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bijps-1538
A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city –Iraq(Conference Paper )#
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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.

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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Physics: Conference Series
Evaluation and development of Shatt Al-Diwaniya and the diversion canal of Shatt Al-Diwaniya
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Abstract<p>Shatt Al-Diwaniya branches from Shatt Al-Hilla and extends for about 112 km until the Al-Rumaitha district within the study area located in Al-Diwaniya Governorate, Iraq. It is considered the main source for providing drinking water and supplying irrigation projects to the cities Al-Diwaniya and Al-Rumaitha. The study aims to evaluate, study, and develop Shatt Al-Diwaniya, as well as the new lined canal branching from Shatt Al-Diwaniya which. It is called Shatt Al-Diwaniya Diversion Canal. Field measurements of the discharge and water level were monitored, six sets for Shatt Al-Diwaniya and three sets for Diversion Canal. A one-dimensional model was developed by using HEC-RAS 5.0.7 so</p> ... Show More
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Tue Jun 30 2020
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Journal Of Economics And Administrative Sciences
Using the Critical Path Method (CPM) for scheduling the project (paving the Amil Sayid Al-Ayyam Street with a length of 1.25 km) In terms of Decresing the time
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The implementation of the concept of project scheduling in the organizations generally requires a set of procedures and requirements, So, most important of all is the understanding and knowledge of the tools and techniques which are called the methods of scheduling projects. Consequently, the projects of the municipality administration in the holy governorate of Karbala suffer from the problem of delaying their projects and chaos in the ways of implementation. To provide assistance to this directorate and to demonstrate how to schedule projects using one of the advanced scientific methods that proved their ability to schedule any project and its potential to accelerate the time of completion, as well as ease of use and effectiven

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Mon Dec 06 2021
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Assessment the Complications of Caesarean Section among Women’s attending AL -Diwaniyah Maternity and Pediatric Hospital/Iraq
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Publication Date
Sun Jun 20 2021
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
PETROLOGY AND PROVENANCE OF THE NATURAL STONE TOOLS FROM Al-DALMAJ ARCHAEOLOGICAL SITE, MESOPOTAMIAN PLAIN, IRAQ
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Wed Dec 15 2021
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IMPACT OF A SOCIAL SUPPORT FOR PREGNANT WOMEN UPON THEIR PREGNANCY OUTCOMES AT MATERNITY HOSPITALS IN BAGHDAD CITY
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Wed Dec 15 2021
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The communicative education of fine arts in the COVID-19 crisis and its manifestations in the modernization of the works of the Iraqi painter "Nabil Ali as a model"
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Sun May 15 2016
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Population growth and the culture of consumption A field study in the city of Arbil.: Population growth and the culture of consumption A field study in the city of Arbil.
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Publication Date
Wed Dec 01 2021
Journal Name
Baghdad Science Journal
Comparison of Conventional and Aerobic Iandfill Simulator Reactors (case study; Kirkuk city, Iraq)
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conditions were created in the aerobic reactor. This study shows that the aerobic reactor was more efficient in
COD and BOD5 removal which were 97.88% and 91.25% while in case of anaerobic reactor, they were
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Sun Oct 31 2021
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Iraqi Geological Journal
Use Conventional and Statistical Methods for Porosity Estimating in Carbonate Reservoir in Southern Iraq, Case Study
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Sun Sep 01 2024
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Journal Of Radiation Research And Applied Sciences
Bioaccumulation and translocation of radionuclides heavy metals in Cynodon dactylon: A phytoremediation approach in Al-Dora refinery
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