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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
Thu Mar 30 2023
Journal Name
College Of Islamic Sciences
The guiding strategy In the Friday declaim of the Mohammad Mohammad Sadiq al-Sadr.
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Discourse is a form of communication, and It carries with it an Intellectual framework, and It is a form of expression to communicate Ideas to people through an interactive process.The interest and analysis of discourse Is one of the most important fields of linguistic studies, and It has a basis In ancient studies, and It has become one of the most Important topics of the study, and (Sayyid al-Sadr) often uses guidance In his sermons.

By extrapolating and analyzing a set of examples received, from the perspective of the deliberative approach and the theory of speech acts, and the statement of the extent to whichh (Sayyid al-Sadr) relied on linguistic elements, and the use of the rank of the speaker In issuing directives, and the

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Tue Mar 01 2022
Journal Name
Iraqi Journal Of Physics
Effect of Copper on Tensile and Hardness of Al-Si Alloy in Automotive Application
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In current research Copper was employed for preparing a ternary system of Al–Si alloy in different (0.2–2.5 wt. %) the best was taken is (1.5%wt) of copper that circumstances of solidification for improving the mechanical performance of the available in aluminium alloy. Cast iron molds were prepared to obtain tensile strength testing specimens. Alloys were prepared by employing gas furnaces. The molten metal was poured into a preheated cast-iron mold. The obtained alloy structures were studied using an X-ray diffractometer and optical microscopy. The mechanical performance of the prepared alloys was examined under the influence of different hardening conditions in both heat and non-heat-treated conditions. The outcomes showed at the

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Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Medical students’ attitudes concerning medical ethics courses in AL-Kindy medical college 2013-2014
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ABSTRACTBackground: In Medical ethics education, improving medical student’s attitudes toward respecting the right of patients is an essential task. The medical students’ attitude has been affected by social, educational and personality background factors.Objective: To investigate medical student’s attitudes regarding medical ethics courses.Method: The study was conducted in Al-Kindy College of Medicine on academic year (2013 -2014) for the period from January to September. A cross- sectional study design was adopted with a self- administered questionnaire form distributed to medical students in the 5th-6th under graduate grades. The questionnaire consisted of 31 items relevant to student’s opinion about attitudes concerning ethi

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Publication Date
Tue Jun 11 2019
Journal Name
Al-kindy College Medical Journal
Evaluation of Application of Nutritional Status Assessment for Children Under 5 years by Using IMCI Program in a Sample of Primary Health Care Centers in Baghdad City
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Background: World Health Organization (WHO) and United Nation International Children Fund (UNICEF) developed a strategy known as Integrated Management of Childhood Illness (IMCI); which aims to reduce less than five years children morbidity and mortality in developing countries.

Objective: To assess the completion of the IMCI format status in primary health care centers, Baghdad.

Methods:  A cross sectional study with analytic element was conducted during the period from 15th  of January till 15th  May 2016 in selected Primary health centers in Baghdad, Iraq. The sample consists of form of child files less than 2 months and form from 2

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of integration between the earned value management model and the value flow map in rationalizing the costs of construction projects: applied research in Al-Rasheed General Company for Construction Contracting
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The research problem is that most of the construction projects exceed the planned value, due to the failure to implement the plans on time. The current study aims to monitor the implementation of the project and for each of the executed tasks of the table of quantities in order to detect deviations at the time they occur, evaluate the time and cost performance, and then identify the areas of waste and analyze the implementation of each task in order to diagnose the underlying problems and find possible and applicable solutions in the environment Iraqi. The research was applied in one of the companies specialized in the field of construction projects, and one of the most important conclusions reached is the possibility of applying

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Publication Date
Wed Feb 12 2020
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مجلة الآداب والفنون الاماراتية
Jalal Jaafar al-Awqati and his political and military role
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Jalal Jaafar Al-Awqati is a military figure who played a significant role in developing the Iraqi Air Force after the July 14, 1958 revolution. His personality crystallized during his studies. He was a thoughtful person, a good communicator, a man of few words, and held firm principled positions. He was known for his unique way of thinking. He was not violent in his daily dealings. He believed in democracy as a political doctrine and saw it as the best means and sure guarantee for solving the country's problems.

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Thu Mar 30 2023
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College Of Islamic Sciences
Human ability (Al qoudra) according to speakers and Fundamentalist jurists
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The term of ability (Al qoudra) is of the common terms which used by speech scientists to relate to one of the important verbal issues which called “Fate and destiny”. the issues of fate and destiny has been raised by Muslims since the dawn of Islam and It was researched among speech scientists, there are many opinions about this issues as the man can do or leave anything or he forced to do something that mean he hasn’t ability.

Also the term was used by jurists and they mention to the ability conditions (Assigning the Divine) and when this conditions are not available that means the man is not commissioning, the conditions are Mind, puberty and other conditions which mentioned in the books of jurisp

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Publication Date
Sat Oct 01 2011
Journal Name
Journal Of Engineering
POLLUTION OF MINING INDUSTRY SULFUR PURIFICATION PLANT AT AL MISHRAQ
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The Al Mishraq site has been the subject of many scientific studies for the period before and
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Publication Date
Sat Jan 01 2022
Journal Name
Aip Conference Proceedings
The effect of different flooding ratio on Al-Shuwaija marsh
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In this research, the effect of changing the flood level of Al-Shuwaija marsh was studied using the geographic information systems, specifically the QGIS program, and the STRM digital elevation model with a spatial analysis accuracy of 28 meters, was used to study the marsh. The hydraulic factors that characterize the marsh and affecting on the flooding such as the ranks of the water channels feeding the marsh and the degree of slope and flat areas in it are studied. The area of immersion water, the mean depth, and the accumulated water volume are calculated for each immersion level, thereby, this study finds the safe immersion level for this marsh was determined.

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
The Conflict between Somalian – Ethiopian Aboyt Al – Oaghaden 1960 – 1978
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The study of the subject shows us the couflict between Somalian- Ethiopian. About Al-Oaghaden (1960-1978). This province is purely Somalian area in their language ،manners ،
traditions ،and their most population from Migrant bedouin.
In the last nineteenth century ،Ethiopia had entered to exit from plateau ،and become nearly from Red Sea and Indian Ocean.
The study shows us ،the conflict between colonization countries ،about African horn ،then fore Ethiopia entered as partner to divide the zone area ، and that division hadn’t Cares about the unity of people ،or the similar of language or religoun ،for this reason which had interference happened between broders and division about the same tribe from more Century ،

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