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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 04 2019
Journal Name
Journal Of The College Of Education For Women
THE QURAANIC REITERATION IN AL- JAAHED S THOUGHT
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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
The Haughtiness and the Humility in Al Koran
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Abstract
What the research come to:
1- The presentation of the image of the proud person in this
mortal life appeared in several styles such as (conversation)
arousing the insert once and convincing in other time,
(confirmation) in all its types، (argument) scolding with the
gradual progress of time of the discourse .Interview and
parallelism are two of these styles with the presences of the
repetition style especially in the topics that has a reference to
the theme of (pride) being implied not directly stated. The
Koran discourse varied in its reference to the theme of pride
according to the context which is mentioned directly
(eighteen times) which formed one third of the number of

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Publication Date
Mon Sep 30 2019
Journal Name
College Of Islamic Sciences
Grammatical and rhetorical methods   In Surat Al - Iftar
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I started writing the research because of the linguistic and rhetorical methods in the Holy Quran.
This Sura included in all its verses the plural form such as the word planets graves and seas except the word sky was singular as the name of a genus, and this Sura showed the horrors of the Day of Judgment at the world level Included another science is the science of the interview and also came in the repetition and deletion and other linguistic and rhetorical things and concluded this Sura that the goal of breaking the sky and scattering planets and scatter graves is the human himself.
The Koran is a miracle immortal and science is still drawn from him each according to his specialty.

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Publication Date
Sat Jul 22 2023
Journal Name
Journal Of Engineering
Self Purification in Al-Saqlawiya Drain in Abu-Grebe
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Surface water flow samples were collected with distances downstream over Saqlawiya main drain whose stretch of about 24.5 km. The drain travels through different land use pattern, before, flowing into Tigris River. Eight sampling points were carefully
selected downstream the channel during dry season. The examined water parameters were pH, NH3, NO3, PO= 4, BOD5, COD, TDS, S.S, Cl-, SO= 4, Na+ , Ca+2, Mg+2, and Oil and Grease. Descriptive and inferential methods through finding the best curve fit correlation were employed in the study to test the strength of the association between water chemical characteristics and distance downstream the channel. A comparison of the values of chemical parameters at the Al-Saqlawiya Drain-Tigris Riv

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Publication Date
Wed Mar 10 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The revival of the historic Islamic geometric pattern on the gate of The Al-Sharabeya School in Wasit City using the Grasshopper program
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Publication Date
Wed Mar 10 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The revival of the historic Islamic geometric pattern on the gate of The Al-Sharabeya School in Wasit City using the Grasshopper program
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Publication Date
Thu Jan 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Associated Risk Factors with the Incidence Rate of Abortion Cases among Women at Maternity and Pediatric Hospital in Al-Diwaniyah City
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Objective(s):  To find out the incidence Rate of abortions in pregnant women Admitted Maternal and pediatric Hospitals at Al-Diwaniyah City and to identify the relationship between the incidence rate of abortion and the associated risk factors that led to the occurrence of abortion.

Methodology: A descriptive study was conducted to identify the Incidence Rate of Abortions and its Associated Factors among Women at AL-Diwaniyah City’s Maternity and pediatric Hospital from 16 September 2020 to 16 March 2021 . The sample study includes (100) pregnant women with abortion out of (3800) pregnant women. The data was collected by means of a questionnaire through a personal intervie

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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Factors upon Children’ Weight Status of age one to Five years old at Primary Health Care Centers in AL Samawah City
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Objective: The study aim is to identify factors that may contribute to children’s weight status variations. Methodology: A descriptive cross sectional study is carried out has been conducted at the AL- Samawah city in Primary Health Care Centers for the purpose of the screening children’s weight status of Age One to five Years Old. This study is started from December 16th 2018 to February 14th 2019. A(non propriety) purposive sample comprised of (20) primary health centers (10 main and 10 sub) are selected of 500 children who visit the primary health care center during the period for the purpose of the study; Data was collected through using a questionnaire designed and developed for the purpose of the study . It consists of two main

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The psychological, social and academic problems that encounter students of college of education in Al-Anbaar University /Al-qaim
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The study aims to identify the psychological, social, and academic problems that encounter students at the college of education. To this end, the researcher utilized the descriptive approach, where a questionnaire was used as a tool to collect the study data. The findings of study revealed that the main academic problems are inability to understand what the students read, lack of concentration over the process of studying. The Difficulty of preparation for test. Lack of ability to memorize quickly. As for the prominent social problems: the excessive usage of social media that drove students away from their main tasks, the Lack of participation in social activities, the scarcity the religious information. The psychological problems includ

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Publication Date
Mon Dec 28 2020
Journal Name
Journal Of The College Of Education For Women
Al-Bayhaqi’s Preferred Opinions in his Book Al-Khilafiyat-Chapter of Breastfeeding: عذراء حميد فريح , وايمن عبد القادر الهيتي
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This research is a comparative jurisprudential study that focuses on Imam Al-Bayhaqi’s preferred opinions in his book Al-Khilafiyat (The Disagreements), the part of Al-Rida’a (Breastfeeding). It is considered one of the most important familial topics that is concerned with organizing the social relations in Islam, strengthens the family ties and that prevents the family disintegration due to the ignorance and lack in comprehending Sharia laws (Islam law) in all aspects. The study follows the inductive and descriptive method. It aims at examining the prohibition of marriage when breastfeeding takes place at the time of woman’s conversion to Islam or during her infidelity period. It further aims at verifying the prohibition

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