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.
This paper describes the digital chaotic signal with ship map design. The robust digital implementation eliminates the variation tolerance and electronics noise problems common in analog chaotic circuits. Generation of good non-repeatable and nonpredictable random sequences is of increasing importance in security applications. The use of 1-D chaotic signal to mask useful information and to mask it unrecognizable by the receiver is a field of research in full expansion. The piece-wise 1-D map such as ship map is used for this paper. The main advantages of chaos are the increased security of the transmission and ease of generation of a great number of distinct sequences. As consequence, the number of users in the systems can be increased. Rec
... Show MoreBackground: Plantar heel pain is a clinical syndrome characterized by pain and tenderness beneath the heel which is typically worse in the morning and improves after the first few steps in the day. It is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft tissue disorders.
Objective: To evaluate the effectiveness of an operation of multiple drilling of calcaneum for resistant plantar heel pain syndrome.
Methods: During the period from November 2012 to August 2016, 17 patients (17heels) were enrolled in a cohort clinical study at the orthopedic unit in AL-Sheikh Zayed and Al-Wassity Hospitals.
Optimizing the Access Point (AP) deployment has a great role in wireless applications due to the need for providing an efficient communication with low deployment costs. Quality of Service (QoS), is a major significant parameter and objective to be considered along with AP placement as well the overall deployment cost. This study proposes and investigates a multi-level optimization algorithm called Wireless Optimization Algorithm for Indoor Placement (WOAIP) based on Binary Particle Swarm Optimization (BPSO). WOAIP aims to obtain the optimum AP multi-floor placement with effective coverage that makes it more capable of supporting QoS and cost-effectiveness. Five pairs (coverage, AP deployment) of weights, signal thresholds and received s
... Show MoreA Tonido cloud server provides a private cloud storage solution and synchronizes customers and employees with the required cloud services over the enterprise. Generally, access to any cloud services by users is via the Internet connection, which can face some problems, and then users may encounter in accessing these services due to a weak Internet connection or heavy load sometimes especially with live video streaming applications overcloud. In this work, flexible and inexpensive proposed accessing methods are submitted and implemented concerning real-time applications that enable users to access cloud services locally and regionally. Practically, to simulate our network connection, we proposed to use the Raspberry-pi3 m
... Show MoreObjective: to assess the predictive value of Doppler imaging of the uterine artery in the identification of early intrauterine abnormal pregnancy as compared to a normal intrauterine pregnancy.
Subjects and methods: one hundred and twenty pregnant ladies, at their 6-12 weeks of gestation, with a singleton pregnancy were included in this population-based case-control study. Thirty women with a missed miscarriage, 30 with hydatidiform mole, 30 with a blighted ovum, and 30 as a control group, without risk factors, underwent Doppler interrogation of the uterine arteries. Resistive index (RI), pulsatility index (PI), and the systolic/diastolic ratio (S/D) were measured for both sides. The t-test, or ANOVA test when a
... Show MoreIn this paper we proposes the philosophy of the Darwinian selection as synthesis method called Genetic algorithm ( GA ), and include new merit function with simple form then its uses in other works for designing one of the kinds of multilayer optical filters called high reflection mirror. Here we intend to investigate solutions for many practical problems. This work appears designed high reflection mirror that have good performance with reduction the number of layers, which can enable one to controlling the errors effect of the thickness layers on the final product, where in this work we can yield such a solution in a very shorter time by controlling the length of the chromosome and optimal genetic operators . Res
... Show MoreThe need for wireless sensing technology has rapidly increased recently, specifically the usage of electromagnetic waves which becoming more required as a source of information. Silicon carbide (SiC) Nano particles has been used in this study, the material under test (MUT) was exposed directly to a microwave field to examine the electromagnetic behavior. The permittivity and permeability were investigated with different filler materials to approach best and optimal electromagnetic absorbing characteristics to assist engineers to monitor structure-based composite for defects evaluation that may occur during operation conditions or through manufacturing process. XRD, FESEM and both complex permittivity and permeability were measured f
... Show More
In this paper an estimator of reliability function for the pareto dist. Of the first kind has been derived and then a simulation approach by Monte-Calro method was made to compare the Bayers estimator of reliability function and the maximum likelihood estimator for this function. It has been found that the Bayes. estimator was better than maximum likelihood estimator for all sample sizes using Integral mean square error(IMSE).