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.
The ground charge density distributions (CDD), elastic charge form factors and proton, charge, neutron, and matter root mean square (rms) radii for stable 40Ca and 48Ca have been calculated using single-particle radial wave functions of Woods-Saxon (WS) and harmonic-oscillator (HO) potentials. Different central potential depths are used for each subshell which is adjusted so as to reproduce the experimental single-nucleon binding energies. An excellent agreement between the calculated rms charge radii and experimental data are found for both nuclei using WS and HO potentials. The calculated proton rms radii for 40Ca are found to be in good agreement with experiment data using both WS and HO potentials while the results for 48Ca showed an ov
... Show MoreThe importance of the current research lies in the importance of teaching competencies and the ability of the teacher to deal and success in his educational career. The research aimed to identify the degree of teaching competencies according to Hermann model of physical education teachers in Baghdad governorate. The descriptive method using the survey method was used on a randomly selected sample of 462 teachers and 314 school principals. After the completion of the survey, the Hermann scale forms were distributed to the teachers. The forms of the teaching competency scale were distributed to their school principals as the direct supervisors of the teachers' evaluation. After completing the survey, the results of each scale were classified
... Show MoreBackground: It has been well known that the success of mandibular implant- retained overdenture heavily depends on initial stability, retention and long term osseointegration this is might be due to optimal stresses distribution in surrounding bones. Types of mandibular implant- retained overdenture anchorage system and number of dental implants play an important role in stresses distribution at the implant-bone interface. It is necessary to keep the stresses below the physiologic tolerance level of the bone .since. And it is difficult to measure these stresses around bone in vivo. In the present study, finite element analysis used to study the stresses distribution around dental implant supporting Mandible implant retained overdenture Mate
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The aim of this research is to determine the most important and main factors that lead to Preeclampsia. It is also about finding suitable solutions to eradicate these factors and avoid them in order to prevent getting Preeclampsia. To achieve this, a case study sample of (40) patients from Medical City - Oncology Teaching Hospital was used to collect data by a questionnaire which contained (17) reasons to be investigated. The statistical package (SPSS) was used to compare the results of the data analysis through two methods (Radial Bases Function Network) and (Factorial Analysis). Important results were obtained, the two methods determined the same factors that could represent the direct reason which causes Preecla
... Show MoreIn the present work the Buildup factor for gamma rays were studied in shields from epoxy reinforced by lead powder and by aluminum powder, for NaI(Tl) scintillation detector size ( ×? ), using two radioactive sources (Co-60 and Cs-137). The shields which are used (epoxy reinforced by lead powder with concentration (10-60)% and epoxy reinforced by aluminum powder with concentration (10-50)% by thick (6mm) and epoxy reinforced by lead powder with concentration (50%) with thick (2,4,6,8,10)mm. The experimental results show that: The linear absorption factor and Buildup factor increase with increase the concentration for the powders which used in reinforcement and high for aluminum powder than the lead powder and decrease with inc
... Show MoreThe Ground Penetrating Radar (GPR) is frequently used in pavement engineering
for road pavement inspection. The main objective of this work is to validate
nondestructive, quick and powerful measurements using GPR for assessment of subgrade
and asphalt /concrete conditions. In the present study, two different antennas
(250, 500 MHz) were used. The case studies are presented was carried in University
of Baghdad over about 100m of paved road. After data acquisition and radar grams
collection, they have been processed using RadExplorer V1.4 software
implementing different filters with the most effective ones (time zero adjustment and
DC removal) in addition to other interpretation tool parameters.
The interpretatio
After looking at the books of the first two grammarians, may God have mercy on them and reward them for what they have provided us with the rules of service to the Book of God and service to Arabic, we must highlight some of the things that the grammarians wanted to clarify, which did not come out of what they proved, but we are working on the statement of the issuance of the passport Provisions from the syntactic industry, and whether it is intended to prove a rule is not very added to the statement of speech, and we know that language, any language was the function of understanding; therefore they said: (speech is a useful word that indicates the benefit improves silence on them), and this concept between Grammatical controls and conte
... Show MoreIn this paper the nuclear structure of some of Si-isotopes namely, 28,32,36,40Si have been studied by calculating the static ground state properties of these isotopes such as charge, proton, neutron and mass densities together with their associated rms radii, neutron skin thicknesses, binding energies, and charge form factors. In performing these investigations, the Skyrme-Hartree-Fock method has been used with different parameterizations; SkM*, S1, S3, SkM, and SkX. The effects of these different parameterizations on the above mentioned properties of the selected isotopes have also been studied so as to specify which of these parameterizations achieves the best agreement between calculated and experimental data. It can be ded
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