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.
Human herpes virus-8 (HHV-8) infection has increased recently in Arabic countries. HHV-8 in healthy persons does not necessarily cause life-threatening infection, and however, it causes a more severe infection among immunocompromised patients. The distribution of HHV-8 genotypes varies according to ethnicity and depends on the geographic region prior rapid development of global travel. A cross sectional prospective study included a hundred healthy blood donor samples with a mean age of (36.60±10.381), 81% were positive for molecular detection of HHV-8 DNA. PCR results for HHV-8 were strongly related with risk factors such as the number of sexual relations, previous surgeries, blood transfusion, dental operation, and the number of b
... Show MoreThe tax revenues achieved through projects of transition to private sector are regarded as an important source for using in achieving political, economic and social objectives. Since Iraq is heading towards free market economy, new strategies should be adopted to reform the taxation system from by a qualified taxation management office and to activate the taxation policy and to reconsider legislation in relation to the aware of the legible to the importance of disclosure of their taxable real income in order to arrive at contribution of privatization in the taxation revenues for the important role effect on economic activities. In the light of the above, the research is based upon a hypothesis which stipulates that privatization contribu
... Show MoreThe purpose of this paper is to examine absorbance for the removal of the Red Congo using wheat husk as a biological pesticide. Several experiments have been conducted with the aim of configuring breakthrough data in a fluidized bed reactor. The minimum fluidized velocities of the bed were found to be 0.031 mm/s for mish sizes of (250) µm diameter with study the mass transfer be calculated KL values. The results showed a well-fitting with the experimental data. Different operating conditions were selected: bed height (2, 5 and 10) cm, flow rate (90, 100and 120) ml/sec and particle diameter (250, 600, 1000) µm. The breakthrough curves were plotted for Congo Red, Values showed that the lower the bed, the lower the number of ad
... Show MoreThis study deals with the intellectual representations whose intellectual systems are incarnated in the Jewish personality, which is considered one of the complex intellectual systems that has caused controversy throughout the ages because of the ambiguity due to the religious and psychological factors that were reflected directly and strongly on the intellectual structure of the Jewish community in general and the Jewish - Zionist personality in particular, in an attempt (to create new dimensions embodied by intellectual representations of a human nature embodied by what that - peaceful - religiously oppressed - psychologically and socially isolated character presents, because of the curse of the peoples of the world that was a cause fo
... Show MoreThe objective of the conventional well testing technique is to evaluate well- reservoir interaction through determining the flow capacity and well potential on a short-term basis by relying on the transient pressure response methodology. The well testing analysis is a major input to the reservoir simulation model to validate the near wellbore characteristics and update the variables that are normally function of time such as skin, permeability and productivity multipliers.
Well test analysis models are normally built on analytical approaches with fundamental physical of homogenous media with line source solution. Many developments in the last decade were made to increase the resolution of transient response derivation to meet the
... Show MoreIn this paper, we introduce the concept of cubic bipolar-fuzzy ideals with thresholds (α,β),(ω,ϑ) of a semigroup in KU-algebra as a generalization of sets and in short (CBF). Firstly, a (CBF) sub-KU-semigroup with a threshold (α,β),(ω,ϑ) and some results in this notion are achieved. Also, (cubic bipolar fuzzy ideals and cubic bipolar fuzzy k-ideals) with thresholds (α,β),(ω ,ϑ) are defined and some properties of these ideals are given. Relations between a (CBF).sub algebra and-a (CBF) ideal are proved. A few characterizations of a (CBF) k-ideal with thresholds (α, β), (ω,ϑ) are discussed. Finally, we proved that a (CBF) k-ideal and a (CBF) ideal with thresholds (α, β), (ω,ϑ) of a KU-semi group are equivalent relations.
The Dynamic Load Factor (DLF) is defined as the ratio between the maximum dynamic and static responses in terms of stress, strain, deflection, reaction, etc. DLF adopted by different design codes is based on parameters such as bridge span length, traffic load models, and bridge natural frequency. During the last decades, a lot of researches have been made to study the DLF of simply supported bridges due to vehicle loading. On the other hand, fewer works have been reported on continuous bridges especially with skew supports. This paper focuses on the investigation of the DLF for a highly skewed steel I-girder bridge, namely the US13 Bridge in Delaware State, USA. Field testing under various load passes of a weighed load vehicle was u
... Show MoreBasic Orientation and search path in determining the impact of creative thinking in cultural intelligence field research on the doctors competence, as is a theme of creative thinking great importance in spite of being a old , but his role at the individual level and / or organizational a sustainable effect toward developing a fact uncommon , any sense that one of the pillars of modernity and provide a unique future, as is the competitive weapon of the organizations in an environment dubbed fundamental change and provide all that is unfamiliar, and in the center of the field of research and objective measurement of creative thinking on doctors specialists at the construction of a state of the preference and
... Show MoreAim: The Aim of the study is to compare between Er,Cr:YSGG 2780 nm laser and carbide fissure bur in root-end resection regarding the morphological variations, temperature changes and the duration of resection process.
Settings and Design: 5 W, 25 Hz, 50% water, 80% air,25.47 J/cm2 .
Material and method: twenty-one extracted single rooted teeth endodontically were treated, twenty teeth were obturated and divided into two groups according to method of resection. Group 1 root-end resected using cross cut carbide bur while group 2 root-end resected using laser with MGG6 sapphire tip of 600 μm diameter. Temperature on external root surface and duration of resection were recor
... Show MoreThe construction of development is required to develop various economic sectors with the necessity to meet the various requirement of both individuals and institutions , or through the import process , which must be commensurate with the needs of the market and the economy and development. But in fact , we find that the process of import in Iraq after 2003 took a turn dangerous excesses on limits of philosophy and objectives of the import , which is reflected at the level of national production as well as the policy of dumping and given and the lack of matching a lot of goods and materials imported for Standards and Measures of quality and stands behind it causes many of them exposure to the market and weak sectors with an overlap betwee
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