stress may play a role in the pathogenesis of RAU. The objective of this study was to evaluate the free radical metabolism and antioxidant activity of RAU patients treated by lavender or flax oil paint.
Materials and Methods: Sixty-six RAU patients were enroll
... Show MoreIn this research study theory to find the stress and emotion gases in the glass as a result of exposure to pulses of the laser beam has been the study using vehicles three major on-system axes cylindrical (r, 0, z), where I took three models of glass silica glass soda glass fused and shedtwo types of lasers where the study showed that the thermal stresses and emotions ...
An experimental and numerical study has been carried out to investigate the heat transfer by natural convection in a three dimensional annulus enclosure filled with porous media (silica sand) between two inclined concentric cylinders with (and without) annular fins attached to the inner cylinder under steady state condition; The experiments were carried out for a range of modified Rayleigh number (0.2 ≤Ra*≤ 11) and extended to Ra* =500 for numerical study, annulus inclination angle of (δ = 0˚, 30˚, 60˚ and 90˚). The numerical study was to write the governing equation under an assumptions used Darcy law and Boussinesq’s approximation and then solved numerically using finite difference approximation. It was found that the averag
... Show MoreLight has already becomes a popular means of communication, and the high-bandwidth data into free space without the use of wires. A great idea took us to design a new system for transmitting sound through free space at (650, 532) nm wavelengths using reflective mirrors under different atmospheric conditions. The study showed us the effect of various weather factors (temperature, wind speed and humidity) on these wavelengths for different distances. As well as studying the attenuation caused by long-distance laser and beam divergence, A reflective dish was used to focus the spot of the laser beam on the photocell. Results were discussed under the effect of these factors and the attenuation resulting from the beam divergence. Thus, the sys
... Show MoreBackground: Dental erosion is a common oral condition which results due to consumption of high caloric and low pH acidic food such as carbonated drinks and fruit juices. It is expected that these food types can cause irreversible damage to dental hard tissues and early deterioration of the dental restorations. So, this study aimed to evaluate and compare the erosive potential effects of orange fruit juice and Miranda orange drink on the microhardness of an orthodontic composite material. Materials and methods: Thirty discs with a thickness of 2 mm and a diameter of 10 mm were prepared from orthodontic bonding composite. The prepared discs were equally divided into three groups (n=10). Microhardness analysis was carried out both prior to
... Show MoreBreast tumors patients generally have more oxidative stress than normal females. This was clear from a highly significant elevation (P<0.05) in malondialdehyde level in RBCs, serum and tissue of all patients groups with breast cancer as compared with control group. In this study we had found that free radicals in malignant breast tumors were higher than benign tumors, therefore the MDA might be used as a marker for prognosis of the disease.