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.
Nonmissile penetrating traumatic brain injuries (pTBIs) are low-velocity injuries which can be caused by a variety of inflicting tools and represent a rare entity in children. Poor outcome has been attributed with an initial admission Glasgow Coma Scale (GCS) of <5, asymmetrical pupil size, and specific initial computed tomography scan findings including brainstem injury.
We report a case of an 11-year-old boy who presented to our ER with a GCS of 6 after being assaulted on his head by a 30 cm length metallic tent hook penetrating his forehead reaching down to the central skull bas
Manipulation is a discursive concept which plays a key role in political discourse by which politicians can impose some impact on their recipients through using linguistic features, most prominent of which are personal pronouns (Van Dijk, 1995). The aim of this study is to investigate how politicians utilize the personal pronouns, namely; We and I and their possessive forms as a tool of manipulating the audience's mind based on Van Dijk's "ideological square" which shows positive-self representation and negative-other representation (Van Dijk,1998:p.69). To this end, American President Donald Trump's 2020 State of the Union speech was chosen to be the data of analysis. Only (8)
... Show MoreThe general trend in Iraqi banks is focused towards the application of international financial reporting standards, especially the international financial reporting standard IFRS 9 “Financial Instruments”, in addition to the directives issued on the Central Bank of Iraq’s instructions for the year 2018 regarding the development of expected credit losses models, and not to adhere to a specific method for calculating these losses and authorizing the banks’ departments to adopt the method of calculating losses that suits the nature of the bank’s activity and to be consistent in its use from time to time. The research problem revolves around the different methodologies for calculatin
... Show MoreIn the present research we the study the deposition of radioactive elements naturally and particularly radioactive radon gas in parts of the body of organisms which are of direct relevance to human life in the city of Baghdad as the samples which were collected from the bones and skin of some kinds of birds and chicken based on the principle that radioactive elements are concentrated always on the bones. We use of this as the exercise detector impact nuclear (CR-39), using the technology Cylindrical diffusion , the results indicated that the largest concentration of radon found in the bone bird Seagull tapered as it was (625 ± 37) Bq.cm-3, and less concentration of radon gas in the chicken bones of Al-kafeel as it was (105 ± 10) Bq.c
... Show MoreMedium Access Control (MAC) spoofing attacks relate to an attacker altering the manufacturer assigned MAC address to any other value. MAC spoofing attacks in Wireless Fidelity (WiFi) network are simple because of the ease of access to the tools of the MAC fraud on the Internet like MAC Makeup, and in addition to that the MAC address can be changed manually without software. MAC spoofing attacks are considered one of the most intensive attacks in the WiFi network; as result for that, many MAC spoofing detection systems were built, each of which comes with its strength and weak points. This paper logically identifies and recognizes the weak points
and masquerading paths that penetrate the up-to-date existing detection systems. Then the
A study carried out in quail’s field owned by the Department of Animal production/ Collage of Agriculture / Tikrit University. For the period 14/ 5/ 2016 to 4/ 6/ 2016 in order to study the effect of adding Curcuma longa - to the diet of quails - on some productive and physiological characteristics of the Japanese quail birds bred for meat production. Using (48) quail birds which are two weeks old provided by Department of Agricultural Research. The birds were divided randomly after weighing them into three treatments; four replicate treatments for (4 bird/ replicate). The treatments as follows: (T1) control group (fed diet without any supplement), second (T2) and third (T3) groups were fed diet supplemental 4.5 and 9g Curcuma powder /
... Show MoreIn order to improve the students’ performance level in some of the skills that are implemented on the mat device of ground movements, including the front and rear rolling, it is necessary to study the most important indicators that have a clear impact on the performance of those rolls. Among the objectives of the research: To identify the percentage of the contribution of flexibility of the hip joint, the angle of the knees and the muscular strength of the arms in the performance of the front and rear rolling skills, an opening of the research sample. The researchers used the descriptive method in the survey method for its suitability to the nature of the work, and the research community was represented by students of the third st
... Show Moreيعتقد البعض ان مفهوم العلم يعني الآلات والاجهزة العلمية (تقنيات التعليم) وهي لا تختلف عن مفهوم تكنولوجيا المعلومات , ويعد هذا الاعتقاد خاطئ , لان العلم هو بناء المعرفة العلمية المنظمة والتي يتم التوصل اليها عن طريق البحث العلمي , اما تكنولوجيا المعلومات فهي "التطبيقات العملية للمعرفة العلمية في مختلف المجالات ذات الفائدة المباشرة بحياة الانسان, او هي النواحي التطبيقية للعلم وما يرتبط بها من آلات واجهزة".
Benign prostate hyperplasia (BPH), non-cancerous enlargement of prostate, is the most prevalent disease entity in elderly men. BPH affects 40% of men after the age of 60year worldwide. BPH causes problems for patients with significant lower urinary tract obstructive symptoms, if not responding to medical therapy, surgical intervention is instituted. One method of the treatment of symptomatic BPH is laser prostatectomy. The understanding of tissue effects by laser radiation is very important for the safe clinical application of laser. Objective: study the 2100 nm Ho: YAG laser gross tissue effects in the prostate at different laser dose settings in an vitro model prostate tissue samples harvested from same specimen of open surgery prostat
... Show MoreThe corcosion behoviour of Aluminum bronze in sodium chloride solution has been studied ^tentiostatically at five temperatures in the range 293-313K.The corrosion potential shifted to more negative values with increasing temperature. The corrosion current density increased with increasing temperature. Values of Tal'el slopes and the transfer coefficients indicated hydrogen evolution reaction to occur at the cathode and mainly the dissolution at the anode.Benzotriazole (BTA) had an inhibiting effect ??? the corrosion of the Al-bronze in deaerated NaCl solution at a concentration (1*10'?- IxlO‘1) mol dm'^ over the temperature range 293-313K. Values of the protection efficiency and kinetics parameters were obtained from the corrosion current
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