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.
In modern years, internet and computers were used by many nations all overhead the world in different domains. So the number of Intruders is growing day-by-day posing a critical problem in recognizing among normal and abnormal manner of users in the network. Researchers have discussed the security concerns from different perspectives. Network Intrusion detection system which essentially analyzes, predicts the network traffic and the actions of users, then these behaviors will be examined either anomaly or normal manner. This paper suggested Deep analyzing system of NIDS to construct network intrusion detection system and detecting the type of intrusions in traditional network. The performance of the proposed system was evaluated by using
... Show MoreQuadrotors are coming up as an attractive platform for unmanned aerial vehicle (UAV) research, due to the simplicity of their structure and maintenance, their ability to hover, and their vertical take-off and landing (VTOL) capability. With the vast advancements in small-size sensors, actuators, and processors, researchers are now focusing on developing mini UAV’s to be used in both research and commercial applications. This work presents a detailed mathematical nonlinear dynamic model of the quadrotor which is formulated using the Newton-Euler method. Although the quadrotor is a 6 DOF under-actuated system, the derived rotational subsystem is fully actuated, while the translational subsystem is under-actuated. The der
... Show MoreHygienic engineering has dedicated a lot of time and energy to studying water filtration because of how important it is to human health. Thorough familiarity with the filtration process is essential for the design engineer to keep up with and profit from advances in filtering technology and equipment as the properties of raw water continue to change. Because it removes sediment, chemicals, odors, and microbes, filtration is an integral part of the water purification process. The most popular technique for treating surface water for municipal water supply is considered fast sand filtration, which can be achieved using either gravity or pressure sand filters. Predicting the performance of units in water treatment plants is
... Show More74 fanners were randomily selected from the Lc:ital. of 406 fanners using the Modern Irrigation System up to November , 2000 , for the purpose of wide adoptation of such system. Rcsults indicated according to the data which has been obtained and statistically analysed by the statistical package for the Social Sciences (SPSS) program showed that the majority of the farmers adopted this new system of irrigation due to the increase in the yield up to 5" .
The paper is concerned with the state and proof of the solvability theorem of unique state vector solution (SVS) of triple nonlinear hyperbolic boundary value problem (TNLHBVP), via utilizing the Galerkin method (GAM) with the Aubin theorem (AUTH), when the boundary control vector (BCV) is known. Solvability theorem of a boundary optimal control vector (BOCV) with equality and inequality state vector constraints (EINESVC) is proved. We studied the solvability theorem of a unique solution for the adjoint triple boundary value problem (ATHBVP) associated with TNLHBVP. The directional derivation (DRD) of the "Hamiltonian"(DRDH) is deduced. Finally, the necessary theorem (necessary conditions "NCOs") and the sufficient theorem (sufficient co
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This research aims to study and improve the passivating specifications of rubber resistant to vibration. In this paper, seven different rubber recipes were prepared based on mixtures of natural rubber(NR) as an essential part in addition to the synthetic rubber (IIR, BRcis, SBR, CR)with different rates. Mechanical tests such as tensile strength, hardness, friction, resistance to compression, fatigue and creep testing in addition to the rheological test were performed. Furthermore, scanning electron microscopy (SEM)test was used to examine the structure morphology of rubber. After studying and analyzing the results, we found that, recipe containing (BRcis) of 40% from th
... Show MoreThe study aims to analyze computer textbooks content for preparatory stage according to the logical thinking. The researcher followed the descriptive analytical research approach (content analysis), and adopted an explicit idea during the analysis process. One of the content analysis tools which was designed based on mental processes employed during logical thinking has utilized to figure out the study results. The findings revealed that logical thinking skills formed (52%) in fourth preparatory textbook and (47%) in fifth preparatory textbook.
Human beings are greatly inspired by nature. Nature has the ability to solve very complex problems in its own distinctive way. The problems around us are becoming more and more complex in the real time and at the same instance our mother nature is guiding us to solve these natural problems. Nature gives some of the logical and effective ways to find solutions to these problems. Nature acts as an optimized source for solving the complex problems. Decomposition is a basic strategy in traditional multi-objective optimization. However, it has not yet been widely used in multi-objective evolutionary optimization.
Although computational strategies for taking care of Multi-objective Optimization Problems (MOPs) h
... Show MoreThe aim of this paper is to study the asymptotically stable solution of nonlinear single and multi fractional differential-algebraic control systems, involving feedback control inputs, by an effective approach that depends on necessary and sufficient conditions.