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 study, we used Bayesian method to estimate scale parameter for the normal distribution. By considering three different prior distributions such as the square root inverted gamma (SRIG) distribution and the non-informative prior distribution and the natural conjugate family of priors. The Bayesian estimation based on squared error loss function, and compared it with the classical estimation methods to estimate the scale parameter for the normal distribution, such as the maximum likelihood estimation and th
... Show Moreimportumt educational institution as (kindergartens) need teachers which qualified ownes modalities in their education for children , as Marzanu method in a way of learning and own methods of crisis management, because the teachers that own those styles of learning ginekindergarten children knowledge and the childrenIeaving based on theMeaing and knowledge and integration of their information, And teachers that earn methods of crisis management provide for the children of the kindergarten security within the educational institution which in turn affect the growth and development of the Child and then abilities, health physical, mental, psychological …etc.., The aims of the current research have identified to recognize: 1- the dimension
... Show MoreThis paper discusses using H2 and H∞ robust control approaches for designing control systems. These approaches are applied to elementary control system designs, and their respective implementation and pros and cons are introduced. The H∞ control synthesis mainly enforces closed-loop stability, covering some physical constraints and limitations. While noise rejection and disturbance attenuation are more naturally expressed in performance optimization, which can represent the H2 control synthesis problem. The paper also applies these two methodologies to multi-plant systems to study the stability and performance of the designed controllers. Simulation results show that the H2 controller tracks a desirable cl
... Show MoreBackground: The repair of bone defects remains a major clinical orthopaedic challenge. Bone is a highly vascularised tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. This study aimed to study the efficacy of Panax ginseng as a osteoinducer in tibia of rat and as a stimulator for bone healing and to study the immunohistochemical expression of osteonectin as bone formation markers in experimental and control groups during bone healing. Material and method: : In this study thirty albino male rats , weighting (200-300) gram ,aged (2-3) months ,will be used under control conditions of temperature ,drinking and food consumption. The animals will subject for an
... Show MoreIn this research, Zinc oxide (ZnO)/epoxy nanocomposite was synthesized by simple casting method with 2wt. % ZnO concentration. The aim of this work was to study the effect of pH and composite dosage on the photocatalytic activity of ZnO/ epoxy nanocomposite. Scanning electron microscopy (SEM) technique images proof the homogeneous distribution of ZnO nanoparticles in epoxy. A synthesized nanocomposite samples were characterized by Fourier Transform Infrared spectrometer (FTIR) measurements. Two spectra for epoxy and 2wt.% ZnO/epoxy nanocomposites were similar and there are no new bonds formed from the incorporation of ZnO nanoparticles. Using HCl and NaOH were added to Methylene blue (MB) dye (5ppm) to gat pH values 3 and 8. The degradat
... Show MoreThe information required for construction quantities surveying is not only generated by various participants in different construction phases but also stored in different forms including graphics, text, tables, or various combinations of the three. To report a bill of quantities (BOQ), the project manager has to continuously excerpt information from various resources and record it on papers. Without adequate staff and time, this repetitive and tedious process is difficult for the project manager to handle properly and thus reduces the effectiveness and the accuracy of the quantities surveying process which creates problems during the design, tender, and construction supervision of construction projects for designers and contractors pract
... Show MoreMetasurface polarizers are essential optical components in modern integrated optics and play a vital role in many optical applications including Quantum Key Distribution systems in quantum cryptography. However, inverse design of metasurface polarizers with high efficiency depends on the proper prediction of structural dimensions based on required optical response. Deep learning neural networks can efficiently help in the inverse design process, minimizing both time and simulation resources requirements, while better results can be achieved compared to traditional optimization methods. Hereby, utilizing the COMSOL Multiphysics Surrogate model and deep neural networks to design a metasurface grating structure with high extinction rat
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Theoretical spectroscopic studies of beryllium oxide has been carried out, potential energy curves for ground states X1Σ+ and exited states A1Π , B1Σ+ by using two functions Morse and and Varshni compared with experimental results. The potentials of this molecule are agreement with experimental results. The Fortrat Parabola corrcponding to and branches were determind in the range 1<J<20 for the (0-0) band. It was found that for electronic transition A1Π- X1Σ+ the bands head lies in branche of Fortrat p |