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.
There is no access to basic sanitation for half the world's population, leading to Socioeconomic issues, such as scarcity of drinking water and the spread of diseases. In this way, it is of vital importance to develop water management technologies relevant to the target population. In addition, in the separation form of water treatment, the compound often used as a coagulant in water treatment is aluminum sulfate, which provides good results for raw water turbidity and color removal. Studies show, however, that its deposition in the human body, even Alzheimer's disease, can cause serious harm to health and disease development. The study aims to improve the coagulation/flocculation stage related to the amount of flakes, i
... Show MoreLet be a ring. Given two positive integers and , an module is said to be -presented, if there is an exact sequence of -modules with is -generated. A submodule of a right -module is said to be -pure in , if for every -Presented left -module the canonical map is a monomorphism. An -module has the -pure intersection property if the intersection of any two -pure submodules is again -pure. In this paper we give some characterizations, theorems and properties of modules with the -pure intersection property.
the pursue of social systems history present to us solid evidence that the collapse of that systems be caused by either the stagnancy aftermath maturity or unreal intellectual foundation which lead to sudden collapse, while the capitalism can avoided that intellectual damages due to its dynamic system with appropriate auto adaptation mechanism and use it excellently in the right time.
The globalization had excrete (as one of the capitalism adaptation mechanism) its own targets and its methods in framework of multinationals corporations which consist with capitalism states that employed the international organizations to reconstruction the global economy to serve such targets. So the glob
... Show MoreHoneywords are fake passwords that serve as an accompaniment to the real password, which is called a “sugarword.” The honeyword system is an effective password cracking detection system designed to easily detect password cracking in order to improve the security of hashed passwords. For every user, the password file of the honeyword system will have one real hashed password accompanied by numerous fake hashed passwords. If an intruder steals the password file from the system and successfully cracks the passwords while attempting to log in to users’ accounts, the honeyword system will detect this attempt through the honeychecker. A honeychecker is an auxiliary server that distinguishes the real password from the fake passwords and t
... Show MoreThis work aims to develop a secure lightweight cipher algorithm for constrained devices. A secure communication among constrained devices is a critical issue during the data transmission from the client to the server devices. Lightweight cipher algorithms are defined as a secure solution for constrained devices that require low computational functions and small memory. In contrast, most lightweight algorithms suffer from the trade-off between complexity and speed in order to produce robust cipher algorithm. The PRESENT cipher has been successfully experimented on as a lightweight cryptography algorithm, which transcends other ciphers in terms of its computational processing that required low complexity operations. The mathematical model of
... Show MoreBackground. Body mass index (BMI) is a person's weight in kilograms (or pounds) divided by the square of height in meters (or feet). Obesity affects a wide spectrum of age groups, from the young to the elderly, and there are several eye diseases related to obesity like diabetic retinopathy, floppy eyelid syndrome, retinal vein occlusion, stroke-related vision loss, age-related macular degeneration, and possibly, refractive errors. Refractive errors (RE) are optical imperfections related to the focusing ability of the eye and are the main cause of visual impairment which may result in missed education and employment opportunities, lower productivity and impaired quality of life. Aim. The study aimed to find an association between bod
... Show MoreSince Internet Protocol version 6 is a new technology, insecure network configurations are inevitable. The researchers contributed a lot to spreading knowledge about IPv6 vulnerabilities and how to address them over the past two decades. In this study, a systematic literature review is conducted to analyze research progress in IPv6 security field following the Preferred Reporting Items for the Systematics Review and Meta-Analysis (PRISMA) method. A total of 427 studies have been reviewed from two databases, IEEE and Scopus. To fulfil the review goal, several key data elements were extracted from each study and two kinds of analysis were administered: descriptive analysis and literature classification. The results show positive signs of t
... Show MoreA quadruped (four-legged) robot locomotion has the potential ability for using in different applications such as walking over soft and rough terrains and to grantee the mobility and flexibility. In general, quadruped robots have three main periodic gaits: creeping gait, running gait and galloping gait. The main problem of the quadruped robot during walking is the needing to be statically stable for slow gaits such as creeping gait. The statically stable walking as a condition depends on the stability margins that calculated particularly for this gait. In this paper, the creeping gait sequence analysis of each leg step during the swing and fixed phases has been carried out. The calculation of the minimum stability margins depends up
... Show More