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.
For many years, the construction industry damages have been overlooked such as unreasonable consumption of resources in addition to producing a lot of construction waste but with global awareness growth towards the sustainable development issues, the sustainable construction practices have been adopted, taking into account the environment and human safety. The research aims to propose a management system for construction practices which could be adopted during constructing different types of sustainable buildings besides formulating flowcharts which clarify the required whole phases of sustainable buildings life cycle. The research includes two parts: theoretical part which generally ,handles the sustainability concepts at construction i
... Show MoreLuminescent sensor membranes and sensor microplates are presented for continuous or high-throughput wide-range measurement of pH based on a europium probe.
It is certain that marriage has the favor of the continuity of human kind since the Prophet Adam till now. But this important event is threatened by some justifications which lead to its delay or abandonment. In the West, sexual relations, illegal friendships, and disrespect of marriage sacredness lead to this delay. While the reasons behind the delay of marriage in the Arab world refer to high dowries, women go out to work, and the religious and scientific ignorance of the need and importance of marriage. The problem also differs according to the difference between the rural and urban regions. On one hand, we find that early marriage is a necessity in the rural regions; on the other hand, the delay of marriage is a clear and nat
... Show MoreSentiment analysis refers to the task of identifying polarity of positive and negative for particular text that yield an opinion. Arabic language has been expanded dramatically in the last decade especially with the emergence of social websites (e.g. Twitter, Facebook, etc.). Several studies addressed sentiment analysis for Arabic language using various techniques. The most efficient techniques according to the literature were the machine learning due to their capabilities to build a training model. Yet, there is still issues facing the Arabic sentiment analysis using machine learning techniques. Such issues are related to employing robust features that have the ability to discrimina
... Show MoreThis paper proposes feedback linearization control (FBLC) based on function approximation technique (FAT) to regulate the vibrational motion of a smart thin plate considering the effect of axial stretching. The FBLC includes designing a nonlinear control law for the stabilization of the target dynamic system while the closedloop dynamics are linear with ensured stability. The objective of the FAT is to estimate the cubic nonlinear restoring force vector using the linear parameterization of weighting and orthogonal basis function matrices. Orthogonal Chebyshev polynomials are used as strong approximators for adaptive schemes. The proposed control architecture is applied to a thin plate with a large deflection that stimulates the axial loadin
... Show MoreIn this paper, a design of the broadband thin metamaterial absorber (MMA) is presented. Compared with the previously reported metamaterial absorbers, the proposed structure provides a wide bandwidth with a compatible overall size. The designed absorber consists of a combination of octagon disk and split octagon resonator to provide a wide bandwidth over the Ku and K bands' frequency range. Cheap FR-4 material is chosen to be a substate of the proposed absorber with 1.6 thicknesses and 6.5×6.5 overall unit cell size. CST Studio Suite was used for the simulation of the proposed absorber. The proposed absorber provides a wide absorption bandwidth of 14.4 GHz over a frequency range of 12.8-27.5 GHz with more than %90 absorp
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