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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 Dec 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Oral cleanness and periodontal health status among coffee-shop workers in Najaf city / Iraq
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Background: Water-pipe can be defined as a single or multi stemmed device that used to vaporize and smoke flavored tobacco whose smoke is passed via water vase before inhalation. Water-pipe smokers are at risk of exposure to many toxic chemicals that are not filtered by water, as well as risk of infectious diseases when the mouth piece of the water-pipe is shared. This study was carried out to investigate the effect of water pipe on the oral health. Materials and Methods: Sixty persons were included in this study aged between 22 and 23 years. Forty persons were coffee shop workers for at least five years, half of them were water-pipe smokers (active smokers) and the other weren’t smokers (passive smoker), the last group was the co

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Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
General Conditions of Women in Ibn al-Jawzi’s Book Safwat Al-Safwa: A Historical Study
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The research aims at the scholars’attention to the importance and role of Arab Muslim women through books and historical studies that historians and scholars have taken up like Ibn Al-Jawzi (597 AH) and his book Safwat Al-Safwa,  where he presented the conduct of worship and their words and deeds, and explained to women worshipers other aspects of their lives, such as the scientific aspect Crafts and works as well as their prominent role in preaching and religious guidance, and the impact of this on their morals and qualities. This study showed the strength of the personality of women and their high interest in worship. The importance of the study lies in knowledge.The research followed the role of Muslim women to carry t

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
The women at Al-Sakhaawi Book "A;-Dhau Al-Lami", Study in the social life
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In our previous research , we study the method of women by ( al – sakhaawi " died 902
ah/1496a.c"book witch called ( al- dhau, al-lami) .
So in this paper , we will discuss the social life of women in the mamluk period through the
same book ,especially when the sakhaawi devoted a full part for women in the same book
called it (mhagam ,al –nessa)wich it translations a large number of women like wives
,daughters ,sisters ,and maids of mamluk sultans ,so that make my able to know a lot about
the social life of woman which we study it like a social aspects of women, here wealth,
business, professions ,and in the last we study the habits of them marriage .

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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
An Environmental Study on Phytoplankton (Diatoms) in Al-Yusifiya River, Iraq
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An environmental study conducted on diatoms in Al Yusifiya river beyond its branching from Euphrates river. Four sites were selected along the river for the period from march 2013 to September 2013. The present study involved the measurement of physicochemical parameters, also the qualitative and quantities of diatoms. The studied parameters values ranged as follows: 19-44Cº and 16-30 Cº for air and water temperature respectively, 6.9-8.7, 595-1248 µS/cm, 6.4-8.0 mg/l for pH, electric conductivity and dissolved oxygen respectively. A total of 74 taxa were recorded for diatoms, where the pinnate diatom was the predominant and recorded 64 taxa while 10 taxa for centric diatoms. The total number of diatoms was 1197.55*104 cell /l. The tota

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
Evaluation the Role of CD4 and CD8 Reducing the Deterioration of COVID-19 Iraqi Patients
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Since its start spreed "Severe acute respiratory syndrome coronavirus 2" was discovered in Wuhan, China.that is chargeable COVID-19, a pandemic virus, has end up a widespread fitness hassle everywhere in the global Over 2.1 million people have been affected. We analyze serum concentration of CD4 marker and CD8 marker depend in COVID-19 sufferers, and to make clear a relationship between these variables and disorder Progression and severity For those purpose, (158) sufferers with COVID-19 (showed with the aid of using polymerase chain reaction) and (22) seemingly wholesome human beings have been protected withinside the present day examine and taken into consideration as a manipulate group. All examine population (sufferers and manipulate) h

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Mon Jan 01 2024
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Normalized-UNet Segmentation for COVID-19 Utilizing an Encoder-Decoder Connection Layer Block
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The COVID-19 pandemic has had a huge influence on human lives all around the world. The virus spread quickly and impacted millions of individuals, resulting in a large number of hospitalizations and fatalities. The pandemic has also impacted economics, education, and social connections, among other aspects of life. Coronavirus-generated Computed Tomography (CT) scans have Regions of Interest (ROIs). The use of a modified U-Net model structure to categorize the region of interest at the pixel level is a promising strategy that may increase the accuracy of detecting COVID-19-associated anomalies in CT images. The suggested method seeks to detect and isolate ROIs in CT scans that show the existence of ground-glass opacity, which is fre

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Publication Date
Tue Sep 28 2021
Journal Name
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Efficiency of Infrastructure Services in Khor Al-Zubair City (Iraq) Firas Sami Abdulaziz Alqatrani1 and Amira
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The aim of the research is to demonstrate the concept, characteristics, efficiency and adequacy of infrastructure in Khor Al-Zubair, as it represents an important benchmark for judging the development of the city. The researchers thus aim to measure the efficiency, adequacy and personal impression of each service in Khor Al-Zubair city and its residential neighborhoods. To meet this objective, the researchers used the descriptive and analytical approach that involves randomly distributing a questionnaire with specific questions to the neighbors of the city. The study has reached a set of results and recommendations that contribute to addressing the problems to the sector of infrastructure services in the city, such as: the per capita sha

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Publication Date
Tue Nov 16 2021
Journal Name
Journal Of Clinical Laboratory Analysis
Hematological changes associated with COVID‐19 infection
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Abstract<sec><title>Background

The unresolved COVID‐19 pandemic considerably impacts the health services in Iraq and worldwide. Consecutive waves of mutated virus increased virus spread and further constrained health systems. Although molecular identification of the virus by polymerase chain reaction is the only recommended method in diagnosing COVID‐19 infection, radiological, biochemical, and hematological studies are substantially important in risk stratification, patient follow‐up, and outcome prediction.

Aim

This narrative review summarized the hematological changes including the blood indices, coagulative indicator

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Publication Date
Sat Feb 18 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Food on the Pharmacokinetics of Fluoxetine in Healthy Male Adult Volunteers(Conference Paper )#
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Fluoxetine (FX) is an antidepressant drug administered only orally in humans. Despite the wide use of FX, until now, there is only limited literature concerning the pharmacokinetics (PK) of FX and the effect of food on its PK. Thus, the objective of this investigation was to study the PK of FX in Arabic healthy male adult volunteers under fasting and fed conditions. In the fasting study, FX 20 mg capsules (Prozac®, Eli Lilly, Canada) were administered to 41 volunteers after overnight fasting of 12 hours, followed by blood sampling from each volunteer immediately before dosing (zero time) and then at 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 24, 36, 48, 60, 72, 96, 120, and eventually at 144 hours after FX dosing. The fed study was conduct

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Publication Date
Thu Feb 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Formulation Variables Effect on Gelation Temperature of Nefopam Hydrochloride intranasal in Situ Gel (Conference Paper) #
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Nefopam (N.F.) HCl is a non-narcotic centrally-acting, non-opioid benzoxazocine analgesic to relieve acute and chronic pain. It exhibits low bioavailability (about 36%) due to its first-pass degradation in the liver.

Intranasal administration has been used as a new route for targeting active brain sites and enhancing the bioavailability of N.F. HCl bypassing hepatic metabolism.

In situ gel of N.F. HCl was prepared by the cold method using different concentrations of Poloxamer 407, Poloxamer 188, HPMC K4M, Carbapol 934, and Hyaluronic acid polymers.

The results show that identification tests are superimposed with references, solubility study shows that N.F. HCl is suitable to be administered intranasally; Compatibi

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