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.
Retreatment Efficacy of Continuous Rotation Versus Reciprocation Kinematic Movements in Removing Gutta-Percha with Calcium Silicate-Based Sealer: SEM Study, Raghad Noori Nawaf*, Ra
This work involves separating and studying the aminoacylase-1 (ACY1) of amniotic fluid from healthy pregnant, mainly one peak with higher activity has been isolated by DEAE-Cellulose ion exchange from the proteinous supernatant produced by deposition of proteins using ammonium sulfate (65%) after dialysis. The purification folds reaching to 19 folds also gave one protein peak when injected into the gel filtration column, a high ACY1 purity was obtained, with 38 folds of purification. It was found that the molecular weight of the isolated ACY1 was up to 46698 Dalton when using gel chromatography technique.The effect of ACY1 isolate was studied on rats with oxidative stress caused by lead acetate(LA) at 40 mg / kg body weight and compare
... Show MoreABSTRACT Background: resin cement type and intraoral temperature fluctuations may affect the fracture performance of successful zirconia restorations. To fill this gap, the purpose of this study is to evaluate and compare the influence of thermocycling on fracture resistance and mode of failure of monolithic zirconia crowns luted with Rely X™ U200 and BreezeTMself-adhesive resin cements as well as imply the effect of adding 2 % of polylysine (PLS) to these cements. Materials: 64 maxillary premolars were milled out of zirconia blocks using CAD/CAM milling system. They were divided into four groups (n = 16) according to the cement type. Four different resin cements were used (RelyXTMU200, Breeze™, RelyX™ U200 with 2 % PLS
... Show MoreBackground: Decontamination of gutta percha cones was important factor for success of root canal treatment. The aim of the present in vitro study was to identify and to compare the antimicrobial effect of following disinfection solutions: 0.2% chlorhexidine gluconate, Iodine, tetracycline hydrochloride solution, EDTA & formocresol mixed with zinc oxide eugenol, on E faecalis, E coli and Candida albicans using sensitivity test Materials and Methods: Three types of microorganisms were isolated from infected root canals (E faecalis, E coli and Candida albicans) and cultured on Mueller Hinton agar petri-dishes. Disinfection of gutta percha cones done by immersion in six disinfection solutions (six groups), the groups are: distill water (used a
... Show MoreATTAPULGITE clay was modified in this study by the graphene oxide sheets and the clay was diagnosed before and after modification using several techniques (Fourier-transform infrared spectroscopy FT-IR, X-ray powder diffraction XRD, Scanning electron microscope SEM , energy dispersive spectroscopy EDX ) ,The surface of the attapulgite clay (before (Ata) after modification by graphene oxide (Ata-GO) ) was applied to adsorption of the Alizarin dye from its water solutions through the application of several kinetic models (pseudo first-order model , pseudo second -order model , intraparticle diffusion model ),It was found that the practical results follow pseudo second -order model. The process of modification on the surface of the mud has imp
... Show MoreThis study was conducted on Lake Hamrin situated in Diyala governorate, focal Iraq, between latitudes 44º 53ʹ 26.16 '- 45º 07 ʹ 28.03ʺ and 34º 04ʹ 24.75ʺ ــ 34º 19ʹ 12.74ʺ . As in this study, the surface area of Hamrin Lake was calculated from satellite images during the period from October 2019 to September 2020, with an average satellite image for each month, furthermore,by utilizing the Normalized Differences Water Index (NDWI), the largest surface area was 264,617 km2 for October and the lowest surface area 140.202 km2 for September. The surface temperature of the lake water was also calculated from satellite images of the Landsat 8 satellite, based on ban
... Show MoreAbstract
The current research aims to develop a guidance program suitable for high school students and apply it to them in order to ensure the reduction of addiction to the use of different means of communication. The researchers used the scale of addiction to the means of communication (SAS) to measure the level of addiction as well as to identify the impact of the proposed guidance program in reducing the degree of addiction to communication. It was applied to a sample of (20) female students divided equally into two groups: an experimental group of (10) female students and a control group of (10) female students from the secondary level in a school under the department of education in the education of the alma
... Show MoreLately great interests have emerged to find educational alternatives to teach and improve motor skills according to modern educational methods that take into account individual differences and speed in learning for the learner through individual learning that the learner adopts by teaching himself by passing through various educational situations to acquire skills and information in the way he is The learner is the focus of the educational process and among these alternatives the interactive video, the researchers noted through the educational training units at the Model Squash School of the Central Union, and that most of the methods and methods used in learning basic skills take a lot of time in the educational program and do not involve
... Show MoreIn the age of information and communication revolution, education as one of life
aspects has influenced with that revolution by integrating technology in education, which
have become as an important learning tools of the whole educational process . Technology,
when used appropriately, can help make science classroom a site of active learning and
critical thinking, furthering student inquiry and connections with different materials. It is
necessary to develop human rights education programs and materials for discretionary and
extracurricular activities as it provide them with the skills and tools so that they are
empowered to take action to realize their rights. Human rights education is a critical means of
instill