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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
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
What are the unique words used in the Holy Qur’an
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Summary:
We are aware that we cannot reach a correct level of understanding of the Arabic language without using the Quran as our main source in our research. Since the word of the Quran that put an end to all words which kneeled before it all the phrases that lead to the showcasing of the Arabic language in its best self.
Arab scientist realized this truth and gave all their attention to the singular and created from it an important subject for their research in the origins of the language and the science behind. Thus, since they dealt with the structure and studied the significance of the context through the use of vocabulary. Therefore, researching Islamic words or the “surat” mentioned in the Qur’an was necessar

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Wed Nov 02 2022
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Linguistics And Translation Studies
The football lexicon used in Arabic and Russian sport press
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The article is devoted to football lexicon in Arabic and Russian. The charr acteristics that determine the coincidence of lexical units in the Arabic and Russian languages are revealed. Football related words and phrases exist in different languages and in most cases they are the same. With the develop ment of football in the world and thanks to the media, new words and terms have become firmly established in the language. In Arabic, Italian and Span ish words are often used, but there are original Arabic phrases, most often consisting of two words - sports journalists and commentators actively use them. The word »mercato« was borrowed from the Italian language; in addi tion, in the Arabic language there is a phrase »Bab al-inti

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Wed May 17 2023
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College Of Islamic Sciences
The methods used by the Prophet in teaching the Companions
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The condition of Islam and Muslims and what their political, social, cultural and educational status, and even religious and faith status, has led to whoever feels his belonging to this great religion and that middle nation, to try as much as he can to fix what has been corrupted as much as he can, and perhaps in diagnosing illness and illness as It was said half the way to treatment, and from this standpoint I liked to occupy thought, work consideration and harness part of the youth’s life in order to reach what contributes to reforming the situation and the safety of generations, and this is only in seeking knowledge and learning it by following the guidance of the Messenger (r) and his companions ( y) Therefore, the subject of my re

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Publication Date
Wed Mar 11 2020
Journal Name
Journal Of Cardiovascular Disease Research
Resistive Index is an Early Indicator for Flow Deterioration in Comparison with Intima Media Thickness for Patients with Hypertension and Diabetes in Relation to Age
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Background: Atherosclerosis is well known related to age and certain cardiovascular diseases. Aging is one reason of arteries function deterioration which can cause loss of compliance and plaque accumulation, this effect increases by the presence of certain diseases such as hypertension and diabetes disease. Aim: To investigate the reduction of blood supply to the brain in patients with diabetes and hypertension with age and the role of resistive index in the diagnosis of reduced blood flow. Method: Patients with both diseases diabetic and hypertension were classified according to their age to identify the progression of the disease and factors influencing the carotid artery blood flow. By using ultrasound and standard Doppler techniq

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Publication Date
Sun Dec 31 2023
Journal Name
Iraqi Geological Journal
A Comparative Reservoir Study of Zubair and Nahr Umr Formations in Subba Oilfield, Southern Iraq
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The lower Cretaceous sandstones of Zubair and Nahr Umr formations are the main producing reservoirs in Subba oilfield in southern Iraq. Key differences in their petrophysical and depositional attributes exist affecting their reservoir characteristics. The evaluation of well logs and core porosity-permeability data show better reservoir properties in Nahr Formation. The Litho-saturation logs indicate greater thickness of oil-saturated reservoir units for Nahr Unr Formation associated with lower values of shale volume, and higher values of effective porosity. In addition, higher values of permeability for Nahr Umr Formation is suggested by applying porosity-irreducible water saturation cross plot. The reducing reservoir quality of Zub

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Publication Date
Tue Dec 06 2022
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A Comparative Study to Reveal Earnings Management in Emerging Markets: Evidence from Tunisia and Iraq
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Purpose: The purpose of the study is to compare and evaluate Earnings Management in Tunisia and Iraq.   Theoretical framework: Earnings Management is an important topic that has been studied by a significant number of researchers, as well as those who are interested in the accounting profession. Earnings Management has gotten a lot of attention from academics, professionals, and other interested parties in recent years (e.g. Kliestik et al., 2020; Rahman et al., 2021; Gamra &Ellouze, 2021)   Design/methodology/approach: The sample includes ten banks listed on the Bourse of Tunisia and Iraq Stock Exchanges for the year 2017. We have used a model of Kothari et al., (2005) as a tool to measure Earnings Management in both mark

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Mon Feb 08 2021
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Causes of Problems in Post-Disaster Emergency Re-Construction Projects—Iraq as a Case Study
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This study examines the causes of time delays and cost overruns in a selection of thirty post-disaster reconstruction projects in Iraq. Although delay factors have been studied in many countries and contexts, little data exists from countries under the conditions characterizing Iraq during the last 10-15 years. A case study approach was used, with thirty construction projects of different types and sizes selected from the Baghdad region. Project data was gathered from a survey which was used to build statistical relationships between time and cost delay ratios and delay factors in post disaster projects. The most important delay factors identified were contractor failure, redesigning of designs/plans and change orders, security is

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Tue Oct 01 2019
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Urban geochemistry assessment using pollution indices: a case study of urban soil in Kirkuk, Iraq
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Sun Sep 27 2020
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Effectiveness of an Instructional Program Concerning Healthy Lifestyle on Patients’ Attitudes after Percutaneous Coronary Intervention at Cardiac Centers in Baghdad City
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Objective: The study’s aim to evaluate the effectiveness of instructional program about healthy lifestyle on patients’ attitudes after undergoing percutaneous coronary intervention.

Methodology: Quasi-experimental design/ has been utilized for the current study starting from December 2018 to March 2020 to achieve the objectives of the study. Non-probability (purposive) sample of 60 patients was divided into intervention and control groups. Data were analyzed by the application of descriptive and inferential statistical methods.

Results: findings reported that before intervention both study and control groups demonstrated low total mean of score relat

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Ingots Defects under the influence of Solidification and Freezing Conditions. : Farouk Mahdi Mansour|Mustafa A. Rijab Al-Najar|Amera kanan Asfur
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The results of research to reach the conditions that prevents the emergence of primary or secondary voids and achieve worker benefit from molded by almost 100%, which was the situation that cast poured in a mold heated and insulated from all sides to achieve freezing directional full starting from the region remote from the casting and ending then. Has also been compared to the microscopic structure of the resulting castings of various molding conditions, as these conditions have achieved the best sound microscopic structures.

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