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.
Pregnancy and delivery are physiological conditions that are marked by abrupt alterations to hormones, immunological and molecular characters. The current study aimed to evaluate oxytocin (OT), prolactin (PRL), cortisol and insulin growth factor-2 (IGF-2) levels as physiological biomarkers; programmed cell death protein-1 (PD-1), programmed cell death ligand-1 (PD-L1),interleukin-6 (IL-6) as immunological biomarkers, and single nucleotide polymorphisms (SNPs; rs53576 and rs2254298) of oxytocin receptor gene OXTR as molecular factors in samples of Iraqi women undergoing caesarean section (CS) and normal delivery (ND). Blood samples were collected from 96 pregnant women at term with ages ranging between 16-43 years. Regarding
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The work of this paper is an investigation to improve the condenser performance of the automobile air conditioning system by enhancing the air-side heat transfer from the condenser through the use of an air guide net installed in front of the condenser face which is basically an aluminum plate having a circular entrance shape for the air passage. The A/C system was examined under two types of test. The first test was conducted the air guide net, while the second was done with the air guide net. The performances of the A/C system under these tests were compared. For the second type of test, the experiment was carried out with three different size of air guide net, three different circular diameters (2, 3 and 3.5 cm) a
... Show MoreDual-species biofilms of Pseudomonas aeruginosa and Staphylococcus aureus generate difficult-to-treat illnesses. Nutrition stress in biofilms affects physiology, microbial metabolism, and species interactions, impacting bacteria growth and survival. Furthermore, the function of alginate, which is encoded by the algD gene, in the production of biofilms has been established. The present study aimed at investigating the impact of starvation on algD gene expression in single-species biofilm of P. aeruginosa and dual-species biofilms of P. aeruginosa and S. aureus from hospital sewage. A total of six P. aeruginosa and six S. aureus isolates were obtained from the microbiology laboratory at the Department of Biology, College of Science, Universit
... Show MoreThis study deals with the corrosion inhibition of metal corrosion process of medium carbon steel using 1M HCl for kinetic studies and rate reaction determination. The weight loss method is applied to pieces of Medium carbon steel divided to Cubans with dimensions (0.4*2*2.4) cm , and use Tafel Extrapolation Method, the samples were polished using carbide silicon paper with dimensions of (180,200,400,600,800,1000). The samples were immersed in the alcoholic medium ethanol at a temperature 293K for 3hr. Natural inhibitor Kujarat Tea (Hibiscus sabdarriffa L.) is used which is extracted in aqueous and alcoholic medium, different concentrations (1000،2000, 3000) ppm have been used ; The best concentration found through the results is a
... Show MoreTuaimah GS, AQ Al-Awadi, Ahmed ME., Effect of Cutibacterium acnes cell free antigen (CFAg) immunization, levofloxacin and cinnamon oil on Cutibacterium acnes infection in rabbits, Onl J Vet Res., 22 (9):811-822, 2018. C. acnes causes acne vulgaris most commonly in 12-24 year olds. Five albino rabbits were immunized at day 1 and 14 with Cutibacterium acnes cell free antigen (CFAg) and then infected intradermally with 0.1 ml C. acnes suspension (2×108 cfu/ml) at day 30. Two groups of five infected rabbits were then treated at Day 30 with 0.5% levofloxacin or 0.2% cinnamon oil twice daily for 12 days. Five control rabbits were infected intradermally with 0.1 ml 2×108 cfu/ml Cutibacterium acnes n (2×108 cfu/ml). At day 42, skin test (mm), se
... Show MoreAfter the success of the reforms Keynesian save the capitalist system from collapse and to apply the concepts of state intervention in economic activity in order to revive aggregate demand to achieve the purposes of macro-economic policies which draw their scope of economic (John Keynes) theory of effective demand, which created the new role of the state away from the classical concepts. Valley transmission role of the State of (State Guardian) to the process of state overlapping that increased and social functions have become responsible for raising the standard of living of classes with limited incomes, in particular, and the rest of the classes in general, through the expansion of the delivery of public servic
... Show MoreThe study seeks the relationship between the mathematical-procedural Knowledge and the logical-mathematical intelligence among students at the third stage in mathematics department. To this end, three questions were arisen: what is the level of mathematical-procedural Knowledge among the third stage students in mathematics department regarding their gender? Do male or female students have more logical-mathematical intelligence and are there significant differences base on their gender? What kind of correlation is between the level of mathematical-procedural Knowledge and the logical-mathematical intelligence of male and female students in the third stage in the mathematics department? A sample of (75) male and female students at the thir
... Show MoreThe objective of the research is to evaluate the risk management practices of the variables (risk management structure, risk management methods, key components of risk management) and their relation to the principled behavior of managers behavior(innovation, proactive, risk acceptance) By adopting the questionnaire as a main tool in collecting data from managers in the National and raq insurance companies of (50) officials Department manager, department administrator, unit administrator, and analyzed their answers using the SPSS In calculating arithmetic mean, standard deviation, percentage weight and simple correlation coefficient. The most prominent conclusions were:1.There is a positive trend in the sample in both companies and a high
... Show MoreThe purpose of this paper is to find the best multiplier approximation of unbounded functions in –space by using some discrete linear positive operators. Also we will estimate the degree of the best multiplier approximation in term of modulus of continuity and the averaged modulus.