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 utilization of carbon dioxide (CO₂) to enhance wellbore injectivity presents a cost-effective and sustainable strategy for mitigating greenhouse gas emissions while improving reservoir performance. This study introduces an environmentally friendly method employing a water-soluble chitosan salt (CS) that generates a carbonated-rich acid solution upon contact with dry CO₂ at 25 °C and 508 psi. CS solutions (100–2000 ppm) were prepared and evaluated for CO₂ uptake, acid generation, and rheological behavior. Results show that 1000 ppm achieves an optimal CO2 uptake (2612 mg/l), with moderate viscosity increase (from 1.52 to 3.37 cp), while higher concentrations exhibit a sharp rise due to polymer-like network formation. Core floodi
... Show MoreThis work involved the successful synthesis of three new Schiff base complexes, including Ni(II), Mn(II), and Cu(II) complexes. The Schiff base ligand was created by reacting the malonyldihydrazide molecule with naphthaldehyde, and the final step involved reacting the ligand with the corresponding metallic chloride yielding pure target complexes. FTIR, 1 H NMR, 13 C NMR, mass, and UV/Vis spectroscopies were used to comprehensively characterize the produced complexes. These substances have been employed in this study to photo-stabilize polystyrene (PS) and lessen the photo-degradation of its polymeric chains. Several methods, including FTIR, weight loss, viscosity average molecular weight, light and atomic force microscopy, and energy disper
... Show MoreSoil water retention curves (SWRCs) are crucial for characterizing soil moisture dynamics and are particularly relevant in the context of irrigation management. A study was carried out to obtain the SWRC, inflection point, S index, pore size distribution curve, macro porosity, and air capacity from samples submitted to saturation and re-saturation processes. Five different-texture disturbed soil samples Sandy Loam, Loam, Sandy Clay Loam, Silt Loam, and Clay were collected. After obtaining SWRC, each air-dried soil samples were submitted to particle size distribution and clay dispersed in water analyses to verify the soil lost clay. The experimental design was completely randomized with three replications using two processes of SWRC (saturat
... Show MoreThis paper numerically and theoretically investigates the optical and thermal performance of a parabolic trough collector PTC system. Many numerical simulations and theoretical analyses are conducted to demonstrate the influence of the receiver geometry and shifting from the focal position on the optical performance. The examined receiver geometries are circular, square, triangular, elliptical, and the new circular–square combined geometry is named as channel receiver. The thermal performance of PTC is examined for different volume flow rates theoretically in the range of (0.36 to 2.4 lpm). The results show that the best optical design is the channel receiver with an intercept factor of 84%, while the worst is the elliptical receiver with
... Show MoreDespite extensive investigation as biocompatible drug carriers, gelatin nanoparticles (GNPs) have not been thoroughly assessed for carrying chemically distinct cationic molecules such as acriflavine (ACF) and triethylenetetramine (TETA). In this study, we hypothesize that GNPs can effectively encapsulate ACF and TETA, forming stable delivery systems with distinct antibacterial and cytotoxic activities. ACF encapsulated in gelatin was prepared adapting desolvation technique. The procedure involved stirring of an aqueous solution of gelatin and ACF at room temperature, the pH was titrated to eight using NaOH followed by addition of ethanol. The resulting nanopart
On of the direct causes which led to the global financial crisis 2008 is decrease or collapse in liquidity of large financial institutions which is reflected on investments of a considerable number of institutions and persons.
This study aim's through out its three sections to explain the disclosure level of financial institutions which affected by Financial Crisis from liquidity information which explained in the statement of cash flow according to Timeliness and Completeness.
The study concluded an important result the company of research sample was disclosure in Timeliness and Completeness from all of accounting information is related in liquidity or that related in result of operations and financial position. The more
... Show MoreThe research aims to determine the role of training strategy dimensions of (trainers، curriculum training programs، trainees and their desire for training، administrative and supervisory services and their impact on the success of the training program) in the entrepreneurial performance of the organization dimensions of (pre-planning، renovation and modernization، efficiency، effectiveness)، so search ranks of great importance because it addresses an important and modern issue in performance entrepreneurial، and strategy training، aware of the importance of the subject and expected outcomes (General company for electrical Industries - motor plant) surveyed، was an analysis of data obtained through field visits in addition to the q
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