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 student of the structure of the city and its constituent elements will clearly sense the invisible relationships that underlie the different forms of urban activity, which in turn are defined by the generality of the urban patterns in that city, which will vary clearly according to the location in the city. These relations will be embodied in their true form in the interactions between the different uses of the earth, and the change that will result from their regularity in the form of entities in independent groups, which may share with each other a component of it.
Therefore, the process of controlling the functional interactions between the uses of the urban land and the awareness of t
Antibiotics present the greatest threat to soil and aquatic ecosystems among the different therapeutic groups of medicines (which include prescription drugs and treatments for cancer). The strongest drugs, antibiotics, have been utilized to stop the growth of microorganisms or eradicate them. Using high-performance liquid chromatography technology with fluorescence detection, the amounts of levofloxacin and tetracycline in the wastewater from three hospitals (Medical City, Al-Kindi, and Al-Yarmouk) were determined. Levofloxacin and tetracycline were chosen in this study because they are the most important water pollutants. These antibiotic residues were separated and measured using a gradient elution technique on a reverse-phase C18
... Show MoreAntibiotics present the greatest threat to soil and aquatic ecosystems among the different therapeutic groups of medicines (which include prescription drugs and treatments for cancer). The strongest drugs, antibiotics, have been utilized to stop the growth of microorganisms or eradicate them. Using high-performance liquid chromatography technology with fluorescence detection, the amounts of levofloxacin and tetracycline in the wastewater from three hospitals (Medical City, AlKindi, and Al-Yarmouk) were determined. Levofloxacin and tetracycline were chosen in this study because they are the most important water pollutants. These antibiotic residues were separated and measured using a gradient elution technique on a reverse-phase C18 co
... Show MoreCholesteryl ester transfer protein gene contains some single nucleotide polymorphisms, which have been associated with serum high-density lipoprotein concentration and other lipoproteins. This study is done for determining of cholesteryl ester transfer protein polymorphism and evaluate its effect on serum lipid profile concentrations in some hyperlipidemic patients compared with healthy subjects in Salah Al-din governorate-Iraq. Blood samples were taken from (90) patients suffering from hyperlipidemia, and (70) samples that were apparently healthy controls. Serum lipid concentrations were measured by enzymatic assays. The polymorphism was genotyped using polymerase chain reaction restriction fragment length polymorphism analysis.&n
... Show MoreThe performance of a synergistic combination of electrocoagulation (EC) and electro-oxidation (EO) for oilfield wastewater treatment has been studied. The effect of operative variables such as current density, pH, and electrolyte concentration on the reduction of chemical oxygen demand (COD) was studied and optimized based on Response Surface Methodology (RSM). The results showed that the current density had the highest impact on the COD removal with a contribution of 64.07% while pH, NaCl addition and other interactions affects account for only 34.67%. The optimized operating parameters were a current density of 26.77 mA/cm2 and a pH of 7.6 with no addition of NaCl which results in a COD removal efficiency of 93.43% and a specific energy c
... Show MoreThis study is aimed to Green-synthesize and characterize Al NPs from Clove (Syzygium aromaticum
L.) buds plant extract and to investigate their effect on isolated and characterized Salmonella enterica growth.
S. aromaticum buds aqueous extract was prepared from local market clove, then mixed with Aluminum nitrate
Al(NO3)3. 9 H2O, 99.9% in ¼ ratio for green-synthesizing of Al NPs. Color change was a primary confirmation
of Al NPs biosynthesis. The biosynthesized nanoparticles were identified and characterized by AFM, SEM,
EDX and UV–Visible spectrophotometer. AFM data recorded 122nm particles size and the surface roughness
RMs) of the pure S. aromaticum buds aqueous extract recorded 17.5nm particles s
The work reported in this study focusing on the abrasive wear behavior for three types of pipes used in oil industries (Carbone steel, Alloy steel and Stainless steel) using a wear apparatus for dry and wet tests, manufactured according to ASTM G65. Silica sand with
hardness (1000-1100) HV was used as abrasive material. The abrasive wear of these pipes has been measured experimentally by measuring the wear rate for each case under different sliding speeds, applied loads, and sand conditions (dry or wet). All tests have been conducted using sand of particle size (200-425) µm, ambient temperature of 34.5 °C and humidity 22% (Lab conditions).
The results show that the material loss due to abrasive wear increased monotonically with
We conclude that this study has dealt with an important aspect of the book that was not clearly defined in the book as it was derived through the book's translations, namely, the extraction of those urban structures of the city of Baghdad, which were of great importance in the religious, cultural, economic and social life at that time, The important link that reflected the development of the Islamic city in general and Baghdad in particular, as he addressed such urban facilities through the translations of the book that did not offer the outline or information about those facilities, but only the name only, and here lies the difficulty in addressing Such as T. As subjects because they need the most accurate analysis of facilities t
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