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.
For the design of a deep foundation, piles are presumed to transfer the axial and lateral loads into the ground. However, the effects of the combined loads are generally ignored in engineering practice since there are uncertainties to the precise definition of soil–pile interactions. Hence, for technical discussions of the soil–pile interactions due to dynamic loads, a three-dimensional finite element model was developed to evaluate the soil pile performance based on the 1 g shaking table test. The static loads consisted of 50% of the allowable vertical pile capacity and 50% of the allowable lateral pile capacity. The dynamic loads were taken from the recorded data of the Kobe e
This study was conducted on the effect of the sedimentary source (the sediments coming from both the Iraqi-Iranian borderline and the Tigris river) on the optical and textural features, especially sphericity and roundness of feldspar minerals (potassium and plagioclase types) in soils of the southern part of the alluvial plain. Eight pedons were selected to represent the study area, five of them represented sediments coming from the borderline, which included pedons of (Badra, Taj Al-Din, Al-Shihabi, Jassan, and Galati), while two of them represent the sediments of the Tigris River (Essaouira, Al-Dabouni), the pedon of Ali Al-Gharbi was represented the mixing area of sediments of all the floods coming from the borderline and the sediments o
... Show MoreObesity is a risk factor associated with age-related disorders that accelerate aging, and it increases the risk of metabolic diseases. Therefore, this study was conducted to investigate the association of leukocyte telomere length (LTL) with the presence of higher body weight in middle-aged females and males. The study subjects comprised 160 (80 control and 80 higher body mass index BMI groups) with ranging ages of 30-50 years included and stratified for BMI. The physio-biochemical analysis was measured using enzymatic determination. Mean telomere length was determined by using the southern blotting technique. The association analysis revealed a significant variance (P < 0.01) in biochemical parameters between higher BMI grou
... Show MoreMature oil reservoirs surrounded with strong edge and bottom water drive aquifers experience pressure depletion and water coning/cresting. This laboratory research investigated the effects of bottom water drive and gas breakthrough on immiscible CO2-Assisted Gravity Drainage (CO2-AGD), focusing on substantial bottom water drive. The CO2-AGD method vertically separates the injected CO2 to formulate a gas cap and Oil. Visual experimental evaluation of CO2-AGD process performance was performed using a Hele-Shaw model. Water-wet sand was used for the experiments. The gas used for injection was pure CO2, and the “oleic” phase was n-decane with a negative spreading coefficient. The aqueous phase was deionized water. To evaluate the feasibilit
... Show MoreThis research has presented a solution to the problem faced by alloys: the corrosion problem, by reducing corrosion and enhancing protection by using an inhibitor (Schiff base). The inhibitor (Schiff base) was synthesized by reacting of the substrates materials (4-dimethylaminobenzaldehyde and 4-aminoantipyrine). It was diagnosed by infrared technology IR, where the IR spectrum and through the visible beams proved that the Schiff base was well formed and with high purity. The corrosion behavior of carbon steel and stainless steel in a saline medium (artificial seawater 3.5%NaCl) before and after using the inhibitor at four temperatures: 20, 30, 40, and 50 C° was studied by using three electrodes potentiostat. The corrosion behavior was
... Show MoreAbstract Liver cancer with hepatocellular carcinoma a serious clinical illness that progresses quickly and has a bad prognosis because to increased malignancy. Fibrosis is the precursor of liver cancer, which progresses to cirrhosis and carcinoma Diethylnitrosamine (DEN) is a chemical molecule that has been used as a carcinogenic agent to promote cancer in test animals because of its strong carcinogenic potential. Herbal plants have long been used as inexpensive, effective alternatives to pharmaceuticals in various liver-associated complications, since they contain many bioactive compounds useful in liver disorders. Hibiscus tiliaceus L. (Malvaceae) contain various phytochemicals in the plant extracts such as Flavonoids, phe
... Show MoreIn this paper, three tool paths strategies; iso-planar, helical and adaptive have been implemented to investigates their effect on the mechanical properties of Brass 65-35 formed by single point incremental sheet metal forming process. To response this task, a fully digital integrated system from CAD modeling to finished part (CAD/CAM) for SPIF process has been developed in this paper.
The photo-micrographs shows an identical grain formation due to the plastic deformation of the incremental forming process, change in the grain shape and size was observed. It's found that the adaptive tool path play a significant role to increase the hardness of the formed specimen from (48 to 90 HV) and the grain texture of the formed specimen found a
Accurate description of thermodynamic, structural, and electronic properties for bulk and surfaces of ceria (CeO2) necessitates the inclusion of the Hubbard parameter (U) in the density functional theory (DFT) calculations to precisely account for the strongly correlated 4f electrons. Such treatment is a daunting task when attempting to draw a potential energy surface for CeO2-catalyzed reaction. This is due to the inconsistent change in thermo-kinetics parameters of the reaction in reference to the variation in the U values. As an illustrative example, we investigate herein the discrepancy in activation and reaction energies for steps underlying the partial and full hydrogenation of acetyl
... Show MoreNatural honey is well known for its therapeutic value and has been used in traditional medicine of different cultures throughout the world. The aim of this study was to investigate the anti-inflammatory effect of Malaysian Gelam honey in inflammation-induced rats. Paw edema was induced by a subplantar injection of 1% carrageenan into the rat right hind paw. Rats were treated with the nonsteroidal anti-inflammatory drug (NSAID) Indomethacin (10 mg/kg, p.o.) or Gelam honey at different doses (1 or 2 g/kg, p.o.). The increase in footpad thickness was considered to be edema, which was measured using a dial caliper. Plasma and paw tissue were collected to analyze the production of inflammatory mediators, such as NO, PGE2
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