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.
The photo-electrochemical etching (PECE) method has been utilized to create pSi samples on n-type silicon wafers (Si). Using the etching time 12 and 22 min while maintaining the other parameters 10 mA/cm2 current density and HF acid at 75% concentration.. The capacitance and resistance variation were studied as the temperature increased and decreased for prepared samples at frequencies 10 and 20 kHz. Using scanning electron microscopy (SEM), the bore width, depth, and porosity % were validated. The formation of porous silicon was confirmed by x-ray diffraction (XRD) patterns, the crystal size was decreased, and photoluminescence (PL) spectra revealed that the emission peaks were centered at 2q of 28.5619° and 28.7644° for et
... Show MoreThe aim of this work is to study the histological and histochemical structure of the Harderian gland in indigenous pigeons. Samples were obtained from 10 males and 10 females of adult healthy pigeons. Hematoxylin and eosin, Alcian blue (pH 2.5), periodic acid-Schiff and promo phenol blue, stains were used for paraffin section examination. The gland was teardrop like in shape, light brown to pink in color, capsulated with thin connective tissue. It was multilobular compound acinotubular in structure and lined by columnar epithelial cells. Lymphocyte, plasma cells and plasma cells with Russell bodies were present underneath the epithelia of central collecting duct and around the secretory unite. Histochemically; the
... Show MoreIR, MIR, UV – Visible spectra have been studied for Cobalt chloride molecule (CoCl2. 6H2O) compound, In wide range spectra (40000 – 410) cm-1 specially MIR range. Assignment were achieved for the fundamental vibrational bands of (CoCl2 . 6H2O ) to symmetry stretching ?1 (?^+) Anti – symmetry stretching ?3(?^+), these bands are non-degenerate , and the bending band is ?2(?) is doubly degenerate thought they have activity in IR and Raman , which explain the weakness in symmetry of this molecule, the fundamental bands for the molecule are centered at the following wave numbers (615, 685, 795, 1115, 1340, 1375, 1616.35, 2091, 2386, 2410, 3364) cm-1 which are corresponding to wave lengths (16260, 14598, 12578, 8968, 7462, 7272, 6186,
... Show MoreSoftware cost management is a significant feature of project management. As such, it needs to be employed in a project or line of work. Software cost management is integral to software development failures, which, in turn, cause software failure. Thus, it is imperative that software development professionals develop their cost management skills to deliver successful software projects. The aim of this study is to examine the impact of cost management success factors with project management factors and three agile methodologies – Extreme Programming (XP), Scrum and Kanban methodologies which are used in the Pakistani software industry. To determine the results, the researchers applied quantitative approach through an extensive survey on
... Show MoreThe species Vitex agnus-castus is an important medicinal plants and it is one of the cultivated and dicotyledon plants in Iraq. The anatomical of stem, petiole, midrib area, epidermis, veins, type of leaf stomata and seeds were studied by light microscope. In this research, shows the knowledge of anatomical characteristics of the studied plant, showing its importance as taxonomic characteristics through the sections of the stem, petiole, the midrib and the petals.
This research aimd to analyze the role of strategic entreprenenial on according to the external performance of a sample of Iraqi private banks, namely, (National Islamic Bank, Iraqi Ahli Bank, Baghdad Bank , Middle East Iraqi Investment Bank) has launched research in fundamental problem stems from the question seeking his response to the characterization of the problem which is improve banking performance through strategic entreprenenial and to achieve the goal of the research was to prepare a questionnaire included a number of questions about the independent research and approved variables accounting for the independent variable strategic entreprenenial and included four dimensions (entreprenenial culture), entreprenenial leader
... Show MoreThe marketing logistic chain, as an integrated system aimed to balance the achievement of its main opposite objectives which represented in the access to the best service presented to the customer with lowest possible logistic costs especially the transportation costs, where encourages the researcher to choose the second objective as a field of this study in order to reduce the transportation costs in the final link of marketing logistic chain which related to delivering of fuel oil to the customer that falls within organizational responsibilities of the company under consideration (Oil Marketing Company) and also known in a brief name by (SOMO) through two methods, the first is by functioning quantative techniques by using trans
... Show MoreThis work is divided into two parts first part study electronic structure and vibration properties of the Iobenguane material that is used in CT scan imaging. Iobenguane, or MIBG, is an aralkylguanidine analog of the adrenergic neurotransmitter norepinephrine and a radiopharmaceutical. It acts as a blocking agent for adrenergic neurons. When radiolabeled, it can be used in nuclear medicinal diagnostic techniques as well as in neuroendocrine antineoplastic treatments. The aim of this work is to provide general information about Iobenguane that can be used to obtain results to diagnose the diseases. The second part study image processing techniques, the CT scan image is transformed to frequency domain using the LWT. Two methods of contrast
... Show More