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 goal (purpose) from using development technology that require mathematical procedure related with high Quality & sufficiency of solving complex problem called Dynamic Programming with in recursive method (forward & backward) through finding series of associated decisions for reliability function of Pareto distribution estimator by using two approach Maximum likelihood & moment .to conclude optimal policy
Background: Extracorporeal Shock wave lithotripsy (ESWL) is widely used in treating patients with ureteralstones because it is effective, safe, and noninvasive. Based on factors such as size and the location of stones,there is a significant variation in the overall stone-free rate (SFR).Aim of the study: To evaluate the effect of ureteral wall thickness (UWT), stone attenuation, the time fromfirst attack of pain till first session of ESWL and stone/ rib density on the outcome of SWL in the treatmentof upper ureteral stones (UUS).Patient and methods: A prospective study when 127 patients with radio-opaque UUS ranging from 7 to 20mm and treated by ESWL were included in this study. The effect of (stone/ 12th rib) density by KUB, ureter
... Show MoreIn this work, the fusion cross section , fusion barrier distribution and the probability of fusion have been investigated by coupled channel method for the systems 46Ti+64Ni, 40Ca+194Pt and 40Ar+148Sm with semi-classical and quantum mechanical approach using SCF and CCFULL Fortran codes respectively. The results for these calculations are compared with available experimental data. The results show that the quantum calculations agree better with experimental data, especially bellow the Coulomb barrier, for the studied systems while above this barrier, the two codes reproduce the data.
The expanding of the medically important diseases created by multidrug-resistant Acinetobacter baumannii warrants the evolve a new methodology for prevention includes vaccination and treatment. Totally of forty-five clinical isolates identified as A.baumannii were obtained from hospitalized patients from three hospital in Baghdad City during the period from February 2016 to August 2016. Followed by diagnosing using different methods. Every strain was tested for susceptibility testing also some important virulence factorswere detected. Two isolates were chosen for the immunization and vaccine model, the first one remittent for most antibiotics except one are too virulence (strong) and the second is less virulent and resistance (weak).Enzyme-
... Show MoreIn this research, the mechanism of cracks propagation for epoxy/ chopped carbon fibers composites have been investigated .Carbon fibers (5%, 10%, 15%, and 20%) by weight were used to reinforce epoxy resin. Bending test was carried out to evaluate the flexural strength in order to explain the mechanism of cracks propagation. It was found that, the flexural strength will increase with increasing the percentage weight for carbon fibers. At low stresses, the cracks will state at the lower surface for the specimen. Increasing the stresses will accelerate the speed of cracks until fracture accorded .The path of cracks is changed according to the distributions of carbon fibers
In this work, silicon nitride (Si3N4) thin films were deposited on metallic substrates (aluminium and titanium sheets) by the DC reactive sputtering technique using two different silicon targets (n-type and p-type Si wafers) as well as two Ar:N2 gas mixing ratios (50:50 and 70:30). The electrical conductivity of the metallic (aluminium and titanium) substrates was measured before and after the deposition of silicon nitride thin films on both surfaces of the substrates. The results obtained from this work showed that the deposited films, in general, reduced the electrical conductivity of the substrates, and the thin films prepared from n-type silicon targets using a 50:50 mixing ratio and deposited on both
... 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 MoreThis paper presents the first data for bremsstrahlung buildup factor (BBUF) produced by the complete absorption of Y-91 beta particles in different materials via the Monte Carlo simulation method. The bremsstrahlung buildup factors were computed for different thicknesses of water, concrete, aluminum, tin and lead. A single relation between the bremsstrahlung buildup factor BBUF with both the atomic number Z and thickness X of the shielding material has been suggested.
The 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