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.
As the bit rate of fiber optic transmission systems is increased to more than , the system will suffer from an important random phenomena, which is called polarization mode dispersion. This phenomenon contributes effectively to: increasing pulse width, power decreasing, time jittering, and shape distortion. The time jittering means that the pulse center will shift to left or right. So that, time jittering leads to interference between neighboring pulses. On the other hand, increasing bit period will prevent the possibility of sending high rates. In this paper, an accurate mathematical analysis to increase the rates of transmission, which contain all physical random variables that contribute to determine the transmission rates, is presen
... Show MoreWilla Cather (1873-1947) sought to capture the gradation of human emotion through carefully selected descriptive and narrative touches and firmly controlled management of dramatic scenes, situations, dialogue, and point of view. Cather’s novels and stories drew increasingly upon her personal experiences and memories.
The old settlement of Virginia and the new lands of Nebraska formed the bedding ground for Willa Cather’s talents; so did the layers of memory she found across the North American continent, from New Mexico to Canada. She saw the full-blooded European immigrants, Czechs and Swedes, plowing the unbroken land, on the way up from peasants to proprietors.
 
... Show MoreThe graphic privacy feature is one of the most important specifications for the existence of any type of design achievements alike, which is one of the graphic products with its multiple data, and from here the current research investigates the graphic privacy of vector graphics design with all its technical descriptions and concepts associated with it and the possibility of achieving it to the best that it should be from Where its formal structure in children's publications, where the structural structure of the current research came from the first chapter, which contained the research problem, which came according to the following question: What is the graphic privacy in the design of vector graphics in children's publ
... Show MoreBackground: This study is to evaluate the necessity of prescribing prophylactic antibiotics for nasal packing in spontaneous epistaxis. There are few published papers of infective complications in such patients.
Methods: This prospective study analysed 149 consecutive patients admitted to AL-Kindy teaching hospital with spontaneous, epistaxis, who underwent nasal packing over 2 years period . in the first year, 78 patients received prophylactic antibiotics , In the second year 71 patients were not given prophylatic antibiotics. Exclusion criteria included antibiotics prescribed for unrelated pathology and post-operative epistaxis. Signs and symptoms of acute otitis m
... Show MoreThe specialist researcher fined the relations between economic ideas with economic facts in his theory which called humanity building it is appeared clearly ( in Ibn Khalduons’ Muqaddimah) in a clothe of economic social phenomenon's as a systematical analysis in all fifty chapters of al Muqaddimah ,therefore this paper deal with Ibn Khalduon economic thoughts as important says which describe the society building in its economic subjective and examine the relationship between The dissert and the city within economic says which are cover the social analysis ,and determinate the analysis objects which clearly in this dualism model ,between the state and economic bas
... Show MoreThe research focuses on determination of best location of high elevated tank using the required head of pump as a measure for this purpose. Five types of network were used to find the effect of the variation in the discharge and the node elevation on the best location. The most weakness point was determined for each network. Preliminary tank locations were chosen for test along the primary pipe with same interval distance. For each location, the water elevation in tank and pump head was calculated at each hour depending on the pump head that required to achieve the minimum pressure at the most weakness point. Then, the sum of pump heads through the day was determined. The results proved that there is a most economical lo
... Show MoreA UV-Vis spectrophotometry method was developed for the determination of metoclopramide hydrochloride in pure and several pharmaceutical preparations, such as Permosan tablets, Meclodin syrups, and Plasil ampoules. The method is based on the diazotization reaction of metoclopramide hydrochloride with sodium nitrate and hydrochloric acid to yield the diazonium salt, which is then reacted with 3,5-dimethyl phenol in the presence of sodium hydroxide to form a yellow azo dye. Calibration curves were linear in the range from 0.3 to 6.5 µg/mL, with a correlation coefficient of 0.9993. The limits of detection and quantification were determined and found to be 0.18 and 0.61 µg/mL, respectively. Accuracy and precision were also determined b
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