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.
Abstract Software-Defined Networking (commonly referred to as SDN) is a newer paradigm that develops the concept of a software-driven network by separating data and control planes. It can handle the traditional network problems. However, this excellent architecture is subjected to various security threats. One of these issues is the distributed denial of service (DDoS) attack, which is difficult to contain in this kind of software-based network. Several security solutions have been proposed recently to secure SDN against DDoS attacks. This paper aims to analyze and discuss machine learning-based systems for SDN security networks from DDoS attack. The results have indicated that the algorithms for machine learning can be used to detect DDoS
... Show MoreThe purpose of this study is to elucidate the microfacies and the biozones present in the studied rocks as well as to determine their environments or deposition. The study depends mainly on the benthonic foraminiferal assemblages identified from (27) rock thin sections made available from an outcrop at Wadi Banat Al-Hassan area in the Upper Euphrates Valley. X-Ray diffraction was also used to determine the type of carbonate minerals present in the studied rocks.
Al-Chibayish Marsh (CM) is considered as the major part of Central Marshes area of this marsh is 1050 Km². The water quality of these marshes is suffering from salt accumulation due to intensive dam construction, limited supply of water from sources, climate change impacts, and the absence of outlet flow from these marshes, specifically at low flow periods. So, the current research aims to assess and improve these marshes' hydraulic behavior and water quality and define the best location for outlet drains. Field measurements and laboratory tests were conducted for two periods (November 2020 and February 2021) to define the (TDS) concentrations at nine different locations. Samples were also examined for water's phy
... Show MoreThe aim of the research is to know the level of time management application and its impact on the performance of the job, a survey search in the general company for communication and information technology and provide recommendations that help employees to optimize the use of time and improve performance, which is an important element in controlling the various functions of the company. In order to achieve the objectives of the research, the questionnaire was based on two main variables and distributed to a random sample of (44) employees in the company out of (308) employees, thus the proportion of the sample (14%). After collecting the samples from the sample, there are (6) incomplete forms that have been retri
... Show MoreThis work deals with the effect of adding aluminum nanoparticles on the mechanical properties, micro-hardness and porosity of memory-shape alloys (Cu-Al-Ni). These alloys have wide applications in various industrial fields such as (high damping compounds and self-lubricating applications). The samples are manufactured using the powder metallurgy method, which involved pressing in only one direction and sintered in a furnace surrounded by an inert gas. Four percentages (0%, 5%, 10%, and 15%) of aluminum nanoparticles were fabricated, which depended on the weight of aluminum powder (13%) in the sample under study. To find out which phase is responsible for the reliability of the formation of this type of alloy and its porosity, X-ray diffr
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The phenomenon of celebration of army leaders in the Abbasid era formed a distinct phenomenon at which the poets stood, and among those leaders was the Arab leader Hamid al-Taie, and the poets who stood on him and his sons Abu Tammam and al-Bohtari recorded in their poems the exploits of that leader, and the exploits of his sons through images that represented sadness, courage In this research, the generosity, and the rhetorical and artistic aspects of those images, have been spotted, balancing the poets.
The reason for my choice of the topic (what Imam Al-Tirmidhi mentioned in his book Al-Sunan regarding the provisions of sales) is that he mentioned many topics that affect people's lives, which are represented by commercial transactions and the exchange of benefits between them, so it became clear to them what is forbidden and what is not, aiming not to fall into the prohibited, and to achieve their interests, and relieve them of embarrassment. What we will see in the research.