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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
Thu Oct 01 2020
Journal Name
Journal Of Engineering
Financing Cost Optimization in Construction Sector: A Review
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The main aim of this research is to introduce financing cost optimization and different financing alternatives. There are many studies about financing cost optimization. All previous studies considering the cost of financing have many shortcomings, some considered only one source of financing as a credit line without taking into account different financing alternatives. Having only one funding alternative powers, restricts contractors and leads to a very specific financing model. Although it is beneficial for the contractor to use a long-term loan to minimize interest charges and prevent a substantial withdrawal from his credit line, none of the existing financial-based planning models have considered long-term loans in

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Crossref
Publication Date
Thu Jun 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
Colonization and Civilization in Aimé Cesaire’s A Tempest
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This study deals with the concepts of Colonialism and Civilization in Aimé Cesaire’s A Tempest. The concern of this study is to discuss how postcolonial writers are continually re-writing the Western canonical works as a reaction to the European cultural hegemony. The Western representations of the black are products of specific moments and developments in history and culture. A Tempest reflects a certain historical moment in the decolonization process.

A Tempest is analysed to reveal the counter literary strategy used by Aimé Cesaire, and to disclose the reasons why re-writing and writing back are considered as vital and inescapable tasks. Shakespeare’s The Tempest, which deals with the

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Publication Date
Thu Sep 30 2021
Journal Name
International Journal Of Research In Social Sciences And Humanities
Black Lives Matter in Brother: A Postcolonial Perspective
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This study aims to examine how the lives of blacks are reduced and eliminated in Brother (2017) by David Chariandy. Black Lives Matter is a hash tag that appears after the killing of Trayvon Martin (17 years old African American) in 2012 by the savage hands of George Zimmerman (white person). This hash-tag has become a social movement that calls for equality in order to stop the violence against black people because their live is as valuable as white’s. The movement comes into being to highlight the “hypocritical democracy in service to the white males whose freedom are openly depended upon the oppression of blacks” (Lebron, 2017, P. 1). Those who have started this movement try to redeem a state and its arbitrary actions again

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Crossref
Publication Date
Tue Sep 09 2025
Journal Name
Nursing Science Quarterly
Artificial Intelligence in Nursing: Toward a Global Perspective
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The use of artificial intelligence (AI) technology is rapidly expanding in nursing and society. However, its use in healthcare comes with a number of challenges and concerns. The authors of this article use the sociotechnical model to consider the expanding use of AI in nursing and healthcare from a global perspective. Select references from the literature are used to support this important discussion for nurses and other healthcare professionals. Artificial intelligence is a major innovation that, if used properly, can reduce errors and improve efficiency and healthcare quality. It has also been shown to increase patient support, healthcare access and patient care. Here the authors address some of the limitations and challenges of

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Publication Date
Thu Jun 08 2023
Journal Name
Open Engineering
A review of rutting in asphalt concrete pavement
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Undoubtedly, rutting in asphalt concrete pavement is considered a major dilemma in terms of pavement performance and safety faced by road users as well as the road authorities. Rutting is a bowl-shaped depression in the wheel paths that develop gradually with the increasing number of load applications. Heavy axle loadings besides the high pavement summer temperature enhance the problem of rutting. According to the AASHTO design equation for flexible pavements, a 1.1 in rut depth will reduce the present serviceability index of relatively new pavement, having no other distress, from 4.2 to 2.5. With this amount of drop in serviceability, the entire life of the pavement in effect has been lost. Therefore, it is crucial to look at the mechani

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Distribution of Municipal Services and Some Factors Affecting Them (A survey in a sample of districts from Rushed municipal in Baghdad)
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s The study aims to identify the fairness in the distribution of municipal services between  municipal districts and areas, from point of view  of municipal chamber staff and from the point of view of the citizen. It also aims to identify factors affecting the fairness of the distribution of municipal services. Municipal services were being studied : hygiene and waste, water supply, sewer, creating gardens,  and street paving .Factors which  examined its impact on municipal services are: resources available to municipal chamber, the managerial  process at municipal chamber,  and factors in the external environment surrounding  municipal chamber.The results of the study showed that level of the e

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Crossref
Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The research is based on a thesis not discussed: Test the strategy of the General Organization based on the model Wichler and Bakov A case study at the Iraqi Ministry of Interior
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The study aimed at identifying the strategic gaps in the actual reality of the management of public organizations investigated to determine the strategy used based on the study model. The study relied on the variable of the general organization strategy in its dimensions (the general organization strategy, the organization's political strategy and the defense strategy of the organization) The sample of the study was (General Directorate of Traffic, Civil Status Directorate and Civil Defense Directorate), formations affiliated to the Ministry of the Interior, for the importance of the activity carried out by these public organizations by providing them In order to translate the answers into a quantitative expression in the analysi

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Crossref
Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
Forward and Reverse Osmosis Process for Recovery and Re-use of Water from Polluted Water by Phenol
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The research aims to apply the novel forward osmosis (FO) process to recover pure water
from contaminated water. Phenol was used as organic substance in the feed solution, while sodium
chloride salt was used as draw solution. Membranes used in the FO process is the cellulose
triacetate (CTA) and polyamide (thin film composite (TFC)) membrane. Reverse osmosis process
was used to treatment the draw solution, the exterior from the forward osmosis process. In the FO
process the active layer of the membrane faces the feed solution and the porous support layer faces
the draw solution and this will show the effect of dilutive internal concentration polarization and
concentrative external concentration polarization.
In th

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Publication Date
Wed Apr 07 2010
Journal Name
Ibn Al-haitham Journal For Pure And Applied Science
Synthesis and Spectral Studies for new Schiff base and its Binuclear Complexes with ZnII,CdII and HgII
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A new ligand (H4L) and its complexes with ( ZnII, CdII and HgII) were prepared. This ligand was prepared in two steps. In the first step a solution of terephthaldehyde in methanol was reacted under reflux with 1,2-phenylenediamine to give an precursor compound which reacted in the second step with 2,4-dihydroxybenzaldehyde to give the ligand. The complexes were then synthesized by direct reaction of the corresponding metal chloride with the ligand. The ligand and complexes were characterized by spectroscopic methods FT-IR, UV-Vis, 1 HNMR, and atomic absorption, chloride content, HPLC, mole-ratio determination. in addition to conductivity measurement. The data of these measurements suggest a distorted tetrahedral geometry for ZnII, C

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Publication Date
Mon Sep 01 2014
Journal Name
Engineering And Technology Journal
Analysis of the Capacity, Spectral Efficiency and Probability of Outage of Adaptive Mobile Channel for WiMAX System
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