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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
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
A Comparative Study on the Double Prior for Reliability Kumaraswamy Distribution with Numerical Solution
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This work, deals with Kumaraswamy distribution. Kumaraswamy (1976, 1978) showed well known probability distribution functions such as the normal, beta and log-normal but in (1980) Kumaraswamy developed a more general probability density function for double bounded random processes, which is known as Kumaraswamy’s distribution. Classical maximum likelihood and Bayes methods estimator are used to estimate the unknown shape parameter (b). Reliability function are obtained using symmetric loss functions by using three types of informative priors two single priors and one double prior. In addition, a comparison is made for the performance of these estimators with respect to the numerical solution which are found using expansion method. The

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Publication Date
Sun Jan 01 2023
Journal Name
Rawal Medical Journal
Efficacy of lumbar interlaminar epidural steroid injections for lumbar spinal stenosis: A prospective study
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Objective: To study the effect of epidural spinal injection over one year in case of spinal stenosis. Methodology: This prospective study included 566 patients with spinal stenosis seen at Al-Kindy Teaching and Al-Sader, Hospitals who were treated by local epidural steroid injection. They were followed up for at least five subsequent visits after seven days, one month, three months, six months, and one year to assess efficacy. Result: Mean age of patients was 49.5 years, with a predominance of females (65%). L4/L5 was the most involved level in the spinal stenosis (70%). Grade II stenosis accounted for (45.4%) of cases. The pairwise comparison revealed that there was significant decrease in proportions of patients with pain in day

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Publication Date
Sat Mar 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Estimation of rock strength from sonic log for Buzurgan oil field: A Comparison study
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It is very difficult to obtain the value of a rock strength along the wellbore.  The value of Rock strength utilizing to perform different analysis, for example, preventing failure of the wellbore, deciding a completion design and, control the production of sand.  In this study, utilizing sonic log data from (Bu-50) and (BU-47) wells at Buzurgan oil field.  Five formations have been studied (Mishrif, Sadia, Middle lower Kirkuk, Upper Kirkuk, and Jaddala) Firstly, calculated unconfined compressive strength (UCS) for each formation, using a sonic log method.  Then, the derived confined compressive rock strengthens from (UCS) by entering the effect of bore and hydrostatic pressure for each formation.  Evaluations th

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Publication Date
Sun Dec 03 2017
Journal Name
Al-khwarizmi Engineering Journal
A theoretical study for increasing production of electric power from Iraqi steam power plants.
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This article conclude a theoretical study for the possibility to produce additional electric power from Iraqi steam power plants by  cutting – off high-pressure feed water heaters .  Three separated steam power plants which Dura , south –Baghdad and Nasria were studied . The investigation showed the possibity of increasing the electric power from 10 to 15% for Dura and Nasria , whereas 6% for south – Baghdad . According to the nowadays of operation to Iraqi steam power plants , the results showed that by cutting–off high  pressure feed water heaters we can generate additional electric power about 250 MW during 3-4 hrs. daily. In addition, the fuel consumption can be reduced in comparison with diesel generat

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Loading and Activating a Carbon Surface and Applied for Congo Red Adsorption, Kinetic Study
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Abstract<p>this paper contains preparation of Active carbon surface (AC) from pro so millet grain husks and Loading and activating by Iron oxide and hydrogen peroxide sequentially to obtain surface (ACIPE). The changes of previous processes on Active carbon surface were diagnosed by Fourier transform infrared spectroscopy (FTIR) and Scanning electron microscopy ( SEM ). These surfaces (AC and ACIPE ) were using as adsorbent for removing of congo red dye from aqueous solutions under certain conditions through batch system. More than one kinetic model was applied to congo red dye adsorption process and it was found that the most kinetic model applied to it is a model ( pseudo second order model). </p> ... Show More
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Publication Date
Wed Jun 20 2018
Journal Name
Al-academy
Study in contemporary folk jewelry designs in Iraq
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I came back and made my jewelery from the first research or studies known to man, and the oldest era and confirmed the problem of searching for the links of sweets and admiration of the magnificence of the effectiveness of the search for the importance of preserving the heritage of the Iraqi civilization in its original creative aspects. Metal in Iraq, Head Costume, Neck Costume, Party Costume (Hands and Legs). The main results of the research were;

1-Contemporary folk jewelry in Iraq was characterized by design units for use.

Dependence in the feed industry in the form of laboratory mold.

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Publication Date
Wed Aug 31 2022
Journal Name
Journal Of Positive School Psychology
Impact Of An Educational Program For Nursing Management About Care Of Children Treated With VP Shunt In Mosul City
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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Screening Program for Idiopathic Scoliosis by Adam's Bending Forward Test of Prepubertal Children at Primary Schools in Baghdad City
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Objective: The study aimed to screen the prepubertal children for idiopathic scoliosis at earlier stages, and find
out the relationship between idiopathic scoliosis and demographic data such as age, sex, body mass index,
heavy backpacks, and heart & lung diseases.
Methodology: A descriptive study was conducted on screening program for prepubertal children in primary
schools at Baghdad city, starting from 24th of February to the end of October 2010. Non- probability
(purposive) sample of 510 prepubertal children were chosen from primary schools of both sides of Al-Karkh
and Al-Russafa sectors. Data was collected through a specially constructed questionnaire format include (24)
items multiple choice questions, and

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Publication Date
Sun Mar 06 2011
Journal Name
Baghdad Science Journal
Effect of Waste Water Bacteria and some chemical properties on drinking Water in AL-Mada,in Treatment Plan Station
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Three stations were chosen on the water treatment plan of al- madaan .The Samples collected from the (Raw water) and the Sedimentation, filtration and storage water and the drinking water of outlet. Coliform densities T.S and F.C and TS and F.S and total bacterial count as bacteriological pollution indicators, as moste probable number (MPN) method was studied in test. Also some of the chemical characteristics of the water like pH , total suspended solid T.S.S, T.D.D.and S04 , T.Hardness , Ca++ , Mg++ . From the results it were indicated . The study showed the drinking water of outlet (distriputed in system) was agree with WHO criteria and Iraqi limits standards .

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Weightings of Imam Ibn al-Mundhir               In his middle book in Sunan, unanimity and difference - the book of prayer
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The Imam Ibn al-Mundhir is likely in Shafi'i school. He has outlined some issues and disagreed with his doctrine. And that the vocabulary on which he relied on the weighting is correct and correct and I choose which I say. One of the most likely issues is the delay of Isha prayer to the darkness. And other issues simplified in the folds of research and study.

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