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.
A theoretical analysis studied was performed to study the opacity broadening of spectral lines emitted from aluminum plasma produced by Nd-YLF laser. The plasma density was in the range 1028-1026 )) m-3 with length of plasma about ?300) m) , the opacity was studied as function of plasma density & principle quantum number. The results show that the opacity broadening increases as plasma density increases & decreases with the spacing between energy levels of emission spectral line.
Background: The timing of eruption of permanent teeth is of considerable importance to the dental health planning for diagnostic, preventive and therapeutic measures for children and teenagers. The purposes of this study were to determine timing of maxillary and mandibular permanent teeth emergence (except third molars) and to evaluate the effect nutritional status by anthropometric measures on the eruption time of permanent teeth, investigations had been done according to jaw and gender variations. Materials and Methods: This study was conducted among four to fifteen years old children and teenagers from kindergarten and schools in Basrah city in the south region of Iraq. The total sample composed of 1807 children and teenagers that were
... Show MoreThe aim of the research is to determine the impact of profit management practices on the quality of profits through the use of flexibility in determining accounting methods and practices profit information is one of the most important information that concerns current users in general and observing users in particular. Some corporations managements manipulate the results of the company's profit or loss (income statement) and financial position statement with multiple reasons, including capital market motivations to raise their share prices in the stock market and attract investors, and on the other hand the motives of funding and borrowing loans, and the use of the flexibility in accounting policies and estimates to change the in
... Show MoreABSTRUCT
This research aims at examining the expected gap between the fact of planning and controlling process of production at the State Company for Electric Industries and implementation of material requirements planning system in fuzzy environment. Developing solutions to bridge the gap is required to provide specific mechanisms subject to the logic of fuzzy rules that will keep pace with demand for increased accuracy and reduced waiting times depending on demand forecast, investment in inventory to reduce costs to a minimum.
The proposed solutions for overcoming the research problem has required some questions reflecting the problem with its multiple dimensions, which ar
... Show MoreThe aim of this study is to develop a novel framework for managing risks in smart supply chains by enhancing business continuity and resilience against potential disruptions. This research addresses the growing uncertainty in supply chain environments, driven by both natural phenomena-such as pandemics and earthquakes—and human-induced events, including wars, political upheavals, and societal transformations. Recognizing that traditional risk management approaches are insufficient in such dynamic contexts, the study proposes an adaptive framework that integrates proactive and remedial measures for effective risk mitigation. A fuzzy risk matrix is employed to assess and analyze uncertainties, facilitating the identification of disr
... Show MoreThe effects of T-shaped fins on the improvement of phase change materials (PCM) melting are numerically investigated in vertical triple-tube storage containment. The PCM is held in the middle pipe of a triple-pipe heat exchanger while the heat transfer fluid flows through the internal and external pipes. The dimension effects of the T-shaped fins on the melting process of the PCM are investigated to determine the optimum case. Results indicate that while using T-shaped fins improves the melting performance of the PCM, the improvement potential is mainly governed by the fin’s body rather than the head. Hence, the proposed T-shaped fin did not noticeably improve melting at the bottom of the PCM domain; additionally, a flat fin is ad
... Show MoreThis study included the estimation of growth rate, viability and morphological changes in different culture media (NNN, P-Y, RPMI- 1640, and Panmed). Promastigotes cultured in RPMI-1640 showed maximal growth rate after (2, 4, 6) days of cultivation (27.26 ± 0.05), (172.20 ± 0.1) and (343.81 ± 1.48) million parasites / ml for each day respectively, while P-Y media gave the highest mean of growth rat after (8 and 10) days of cultivation (307.16 ± 1.67) and (303.5 ± 4.96) million parasites / ml for each day respectively. P-Y medium showed the maximal percentage of viability after (2, 4, 6, 8, and 10) days of cultivation (99.76 ± 0.5) %, (98.30 ± 0.17) %, (96.1 ± 0.1) %, (92.5 ± 0.52) % and (87.26 ± 0.05) % for each day respectively.
... Show MoreThe kaizen is considered as one of the most important modern techniques which has been adopted by various economics entities especially manufacturing firms and its beginnings return to the middle of the earlier century that has been used by companies like Toshiba, Matsushita Electric, and Toyota. Which realized that these modern techniques would make a total change in the competitive environment and started qualifying and its staff in such away that enables them to go along with this unique environment. The continuous improvement (Kaizen) depends on the small continuous improvements in the product and the production operations during the production stage. Consequently, the research problem is represented in the improperly of the budg
... Show MoreThe objective of this study was shed light for cultivation and maintenance of Trichomonas vaginalis parasite growth after isolated it by vaginal swaps from females suffering vaginitis and abnormal vaginal discharges in these media CPLM and TAB media to detect growth curve, morphological changes and viability of parasite in the two culture media, together with effect of sheep and bovine serum on the growth of it. The results of this studies were showed there was abtaine differences between the two types of media , The maximum growth of parasite was in TAB medium after 72 hours incubation with use of bovine serum, while such growth was maximized after 144 hours incubation with the use of sheep serum. In CPLM medium, a maximum gro
... Show MoreIn this work, we carried out an experimental study of thedusty
plasma by taking the dust material Fe3O4 with radius of the any grain
0.1μm - 0.5μm. In experiment we use air in the vacuum chamber
system under different low pressure (0.1-1) Torr. The results
illustrated that the present of dust particles in the air plasma did not
effect on Paschen minimum which is 0.5 without dust and with Fe3O4
dusty grains.
The effect of Fe3O4 dust particles on plasma parameters can be
notice in direct current system in glow discharge region. The plasma
parameters which were studied in this work represent plasma
potential, floating potential,electron saturation current, temperatu