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.
In this paper, we will illustrate a gamma regression model assuming that the dependent variable (Y) is a gamma distribution and that it's mean ( ) is related through a linear predictor with link function which is identity link function g(μ) = μ. It also contains the shape parameter which is not constant and depends on the linear predictor and with link function which is the log link and we will estimate the parameters of gamma regression by using two estimation methods which are The Maximum Likelihood and the Bayesian and a comparison between these methods by using the standard comparison of average squares of error (MSE), where the two methods were applied to real da
... Show MoreThe present work focuses on the experimental implementation of one of the fiber optical sensors, the optical glass fiber built on surface Plasmon resonance. A type of optical glass fiber was used in this work, single-mode no-core fiber with pre-tapering diameter: (125.1 μm) and (125.3 μm), respectively. The taper method can be tested by measuring the output power of the optical fiber before and after chemical etching to show the difference in cladding diameter due to the effect of hydrofluoric acid with increasing time for the taper process. The optical glass fiber sensor can be fabricated using the taper method to reduce the cladding diameter of the fibers to (83.12 µm, 64.37 µm, and 52.45 µm) for single-mode fibers using Hydrofluoric
... Show MoreThe pollution producing from textile industries effluents is growing since the years, due to at discharged lots of it in water without treatment. The resulting effluent is colourful, highly toxic, and poses a significant environmental hazard. This problem can be solved by using enzymic biological treatment, where the Congo red dye was used with concentrations (100,200,300,500) mg /L, pH values (3,4,5,6,7,8), and variable temperatures (25,35,45)°C, the best removal of Congo red (CR) dye under optimum conditions for degradation was at concentration of 100 mg/L, at (pH 6, 25 °C) with efficiency of 99.85 % using the peroxidase enzyme extracted from red radish plant, while the removal percentage decreased when increase dye concentration
... Show MoreThe Electrical power system has become vast and more complex, so it is subjected to sudden changes in load levels. Stability is an important concept which determines the stable operation of the power system. Transient stability analysis has become one of the significant studies in the power system to ensure the system stability to withstand a considerable disturbance. The effect of temporary occurrence can lead to malfunction of electronic control equipment. The application of flexible AC transmission systems (FACTS) devices in the transmission system have introduced several changes in the power system. These changes have a significant impact on the power system protection, due to differences inline impedance, line curre
... Show MoreWellbore instability is one of the most common issues encountered during drilling operations. This problem becomes enormous when drilling deep wells that are passing through many different formations. The purpose of this study is to evaluate wellbore failure criteria by constructing a one-dimensional mechanical earth model (1D-MEM) that will help to predict a safe mud-weight window for deep wells. An integrated log measurement has been used to compute MEM components for nine formations along the studied well. Repeated formation pressure and laboratory core testing are used to validate the calculated results. The prediction of mud weight along the nine studied formations shows that for Ahmadi, Nahr Umr, Shuaiba, and Zubair formations
... Show MoreIn this paper, Bayes estimators of Poisson distribution have been derived by using two loss functions: the squared error loss function and the proposed exponential loss function in this study, based on different priors classified as the two different informative prior distributions represented by erlang and inverse levy prior distributions and non-informative prior for the shape parameter of Poisson distribution. The maximum likelihood estimator (MLE) of the Poisson distribution has also been derived. A simulation study has been fulfilled to compare the accuracy of the Bayes estimates with the corresponding maximum likelihood estimate (MLE) of the Poisson distribution based on the root mean squared error (RMSE) for different cases of the
... Show MoreIn this paper, we present a Branch and Bound (B&B) algorithm of scheduling (n) jobs on a single machine to minimize the sum total completion time, total tardiness, total earliness, number of tardy jobs and total late work with unequal release dates. We proposed six heuristic methods for account upper bound. Also to obtain lower bound (LB) to this problem we modified a (LB) select from literature, with (Moore algorithm and Lawler's algorithm). And some dominance rules were suggested. Also, two special cases were derived. Computational experience showed the proposed (B&B) algorithm was effective in solving problems with up to (16) jobs, also the upper bounds and the lower bound were effective in restr
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This study highlights the importance of Iraq in the analysis of foreign trade and economic growth for the period (1980 - 2013) is an attempt to determine the equilibrium relationship long term and short term between these two variables were used ARDL model to explain the economic relationship between the two variables.
To achieve the objectives of the research has been the standard model estimate after testing the stability of exports X data series, and imports M, and GDP current prices, and exchange rate EXR, and verify the existence of a joint integration relationship between these variables.
In order to achieve the objectives of the research it
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