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 Modified version of the Generlized standard addition method ( GSAM) was developed. This modified version was used for the quantitative determination of arginine (Arg) and glycine ( Gly) in arginine acetyl salicylate – glycine complex . According to this method two linear equations were solved to obtain the amounts of (Arg) and (Gly). The first equation was obtained by spectrophotometic measurement of the total absorbance of (Arg) and (Gly) colored complex with ninhydrin . The second equation was obtained by measuring the total acid consumed by total amino groups of (Arg) and ( Gly). The titration was carried out in non- aqueous media using perchloric acid in glacial acetic acid as a titrant. The developed metho
... Show MoreLowering the emission, fuel economy and torque management are the essential
requirements in the recent development in the automobile industry. The main engine control
input that satisfies the above requirements is the throttling angle which adjusts the air mass
flow rate to the engine port. Due to the uncertainty and the presence of the nonlinear
components in its dynamical model, the sliding mode control theory is utilized in this work
for the throttle valve angle control system to design a robust controller for this system in the
presence of a nonlinear spring and Coulomb friction. A continuous sliding mode control law
which consists of a saturation function, instead of a signum function, and the integral of
ano
An analytical model in the form of a hyperbolic function has been suggested for the axial potential distribution of an electrostatic einzel lens. With the aid of this hyperbolic model the relative optical parameters have been computed and investigated in detail as a function of the electrodes voltage ratio for various trajectories of an accelerated charged-particles beam. The electrodes voltage ratio covered a wide range where the lens may be operated at accelerating and decelerating modes. The results have shown that the proposed hyperbolic field has the advantages of producing low aberrations under various magnification conditions and operational modes. The electrodes profile and their three-dimensional diagram have been determined whi
... Show MoreThe Cu(II) was found using a quick and uncomplicated procedure that involved reacting it with a freshly synthesized ligand to create an orange complex that had an absorbance peak of 481.5 nm in an acidic solution. The best conditions for the formation of the complex were studied from the concentration of the ligand, medium, the eff ect of the addition sequence, the eff ect of temperature, and the time of complex formation. The results obtained are scatter plot extending from 0.1–9 ppm and a linear range from 0.1–7 ppm. Relative standard deviation (RSD%) for n = 8 is less than 0.5, recovery % (R%) within acceptable values, correlation coeffi cient (r) equal 0.9986, coeffi cient of determination (r2) equal to 0.9973, and percentage capita
... Show MoreThis study employs evolutionary optimization and Artificial Intelligence algorithms to determine an individual’s age using a single-faced image as the basis for the identification process. Additionally, we used the WIKI dataset, widely considered the most comprehensive collection of facial images to date, including descriptions of age and gender attributes. However, estimating age from facial images is a recent topic of study, even though much research has been undertaken on establishing chronological age from facial photographs. Retrained artificial neural networks are used for classification after applying reprocessing and optimization techniques to achieve this goal. It is possible that the difficulty of determining age could be reduce
... Show MoreThe virtual decomposition control (VDC) is an efficient tool suitable to deal with the full-dynamics-based control problem of complex robots. However, the regressor-based adaptive control used by VDC to control every subsystem and to estimate the unknown parameters demands specific knowledge about the system physics. Therefore, in this paper, we focus on reorganizing the equation of the VDC for a serial chain manipulator using the adaptive function approximation technique (FAT) without needing specific system physics. The dynamic matrices of the dynamic equation of every subsystem (e.g. link and joint) are approximated by orthogonal functions due to the minimum approximation errors produced. The contr
In recent years, the migration of the computational workload to computational clouds has attracted intruders to target and exploit cloud networks internally and externally. The investigation of such hazardous network attacks in the cloud network requires comprehensive network forensics methods (NFM) to identify the source of the attack. However, cloud computing lacks NFM to identify the network attacks that affect various cloud resources by disseminating through cloud networks. In this paper, the study is motivated by the need to find the applicability of current (C-NFMs) for cloud networks of the cloud computing. The applicability is evaluated based on strengths, weaknesses, opportunities, and threats (SWOT) to outlook the cloud network. T
... Show MoreHCl is separated from HCl –H2SO4 solution by membrane distillation process(MD). The flat –sheet membranes made from polyvinylidene fluoride (PVDF) and polypropylene (pp.). Plate and frame these types of membrane where used in the process. The feed is a mixture of HCl and H2SO4 acids compositions depended on metals treated object.HCl concentration increased in the permeate during the process but sulfuric acid increased gradually in the feed .During the concentration of solution acids concentrations in the feed at the beginning were 50 g/dm3 of sulfuric acid and 50 g/dm3 of hydrochloric acid at 333K feed temperature the permeate flux was 71 dm
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