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.
Nowadays power systems are huge networks that consist of electrical energy sources, static and lumped load components, connected over long distances by A.C. transmission lines. Voltage improvement is an important aspect of the power system. If the issue is not dealt with properly, may lead to voltage collapse. In this paper, HVDC links/bipolar connections were inserted in a power system in order to improve the voltage profile. The load flow was simulated by Electrical Transient Analyzer Program (ETAP.16) program in which Newton- Raphson method is used. The load flow simulation studies show a significant enhancement of the power system performance after applying HVDC links on Kurdistan power systems. Th
... Show MoreExtreme conditions will cause the water level of high fill canal segment to change suddenly, which will affect the velocity and pore pressure of the slope. A 9 km irrigation earth canal in the city of Alsyahy, 15 km away from Al-Hilla city, and branching off from the left side of Shatt Al-Hilla at 57 km, was studied. The aim of this work is to study and analyze the effect of rationing system on the Birmana earthen canal during rapid drawdown case. Finite element modeling with Geo-Studio software was used in the present study to analyze the combined seepage and slope stability for three cycles. The resulting minimum safety factor obtained from the analysis using the saturated and
The TV plays an active role in building the general culture of the recipients, which calls for emphasizing its contemporary mission in rebuilding the values that support the development and modernization of diverse societies. Such importance is necessary to explore the challenges facing the cultural invasion, The space opening, which had its cultural returns to the societies, produced a space for alternative values and antagonisms in the cultures and traditions of these societies in the midst of a psychological / social conflict behind a clash with the peculiarities of Muslim societies. Cultural Adtha.
From these points of view, and because the universities are an important stage to announce the demands of the advocates of change and
Wastewater recycling for non-potable uses has gained significant attention to mitigate the high pressure on freshwater resources. This requires using a sustainable technique to treat natural municipal wastewater as an alternative to conventional methods, especially in arid and semi-arid rural areas. One of the promising techniques applied to satisfy the objective of wastewater reuse is the constructed wetlands (CWs) which have been used extensively in most countries worldwide through the last decades. The present study introduces a significant review of the definition, classification, and components of CWs, identifying the mechanisms controlling the removal process within such units. Vertical, horizontal, and hybrid CWs
... Show MoreThe research aims to prepare a preliminary feasibility study that shows the importance of preliminary feasibility study in investment decision making, carrying out of the local demand of service provided in accordance with international standards and statement of investment opportunities available to the private sector in several investment methods. In order to reach the objectives of the study was adopted as a method of partial analysis at the level of economic unity through the study demand, supply, costs, economic and social profitability.
The health sector in Iraq is one of the service sectors facing today a continuous deficiency
... Show MoreThe study included the determination of pollen grains features for 8 genera and 13 taxa of Mimosoideae subfamily grown in Baghdad/ Iraq by using each of light and scanning electron microscope. The samples of taxa were collected from various sites in Baghdad province in central Iraq located on 32 45° 0-33 45 0 N and 44 0 0- 44° 45 0 E. the results from this study revealed different pollen types as monad in each of Leucaena, Prosopis, and Neltuma, tetrad in Mimosa and polyads in Acacia, Albizia, Calliandra, Pithecellobium and Vachellia. Each taxa of these genera characterized by special palynological features as shape, size, number of polyads grain and conplateuration as well as other parameters included other dimensions, and these
... Show MoreAbstract Iraq has an important place in the regional and international balance, and the competition among countries has increased in rapprochement with Iraq, not only for its geography or its privileged location, but because it has many other components that make regional and international countries want to strengthen their relations with it (Regional and international powers). In addition to that, Iraq has become increasingly important for these international and regional powers after its victory over the terrorist organization (ISIS), which proved an important fact that Iraq represents the most important pillars in the international balance.
This study develops a systematic density functional theory alongside on-site Coulomb interaction correction (DFT + U) and ab initio atomistic thermodynamics approachs for ternary (or mixed transitional metal oxides), expressed in three reservoirs. As a case study, among notable multiple metal oxides, synthesized CoCu2O3 exhibits favourable properties towards applications in solar, thermal and catalytic processes. This progressive contribution applies DFT + U and atomistic thermodynamic approaches to examine the structure and relative stability of CoCu2O3 surfaces. Twenty-five surfaces along the [001], [010], [100], [011], [101], [110] and [111] low-Miller-indices, with varying surface-termination configurations were selected in this study.
... Show MoreBackground: Beta-thalassemia major is the most common monogenic known disorder in the Middle East, characterized by anomalies in the synthesis of the beta chains of hemoglobin resulting in variable phenotypes ranging from severe anemia to clinically asymptomatic Individuals. This study aimed to evaluate salivary flow rate and salivary IgA in β-thalassemia major patients. Since many oral and systemic conditions manifest themselves as changes in the flow and composition of saliva the dental practitioner is advised to remain up-to-date with this issue. Materials and methods: The study samples consist of (60) subjects, patients group composed of (30) patients with β –thalassemia major, age rang (5-23) years and (30) healthy locking
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