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 an estimator of reliability function for the pareto dist. Of the first kind has been derived and then a simulation approach by Monte-Calro method was made to compare the Bayers estimator of reliability function and the maximum likelihood estimator for this function. It has been found that the Bayes. estimator was better than maximum likelihood estimator for all sample sizes using Integral mean square error(IMSE).
The emphasis of Master Production Scheduling (MPS) or tactic planning is on time and spatial disintegration of the cumulative planning targets and forecasts, along with the provision and forecast of the required resources. This procedure eventually becomes considerably difficult and slow as the number of resources, products and periods considered increases. A number of studies have been carried out to understand these impediments and formulate algorithms to optimise the production planning problem, or more specifically the master production scheduling (MPS) problem. These algorithms include an Evolutionary Algorithm called Genetic Algorithm, a Swarm Intelligence methodology called Gravitational Search Algorithm (GSA), Bat Algorithm (BAT), T
... Show MoreThe nucleon momentum distributions (NMD) for the ground state and elastic electron scattering form factors have been calculated in the framework of the coherent fluctuation model and expressed in terms of the weight function (fluctuation function). The weight function has been related to the nucleon density distributions of nuclei and determined from theory and experiment. The nucleon density distributions (NDD) is derived from a simple method based on the use of the single particle wave functions of the harmonic oscillator potential and the occupation numbers of the states. The feature of long-tail behavior at high momentum region of the NMD has been obtained using both the theoretical and experimental weight functions. The observed ele
... Show MoreFlexible pavements are considered an essential element of transportation infrastructure. So, evaluations of flexible pavement performance are necessary for the proper management of transportation infrastructure. Pavement condition index (PCI) and international roughness index (IRI) are common indices applied to evaluate pavement surface conditions. However, the pavement condition surveys to calculate PCI are costly and time-consuming as compared to IRI. This article focuses on developing regression models that predict PCI from IRI. Eighty-three flexible pavement sections, with section length equal to 250 m, were selected in Al-Diwaniyah, Iraq, to develop PCI-IRI relationships. In terms of the quantity and severity of eac
... Show MoreThis research including lineament automated extraction by using PCI Geomatica program, depending on satellite image and lineament analysis by using GIS program. Analysis included density analysis, length density analysis and intersection density analysis. When calculate the slope map for the study area, found the relationship between the slope and lineament density.
The lineament density increases in the regions that have high values for the slope, show that lineament play an important role in the classification process as it isolates the class for the other were observed in Iranian territory, clearly, also show that one of the lineament hit shoulders of Galal Badra dam and the surrounding areas dam. So should take into consideration
In this research, porous silicon (PS) prepared by anodization etching on surface of single crystalline p-type Si wafer, then Gold nanoparticle (AuNPs) prepared by pulsed laser ablation in liquid. NPs deposited on PS layer by drop casting. The morphology of PS, AuNPs and AuNPs/PS samples were examined by AFM. The crystallization of this sample was characterized by X-ray diffraction (XRD). The electrical properties and sensitivity to CO2 gas were investigated to Al/AuNPs/PS/c-Si/Al, we found that AuNPs plays crucial role to enhance this properties.
The rivers are the main source of fresh water for many countries and the great development which is considered as one of the sustainable development elements in its various agricultural, industrial, domestic and environmental fields .The countries of the world seek food security and water security in order to ensure the basic needs of citizens .Because their distribution is uneven in many regions of the world with different human needs, which leads to conflicts over water sources, especially those located in one international river basin .This has led to the emergence of internationallegal rules governing the management of The problem revolves around the dialectic between limited water resources and increased need for water use b
... Show MoreThis research is marked by " lighting and processors formalism for spaces of shops selling mobile phones ," aims to " reveal about the relationship between lighting treatments formal designs spaces own internal selling mobile phone in addition to the recognition criteria Altsamama to lighting techniques and processes formality spaces shops competent to sell mobile phone " and lies the importance of this research in the " active role of the lighting in the building processors formalities and processes to prepare designs and show the final form integrated functionally and aesthetically so as to be ready for implementation , taking into consideration the role expressionist in the recipient and to make these spaces more than meet the require
... Show MoreOptimizing the Access Point (AP) deployment is of great importance in wireless applications owing the requirement to provide efficient and cost-effective communication. Highly targeted by many researchers and academic industries, Quality of Service (QOS) is an important primary parameter and objective in mind along with AP placement and overall publishing cost. This study proposes and investigates a multi-level optimization algorithm based on Binary Particle Swarm Optimization (BPSO). It aims to an optimal multi-floor AP placement with effective coverage that makes it more capable of supporting QOS and cost effectiveness. Five pairs (coverage, AP placement) of weights, signal threshol