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 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
... 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 reactions of ozone with 2,3-Dimethyl-2-Butene (CH3)2C=C(CH3)2 and 1,3-Butadiene CH2=CHCH=CH2 have been investigated under atmospheric conditions at 298±3K in air using both relative and absolute rate techniques, and the measured rate coefficients are found to be in good agreement in both techniques used. The obtained results show the addition of ozone to the double bond in these compounds and how it acts as function of the methyl group substituent situated on the double bond. The yields of all the main products have been determined using FTIR and GC-FID and the product studies of these reactions establish a very good idea for the decomposition pathways for the primary formed compounds (ozonides) and give a good information for the effe
... Show MoreThe research aims to identify the effect of teaching according to the augmented reality on the technique of the visual thinking skills among scientific fifth-grade students in a biology course. In order to achieve the goal of the research, the researcher adopted the experimental approach with the partial set of the two equal groups with the dimensional test of visual thinking skills, The research population represented all the scientific students of the fifth grade for morning government schools affiliated to the General Directorate of Education of Baghdad / Karkh II, alshakerin preparatory for boys was chosen intentionally, in which two groups were chosen for this study, one group is chosen randomly as the control group via lottery, whe
... 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 Moreالمستخلص:
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 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 MoreThis research discusses one of the largest and most important issues of a doctrinal and philosophical dimension at the same time, which is the issue of man’s freedom to choose his actions, and thus his responsibility for those actions, by looking at the nature of these acts, their being and the origin of their creation. He showed that they were created in man by force, and that he was their original creator, and that they were among the creatures of the God Almighty God like others, but they are attributed to man through acquisition. So to the first saying went Jahmiyya or Jabariyya, and to the second saying went to fatalism in the past, and the existentialists shared with them in the modern era, and to the third saying went to the Sun
... 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
... Show MoreNanoparticles of humic acid and iron oxide were impregnated on the inert sand to produce sorbent for treating groundwater contained of cadmium and copper ions by technology of permeable reactive barrier (PRB). Sewage sludge was the source of the humic acid to prepare the coated sand by humic acid—iron oxide (CSHAIO) sorbent; so, this work is consistent with sustainable development. For 10 mg/L metal concentration, batch tests at speed of 200 rpm signified that the removal efficiencies are greater than 90% at sorbent dosage 0.25 g/ 50 mL, pH 6 and contact time 1 h. The kinetic data was well described by the Pseudo first-order model indicating that physicosorption is the predominant mechanism. The maximum adsorption capacities (qmax) were c
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