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: Diabetes mellitus consists of a group of diseases characterized by abnormally high blood glucose levels. Glycated haemoglobin (HbA1c) is a form of haemoglobin used to identify the average concentration of plasma glucose over prolonged periods of time. It is formed in a non-enzymatic pathway by normal exposure of hemoglobin to high levels of plasma glucose, The main alterations observed in the saliva of Type 1 diabetic patients are hyposalivation and alteration in its composition, particularly those related to the levels of glucose. The aim of the present study was to assess the effect of Glycated haemoglobin level on the level of salivary glucose which may have an effect on oral health condition. Materials and methods
... Show MoreBackground: Alternative natural therapy by plants extracts had opened wide door for the use of natural products as an alternative therapy instead of many antibiotics and drugs , which had many harmful side effects.Also, an increased interest has been centered on the industrial wastes, especially plant raw materials which contain phenols (e.g. Pomegranate peel and Bay leaves) which is a sources of natural antioxidants ,which are on the contrary of synthetic antioxidants that had restrict use due to their health risks , carcinogenesis and toxicity .
Objectives :This study was done to fi
... Show MoreBACKGROUND: Breast cancer remains the most common malignancy among the Iraqi population. Affected patients exhibit different clinical behaviours according to the molecular subtypes of the tumour. AIM: To identify the clinical and pathological presentations of the Iraqi breast cancer subtypes identified by Estrogen receptors (ER), Progesterone receptors (PR) and HER2 expressions. PATIENTS AND METHODS: The present study comprised 486 Iraqi female patients diagnosed with breast cancer. ER, PR and HER2 contents of the primary tumours were assessed through immunohistochemical staining; classifying the patients into five different groups: Triple Negative (ER/PR negative/HER2 negative), Triple Positive (ER/PR positive/HER2 positive), Luminal A (ER
... Show MoreBackground: A diverse group of bacteria live in biofilms in the oral cavity. On dental surfaces biofilms form plaque that is potentially involved in caries and periodontal diseases. Periodic studying of plaque microflora and their antimicrobial sensitivity patterns strongly affects the clinical practice in plaque-induced oral diseases. Materials and methods: Dental plaque samples were collected from 22 patients having ages ranged between 33 and 49 years with gingivitis that met the study criteria. Plaque, gingival and gingival bleeding indices (PI, GI, GBI) were measured for each patient. Laboratory procedures included microbiological examination of plaque samples followed by antibiotic sensitivity testing using disc diffusion method were
... Show MoreIncreasing requests for modified and personalized pharmaceutics and medical materials makes the implementation of additive manufacturing increased rapidly in recent years. 3D printing has been involved numerous advantages in case of reduction in waste, flexibility in the design, and minimizing the high cost of intended products for bulk production of. Several of 3D printing technologies have been developed to fabricate novel solid dosage forms, including selective laser sintering, binder deposition, stereolithography, inkjet printing, extrusion-based printing, and fused deposition modeling. The selection of 3D printing techniques depends on their compatibility with the printed drug products. This review intent to provide a perspecti
... Show MoreReducing the drag force has become one of the most important concerns in the automotive industry. This study concentrated on reducing drag through use of some external modifications of passive flow control, such as vortex generators, rear under body diffuser slices and a rear wing spoiler. The study was performed at inlet velocity (V=10,20,30,40 m/s) which correspond to an incompressible car model length Reynolds numbers (Re=2.62×105, 5.23×105, 7.85×105 and 10.46×105), respectively and we studied their effect on the drag force. We also present a theoretical study finite volume method (FVM) of solvi
Teresa Fitzpatrick presents a connection between oppressed women and the plant of Wisteria in gothic fiction in her article “Wisteria: A Female Eco-Gothic Metaphor in American Fiction Through the Ages.” The connection between women and nature is common in literature as women are usually compared to the beauty or ferocity of flowers, rivers, or natural phenomena in general. The connection extends to the architecture and sort of plants that appear in gothic literature. Gothic novels have routinely been connected to the secrets and life stories of women who cannot have the liberty to live or share them outside their homes. A fearful house with a prisoned person, ghost, or a secret is mostly normally found in gothic writing. Women have exce
... Show MoreThe rate of gas induction was measured in gas-inducing type mechanically agitated contactors provided with two impellers. A reactor of 0.5 m i.d. was used with a working capacity of 60 liters of liquid. Tap water was used as the liquid phase, and air was used as the gas phase. The bioreactor mixing system consists of two equal diameter stirrers; the top impeller is shrouded-disk/curved-blade turbine with six evacuated bending blades, while the bottom impeller was disk turbine. The impeller speed was varied in the range of 50 to 800 rpm. The ratio of impeller diameter to tank diameter (D/T) and the submergence (S) of upper impeller from the top were varied. The effects of clearance of lower impeller from the tank bottom (C2) an
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