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.
Security reflects a permanent and complex movement that complies with international and societal needs and developments in all its dimensions, interactions and levels. To constitute a universal demand for all States, communities and individuals. The question of security is one of the most important motivations and motivations that govern the behavior, and even the objectives of those societies and States. These groups or individuals have always sought to avoid fear and harm, and to provide stability, safety and security. In the light of this, security studies have been among the important fields of study in the field of international and strategic relations. The field witnessed many theoretical efforts, from the traditional perspective,
... Show MoreThe present study was included the isolation of Keratinophilic fungi from water samples taken from 19 indoor public swimming pools in Baghdad during four season (summer ,fall ,spring ,and winter). Isolation period was September 2011and September 2012 . Samples were collected from different places in swimming pool . Sixteen keratinophilic fungal species, belonging to twenty –one genera were isolated using Surface Dilution Plating (SDP) and Hair Bait Technique (HBT) . Aspergillus genus was the most frequent and occurrence (19.84%), followed by Trichophyton (11.60%) and Fusarium (7.59% ) . The most common fungal infection occurred in summer season (42.16%) , and the most frequent month manifestation of species occurred in August
... Show MoreMefenamic acid was esterified with starchwith[1:1] Molar ratio, as drug substituted with natural polymer, to prolongthe period of hydrolysis of drug polymer with other advantages. The new prodrug starch was characterized by FT-IR and UV-Visible and 1H-NMR spectroscopies. The physical properties were studied and controlled drug release was studied in different pH values at 37oC. The stability of drug was carried out by measuring the absorbance of mefenamic starch which hydrolyzed in HCl solution of pH 1.1 (artificial gastric fluid) and phosphate buffer of pH 7.4 (simulating intestinal fluid SIF) at 37oC for several days. The thermal analysis such as DSC was studied.
A mathematical model is developed which predicates the performance of cylindrical ion exchange bed involving comparing of axial dispersion model for cation exchange column with different assumption, this model permits the performance to predicate the residence time within the bed with the variance, axial dispersion and Pecklet No. to indicated deviation from plug flow model.
Two type of systems are chosen for positive ions first with divalent ions (Ca+2) to exchange with resin of Na+1form used as application in water softener units and second with monovalent ions (Na+1) to exchange with resin of H+1 form used as application in deionize water units &n
... Show MoreTo develop a petrol engine so that it works under the bi-engine pattern (producer gas-petrol) without any additional engine modifications, a single-point injection method inside the intake manifold is a simple and inexpensive method. Still, it leads to poor mixing performance between the air and producer gas. This deficiency can cause unsatisfactory engine performance and high exhaust emissions. In order to improve the mixing inside the intake manifold, nine separate cases were modelled to evaluate the impact of the position and angle orientation inside the intake manifold on the uniformity and spread of the mixture under AFR=2.07. A petrol engine (1.6 L), the maximum engine speed (8000 rpm), and bi-engine mode (petrol-producer ga
... Show MoreThe research aims to get acquainted with the evaluation of the reality of the application of the curriculum axis from among the eight Iraqi academic accreditation standards in a sample of governmental and private universities and colleges in Iraq and to identify the main and secondary reasons for it as well as to provide proposed mechanisms and procedures to help reduce gaps, If the research problem is represented in the weak availability of the requirements of the curriculum axis in universities and colleges (the study sample) due to the weak documentation and successful implementation of them and interest in them is still below the level of ambition, In order to arrive at scientific facts, the researchers adopted the comparativ
... Show MoreSomerset Maugham is known mainly as a novelist . This paper presents Maugham the dramatist . Many critics have found him a promising dramatist . He has written 30 plays , then he turns his back upon the theater and writes his autobiographical and most successful novel Of Human Bondage ( 1915) .
Maugham's writing is clear , precise , and simple . He is described as a realist who is keenly aware of human nature , its concentration and frustration . His only tragedy A Man of Honour is a play in 4 acts . This paper concentrates mainly on this play to show Maugham as a dramatist and to show his concept of " honour " .
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... Show MoreModeling the microclimate of a greenhouse located in Baghdad under its weather conditions to calculate the heating and cooling loads by computer simulation. Solar collectors with a V-corrugated absorber plate and an auxiliary heat source were used as a heating system. A rotary silica gel desiccant dehumidifier, a sensible heat exchanger, and an evaporative cooler were added to the collectors to form an open-cycle solar assisted desiccant cooling system. A dynamic model was adopted to predict the inside air and the soil surface temperatures of the greenhouse. These temperatures are used to predict the greenhouse heating and cooling loads through an energy balance method which takes into account the soil heat gain. This is not included in
... Show MoreAcne vulgaris is a very common, chronic disorder, involving inflammation of the pilosebaceous units that can be varied in presentation and difficult to treat. Inflammatory acne may yield both scarring and pigmentary changes so early and adequate therapy will, in all cases, decrease its severity and may entirely suppress this disease. Serratiopeptidase has anti-inflammatory, anti-edemic and fibrinolytic activity and acts rapidly on localized inflammation. Serratiopeptidase was added in aim to hasten acne resolution. During March to July 2010, A comparative study for a 50 healthy patient suffering from acne was divided into 2 groups: 1st group treated by common acne modalities and the 2nd one with same modalities
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