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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
Sat Jul 20 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy
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BACKGROUND: Montelukast (Singulair) is a cysteinyl leukotriene receptor antagonist, used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergic rhinitis and asthma, also used for exercise-induced bronchospasm. AIM: This study was performed to determine the prevalence of Montelukast use as an add-on therapy among Iraqi asthmatic patients on treatment. Comparing the effectiveness of regimens with and without montelukast. METHODS: This descriptive cross-sectional study was carried out on 73 Iraqi asthmatic patients on treatment of both sexes with age range (18-60) years old, attending Al-Kindy Teaching Hospital and Al-Zahraa Centre of Asthma and Allergy, Baghdad, for the period between February

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Publication Date
Sat Jul 20 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy
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BACKGROUND: Montelukast (Singulair) is a cysteinyl leukotriene receptor antagonist, used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergic rhinitis and asthma, also used for exercise-induced bronchospasm. AIM: This study was performed to determine the prevalence of Montelukast use as an add-on therapy among Iraqi asthmatic patients on treatment. Comparing the effectiveness of regimens with and without montelukast. METHODS: This descriptive cross-sectional study was carried out on 73 Iraqi asthmatic patients on treatment of both sexes with age range (18-60) years old, attending Al-Kindy Teaching Hospital and Al-Zahraa Centre of Asthma and Allergy, Baghdad, for the period between February

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Publication Date
Mon Mar 11 2019
Journal Name
Baghdad Science Journal
Laboratory Study for Biodegradation of Oxymatrine Insecticide by Single and Mixed Cultures of Fungi Isolated from Agriculture Soils in Basrah Governorate, Iraq
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This study focuses on the biodegradation of oxymatrine insecticide by some soil fungi isolated from four agriculture stations. The results showed that the highest degradation rate 94.66% was recorded by Ulocladium sp. at 10 days and A. niger recorded the lowest degradation rate 45.86%, while at 20 days Ulocladium sp. also showed the highest degradation rate 94.98% and the lowest degradation rate reached to 82.49% with A.niger. The mix (Exerohilum sp.+Ulocladium sp.) recorded the highest degradation rate of oxymatrine insecticide 90.22%, 88.51%, 85.34%  at 4, 8 and 12 ppm.The use of mixed isolates enhanced the biodegradation process. There is no study of oxymatrine biodegradation

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Publication Date
Sat Dec 01 2018
Journal Name
Political Sciences Journal
A study in Tunisian - Iraqi Relations and its role in determining strategies for dealing with conflict and peace situations
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If the State attaches great importance to its foreign relations and intends to strengthen them in order to ensure the achievement of the highest national goals and interests. External relations between countries are one of the most prominent features of foreign policy, which depends on a combination of internal and external factors, the modern relations between Tunisia and Tunisia, which goes back to the pre-independence of Tunisia, when Iraq was a supporter of Tunisia's independence from France in the 1940s, Although these relations did not cause any disturbance by the two countries, but they remained weak relations did not develop in all areas except the sports and cultural field, which we will determine the reasons and the pos

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Publication Date
Wed Aug 13 2014
Journal Name
Journal Of Biotechnology Research Center
In Vivo Study for Measuring the Toxicity of Heat Stable Enterotoxin (a) Produced by Enterotoxigenic Escherichia coli in Mice
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This research was conducted to measure the safety of heat stable enterotoxin a (STa) produced by enterotoxigenic Escherichia coli, through studying its toxic effect on mice since it showed a promising effect in reducing the proliferation of colorectal cancer cells. The cytogenetic effect was determined after giving five different doses (100, 200, 400, 800 and 1600)μg/Kg in comparison with negative (phosphate buffer saline / PBS) and positive (mitomycin C/ MMC, at doses of 2 and 5μg/Kg) controls on mouse bone marrow cells by employing the following parameters: mitotic index, chromosomal aberrations and micronucleus, also, the serum level of liver functional enzymes (GOT, GPT, ALP) was recorded. In addition, lethal dose 50 (LD 50) with cert

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Green Regulatory Tapes and Their Reflections on the Job Development - A Study for the Sample of Employees in the Nineveh Directorate for Bridges & Roads
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The performance of job effectively requires narrowing the meaningful routine activities and attempting employing the job procedures in favor of public welfare through adding the green impact as well as removing them from the red tapes which reflect the firmness of procedures, to enable the job parties to make their job independently, and pushing them to gain priority in the competition layer. This is not attaining easily amidst the regulatory problems expressed by the complication of procedures, the thing which make identifying the problem of the study through the following question:

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Publication Date
Sat Dec 11 2021
Journal Name
Engineering, Technology And Applied Science Research
Efficiency Assessment of a Signalized Roundabout and a Traffic Intersection in Baghdad City
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In Baghdad city, Iraq, the traffic volumes have rapidly grown during the last 15 years. Road networks need to reevaluate and decide if they are operating properly or not regarding the increase in the number of vehicles. Al-Jadriyah intersection (a four-leg signalized intersection) and Kamal Junblat Square (a multi-lane roundabout), which are two important intersections in Baghdad city with high traffic volumes, were selected to be reevaluated by the SIDRA package in this research. Traffic volume and vehicle movement data were abstracted from videotapes by the Smart Traffic Analyzer (STA) Software. The performance measures include delay and LOS. The analysis results by SIDRA Intersection 8.0.1 show that the performance of the roundab

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Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Environmental management system in accordance with the requirements of the international standard (ISO 14004) and its applicability "Case study at Al-Ma'mun plant (vegetable oil)"
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 The search aims to clarify pollution to negative effects on environment and to an increasing in the dangerous polluted materials that discharged out these factories. To make active procedures in order to limit the environmental pollution.   

 The search problem came from an assumption which has the researched factory is suffering from the lack of applying the international specification      ( ISO 14004 ). The research problem assimilated by these questions:

  1. What is the level or organization in thinking of environmental system according to ISO 14004 .
  2. What are the requirements used in researched factor

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of The College Of Education For Women
The Doctrinal Complication in Al-Ash'ari’s Doctrine and its Role in Managing the Doctrinal Disputes: محمد أَرَارُو
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This research aims to clarify the concept of doctrinal rules and adjust its basic terminologies. It further aims to lay down a map for the method of rooting this science by mentioning its rooted sources, in addition to drawing a miniature picture of its history, origin, formation and development. The paper ends with practical models to highlight its importance in rooting the science of nodal rules and facilitating the mentioning of its scattered discussions in a short and comprehensive phrase. The study further illustrates the pioneering role of doctrinal rules science in managing the doctrinal disputes, combining multiple sayings, and in bringing together opposing opinions. The study follows the inductive, descriptive and analytical app

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Publication Date
Sun Jun 13 2021
Journal Name
Turkish Journal Of Computer And Mathematics Education
Private Drinking Stations In Al-Dora And Ways To Unify Them In One Station To Prevent Pollution
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The Current Research Seeks To Identify The Possibility Of Unifying The Private Drinking Stations In The Session In A Single Station In Order To Prevent Pollution. In Order To Achieve The Goal Of The Current Research, The Researcher Followed The Descriptive Survey Approach. The Researcher Identified The Research Community As Working In Institutions Related To Drinking Water Filtering In The Governorate Of Baghdad, And In Order To Collect Data And Information Necessary To Answer The Study's Question (Is It Possible To Supply Private Drinking Stations With One Station?) Researcher Designed A Questionnaire Consisting Of (10) Paragraphs Measuring Aspects Of This Topic, And Applied It To A Sample Of Employees And Workers Amounted To (200) People,

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