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.
To study the site of placentae and the umbilical artery blood flow of different age groupsand relate that to the newborn baby and the mother. 117 placentae samples were investigatedusing ultrasound and 30 placentae samples were studied using Doppler ultrasound during theperiod from August 2007 to August 2008 for full term placentae of mothers aged 15- > 45 yearsold. By ultrasound; there was detection of good pe rcentage of the placental site to be on theposterior wall of the uterus in case of male babies, while it was anterior in case of female babiesand it was previa and fundal in females more than in the males. The Doppler ultrasound revealedthat the mother in any age group can conceive and have a healthy placenta because the readings ina
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The Ash'aris and their position on faith, An Ideological Study
Omed AbdulQader rasool
College of Islamic Sciences/Salahaddin University-Erbil
Abstract
The concept of faith is very complex, and there are a lot of talk about it among the major Islamic groups such as the Kharijites, the Mu'tazila, the Jahmiyya and others, because of its great importance, and the worldly and eschatological effects it entails according to the elements of faith such as recognition, ratification and action.
The researcher chose one sect, which is the
... Show MoreAn experimental study is made here to investigate the discharge coefficient for contracted rectangular Sharp crested weirs. Three Models are used, each with different weir width to flume width ratios (0.333, 0.5, and 0.666). The experimental work is conducted in a standard flume with high-precision head and flow measuring devices. Results are used to find a dimensionless equation for the discharge coefficient variation with geometrical, flow, and fluid properties. These are the ratio of the total head to the weir height, the ratio of the contracted weir width to the flume width, the ratio of the total head to the contracted width, and Reynolds and Weber numbers. Results show that the relationship between the discharge co
... Show MoreThe purpose of this study was to examine the association of oral administration of Carbamazepine during pregnancy and the histological changes in the ovaries of mice. Timed-pregnant mice were divided into experimental and control groups. 60 mice in the experimental group received daily oral of 15 mg/kg of carbamazepine via intragastric tube on gestational days 0 to 18. 20 mice were used as control group. They received normal saline via the same route. Dams underwent laparotomy on pregnancy days 13, 15, and 18 and the ovaries were collected. Routine histological processing of the ovaries histology of paraffin sections stained with haemotoxylin and eosin, were conducted. The ovary under the effect of the drug, there was signs of degeneration
... Show MoreThis study involves adding nano materials and interaction with cement mortar behavior for several mortar samples under variable curing time with constant water to cement ratio (W/C = 0.5). The effects of adding nano materials on the microstructure of cement mortar were studied by (Scanning Electronic Microscopy (SEM) and X-Ray (for samples at different curing time 28 and 91 days. Small ratio replacements of nano particles (SiO2 or Al2O3) were added to Ordinary Portland Cement (OPC) type (I). The percentage of nano materials additives replacement by weight of ordinary Portland cement includes (1, 2, 3, 4 and 5%) for both types of nano materials with constant (W/C) ratio, also the amount of the fin
... Show MoreIn the present study, a powder mixture of elements Ti and Ni was mechanically alloyed in a high energy ball mill. Microstructure of the nanosized amorphous milled product in different stages of milling has been characterized by X- ray diffraction, scanning electron microscopy and differential thermal analysis. We found that time of mechanical alloying is more significant to convert all crystalline structure to the amorphous phase. Nanocrystalline phase was achieved as a result of the mechanical alloying process. The results also indicates that the phase transformation and the grain size occurs in these alloys are controlled by ball milling time
In this research, geopolymer mortar had to be designed with 50% to 50% slag and fly ash with and without 1% micro steel fiber at curing temperature of 240℃. The molarity of alkaline solution adjusted with 12 molar sodium hydroxid to sodium silicate was 2 to 1, reaspectivly. The heat of curing increased the geopolymerization proceses of geoplymer mortar, which led to increasing strength, giving the best result and early curing age. The heat was applied for two days by four hours each day. It was discovered in the impact test that the value first crack of each mix was somewhat similar, but the failure increased 72% for the mixture that did not contain fiber. For the energy observation results it was shown that the mixt
... Show MoreWe have investigated the photoemission and electronic properties at the PTCDI molecules interface on TiO2 and ZnO semiconductor by means of charge transition. A simple donor acceptor scenario used to calculate the rate for electron transfer of delocalized electronics in a non-degenerately TiO2 and ZnO electrodes to redox localized acceptors in an electrolytic. The dependent of electronic transition rate on the potential at contact of PTCDI with TiO2 and ZnO semiconductors, it has been discussion using TiO2 and ZnO electrodes in aqueous solutions. The charge transfer rate is determining by the overlapping electronic coupling to the TiO2 and ZnO electrodes, the transition energy, potential and polarity media within the theoretical scenario of
... Show MoreThis study was designed to evaluate the effect of major surgery on thyroid hormones and thyrotropin in patient undergoing major lower abdominal surgery. The study included fifty patients scheduled for elective major lower abdominal surgery, the serum levels of T3, T4 and TSH were determined one day preoperatively, intraoperative, one day postoperatively, two days postoperatively, and rT3 was determined one day preoperatively, and one day postoperatively. We observed that the levels of (T3, T4, TSH) increased significantly (P<0.05) intraoperatively, one day postoperatively the levels of T3 and T4 reduced significantly (P<0.05), while TSH reduced not significantly (P>0.05), and two days postoperatively T4 and TSH returned to increase si
... Show MoreThe effects of solar radiation pressure at several satellite (near Earth orbit satellite, low Earth orbit satellite, medium Earth orbit satellite and high Earth orbit satellite ) have been investigated. Computer simulation of the equation of motion with perturbations using step-by-step integration (Cowell's method) designed by matlab a 7.4 where using Jacobian matrix method to increase the accuracy of result.