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 effect of micro-and nano silica particles (silica SiO2 (100 μm), Fused silica (12nm)) on some mechanical properties of epoxy resin was investigated (Young's modulus, Flexural strength). The micro-and nano composites were prepared by using three steps process with different volume fraction of micro-and nano particles (1, 2, 3, 4, 5, 7, 10, 15, and 20 vol. %). Flexural strength and Young's modulus of nano composites were increased at low volume fraction (max. enhancement at 4 vol.% ). However at higher volume fraction both Young's modulus and flexural strength decrease. Moreover, above, the mechanical properties are enhanced more than that of neat epoxy resin. The flexural strength decreases with increasing the volume fraction of micr
... Show MoreIn the present study, mixed ligand compounds of Mn(II), Ni(II), Co(II), Cu(II), Cd(II) and Hg(II) were synthesized using new Ligand N1,N4-bis (pyrimidin-2-ylcarbamothioyl) succinimide (NPS) derived from [Butanedioyl diisothiocyanate with 2- aminipyridine] as first ligand, proline (pro) as second ligand and evaluation of their antioxidant activities for ligand, nickel and cobalt complex towards 1.1-Di-phenyl-2picrylhydrazyl (DPPH) will be compared to the standard anti-oxidants (i.e. the ascorbic acid). Those materials that have been prepared provided results are a result of exhibiting different activities of the radical scavenging for all of the compounds. Compounds were observed then confirmed through the Fourier-tra
... Show MoreThe present study intends to prepare nanofibers mat of polyacrylonitrile by electrospinning technique and investigates their adsorption capacity to Congo red dye from the aqueous solution, after characterize it by different techniques such as FTIR, SEM, EDA, XRD and BET. The influence factors on adsorption were studied including adsorbent dosage, initial concentration, contact time, pH and ionic strength. The results confirmed that the increasing in pH decreases the adsorption capacity. So, the optimum adsorbent dosage, initial concentration and contact time were 0.006 g, 25 mg/L and 150 min respectively. The isotherm models of Freundlich and Langmuir were applied on the experimental adsorption data to evaluate the maximum capacity and ener
... Show MoreManagement of Foreign Exchange Rate Exposure by Using Financial Hedging An Analytical Empirical Study The main purpose of this Research is to investigate the ability to reduce the effect of exchange rate fluctuation on firm value , by usage appropriate hedging strategies to provide the firms force to adopted with complex and highly uncertainty conditions , characteristic of the most of the financial markets . The field of this study is the giant five Multinational on the world. Nokia, Toyota Motor, Intel , Coca Cola, Microsoft. practical analysis is provide the truth of all study's hypothesis , and it is reach to many of conclusion, the most important of them is Stem from unexpected fluctuation on nominal ex
... Show MoreThe research involves preparing gold nanoparticles (AuNPs) and studying the factors that influence the shape, sizes and distribution ratio of the prepared particles according to Turkevich method. These factors include (reaction temperature, initial heating, concentration of gold ions, concentration and quantity of added citrate, reaction time and order of reactant addition). Gold nanoparticles prepared were characterized by the following measurements: UV-Visible spectroscopy, X-ray diffraction and scanning electron microscopy. The average size of gold nanoparticles was formed in the range (20 -35) nm. The amount of added citrate was changed and studied. In addition, the concentration of added gold ions was changed and the calibration cur
... Show MoreOral swab samples were collected from 120 children (ages between one month- 10 years) who were infected with oral thrush and 30 healthy children. The percentages of isolated yeasts and Bacteria were 66.6% and 96.6% respectively. The dominate yeast and bacteria were Candida albicans and Staphylococcus aureus with of 78.7% and 34.4% respectively. Results revealed that the highest percent of infection with oral thrush disease was 32.5% in children within the age of 1-2 months.
Polycyclicacetal was prepared by the reaction of PEG with 4-nitrobenzaldehyde. Cobalt was used for producing a polymer metal complex and solution casting was used to produce a polymer blend including nano chitosan. All produced compounds have been characterized by FT-IR, DSC/ TGA, and SEM techniques as well as biological activity. The production of polyacetal is illustrated by the FT-IR analysis. The DSC/TGA results indicate the prepared polymer blends' thermal stability. Staphylococcus aureas, Klebsiella pneumoniae, Bacillus subtilis, and Escherichia coli were the four types of bacteria selected to study and evaluate the antibacterial activity of produced polyacetal, its metal complex, and polymer blend. Results indicates that ther
... Show MoreThis study aims to suggest a technique for soil properties improvement of AL- Kadhimin shrine Minaret and to support the foundation, which has a tilt of roughly 80 cm from the vertical axis. The shrine of the AL- Kadhimin is made up of four minarets with two domes set in a large courtyard. The four minarets have skewed to varying degrees due to uncontrolled dewatering inside the shrine in recent years. However, the northeast minaret was the most inclined due to its proximity to the well placed inside shrine courtyard. When the well near the minaret is operated, the water level drops, increasing the effective stresses of the soil and causing differential settling of the minaret foundation. To maintain the minaret's foundation from potenti
... Show MoreExperimental results for the density of states of hydrogenated amorphous silicon due to Jackson et al near the valence and conduction band edges were analyzed using Levenberg-Marquardt nonlinear fitting method. It is found that the density of states of the valence band and the conduction band can be fitted to a simple power law, with a power index 0.60 near the valence band edge, and 0.55 near the conduction band edge. These results indicate a modest but noticeable deviation from the square root law (power index=0.5) which is found in crystalline semiconductors. Analysis of Jackson et al density of states integral J(E) data over about (1.4 eV) of photon energy range, showed a significant fit to a simple power law with a power index of 2.11
... Show MoreThis study aimed to show the histological changes that 0ccured in Culex pipiens pipiens larvae and adults infected with Beauveria bassiana . The 4th instar larvae and adult mosquitoes were infected with B.bassiana in 10-4 spore/ml dilution, after 96 hours histological section was studied showing that the fungi infected all the body parts specially Cuticle , Epiderms, fat bodies and midgut. After 120 hours of exposure to the fungi the insect have a white appearance and covered with a thick coat of hyphea. Thus study shows biological control of B .bassiana on mosquitoes.