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 banking sector is currently facing great challenges resulting from intense competition in the financial environment, and this is what makes the supreme audit bodies and the Central Bank audit as the highest supervisory authority on banks in order to achieve profit and not be exposed to loss, and this requires identifying the banking strengths and risks that constitute points Weakness that affects the future performance and the life of the bank, which requires special supervisory care, and from this point of view, the research aims to use the CAMELS model as a control tool in banks, through the use of its six indicators: capital adequacy, asset quality, management quality, profits, liquidity And sensitivity to market risks, th
... Show MoreTwo homopolymeric and three copolymeric additives for base oil were synthesized using octyl acrylate (OA) and tert-butyl acrylamide (TBA) monomers. The two additives named P1 and P2 are the homopolymers of TBA and OA, respectively, whereas copolymeric additives named Co1, Co2, and Co3 were synthesized by varying the ratios of TBA:OA as 1:3, 3:1 and 1:1, respectively. The prepared polymers were characterized by Fourier Transform Infrared (FTIR). Based on the solubility of synthesized polymers in base oil and reactivity ratios of TBA/OA copolymer (0.222, 0.434) calculated by Fineman-Ross method, P2, Co1, Co2 and Co3 were selected to evaluate their performance as pour point depressant (PPD), viscosity improver (VII), and anticorrosion addit
... Show MoreIn this study Microwave and conventional methods have been used to extract and estimate pectin and its degree of esterification from dried grapefruit and orange peels. Acidified solution water with nitric acid in pH (1.5) was used. In conventional method, different temperature degrees for extraction pectin from grape fruit and orange(85 ,90 , 95 and 100?C) for 1 h were used The results showed grapefruit peels contained 12.82, 17.05, 18.47, 15.89% respectively, while the corresponding values were 5.96, 6.74, 7.41 and 8.00 %, respectively in orange peels. In microwave method, times were 90, 100, 110 and 120 seconds. Grapefruit peels contain 13.86, 16.57, 18.69, and 17.87%, respectively, while the corresponding values were of 6.53, 6.68, 7.2
... Show MoreA new, simple and sensitive method was used forevaluation of propranolol withphosphotungstic acidto prove the efficiency, reliability and repeatability of the long distance chasing photometer (NAG-ADF-300-2) using continuous flow injection analysis. The method is based on reaction between propranolol and phosphotungstic acid in an aqueous medium to obtain a yellow precipitate. Optimum parameters was studied to increase the sensitivity for developed method. A linear range for calibration graph was 0.007-13 mmol/L for cell A and 5-15 mmol/L for cell B, and LOD 207.4792 ng/160 µL and 1.2449 µg/160 µL respectively to cell A and cell B with correlation coefficient (r) 0.9988 for cell A, 0.9996 for cell B, RSD% was lower than 1%, (n=8) for the
... Show MoreThe current study aimed the syntheses and characterizations of Gold nanoparticles (Au NPs) using a laser ablation Q-switched Nd: YAG laser with a wave-length of 355 nm at a variety of laser pulse energies (E) and deposited on porous silicon (PS). Optical emission spectrometer was used to diagnosed medium air to study gold plasma characteristics and prepared Au nanoparticles. The laser pulse energy influence has been studied on the plasma characteristics in air. The data showed the emergence of the ionic (Au II) spectral emission lines in the gold plasma emission spectrum. XRD has been utilized to examine structural characteristics. Moreover, AFM results 37.2 nm as the mean value of the diameter that is coordinated in a shape similar to the
... Show MoreThe research aims to: Preparing rehabilitative exercises with accompanying tools to rehabilitate those with shoulder dislocation. Knowing the effect of rehabilitative exercises and accompanying aids in improving the muscular strength and motor range of those with dislocations in the shoulder joint. The two researchers used the experimental design with the same experimental group with the pre and post tests, so the researcher chose a sample appropriate to the nature of his research problem, its goals and its hypotheses, as a sample of the injured was chosen to remove the shoulder joint, who completed the treatment, who were not practicing sports, and those who went to the Physiotherapy Center at Al-Was
... Show MoreNew metal ion complexes were synthesized with the general formula; K[PtLCl4], [ReLCl4] and K[ML(Cl)2] where M = Pd(II), Cd(II), Zn(II) and Hg(II), from the Azo ligand (HL) [2-Hydroxy-3-((5-mercapto-1,3,4-thiadiazol-2-yl)diazenyl)-1-naphth aldehyde] (HL) the ligand was synthesized from (2-hydroxy-1-naphthaldehyde) and (5-amino-1,3,4-thiadiazole-2-thiol). The ligand and its metal complexes are characterized by phisco- chemical spectroscopic techniques (FT.IR, UV-Vis and Mass spectra, elemental analysis, molar conductivity, Atomic Absorption, Chloride contain and magnetic susceptibility). The spectral data suggest that the (HL) behaves as a bidentate ligand in all complexes. These studies revealed tetrahedral geometries for all metal complexes
... Show MoreThe simulation have been made for 3D flow structure and heat transfer with and without
longitudinal riblet upstream of leading edge vane endwall junction of first stage nozzle guide vane .The research explores concept of weakening the secondary flows and reducing their harmful effects.Numerical investigation involved examination of the secondary flows ,velocity and heat transfer rates by solving the governing equations (continuity, Navier -stokes and energy equations ) using the known package FLUENT version (12.1).The governing equations were solved for three dimentional, turbulent flowe, incompressible with an appropriate turbulent model (k-ω,SST) .The numerical solution was carried out for 25 mode
... Show MoreThis research, involved synthesis of some new 1,2,3-triazoline and 1,2,3,4- tetrazole derivatives from antharanilic acid as starting material .The first step includes formation of 2-Mercapto-3-phenyl-4(3H)Quinazolinone (0) through reacted of anthranilic acid with phenylisothiocyanate in ethanol, then compound (0) reaction with chloro acetyl chloride in dimethyl foramamide (DMF) to prepare intermediate S-(α-chloroaceto-2-yl)-3-phenylquinazolin-4(3H)-one (1); compound (1) reacted with sodium azide to yield S-(α-azidoaceto-2-yl)-3-phenylquinazolin-4(3H)-one (2), while Schiff bases (3-10) were prepared from condensation of substituted primary aromatic amines with different aromatic aldehydes in absolute ethanol as a solvent. Compound (2)
... Show MoreThis study deals with the Spatial and Periodical Variation of the Economical Activities for the
Population of Al – Anbar Province on the level of districts , according to the Population
Computation for the period 1987 and 1997 and the results of determinations and numberings
for the year of 2011 .
This study depends on the Details Classifications of the 17th Activities for 1997 and 2011
beside the Triple Classification of the Economical Activities for the three study years .
The study proves that there is a spatial and periodical variation on the level of study area , and
that’s because of many factors , one of the most important of them was the distribution of
economical siege, as well as the weakness of the