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.
In this paper, a theoretical investigation was suggested to study underwater wireless optical communication (UWOC) system based on multiple input–multiple output (MIMO) technique. The modulation schemes such as RZ-OOK, NRZ-OOK, 32-PPM and 4-QAM applied under different coastal water types. MIMO technique enabled the system to transmit data rate with longer distance link. The performance of the proposed system examined by BER and data rate as a metrics. Several impairments such as the types of water by the attenuation of coastal water and the distance link were taken into account for the transmission of the optical signal to appreciate the reliability of the MIMO technique. The theore
The current research discusses the topic of the formal data within the methodological framework through defining the research problem, limits and objectives and defining the most important terms mentioned in this research. The theoretical framework in the first section addressed (the concept of the Bauhaus school, the philosophy of the Bauhaus school and the logical bases of this school). The second section dealt with (the most important elements and structural bases of the Bauhaus school) which are considered the most important formal data of this school and their implications on the fabrics and costumes design. The research came up with the most important indicators resulting from the theoretical framework.
Chapter three defined the
This work deals with preparation of Sulfated Zirconia catalyst (SZ) for isomerization of n-hexane model and refinery light naphtha, as well as enhanced the role of promoters to get the target with the mild condition, stability, and to prevent formation of coke precursors on strong acidic sites of the catalyst. The prepared SZ catalysts were characterization by fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Brunauer –Emmett-Teller (BET) surface area analysis, Thermogravimetric Analysis (TGA), Scanning Electron Microscope (SEM) and atomic force microscopy (AFM) Analyzer. The results illustrate that the maximum conversion and selectivity for n-hexane isomerization with Ni-WSZ and operating temperature of 150 °C
... Show MoreIn this work, excess properties (eg excess molar volume (VE), excess viscosity (ȠE), excess Gibbs free energy of activation of viscos flow (ΔG* E) and molar refraction changes (ΔnD) of binary solvent mixtures of tetrahydrofurfuryl alcohol (THFA) with aromatic hydrocarbons (benzene, toluene and p-xylene) have been calculated. This was achieved by determining the physical properties including density ρ, viscosity Ƞ and refraction index nD of liquid mixtures at 298.15 K. Results of the excess parameters and deviation functions for the binary solvent mixtures at 298.15 K have been discussed by molecular interactions that occur in these mixtures. Generally, parameters showed negative values and have been found to fit well to Redlich-Kister
... Show MoreThe objective of this study is to examine the properties of Bayes estimators of the shape parameter of the Power Function Distribution (PFD-I), by using two different prior distributions for the parameter θ and different loss functions that were compared with the maximum likelihood estimators. In many practical applications, we may have two different prior information about the prior distribution for the shape parameter of the Power Function Distribution, which influences the parameter estimation. So, we used two different kinds of conjugate priors of shape parameter θ of the <
... Show MoreTitanium alloy (Ti-6Al-4V or Gr.23) was widely used as a dental alloy. In the current study, polymerization of eugenol (PE) on Gr.23 titanium alloys was conducted by an electrochemical process before and after being treated by Micro Arc Oxidation (MAO). The formed films were characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray diffraction (XRD). The corrosion behavior of Gr.23 alloy in an artificial saliva environment at a temperature range of 293–323 K has been studied and assessed by means of electrochemical polarization and impedance spectroscopy techniques. Three cases are taken into consideration; bare Gr.23, Gr.23 coated by PE, and Gr.23 coated by PE after MAO treatment. The maxi
... Show MorePhotocatalyst composed of core/shell magnetic zincoxysulfide nanocomposite coated with sulfonated polyindole ([email protected]/SPID) has been prepared and used for simultaneous photocatalytic H2 production and Bisphenol A (BPA) degradation. XRD, FE-SEM, EDX, BET surface area, UV-vis DRS and VSM were used to characterize the synthesized nanocomposites. The photocatalytic performance was evaluated using batch reactor under visible light irradiation. The photocatalytic activity of [email protected]/SPID nanocomposite was revealed to exceed that of [email protected] nanocomposite due to the heterojunctions between SPID and [email protected] species. The results exhibited that the effect of BPA initial concentration was found to be effectual on the improvement
... Show MoreThe 3-parameter Weibull distribution is used as a model for failure since this distribution is proper when the failure rate somewhat high in starting operation and these rates will be decreased with increasing time .
In practical side a comparison was made between (Shrinkage and Maximum likelihood) Estimators for parameter and reliability function using simulation , we conclude that the Shrinkage estimators for parameters are better than maximum likelihood estimators but the maximum likelihood estimator for reliability function is the better using statistical measures (MAPE)and (MSE) and for different sample sizes.
Note:- ns : small sample ; nm=median sample
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