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.
Number theorists believe that primes play a central role in Number theory and that solving problems related to primes could lead to the resolution of many other unsolved conjectures, including the prime k-tuples conjecture. This paper aims to demonstrate the existence of this conjecture for admissible k-tuples in a positive proportion. The authors achieved this by refining the methods of “Goldston, Pintz and Yildirim” and “James Maynard” for studying bounded gaps between primes and prime k-tuples. These refinements enabled to overcome the previous limitations and restrictions and to show that for a positive proportion of admissible k-tuples, there is the existence of the prime k-tuples conjecture holding for each “k”. The sig
... 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 MorePlant extracts occupied a big place in diseases treatment and preserving human health because, they contain many active substances that can be exploited in the field of pharmaceutical manufacturing from natural materials. Therefore, this study was conducted to evaluate the effect of different concentrations of plant extracts for each of Nigella sativa, Alliumsativum and Allium cepa against the fungal growth of Candida albicans that cause many skin diseases and infections to humans as well as Trichophyton mentagrophytes, which affects the hair, skin and nails. These two fungi have been isolated and diagnosed from people who have skin infection. Both fungal isolates were treated with extracts of Nigella sativa, Alliumsativum and Allium cepa
... Show MoreIn this study, composite materials were prepared using unsaturated polyester resin as binder with two types of fillers (sawdust and chopped reeds). The molding method is used to prepare sheets of UPE / sawdust composite and UPE / chopped reeds composite. The mechanical properties were studied including flexural strength and Young's modulus for the samples at normal conditions (N.C). The Commercial wood, UPE and its composite samples were immersed in water for about 30 days to find the weight gain (Mt%) of water for the samples, also to find the effect of water on their flexural strength and Young's modulus. The results showed that the samples of UPE / chopped reeds composite gained highest values of flexural strength (24.
... Show MoreMost 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.<
An efficient modification and a novel technique combining the homotopy concept with Adomian decomposition method (ADM) to obtain an accurate analytical solution for Riccati matrix delay differential equation (RMDDE) is introduced in this paper . Both methods are very efficient and effective. The whole integral part of ADM is used instead of the integral part of homotopy technique. The major feature in current technique gives us a large convergence region of iterative approximate solutions .The results acquired by this technique give better approximations for a larger region as well as previously. Finally, the results conducted via suggesting an efficient and easy technique, and may be addressed to other non-linear problems.
The dynamic behavior of laced reinforced concrete (LRC) T‐beams could give high‐energy absorption capabilities without significantly affecting the cost, which was offered through a combination of high strength and ductile response. In this paper, LRC T‐beams, composed of inclined continuous reinforcement on each side of the beam, were investigated to maintain high deformations as predicted in blast resistance. The beams were tested under four‐point loading to create pure bending zones and obtain the ultimate flexural capacities. Transverse reinforcement using lacing reinforcement and conventional vertical stirrups were compared in terms of deformation, strain, and toughness changes of the tes
In this paper, we used maximum likelihood method and the Bayesian method to estimate the shape parameter (θ), and reliability function (R(t)) of the Kumaraswamy distribution with two parameters l , θ (under assuming the exponential distribution, Chi-squared distribution and Erlang-2 type distribution as prior distributions), in addition to that we used method of moments for estimating the parameters of the prior distributions. Bayes