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.
This study aims to examine the technologies of education and their importance, shedding light on their reality and status in Sudan especially in the secondary stage. It has become necessary to invest these technologies and include them in different aspects of the technical education curricula. Such a step helps cope with the innovative scientific development in the advanced countries, qualify professors and technicians, develop the factories and workshops, and create an attractive technical educational environment to the pupils. Thus, the researcher has adopted a descriptive analytical approach that is based on conducting pilot visits to certain technical schools in Al-Khartoum state. Different aspects of such schools were examined
... Show MoreBackground: Prophylaxis methods are used to mechanically remove plaque and stain from tooth surfaces; such methods give rise to loss of superficial structure and roughen the surface of composites as a result of their abrasive action. This study was done to assess the effect of three polishing systems on surface texture of new anterior composites after storage in artificial saliva. Materials and methods: A total of 40 Giomer and Tetric®N-Ceram composite discs of 12 mm internal diameter and 3mm height were prepared using a specially designed cylindrical mold and were stored in artificial saliva for one month and then samples were divided into four groups according to surface treatment: Group A (control group):10 specimens received no surfa
... Show MoreBackground: Waterpipe tobacco smoking has become common especially among young people, Waterpipe smoking misconcepted as a safer mean of smoking, so in this study we will highlight the effect of Waterpipe smoking ‎on periodontal and oral health.‎ Materials and method. The selected ‎‎‎100 male subjects of 30-40 years, ‎categorized into 4 groups (each group ‎‎25 subject): Waterpipe smoker ‎with ‎healthy periodontium, ‎Waterpipe smoker ‎‎with chronic periodontitis, Non-‎‎smoker ‎with healthy periodontium and Non-smoker ‎with chronic periodontitis. Whole ‎unstimulated ‎saliva was collected. Clinical measurements: plaque ‎index
... Show MoreBackground:Temporomandibular joint (TMJ) problems refer to a group of heterogeneous pain and dysfunction conditions involving the mastication, reducing life quality of the patients. Arthrocentesis is a simple and less invasive surgical method for the treatment of inflammatory-degenerative disease than other conservative procedures and better than arthroscope. This clinical study aimed at evaluating the benefit of arthrocentesis with injection of hyaluronic acid in the management of inflammatory-degenerative disease of the TMJ. Material and methods: Eighty consecutive patients were enrolled in this study with pain symptoms of TMJ, insufficient masticatory efficiency during function and limitation of mouth opening; they were assessed with
... Show MoreLeishmania species are the causative agent of a tropical disease known as leishmaniasis. Previous studies on the old world species Leishmania major, showed that the amastigotes form which resides inside the macrophage of the vertebrate host, utilize host’s sphingolipids for survival and proliferation. In this study, gene expression of serine palmitoyltransferase (SPT) subunit two (MmLCB2) of the mouse macrophage cell line (RAW264.7), which is the first enzyme in the de novo sphingolipid biosynthesis, was detected in both infected and non-infected macrophages. This was detected under condition where available sphingolipid was reduced, with the new world species Leishmania mexicana. Results of qPCR analysis showed that there was no differen
... Show MoreDental implants can be made of various materials, and amongst them, titanium and titanium alloy were the materials of choice for dental implants for many years because of their biocompatibility. The two alloys have a high level of biocompatibility, a lower modulus of elasticity, and better corrosion resistance than other alloys. Thus, they are frequently utilized in biomedical applications and mostly replace stiff fabrics. The latest advances in a new strontium oxide–cp titanium composite alloy are the main topic of this research. With regard to biomedical applications, additions of strontium oxide were synthesized at three distinct weight percentages (2%, 4%, and 6% by wt%). Powder metallurgy was used to create the alloys, which
... Show MoreAlthough many technological improvements are occurring in power production worldwide, power plants in third world countries are still using old technologies that are causing thermal pollution to the water bodies. Power facilities that dump hot water into water bodies are damaging aquatic life. In the study, the impact of the Al Dora thermal power plant on a nearby stretch of Tigris River in Baghdad city was assessed by measuring the temperature of the disposed of hot water in various cross-sections of the selected stretch of Tigris River, including measuring the thermal mixing length. The measurements were conducted in winter, spring, and summer. For field measurements, it was found that the impact of recovery distances
... Show MoreThis study was aimed to monitor oral zinc sulfate role on local cervical proinflammatory cytokines in HPV-infected women comparing with these cytokines before treatment application. A cervical secretion got from 28 infected women before and after treatment with zinc sulfate, these samples assessed various markers of inflammation including interleukin-1β, IL-8, and IL-12. Results manifested that improve and clear the cervical HPV infections after three months of zinc treatment 46.43% and 21.43%, respectively. Viral infections with single and multiple HPV high-risk types are raising of studied cytokines after 3-month compared with single HPV low-risk type. Moreover, this increasing was statistically significant only in IL-12 and IL-1. Women
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