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.
Background: Thymus vulgaris is a plant rich in essential oils acclaimed for the management of oxidative stress and inflammation in the organs. Meanwhile, the heavy metal lead is widely distributed in nature and continued exposure to lead acetate causes reduced fertility.Objectives: The present study aimed to investigate the effects of T. vulgaris on ovarian and uterine structural and functional characteristics in female rats exposed to lead acetate. Methods: Three groups of 18 mature Wistar albino female rats (Rattus norvegicus), 15 weeks old and weighing between 200 and 210 g, were established and handled for 60 days as follows: Group A (control group) received 0.5 mL of distilled water (DW) daily; group B received 5 mg/kg body weight (BW
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The study focused on the application of smart tourism as one of the applications of electronic commerce in the form of (B2C) to attract tourists to Saudi Arabia, where the tourism sector is one of the important sectors on which the Kingdom depends on the diversity of its economy.
The purpose of the research: With the issuance of tourist visas for the first time the study noted a deterioration in the case of Saudi tourist sites over the Internet, which do not live up to this great interest by the Saudi government for this sector, which became vital to them. The study tried to identify the reality of the Saudi tourist sites through the Internet in order to identify the sui
... Show MoreEstimation the unknown parameters of a two-dimensional sinusoidal signal model is an important and a difficult problem , The importance of this model in modeling Symmetric gray- scale texture image . In this paper, we propose employment Deferential Evaluation algorithm and the use of Sequential approach to estimate the unknown frequencies and amplitudes of the 2-D sinusoidal components when the signal is affected by noise. Numerical simulation are performed for different sample size, and various level of standard deviation to observe the performance of this method in estimate the parameters of 2-D sinusoidal signal model , This model was used for modeling the Symmetric gray scale texture image and estimating by using
... Show MoreIn this study, from a total of 856 mastitis cases in lactating ewes, only 34 Streptococcus agalactiae isolates showed various types of resistance to three types of antibiotics (Penicillin, Erythromycin and Tetracycline). St. agalactiae isolates were identified according to the standard methods, including a new suggested technique called specific Chromogenic agar. It was found that antibiotic bacterial resistance was clearly identified by using MIC-microplate assay (dilution method). Also, by real-time PCR technique, it was determined that there were three antibiotics genes resistance ( pbp2b, tetO and mefA ). The high percentage of isolate carried of a single gene which was the Tetracycline (20.59%) followed by percentage Penicillin was
... Show MoreThis study was aimed to evaluate the effect of conventional ingredients replacement with alternative ingredients on growth performance, carcass quality, nutrient digestibility and intestinal microbial of broilers. One hundred twenty Cobb500 broiler chicks were randomly assigned to four diets. Corn, soybean meal and fish meal were replaced with rice waste, meat and bone waste and black soldier fly larvae (BSFL) at 0, 10, 30 and 50% to form four treatments. Body weight gain, feed conversion ratio and digestibility of crude protein and fat were improved in broilers fed the replacement diets. Feed intake was not affected by the treatments suggesting that the replacement diets were well accepted by the chicken. Escherichia coli was decre
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The aim of the study is to study the relationship between strategic orientation and organizational performance. The strategic direction is the main purpose for which the organization is found. Therefore, it is the main engine for all the activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. ,. The research problem was formed by several questions to determine the level of the strategic direction and the nature of its relationship with organizational performance in the Iraqi Ministry of Defense / Inspector General's Office as the field of application to answer. The sample was selected by a sample of 60 individuals, department managers, And the que
Lead toxicity elicits neurological damage which is a well-known disorder that has been considered to be a major cause for multiple condition such as behavioral defect; mental retardation; and nerve insufficient activity.
This research is designed to estimate potential protective effect of vinpocetine on neurotoxicity stimulated by lead acetate in rats.
Eighteen adult rats of both sexes were randomly enrolled into three groups. Each group includes 6 rats as followings: Group I- Rats were given 0.3ml normal saline solution orally; then intraperitoneal injection of 100μl of the normal saline was given 1h later; this group was considered as control. Group II- Rats were given an intraperitoneal injection of 20mg/kg lead acetate
... Show MoreAcute Respiratory Distress Syndrome (ARDS) causes up to 40% mortality in humans and is difficult to treat. ARDS is also one of the major triggers of mortality associated with coronavirus-induced disease (COVID-19). We used a mouse model of ARDS induced by Staphylococcal enterotoxin B (SEB), which triggers 100% mortality, to investigate the mechanisms through which Δ9-tetrahydrocannabinol (THC) attenuates ARDS. SEB was used to trigger ARDS in C3H mice. These mice were treated with THC and analyzed for survival, ARDS, cytokine storm, and metabolome. Additionally, cells isolated from the lungs were used to perform single-cell RNA sequencing and transcriptome analysis. A database analysis of human COVID-19 patients was also performed t
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