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 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
Background: The apical seal is the single most important factor in determining the success of surgical endodontics, the aim of this study was to compare the sealing ability of Mineral Trioxide Aggregate in three different cavity designs. Materials and Methods: Thirty extracted human single-rooted teeth were divided into three groups of ten teeth per group, a retrograde cavity preparation was carried out using a low speed handpiece and round bur with parallel walls in the first group, ultrasonic retrotip and unit in the second group and a low speed handpiece with a carbide inverted cone bur with undercuts in the third group, all the cavities were filled with MTA. microleakage was measured by dye penetration technique using methylene blue. Re
... Show MoreAutorías: Muayad Kadhim Raheem, Lina Fouad Jawad. Localización: Opción: Revista de Ciencias Humanas y Sociales. Nº. 21, 2019. Artículo de Revista en Dialnet.
The researcher deals with an important issue in her research - especially as she progresses to the doctoral stage thanks to God (Almighty) and his mentor - the relationship of philosophy to nodal origins. Therefore, she studied the philosophy of Shirazi, which is the key to the mental solutions that the speakers and philosophers stopped. And to conclude scientific results as well as the study of philosophy researcher as a station in the doctoral stage, to be familiar with the philosophical interpretation and the origins of the faith and its philosophical vocabularies such as existence, self, movement, astronomy, time and others. At the same time draw the attention of science students to the issue of philosophical interpretation and its r
... Show MoreSecond language learner may commit many mistakes in the process of second language learning. Throughout the Error Analysis Theory, the present study discusses the problems faced by second language learners whose Kurdish is their native language. At the very stages of language learning, second language learners will recognize the errors committed, yet they would not identify the type, the stage and error type shift in the process of language learning. Depending on their educational background of English as basic module, English department students at the university stage would make phonological, morphological, syntactic, semantic and lexical as well as speech errors. The main cause behind such errors goes back to the cultural differences
... Show MoreThe reaction paths of the C-C and C-H bond cleavage in the anthracene and phenanthrene aromatic molecules are studied by applying the ab-initio DFT method. It is found that the C-C bond cleavage proceeds via a singlet aromatic transition state, compelled through a disrotatoric ring opening reaction. A suprafacial H atom shift follows the transition state, leading to the formation of a methylene -CH2 and an acetylenic or allenic moiety. The calculated activation energies for anthracene range from 158.81-208.90 kcal/mol and the reaction energies from 96.106-156.976 kcal/mol. For phenanthrene, the energy values are 157.39-202.34 kcal/mol and 62.639-182.423 kcal/mol, respectively. For the C-H cleavage reactions, the calculated reaction energies
... Show MoreThe collected premiums and the compensations paid are among the main variables that have a prominent role in determining the level of financial solvency of insurance companies, as the higher the financial solvency of the insurance company, the more attractive it is to the target audience to acquire the company's insurance services.
Hence the importance of the issue of the solvency of insurance companies, as it is one of the critical matters on which the effectiveness of the insurance company and its continuation in the labor market depend.
In this research, we try to clarify the role of collected premiums and compensations paid in determining the level of operational solvency of t
... Show MoreThis 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
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