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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 Jun 30 2021
Journal Name
College Of Islamic Sciences
Phonological, dialectical and semantic explanation of the two phenomena of substitution and compulsion in the book of translation Thirty surahs from the Noble Qur’an by Ibn Khallouh d. 370 AH
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This research aims to find out the phonemic, dialect and semantic ailments that were interrogated by the book of the parsing of thirty surahs of the Noble Qur’an by Ibn Khalawiyeh, by examining some phonemic phenomena of Qur’anic expressions and their explanatory relationships that resulted in their occurrence, such as substitution and compression, as the sounds in a word are affected by one another, especially during performance and composition. This influence and influence is the tendency of the human being to the law of ease, facilitation, and the reduction of muscular effort in speech often, all for the purpose of obtaining phonemic harmony for the compound letters; To facilitate pronunciation; And get rid of the muscular effort

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Publication Date
Sun Apr 01 2012
Journal Name
2012 International Conference On Future Communication Networks
Efficient method to find the multiplicative inverse in GF (2&lt;sup&gt;m&lt;/sup&gt;) using FPGA by exponentiation to (2&lt;sup&gt;k&lt;/sup&gt;)
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Publication Date
Sun Apr 01 2012
Journal Name
2012 International Conference On Future Communication Networks
Efficient method to find the multiplicative inverse in GF (2&lt;sup&gt;m&lt;/sup&gt;) using FPGA by exponentiation to (2&lt;sup&gt;k&lt;/sup&gt;)
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Multiplicative inverse in GF (2 m ) is a complex step in some important application such as Elliptic Curve Cryptography (ECC) and other applications. It operates by multiplying and squaring operation depending on the number of bits (m) in the field GF (2 m ). In this paper, a fast method is suggested to find inversion in GF (2 m ) using FPGA by reducing the number of multiplication operations in the Fermat's Theorem and transferring the squaring into a fast method to find exponentiation to (2 k ). In the proposed algorithm, the multiplicative inverse in GF(2 m ) is achieved by number of multiplications depending on log 2 (m) and each exponentiation is operates in a single clock cycle by generating a reduction matrix for high power of two ex

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Publication Date
Wed Jan 01 2025
Journal Name
Open Veterinary Journal
&lt;b&gt;Antimicrobial susceptibility patterns of infective &lt;i&gt;Streptococci&lt;/i&gt; recovered from local and imported mozzarella cheese from different markets in Baghdad&lt;/b&gt;
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Background: This research identified Streptococci spp. depending on culture, biochemistry, the VITEK technique, ability to produce biofilms, and antibiotic resistance. Aim: The goal of this study was to perform microbiological procedures to evaluate the qualitative qualities of mozzarella cheese against infective Streptococci using microbiological care. Methods: Sixty (60) mozzarella cheese samples were brought from diverse markets in Baghdad from October 2023 to December 2023 at the Zoonoses Research Unit and Veterinary Public Health Department, Veterinary Medicine College, University of Baghdad. Culture of samples on agar (MacConkey and blood) and aerobically incubated at 37°C for 48 hours. Gram staining purified colonies to

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Publication Date
Fri Jun 02 2023
Journal Name
Bandaoti Guangdian/semiconductor Optoelectronics
NMUSING AN INNOVATIVE DEVICE TO IMPROVE THE EFFICIENCY OF THE ANTERIOR QUADRICEPS MUSCLE OF THE INJURED KNEE JOINT AFTER SURGICAL INTERVENTION OF THE ANTERIOR CRUCIATE LIGAMENT IN ADVANCED SOCCER PLAYERS
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This study aimed to manufacture an innovative device that enables the player to walk after the operation and improves the functional efficiency through the improvement in the range of motion as well as the improvement in the size of the muscles working on the knee joint. The research, the study population consisted of players with severing the anterior cruciate ligament of the advanced soccer players, and the number of the research sample was (5) injured for the control sample and (5) for the experimental sample in Abu Ghraib Hospital and some rehabilitation centers for a period of six months, and the pre-tests were conducted after two weeks of The cruciate ligament surgery was performed, and the innovative device was used for the e

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
Analysis of the symbolic images in the work of Mexican theater of: "all cats are brown," the writer Carlos Fuentes and "Palinuro on the stairs," the writer Fernando del Paso
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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Physical Education Program on the Domains of the University Students, Attitudes toward Physical Fitness
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Objectives: To determine the effectiveness of physical education program on the domains of the university
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test-retest approach through the period from February 3rd 2013 to June 30th 2013. The study is conducted on
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Consisted of (20) males and (20) females. Questionnaire of two main parts, Personal and demographic
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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The Mathematical construct and its relationship with effective mathematical operations in both sides of the brain among students of the Department of Mathematics at the Colleges of Education and Basic Education
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The current research aims to identify: 1. The level of mathematical construct among the Department of Mathematics students in the colleges of education and basic education. 2. The level of effective mathematical operations in both sides of the brain at the Department of Mathematics students in the colleges of education and basic education. 3. The strength and direction of the correlation between the mathematical construct and effective mathematical operations on both sides of the brain at the Department of Mathematics students in the colleges of Education and Basic Education. To investigate the research objectives, the researcher formulated zero-main hypothesis for each aim and from the same hypothesis, three sub-zero hypotheses are deri

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Publication Date
Sun Dec 12 2010
Journal Name
Journal Of Planner And Development
Utilizing the resources of the local environment in the establishment of the constituent units of the urban fabric within the framework of preservation of the urban heritage (Hassan Fathi's model experiment)
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No country in the world has an ancient heritage of its own. It represents the product of the civilizations left behind by previous eras. It represents the development of urban life and its capital of the interest of its people in the field of construction and reconstruction. The urban heritage and its associated arts may seem to be a material heritage at first glance, but it is not free from the spiritual side. Therefore, the nations in different parts of the earth cherish it and care for it with all due diligence, because it mixes with its history, memories and emotions.
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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
(comparative analysis of phraseological units in the lexical-semantic field "on the material of Arabic and Russian languages"): (сопоставительный анализ фразеологических единиц лексико-семантического поля " на материале арабского и русского языков")
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Establishing the systemic character of vocabulary, its relationship with other language systems, their interdependence creates the possibility of a comprehensive scientific study and description of the lexical system of each language, as well as contrastive comparative studies of several languages, including their phraseological composition.

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