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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
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
Patterns of Feedback Used in the E-Learning System from the Teachers of the First Cycle in the Governorate of Muscat at the Sultanate of Oman
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Abstract

This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the e-learning system in addition to the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment, as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in government schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire that contained four different patterns of feedback, which are reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the que

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Publication Date
Tue Sep 24 2019
Journal Name
Journal Of Petroleum Research And Studies
Lithofacies Characterization of the Early – Middle Miocene Succession, Case-Study, South Iraq
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The Early – Middle Miocene Ghar and Lower Fars sedimentary succession at the representative oil-well Nu-18 of the Nahr Umr oil field south Iraq; is taken by this study to investigate the sedimentological to reservoir rock facies buildups and related reservoir zonation; as first rock-typing attempt for the both formations. The sedimentological characterization of the Early Miocene Ghar formation is mainly comprised by successive buildups of sands-gravels and sandstones, whereas; the Middle Miocene Lower Fars formation is started by limestone, limestone-marly/marl anhydritic, upgraded into interbedded-series of marl and anhydrite facies, with less-common occurrences of thin-sandstone interlayers, terminated by marl-sandy-secti

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Publication Date
Sun Nov 01 2020
Journal Name
International Journal Of Engineering
Pavement Maintenance Management Using Multi-objective Optimization: (Case Study: Wasit Governorate-Iraq)
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Publication Date
Sun Aug 06 2017
Journal Name
Journal Of Education College Wasit University
Cloud Computing Adoption by Higher Education Institutions of Iraq: An Empirical Study
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In the last years, a new technology called Cloud computing has been developed. Empirical and previous studies, commonly examined in business field and other domains. In this study, the significant factors that affecting the adoption of cloud computing have been examined using a frequency analysis that have been explored by the previous studies. The results showed that the most effected factors were relative advantage which followed by security and privacy, complexity, innovativeness, and external support. In this study the model of technology organization-environment was used to examine the significant factors that affecting the adoption of cloud computing.

Publication Date
Sun Jul 01 2018
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
STUDY ON DIVERSITY OF BEES (HYMENOPTERA, APOIDEA) FROM DIFFERENT REGIONS OF IRAQ
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    The fauna of bees (Hymenoptera, Apoidea) from different regions of Iraq is surveyed in this study; there were 16 species, 13 genera that belong to four families which are collected in this investigation.

 

    Also, all the species that are recorded for Iraq in previous investigations are revised; totally there are 110 species, 32 genera belonging to  five families: Apidae, Andernidae, Colletidae, Halictidae and Megachilidae were listed.

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Publication Date
Wed Jun 30 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ELECTROCHEMICAL PREPARATION OF A MOLECULAR IMPRINTED POLYMER ELECTRODE FOR ESTEMATION OF ASPIRIN USING TWO DIFFERENT FUNCTIONAL MONOMERS.: ELECTROCHEMICAL PREPARATION OF A MOLECULAR IMPRINTED POLYMER ELECTRODE FOR ESTEMATION OF ASPIRIN USING TWO DIFFERENT FUNCTIONAL MONOMERS.
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For aspirin estimated, a molecularly imprinted polymer MIP-ASP electrodes were generated by electro-polymerization process, the electrodes were prepared by combining the template (aspirin) with (vinyl acetate (VA), 1-vinylimidizole (VIZ) as a functional monomer and N, N-methylene bisacrylamide (MBAA) as crosslinkers using benzoyl peroxide (BPO) as an initiator. The efficiency of the membrane electrodes was analyzed by differential pulse voltammetry (DPV). Four electrodes were synthesized using two different plasticizers, di-butyl sebacate (DBS), di-octyl phthalate (DOP) in PVC matrix. Scanning electron microscopy (SEM) was used to describe the generated MIP, studying the electrodes properties, the slope, detection limit, and life

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Publication Date
Wed Apr 01 2020
Journal Name
Plant Archives
Determination of heavy metals in tattoo inks from the local market in Baghdad city
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Publication Date
Thu Dec 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary vitamin D3 in relation to dental caries among pregnant women in Baghdad city
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Background: Vitamin D deficiency is a problem for pregnant women, and it affects general and oral health. This problem increases as vitamin D requirements increase during pregnancy. This study was conducted among pregnant women in urban and rural areas in order to assess the relation between salivary vitamin D3 and dental caries. Materials and methods: In this comparative cross-sectional study, all women participating were attending the primary Health Care Centers in Baghdad city in AL-Karkh sector, they were with age ranged from (15-44) years old. The total number 90 pregnant women in the second trimester only which include: The first group consists of (45) pregnant women attendance seeking dental treatment in urban areas, The second gr

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Determination Oxidant - Antioxidant Enzyme and some Trace Elements in Breast Cancer in Baghdad City
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level of effectiveness of Glutathione - S - Transferees (GST), Glutathione peroxides (GPX),Malondialdehyde (MDA) the product of lipid peroxidation and some trace elements ( zinc,seleinum,iron ,copper ) had been measured in sera of (50) women with breast disease.which had been divided to : Control group (25),The first group (A) benign breast tumors (25),the second group (B) breast cancer (25). The results showed a clear moral high level of Glutathione - S - Transferees (GST), Glutathione peroxidase (GPX) , and Malondialdehyde (MDA) level in breast cancer group while a slight increase were observed in the levels of these enzymes and(MDA) in benign breast group. A significant reduction was evident in the levels of selenium and zinc

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
Attitudes of the Elderly towards Social Service Provided in Nursery Home in Baghdad City
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Abstract

Through social service tasks for the elderly, it natural for elder people to have some attitudes about the quality and nature of provided services, whether negative or positive. Accordingly, the current research is an attempt to investigate the attitudes of the elderly toward the social service provided to them in the nursery homes. The research sample included 60 elderly people chosen from the nursey home at Al-Karrada district and then a scale of attitudes was administered to them that had proved its reliability and validity. The study concluded with a set of recommendations and suggestions were.

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