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bijps-1538
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
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Analytical Potentiality of Computer - Controlled Background Correction with Electrothermal Atomic Emission Spectrometry : Determination of Copper in Milk Powder
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A fully automatic electrothermal atomic emission spectrometry (ETA-AES) is described. This system is based on an echelle monochromator modified for wave¬length modulation which is completely controlled by microcomputer . The advantages of the system in atomic spectrometry have been discussed . Aspects of the analytical performances such as calibration ? dection limit, precision , and recovery for copper are considered . This system is applied for routine determination of copper in commercial powdered mill? by slurr>' atomization versus aqueous atomization techniques.

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Sun Jan 01 2023
Journal Name
Journal Of Indian Academy Of Oral Medicine And Radiology
The Degenerative Condylar Change in Temporomandibular Joint Disorder of Iraqi Population and their Variability Based on Clinical Diagnosis
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Background: As a multifactorial disorder, temporomandibular joint (TMD) is difficult to diagnose, and multiple factors affect the joint and cause the temporomandibular disorder. Standardization of clinical diagnosis of TMD should be used to reach a definite clinical diagnosis; the condylar bone may degenerate in accordance with these disorders. Aims: Evaluate the correlation between the clinical diagnosis and degenerative condylar change (flattening, sclerosis, erosion, and osteophyte). Materials and Methods: A prospective study with a study group of 97 TMD patients (total of 194 joints) aged 20 to 50. Patients were sent to cone beam computed tomography (CBCT) to assess the degenerative condylar change. Results: No association was found bet

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Publication Date
Sun Feb 08 2026
Journal Name
Journal Of The College Of Basic Education
The impact of compound exercises in the development of some of the skills of the players football halls
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Wed Nov 01 2023
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Neuroprotective effects of daidzein against ifosfamide-induced neurotoxicity in male rats: role of selected inflammatory and apoptotic markers
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Thu Nov 01 2018
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Publication Date
Wed May 29 2019
Journal Name
Iraqi Journal Of Physics
Analysis the effect of economic conditions on the vegetative change in Baghdad using GIS and remote sensing techniques
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The study of vegetative change of cities is one of the most important studies related to human life because of its direct correlation with the temporal conditions that occur. These include the economic problems that force people to move and look for job opportunities in the city, which leads to an increase in the population density of cities, especially for cities with an important economic and administrative location as in the capital city of Baghdad. In this study, the effect of the increasing in population density was analyzed on the urban planning of Baghdad city. The decreasing in vegetation was due to the increasing of urban areas on the outskirts of the city, which led to an increase in its area. Moreover, urban cities increased t

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Wed Jan 02 2019
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Methods of Teaching Conversation in Russian Students Speaking Arabic: Методы преподавания говорения на русском языке в арабской аудитории
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Publication Date
Thu Mar 15 2018
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The Role of Cone Beam Computed Tomography in Determination of the Greater Palatine Foramen Position Among Iraqi Population
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Background: The use of the cone beam computed tomography for analysing the position of the greater palatine foramen in relation to various anatomical landmarks is crucial in dentistry. The aims of the current study, firstly is to determine the greater palatine foramen position in relation to various anatomical landmarks by using cone beam computed tomography and secondly is to make a comparison of the measurements according to side, gender, and age. Materials and methods: This prospective study included 60 Iraqi patients (28males and 32 females) who selected according to availability of Inclusion criteria, which include age range (21 - 60 years), with no dentofacial deformities or pathological lesion at the maxilla. All patients had inform

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Fri Jan 11 2019
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Determination the concentrations of radon gas and exhalation rate in some phosphate fertilizer using CR-39 track detector
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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Nurses- midwives' Knowledge about Pain Management during Labor in Baghdad Maternity Hospitals
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Objectives: To assess nurses-midwives' knowledge about pain management during labor before and after implementation of educational program and to determine the effectiveness of educational program on nurses-midwives' knowledge about pain management during labor in Baghdad Maternity Hospitals.

Methodology: A quasi-experimental design has been conducted during the period of (February 27th 2019 through 2nd June 2019) on non-probability sample (purposive) consists of (44 Nurses/midwives') who are work in delivery room, the sample was exposed to pretest, educational program, posttest. The study was conducted in three Directories, (Baghdad Teaching Hospital) at medical city health

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