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.
The present study investigates the use of intensifiers as linguisticdevices employed by Charles Dickens in Hard Times. For ease of analysis, the data are obtained by a rigorous observation of spontaneously occurring intensifiers in the text. The study aims at exploring the pragmatic functions and aesthetic impact of using intensifiers in Hard Times.The current study is mainly descriptive analytical and is based on analyzing and interpreting the use of intensifiers in terms ofHolmes (1984) andCacchiani’smodel (2009). From the findings, the novelist overuses intensifiers to the extent that 280 intensifiers are used in the text. These intensifiers(218) are undistinguished
... Show MoreToday, the role of cloud computing in our day-to-day lives is very prominent. The cloud computing paradigm makes it possible to provide demand-based resources. Cloud computing has changed the way that organizations manage resources due to their robustness, low cost, and pervasive nature. Data security is usually realized using different methods such as encryption. However, the privacy of data is another important challenge that should be considered when transporting, storing, and analyzing data in the public cloud. In this paper, a new method is proposed to track malicious users who use their private key to decrypt data in a system, share it with others and cause system information leakage. Security policies are also considered to be int
... Show MoreThis paper examines the use of one of the most common linguistic devices which is hyperbole. It shows how hyperbolic devices are used as an aspect of exaggeration or overstatement for an extra effect in which the speaker can use hyperbole to add something extra to a situation in order to exaggerate his idea or speech. It is, like other figures of speech, used to express a negative or positive attitude of a specific unit of language. Thus, this paper is set against a background of using hyperbole concerning two main fields (advertisements and propaganda). So, the use of hyperbole will be implied by analyzing them concerning their meaning) literal and non-literal). Methodology of this
... Show MoreIn 1908 , the American poet Ezra Pound (1885-1972) , the central figure in the modern movement who was the driving force behind several movements , notably Imagism and Vorticism , met the Irish poet W. B. Yeats in London . Pound was employed as his secretary and the two soon became close friends . He found Yeats a realist, symbolist and a metaphysical poet with an uncanny power over words and regarded him the greatest living poet .The poetical style and the occult beliefs of the Irish poet drew the attention of the American Imagist .During the war, Pound and Yeats lived together at Stone Cottage in Sussex studying Japanese literature .Speaking of Yeats , T. S. Eliot described him as "one of those few whose history is the history of their
... Show MoreIn recent years the interest in fractured reservoirs has grown. The awareness has increased analysis of the role played by fractures in petroleum reservoir production and recovery. Since most Iraqi reservoirs are fractured carbonate rocks. Much effort was devoted to well modeling of fractured reservoirs and the impacts on production. However, turning that modeling into field development decisions goes through reservoir simulation. Therefore accurate modeling is required for more viable economic decision. Iraqi mature field being used as our case study. The key point for developing the mature field is approving the reservoir model that going to be used for future predictions. This can
This study we have made a subject of fanny podcast in electronic media, as a new way to express different issues by the public, This study focuses started on how to address social issues in Alegria by ANAS TINA vidéo on the youtube network , you are to know the trends of young amateur about the various issues dealt with as well as the most important methods used to convince browsers.
The researcher used the survey method based on studying 10 episodes videos of blogger ANAS TINA.
The result of the study found that the most important issues are the abduction of children, teaching in Algeria; women in Algeria, The negative aspects of the issues addressed have been established in order to direct public opinion and awareness of ph
Asthma is a condition characterized by bronchial spasms, inflammation, and mucous hypersecretion which leads to difficulties in respiration. Asthmatic patients are usually presented with recurrent attacks of coughing, wheezing, and shortness of breath which could be life-threatening. More than three million cases of asthma in the United States are diagnosed annually. Resveratrol, a polyphenolic stilbene, is known to be useful in controlling asthmatic attacks via different molecular mechanisms within the lung epithelium and infiltrating immune cells. However, few studies mentioned the effect of resveratrol on the microbiome in ovalbumin-induced asthma mouse model. In this study, we ind
A simple, accurate, precise, rapid, economical and a high sensitive spectrophotometric method has been developed for the determination of tadalafil in pharmaceutical preparations and industrial wastewater samples, which shows a maximum absorbance at 204 nm in 1:1 ethanol-water. Beer's law was obeyed in the range of 1-7?g/ mL ,with molar absorptivity and Sandell ? s sensitivity of 0.783x105l/mol.cm and 4.97 ng/cm2respectively, relative standard deviation of the method was less than 1.7%, and accuracy (average recovery %) was 100 ± 0. 13. The limits of detection and quantitation are 0.18 and 0.54 µg .ml-1, respectively. The method was successfully applied to the determination of tadalafil in some pharmaceutical formulations
... Show More