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.
Nanofluids are proven to be efficient agents for wettability alteration in subsurface applications including enhanced oil recovery (EOR). Nanofluids can also be used for CO2-storage applications where the CO2-wet rocks can be rendered strongly water-wet, however no attention has been given to this aspect in the past. Thus in this work we presents contact angle (θ) measurements for CO2/brine/calcite system as function of pressure (0.1 MPa, 5 MPa, 10 MPa, 15 MPa, and 20 MPa), temperature (23 °C, 50 °C and 70 °C), and salinity (0, 5, 10, 15, and 20% NaCl) before and after nano-treatment to address the wettability alteration efficiency. Moreover, the effect of treatment pressure and temperature, treatment fluid concentration (SiO2 wt%) and
... Show MoreObjective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation
... Show MorePortland Cement is manufactured by adding 3% gypsum to clinker which is produced by grinding, pulverizing, mixing, and then burning a raw mix of silica, and calcium carbonate. Limestone is the main source of carbonates, while clay collected from arable land is the main source of silica. The marl in the Euphrates Formation was studied as an alternative to arable lands. Nine boreholes drilled and penetrated the marl layer in selected locations at the Kufa cement quarry. Forty-one samples of marl from boreholes and four samples of limestone from the closed area were collected. The chemical content of the major oxides and the hardness of the marl layer was very encouraging as a raw material for Portland Cement as they are SiO2 (17.60),
... Show MoreTwo different polyvinyl alcohol/polyvinyl chloride (PVA/PVC) hollow fiber composite nanofiltration membranes were prepared after PVC hollow fiber membranes were coated using dip-coating method with PVA aqueous solution, which was composed of PVA, fatty alcohol polyoxyethylene ether (AEO9), and water [PVA/AEO9/water (4:0.5:95.5) wt%]. Effect of two different PVC hollow fiber immersion times in coating solution were studied. Cross-section, internal and external surfaces of the PVC hollow fibers and PVA/PVC composite nanofiltration membranes structures were characterized by scanning electron microscopy (SEM), pure water permeation flux and solutes rejection. It was found that, the coating layer thickness on the outer surface of the 19 wt% P
... Show MoreThis study looks into the many methods that are used in the risk assessment procedure that is used in the construction industry nowadays. As a result of the slow adoption of novel assessment methods, professionals frequently resort to strategies that have previously been validated as being successful. When it comes to risk assessment, having a precise analytical tool that uses the cost of risk as a measurement and draws on the knowledge of professionals could potentially assist bridge the gap between theory and practice. This step will examine relevant literature, sort articles according to their published year, and identify domains and qualities. Consequently, the most significant findings have been presented in a manne
... Show MoreBecause of the quick growth of electrical instruments used in noxious gas detection, the importance of gas sensors has increased. X-ray diffraction (XRD) can be used to examine the crystal phase structure of sensing materials, which affects the properties of gas sensing. This contributes to the study of the effect of electrochemical synthesis of titanium dioxide (TiO2) materials with various crystal phase shapes, such as rutile TiO2 (R-TiO2NTs) and anatase TiO2 (A-TiO2NTs). In this work, we have studied the effect of voltage on preparing TiO2 nanotube arrays via the anodization technique for gas sensor applications. The results acquired from XRD, energy dispersion spectro
... Show MoreBecause of the quick growth of electrical instruments used in noxious gas detection, the importance of gas sensors has increased. X-ray diffraction (XRD) can be used to examine the crystal phase structure of sensing materials, which affects the properties of gas sensing. This contributes to the study of the effect of electrochemical synthesis of titanium dioxide (TiO2) materials with various crystal phase shapes, such as rutile TiO2 (R-TiO2NTs) and anatase TiO2 (A-TiO2NTs). In this work, we have studied the effect of voltage on preparing TiO2 nanotube arrays via the anodization technique for gas sensor applications. The results acquired from XRD, energy dispersion spectroscopy (EDX), and field emission scanning electron microscopy
... Show MoreThe aim of this study is to know the effect of using locally manufactured fishmeal and its nutritional value note that its manufactured from uneconomical local fish are not for human consumption. Cyprinus carpio fed with three different diets levels of locally manufactured fishmeal at a rate of 0.03 and 0.05 of the body weight. For control treatment (C1), the second treatment (C2) and the third treatment (C3). It was found that the C3 was superior to the first two parameters, control (C1) and (C2), in most of the studied standards with a high significance level (P≥0.05). The average final weight of the fish in the third parameter (C3) was 7.75g. The daily growth rate (DGR) of the th
This paper aims to decide the best parameter estimation methods for the parameters of the Gumbel type-I distribution under the type-II censorship scheme. For this purpose, classical and Bayesian parameter estimation procedures are considered. The maximum likelihood estimators are used for the classical parameter estimation procedure. The asymptotic distributions of these estimators are also derived. It is not possible to obtain explicit solutions of Bayesian estimators. Therefore, Markov Chain Monte Carlo, and Lindley techniques are taken into account to estimate the unknown parameters. In Bayesian analysis, it is very important to determine an appropriate combination of a prior distribution and a loss function. Therefore, two different
... Show MoreA batch adsorption system was applied to study the adsorption of methylene blue from aqueous solution by Iraqi bentonite and treated bentonite with different amount of zinc oxide (ZnO). The adsorption capacities of methylene blue onto bentonite were evaluated. The equilibrium between liquid and solid phase was described by Langmuir model better than the Freundlich model. Langmuir and Freundlich constants have been determined. The separation factor or equilibrium parameter, RL which is used to predict if an adsorption system is favourable or unfavourable was calculated for all cases.