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.
Experimental study has been conducted for laminar natural convection heat transfer of air flow through a rectangular enclosure fitted with vertical partition. The partition was oriented parallel to the two vertical isothermal walls with different temperatures, while all the other surfaces of the enclosure were insulated. In this study a test rig has been designed and constructed to allow studying the effect of Rayleigh number, aperture height ratio, partition thickness, the position of aperture according to the side walls and according to the height, the position of the partition according to the hot wall, and partition inclination. The experiments were carried out with air as the working fluid for Rayleigh number range (5*107 – 1.3*10
... Show MoreConcurrently with the technological development that the world is witnessing the crime of money laundering to evolve faster and with multiple methods and its economic, political and social impacts raised increasingly. And for phenomenon dangerous the international community in recent years is keen to be considered combating money laundering as a general indication whereby verification of the international response the stats and its banks and financial institutions with international requirements mandated in this aspect, so the increasing interest the governments of countries in the laws and procedures that contribute to the reduction of the phenomenon of money laundering and avoid legislation economy and the banking and financial sectors
... Show MoreThis research aims to study the performance of operations to provide nursing services, which included dimensions (quality, timeliness, leadership skills, behavioral manifestations, relationships with others, problem-solving and decision-making, job performance) and its effects in nursing performance. The research to prove the value of the performance of service delivery processes dimensions by nursing staffs working in Iraqi hospitals, nursing and measuring performance. To find out the nature of nursing services, and a comparison between hospitals to measure the extent of the application dimensional among themselves, and that by relying on the dimensions of a global study, which was measu
... Show MoreIn this work, a single pile is physically modeled and embedded in an upper liquefiable loose sand layer overlying a non-liquefiable dense layer. A laminar soil container is adopted to simulate the coupled static-dynamic loading pile response during earthquake motions: Ali Algharbi, Halabjah, El-Centro, and Kobe earthquakes. During seismic events with combined loading, the rotation along the pile, the lateral and vertical displacements at the pile head as well as the pore pressure ratio in loose sandy soil were assessed. According to the experimental findings, combined loading that ranged from 50 to 100% of axial load would alter the pile reaction by reducing the pile head peak ground acceleration, rotation of the pile, and lateral displacem
... Show MoreObjectives: To assess the performance of a novel resin-modified glass-ionomer cement (pRMGIC) bonded to various tooth tissues after two-time intervals. Methods: 192 sound human molars were randomly assigned to 3 groups (n = 64): sound enamel, demineralised enamel, sound dentine. Sixty-four teeth with natural carious lesions including caries-affected dentine (CAD) were selected. All substrates were prepared, conditioned and restored with pRMGIC (30% ethylene glycol methacrylate phosphate (EGMP, experimental), Fuji II LC (control), Fuji IX, and Filtek™ Supreme with Scotchbond ™ Universal Adhesive. Shear bond strength (SBS) was determined after 24 h and three months storage in SBF at 37C. The debonded surfaces were examined using stereomi
... Show MoreSurface water samples from different locations within Tigris River's boundaries in Baghdad city have been analyzed for drinking purposes. Correlation coefficients among different parameters were determined. An attempt has been made to develop linear regression equations to predict the concentration of water quality constituents having significant correlation coefficients with electrical conductivity (EC). This study aims to find five regression models produced and validated using electrical conductivity as a predictor to predict total hardness (TH), calcium (Ca), chloride (Cl), sulfate (SO4), and total dissolved solids (TDS). The five models showed good/excellent prediction ability of the parameters mentioned above, which is a very
... Show MoreIn this numerical study a detailed evaluation of the heat transfer characteristics and flow structure in a laminar and turbulent flow through a rectangular channel containing built-in of different type vortex generator has been a accomplished in a range of Reynolds number between 500 and 100,000.A modified version of ESCEAT code has been used to solve Navier-Stokes and energy equations. The purpose of this paper is to present numerical comparisons in terms of temperature, Nusselt number and flow patterns on several configurations of longitudinal vortex generator including new five cases. The structures of heat and flow were studied, using iso-contours of velocity components, vortices, temperature and Nusselt n
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