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.
The present work aims to study the removal of dyes from wastewater by reverse osmosis process. Two dyes were used direct blue 6, and direct yellow. Experiments were performed with feed concentration (75 – 450 ppm), operation temperature (30 – 50 oC) and time (0.2 – 2.0 hr). The membrane used is thin film composite membrane (TFC). It was found that modal permeate concentration decreases with increasing feed concentration and time operating, while permeate concentration increases with increasing feed temperature. Also it was found that product rate increase with increasing temperature, but it decrease with increasing feed concentration and time. The concentration of reject solution showed an increase with increasing feed concentratio
... Show MorePan sharpening (fusion image) is the procedure of merging suitable information from two or more images into a single image. The image fusion techniques allow the combination of different information sources to improve the quality of image and increase its utility for a particular application. In this research, six pan-sharpening method have been implemented between the panchromatic and multispectral images, these methods include Ehlers, color normalize, Gram-Schmidt, local mean and variance matching, Daubechies of rank two and Symlets of rank four wavelet transform. Two images captured by two different sensors such as landsat-8 and world view-2 have been adopted to achieve the fusion purpose. Different fidelity metric like MS
... Show MoreHuman beings have an innate and natural aim to achieve their self-interests and to show their ability to overcome challenges in a better way, therefore the move towards self determination is expressed by intrinsic motivation. The desire of absorbing in this task is to enjoy the task in it self and benefitting from it such a motivation is the desire rooted in human nature to judge and choose in which individual is conscious in his self, abilities and adequacy that help him in control the different situations of life passed by him. His choices and actions are voluntary and non-restricted to intervention or external control because control is inner and subjective, while his behavior is self-regulated with the feeling of
... Show MoreThe aim of this research is to identify the availability of visual thinking skills in the chemistry textbook scheduled for the third intermediate grade for the academic year (2020-2021) in the Republic of Iraq. The study sample consisted of all (85) images contained in the chemistry course for the third intermediate grade, which are (85) form using the curriculum. Analytical descriptive A list of visual thinking skills was prepared, and the unit of form was adopted as a unit of analysis and repetition as a unit of counting, and frequencies and percentages were used for statistical treatment, and validity and reliability were calculated. And using the Holste equation. The following results were reached: The skill
... Show MoreThe effective application of the method of measuring and evaluating performance according to the Balanced Scorecard the need for an information system a comprehensive and integrated for internal and external environment, Which requires the need to develop accounting information system in general and cost management information systems to suit the particular requirements of the environment in terms of the development of modern methods of measurement to include the use of some methods that have proven effective in measuring and evaluating performance.
The research problem in need of management to develop methods of measuring and evaluating performance through the use of both financial measures and non
... Show MoreThe primary components of successful engineering projects are time, cost, and quality. The use of the ring footing ensures the presence of these elements. This investigation aims to find the optimum number of geogrid reinforcement layers under ring footing subjected to inclined loading. For this purpose, experimental models were used. The parameters were studied to find the optimum geogrid layers number, including the optimum geogrid layers spacing and the optimum geogrid layers number. The optimum geogrid layers spacing value is 0.5B. And as the load inclination angle increased, the tilting and the tilting improvement percent for the load inclination angles (5°,10°,15°) are (40%,28%, and 5%) respectively. The reduction percent o
... Show MorePower switches require snubbing networks for driving single – phase industrial heaters. Designing these networks, for controlling the maximum allowable rate of rise of anode current (di/dt) and excessive anode – cathode voltage rise (dv/dt) of power switching devices as thyristors and Triacs, is usually achieved using conventional methods like Time Constant Method (TCM), resonance Method (RM), and Runge-Kutta Method (RKM). In this paper an alternative design methodology using Fuzzy Logic Method (FLM) is proposed for designing the snubber network to control the voltage and current changes. Results of FLM, with fewer rules requirements, show the close similarity with those of conventional design methods in such a network of a Triac drivin
... Show MoreThe effect of high energy radiation on the energy gap of compound semiconductor Silicon Carbide (SiC) are viewed. Emphasis is placed on those effects which can be interpreted in terms of energy levels. The goal is to develop semiconductors operating at high temperature with low energy gaps by induced permanent damage in SiC irradiated by gamma source. TEACO2 laser used for producing SiC thin films. Spectrophotometer lambda - UV, Visible instrument is used to determine energy gap (Eg). Co-60, Cs-137, and Sr-90 are used to irradiate SiC samples for different time of irradiation. Possible interpretation of the changing in Eg values as the time of irradiation change is discussed
The process of cognitive representation includes mental activities such as perception, concepts formation and decision making leading to formation of Cognitive representation where the need for Cognition is one of basic humane needs promoting individuals to have more information.
This Study aims to measure the level of Cognitive representation among gifted Schools, the level of need for Cognition among them, recognize statistical Significant differences with Cognitive representation according to gender Variable and recognize the Correlation between Cognitive representation and the need for Cognition among giftel schools . The sample Consists of subsample of mair application one Consisting of( 400) students, noting that the first sampl