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 research the Empirical Bayes method is used to Estimate the affiliation parameter in the clinical trials and then we compare this with the Moment Estimates for this parameter using Monte Carlo stimulation , we assumed that the distribution of the observation is binomial distribution while the distribution with the unknown random parameters is beta distribution ,finally we conclude that the Empirical bayes method for the random affiliation parameter is efficient using Mean Squares Error (MSE) and for different Sample size .
The paper deals with the language of Russian folklore. Folklore is a unique sphere of existence of the language, the most vivid expression of the national mentality. The folklore word embodied the perception and evaluation of the surrounding world. “What did the word in general mean for the life of the people? The word was equated ... with life itself. The word generated and explained life, it was ... the keeper of memory and the guarantee of the infinity of the future. The folklore text is studied by literary critics, ethnographers, historians, culturologists, and art historians. In the twentieth century, a new science emerged - linguo-folkloristics, the goals and objectives of which were formulated by A.T. Khrolenko only in the seven
... Show MoreMT Abed, ALSG Irhayyim, TH Rija, International Journal of Psychosocial Rehabilitation, 2020 - Cited by 1
Abstract:
The underlying objective of the international standard No. (6) to assist in accounting applications for the extractive industries, taking into consideration the goals and objectives contained in the sixteenth of the private International Accounting Standards criterion accounting for land, machinery and equipment, as well as Standard No. axes (38) relating to intangible assets, and in order to create a vision of a comprehensive development needs oil in order to exact evaluation of policies related to the particular needs and draw a comprehensive frameworks with respect to treatment of expenditures and revenues in the oil production industry, is also interested in Standard No. (6) within the primary objectiv
... Show MoreThe objective of this investigation was to study the effects of amixture of three arbuscular mycorrhizal species : Glomus etunicatum , G. leptotichum and Rhizophagus intraradices on the induced resistance of Lycopersicon esculentum roots infected with Fusarium oxysporum f.sp.lycopersici which is causal agent of wilt in the presence of organic matter peatmose (O). The work was achieved in aplastic house ( Shed) using pot culture planted for 10 weeks. Results indicated significant increase of all mycorrhizal colonization parameters ( F% , M% , m% , a% , A% ) . Highest percentage of mycorrhization was detected in roots infected with the pathogen 4 weeks after mycorrhizal colonization . On the other hand least colonization was shown in the dual
... Show MoreIn this paper we proposed the method of X-ray fluorescence (XRF) determination of some essential trace elements in medicinal herbs and vitamin-mineral complexes at the level of 100-101 mg/ml. To increase sensitivity and selectivity of the determination we simple and effective approach based on the extraction of metal ions from aqueous solutions with chemically modified polyurethane foam sorbents followed by direct XRF analysis. The conditions of sorption preconcentration of Co(II), Ni(II) and Zn(II) ions with modified sorbents were optimized. The proposed approach is used for the determination of trace elements in several kinds of medicinal herbs (coltsfoot leaves, nettle leaves and yarrow herb) and vitamin-mineral
... Show MoreThe pharmacokinetics and bioequivalence of a newly developed extended-released (ER) tablet containing 400 mg pentoxifylline as a test product was compared with the reference brand product Trental® 400 mg ER tablet produced by Sanofi-Aventis. Two separate studies were conducted simultaneously. The first study was conducted under fasting condition, whereas, the second study was conducted under fed condition; using the same batches of the test and reference products in both studies. In each study, both products were administered to 32 healthy male adult volunteers applying a single-dose, two-treatment, two-period, two-sequence, randomized crossover design with one-week washout period between dosing. Twenty two blood samples we
... Show MoreThis research deals with and which was entitled: relationship between psychological time and elements of filming expression (one-day event filmsas an example). It is about the relationship of psychological time (internal) with the elements of filming expression and how the time affected when using these elements in terms of its deceleration or acceleration. In particular, this research focus on elements that slow down time or stops it when using these elements. As one day time is short and heavy at the time of spectators in terms of the large number of film events which makes the viewer runs out of breath to understand the nature of those events and then identify the causes and consequences, as they occur in a short time (one day time) a
... Show MoreAbstract
This study aims to identify the reality of using electronic applications in teaching language skills to people with mild intellectual disabilities from the mothers’ perspective. A descriptive approach was used. The electronic questionnaires were administered to the study sample, 122 responses were received from mothers of the students with mild intellectual disability in Hafer Al-Baten schools. The response average rate was 94%. The results showed that there are statistically significant differences that are related to the variant of monthly income as for the barriers to using electronic applications in such schools, whereas there were no differences regarding the variant of monthly income regarding t
... Show More