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 presents a new experimental study of the enhancement of turbulent
convection heat transfer inside tubes for combined thermal and hydrodynamic entry length of one
popular “turbulator” (twisted tape with width slightly less than internal tube diameter) inserted for
fire tube boilers. Cylindrical combustion chamber was used to burn (1.6 to 7kg/h) fuel oil #2 to
deliver hot gases with ranges of Reynolds number (10500 to 21700), and (11400 to 24150) for both
empty and inserted tube respectively.A uniform wall temperature technique was used by keeping
approximately constant water temperature difference (25ºC) between inlet and exit cooling water in
parallel flow shell and tube heat exchanger. The test
Correlation equations for expressing the boiling temperature as direct function of liquid composition have been tested successfully and applied for predicting azeotropic behavior of multicomponent mixtures and the kind of azeotrope (minimum, maximum and saddle type) using modified correlation of Gibbs-Konovalov theorem. Also, the binary and ternary azeotropic point have been detected experimentally using graphical determination on the basis of experimental binary and ternary vapor-liquid equilibrium data.
In this study, isobaric vapor-liquid equilibrium for two ternary systems: “1-Propanol – Hexane – Benzene” and its binaries “1-Propanol –
... Show MoreThis paper deals with, Bayesian estimation of the parameters of Gamma distribution under Generalized Weighted loss function, based on Gamma and Exponential priors for the shape and scale parameters, respectively. Moment, Maximum likelihood estimators and Lindley’s approximation have been used effectively in Bayesian estimation. Based on Monte Carlo simulation method, those estimators are compared in terms of the mean squared errors (MSE’s).
The aim of this paper is to determine the role of job engagement in the Iraqi Residency Affairs Directorate and its impact on employees, as the job engagement variable based on the Rich’s model included dimensions of cognitive engagement, emotional engagement and physical engagement. This variable has been studied in the Directorate of Residence Affairs which are one of the specialized directorates in the Iraqi Ministry of Interior. This study relied on a questionnaire as a main tool for measuring and collecting data based on the random sampling method . The sample size included 206 individuals among 400 individuals. However, the respondents were 190 whereas the final
... Show MoreIn this paper, we proposed a new class of Weighted Rayleigh Distribution based on two parameters, one is scale parameter and the other is shape parameter which introduced in Rayleigh distribution. The main properties of this class are derived and investigated in . The moment method and maximum likelihood method are used to obtain estimators of parameters, survival function and hazard function. Real data sets are collected to investigate two methods which depend it in this study. A comparison was made between two methods of estimation.
In this study, we made a comparison between LASSO & SCAD methods, which are two special methods for dealing with models in partial quantile regression. (Nadaraya & Watson Kernel) was used to estimate the non-parametric part ;in addition, the rule of thumb method was used to estimate the smoothing bandwidth (h). Penalty methods proved to be efficient in estimating the regression coefficients, but the SCAD method according to the mean squared error criterion (MSE) was the best after estimating the missing data using the mean imputation method
Fractional calculus has paid much attention in recent years, because it plays an essential role in many fields of science and engineering, where the study of stability theory of fractional differential equations emerges to be very important. In this paper, the stability of fractional order ordinary differential equations will be studied and introduced the backstepping method. The Lyapunov function is easily found by this method. This method also gives a guarantee of stable solutions for the fractional order differential equations. Furthermore it gives asymptotically stable.
Recently, new generalizations have been presented for the hyponormal operators, which are (N, k)-hyponormal operators and (h, M)-hyponormal operators. Some properties of these concepts have also been proved, one of these properties is that the product of two (N, k)-hyponormal operator is also (N, k)- hyponormal operator and the product of two (h, M)-hyponormal operators is (h, M)-hyponormal operator. In our research, we will reprove these properties by using the (l,m)-commuting operator equations, in addition to that we will solve the (l, m)-commuting operator equations for (N, k)-hyponormal operators and (h, M)-hyponormal operators.
This paper includes the estimation of the scale parameter of weighted Rayleigh distribution using well-known methods of estimation (classical and Bayesian). The proposed estimators were compared using Monte Carlo simulation based on mean squared error (MSE) criteria. Then, all the results of simulation and comparisons were demonstrated in tables.
In this study, we derived the estimation for Reliability of the Exponential distribution based on the Bayesian approach. In the Bayesian approach, the parameter of the Exponential distribution is assumed to be random variable .We derived posterior distribution the parameter of the Exponential distribution under four types priors distributions for the scale parameter of the Exponential distribution is: Inverse Chi-square distribution, Inverted Gamma distribution, improper distribution, Non-informative distribution. And the estimators for Reliability is obtained using the two proposed loss function in this study which is based on the natural logarithm for Reliability function .We used simulation technique, to compare the
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