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.
Most available methods for unit hydrographs (SUH) derivation involve manual, subjective fitting of
a hydrograph through a few data points. The use of probability distributions for the derivation of synthetic
hydrographs had received much attention because of its similarity with unit hydrograph properties. In this
paper, the use of two flexible probability distributions is presented. For each distribution the unknown
parameters were derived in terms of the time to peak(tp), and the peak discharge(Qp). A simple Matlab
program is prepared for calculating these parameters and their validity was checked using comparison
with field data. Application to field data shows that the gamma and lognormal distributions had fit well.<
The aim of this paper to find Bayes estimator under new loss function assemble between symmetric and asymmetric loss functions, namely, proposed entropy loss function, where this function that merge between entropy loss function and the squared Log error Loss function, which is quite asymmetric in nature. then comparison a the Bayes estimators of exponential distribution under the proposed function, whoever, loss functions ingredient for the proposed function the using a standard mean square error (MSE) and Bias quantity (Mbias), where the generation of the random data using the simulation for estimate exponential distribution parameters different sample sizes (n=10,50,100) and (N=1000), taking initial
... Show MoreTo promote sustainable steel-concrete composite structures, it is essential to develop special shear connectors that facilitate accelerated construction and deconstruction. A lockbolt demountable shear connector (LBDSC) was recently proposed. While the LBDSC has been evaluated using horizontal and vertical (standard) push-out tests, it is essential to further assess the disassembly mechanism and the positive flexural performance of prefabricated demountable composite beams (PDCBs) under both serviceability and ultimate limit states. Two full-scale test specimens of PDCBs with LBDSC were designed with partial shear connections and assessed using a three or four-point load beam setup under both cyclic and static monotonic loading conditions.
... Show MoreThis research included measuring the concentrations of natural radioactive isotopes U-238 and Th-232 and radiation dose rates for selected areas of Missan province, GR-460 system was used which has the potential to measure the concentrations of natural radioactive isotopes in (ppm) unit and measuring the radiation dose rates in μR/h unit. It was also used with the system the mobile device FH-40 which measures the radiation dose rates in units μSμ/h the measurement results showed the absence of a significant increase in the U-238 and Th-232 concentration where the concentration of isotopes of U-238 and natural Th-232 (3.35-5.46) ppm respectively it is authorized and universally accepted. In terms of radiation dose rates it ranged betwe
... Show MoreThe study of entry and reentry dynamics for space vehicles is very important, particularly for manned vehicles and vehicles which is carry important devices and which can be used again. There are three types for entry dynamic, ballistics entry, glide entry and skip entry. The skip entry is used in this work for describing entry dynamics and determining trajectory. The inertia coordinate system is used to derive equations of motion and determines initial condition for skip entry. The velocity and drag force for entry vehicle, where generate it during entry into earth’s atmosphere are calculated in this work. Also the deceleration during descending and determining entry angles, velocities ratio and altitude ratio have been studied. The c
... Show MoreThe concept of the active contour model has been extensively utilized in the segmentation and analysis of images. This technology has been effectively employed in identifying the contours in object recognition, computer graphics and vision, biomedical processing of images that is normal images or medical images such as Magnetic Resonance Images (MRI), X-rays, plus Ultrasound imaging. Three colleagues, Kass, Witkin and Terzopoulos developed this energy, lessening “Active Contour Models” (equally identified as Snake) back in 1987. Being curved in nature, snakes are characterized in an image field and are capable of being set in motion by external and internal forces within image data and the curve itself in that order. The present s
... Show MorePoly vinyl alcohol has been studied for its ability to form crystallites by using annealing method. Semicrystalline films of poly vinyl alcohol (PVA) were prepared by casting 11.5 wt. % and 13 wt. % PVA aqueous solution onto glass slides at annealing temperature range 90 -120°C and duration time 15- 60 minute. This allowed the macromolecules to form crystallites, small regions of folded and compacted chains separated by amorphous regions where single PVA chain may pass through several of these crystallites. Degree of crystallinity of PVA films (hydrogels) was determined by method of density; on the other hand the swelling behavior was conducted by the determination of water uptake, wet degree of crystallinity, gel fraction and solubilit
... Show MoreDue to the advantages over other metallic materials, such as superior corrosion resistance, excellent biocompatibility, and favorable mechanical properties, titanium, its alloys and related composites, are frequently utilized in biomedical applications, particularly in orthopedics and dentistry. This work focuses on developing novel titanium-titanium diboride (TiB2; ceramic material) composites for dental implants where TiB2 additions were estimated to be 9 wt.%. In a steel mold, Ti-TiB2 composites were fabricated using a powder metallurgy technique and sintered for five hours at 1200 °C. Microstructural and chemical properties were analyzed by energy dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), and X-ra
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