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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
Sun May 22 2016
Journal Name
Al-mustansiriyah Journal Of Science
Morphological and histological study of the liver in migratory starling bird (Sturnus vulgaris)
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The present work was aimed to form the baseline data of normal morphological and histological structure features of liver in migratory starling (Sturnus vulgaris). Anatomically, the starling liver bird was dark red -brown in colour and located in the cranial third of the abdominal cavity and consisted of undivided lobes (left and right). The liver right lobe was larger than the left. Histological examination revealed that the liver parenchyma was covered by a connective tissue capsule which appears to be thicker in the rim of liver lobes than other area in the liver lobe. Liver parenchyma was arranged in an unlimited hepatic lobules, which composed of polygonal hepatocytes organized as irregular, radial interconnecting cords or laminae of o

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Publication Date
Wed Nov 05 2025
Journal Name
Annals Of Parasitology
Artemisinin efficacy against old world Leishmania donovani: in vitro and ex vivo study
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Visceral leishmaniosis is one of the most fatal old-world neglected disease with estimated 90 thousand worldwide cases emerge each year. In Iraq, the cutaneous and visceral form are endemic but available chemotherapies are either toxic with diverse side effects, expensive available drugs or parasite …

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Scopus
Publication Date
Fri Jul 31 2020
Journal Name
Lark Journal For Philosophy, Linguistics And Social Sciences
Identity crisis of Arab-American in Laila Halaby's Novel once in a promise Land
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This study aims at describing the identity crisis of Diaspora people (Arab -American) in "Laila Halaby's" novel "Once in A promise Land". Halaby tackles the issues of racism, exclusion, and instability of identity that affect the Arab American community after the terrorist event of eleventh of September. She sheds light on the experiences of her significant characters Salwa and Jassim in America, clarifying how this event weakened their social position and turns their presence in America questionable. "Halaby" describes the bitterness of her characters who are induced into a dream of belonging to a land that transcends their original culture and religious values as well as their language. "Halaby" explains the subsistence in America involvi

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Craniofacial Surgery
Barbed Broach in the Maxillary Sinus: A Report of Unusual Complication in Craniofacial Area
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Crossref
Publication Date
Wed Jan 02 2019
Journal Name
International Journal Of Research In Social Sciences And Humanities
MUSLIM AMERICANS DELIMMA POST 9/11 IN LAILA HALABY’S ONCE IN A PROMISED LAND
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September 11th attacks held the biggest tragedy in American history. It was a day of grief, and it proved that America was not immune to attacks and threat. Afterwards life has changed not only for the American Muslims but also American Christians and Jews and to people from other religions. The cruelty of that day has left its shed particularly on the Muslims’ life in America who in reality had nothing to do with the attacks. Arab American Muslim writer Laila Halaby’s novel, Once in a Promised Land, intensely displays the problems that Arab Muslims went through after September 11th attacks. This paper discusses this issue through analysing Halaby’s novel, where she deals with the issues such as discrimination, stereotype, and prejudi

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
The Effect of a Training Program in Introducing Saudi Traditional Fashion in Local Museums
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Museum education is of great importance to an appropriate representation of museums’ collections and exhibits, including traditional fashion. Therefore, museum educators/curators need to be equipped with the most essential skills in their profession in order to adequately present the museum’s history and holdings. This could be achieved through specialized training programs. However, Arab countries are still behind in terms of museum education. Therefore, this article aims to shed light on this issue by assessing the knowledge and skills possessed by museum educators/curators and how training programs could affect them

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Publication Date
Wed Oct 05 2022
Journal Name
Journal Of Basic Science
Loss in the Translation of Colour Euphemstic Expressions in the Qur’an: A Pragmatic Analysis
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Publication Date
Mon Jan 21 2019
Journal Name
International Journal Of Pharmaceutical Quality Assurance
Genetic Assessment of Antibiotic Resistance in Salmonella Enteric a Serovar Typhi in Kirkuk Province
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Around fifty isolates of Salmonella enterica serovar Typhi were isolated from blood specimens of patients referring to several hospitals in Kirkuk province, Iraq. The results revealed that all isolates developed resistance to trimethoprim-sulfamethoxazole and chloramphenicol. However, neither sul2 nor tem genes were detected. Moreover, only ten isolates were positive for catP. Our data suggested participation of other genes or mechanisms allow these multidrug isolates to resist the antibiotics in question.

Publication Date
Wed May 10 2017
Journal Name
Journal Of The College Of Languages (jcl)
Technical methods in foreign language teaching as a new method in foreign language learning
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Unter dem Titel " Technische Methoden im Fremdsprachunterricht als eine neueste Methode im Fremdsprachlernen, die Spiele als Muster"

versteht man, dass die Forschung  sich mit einer neuen Methoden im Fremdsprachunterricht beschäftigt. Von den neuen Methoden im Unterricht sind die Spiele. So man sieht  in den letzten Jahren viele Artikel zum Thema Spiele im Fremdsprschunterricht. Davon gehen wir aus, dass die Spiele im Unterricht eine groβe Rolle spielt, denn diese Methode macht Lust, Spaβ im Lernenprozeβ. Die Spiele im Unterricht bezeichnen als ein Mittel, um Unterricht etwas Schönes , Nützliches und Lebendigs zu sein. Die Spiele sind vielfälltig und unterscheidet sich nach den Themen und Materialien. In dieser F

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Publication Date
Wed Jan 01 2020
Journal Name
Annals Of Tropical Medicine And Public Health
Serum Adropin and Apelin as Potential Markers PredictingAcute Heart Failure-associated Renal Dysfunction among Elderly Iraqi Patients
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