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.
In this experimental and numerical analysis, three varieties of under-reamed piles comprising one bulb were used. The location of the bulb changes from pile to pile, as it is found at the bottom, center, and top of the pile, respectively.
Of the new concepts introduced by the decree of the amendment of the French Civil Code No. 131-2016 issued on 10 February 2016, which raised a debate in jurisprudence both at the level of French jurisprudence or the Arab, the concept of (the content of the contract), which seems to have emerged from the appearance of new legal articles ( 1162-1171) is the cornerstone of the contract and the contract in the contract, the two pillars which, over the course of 200 years and a half, have been one of the main pillars of the codification of Napoleon. Is that the decree of amendment has already abandoned these two pillars, or most of what he did is a change in terminology while preserving the content of these two pillars implicitly, this is what w
... Show MoreBackground: The formation of white spot lesions around fixed orthodontic attachments is a common complication during and after fixed orthodontic treatment, which hinders the result of a successfully completed orthodontic treatment. The aim of the study was to assess the effectiveness of the Caries Infiltrant (ICON®) on prevention of caries on the smooth enamel surface when applied alone or combined with conventional adhesives. Materials and methods: Seventy eight human premolar enamel discs were randomly assigned to six groups (n=13). The discs were etched and treated with resins of different monomer content forming the following groups: (1)Untreated etched samples served as the negative control, (2) ICON® (DMG), (3) Adper™ S
... Show MoreEvaluation of the Antibacterial Efficacy of Electrolyzed Oxidizing Water as an Irrigant against Enterococcus faecalis (An In vitro Study), Noor A Khait*, Muna Saleem Kalaf
Background: White spot lesion is the first visible sign of dental caries that is characterized by demineralized lesion underneath an intact surface. Several studies demonstrated that they could be treated using noninvasive techniques like the use of fluoride or casein phospho-peptide and amorphous calcium phosphate. Improvement in aesthetic outcomes by covering the demineralized enamel is one of the advantages of the use of resin infiltration and opal-ustre microabrasion, which are two new techniques that had been used for treatment of white spot lesion. The purpose of this study was to evaluate the impact of resin infiltration and microabrasion in the microhardness of the artificial white spot lesions at various depths. Material and method
... Show MoreSixty urine samples were collected from women with urinary tract infection in different ages. The aims of this study were determined the dominancy of pathogens isolated from urine of women with UTI and evaluating the antibacterial activity of Rosmarinus officinalis L. essential oil against these pathogenic isolates. Identification of bacteria was done on Chromogenic orientation agar while disc diffusion method was used for determination the sensitivity of bacterial isolates to antibiotics and Agar well diffusion method was used for evaluation the antibacterial effect of Rosemary essential oil on these isolates. The results showed that 50% of women infected with Escherichia coli, it was dominants in ages above 15 years old while Staphylococc
... Show MoreBackground: The marginal fit is the most characteristic that closely related to the longevity or success of a restoration, which is absolutely affected by the fabrication technique. The objective of present in vitro study was to evaluate the effect of four different CAD/CAM systems on the marginal fit of lithiµm disilicate all ceramic crowns. Materials and Methods: Adentoform tooth of a right mandibular first molar was prepared to receive all ceramic crown restoration with deep chamfer finishing line (1mm) and axial reduction convergence angle of 6 degree, dentoform model duplicated to have Nickel-Chromiµm master die. Thirty two stone dies produce from master die and distributed randomly in to four groups (8 dies for each group) accor
... Show MoreBackground In recent years, there has been a notable increase in the level of attention devoted to exploring capabilities of nanoparticles, specifically gold nanoparticles AuNPs, within context of modern times. AuNPs possess distinct biophysical properties, as a novel avenue as an antibacterial agent targeting Streptococcus Mutans and Candida Albicans. The aim of this study to create a nano-platform that has the potential to be environmentally sustainable, in addition to exhibiting exceptional antimicrobial properties against Streptococcus Mutans as well as Candida Albicans. Methods this study involved utilization of
Background: This in vitro study evaluated the fracture resistance of weakened endodontically treated premolars with class II MOD cavities restored with different composite restorations (Low-shrinkage Filtek P90, nanohybrid Filtek Z250 XT and SDR bulk fill). The type and mode of fracture were also assessed for all the experimental groups. Materials and Method: Fifty human adult maxillary premolar teeth were selected for this study. Standardized extensive class II MOD cavities with endodontic treatment were prepared for all teeth, except those that were saved as intact control. The teeth were divided into five groups of ten teeth each (n=10): (Group 1) intact control group, (Group 2) unrestored teeth with endodontic treatment, (Group 3) resto
... Show MoreThe study aimed to evaluate educational programs efficiency in applying the best educational practices to educate students from the dangers of indecent behaviors, in line with higher education policy and the appropriateness of educational program dimensions to spread awareness among students to not fall into the indecent behaviors clutches. The study adopted the inductive exploratory approach through structural equation modeling and the descriptive analysis of the collected data from randomly selected sample (n=385) from educational academics at Northern Border University in the Saudi Arabia using a specially designed survey tool to meet study purposes to evaluate dimensions of teaching methods, evaluation tools, training courses, course
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