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 this paper, the Monte-Carlo simulation method was used to compare the robust circular S estimator with the circular Least squares method in the case of no outlier data and in the case of the presence of an outlier in the data through two trends, the first is contaminant with high inflection points that represents contaminant in the circular independent variable, and the second the contaminant in the vertical variable that represents the circular dependent variable using three comparison criteria, the median standard error (Median SE), the median of the mean squares of error (Median MSE), and the median of the mean cosines of the circular residuals (Median A(k)). It was concluded that the method of least squares is better than the
... Show MoreThe phenomenon of delayed marriage triggered the intention of most researchers and specialists to reveal the social factors associated with the spread of this phenomenon in order to identify the characteristics of that phenomenon and the social factors resulting from it. Thus, the current research aims to identify the social factors most related to the delay in marriage age among working-women at the University of Baghdad, represented by family factors, economic factors-professional, psychological factors – subjective, and environmental factors. The researcher also aims to identify the differences in social factors associated with late marriage age for working women at the University of Baghdad in terms of the type of profession (teach
... Show MoreSince the beginning of mankind, the view of the sky was present through observations with the naked eye, then it developed with time, and the sciences and tools of astronomical observations developed, including photometric measurements, which reached a high degree of accuracy in describing various cosmic phenomena, including the study of galaxies, their composition, and the differences between them, and from here the importance of this study emerged, to determine the differences between two distinct types of classification of galaxies, which are normal and barred spiral galaxies, where two galaxies NGC 4662 and NGC 2649 were chosen that represented certain types of galaxies to study the morphological structure of the two galaxies, a
... Show More'Steganography is the science of hiding information in the cover media', a force in the context of information sec, IJSR, Call for Papers, Online Journal
A new synthesis of Schiff (K) 6 and Mannich bases (Q) 7 had formed compound (Q) 7 by reacting compound (K) with N-methylaniline at the presence of formalin 35% to given Mannich base (Q). Additionally, new complexes were formed by reacting Schiff base (K) with metal salts CuCl2·2H2O, PdCl2·2H2O, and PtCl6·6H2O by 2:1 of M:L ratio. New ligands and their complexes were characterized, exanimated, and confirmed through several techniques, including FTIR, UV-visible, 1H-NMR, 13C-NMR spectroscopy, CHN analysis, FAA, TG, molar conductivity, and magnetic susceptibility. These compounds and their complexes were screened against breast cancer cells. It was determined that several of these compounds had a significant anti-breast cancer effec
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Abstract
The miraculous of al-Quran has been surrounded by the attention of scholars, as it is the one that has astonished the rhetoricians with its eloquence. So , they paid attention to every part of it and hugely they studied it with accuracy in respect to its Surah ad Ayahs. It is considered the most important source from which Arab scholars and early grammarians drew, given their unanimity that it is the highest degree of eloquence and the best record of the common literary language.
Among these sciences is the science of Grammar, and without Qur’an, this science would not have emerged, which later had control over every science of Arabic
... Show MoreThe turning process has various factors, which affecting machinability and should be investigated. These are surface roughness, tool life, power consumption, cutting temperature, machining force components, tool wear, and chip thickness ratio. These factors made the process nonlinear and complicated. This work aims to build neural network models to correlate the cutting parameters, namely cutting speed, depth of cut and feed rate, to the machining force and chip thickness ratio. The turning process was performed on high strength aluminum alloy 7075-T6. Three radial basis neural networks are constructed for cutting force, passive force, and feed force. In addition, a radial basis network is constructed to model the chip thickness ratio. T
... Show MoreThe aim of this work is to detect the best operating conditions that effect on the removal of Cu2+, Zn2+, and Ni2+ ions from aqueous solution using date pits in the batch adsorption experiments. The results have shown that the Al-zahdi Iraqi date pits demonstrated more efficient at certain values of operating conditions of adsorbent doses of 0.12 g/ml of aqueous solution, adsorption time 72 h, pH solution 5.5 ±0.2, shaking speed 300 rpm, and smallest adsorbent particle size needed for removal of metals. At the same time the particle size of date pits has a little effect on the adsorption at low initial concentration of heavy metals. The adsorption of metals increases with increas
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