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.
Abstract
Suffering the human because of pressure normal life of exposure to several types of heart disease as a result of due to different factors. Therefore, and in order to find out the case of a death whether or not, are to be modeled using binary logistic regression model
In this research used, one of the most important models of nonlinear regression models extensive use in the modeling of applications statistical, in terms of heart disease which is the binary logistic regression model. and then estimating the parameters of this model using the statistical estimation methods, another problem will be appears in estimating its parameters, as well as when the numbe
... Show MoreEach Intensity Modulated Radiation Therapy (IMRT) plan needs to be tested and verified before any treatment to check its quality. Octavius 4D-1500 phantom detector is a modern and qualified device for quality assurance procedure. This study aims to compare the common dosimetric criteria 3%/3 mm with 2%/2 mm for H&N plans for the IMRT technique. Twenty-five patients with head and neck (H&N) tumor were with 6MV x-ray photon beam using Monaco 5.1 treatment planning software and exported to Elekta synergy linear accelerator then tested for pretreatment verification study using Octavius 4D-1500 phantom detector. The difference between planned and measured dose were assessed by using local and global gamma index (GI) analysis method at
... Show MoreHypoxic training, which in turn is one of the methods adopted in sports training methods, especially in activities that depend on the aerobic system in its performance, which includes training with a lack of oxygen by reducing its molecular pressure, since this method targets functional organs and works temporary responses during training and permanent responses After training as an adaptation to these devices as a result of training in this way, the study aimed to identify the effect of hypoxic exercises using the training mask and the extent of the change in some biochemical indicators, in addition to that to identify the effect of these exercises on the indicator of energy expenditure and )VMA) and the achievement of the effectiveness of
... Show MoreThe optimum conditions for production of fibrinolytic protease from an edible mushroom Pleurotus ostreatus grown on the solid medium , Sus medium, composed of Sus wastes (produced from extracted medicinal plant Glycyrrhiza glabra) were determined. Addition of 5% of Soya bean seeds meal in Sus medium recorded a maximum fibrinolytic protease activity resulting in 7.7 units / ml. The optimum moisture content of Sus medium supplemented with 5% Soya bean seeds meal was 60% resulting in 7.2 units / ml.Pleurotus ostreatus produced a maximum fibrinolytic protease activity when the spawn rate,pH of medium and incubation temperature were 2,6 and 30°C, respectively. The maximum fibrinolytic protease activity was 7.6 units / ml when incubat
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في هذا البحث , استعملنا طرائق مختلفة لتقدير معلمة القياس للتوزيع الاسي كمقدر الإمكان الأعظم ومقدر العزوم ومقدر بيز في ستة أنواع مختلفة عندما يكون التوزيع الأولي لمعلمة القياس : توزيع لافي (Levy) وتوزيع كامبل من النوع الثاني وتوزيع معكوس مربع كاي وتوزيع معكوس كاما وتوزيع غير الملائم (Improper) وتوزيع
... Show MoreIn order to advance the education process and raise the educational level of the players, it became necessary to introduce new educational aids, programmed education in the education process, through which the basic skills to be learned are explained and clarified, and immediate feedback is provided that would enhance the information of the learner, and Reaching the goal to be achieved, taking into account the individual differences between the players, and thus it is possible to move away from the educational methods used in learning skills, which requires great effort and time, in addition to that the open playground may not perform the skill accurately and the player looks from one side, while when using the computer you look from severa
... Show MoreCrystalline silicon (c-Si) has low optical absorption due to its high surface reflection of incident light. Nanotexturing of c-Si which produces black silicon (b-Si) offers a promising solution. In this work, effect of H2O2 concentrations towards surface morphological and optical properties of b-Si fabricated by two-step silver-assisted wet chemical etching (Ag-based two-step MACE) for potential photovoltaic (PV) applications is presented. The method involves a 30 s deposition of silver nanoparticles (Ag NPs) in an aqueous solution of AgNO3:HF (5:6) and an optimized etching in HF:H2O2:DI H2O solution under 0.62 M, 1.85 M, 2.47 M, and 3.7 M concentrations of H2O<
... Show MoreThe aim of this article is to solve the Volterra-Fredholm integro-differential equations of fractional order numerically by using the shifted Jacobi polynomial collocation method. The Jacobi polynomial and collocation method properties are presented. This technique is used to convert the problem into the solution of linear algebraic equations. The fractional derivatives are considered in the Caputo sense. Numerical examples are given to show the accuracy and reliability of the proposed technique.
The current research aims to train students to take benefit of their studies to analyze and taste the artistic works as one of the most important components of the academic structure for students specializing in visual arts; then to activate this during training them the methods of teaching. Consequently, the capabilities of mind maps were employed as a tool that would be through freeing each student to analyze a model of artistic work and think about his analytical principles according to what he knows. Then, a start-up with a new stage revolves around the possibility of transforming this analysis into a teaching style by thinking about how the student would do. The same person who undertook the technical analysis should offer this work
... Show MoreThe research aims to identify the relationship between spatial ability and the physical structure of concepts to the students of the Faculty of Education for Pure Sciences / Ibn al-Haitham، research involved students from the third class / morning study for the year 2011/2012 totaling (98) male and female students ،distributed into three groups which were selected randomly . The number of students (26 males and females) represented research sample after excluding repeaters and absentees، the research included two tests ; one test of spatial ability، which included (20) items and other test the physical structure of concepts، which included (12) items distributed into four domains ، the first (linking b
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