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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
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Vitamin D deficiency/ insufficiency and some of its related factors in a sample of Iraqi pregnant women and their neonates at Al-Elwiya Maternity Teaching Hospital during 2019
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In their cross-sectional study, Al-Rubaye et al studied the extent of vitamin D (VD) deficiency/ insufficiency, factors affecting its degree, and the adverse outcomes of the altered VD status among a group of mothers and their neonates from Baghdad, Iraq. They found that 96.6% of the mothers had VD deficiency/ insufficiency compared to 86.4% in their neonates. Maternal VD levels and neonatal weights were significantly correlated with neonatal VD levels. We believe that the study results need to be revised. This is based  two points listed in this letter to editor

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Publication Date
Mon Dec 21 2020
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Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
MONITORING OF THE WILD MAMMAL FAUNA IN BAMO MOUNTAIN IN NORTHERN IRAQ (KURDISTAN) FOR THE FIRST TIME USING CAMERA TRAP METHOD AND RAISING AWARENESS FOR ITS CONSERVATION
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Mammals are under threat worldwide due to deforestation, hunting, and other human activities. In Iraq, a total of 93 species of wild mammals have been recorded including species with global conservation concern. Bamo Mountain is situated within the Zagros Mountains in northern Iraq which is a suitable habitat for wild mammals. Due to scarcity of the field survey efforts and cryptic behavior, monitoring of the wild mammals fauna in Zagros Mountain seems challenging. Therefore, we used a camera trap which seems to be an ideal way to determine species diversity of wild mammals in Bamo Mountain. Moreover, interviews with local villagers were performed. The mammalian diversity of Bamo Mountain is not fully explored but seemed threatened by lo

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Thu Oct 01 2015
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Thu Apr 01 2021
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Comparative study for Environmental Impact Assessment in Environmental Iraqi and Saudi legislation
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Publication Date
Thu Nov 01 2018
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Testing Bromocriptine Dose Necessary For Suppression of Lactation in Rats: Morphological Study
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Abstract: Objectives: The lowest dose of bromocriptine, necessary for suppression of lactation in rats, was estimated in this investigation. Methodology: Fifty healthy lactating rats were treated with different doses of bromocriptine. Cessation of lactation was assessed clinically and histologically. Results: Revealed that the lowest dose capable of lactation suppression is 4 mg bromocriptine / kg body wt. / day. It is very important to know the exact dose, which can suppress lactation in rats because these laboratory animals are commonly employed in experiments concerning this topic. Key words: Bromoci

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Publication Date
Sun Jul 09 2023
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Study the Application of Ultrasonic Technology for Phenol Removal in Petroleum Industry
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In this study, the sonochemical degradation of phenol in water was investigated using two types of ultrasonic wave generators; 20 kHz ultrasonic processor and 40 kHz ultrasonic cleaner bath. Mineralization rates were determined as a function of phenol concentration, contact time, pH, power density, and type of ultrasonic generator. Results revealed that sonochemical degradation of the phenol conversion was enhanced at increased applied power densities and acidic conditions. At 10 mg/L initial concentration of phenol, pH 7, and applied power density of 3000 W/L, the maximum removal efficiency of phenol was 93% using ultrasonic processor at 2h contact time. Whereby, it was 87% using and ultrasonic cleaner bath at 16h contact time and 150 W

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Mon Feb 28 2022
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Perceptual for enrolled and not enrolled the puplis in kindergartens (comparative study)
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Publication Date
Tue Jan 18 2022
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Materials Science Forum
Spatial Analyzing of the Chemical Soil Properties for the Sanam Mountain- Al Zubair Region South of Basra Province and Diagnosis of its Effects on Soil Qualities Using Remote Sensing Technology and GIS
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Spatial Analyzing of the Chemical Soil Properties for the Sanam Mountain-Al Zubair Region South of Basra Province and Diagnosis of its Effects on Soil Qualities Using Remote Sensing Technology and GIS
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Association study of two single nucleotide polymorphisms rs10757278 and rs1333049 with atherosclerosis, a case-control study from Iraq
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