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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
Wed Aug 30 2023
Journal Name
Baghdad Science Journal
Biochemical Action of Vaccines in Iraqi Patients with COVID-19 Infection
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      The aim of the present study is to compare the biochemical action of the three vaccines taken in Iraq: Pfizer Biontech, AstraZeneca Oxford and Sinopharm based on biochemical parameters. Seventy COVID-19 Iraqi patients ( males and females ) were participated in the present study and classified into 7 groups : Gc :  COVID-19 patients ( without vaccine ) , Gp1: COVID-19 patients took one dose of Pfizer Biontech, Gp2 : COVID-19 patients took two doses of Pfizer Biontech, Ga1 : patients took one dose of AstraZeneca Oxford vaccine , Ga2: patients took two doses of AstraZeneca Oxford vaccine , Gs1 : patients took one dose of Sinopharm vaccine and Gs2:

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
A Spotlight on the Experience of E-learning as a Learning Method for the Undergraduate Pediatric Nursing Students in Iraq during the COVID-19 Pandemic
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    The emergence of COVID-19 has resulted in an unprecedented escalation in different aspects of human activities, including medical education. Students and educators across academic institutions have confronted various challenges in following the guidelines of protection against the disease on one hand and accomplishing learning curricula on the other hand. In this short view, we presented our experience in implementing e-learning to the undergraduate nursing students during the present COVID-19 pandemic emphasizing the learning content, barriers, and feedback of students and educators. We hope that this view will trigger the preparedness of nursing faculties in Iraq to deal with this new modality of learning and improve it should t

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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Engineering
Estimation of Surface Runoff to Bahr AL-Najaf
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The estimation of the amounts of Surface runoff resulting from rainfall in the water basins is of great importance in water resources management. The study area (Bahr Al-Najaf) is located on the western edge of the plateau and the southwestern part of the city center of Najaf, with an area of 2729.4 (km2). The soil and water assessment tool (SWAT) with ArcGIS software was used to simulate the runoff coming from the three main valleys (Kharr (A and B)), Shoaib Al-Rahimawi, and Maleh), that contribute the flow to the study area. The results of the model showed that the SWAT software was successfully simulating the flow conditions based on the coefficient of determination (R2), the Nash coefficient (NS

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Publication Date
Thu Feb 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Cost-effectiveness Analysis of Reference Infliximab (Remicade) Compared to its Biosimilar (Remsima) in Iraqi Patients with Rheumatoid Arthritis (Conference Paper )#
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The study objective was to conduct Pharmacoeconomics study (cost-effective analysis) between infliximab reference (Remicade) and its biosimilar (Remsima) in patients with rheumatoid arthritis (RA) in Iraqi hospitals.

This is a retrospective multicenter pharmacoeconomic analysis conducted at two large teaching governmental hospitals in Baghdad, Iraq which provided infliximab to patients with RA. Data were collected from patient’s medical records and face-to-face interviews with the patients from December 2021 to April 2022.

The study included 57 patients with rheumatoid arthritis (RA).  The patients were categorized into two groups according to the type of infliximab they received over 30 weeks: 27 patients received

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Publication Date
Mon Jan 02 2023
Journal Name
International Journal Of Nonlinear Analysis And Applications
Diagnostic COVID-19 based on chest imaging of COVID-19: A survey
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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Instructional Health Educational Vascular Access on Hemodialysis Patients' Knowledge at Al-Hussein Teaching Hospital in AL-Nasiriyah City.
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Objectives: The study aims: (1) To determine effectiveness of instructional health education vascular access on hemodialysis patients' knowledge, (2) To find out the association between effects of instructional health education vascular access and demographic characteristics of (age, gender and educational level). Methodology: A quasi experimental study –control study design is carried out at AL-Hussein Teaching Hospital in AL-Nasiriyah City, from 3November,2015 to 2 June, 2016. A non-probability (Purposive sample) of (80) patients with vascular access devices on maintenance hemodialysis patients divided int

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Clinical Analysis of Four Maternity Deaths in Iraq by COVID-19
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This study aims to identify maternal death cases caused by Coronavirus infection 2019 pneumonia, including disease progression, fetal consequences, and the fatality cause.

Patients and methodology: A retrospective case collection of Iraqi pregnant women in their second and third trimesters diagnosed with COVID-19 pneumonia and died due to it.

The four cases were all of a young age, had a brief complaint period, and had no comorbidities. Fever, dyspnea, and fatigue were the most common symptoms. Hypoxia was present in all cases and was the cause of mortality in three cases, with thromboembolism being a potential cause in the fourth. Prelabour membrane breakup, fetal growth restriction, and fetal death are al

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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
Study the infection with intestinal protozoa Entamoeba histolytica and Giardia lamblia among Patients who attending Bint Al- Huda for maternity and children hospital and Al hussin hospital in Nassriyia city in Thi-Qar province
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The aims of this study the infection with parasites Entamoeba histolytica and Giardia lamblia and prevalence rates and their relationship with gende , age group , the number of family members and source of drinking water among the patients at attending the Bint Al Huda and Al- Hussin Teaching hospital in Nassriyia city in Thi- Qar province , it was noticed that the percentage of parasitic infection at females was 38.55% and at males was 61.45% and the percentage of parasitic infection with Entamoeba histolytica 97% was higher than the percentage of parasitic infection with Giardia lamblia 3%,and the reduction of percentage of infection is associated with increasing of the number of family member ,the percentage of infection was 49% at the

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Publication Date
Thu Jun 01 2023
Journal Name
Ifip Advances In Information And Communication Technology
Rapid Thrombogenesis Prediction in Covid-19 Patients Using Machine Learning
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Machine Learning (ML) algorithms are increasingly being utilized in the medical field to manage and diagnose diseases, leading to improved patient treatment and disease management. Several recent studies have found that Covid-19 patients have a higher incidence of blood clots, and understanding the pathological pathways that lead to blood clot formation (thrombogenesis) is critical. Current methods of reporting thrombogenesis-related fluid dynamic metrics for patient-specific anatomies are based on computational fluid dynamics (CFD) analysis, which can take weeks to months for a single patient. In this paper, we propose a ML-based method for rapid thrombogenesis prediction in the carotid artery of Covid-19 patients. Our proposed system aims

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Publication Date
Fri Dec 23 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Descriptive, Prospective Observational Study- Studying Possible Prediction Factors for Disease Severity and Progression among a Sample of COVD 19 Patients in Iraq
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Abstract

Coronavirus has affected many people around the world and caused an increase in the number of hospitalized patients and deaths. The prediction factor may help the physician to classify whether the patient needs more medical attention to decrease mortality and worsening of symptoms. We aimed to study the possible relationship between C reactive protein level and the severity of symptoms and its effect on the prognosis of the disease. And determine patients who require closer respiratory monitoring and more aggressive supportive therapies to avoid poor prognosis. The data was gathered using medical record data, the patient's medical history, and the onset of symptoms, as well as a blood sample to test the

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