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.
Wellbore instability is one of the most common issues encountered during drilling operations. This problem becomes enormous when drilling deep wells that are passing through many different formations. The purpose of this study is to evaluate wellbore failure criteria by constructing a one-dimensional mechanical earth model (1D-MEM) that will help to predict a safe mud-weight window for deep wells. An integrated log measurement has been used to compute MEM components for nine formations along the studied well. Repeated formation pressure and laboratory core testing are used to validate the calculated results. The prediction of mud weight along the nine studied formations shows that for Ahmadi, Nahr Umr, Shuaiba, and Zubair formations
... Show MoreOptimization is essentially the art, science and mathematics of choosing the best among a given set of finite or infinite alternatives. Though currently optimization is an interdisciplinary subject cutting through the boundaries of mathematics, economics, engineering, natural sciences, and many other fields of human Endeavour it had its root in antiquity. In modern day language the problem mathematically is as follows - Among all closed curves of a given length find the one that closes maximum area. This is called the Isoperimetric problem. This problem is now mentioned in a regular fashion in any course in the Calculus of Variations. However, most problems of antiquity came from geometry and since there were no general methods to solve suc
... Show MoreThe centers of cities and historical quarter are exposed to a severe threat to the values of the physical and legal urban environment as a result of the value deterioration and the emergence, emergence and spread of new values on the intellectual and urban context, which generates the loss of the urban environment for its spatio-temporal continuity, flexibility, adaptation and continuity, and thus urban obsolescence, Hence the problem of the research in “the lack of comprehensiveness of studies on the phenomenon of urban obsolescence and its impact on the decline in the values of the quality of the built environment in historic
... Show MoreThe presented work shows a preliminary analytic method for estimation of load and pressure distributions on low speed wings with flow separation and wake rollup phenomena’s. A higher order vortex panel method is coupled with the numerical lifting line theory by means of iterative procedure including models of separation and wake rollup. The computer programs are written in FORTRAN which are stable and efficient.
The capability of the present method is investigated through a number of test cases with different types of wing sections (NACA 0012 and GA(W)-1) for different aspect ratios and angles of attack, the results include the lift and drag curves, lift and pressure distributions along the wing s
... Show MoreThe permeability is the most important parameter that indicates how efficient the reservoir fluids flow through the rock pores to the wellbore. Well-log evaluation and core measurements techniques are typically used to estimate it. In this paper, the permeability has been predicted by using classical and Flow zone indicator methods. A comparison between the two methods shows the superiority of the FZI method correlations, these correlations can be used to estimate permeability in un-cored wells with a good approximation.
The preparation of the phenanthridine derivative compound was achieved by adopting an efficient one-pot synthetic approach. The condensation of an ethanolic mixture of benzaldehyde, cyclohexanone and ammonium acetate in a 2:1:1 mole ratio resulted in the formation of the title compound. Analytical and spectroscopic techniques were used to confirm the nature of the new compound. A mechanism for the formation of the phenanthridine moiety that is based on three steps has been suggested
A field experiment was carried out at University of Baghdad, College of Agricultural Engineering Sciences during fall season of 2020 and spring season of 2021. This study was aimed evaluate the effect of the organic fertilizer and boron foliar on the yield of potatoes for processing. The factorial experiment (5*4) within RCBD and three replicates. The organic fertilizer as palm peat at four levels (0, 12, 24 and 36 ton. ha-1) in addition to the chemical fertilizer recommendation treatment. Boron at four Concentrations 0, 100, 150 and 200 mg. L-1 . The results revealed significant different among application of organic fertilizer at the level of 24 ton. ha-1 and the foliar application of boron at a concentration of 100 mg. L-1 in the
... Show MoreThe purpose of current study is to analyze the computer textbooks content for intermediate stage in Iraq according to the theory of multiple intelligence. By answering the following question “what is the percentage of availability of multiple intelligence in the content of the computer textbooks on intermediate stage (grade I, II) for the academic year (2017-2018)? The researcher followed the descriptive analytical research approach (content analysis), and adopted an explicit idea for registration. The research tool was prepared according the Gardner’s classification of multiple intelligence. It has proven validity and reliability. The study found the percentage of multiple intelligence in the content of computer textbooks for the in
... Show MoreThe present work aims to study the removal of dyes from wastewater by reverse osmosis process. Two dyes were used direct blue 6, and direct yellow. Experiments were performed with feed concentration (75 – 450 ppm), operation temperature (30 – 50 oC) and time (0.2 – 2.0 hr). The membrane used is thin film composite membrane (TFC). It was found that modal permeate concentration decreases with increasing feed concentration and time operating, while permeate concentration increases with increasing feed temperature. Also it was found that product rate increase with increasing temperature, but it decrease with increasing feed concentration and time. The concentration of reject solution showed an increase with increasing feed concentratio
... Show MoreLet G be a graph with p vertices and q edges and be an injective function, where k is a positive integer. If the induced edge labeling defined by for each is a bijection, then the labeling f is called an odd Fibonacci edge irregular labeling of G. A graph which admits an odd Fibonacci edge irregular labeling is called an odd Fibonacci edge irregular graph. The odd Fibonacci edge irregularity strength ofes(G) is the minimum k for which G admits an odd Fibonacci edge irregular labeling. In this paper, the odd Fibonacci edge irregularity strength for some subdivision graphs and graphs obtained from vertex identification is determined.