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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
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of some robust methods in the presence of problems of multicollinearity and high leverage points
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The multiple linear regression model of the important regression models used in the analysis for different fields of science Such as business, economics, medicine and social sciences high in data has undesirable effects on analysis results . The multicollinearity is a major problem in multiple linear regression. In its simplest state, it leads to the departure of the model parameter that is capable of its scientific properties, Also there is an important problem in regression analysis is the presence of high leverage points in the data have undesirable effects on the results of the analysis , In this research , we present some of

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Publication Date
Mon Jul 25 2022
Journal Name
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Sequencing of ca-int-l gene of Candida Spp. In infected urinary tract among Iraqi women
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The most common nosocomial fungal infection in hospitals is urinary tract candidiasis. Candida albicans is the most prevalent cause of nosocomial fungal urinary tract infections, however Candida species distribution is changing rapidly. At the same time, the rise in urinary tract candidiasis has resulted in the emergence of antifungal-resistant Candida species. This study aimed to diagnose Candida Spp. In women with UTI and reveal the nucleotides sequences of CA-INT-L Gene to look for mutation within the gene. This study included 100 women patients suffering from urinary tract infections and vaginal swabs samples from those individuals were taken to identify the presence of Candida. They were between the ages of 22 and 67. Candida i

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Fri Jun 30 2023
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Bestiality and the Deconstruction of Family Cohesion in Edward Albee's The Goat or, Who Is Sylvia?
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Publication Date
Mon Mar 01 2021
Journal Name
Iraqi Journal Of Physics
The Toxic Effect of Pb Nanoparticles Prepared by Laser ablation on Some Biochemical Aspects in Rats
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This work aimed to prepare and study the characteristic feature of lead nanoparticles (PbNPS) and follow its effects on some physiological aspects in rats.PbNPS was prepared by laser ablation of pure lead mass with a pulse of 500 and 100 mJ of energy. The results indicated that the wavelength was approximately 196 and the concentration was reported at 53,8967 mg / L. AFM, as the average diameter has been estimated at 69.93 nm. EFSEM shows the spherical shape of the particle.The experimental animals (rats) were divided into two groups, with seven rats for each one. The first group was a control and the second group was injected with 1 milliliter of PbNPS (53.8673 mg/l) per day for 45 days. Bioaccumulated lead ( in liver, spleen kidney and

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Problems lead to the low level of academic achievement in the evening school: suggestions and solutions
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Academic achievement is a professional standard for measuring student levels in the first stages. Therefore, any indication of the level of achievement makes us in an attempt to employ students in evening schools. The researcher has developed a closed questionnaire of (36) paragraphs. A total of (164) male and (24) female students were chosen from evening schools. The result of this research revealed that the number of students was a reason for the low level of their achievement, the lack of laboratories, educational methods, and techniques of the most prominent problems confirmed by students in these schools. In addition, to support educational institutions with their necessary needs. The most important conclusion in this research is th

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Publication Date
Sat Aug 25 2012
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The effect of utilization of parsley (Petroselinum crispum) in local Iraqi geese diets on blood biochemistry
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This experiment was conducted to study the effect of feeding diets containing different levels of parsley on the blood biochemical characteristics of local Iraqi geese. A total of twenty-four local geese, one year old, were used in this experiment during the period from the beginning of October to the end of December. The birds were allocated for Four treatment groups consisted of six geese each. Treatment groups were as follows: Control diet (T1) (free from parsley), T2: Control diet + 80 g / d parsley, T3: Control diet + 160 g / d parsley; T4: Control diet + 240 g / d parsley. At the end of experiment, blood samples were obtained from all geese by venipuncture from brachial vein and blood plasma samples were prepared. Blood biochemical tr

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Sun Oct 21 2018
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Al-kindy College Medical Journal
Biochemical Risk Determinants of Osteoporosis in Overweight and Obese Postmenopausal Women with Type 2 Diabetes Mellitus
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Background: Several studies suggested that skeletal system is adversely affected by diabetes and is associated with increased risk of osteoporosis and fragility fractures  

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Type of the study: Cross- sectional study.

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Publication Date
Wed Apr 01 2015
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The effect of Constructive Conflict on the Organizational Identification Applied Research in the Ministry of Planning
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Publication Date
Mon Dec 01 2014
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The use of value chain analysis of information in determining the most important the accounting information
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Publication Date
Thu Dec 01 2011
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The effect of organizational learning dimensions on availability of learning organization dimensions in Iraqi planning ministry
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The aim of this research to study.

The dimensions of organizational learning have been defined(learning dynamics, individuals empowerment, knowledge management and technology application) as well as the dimensions of learning organization have been defined (culture values, knowledge transfer, communication and employee characteristics), Asset completion questionnaire was used to collect data of this research from a purposely sample represent forty employees who works in Iraqi Planning Ministry at different positions. The research divided to four parts :

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