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 study, a bioadhesive dosage form of eoconazole nitrate for vaginal delivery was designed using a combination of bioadhesive polymers: Carbopol 941 p and sodium carboxymethylcellulose or methylcellulose in different ratios. The bioadhesive strength was evaluated by measuring the force required to detach the tablet from sheep vaginal mucosal membrane. It was found that the bioadhesive force was directly proportional to Carbopol 941 p content in the different formulae. The formulae were tested for their swelling behavior using agar gel plate method. The results showed that formulae containing a combination of Carbopol 941 p and sodium carboxymethylcellulose had greater swelling index
... Show MoreThis study investigates the performance of granular dead anaerobic sludge (GDAS) bio-sorbent as permeable reactive barrier in removing phenol from a simulated contaminated shallow groundwater. Batch tests have been performed to characterize the equilibrium sorption properties of the GDAS and sandy soil in phenol-containing aqueous solutions. The results of GDAS tests proved that the best values of operating parameters, which achieve the maximum removal efficiency of phenol (=85%), at equilibrium contact time (=3 hr), initial pH of the solution (=5), initial phenol concentration (=50 mg/l), GDAS dosage (=0.5 g/100 ml), and agitation speed (=250 rpm). Fourier transform infrared (FTIR) analysis proved that the carboxylic acid, aromatic, alk
... 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 MoreThe present study investigates the relation between the biliteral and triliteral roots which is the introduction to comprehend the nature of the Semitic roots during its early stage of development being unconfirmed to a single pattern. The present research is not meant to decide on the question of the biliteral roots in the Semitic languages, rather it is meant to confirm the predominance of the triliteral roots on these languages which refers, partially, to analogy adopted by the majority of linguists. This tendency is frequently seen in the languages which incline to over generalize the triliteral phenomenon, i. e., to transfer the biliteral roots to the triliteral room, that is, to subject it to the predominant pattern regarding the r
... Show MoreThe research focuses on how to reach a mechanism that assists experts, engineers, and others in the architectural & engineering project to verify the co-existence of values and sustainability constituents in it. Research problem shows a clear lack, locally, in the interest to establish a value system and a list that cares about comprehending building components whether considering sustainable building criteria. Hypothesis shows that in order to head towards the applicable sustainable approach of buildings, then a local assessment system should be established to evaluate buildings during its life cycle, and from which buildings would be categorized as sustainable or not. Research aims at establishing main and general
... Show MoreThis paper is devoted to an inverse problem of determining discontinuous space-wise dependent heat source in a linear parabolic equation from the measurements at the final moment. In the existing literature, a considerably accurate solution to the inverse problems with an unknown space-wise dependent heat source is impossible without introducing any type of regularization method but here we have to determine the unknown discontinuous space-wise dependent heat source accurately using the Haar wavelet collocation method (HWCM) without applying the regularization technique. This HWCM is based on finite-difference and Haar wavelets approximation to the inverse problem. In contrast to othe
This research will cover different aspects of estimating process of construction work in a desert area. The inherent difficulties which accompany the cost estimating of the construction works in desert environment in a developing country, will stem from the limited information available, resources scarcity, low level of skilled workers, the prevailing severe weather conditions and many others, which definitely don't provide a fair, reliable and accurate estimation. This study tries to present unit price to estimate the cost in preliminary phase of a project. Estimations are supported by developing mathematical equations based on the historical data of maintenance, new construction of managerial and school projects.
... Show MoreThe principle of citizenship has international dimensions that affect the application of the principle, such as the structure of the international system, and the control of the concepts of globalization, international organizations which played an important role in the consolidation of this principle.
The problem of the study revolves around the effects of international variables on the principle of citizenship in Kuwait during the period 1991-2018.
The study used several indicators, such as: the rule of law, achieving the principle of separation of powers, the right to form parties, the application of the law of nationality, and racial discrimination, women's rights, and freedom of expression.
This work presents the use of laser diode in the fiber distributed data interface FDDI networks. FDDI uses optical fiber as a transmission media. This solves the problems resulted from the EMI, and noise. In addition it increases the security of transmission. A network with a ring topology consists of three computers was designed and implemented. The timed token protocol was used to achieve and control the process of communication over the ring. Nonreturn to zero inversion (NRZI) modulation was carried out as a part of the physical (PHY) sublayer. The optical system consists of a laser diode with wavelength of 820 nm and 2.5 mW maximum output power as a source, optical fiber as a channel, and positive intrinsic negative (PIN) photodiode
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