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.
Background: Hyperfunction of the muscles of the upper lip is considered as the most common cause of excessive gingival display (EGD). The aim of this study was to demonstrate the effectiveness of botulinum toxin (BT) injection as a conservative treatment for EGD due to muscular hyperfunction and to compare the outcome of 2 injection methods. Material and methods: This study included 40 participants who were randomly assigned into 2 groups of 20 each, The first group received 2.5IU BT injection at 1 point per side (2-points group), while the second group received a total of 5 IU of BT at 2 points per side (4-points group). The outcome variables were the reduction in the central and lateral gingival display expressed as the difference between
... Show MoreHeart disease is a non-communicable disease and the number 1 cause of death in Indonesia. According to WHO predictions, heart disease will cause 11 million deaths in 2020. Bad lifestyle and unhealthy consumption patterns of modern society are the causes of this disease experienced by many people. Lack of knowledge about heart conditions and the potential dangers cause heart disease attacks before any preventive measures are taken. This study aims to produce a system for Predicting Heart Disease, which benefits to prevent and reduce the number of deaths caused by heart disease. The use of technology in the health sector has been widely practiced in various places and one of the advanced technologies is machine lea
... Show MoreIn this paper, new integro-differential operators are introduced that defined by Salagean’s differential operator. The major object of the present study is to investigate convexity properties on new geometric subclasses included these new operators.
Fluorescent Carbon Quantum Dots (CQDS) are a new kind of carbon nanoparticles that have appeared recently and have collected much interest as potential competitors to conventional semiconductor quantum dots (QDs). In addition to their comparable fluorescent properties, CQDs have the desired specifications of environmental friendliness, low toxicity, simple synthetic routes, low cost and surface passivation The functionalization of CQDS allow the control of their physicochemical properties. The main aim of this kind of researches is to account the variables that cannot be measured directly from practical experiments. Therefore, the work here is focused on the account energy gap of bulk (Eg bulk) by theoretically method (simulation) after
... Show MoreThree Saccharomyces cerevisiae isolates from different sources (China, Turkey and Egypt) were screened by culturing on solid state fermentation to select the most efficient isolate for invertase production. S. cerevisiae from China was high specific activity 34.7 U/mg. The optimum conditions for enzyme production from this isolate were determined by using a medium composed of wheat bran moisten with 1:0.5 (v:w) corn steep liquor as nitrogen source at initial pH 5.0 for 5 days at 30OC.
A demonstration of the inverse kinematics is a very complex problem for redundant robot manipulator. This paper presents the solution of inverse kinematics for one of redundant robots manipulator (three link robot) by combing of two intelligent algorithms GA (Genetic Algorithm) and NN (Neural Network). The inputs are position and orientation of three link robot. These inputs are entering to Back Propagation Neural Network (BPNN). The weights of BPNN are optimized using continuous GA. The (Mean Square Error) MSE is also computed between the estimated and desired outputs of joint angles. In this paper, the fitness function in GA is proposed. The sinwave and circular for three link robot end effecter and desired trajectories are simulated b
... Show MoreBackground: Luliconazole, a newer class of imidazole anti-fungal agent, is very effective against several species of fungi, especially dermatophytes. It has very low aqueous solubility acting as barrier for topical delivery and limiting its dermal availability.
Aim of the study: This study aimed to formulate luliconazole oil/water nanoemulsion by the aqueous titration method.
Methods: Solubility study resulted in selecting peppermint oil, tween 80 and transcutol p as oil phase, surfactant and cosurfactant respectively, although pseudoternary phase diagram construct nanoemulsion area for picking formulations. Fifteen o/w nanoemulsion formulations prepared and characterised f
... Show MoreA mixture model is used to model data that come from more than one component. In recent years, it became an effective tool in drawing inferences about the complex data that we might come across in real life. Moreover, it can represent a tremendous confirmatory tool in classification observations based on similarities amongst them. In this paper, several mixture regression-based methods were conducted under the assumption that the data come from a finite number of components. A comparison of these methods has been made according to their results in estimating component parameters. Also, observation membership has been inferred and assessed for these methods. The results showed that the flexible mixture model outperformed the others
... Show MorePermanent deformation in asphalt concrete pavements is pervasive distress [1], influenced by various factors such as environmental conditions, traffic loading, and mixture properties. A meticulous investigation into these factors has been conducted, yielding a robust dataset from uniaxial repeated load tests on 108 asphalt concrete samples. Each sample underwent systematic evaluation under varied test temperatures, loading conditions, and mixture properties, ensuring the data’s comprehensiveness and reliability. The materials used, sourced locally, were selected to enhance the study ʼs relevance to pavement constructions in hot climate areas, considering different asphalt cement grades and con- tents to understand material variability ef
... Show MoreIn this work, chemical oxidation was used to polymerize conjugated polymer "Polypyrrole" at room temperature Graphene nanoparticles were added by in situ-polymerization to get (PPY-GN) nano. Optical and Electrical properties were studied for the nanocomposites. optical properties of the nanocomposites were studied by UV-Vis spectroscopy at wavelength range (200 -800 nm). The result showed optical absorption spectra were normally determined and the result showed that the maximum absorbance wave length at 280nm and 590nm. The optical energy gap has been evaluated by direct transition and the value has decreased from (2.1 eV for pure PPy) to (1.3 eV for 5 %wt. of GN). The optical constants such as the band tail width ΔE was evaluated, the
... Show More