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: The study aimed to investigate the effect of different techniques of en masse retraction on the vertical and sagittal position, axial inclination, rate of space closure, and type of movement of maxillary central incisor. Materials and methods: A typodont simulation system was used (CL II division 2 malocclusion). Three groups were used group 1(N=10, T-loop), group 2(N=10, Time-Saving loop), and group 3(N=10, Microimplant). Photographs were taken before and after retraction and measurements were made using Autodesk AutoCAD© software 2010. Kruskal-Wallis one-way analyses of variance and Mann-Whitney U test (p?0.05) were used. Results: The rate of space closure showed no significant difference among the three groups (p?0.05), whi
... Show MoreSingle Point Incremental Forming (SPIF) is a forming technique of sheet material based on layered manufacturing principles. The sheet part is locally deformed through horizontal slices. The moving locus of forming tool (called as toolpath) in these slices constructed to the finished part was performed by the CNC technology. The toolpath was created directly from CAD model of final product. The forming tool is a Ball-end forming tool, which was moved along the toolpath while the edges of sheet material were clamped rigidly on fixture.
This paper presented an investigation study of thinning distribution of a conical shapes carried out by incremental forming and the validation of finite element method to evaluate the limits of the p
... Show MoreHelps to use the mechanics of organizational agility in improving product quality by reducing waste or reduce it by removing activities that do not add value, which is the main reason for inefficiency and low productivity and increase costs, so the difficulty of changing administrative decisions to cope with internal and external changes to keep up with market trends renewable are the basic issue that research seeks to be addressed through the adoption of mechanisms of organizational agility, which will be reflected in bottom line in a positive way in improving the quality of products, and thus lies Applied important to look at the light of the results achieved and in which they can know the nature of the relationship between the
... Show MoreIn this research study the effect of fish in alternating electrical properties at room temperature copper oxide membranes and fish prepared in a manner different thermal spraying chemical on a thin glass bases and heated
Diabetes Mellitus is a group of metabolic diseases characterized by increasing of glucose level in plasma compared with normal value (hyperglycemia). This disease also causes elevation of lipid profile levels except HDL (High density lipoproteins) which increased relatively. The effects of the polyphenolic mixture (catechins, epicatechins, procyanidin B1, procyanidin B2 and procyanidin C1) on total cholesterol (TC), triacylglycerol (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were studied in (30) streptozotocin-induced diabetic mice with (20-25)gm weight. Mice were given (30 mg/mL) of Polyphenolic Cocoa beans Extracts (CE) once daily for (7) days before Streptozotocin STZ injection and for (21 day) there after. A
... Show MoreCO2 laser (10.6 μm) is the most often used laser in the oral surgery due to its high absorption by water of the oral tissues. Several benefits of the use of CO2 laser have been reported for oral surgical procedures. This study aims to evaluate the effect of CO2 laser on soft and hard oral tissues (in vitro study). This study was done on fresh tissues from sheep’s head. CO2Surgical Laser with different operation modes was used; 0.2 mm spot size using different laser parameters on the tongue, and bone making holes, incisions and cutting. The depths and widths of holes and incisions were measured using endodontic file under magnification. The speed of incisions was calculated and the required time for cutting was measured using sport clo
... Show MoreNA Nasir, SHM Ali, HQMA AL-Ess, WA Hussein, MKW Al-Janabi, KIA Mohammed, JM Mosa, Euromediterranean Biomedical Journal, 2020
The Transformation of environments surrounding human which called (place), formed an intermediate compresser in forming awareness pictures, human knowledge, culture and thought features, and changing the systems and contexts of human societies, which led to a change the rhythm of life as a whole. So according to that the place will be encodes according to these data for psychological connotations, lead to human sense of harmony with the place in different manner format, here the search problem lies when trying to detect how Iraqi artist deliberating with the place concept, wondering how to investing place in the contemporary Iraqi drawing within its reference dimension, and showing mechanisms from comparative study for the works of two a
... Show MoreBackground: Apicoectomy and retrograde filling is indicated when conventional endodontic treatment is impossible or failed to achieve apical seal. The aim of this study was to evaluate the effect of ER: YAG laser on apical microleakage. Materials and Methods: Sixty extracted single-rooted teeth were used in this study. The roots were divided into six groups. Group 1: apicoectomy by fissure bur, and apical cavities prepared by round bur, then cavities were filled with MTA. Group 2: the roots preparations and fillings were the same as group 1, then the apical areas were treated by Er:YAG Laser. Group 3: apicoectomy by fissure bur, and apical cavities prepared by ultrasound retrotip and cavities were filled with MTA. Group 4: the roots prepara
... Show More