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.
Medical imaging is a technique that has been used for diagnosis and treatment of a large number of diseases. Therefore it has become necessary to conduct a good image processing to extract the finest desired result and information. In this study, genetic algorithm (GA)-based clustering technique (K-means and Fuzzy C Means (FCM)) were used to segment thyroid Computed Tomography (CT) images to an extraction thyroid tumor. Traditional GA, K-means and FCM algorithms were applied separately on the original images and on the enhanced image with Anisotropic Diffusion Filter (ADF). The resulting cluster centers from K-means and FCM were used as the initial population in GA for the implementation of GAK-Mean and GAFCM. Jaccard index was used to s
... Show MoreThe limited availability of the two-circle diffractometer to collect intensity measurements down to the monoclinic system has been extended in a novel procedure to collect intensities for the triclinic system. The procedure involves the derivation of matrix elements from graphical representation of the reciprocal lattice. Offset of the origins of the upper layers from that of the zero-layer - characteristic of triclinic system - is determined and the 3 x 3 matrix elements are evaluated accordingly. Details of crystal alignment by X-rays for the triclinic system utilizing the intensities of equivalent reflections is described
An optimization analysis of drilling process constitutes a powerful tool for operating under desired pressure levels and simultaneously maximizing the penetration rate, which reduces costs and time thus increases the profit.
In this study, a composite drilling model (Young-Bourgyen model) of eight functions was used to determine the optimum drilling mechanical parameters (Weight on bit and rotary speed) for an Iraqi oil field. These functions model the effect of most drilling parameters such as formation strength, mud density, formation compaction, weight on bit, rotary speed, tooth dullness, and bit hydraulic on drilling rate. Data are extracted from bit record and drilling report of well BUZ-20 for calculation of eight exponents of
The inhibitive action of a blend of sodium nitrite/sodium hexametaphosphate (SN+SHMP) on corrosion of carbon steel in simulated cooling water systems (CWS) has been investigated by weight loss and electrochemical polarization technique. The effect of temperature, velocity, and salts concentrations on corrosion of carbon steel were studied in the absence and presence of mixed inhibiting blend. Also the effect of inhibitors blend concentrations (SN+SHMP), temperatures, and rotational velocity, i.e., Reynolds number (Re) on corrosion rate of carbon steel were investigated using Second-order Rotatable Design (Box-Wilson Design) in performing weight loss and corrosion potential approach. Electrochemical polarization measurements
... Show More<span lang="EN-GB">Transmitting the highest capacity throughput over the longest possible distance without any regeneration stage is an important goal of any long-haul optical network system. Accordingly, Polarization-Multiplexed Quadrature Phase-Shift-Keying (PM-QPSK) was introduced lately to achieve high bit-rate with relatively high spectral efficiency. Unfortunately, the required broad bandwidth of PM-QPSK increases the linear and nonlinear impairments in the physical layer of the optical fiber network. Increased attention has been spent to compensate for these impairments in the last years. In this paper, Single Mode Fiber (SMF), single channel, PM-QPSK transceiver was simulated, with a mix of optical and electrical (Digi
... Show MoreThis work describes the weathering effects (UV-Irradiation, and Rain) on the thermal conductivity of PS, PMMA, PS/PMMA blend for packaging application. The samples were prepared by cast method at different ratios (10, 30, 50, 70, and 90 %wt). It was seen that the thermal conductivity of PMMA (0.145 W/m.K), and for PS(0.095 W/m.K), which increases by PS ratio increase up to 50% PS/PMMA blend then decreased that was attributed to increase in miscibility of the blend involved. By UV-weathering, it was seen that thermal conductivity for PMMA increased with UV-weathering up to (30hr) then decreased, that was attributed to rigidity and defect formation, respectively. For 30%PS/PMMA, there results showed unsystematic decrease in thermal conduct
... Show MoreThe present paper focuses on the study of some characteristics of
comets ions by photometry method which represent by CCD camera
which it provide seeing these images in a graded light. From 0-255
when Zero (low a light intensity) and 255 (highlight intensity). These
differences of photonic intensity can be giving us a curve which
appear from any line of this image.
From these equations the focus is concentrating on determine the
temperature distribution, velocity distribution, and intensity number
distribution which is give number of particles per unit volume.
The results explained the interaction near the cometary nucleus
which is mainly affected by the new ions added to the density of the
solar wind, th
This paper interest to estimation the unknown parameters for generalized Rayleigh distribution model based on censored samples of singly type one . In this paper the probability density function for generalized Rayleigh is defined with its properties . The maximum likelihood estimator method is used to derive the point estimation for all unknown parameters based on iterative method , as Newton – Raphson method , then derive confidence interval estimation which based on Fisher information matrix . Finally , testing whether the current model ( GRD ) fits to a set of real data , then compute the survival function and hazard function for this real data.
Objectives The strategies of tissue-engineering led to the development of living cell-based therapies to repair lost or damaged tissues, including periodontal ligament and to construct biohybrid implant. This work aimed to isolate human periodontal ligament stem cells (hPDLSCs) and implant them on fabricated polycaprolactone (PCL) for the regeneration of natural periodontal ligament (PDL) tissues. Methods hPDLSCs were harvested from extracted human premolars, cultured, and expanded to obtain PDL cells. A PDL-specific marker (periostin) was detected using an immunofluorescent assay. Electrospinning was applied to fabricate PCL at three concentrations (13%, 16%, and 20% weight/volume) in two forms, which were examined through field emission
... Show MoreBackground: Atrioventricular nodal reentrant tachycardia (AVNRT) is the commonest regular supraventricular tachyarrhythmia. Ablation in the area of slow pathway (SP) has been successfully implemented in every day clinical electrophysiological practice for more than 20 years. Although the procedure is generally regarded as effective and safe, data on long-term effects and predictors of success or failure are incomplete.
Objectives: This study was designated to prove that AH interval is an electrophysiological parameter which serves as a predictor for successful AVNRT ablation.
Methods: While performing an electrophysiological study using a programmed atrial stimulation, thirty nine (39) patients (25 female a