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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
Thu Sep 01 2016
Journal Name
Injury Prevention
972 The effectiveness of injury prevention program on reducing the incidence of lower limb injuries in adolescent male soccer players
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The highest incidence of injury is seen in adolescent playing pivoting sports such as soccer, basketball, and handball. Objective: To examine the effectiveness of a neuromuscular prevention program in reducing knee and ankle injuries in adolescent male soccer players.

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Publication Date
Thu Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
The personality of the woman and her role in the products of Agnon: דמותה ותפקידה של האישה ביצירותיו של עגנון
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  Shmuel Yosef Agnon, a well-known Jewish writer, wrote many literary works, including poetry, story, etc. In the field of story, this writer used two areas: the first: a simple exterior, and the second: an inner full of secrets and mysteries. This area is common when Agnon is affected by his symbolic method of purpose. In his productions, we find the political and historical significance embodied in his characters, where there is almost no story without it.

    Agnon and all his productions gave the character a large area, Agnon’s characters often play the center and cornerstone in those productions, where the author dealt deeply and stated the fines details of the external and internal of that ch

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Publication Date
Sun Jun 02 2013
Journal Name
Baghdad Science Journal
Extraction and Determination of Amygdaline in Iraqi Plant Seeds Using the Combined Simple Extraction Procedure and High-Performance Liquid Chromatography
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Abstract :In this study, amygdaline in Iraqi plant seeds was extracted and isolated from their seeds matrix using reflux procedure and subsequently identified and determined by high performance liquid chromatography (HPLC) on reversed phase column of LC-18 (150mm x 4.6mm, 5?m )with actonitrile :water ( 50 : 50 ) as mobile phase at flow rate of ( 0.5 mL/min ) and detection at wavelength of 215 nm.The experimental results indicated that the linearity of calibration is in the range of 1.0-30.0 mg L-1amygdaline with the correlation coefficient of 0.9949. The limit of detection (LOD) and limit of quantitation (LOQ) for amygdaline were of 0.88 and 2.93 mg L-1 in standard pure sample. The mean recovery percent is 97.34±0.58 at 95% confidence inte

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of The College Of Languages (jcl)
EL ULTRAÍSMO EN LA POESÍA ESPAÑOLA: SU APARICIÓN Y SUS RASGOS THE ULTRAISM IN SPANISH POETRY: IT'S APPEARANCE AND CHARACTERISTICS
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Resumen

 

     El Ultraísmo es un movimiento literario que comenzó en España a finales de 1918 y continuó hasta el año 1922. Este movimiento, que representó la contribución de España al Vanguardismo literario, que en la primera parte del siglo XX surgió en toda Europa, se desarrolló no tanto a través de los libros, cuanta a través de las revistas literarias de la época.

 

La creacionista es, sin duda, la escuela que dio a Ultra mayores aportes. Por esta razón, en las literaturas de Vanguardia se funden, y a veces también se confunden, con frecuencia, Ultraísmo y Creacionismo. Los dos movimientos eran como una revo

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Educational And Psychological Researches
The Attitudes of School Teachers and Principals at Regular Government Basic Schools toward Inclusion of Disabled Students in Ajloun Governorate
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This study aimed to identify the attitudes of school teachers and principals at basic government schools in Ajloun governorate towards the inclusion of disabled students at basic schools, and investigate how they will accept the merger. To achieve the purpose of this study, a questionnaire containing 35 items was administered to school teachers and principals to measure their attitudes toward the inclusion of disabled students in regular schools. The sample of this study consisted of 43 male teachers and (74) female teachers and principals. The frequency, normal distribution, arithmetic means and t-test were used to analyze the data of present study.          The findings showed that there

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Publication Date
Tue Aug 23 2022
Journal Name
International Journal Of Health Sciences
Effect of Using Fryer strategy on the achievement and systemic thinking of intermediate second class students in the chemistry subject.
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The objective of this research is to identify the effect of Using Fryer strategy on achievement and systemic thinking in the subject of chemistry of second class intermediate school students. The sample of research consisted of 59 students in one intermediate school in Baghdad/Iraq, split into two groups; experimental and control. The scientific material of the study is related to Chapters II and III of the Science Book for the second Intermediate School for the Year (2019-2020). The scientific test is composed of 25 test items whilst the second instrument for research related to systematic thinking test consisted of 12 items. The results of the research showed that the use of Fryer's chemistry-teaching strategy has increased achieve

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Idea Filtering Strategy on the Achievement of the Second Year Middle School Female Students in Science
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Abstract

The current research aims to identify the effect of the idea filtering strategy on the achievement of second-intermediate school female students in science. The two researchers adopted the experimental method and the experimental design with partial control in the two groups (experimental group and control group). The two researchers applied the research experience to a sample of students of the second intermediate grade in the school Martyrs of (Jiser  Al Aimma for Girls) affiliated with the Baghdad Education Directorate / Rusafa /1 for the academic year (2021/2022), which was chosen intentionally. The number of female students in the research sample was (70) students, with (35) students for the ex

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Publication Date
Thu Aug 10 2017
Journal Name
Journal Of The College Of Basic Education
Detection of some major elements and protein in Fusarium wilt disease infected tomato(Lycopersicon esculentum) treated with Arbuscular mycorrhizal fung
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The present study was Conducted to evaluate the effect of amixture of three species of arbuscular mycorrhizal fungi ( Glomus etunicatum , G. leptotichum and Rhizophagus intraradices ) in Influence on the percentage of the components of NPK and protein of tomato leaves and roots infected with Fusarium oxysporum f.sp. Lycopersici wich cause Fusarial wilt disease , planted for 8 weeks in the presence of the organic matter ( peatmose) , using pot cultures in aplastic green house , Results indicated significant increase in the percentage of the elements of NK and protein of tomato leaves and roots In the control treatment (C), While the percentage of the element P was after infection with the pathogen 4 weaks after mycorrhizal colonization in al

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The impact of cognitive incompatibility schemes on the development of creative thinking skills in history subjects among first grade students
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The aim of this research is to find out the impact of cognitive incompatibility schemes on the development of creative thinking skills among first grade students.
To prove the objective of the research, the researcher put the following hypothesis:
There is no statistically significant difference at the level of (0.05) between the average score of the experimental group who study the history of ancient civilizations according to the patterns of cognitive conflict and the average grades of the control group students who study the same subject in the usual way in the test of post-creative thinking skill

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The use of multi choice Goal Programming to reduce storage and shortage costs of blood units in health care centers
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We use of multi-choice Goal Programming (MCGP), which is a developed model of Goal Programming where it is used in circumstances of the multiplicity and difference of goals when choosing between decision alternatives in cases of allocating resources, as it is a model that seeks to find the closest and best solutions to the specific values ​​of the goals within the aspiration levels, as the first goal in the multi-choice goal programming model that is used to reduce the total cost of storage and shortage, while the other goal was to reduce the difference between the real demand that the hospitals need from the blood transfusion center and the units that already achieved. The case Iraqi Center

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