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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
Tue Dec 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional program on patients with ulcerative colitis adherence for Medication and Diet to prevent Colorectal Cancer: case and control study
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ABSTRACT:

Objectives: The study aims to know the effectiveness of the educational program in the patient’s adherence to medication and diet and to know the relationship between the effectiveness of the education program and their demographic data related to the patient’s age, gender, marital status, education level, occupation, monthly income and residence.

Methodology: A quasi -experimental design study was performed on patient who attended to Gastroenterology and Hepatology Teaching Hospital, from March 2021 to September 2021. The non-probability sampling including 50 patients for case study and 30 patients for control group. The questionnaire consists of 3 parts, part one the socio

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Publication Date
Mon Jun 01 2020
Journal Name
Iraqi Journal Of Physics
Theoretical Model for Spectroscopic Study of Cu+2, Co+2, and Fe+3 Dissolved in Ethanol with A Different Concentrations
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The absorption spectrum for three types of metal ions in different concentrations has been studying experimentally and theoretically. The examination model is by Gaius model in order to find the best fitting curve and the equation controlled with this behavior. The three metal ions are (Copper chloride Cu+2, Iron chloride Fe+3, and Cobalt chloride Co+2) with different concentrations (10-4, 10-5, 10-6, 10-7) gm/m3. The spectroscopic study included UV-visible and fluorescence spectrum for all different concentrations sample. The results refer to several peaks that appear from the absorption spectrum in the high concentration of all metal ions solution.

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Wed Feb 12 2020
Journal Name
Journal Of Xi'an University Of Architecture & Technology
A COMPARATIVE STUDY OF DIRECTIVES IN SAMUEL BECKETT&#8217;S &#8216;END GAME&#8217; AND &#8216;WAITING FOR GODOT&#8217;
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Publication Date
Fri Jan 01 2021
Journal Name
Annals Of Maxillofacial Surgery
The use of screw retained hybrid arch bar for maxillomandibular fixation in the treatment of mandibular fractures: A comparative study
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Introduction: The use of screw-retained hybrid arch bars (HABs) is a relatively recent development in the treatment of mandibular fractures. The purpose of this study is to compare the clinical outcome between HAB and the conventional Erich arch bar (EAB) in the closed treatment of mandibular fractures. Materials and methods: This study included 18 patients who were treated for mandibular fractures with maxillomandibular fixation (MMF), patients were randomly assigned into a control group (n = 10) in which EAB was used and study group (n = 8) in which HAB was used. The outcome variables were time required for application and removal, gingival inflammation scores, postoperative complications, and incidence of wire-stick injury or gloves perf

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Wed Mar 09 2022
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Journal Of Craniofacial Surgery
The Use of Osseodensification for Ridge Expansion and Dental Implant Placement in Narrow Alveolar Ridges: A Prospective Observational Clinical Study
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The osseodensification (OD) drilling technique was suggested as an alveolar ridge expansion technique, so the aim of this prospective clinical study was to evaluate the amount of bone expansion obtained by the OD drilling technique and its effect on implant stability in patients with narrow alveolar ridges. The width of the alveolar ridge was measured at the crest before and after implant site preparation, whereas the implant stability was measured using Osstell Beacon implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. Twenty-three patients were included; they received 40 implants. The mean (± standard deviation [SD]) amount of expansion was 1.29 (± 0.41) mm, and the difference b

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Mon Mar 01 2010
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Ibn Al-haitham Journal For Pure And Applied Sciences
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Thu Dec 31 2020
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Journal Of Accounting And Financial Studies ( Jafs )
Electronic payment methods used for salary resettlement and its impact on improving the mental image of customers: an applied study of the opinions of a sample of (private) commercial banks 'customers contracting with the Ministry of Higher Education and Scientific Research to localize employees' salaries
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The research seeks to identify the contemporary events that face the use of electronic payment methods to localize the salaries of state employees and its impact in enhancing the mental image of customers, and to achieve this purpose from the fact that a questionnaire was designed and distributed to an optional sample of (31) individual customers (employees) dealing With the researched private banks, it has been analyzed and reached a number of conclusions and recommendations, the most prominent of which is the lack of modernity of electronic payment methods by customers, which is reflected in the mental image of customers and the achievement of their satisfaction, in the Emiratization project for salaries needs an advanced leade

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Publication Date
Sun Nov 01 2020
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Pakistan Journal Of Medical And Health Sciences
Impact of smoking on cardiac electrophysiological parameters of symptomatic sinus node patients in Iraq
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Background: Dysfunction of sinoatrial node is a set of abnormal rhythms which are resulted from the sinoatrial node malfunction of the sinus node, the chief natural cardiac pacemaker. The common, and occasionally, the single method for treatment of heart arrhythmias was implantation of pacemaker, which reduce symptoms exactly occurs after implantation. Aim: To detect the role of smoking on cardiac electrophysiology parameters in sinus node dysfunction in Iraqi patients such as SNRT and AH. Methods: A cross sectional study, was conducted on 59 patient ranging between 20-50 years old and involving 35 female and 24 male patients, suffering from an unexplained symptoms of sinoatrial node dysfunction (SND). The enrolled participants were gathere

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Publication Date
Mon Dec 01 2014
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USING SENSITIVITY ANALYSIS IN DETERMINING THE OPTIMAL&EFFICIENT PRODUCTION PLANS IN GREENHOUSES IN ASSOCIATION OF AL-WATAN UNDER CONDITION OF RISK &UNCERTAINTY
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
An Evaluative study for the Arabic language course program: An Evaluative study for the Arabic language course program
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Abstract
Language is one of God’s blessings to human beings through which he
distingushed them from other creatures, then how if this language was arabic.
God honored this language and in which he descended his Gracious Boole
that gave it glory and magnificance, and made it an immortal revelation to the
arab nation in their poetry, oration, history and human tendency to the life of
knowledge, mind leadershipe, innovation and progress.
This study aimed at evaluating the arabic language come program for
the new teachers. The sample was of (25) participants who were shown a
questionaire consisting of (60) items distributed on (9) fields. Then, the data
was processed statisically by using preauency rate, Kai s

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