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.
The process of cognitive representation includes mental activities such as perception, concepts formation and decision making leading to formation of Cognitive representation where the need for Cognition is one of basic humane needs promoting individuals to have more information.
This Study aims to measure the level of Cognitive representation among gifted Schools, the level of need for Cognition among them, recognize statistical Significant differences with Cognitive representation according to gender Variable and recognize the Correlation between Cognitive representation and the need for Cognition among giftel schools . The sample Consists of subsample of mair application one Consisting of( 400) students, noting that the first sampl
ABSTRACT
This research aim to measure the critical success factors for total quality management applications, in order to know the key and important role played by these factors at applying the total quality management through a comparative study conducted in a number of a private colleges.
The research problem posed a set of questions, the most important ones are: Are the colleges (sample of research) aware of the critical success factors at applying the total quality management? What is the availability of the critical success factors at the work of the colleges (sample of research)?
What are the critical success factors in the work of the researc
... Show MoreResearch,s Summary The purpose of the research was to specify the standerd Levels for results of basketball for Iraqi young sters, Becuse there werenot the standerd Levels which related to the testings abilities of the players based on plying centers specially the physical abilities, This made weakness in arrangement and putting the suitable training studies for different age stadges which suitable with game ,s requirements, besides evaluation the performance of the plyers in common and the levels of the coachs train in special according to the scientific style. The researchers depended on (8) special testings of chossen physical abilities, These testings applied on the teams, young players for sharing clubs among excellent series of basket
... Show MoreThe aim of the research is to design a test with cognitive achievement through the use of the inverted class strategy for some basic soccer skills for gyms for first-average students, within the curriculum of the Ministry of Education, where the researcher used the experimental approach. For the same division (B) and the number of each group (10) students, i.e. the total total of the research sample (20) students, and the pre-test for the research sample was applied through the design of the test prepared by the research after which the educational program with the strategy was applied to the research sample and continued (8) weeks after Completion of the tutorial has been post-tested for the research sample, In it, he reached significant r
... Show MoreOne of the most important virulence factors in Pseudomonas aeruginosa is biofilm formation, as it works as a barrier for entering antibiotics into the bacterial cell. Different environmental and nutritional conditions were used to optimize biofilm formation using microtitre plate assay by P. aeruginosa. The low nutrient level of the medium represented by tryptic soy broth (TSB) was better in biofilm formation than the high nutrient level of the medium with Luria Broth (LB). The optimized condition for biofilm production at room temperature (25 °C) is better than at host temperature (37 °C). Moreover, the staining with 0.1% crystal violet and reading the biofilm with wavelength 360 are considered essential factors in
... Show MoreA Raman spectroscopy method was optimised to examine the chemical changes of aspirin tablets after interaction with helium temperatures. Several aspirin tablets were exposed to plasma-assisted desorption ionisation flame for different times (10, 30, 50, 60, 180 and 300s) and then analysed by Raman spectroscopy using optimal conditions. The changes in chemistry between exposed and fresh (without exposure to plasma) tablets were compared. The vibrational peaks of the aspirin molecule in the Raman spectrum were identified by checking the peak position. The results showed clear spectra with increases in intensity of vibrational peaks until 30s, whereas no spectra were measured for the exposed tablets to plasma flame after 50s. It can, the
... Show MoreThis paper provides an attempt for modeling rate of penetration (ROP) for an Iraqi oil field with aid of mud logging data. Data of Umm Radhuma formation was selected for this modeling. These data include weight on bit, rotary speed, flow rate and mud density. A statistical approach was applied on these data for improving rate of penetration modeling. As result, an empirical linear ROP model has been developed with good fitness when compared with actual data. Also, a nonlinear regression analysis of different forms was attempted, and the results showed that the power model has good predicting capability with respect to other forms.
This paper introduces the Multistep Modified Reduced Differential Transform Method (MMRDTM). It is applied to approximate the solution for Nonlinear Schrodinger Equations (NLSEs) of power law nonlinearity. The proposed method has some advantages. An analytical approximation can be generated in a fast converging series by applying the proposed approach. On top of that, the number of computed terms is also significantly reduced. Compared to the RDTM, the nonlinear term in this method is replaced by related Adomian polynomials prior to the implementation of a multistep approach. As a consequence, only a smaller number of NLSE computed terms are required in the attained approximation. Moreover, the approximation also converges rapidly over a
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