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.
In this work, the effects of solvent properties on the characteristics of absorption and fluorescence for two laser dyes was studied. Dyes used in this work include Coumarin 5400 and DCM, while the solvents include ethanol, methanol, acetone, propanol and chloroform. Coumarin 5400 dye shows sharp fluorescence peaks in the green band of visible region while the DCM dye shows relatively wide band within 590-630 nm. Therefore, the selection of any dye for random gain medium applications should be performed after determining the most appropriate solvent as the optimum fluorescence characteristics are obtained.
Extracorporeal Shock Wave Lithotripsy (ESWL) is the most commonplace remedy for kidney stone. Shock waves from outside the body frame are centered at a kidney stone inflicting the stone to fragment. The success of the (ESWL) treatment is based on some variables such as age, sex, stone quantity stone period and so on. Thus, the prediction the success of remedy by this method is so important for professionals to make a decision to continue using (ESWL) or tousing another remedy technique. In this study, a prediction system for (ESWL) treatment by used three techniques of mixing classifiers, which is Product Rule (PR), Neural Network (NN) and the proposed classifier called Nested Combined Classi
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Agricultural production, food security and safety, public health animal welfare, access to markets and alleviation of rural poverty have been achieved by controlling on veterinary services to prevent animal disease. World organization for animal health guidelines focus on controlling of animal disease which depends on good governance and veterinary services quality. The aim of veterinary services is controlling and preventing animal disease some of other aspects; it's responsibility of early detection, rapid response to outbreaks of emerging or re-emerging animal disease, optimizing quality and effectiveness of disease
... Show MoreThe research work was conducted to investigate the effect of oral administration of water extract of black pepper at doses of (1, 5) mg/kg body weight for two weeks daily by determining the genotoxic effect (mitotic index), evaluation of immunological effect (IgG, IgM, IgA, C3, C4) and measuring fertility hormones (follicles stimulation hormone/FSH, lutenising hormone/LH) levels with histopathological examinations of female albino swiss mice ovaries in comparison with control (normal saline). A clear effect in increasing mitotic activity was reveled for both doses in comparison with control. Results also showed a significant increase in the value of the all immunological parameters at both doses in comparison with control. Also obvious rais
... Show MoreThe game of volleyball, like all other sports, has been made by new amendments, the most important of which is the system of what is not the system of the free player in 1998, which gave added importance to the skills of receiving the transmission and defending the stadium being one of the important skills where the law allowed the free player to move and position in the back positions of the stadium Limited support mainly defensive skills. This is to make the state of stability and balance between defensive and offensive skills, which helps in the development of the game and make it exciting and enjoyable for players and fans. Therefore, the researchers decided to shed light by identifying the percentage of the contribution of the free pla
... Show MoreImproved oral bioavailability of lipophilic substances can be achieved using self-emulsifying drug delivery systems. However, because the properties of self-emulsifying are greatly influenced by surfactant amount and type, type of oil used, droplet size, charge, cosolvents, and physiological variables, the synthesis of self-emulsifying is highly complex; consequently, only a small number of excipient self-emulsifying formulations has been developed so far for clinical use. This study reports a highly effective procedure for developing self-emulsifying formulations using a novel approach based on the hydrophilic-lipophilic difference theory. Microemulsion characteristics, such as the constituents and amounts of oil and surfactant electrolyte
... Show MoreUnlike welding, soldering does not involve melting the work pieces. Soldering is a process in which two or more items are joined together by melting and putting a filler metal (solder) into the joint. Failure in the solder joint may make the system components lose their functions. Electrical wiring and electronic components are joined to devices and printed circuit boards using soldering. Soldering and brazing are both used in the assembly of musical instruments. Lead-tin alloy solder employed in the current investigation which has a diameter of 4 mm and a density of 11.0103 kg/m3 with continuous heat flux heating from the domain's left side and complete insulation on the other side. The melting of PCM was simulated using the ANSYS
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