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.
Titanium-dioxide (TiO2) nanoparticles suspended in water, and ethanol based fluids have been prepared using one step method and characterized by scanning electron microscopy (SEM), and UV–visible spectrophotometer. The TiO2 nanoparticles were added to base fluids with different volume concentrations from 0.1% to1.5% by dispersing the synthesized nanoparticles in deionized water and ethanol solutions. The effective thermal conductivity, viscosity and pH of prepared nanofluids at different temperatures from 15 to 30 oC were carried out and investigated. It was observed that the thermal conductivity, pH, and viscosity of nanofluids increases with the increase in TiO2 nanoparticle volume fraction
... Show MoreIn this research work an attempt has been made to investigate about the Robustness of the Bayesian Information criterion to estimate the order of the autoregressive process when the error of this model, Submits to a specific distributions and different cases of the time series on various size of samples by using the simulation, This criterion has been studied by depending on ten distributions, they are (Normal, log-Normal, continues uniform, Gamma , Exponential, Gamble, Cauchy, Poisson, Binomial, Discrete uniform) distributions, and then it has been reached to many collection and recommendations related to this object , when the series residual variable is subject to each ( Poisson , Binomial , Exponential , Dis
... Show MoreThe nay is one of the important in stvument in Arabic music which is considered one of the oriental instruments used in the oriental music tect, and is also considered one of the basic instruments in Arabic music, It is used in many religious and mundane areas, through its expressive capabilities through which expression and conveyance of feelings to the recipient, despite their importance and role in music, and through the researcher's follow-up to this subject did not find a study on the potential capabilities of the machine. In view of the above, and given the importance of this subject at the researcher, the need arose for research to study (the potential of the flute machine)..
formation constants for the conrdination of aniline pyridine dimethyl sulfoxide dimethyl formamide ethanol dimethylamine have been determined the cordination
The nuclear structure of some cobalt (Co) isotopes with mass number A=56-60 has been studied depending on the effect of some physical properties such as the electromagnetic properties effects, such as, elastic longitudinal form factors, electric quadrupole moments, and magnetic dipole moments. The fp model space is used to present calculations using GXFP1 interaction by adopting the single particle wave functions of the harmonic oscillator. For all isotopes under consideration, the 40Ca nucleus is regarded as an inert core in fp model-space, while valence nucleons are moving through 1f7/2, 2p3/2, 1f5/2, and 2p1/2 orbits. The effects of core-polarization are obtained by the first orde
... Show MoreThe research has been concerned with the modalities of foreign trade payments (foreign trade financing), and made an accounting comparison between them to choose the best way to pay for the imported goods (payment of the real values of imported goods), given the importance of the impact of this activity on the national economy of all countries of the world, especially Iraq for the adoption of a very large amount of imported goods to meet the requirements of the people, which require the flow of huge amounts of foreign currency outside Iraq to pay for these goods, and therefore dealing incorrectly with it leads to the destruction of the national economy and the spread of a number of negative social and economic phenomena of
... Show MoreThe Iranian-Sudanese relations during the era of the transitional government (1985-1986), and the era of the third democratic government, has seen a marked improvement, particularly since the transitional government, which was formed in Sudan following a popular uprising that toppled former President Jaafar Nimeiri followed based on balancing policy in international relations, which is the same policy adopted by the government of Sadiq al-Mahdi that, especially that Mr. Sadiq al-Mahdi had enjoyed close ties with the government in Tehran before he took office, and on the basis of the policy of diplomatic representation between the two countries returned since the time of the transitional government after relations were severed due to the
... Show MoreIn the present work polymer electrolytes were formulated using the solvent casting technique. Under special conditions, the electrolyte content was of fixed ratio of polyvinylpyrolidone (PVP): polyacrylonitrile (PAN) (25:75), ethylene carbonate (EC) and propylene carbonate (PC) (1:1) with 10% of potassium iodide (KI) and iodine I2 = 10% by weight of KI. The conductivity was increased with the addition of ZnO nanoparticles. It is also increased with the temperature increase within the range (293 to 343 K). The conductivity reaches maximum value of about (0.0296 S.cm-1) with (0.25 g) ZnO. The results of FTIR for blend electrolytes indicated a significant degree of interaction between the polymer blend (PVP and PAN)
... Show MoreThe work include synthesis of nanocomposites (X / S / Ag) based on blend from Xanthan gum / sodium alginate polymers (X / S) with different loading of synthesized silver nanoparticales (0.01, 0.03 and 0.05 wt%) were added to the blend. The silver nanoparticles were prepared by reduction method and were characterized and analyzed using X-ray diffraction (XRD) and Atomic force microscope (AFM). XRD study showed the presence nanoparticle of silver with crystalline nature and face-centered cubic (FCC) structure and an average size of nanoparticles ranging from 32 to 37 nm. The surface study was performed using AFM which showed a fairly uniform shape to the nanocomposites and a spherical nature for the silver nanoparticles. The nanocomposite exh
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