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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
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Rightness in Evalating Basra and Kufa’s Views in The Work Of Al _ Anbary, Al - Insaf Fi Masael Al - Khilaf
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This paper deals with the Kufis and basris agreements in Abo Al _ Barakat Al _ anbary’s
work “ Al- Insaf Fi Masael Al - Khilaf.It attempts to settle the disputes and find out the right
views.
The book presents the issnes that the two schools of Kufa and Basra dispute upon and try to
evaluate them so as to support the correct ones .The present researcher has noticed that the
author of the above work was not always right or accurate in picturing a number of issues as
disputable whereas they implicitly shared the same views .Accordingly ,this papor sheds light
on such cases and drew acadernic researchers, attention to the invalidity of Al –anbary’s
misjudged views.

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Archaeological Surveying in Wadi Al – yabis in Jordan (( Athnoarchology study ))
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Wadi AL – yabis situated to the north jorden , its extended from Aglon
mountain to the jorden river , the surveying of this valley about 186 KM , and the
highest point in it about 1200 m upon the sea level , the lower point ther under the
sea level . This study lay to appear the historical important and to study the variation
of environment and population which happened in the different periods , in the
beginning the Paleolithic until the later period , and to understand the environment ,
political and economical circumstances , which it can to influenced or limited in
human behavior from choosing , the settlement sits and than ( we could ) knowledge
of living ways and the tools which they used in there living a

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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
Sun Jan 01 2023
Journal Name
Journal Of Engineering
Optimization of Locations for Bioswales Stormwater Management Using BMP Siting Tool - Case Study of Sulaymaniyah City-KRG-Iraq
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Today, urban Stormwater management is one of the main concerns of municipalities and stakeholders. Drought and water scarcity made rainwater harvesting one of the main steps toward climate change adaptation. Due to the deterioration of the quality of urban runoff and the increase of impermeable urban land use, the treatment of urban runoff is essential. Best Management Practice (BMP) and Low Impact Development (LID) approaches are necessary to combat climate change consequences by improving the quantity and quality of water resources. The application of Bioswales along urban streets and roadways can reduce the stress on water resources, recharge groundwater and prevent groundwater pollution. While Sulaymaniyah City has a

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Publication Date
Mon Mar 28 2022
Journal Name
The Open Dentistry Journal
Depression, Anxiety and Stress Among Dentists During COVID-19 Lockdown
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Introduction:

The objective of this study was to investigate the levels of depression, anxiety, and stress among dentists during covid-19 lockdown and to investigate the relationship between stress and each mental health state.

Methods:

A cross-sectional survey on 269 dentists was conducted using DASS-21 and PHQ-9 questionnaires. Bivariate and multivariate models were constructed and the odds ratio (OR) was calculated to assess the strength of the association between an independent categorical variable and the outcome.

Results and Discussion:

Being unsatisfied with the job was as

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Publication Date
Thu Jun 11 2020
Journal Name
American Journal Of Infectious Diseases
Prevalence of Urinary Tract Infections and Associated Risk Factors Among Patients Attending Medical City Hospital in Baghdad City, Iraq
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Abstract: Urinary Tract Infections (UTIs) are the most common bacterial infection in humans and a major cause of morbidity and they are the most common cause of hospital visits worldwide. Proper knowledge in identifying factors associated with urinary tract infection may allow the intervention to easily control of the disease in a timely manner. Therefore, the purpose of the study is determining the prevalence of UTI, diagnosis of causative bacterial agents and identifying the factors associated to the urinary tract infection among patients attending Medical City Hospital in Baghdad, Iraq. A total of 237, morning mid-stream urine samples were collected aseptically and the samples were diagnosed according to the standard methods. I

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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
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
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
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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