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.
Hypoxic 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
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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 MoreThe 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 MoreMM Abdulwahhab, kufa Journal for Nursing sciences, 2017 - Cited by 1
The ion-pair formation method has been applied for the spectrophotometric determination of Cimetidine and Erythromycin ethylsuccinate, in bulk samples and in dosage form. The methods are accurate, simple, rapid, inexpensive and sensitive depending on the extraction of the formed ion-pair with brompthymol blue (BTB) as a chromogenic reagent in chloroform, use phthalate buffer of pH 5.5 and 4.0 for Cimetidine and Erythromycin ethylsuccinate respectively. The formed complexes show absorbance maxima at 427.5 nm and 414.5 nm for Cimetidine and Erythromycin ethylsuccinate respectively against reagent blank. The calibration graphs are linear in the ranges of 0.5-15 µg.mL-1 with detection limit of 0.222 µg.mL-1 for
... Show MoreThe purpose of this research work is to synthesize conjugates of some NSAIDs with sulfamethoxazole as possible mutual prodrugs to overcome the local gastric irritation of NSAID with free carboxyl group by formation of ester linkage that supposed to remain intact in stomach and may hydrolyze in intestine chemically or enzymatically; in addition to that attempting to target the synthesized derivative to the colon by formation of azo group that undergo reduction only by colonic bacterial azo reductaze enzyme to liberate the parent compound to act locally (treatment of inflammation and infections in colon).
Key words: Mutual prodrug, Ester linkage, Azo bond, Colon targeting
A new results for fusion reactivity and slowing-down energy distribution functions for controlled thermonuclear fusion reactions of the hydrogen isotopes are achieved to reach promising results in calculating the factors that covered the design and construction of a given fusion system or reactor. They are strongly depending upon their operating fuels, the reaction rate, which in turn, reflects the physical behavior of all other parameters characterization of the system design
Each 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
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