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.
A detailed study of adsorption from solution of amitriptyline-HCl, chlorpromazine-HCl and
chlordiazepoxide-HCl on bentonite clay surface has been performed at variable conditions of
temperature, pH and ionic strength. It is aimed in this work to explore the capability of this clay in
treatment of poisoning by the mentioned drugs if taken in quantities higher than the usual doses.
Quantities of drugs adsorbed have been determined by UV spectrophotometric technique. The
sequence of adsorption in neutral media at 37.5 CÙ’ followed the order:
Amitriptyline-HCl > chlorpromazine-HCl > chlordiazepoxide-HCl.
The results were discussed in the light of Langmuir and Freundich adsorption isotherms. The usual
basic th
Inherent fluctuations in the availability of energy from renewables, particularly solar, remain a substantial impediment to their widespread deployment worldwide. Employing phase-change materials (PCMs) as media, saving energy for later consumption, offers a promising solution for overcoming the problem. However, the heat conductivities of most PCMs are limited, which severely limits the energy storage potential of these materials. This study suggests employing circular fins with staggered distribution to achieve improved thermal response rates of PCM in a vertical triple-tube heat exchanger involving two opposite flow streams of the heat-transfer fluid (HTF). Since heat diffusion is not the same at various portions of the PCM unit,
... Show MoreNumerous tests are recently conducted to assess vibration's role in accelerating the heat transfer rate in various heat exchangers. In this work, the enhancement of heat transfer by the effect of transfer vibration and inclination angles on the surface of a double pipe heat exchanger experimentally has been investigated. A data acquisition system is applied to record the data of temperatures, flow rates, and frequencies over the tests. A compound technique was adopted, including the application of a set of inclination angles of (0°, 10°, 20°, and 30°) under the effect of frequency of vibration ranging from sub-resonance to over-resonance frequencies. The results showed that the overall heat transfer coefficient enhan
... Show MoreIraqi agriculture faces a major water problem, affecting cultivated areas, agricultural production, farmers’ incomes and food security. However, the results achieved in rationalizing the use of irrigation water are still limited and do not match what they should be in order to meet this serious challenge. The study aimed to provide a vision for the development of the effectiveness of the dissemination of innovations to rationalize the use of irrigation water in Iraqi agriculture. In light of the framework of the dissemination of agricultural innovations, factors related to their effectiveness, and the summary of the Iraqi experience in the field of dissemination of modern irrigation
phenomenon in the Arab women's contemporary literature, but it is rare in Iraqi women's
literature and falls short to the level of the phenomenon until now. Perhaps this is one of the
main reasons that caused the reluctance of researchers to study it, and this is probably the first
academic research in this field.
This research followed the discourse of Autobiography of women in Iraq, depending on the
two factors of charter and reference of the elements of Philippe Lejeune’s definition of the
genre of Autobiography, without focusing on narrative method, so it handled notes,
memories, diaries and biography of the other and counted all under the genre of the
Biography.
It came in three sections, the first follo
This research aims to shed light on the necessity of establishing an information security management system through which banking security risks are managed in the light of the ISO (IEC 27001) standard, through which bank departments seek to demonstrate the management of their security systems and their controls in accordance with the specifications of the standard to obtain an internationally recognized security certificate And the need for senior management in banks to an independent person with scientific and practical qualification and who has accredited certificates in the field of information technology for the purpose of helping them to verify the level of compatibility between the policies and procedures applied and the p
... Show MoreThe objective of this research is to develop a method for applying financial derivatives in the local environment to reduce the risk of foreign exchange rate fluctuations to enhance quality of accounting profits through Financial reporting to local units In accordance with international financial reporting standards, To accomplish this objective was selected a sample of Iraqi units exposed to the risk of fluctuations in foreign currency rates, As the research found:
- many companies and banks in the local environment a lot of losses due to fluctuations in foreign currency exchange rates.
- that financial derivatives in the Iraqi environment represent
The problem of steady, laminar, natural convective flow in an square enclosure with and without partitions is considered for Rayleigh number (103-106) and Prandtl number (0.7). Vertical walls were maintained isothermal at different temperatures while horizontal walls and the partitions were insulated. The length of partition was taken constant. The number of partitions were placed on horizontal surface in staggered arrangement from (1– 3) and ratio of partition thickness (H/L= 0.033, 0.083, 0.124). The problem is formulated in terms of the vorticity-stream function procedure. A numerical solution based on a program in Fortran 90 with the finite difference method is obtained. Representative results illustrating the effects of the thickn
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המשבר הוא מצב מצוי רב בחברת המדינות אחרי המלחמות והשינויים הגדולים במאה העשרים, ומשבר הזהות הוא ממשברי המאה העשרים שזכה בהתעניינות רבה בכל תחומי המדעים האנושיים, ומהם תחום הספרות. ובספרות העברית היה הסופר א. ב. יהושע מהסופרים החשובים שהתעניין בנושא הזהות בישות הציונית, הוא התווכח בנושא ביצירותיו, ראיוניו ורוב הכנסים התרבותיים והפוליטיים שנכח אותם, הוא השתמש באסכולה ספרותית מאו
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