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.
Gaines's A Lesson Before Dying (1993) is about more than the challenges associated with being blacking an Eurocentric society. Though Gaines positions the story within the context of the African American experience, its central theme investigates what it means to be human. The Afro-American writer Ernest Gaines consistently writes about people who face the problems of being denied humanity, dignity, and self-worth. The article illustrates one man's struggle to gain recognition of his humanity in the court (as his attorney insists on calling him a hog for a crime he did not commit) and how this recognition will initiate a change in the community.
Many literary research papers have dealt with the work of Margaret Atwood's The Handmaid's Tale (1985) as a feminist work. However, nearly few studies combine social oppression with religious extremism. To bridge this gap, the present study aims at exploring the use of totalitarian theocracy of terror to oppress its citizens in the name of religion. In other words, it explicates the way religion is used to brutally suppress and exploit people in general and vulnerable women in particular. To meet this objective, the study adopted the qualitative descriptive method to describe how religion is used as a contradictory controlling means in Gilead discourse. It also adopted the Foucault theory in analyzing the data of the study, illu
... Show MoreUtilizing phase change materials in thermal energy storage systems is commonly considered as an alternative solution for the effective use of energy. This study presents numerical simulations of the charging process for a multitube latent heat thermal energy storage system. A thermal energy storage model, consisting of five tubes of heat transfer fluids, was investigated using Rubitherm phase change material (RT35) as the. The locations of the tubes were optimized by applying the Taguchi method. The thermal behavior of the unit was evaluated by considering the liquid fraction graphs, streamlines, and isotherm contours. The numerical model was first verified compared with existed experimental data from the literature. The outcomes re
... Show MoreSocial media is known as detectors platform that are used to measure the activities of the users in the real world. However, the huge and unfiltered feed of messages posted on social media trigger social warnings, particularly when these messages contain hate speech towards specific individual or community. The negative effect of these messages on individuals or the society at large is of great concern to governments and non-governmental organizations. Word clouds provide a simple and efficient means of visually transferring the most common words from text documents. This research aims to develop a word cloud model based on hateful words on online social media environment such as Google News. Several steps are involved including data acq
... Show MoreIn recent years, the field of research around the congestion problem of 4G and 5G networks has grown, especially those based on artificial intelligence (AI). Although 4G with LTE is seen as a mature technology, there is a continuous improvement in the infrastructure that led to the emergence of 5G networks. As a result of the large services provided in industries, Internet of Things (IoT) applications and smart cities, which have a large amount of exchanged data, a large number of connected devices per area, and high data rates, have brought their own problems and challenges, especially the problem of congestion. In this context, artificial intelligence (AI) models can be considered as one of the main techniques that can be used to solve ne
... Show MoreSimulation of free convection heat transfer in a square enclosure induced by heated thin plate is represented numerically. All the enclosure walls have constant temperature lower than the plate’s temperature. The flow is assumed to be two-dimensional. The discretized equations were solved stream function, vorticity, and energy equations by finite difference method using explicit technique and Successive Over- Relaxation method. The study was performed for different values of Rayleigh number ranging from 103 to 105 for different angle position of heated thin plate(0°, 45°, 90°). Air was chosen as a working fluid (Pr = 0.71). Aspect ratio of center of plate to the parallel left wall A2
... Show MoreThe corrosion behavior of Titanium in a simulated saliva solution was improved by Nanotubular Oxide via electrochemical anodizing treatment using three electrodes cell potentiostat at 37°C. The anodization treatment was achieved in a non-aqueous electrolyte with the following composition: 200mL ethylene glycol containing 0.6g NH4F and 10 ml of deionized water and using different applied directed voltage at 10°C and constant time of anodizing (15 min.). The anodized titanium layer was examined using SEM, and AFM technique.
The results showed that increasing applied voltage resulted in formation titanium oxide nanotubes with higher corrosion resistance
The research aims to build a training program to develop the willpower in the kindergarten children. In order to achieve the objective of the research, the two researchers have developed a Training Program according to the following steps:
- Determining the general objective of the Training Program.
- Determining the behavioral objectives of the Training Program.
- Determining the content of the Training Program.
- Implementing the content of the Training Program sessions.
- Evaluating the Training Program.
The training program consisted of (15) sessions, each session included a set of parts (title, general objective, methods, time and place to implement the sessions, behavioral goals, tool
... Show MoreThe investigative film is part of the documentary films and is considered one of the important films that have a high viewership by the recipient, which is of great importance in transmitting information and contributing to creating awareness of the community through the advertising function performed by the cinematic image, as the researcher addresses the concept of advertising and its development through the time stages. And advertising functions. Then the researcher dealt in his research with the cinematic technical elements that contribute to the success of the investigative advertising work, such as camera movements, music, sound effects, dialogue ... etc., which enrich the investigative picture with realism and the flow of informat
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