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 sol-gel preparation technique of transparent silica monoliths containing up to 0.5 M of samarium have been described. The sol-gel processing parameters are: acid catalyzed hydrolysis and controlled drying. The prepared monoliths are analyzed by X-ray diffraction, pycnometer measurements, Fourier transformation infrared spectroscopy and optical spectroscopy. The oscillator strengths of the Sm3+ ions in the silica monoliths are calculated. The results show a linear concentration dependence of some Sm3+ transitions in UV/Vis absorption spectra and formation of Sm3+ clusters inside the pores structure of silica monoliths at high Sm3+ concentration
The political parties are considered to be the basic infrastructure in the political process for their great role in achieving the political movement in the country and to work on implementing the goals and interests of its voters in the event of their coming to power. If the parties that totalitarianism led to monopoly and monopolization, We can not talk in these countries about the liberal concept of the party and can not talk about the existence of a law or laws and regulations governing and regulate the work of parties. But on the other hand, which is represented by the liberal state, we find a lot of talk and practice about the form and nature of the legitimate law in regulating the formation of parties and their work in a manner th
... Show MoreThe most prevalent chronic complication of diabetes mellitus is diabetic neuropathy. The pathogenesis of diabetic neuropathy is exacerbated by hyperglycemia-induced oxidative stress, which causes nerves to deteriorate in a programmed manner. Many clinical trials depend on supplement in an attempt to improve neuropathy symptoms such as (pain & tingling) and patient quality of life, one of them is Coenzyme Q10 which is reported to have an anti-inflammatory and antioxidant effects, and was totally nontoxic and non-reported side effects. This study aimed to evaluate using a Coenzyme Q10 supplement as an adjuvant therapy to gabapentin to improve the clinical symptoms of diabetic neuropathy in relation to its anti-inflammatory and antioxid
... Show MoreThe fuzzy assignment models (FAMs) have been explored by various literature to access classical values, which are more precise in our real-life accomplishment. The novelty of this paper contributed positively to a unique application of pentagonal fuzzy numbers for the evaluation of FAMs. The new method namely Pascal's triangle graded mean (PT-GM) has presented a new algorithm in accessing the critical path to solve the assignment problems (AP) based on the fuzzy objective function of minimising total cost. The results obtained have been compared to the existing methods such as, the centroid formula (CF) and centroid formula integration (CFI). It has been demonstrated that operational efficiency of this conducted method is exquisitely develo
... Show MoreArtificial Intelligence Algorithms have been used in recent years in many scientific fields. We suggest employing flower pollination algorithm in the environmental field to find the best estimate of the semi-parametric regression function with measurement errors in the explanatory variables and the dependent variable, where measurement errors appear frequently in fields such as chemistry, biological sciences, medicine, and epidemiological studies, rather than an exact measurement. We estimate the regression function of the semi-parametric model by estimating the parametric model and estimating the non-parametric model, the parametric model is estimated by using an instrumental variables method (Wald method, Bartlett’s method, and Durbin
... Show MoreIn the present work we prepared heterojunction not homogenous CdS/:In/Cu2S) by spray and displacement methods on glass substrate , CdS:In films prepared by different impurities constration. Cu2S prepared by chemical displacement method to improve the junction properties , structural and optical properties of the deposited films was achieved . The study shows that the film polycrystalline by XRD result for all film and the energy gap was direct to 2.38 eV with no effect on this value by impurities at this constration .