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.
This work presents the use of laser diode in the fiber distributed data interface FDDI networks. FDDI uses optical fiber as a transmission media. This solves the problems resulted from the EMI, and noise. In addition it increases the security of transmission. A network with a ring topology consists of three computers was designed and implemented. The timed token protocol was used to achieve and control the process of communication over the ring. Nonreturn to zero inversion (NRZI) modulation was carried out as a part of the physical (PHY) sublayer. The optical system consists of a laser diode with wavelength of 820 nm and 2.5 mW maximum output power as a source, optical fiber as a channel, and positive intrinsic negative (PIN) photodiode
... Show MoreBackground: Gasoline constituents and its derivatives had many hazardous effects on the general health of humans. Thus, gasoline stations workers may be affected by different types of related diseases.This study was conducted to assess selected salivary elements and their relation with dental caries, oral hygiene status and periodontal diseases among gasoline stations workers in comparison with individuals have no regular exposure to gasoline. Materials and methods: The study group consists of thirty male subjects with an age range (33-39) years who worked in different gasoline stations in different areas of Baghdad city and thirty persons that matching in age and gender and not exposed to gasoline were selected as a control group. Dental c
... Show MoreTransient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic pressure head , , , , and ), sinusoidal amplitude range of
... Show MoreCongenital distal vaginal obstruction is usually asymptomatic in a newborn female. On rare occasions, it may present as an acute emergency with life threatening complications.This paper is reporting the rare condition of two newborn females presenting urgently with abdominal distension and acute urinary retention as a result of congenital distal vaginal Obstruction. The case history and urgent management shall be presented and both conditions shall be discussed.
In this study, a bioadhesive dosage form of eoconazole nitrate for vaginal delivery was designed using a combination of bioadhesive polymers: Carbopol 941 p and sodium carboxymethylcellulose or methylcellulose in different ratios. The bioadhesive strength was evaluated by measuring the force required to detach the tablet from sheep vaginal mucosal membrane. It was found that the bioadhesive force was directly proportional to Carbopol 941 p content in the different formulae. The formulae were tested for their swelling behavior using agar gel plate method. The results showed that formulae containing a combination of Carbopol 941 p and sodium carboxymethylcellulose had greater swelling index
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يجمع المختصون أن ليس من نقد إلا وكان مُرحِّلا لنظرية لسانية إلى فضائه، فكان أثر اللسانيات السوسيرية، ومن ثم اللسانيات التوليدية التحويلية معروفا، ولم يكن هذا الأثر محدودا باللسانيين أو نقاد الأدب فحسب، بل امتد إلى الشعراء والجماليين أيضا. وفي هذا البحث سنتوقف عند أثر اللسانيات الوظيفية، وهو ما لم يتوقف عنده إلا قلة من المختصين. ولن نقف عند نقد الوظيفيين للشعر، بل سنقف عند نقدهم للرواية، بقراءة
... Show MoreThe Security Council has an active role in addressing international crises and dealing with their causes. The Libyan crisis is one of the most important real tests of the Security Council and its role in maintaining international peace and security, as the Council has proven so far an ineffective role in resolving the crisis and dealing withtheir causes, which has prolonged its duration and increased its complexities and dangerous repercussions, perhaps the most prominent of which is the threat of the recently achieved cease-fire and the formation of a new transitional government led by Abdel Hamid al-Dabaiba, the growing significant obstacles facing the political process, foremost of which is the continued presence of foreign forces , m
... Show MoreThis paper is devoted to an inverse problem of determining discontinuous space-wise dependent heat source in a linear parabolic equation from the measurements at the final moment. In the existing literature, a considerably accurate solution to the inverse problems with an unknown space-wise dependent heat source is impossible without introducing any type of regularization method but here we have to determine the unknown discontinuous space-wise dependent heat source accurately using the Haar wavelet collocation method (HWCM) without applying the regularization technique. This HWCM is based on finite-difference and Haar wavelets approximation to the inverse problem. In contrast to othe
Alice Walker's novel The Color Purple1983, whose events take place in the rural Georgia and addresses the most important issues in the early 20thcentury; like male dominant society and women submission to men, weaves a mosaic picture of male-female relationships. Black men like Alphonso, Albert and Harpo are portrayed as oppressors, cruel and they exercise power and violence over their wives and daughters. Through the negative portrayal of black male characters, Walker is accused to be a men hating writer because she ''Views oppression as an essentially masculine activity which springs from the male's aggressive need to dominate. In the novel, man is the premium mobile, the one by whom and t
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