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.
Wettability of CO2-brine-mineral systems plays a vital role during geological CO2-storage. Residual trapping is lower in deep saline aquifers where the CO2 is migrating through quartz rich reservoirs but CO2 accumulation within a three-way structural closure would have a high storage volume due to higher CO2 saturation in hydrophobic quartz rich reservoir rock. However, such wettability is only poorly understood at realistic subsurface conditions, which are anoxic or reducing. As a consequence of the reducing environment, the geological formations (i.e. deep saline aquifers) contain appreciable concentrations of various organic acids. We thus demonstrate here what impact traces of organic acids exposed to storage rock have on their wettabil
... Show MoreManganese dioxide rotating cylinder electrode prepared by anodic deposition on a graphite substrate using MnSO4 solution in the presence of 0.918 M of H2SO4. The influence of different operational parameters (MnSO4 concentration, current density, time, and rotation speed) on the structure, and morphology of MnO2 deposit film was examined widely. The structure and crystal size determined by X-ray diffraction (XRD), the morphology examined by scanning electron microscopy (SEM) and atomic force microscopy (AFM) techniques. The γ-MnO2 obtained as the main product of the deposition process. It found that the four parameters have a significant influence on the structure, morphology, and roughness of the prepared MnO2 deposit. The crystal size in
... Show MoreThe removal of commercial orange G dye from its aqueous solution by adsorption on tobacco leaves (TL) was studied in respect to different factor that affected the adsorption process. These factors including the tobacco leaves does, period of orange G adsorption, pH, and initial orange G dye concentration .Different types of isotherm models were used to describe the orange G dye adsorption onto the tobacco leaves. The experimental results were compared using Langmuir, and frundlich adsorption isotherm, the constants for these two isotherm models was determined. The results fitted frundlich model with value of correlation coefficient equal to (0.981). The capacity of adsorption for the orange G dye was carried out using various kinetic models
... Show MoreDandruff and seborrheic dermatitis (SD) are common skin disorders affecting the scalp and extending to other body sites in the case of SD. They are associated with pruritus and scaling, causing an esthetical disturbance in the population affected. Treatment of such conditions involves using a variety of drugs for long terms, thus optimizing drug formulation is essential to improve therapeutic efficacy and patient compliance. Conventional topical formulations like shampoos and creams have been widely used but their use is associated with disadvantages. To overcome such effects, novel topical nanotechnology-based formulations are currently under investigation. In the following article, we highlight recently published formulatio
... Show MorePMMA (Poly methyl methacrylate) is considered one of the most commonly used materials in denture base fabrication due to its ideal properties. Although, a major problem with this resin is the frequent fractures due to heavy chewing forces which lead to early crack and fracture in clinical use. The addition of nanoparticles as filler performed in this study to enhance its selected mechanical properties. The Nano-additive effect investigated in normal circumstances and under a different temperature during water exposure. First, tests applied on the prepared samples at room temperature and then after exposure to water bath at (20, 40, 60) C° respectively. SEM, PSD, EDX were utilized for samples evaluation in this study. Flexural
... Show More