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.
Abstract:
The models of time series often suffer from the problem of the existence of outliers that accompany the data collection process for many reasons, their existence may have a significant impact on the estimation of the parameters of the studied model. Access to highly efficient estimators is one of the most important stages of statistical analysis, And it is therefore important to choose the appropriate methods to obtain good estimators. The aim of this research is to compare the ordinary estimators and the robust estimators of the estimation of the parameters of
... Show MoreThis study presents a rapid, sensitive, and straightforward approach to measure chlorpheniramine maleate (CPM) by using turbidity CFIA. The method involves CPM reacting with sodium nitroprusside (Nitropress) to produce a pale white precipitate. The NAG-SSP-5S1D analyzer was used to measure turbidity at 0°–180° angle to detect the attenuation of incident light as a result of collision on the surfaces of the precipitate particles. The linear range of CPM measurements was between 0.008 and 11 m.mol/L, with correlation coefficient of 0.9983 and R2% = 99.65. The limit of detection was determined to be 0.0328 µg/sample from the lowest concentration in the calibration curve, and the repeatability of the method (RSD%) was less than 0.4% (n = 6
... Show MoreIn this research investigation, a total of eighteen diverse tetra- and penta-lateral cyclic compounds were synthesized. These included 1,3,4-thiadiazole, thiazolidin-4-one (via an alternative method), 1,2,4-triazole, carbothioamide, thiazole-4-one, azetidin-2-one, and oxazole. The synthesis procedure entailed a sequence of reactions. The thiazolidine-4-one 1 was obtained by reaction p-aminobenzoic acid with thiosemicarbazide, followed by treatment with p-tolualdehyde to produce Schiff base 2. Reaction Schiff base 2 with mercaptoacetic acid in dry benzene was carried out to produce thiazolidine-4-one 3. In another synthesis pathway, the esterification of p-nitro benzoic acid with ethanol in the presence of sulfuric acid was
... Show MoreThe research aims to determine the impact of employees’ retention strategy on organizational memory. This research is historical, descriptive, and analytical. The sample consists of 158 faculty members in five private colleges in Baghdad. The technique used to analyze the data is SEM (Structural Equation Modeling), and SPSS (Statistical Package for the Social Sciences). The research concludes that the employees retaining strategy plays a vital role in retaining employees and hence maintains organizational memory. The findings and recommendations of this research assure the administrations of private colleges that employees retention strategy play a vital role in retaining its employee and hence maintains organizational memory. T
... Show MoreThe research aims to study the administrative problems in the sports management of the members of the administrative bodies of the first-class clubs of the province of Baghdad in football. The researchers used the descriptive approach (survey study) for its relevance to the nature of the research. The research community is represented by first-class football players, who numbered (176) players. The research sample was chosen by the deliberate method, as the basic research sample reached (136) individuals from the total research community. The researchers used the questionnaire to collect the necessary data to achieve the goal of the research by applying a questionnaire that aims to ident
... Show MoreThe current world seeks to supply the most of the fruits of human knowledge and tries hard to search for the most important scientific facts, programs, means and advanced devices in various fields, including the sports field, and among these means is the use of various and advanced training devices and programs for the purpose of achieving the desired goal, which is to reach the desired level, the basketball game is one of the sports that need high technology in training according to scientifically studied principles because it is one of the games that relate to the abundance of its variables, composition and speed of change, all of which require a technical and high training depth and the players ’possession of different physical charact
... Show MoreFiber‐reinforced elastic laminated composites are extensively used in several domains owing to their high specific stiffness and strength and low specific density. Several studies were performed to ascertain the factors that affect the composite plates’ dynamic properties. This study aims to derive a mathematical model for the dynamic response of the processed composite material in the form of an annular circular shape made of polyester/E‐glass composite. The mathematical model was developed based on modified classical annular circular plate theory under dynamic loading, and all its formulas were solved using MATLAB 2023. The mathematical model was also verified with real experimental work involving the vibration test of the f
... Show MoreThe present article discusses the synthesis of tetradentate Schiff base complexes formed by the condensation reaction of 2-hydroxy benzaldehyde and phthalohydrazide. The ligand (LH2) was detected using FT-IR spectra, 1H, 13C-NMR, UV-Vis spectroscopy, elemental microanalysis CHN, and mass spectrometry. The obtained solid complexes have been assessed using physicochemical and spectroscopic techniques, including UV-Vis, FT-IR, nuclear magnetic resonance (1H-NMR, 13C-NMR), mass spectrometry, thermal gravimetric analysis (TGA), and atomic absorption, in addition to complex conductivity and magnetic moment measurements. The infrared results demonstrated that ligands functioning as tetradentate ligands are chelated to metal ions via the ph
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