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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 Jul 03 2023
Journal Name
College Of Islamic Sciences
A critical methodological study in abrogative,abrogated, in a book of (Zad AlTafseer) in Surah Al-Baqara in the holy Quraan.
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This research is a critical methodological  study deals with some Quranic verses abrogative,abrogated.

by Ibn al-Jawzi (may Allah have mercy on him) in his book (Tafseer Zad al-Maseer) inin Surah Al-Baqara the  in the holy Quraan.

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Publication Date
Sat Apr 01 2023
Journal Name
Journal Of Language Studies
Syntactic Deviation in Abdul-Wahhab Al-Bayyati Poetry With Reference to English Syntax A Functional Study
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This research is an attempt to study aspects of syntactic deviation in AbdulWahhab Al-Bayyati with reference to English. It reviews this phenomenon from an extra-linguistic viewpoint. It adopts a functional approach depending on the stipulates of systemic Functional Grammar as developed by M.A.K. Halliday and others adopting this approach. Within related perspective, fairly’s taxonomy (1975) has been chosen to analyze the types of syntactic deviation because it has been found suitable and relevant to describe this phenomenon. The research hypothesizes that syntactic deviation is pervasive in Arabic poetry, in general and in Abdul-Wahhab Al-Bayyati Poetry in specific, and can be analyzed in the light of systemic Functional Grammar

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
Staging Violence in Sarah Kane’s Blasted &amp; Ali Abdulnebi al Ziadi’s Fourth Generation: a Comparative Study
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Violence occurs as a daily human action all over the world; it may cause so many kinds of damage to individuals as well as to society: physical, psychological, or both. Many literary authors of different genres have tried their best to portray violence by showing its negative effects, especially playwrights because they have the chance to show people the dangers of violence through performance on stage to warn them against such negatively affected action. It has been a human action since the beginning of human life on this planet when the first crime happened on earth when Cane killed his brother Abel. In our modern world, people are witnessing daily violent actions as a result of destructive wars that turned the humans into brutal beings.

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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Measuring the Change in the Impact of the Corona Pandemic Factors on Psychological Sensitivity and Covid-19 Phobia in a Sample of University Students
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The aim of the research is to measure the change in the impact of the factors of the Corona pandemic on psychological sensitivity and COVID-19 phobia in a sample of Bisha University students and to detect the differences in the phobia (phobia) Covid-19 among the sample members in the measurement before the ban and after the ban was opened, in addition to the differences in psychological sensitivity of  The sample has between sizes before and after the spread of the Corona pandemic, as well as the differences in them according to the gender variable (male, female). The researcher relied on the comparative approach. The scale of psychological sensitivity and COVID-19 phobia was applied to a sample of (62) male and female respondents.

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Electrocardiographic changes among beta-thalassemic major patients in ibn al-baladi thalassemia center-Baghdad
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Background :Thalassemia is an autosomal
disease of the haemoglobin. Two types of
thalassemia are recognized: thalassemia major
and thalassemia intermedia.
The most serious cardiac complication in
thalassemia major is due to multiple blood
transfusions rather than the disease itself, which
is due to iron overload.
Cardiomyopathy is the most common cardiac
defect that occurs with iron overload. Pricarditis,
congestive heart failure and arrhythmias are due
to hemosidrosis and chronic aneamia.
Aim of the study: to demonstrate the prevalence
and types of electrocardiographic changes among
thalassemic patients with aged over ten years old.

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Asthmatic Patients’ Quality Of Life in Jordan Fadel Hazza' Ali al-Mahameed.*
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Abstract A descriptive study was conducted in Al-Bashir teaching hospital in Amman city from 15th May 2004 to 15th August 2004 , in order to "Assess the adult asthmatic patients’ quality of life (QOL). Objective: This study aimed at identifying the domains of (Environmental, Physical, Daily Living Activity, Drug and Medication, Psychological , and Social), Methodology : A Purposive (Non-Probability) sample of (100) adult asthmatic patients visited the emergency department and outpatient clinic of chest department in Al-bashir hospital .A Questionnaire was constructed for the purpose of the study, and compris

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Publication Date
Sun Dec 31 2023
Journal Name
College Of Islamic Sciences
The book Al-Durr Al-Manzoum in the dropping of prayer and fasting by Issa Al-Safti Al-Hanafi, who died in the year (1143 AH)
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At the conclusion of my research for this readiness, I am ready to show the most important results I have reached, of which I can mention the most important:
Sheikh Al-Safti was a memorizer and jurist, and all the scientific strokes that he left behind for subsequent generations were in the disciplines of Hanafi jurisprudence, and this does not obscure the opinions of the jurists of other schools of thought. But among them: that these lines continue on a group of fatwas for the later in the gold of Abu Hanifa, may God have mercy on him, and then the books of fatwas usually refer to what is below the evidence.

He has no shock other than the knowledge of jurisprudence; And for this reason, it is due to the fact that the s

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Acute Appendicitis and Multisystemic Inflammatory Syndrome due to COVID-19: a Case Report and Literature Review
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The prevalence of gastrointestinal symptoms of COVID-19 is variable with different types of presentations. Some of them many present with manifestations mimicking surgical emergencies. Yet, the pathophysiology of acute abdomen in the context of COVID-19 remains unclear. We present a case of a previously healthy child who presented with acute appendicitis with multisystemic inflammatory syndrome. We also highlight the necessity of considering the gastrointestinal symptoms of COVID-19 infection in pediatric patients in order to avoid misdiagnosis and further complications.

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Publication Date
Fri Jul 01 2016
Journal Name
Al–bahith Al–a'alami
Semiotics of Sufi Texts- Poets of Al Qasr and Al-Asr journals as a Model
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In a common language based on interpretation and diagnosis in the symbols and signs, the subject of Sufism and artistic semiotics is manifested in the construction and intensity of the reading of the text and the dismantling of its intellectual systems.
The emergence of Sufism in its religious features and the spiritual revelations related to the divine love of life in absolute reality, And images and language in a stream of intellectual and artistic unique and harmonious communicates with the subject of the themes of the Arab literature and its implications, but it is separated by a special entity signals and symbols related to the mysticism and worship.
    The unleashing of the imagination and the diagnosis,

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Publication Date
Wed Mar 01 2023
Journal Name
Journal Of Engineering
Hydromorphodynamics Simulation for Selected Stretch of Euphrates River within Al-Anbar Governorate
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In this study, the hydromorphodynamic simulation of a stretch of the Euphrates River was conducted. The stretch of the Euphrates River extended from Haditha dam to the city of Heet in Al-Anbar Governorate and it is estimated to be 124.4 km. Samples were taken from 3 sites along the banks of the river stretch using sampling equipment. The samples were taken to the laboratory for grain size analysis where the median size (D50) and sediment load were determined. The hydromorphodynamic simulation was conducted using the NACY 2DH solver of the iRIC model.  The model was calibration using the Manning roughness,    sediment load, and median particle size and the validation process showed that the error between th

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