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.
Aim: The present study aims to improve the poor water solubility of zaltoprofen which is a non-steroidal anti-inflammatory drug (NSAIDs) with a potent analgesic effect using solid dispersion then formulate it as a hollow type suppository to be more convenient for geriatric patients. Materials and Method: Zaltoprofen solid dispersions were prepared by solvent evaporation technique in different zaltoprofen: Soluplus® ratios. Results: Among the formulations tested, zaltoprofen solid dispersion preparation using 1:5 (zaltoprofen: Soluplus®) ratio showed the highest solubility and selected for further investigation. Solid dispersion characterization was evaluated by differential scanning calorimetry (DSC), X-ray diffraction study (XRD) and Fou
... Show MoreThis study investigates the performance of granular dead anaerobic sludge (GDAS) bio-sorbent as permeable reactive barrier in removing phenol from a simulated contaminated shallow groundwater. Batch tests have been performed to characterize the equilibrium sorption properties of the GDAS and sandy soil in phenol-containing aqueous solutions. The results of GDAS tests proved that the best values of operating parameters, which achieve the maximum removal efficiency of phenol (=85%), at equilibrium contact time (=3 hr), initial pH of the solution (=5), initial phenol concentration (=50 mg/l), GDAS dosage (=0.5 g/100 ml), and agitation speed (=250 rpm). Fourier transform infrared (FTIR) analysis proved that the carboxylic acid, aromatic, alk
... Show MoreThe objective of the conventional well testing technique is to evaluate well- reservoir interaction through determining the flow capacity and well potential on a short-term basis by relying on the transient pressure response methodology. The well testing analysis is a major input to the reservoir simulation model to validate the near wellbore characteristics and update the variables that are normally function of time such as skin, permeability and productivity multipliers.
Well test analysis models are normally built on analytical approaches with fundamental physical of homogenous media with line source solution. Many developments in the last decade were made to increase the resolution of transient response derivation to meet the
... Show MorePenetrating cardiac injuries caused by nail guns are exceedingly rare but often life-threatening, with reports showing an increasing trend. We described the case of an adolescent male who sustained accidental cardiac penetration by an iron nail while performing carpentry work. Rapid referral to a specialized cardiac center enabled timely surgical intervention, illustrating the pivotal role of early recognition, expedited transfer, and expert management in optimizing outcomes. This case also highlights the grave risks associated with the employment of minors in hazardous occupational settings, where exposure to unsafe environments may lead to catastrophic consequences.
Background: To assess the alveolar bone crest level (ABCL) by Cone Beam Computed To-mography (CBCT) and to investigate several variables as predictors for the height of the alveolar bone in adolescents. Materials and methods: Age, sex, and ethnic groups were rec-orded for each patient. CBCT images were used to obtain measurements of the interproximal alveolar bone level from the cementoenamel junction (CEJ) to the alveolar crest. The highest measurement in each sextant was recorded along with any presence of a vertical bone defect or calculus. Results: Total of 720 measurements were recorded for 120 subjects. No vertical bony defects or calculus were observed radiographically. Statistically significant (P< 0.05) differences were observed be
... Show MoreThe current research aims to evaluate liquidity (as an independent variable) to improve the bank’s profitability (as a dependent variable ), by the bank’s ability to maximize its profits from its business results without excessive bank’s liquidity, so that may affect negatively affects the bank’s reputation and it’s dealers confidence in facing their financial obligations. and this may lead trying to come out among other recommendations including contributing to obtain, the bank’s ability to achieve liquidity balance to maximize its profits. This research has been applied to the sample induced intentionally by choosing three Iraqi private banks. The researcher used financial indicators to assess the bank’s liq
... 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 MoreBy reading the book (Endless Forms Most Beautiful: The New Science of Evo Devo) by Sean B. Carroll, new horizons opened up about the nature of the formation of the living organism. Although he presented the idea that the artist was influenced by the material assets of nature in his holographic art formations, the new science of Evo-Devo (Evolutionary Developmental Science) provided models worth standing on when comparing the similarity of the formation of living organisms on the one hand, and the formation of works of art with holographic organic bodies on the other. But the excitement lies in the fact that the formation of living natural organisms is often driven by subtle intelligent mechanisms that are different from the mechanisms us
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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
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