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 pre - equilibrium and equilibrium double differential cross
sections are calculated at different energies using Kalbach Systematic
approach in terms of Exciton model with Feshbach, Kerman and
Koonin (FKK) statistical theory. The angular distribution of nucleons
and light nuclei on 27Al target nuclei, at emission energy in the center
of mass system, are considered, using the Multistep Compound
(MSC) and Multistep Direct (MSD) reactions. The two-component
exciton model with different corrections have been implemented in
calculating the particle-hole state density towards calculating the
transition rates of the possible reactions and follow up the calculation
the differential cross-sections, that include MS
MM Abdulwahhab, kufa Journal for Nursing sciences, 2017 - Cited by 1
Background: Large amounts of oily wastewater and its derivatives are discharged annually from several industries to the environment. Objective: The present study aims to investigate the ability to remove oil content and turbidity from real oily wastewater discharged from the wet oil's unit (West Qurna 1-Crude Oil Location/ Basra-Iraq) by using an innovated electrocoagulation reactor containing concentric aluminum tubes in a monopolar mode. Methods: The influences of the operational variables (current density (1.77-7.07 mA/cm2) and electrolysis time (10-40 min)) were studied using response surface methodology (RSM) and Minitab-17 statistical program. The agitation speed was taken as 200 rpm. Energy and electrodes consumption had been studi
... Show MoreThis study uses an environmentally friendly and low-cost synthesis method to manufacture zinc oxide nanoparticles (ZnO NPs) by using zinc sulfate. Eucalyptus leaf extract is an effective chelating and capping agent for synthesizing ZnO NPs. The structure, morphology, thermal behavior, chemical composition, and optical properties of ZnO nanoparticles were studied utilizing FT-IR, FE-SEM, EDAX, AFM, and Zeta potential analysis. The FE-SEM pictures confirmed that the ZnO NPs with a size range of (22-37) nm were crystalline and spherical. Two methods were used to prepare ZnO NPs. The first method involved calcining the resulting ZnO NPs, while the second method did not. The prepared ZnO NPs were used as adsorbents for removing acid black 210
... Show MoreThe method of analysis is one of the tools the coach to identify strengths andweaknesses of each player, and how to avoid mistakes that in the course ofperformance on the other hand, Voslob analysis is important for the player, as throughthe analysis will determine the capacity enjoyed by both the coach and player, as wellas being the possibility of progress in a scientific manner thoughtful, and also helps inthe evaluation of physical and skill level and tactical, psychological and trainingcapacity of the coach in order to avoid obstacles and make the coach is movingtowards the right track to improve the good level, and then an investigation tocomplete higher education.Hence the importance of research in the analysis of simple attack and n
... Show MoreThe proposed method is sensitive, simple , fast for the determination of mebeverine hydrochloride in pure form or in pharmaceutical dosage . Using Homemade instrument fluorimeter continuous flow injection analyser with solid state laser (405 nm) as a source. Where it is based upon the fluorescence of fluorescein sodium salt and quenching effect of fluorescence by mebeverine in aqueous medium. The calibration graph was linear in the concentration range 0.05 to10 mMol.L-1 (r= 0.9629) with relative standard deviation (RSD%) for 1 mMol.L-1mebeverine solution was lower than 3% (n=6). Three pharmaceutical drugs were used as an application for the determination of mebeverine. A comparison was made between the newly developed method of analysis wit
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