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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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Thu Feb 06 2014
Journal Name
2nd International Conference On Innovation And Entrepreneurship
Is the Organizational Performance of Small Businesses Influenced by HRM Practices and the Governmental Support? A Case of Small Manufacturing Businesses in Malaysia
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Publication Date
Fri Sep 30 2022
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Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of direct withholding tax procedures as a tool to increase tax proceeds : applied research in the General Tax Authority / Direct Deduction Department
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The research aims to evaluate the direct deduction department’s procedures for the process of collecting income tax using the direct deduction method for state departments and the public sector in light of direct deduction tax instructions No. (1) of 2007 and Income Tax Law No. (113) of 1982 (amended) through Giving a clear idea of ​​the reality of tax collection procedures because this type of tax is one of great importance because it contributes to the provision of financial revenues to the state to finance its expenses and direct the economy towards achieving its social, economic and political goals. The researcher makes comparisons between the procedures of the General Tax Authority in collecting the tax and what was approved b

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Tue Mar 01 2022
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Academy Of Accounting And Financial Studies Journal
Impact of Digital Audit on Improving performance Quality and Reduce Costs An applied research in a sample of private auditing firms and offices
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Wed May 01 2024
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Unlocking the Language of the Heart: A Stylistic Analysis of EmotiveTechniques in Paulo Coelho's By the River Piedra I Sat Down and Wept
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This paper presents an in-depth stylistic analysis of the linguistic artistry andliterary techniques employed by Paulo Coelho in his novel By the River Piedra ISat Down and Wept. A close reading approach guided by stylistics and linguisticsframeworks reveals Coelho's extensive incorporation of imaginative metaphors,vivid imagery, poetic diction, and resonant symbols across the narrative. Analysisspecifically elucidates how Coelho adeptly manipulates various stylistic features toconvey thematic content, shape characterization, and produce aesthetic impacts.Findings provide critical insights into Coelho’s linguistic mastery and contribute toresearch in stylistics and literary linguistics through rigorous examination of anentire contemporary

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Publication Date
Sun Oct 12 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Management of Independent Middle Mesial Canal in Mandibular First Molar Using Cone Beam Computed Tomography Imaging as an Adjunct – A Case Report
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The primary objective of root canal therapy is adequate biomechanical preparation of root canal system followed by 3D obturation.in clinics we are encountered with several anatomical variations, which we need to manage efficiently. One of the major factors responsible for failure of root canal therapy is missed canals. Recent technological advances have given the clinician opportunity to identify anatomical variations and treat them to satisfaction.

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Publication Date
Fri Jan 31 2025
Journal Name
Open Veterinary Journal
&lt;b&gt;Histopathological effects of repeated 14-day administration of rizatriptan benzoate in a nitroglycerin-induced migraine rabbit model&lt;/b&gt;
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Background: Migraine is one of multiple attack neurological conditions that causes moderate to severe headaches with no defined pathophysiology and few animal models. Aim: Establishing an animal model that reproduces migraine-like action is important in medical research to identify the mechanism underlying this disorder. Additionally, it facilitates the availability and reliability of new models that may act as human surrogate models. Method: Rabbits were divided into four groups. Negative group, migraine group, rizatriptan- nitroglycerin group, and rizatriptan group. The frequency of head scratching and the histopathological changes in the brain, liver, kidney, and heart for groups were evaluated in all groups. Results: T

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of The College Of Languages (jcl)
SER Y ESTAR EN LA ENSEÑANZA Y EL APRENDIZAJE DEL ELE Verb (to be) in Learning and Teaching Spanish as a Foreign Language
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Resumen

El presente trabajo nace de una inquietud por la enseñanza del español en Irak a nivel universitario especialmente ante las dificultades que los alumnos árabes en general, e iraquíes en particular, encuentran en su proceso de aprendizaje. Nuestra primera inclinación fue, pues, prestar una atención directa  y cercana al alumno como sujeto del aprendizaje, así como a lo que el alumno produce como resultado del mismo. En el presente trabajo pretendemos dotar al estudiante de los conocimientos lingüísticos necesarios para poder interaccionar en una variedad de situaciones y enfrentarse a problemas cotidianos, de manera que desarrolle las destrezas comunicativas que le permitan establecer una co

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Publication Date
Sun Dec 27 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Analysis of factors affecting the desire of the customer and their impact on the market share in a competitive market National Insurance Company
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The research aims to identify the factors affecting the customer and their impact desire for market share in a competitive market National Insurance Company, where he was after the tremendous developments that have taken place in the insurance sector, crowded markets, private companies and the intensified competition among those companies on one side and public sector companies, including national insurance company on the other hand, increased attention and study in a big way the customer and the factors influencing the desire. As the national insurance company ascertains its targets once the sale of insurance documents only, but by knowing the tendencies and aspirations of current and prospective customers a way that helps to strengthen

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Rational Emotional Behavioral Program in Developing Self-Efficacy to Reduce the Burnout among Teachers of Students with Autism Disorder
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The aim of this study is to identify the effectiveness of a rational, emotional, behavioral program in developing self-efficacy to reduce the level of Burnout in 20 teachers of students with autism disorder in Jazan, Saudi Arabia. The proposed program included 12 training sessions. The researcher found that the proposed program has contributed significantly to the development of self-efficacy and reduce the level of Burnout for the targeted subject in this study.

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Publication Date
Sun Dec 01 2019
Journal Name
Saudi Medical Journal
The diagnostic power of circulating micro ribonucleic acid 34a in combination with cancer antigen 15-3 as a potential biomarker of breast cancer
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