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 work, the synergistic effect of chlorinated rubber (additive I),with zeolite 3A (additive II), zeolite 4A (additive III), and zeolite 5A (additive IV) in (1:1) weight percentage, on the flammability for unsaturated polyester resin was studied in the weight ratios for (3,7,10,13&15%) by preparing films of (130×130×3) mm in diameters. Three standard test methods used to measure were the flame retardation which are; ASTM: D-2863, ASTM: D- 635& ASTM: D-3014. Results obtained from these tests indicated that all of the additives were effective additive IV has the highest efficiency as a flame retardant.
The importance of websites appears as a modern tool that helps people connect with each other and exchange information rapidly. An increase number of new websites have been created in public or private spheres, which benefit individuals and society as a whole. This research aims to design a website specialized in marketing sustainable fashion that meets the needs of the Saudi market. It followed a descriptive and analytical approach. A survey has been conducted on a random sample of e-marketing users. The sample number is 101 users. The study resulted in: Determining the effectiveness of e-marketing, studying consumer purchasing tendencies, and designing a website for sustainable fashion based on the survey’s results. The study recomme
... Show MoreThis study deals with the Spatial and Periodical Variation of the Economical Activities for the
Population of Al – Anbar Province on the level of districts , according to the Population
Computation for the period 1987 and 1997 and the results of determinations and numberings
for the year of 2011 .
This study depends on the Details Classifications of the 17th Activities for 1997 and 2011
beside the Triple Classification of the Economical Activities for the three study years .
The study proves that there is a spatial and periodical variation on the level of study area , and
that’s because of many factors , one of the most important of them was the distribution of
economical siege, as well as the weakness of the
A new, simple and sensitive method was used forevaluation of propranolol withphosphotungstic acidto prove the efficiency, reliability and repeatability of the long distance chasing photometer (NAG-ADF-300-2) using continuous flow injection analysis. The method is based on reaction between propranolol and phosphotungstic acid in an aqueous medium to obtain a yellow precipitate. Optimum parameters was studied to increase the sensitivity for developed method. A linear range for calibration graph was 0.007-13 mmol/L for cell A and 5-15 mmol/L for cell B, and LOD 207.4792 ng/160 µL and 1.2449 µg/160 µL respectively to cell A and cell B with correlation coefficient (r) 0.9988 for cell A, 0.9996 for cell B, RSD% was lower than 1%, (n=8) for the
... Show MoreIn this work , an effective procedure of Box-Behnken based-ANN (Artificial Neural Network) and GA (Genetic Algorithm) has been utilized for finding the optimum conditions of wt.% of doping elements (Ce,Y, and Ge) doped-aluminizing-chromizing of Incoloy 800H . ANN and Box-Behnken design method have been implanted for minimizing hot corrosion rate kp (10-12g2.cm-4.s-1) in Incoloy 800H at 900oC . ANN was used for estimating the predicted values of hot corrosion rate kp (10-12g2.cm-4.s-1) . The optimal wt.% of doping elements combination to obtain minimum hot corrosion rate was calculated using genetic alg
... Show MoreLead-free 0.88(Na0.5Bi0.5)TiO3–0.084(K0.5Bi0.5)TiO3–0.036BaTiO3 (BNT–BKT–BT) piezoelectric ceramics were prepared using the conventional mixed-oxide method with a sintering temperature range of 1120–1200 °C. The effect of the sintering temperature on the crystal structure, microstructure, and densification, as well as the dielectrics, piezoelectrics, and the pyroelectric properties of BNT–BKT–BT ceramics were investigated. Scanning electron microscopy and X-ray diffraction were used to study the microstructures of the sintered samples. The results showed that the increase in sintering temperature was very effective in improving both the density and electrical properties. However, the samples deteriorated when the sintering te
... Show MoreThe banking sector is currently facing great challenges resulting from intense competition in the financial environment, and this is what makes the supreme audit bodies and the Central Bank audit as the highest supervisory authority on banks in order to achieve profit and not be exposed to loss, and this requires identifying the banking strengths and risks that constitute points Weakness that affects the future performance and the life of the bank, which requires special supervisory care, and from this point of view, the research aims to use the CAMELS model as a control tool in banks, through the use of its six indicators: capital adequacy, asset quality, management quality, profits, liquidity And sensitivity to market risks, th
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