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.
Background: In capturing a negative image, the digital impression secures a digital record for the purposeof designing and creating restorations. The introduction of scanning system presents a paradigm shift in the way of the dental impression procedure and encourages the accuracy of obtained restoration especially in the marginal area as a result of producing accurate final impression The digital system offers many advantages over the Conventional method.. The objective of this present in vitro study was to evaluate the marginal fitness of all ceramic crowns fabricated by direct digital scanning of the prepared tooth using two types of intra-oral cameras (Bluecam camera with strip light projection technique and Omnicam camera with video sa
... Show MoreThis work involves separating and studying the aminoacylase-1 (ACY1) of amniotic fluid from healthy pregnant, mainly one peak with higher activity has been isolated by DEAE-Cellulose ion exchange from the proteinous supernatant produced by deposition of proteins using ammonium sulfate (65%) after dialysis. The purification folds reaching to 19 folds also gave one protein peak when injected into the gel filtration column, a high ACY1 purity was obtained, with 38 folds of purification. It was found that the molecular weight of the isolated ACY1 was up to 46698 Dalton when using gel chromatography technique.The effect of ACY1 isolate was studied on rats with oxidative stress caused by lead acetate(LA) at 40 mg / kg body weight and compare
... Show MoreThe spectral propetties (absorption and fluorescence) of Coumarine-47 laser dye have been studied. This type of laser dye belong the Coumarine family and it has dissolved in chloroform at different concentrations (1x10-5, 5x10-5, and 1x10-4 M) at room temperature. The achieved results have been pointed out to increase in the absorption and fluorescence as the concentration increased which are agreements with Beer – Lambert law. These have been also showed an expansion in the spectral range of absorption and fluorescence with a noticed shift in the direction of longer wavelength (Red-shift) with increasing concentration. The quantum efficiency of the dissolved C47 in chloroform has been computed by using the brevious concentrations
... Show MoreAfter this systematic presentation of the phenomenon of rotation of formulas, ie the construction of the verb and the verb, and the narrated narratives therein differed among the readers, it became clear to us how the difference was clear between reading and the other, and how readers have varied in their readings of the verb, As we have noted through our modest research that the phenomenon of building the verb for the actor and the effect have included the act of both past and present tense, and not limited to a specific time, and this difference in reading was not limited to a particular environment, but beyond To more than one environment This is evidenced by the readings of various readers from the environment of Kufa, Basra, Mecca,
... Show MoreE-learning is a lifeline for the educational process, which contributed to the sustainability of working educational organizations and prevented them from stopping, so the study came to measure the compatibility between E-learning quality dimensions (information technology, educational curricula, teaching methods, and intellectual capital of educational institution) as an independent variable, and educational services quality dimensions represented by (safety, tangibility, reliability and Confidence) as a dependent variable. The sample was 150 teachers was drawn from the College of Administration and Economics community of 293 teachers through the use of several statistical methods to measure the degree of correlation and impact between the
... Show MoreATTAPULGITE clay was modified in this study by the graphene oxide sheets and the clay was diagnosed before and after modification using several techniques (Fourier-transform infrared spectroscopy FT-IR, X-ray powder diffraction XRD, Scanning electron microscope SEM , energy dispersive spectroscopy EDX ) ,The surface of the attapulgite clay (before (Ata) after modification by graphene oxide (Ata-GO) ) was applied to adsorption of the Alizarin dye from its water solutions through the application of several kinetic models (pseudo first-order model , pseudo second -order model , intraparticle diffusion model ),It was found that the practical results follow pseudo second -order model. The process of modification on the surface of the mud has imp
... Show MoreBackground: Decontamination of gutta percha cones was important factor for success of root canal treatment. The aim of the present in vitro study was to identify and to compare the antimicrobial effect of following disinfection solutions: 0.2% chlorhexidine gluconate, Iodine, tetracycline hydrochloride solution, EDTA & formocresol mixed with zinc oxide eugenol, on E faecalis, E coli and Candida albicans using sensitivity test Materials and Methods: Three types of microorganisms were isolated from infected root canals (E faecalis, E coli and Candida albicans) and cultured on Mueller Hinton agar petri-dishes. Disinfection of gutta percha cones done by immersion in six disinfection solutions (six groups), the groups are: distill water (used a
... Show MoreBackground: Cleaning and shaping of root canals successfully requires high volumes of irrigation solutions that can only be applied to the apical third of root canal after enlargement with instrument, so the aim of this study was to evaluate and to compare the efficiency of Maxi-I-probe (side-vented needle), in the amount of root canal irrigant penetration for five different master apical file sizes (MAF) and four different degrees of coronal and middle thirds flaring. Materials and Methods: Two hundred resin blocks with simulated root canals were used in this study and divided into 5 major groups (40 for each) based on the size of master apical files (#20, #25, #30, #35, and #40). Each major group was subdivided into 4 subgroups depending
... Show MoreThe consequences of ionizing radiation-induced oxidative stress on radiographers in X-ray and CT-scan departments utilizing several biochemical were analyzed. The study found highly considerable discrepancies in the interplay between radiation levels and gender in terms of mean Malondialdehyde (MAD), Vitamin D3 (Vit.D3), Triiodothyronine (T3), Thyroxine (T4), and High-Density Lipoprotein (HDL), but not Thyroid Stimulating Hormone (TSH), cholesterol, triglyceride (TG) and Low-Density Lipoprotein (LDL). The findings indicated that malondialdehyde is a useful biomarker for assessing oxidative stress in radiographers with exposure to ionizing radiation.