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 aim of this research is to measure and analyze the gap between the actual reality and the requirements of the environmental management system in the middle refineries company/refinery cycle according to ISO14001: 2015, as well as to measure the availability of a clean production strategy and test the relationship and impact between the availability of the requirements of the standard and a clean production strategy for the actual reality in the company.
The research problem was determined by the extent to which the requirements of the environmental management system are applied according to ISO14001: 2015 in the middle refineries company? To what extent are the required clean production strategies ava
... Show MoreThin films of ZnSe arc deposited on glass substrates by thermal evaporation in vacuum with different thickness (1000, 2700, 4000) A° temperature (293-373) °K are studies the electrical properties before and after annealing. The result show decrease D.0 conductivity and increasing the activation energy Eat.
Anumerical solutions is presented to investigate the effect of inclination angle (θ) , perforation ratio (m) and wall temperature of the plate (Tw) on the heat transfer in natural convection from isothermal square flat plate up surface heated (with and without concentrated hole). The flat plate with dimensions of (128 mm) length × (64 mm) width has been used five with square models of the flat plate that gave a rectangular perforation of (m=0.03, 0.06, 0.13, 0.25, 0.5). The values of angle of inclination were (0o, 15o 30o 45o 60o) from horizontal position and the values of wall temperature (50oC, 60 oC, 70 oC, 90 oC, 100o<
... Show MoreThe research dealt with the study of choice between a range of different words between the repetitive texts in the verses of the Koran and explain the reason behind this choice, and how the context has the greatest impact in this choice, and that each word in the Koran was placed in the most appropriate place, which can not be replaced by equivalent words, whatever The degree of similarity between them in the indication of the other because it remains at the end that each of those vocabulary synonyms are indicative, the first of them especially that makes the possibility of replacing them with the equivalent vocabulary impossible, and the second general significance and this connotation makes them share with their peers In one aspect of
... Show MoreThe electoral poster is the most important means and methods of the electoral campaign because of its advantages and capabilities if it is organized properly. It is an intensive propaganda message with psychological figures and semiotic connotations belonging to sub-culture. Its construction depends on a group of elements (logo, photo symbols, color and picture) and their consistency is varying from one to another. Posters must be committed the determinants of attraction, excitement, simplicity and clarity. They are working according to the following base: (fixed audience X moved recipients) and walking towards (moving X moving) due to the technical development of optical screens. These developments require double the force of the impact
... Show MoreHere, a high sensitive method for biomarker identification according to nanostructure, using enzyme-linked immunosorbent assays (ELISAs), called Nano-ELISA, was presented. Different shapes of gold nanostructures (star and sphere; GNSs and GNPs) with a particle size of 40 nm for sphere particles were altered with a monoclonal antibody (Ab) as a detector Ab. To amplify the optical signal, gold nanostructures were employed as carriers of the signaling specific antibody against insulin growth factor binding protein- 3 (IGFBP-3). The substrate was catalytically oxidized by the Horseradish Peroxidase (HRP) conjugated gold nanostructure, and HRP also enhanced the optical signals, reflecting the amount of the targeting IGFBP-3. In comparison to t
... Show MoreCarrageenan extract is a compound of sulfated polyglycan that is taken out from red seaweeds. Being hydrocolloid in nature, carrageenan has gelling, emulsifying and thickening properties allowing it to be commonly used in the oral healthcare products and cosmetics. Due to its bioactive compounds, carrageenan has been shown to have antimicrobial, antiviral, and antitumor properties. The purpose of this work is to study the probable use of carrageenan on the diseases that are related to oral cavity and on the genomic DNA in in vitro experimental model
In this study, the effects of k-carrageenan on four different cell lines related to the cancer and normal cells which cultured on selective media were done. Moreover, the eff
... Show MoreObjective. This study aimed to evaluate and compare the force degradation of two types of elastomeric chains following different periods of immersion in zinc-containing mouthwashes. Materials and Methods. Four hundred and forty pieces of Elasto-Force and Super Elasto-Force elastomeric chains were divided into two control and eight experimental groups. The pieces were stretched to 25 mm on pins mounted on an acrylic block and stored in distilled water at 37°C. The experimental groups were immersed in four different types of mouthwash for one minute twice a day throughout the test period. Ten continuous thermocycles per day between cold and hot water baths (5–55°C) were carried out. Forces were measured at six-time intervals (in
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