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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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Mon Jul 05 2010
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Evolutionary Algorithms
Variants of Hybrid Genetic Algorithms for Optimizing Likelihood ARMA Model Function and Many of Problems
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Optimization is essentially the art, science and mathematics of choosing the best among a given set of finite or infinite alternatives. Though currently optimization is an interdisciplinary subject cutting through the boundaries of mathematics, economics, engineering, natural sciences, and many other fields of human Endeavour it had its root in antiquity. In modern day language the problem mathematically is as follows - Among all closed curves of a given length find the one that closes maximum area. This is called the Isoperimetric problem. This problem is now mentioned in a regular fashion in any course in the Calculus of Variations. However, most problems of antiquity came from geometry and since there were no general methods to solve suc

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Thu Dec 01 2022
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The primary components of successful engineering projects are time, cost, and quality. The use of the ring footing ensures the presence of these elements. This investigation aims to find the optimum number of geogrid reinforcement layers under ring footing subjected to inclined loading. For this purpose, experimental models were used. The parameters were studied to find the optimum geogrid layers number, including the optimum geogrid layers spacing and the optimum geogrid layers number. The optimum geogrid layers spacing value is 0.5B. And as the load inclination angle increased, the tilting and the tilting improvement percent for the load inclination angles (5°,10°,15°) are (40%,28%, and 5%) respectively. The reduction percent of the

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Publication Date
Thu Jul 20 2023
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Applying Ensemble Classifier, K-Nearest Neighbor and Decision Tree for Predicting Oral Reading Rate Levels
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For many years, reading rate as word correct per minute (WCPM) has been investigated by many researchers as an indicator of learners’ level of oral reading speed, accuracy, and comprehension. The aim of the study is to predict the levels of WCPM using three machine learning algorithms which are Ensemble Classifier (EC), Decision Tree (DT), and K- Nearest Neighbor (KNN). The data of this study were collected from 100 Kurdish EFL students in the 2nd-year, English language department, at the University of Duhok in 2021. The outcomes showed that the ensemble classifier (EC) obtained the highest accuracy of testing results with a value of 94%. Also, EC recorded the highest precision, recall, and F1 scores with values of 0.92 for

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A load flow program is developed using MATLAB and based on the Newton–Raphson method,which shows very fast and efficient rate of convergence as well as computationally the proposed method is very efficient and it requires less computer memory through the use of sparsing method and other methods in programming to accelerate the run speed to be near the real time.
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Publication Date
Wed May 10 2023
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The effect of urban obsolescence on the quality of the built environment for historical quarters
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Publication Date
Sat Jul 28 2018
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Experimental Investigation for the Removal of Toxic Gases from Vehicle Exhaust using Non-Thermal Plasma
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In this study, the use of non-thermal plasma theory to remove toxic gases emitted from a vehicle was experimentally investigated. A non-thermal plasma reactor was constructed in the form of a cylindrical tube made of Pyrex glass. Two stainless steel rods were placed inside the tube to generate electric discharge and plasma condition, by connecting with a high voltage power supply (up to 40 kV). The reactor was used to remove the contaminants of a 1.25-liter 4-cylinder engine at ambient conditions. Several tests have been carried out for a ranging speed from 750 to 4,500 rpm of the engine and varying voltages from 0 to 32 kV. The gases entering the reactor were examined by a gas analyzer and the gases concentration ratio

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Sat Feb 01 2020
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Using GIS Technique for evaluating water quality of Abu Zarag marsh during the flood season
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Wed Jul 12 2017
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Mon Oct 01 2018
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