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.
In this study, 191 specimens of insects that infect species of the Fabaceae family, including:
Polymeric hollow fiber membrane is produced by a physical process called wet or dry/wet phase inversion; a technique includes many steps and depends on different factors (starting from selecting materials, end with post-treatment of hollow fiber membrane locally manufactured). This review highlights the most significant factors that affect and control the characterization and structure of ultrafiltration hollow fiber membranes used in different applications.
Three different types of polymers (polysulfone PSF, polyethersulfone PES or polyvinyl chloride PVC) were considered to study morphology change and structure of hollow fiber membranes in this review. These hollow fiber membranes were manufactured with different pro
... Show MoreEnhancing fatigue resistance in asphalt binders and mixtures is crucial for prolonging pavement lifespan and improving road performance. Recent advancements in nanotechnology have introduced various nanomaterials such as alumina (NA), carbon nanotubes (CNTs), and silica (NS) as potential asphalt modifiers. These materials possess unique properties that address challenges related to asphalt fatigue. However, their effectiveness depends on proper dispersion and mixing techniques. This review examines the mixing methods used for each nanomaterial to ensure uniform distribution within the asphalt matrix and maximize performance benefits. Recent research findings are synthesized to elucidate how these nanomaterials and their mixing proce
... Show MoreConcerns about the environment, the cost of energy, and safety mean that low-energy cold-mix asphalt materials are very interesting as a potential replacement for present-day hot mix asphalt. The main disadvantage of cold bituminous emulsion mixtures is their poor early life strength, meaning they require a long time to achieve mature strength. This research work aims to study the protentional utilization of waste and by-product materials as a filler in cold emulsion mixtures with mechanical properties comparable to those of traditional hot mix asphalt. Accordingly, cold mix asphalt was prepared to utilize paper sludge ash (PSA) and cement kiln dust (CKD) as a substitution for conventional mineral filler with percentages ranging fro
... Show MoreThis study was conducted to delineate diversity and species composition of non-diatoms planktonic algae in Hoor- Al- Azime marshes, Iran. The samples were collected from four sites at monthly basis from April 2011 to March 2012. A total 88 taxa were identified, out of which (40 taxa, 45.45%) belonging to Cyanophyta followed by Chlorophyta (29 taxa, 32.96%), Euglenophyta (18 taxa, 20.45%) and (1 taxa, 1.14%) of Dinophyta recorded. Comparing species richness (65 taxa, 34.76%) at Shat- Ali (St4) was the highest and the lowest (34 taxa, 18.18%) was observed at Rafi (St2). Species occurrence was associated with temperature where in summer (66 taxa) and (25 taxa) encountered winter. The phy
Abstract To ensure that the distribution system has safe drinking water. It is necessary to know the residual chlorine concentrations at various points in the network. A chlorine photometer device was used to measure twenty points taken every day for a week at a selected time in the distribution system. Both pressures and flows in the network were measured using bourdon gauge and Tuf-2000H Handheld Digital ultrasonic flow meters. WaterGEMS CONNECT Edition update one software was used to simulate the flow in the network. The Baghdad water department provided the data about the network, such as the lengths of pipes, the layout of the network, and pipes diameters. The network calibrated consists of 781 pipes of different lengths and 542 juncti
... Show MoreThe subject of indication is one of many subjects that the Arabic language interest in and we decide that this research which we called (Indication of the abstract and Augmented Tri verbs) in one of Al-Quran Suras which is Al-moulk to dive in the secrets and knowledge of its meanings and knowledge of its structure in terms of abstraction and increase, And the investigation of our ancient scholars of linguistics and interpreters in its meanings. The verbss were classified according to the structure in which they were presented. The research includes two sections followed by the conclusion of the research, sources and its references. The first section (the indication of the abstract Tri verbs) in the sura is divided into four branches in w
... Show Morenouns , because deriving these names will lead to eternity which is impossible, and restrict the derivation only in agent nouns from their verbs, and the adjective names from their adjectives with the condition of truth in derivation.
The derivation of “Allah” names was denied due to a creed thoughts, because saying that “Allah” names is derived will not describe the eternal essence of “Allah”, and if it were derived this will make “Allah” is a Compound from his essence and Attributes.
The Al-Zaher people had recant the derivation of the agent nouns by preventing the derivation of “Allah” names because it will make “Allah” is a Compound from his essence and Attributes.
The Al-Zaher people had recant from
The environmental references represented by the intellectual, social, economic, political and religious pressures are considered fundamental factors for the artistic achievement whose importance comes from their multiplicity and branching into natural and psychological pressures that affect the multiplicity, diversity and variability of the artistic and performative methods. Thus they determine the artist's orientations and the creative artistic visions are summoned through symbols and semantic signs of the visual surface, because the societal thought in art in general and the fine art in specific occupies an influential position
... Show Moreيتناول البحث شخصية شعرية وأدبية فذة هو محمد صالح بحر العلوم الشاعر العراقي المعروف والمولود في بيت ثوري من بيوتات النجف المعادية للاستعمار البريطاني في مطلع القرن العشرين، وينحدر من أسرة عريقة مشهورة بالعلم والأدب، عاش بحر العلوم شاعراً ينقل بصوره الجمالية كل ما يقع في حواسه، وتجربته تثري من اتصاله ببيئته فنجد الشاعر اشبه بالمصور يستمد صوره من واقع بيئته المتنوع. ونحن في بحثنا هذا نحاول أن نرصد أهم المصادر
... Show More