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.
Experiments have been conducted to study the local and average heat transfer by mixed
convection for hydrodynamically fully developed, thermally developing and fully developed
laminar upward air flow in an inclined annulus with adiabatic inner cast iron tube and uniform
heated outer aluminum tube with an aspect ratio ( Ω = 0.72) and (L/Dh≈40) for both calming and
test sections). A wide range of Reynolds number from 859 to 2024 has been covered, and heat
flux has been varied from 159 W/m2 to 812 W/m2 (these values of heat flux and Reynolds
number gave Richardson number range from 0.03 to 0.٣٨), with angles of annulus inclination
φ =0o (horizontal position), φ =60o (inclined position), and φ =90o (vertical posi
BACKGROUND Multiple myeloma (MM) is a plasma cell disorder characterized by the infiltration of clonal plasma cells in the bone marrow and the detection of a monoclonal immunoglobulin in serum and/or urine. Renal failure, anemia, hypercalcemia, and the presence of bone lesions are the hallmarks of the disease. The study aimed to evaluate the clinical, hematological, radiological, and immunophenotypic features of MM patients and to identify prognostic factors influencing survival outcomes. This cohort study included 77 newly diagnosed, untreated MM patients. Their clinical presentation, laboratory data, imaging results, and the expression of flow cytometry markers were analyzed in correlation with the 1-year overall survival (OS). The mean a
... Show MoreOne of the common geotechnical problems is the construction on soft soil and the improvement of its geotechnical properties to meet the design requirements. A stone column is one of the well-known techniques used to improve the geotechnical properties of soft soils. Sometimes thick layers of soft soil imposed the designer to use floating stone columns for improvement of such soil; in this case, the designer will be lost the end bearing of the stone column. In this study, the effects of several patterns of floating stone columns distribution under footing on the bearing capacity of soil and the distribution of excess porewater pressure are investigated. The soft soil used in this study has a very low undrained shear strength (cu) of
... Show MoreThe virulent genes are the key players in the ability of the bacterium to cause disease. The products of such genes that facilitate the successful colonization and survival of the bacterium in or cause damage to the host are pathogenicity determinants. This study aimed to investigate the prevalence of virulence factors (esp, agg, gelE, CylA) in E. faecalis isolated from diverse human clinical collected in Iraqi patient , as well as to assess their ability to form biofilm and to determine their haemolytic and gelatinase activities. Thirty-two isolates of bacteria Enterococcus faecalis were obtained, including 15 isolates (46.87%) of the urine, 6 isolates (18.75%) for each of the stool and uterine secretions, and 5 isolates (15.62%) of the wo
... Show MoreExposing the dorsal superficial skin of rats to partial-depth burn leads to bacterial and microbes Invasion. Topical treatment is required in most superficial burn cases Moist exposed burn ointment (MEBO) protects wounds from infection and enhances healing without any harmful effects of purified chemicals is caused. The topical using of HA gel in rat models with full and partial thickness surgical wounds shows enhancement in wound repair. In this study, we compared the healing efficacy of topical use of hyaluronic acid gel products with MEBO as standard management in rats that were exposed to a partial-thickness burn. The experiment included twenty-four (24) adult albino rats of male sex with weight (150-220 gm) of 3 months’ age divided i
... Show MoreBigheaded carps (bighead carp, Hypophthalmichthys molitrix, and silver carp, Hypophthalmichthys nobilis) and their hybrids play an important ecological and economic role in their original habitat, while their introduced stocks may pose serious ecological risks. To address questions about the persistence and invasiveness of these fish, we need to better understand their population structures. The genetic structures of bigheaded carp populations inhabiting Lake Balaton and the Tisza River were examined with ten microsatellite markers and a mitochondrial DNA marker (COI). The Lake Balaton stock showed higher genetic diversity compared with the Tisza River stock. Based on hierarchical clustering, the Tisza population was characterized o
... Show MoreFor more than seven decades, the Palestinian-Israeli conflict has not ended, and every one claims his right to the land, waters, airspace and wealth of Palestine. This conflict was reflected in the political, military, social and cultural aspects, and the cinema had a prominent role in conveying messages to the world about this conflict. On the geopolitical dimensions and their impact on the cinematic image in the films of the Palestinian cause), the researchers divided the research into four frameworks that came as follows: (methodological framework) and included the research problem, its importance, research objectives, research limits and sealing the chapter by defining the terms. And (theoretical framework): it was divided into two s
... Show MorePurpose: This study aims to shed the light on allusions to real lab rats in Dashner’s trilogy: The Maze Runner (2009), The Scorch Trails (2010), and The Death Cure (2011). It also aims to trace the historical documents and chronicles essential to reveal the justifications behind the vague political and scientific crimes. Methodology: The researchers have used the literary analytical approach to study and analyze selected prominent aspects from each novel; such as the concept of lab rats and genocide crimes in The Maze Runner; references to weather experiments, the climate change conspiracy, gas chambers, and the Holocaust in The Scorch Trails; and finally, the man-made diseases and biological weapons in The Death Cure. Results
... Show MoreRoller compacted concrete (RCC) is a special type of concrete with zero or even negative slump consistency. In this work, it had aimed to produce an RCC mix suitable for roads paving with minimum cost and better engineering properties so, different RCC mixes had prepared i.e. (M1, M2, M3, and M4) using specified percentages of micro natural silica sand powder (SSP) as partial replacement of (0%, 5%, 10%, and 20%) by weight of sulfate resistant Portland cement. Additionally, M-sand, crushed stone, filler, and water had been used. The results had obtained after 28 days of water curing. The control mix (M1) had satisfied the required
Various activities taking place within the city of Baghdad have significantly contributed to organic pollution in Rivers Tigris and Diyala. The present study aimed to assess some physical, chemical and biological aspects of six sites on Rivers Tigris and Diyala as they flow through the city of Baghdad. Monthly samples were collected for the period January to December, 2005. Marked differences in the physical and chemical characteristics of water were noted between the two rivers’ sites. Average values during the study period of dissolved oxygen, biochemical oxygen demand, particulate organic matter, nitrate, phosphate and total dissolved solids for Tigris and Diyala were 7.8,4.7; 2.4,10.4; 350.1,921.4;7.8,13.9;1.2,4.8;814,2176 mg / l re
... Show More