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 cost‐effective dual functions zeolite‐carbon composite (DFZCC) was prepared using an eco‐friendly substrate prepared from bio‐waste and an organic adhesive at intermediate conditions. The green synthesis method used in this study ensures that chemically harmless compounds are used to obtain a homogeneous distribution of zeolite over porous carbon. The greenly prepared dual‐function composite was extensively characterized using Fourier transform infrared, X‐ray diffraction, thermogravimetric analysis, N2 adsorption/desorption isotherms, field emission scanning electron microscope, dispersive analysis by X‐ray, and point of zero charges. DFZCC had a surface area o
In current study, the dye from flowers petals of Strelitzia reginae used for the first time to prepare natural photosensitizer for DSSC fabrication. Among five different solvents used to extract the natural dye from S. reginae flowers, the ethanol extract of anthocyanin dye revealed higher absorption spectrum of 0.757a.u. at wavelength of 454nm. A major effect of temperature was studied to increase the extraction yield. The results show that the optimal temperature was 70 °C and there was a sharp decrease of dye concentration from 0.827 at temperature of 70 °C to 0.521 at temperature of 90°C. The extract solution of flowers of S. reginae showed higher concentration in acidic media, especially at pH 4 (0.902). The
... Show MoreThe posterior regions of the jaws usually represent a significant risk for implant surgery. A non-valid assessment of the available bone height may lead to either perforation of the maxillary sinus floor or encroachment of the inferior alveolar nerve and consequently to implant failure. This study aimed to evaluate the reliability of surgeon’s decision in appraising the appropriate implant length, in respect to vital anatomical structures, using panoramic radiographs.
Only implants that are inserted in relation to the maxillary sinus (MS) or the mandibular canal (MC) were enrolled
This study was conducted to provide a detailed description of the osteology features of Alburnus amirkabiri from the Qareh Chai river, markazi province, Iran. For this purpose, eight specimens of A. amirkabiri were collected from the Qareh Chai River by electrofishing and fixed in 4% buffered formalin after anesthesia. The specimens were cleared and stained for osteological examination and its detailed osteological characterizations and differences with available osteological data of other members of the genus Alburnus were provided.
Background: The final stage of endodontic therapy is complete obturation of the root canal system to provide as perfect as possible at the cementodentinal junction of the apical foramen. The purpose of this in vitro study was to evaluate the sealing ability of injection molded thermoplasticized gutta percha and lateral condensation techniques with and without the use of sealers. Materials and Methods: Forty freshly extracted adult human maxillary central incisors with complete formed apices were utilized in this study. The teeth were randomly divided into four groups for evaluation of the apical seal. Group (1) lateral condensation gutta percha technique without sealer, (2) lateral condensation gutta percha technique with sealer, (3) Inject
... Show MoreThe objectives of this study revolve around identifying the extent of funding impact on the future of the printed Iraqi press, and whether it threatens their chances of survival, stating the extent of technological development on the income of the printed newspaper, and identifying the causes of the financial crisis on the newspaper. This research is classified as descriptive research, and the researcher used the survey method, and adopted the questionnaire of the views of the contactors, in five Iraqi newspapers (morning - extent - time - the way of the people - the call). The research community included (68) respondents, whereby the comprehensive inventory method was used to define the research community, and the researcher used t
... Show MorePolice play an important role in any society. Where they maintain public order by stopping and deterring crime and bringing criminals to justice. In order to achieve these objectives, they have certain means of law (search, arrest, use of force that may be lethal in some cases). However, such means may be misused in a way that harms members of society such as (Exceeding the Scope of a search warrant, violation of privacy of individuals, False Imprisonment, Excessive use of force, Sudden Deaths in custody, Sexual Assault and Harassment, Failure to respond for Domestic violence calls), which raises the civil liability of police officers and their agencies for such damage. Police officers may even abuse their characteristics even outside offic
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