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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 Sep 15 2024
Journal Name
Journal Of Baghdad College Of Dentistry
The reliability of insertion torque as an indicator for primary stability in immediate dental implant: A prospective clinical study
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Background: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratc

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Sun Jun 01 2014
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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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Wed Oct 30 2024
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Oral health status in relation to nutritional status amongst orphans aged (6-12) years in Baghdad city, Iraq
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Aim

Aims: Assess selected measures of oral health: Enamel defect, eruption of permanent teeth, dental caries, investigate the nutritional status of orphans by physical examination and relate the nutritional status with measures of oral health.

Material and methods

Materials and methods: 192 orphans aged of 6 and 12 who were living in all orphanages in Baghdad, Iraq, were studied. Enamel defect was derived from the WHO's modified developmental defects of enamel (DDE) index, investigation of caries using Decay -Missing – Filled index for permanent teeth (DMF), the decay-missing filled index for primary teeth (dmf) index and all of the perm

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Publication Date
Mon Mar 15 2021
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Prevalence of self-reported halitosis and associated factors in 15 years old male students in Karbala City-Iraq
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Background׃ Halitosis is a common condition and is most often caused by a buildup of bacteria in the mouth because of gum disease, food, or plaque. It can result in anxiety among those affected, it is also associated with depression and symptoms of obsessive compulsive disorder. The aim of this study isto assess the prevalence of self-reported halitosis and associated factors (dental plaque, gingival condition and dental caries) in 15 years old male students in Karbala city in Iraq. Additionally, we studied adolescents’ concern with their own breath and whether anyone had ever told them that they had halitosis. Methods׃ A cross sectional observational survey was conducted to15 years old high school students from public and p

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Publication Date
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Assessment of the Natural Radioactivity Levels of Soil Samples in IT1 Oil Reservoirs in Kirkuk City, Northeast Iraq
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Thu Nov 01 2018
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The mechanisms of generation of Unemployment in Iraq and its types and calculating the Disguised of it: Analytical Study for the period 2003-2015
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Publication Date
Tue Dec 01 2020
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Deposit insurance system and its role in financial security for the period (2010-2018) Study the experiences of Selected countries with reference to Iraq
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Mon Nov 14 2022
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Introduction and Aim: Beta-thalassemia is a serious inherited genetic disorder and an increasing health burden globally. Beta -thalassemia is caused by genetic globin abnormalities within the hemoglobin beta (HBB) gene. This study aimed to characterize the HBB gene mutations in beta -thalassemia among southern Iraqi patients. Materials and Methods: The study included 30 beta -thalassemia patients referred to the Thi-Qar Center for Genetic Diseases, Iraq and 15 control samples from a random group of apparently healthy individuals. Genomic DNA was isolated from blood sample collected from each individual. The DNA was amplified for specific regions of the HBB gene and the amplified products sequenced. The sequences generated were analysed for

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Publication Date
Mon Jul 19 2021
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Molecular Analysis of CYP21A2 Gene Mutations among Congenital Adrenal Hyperplasia Patients in Iraq
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