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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 Sep 01 2010
Journal Name
Al-khwarizmi Engineering Journal
Prediction of the Scale Removal Rate in Heat Exchanger Piping System Using the Analogies between Mass and Momentum Transfer
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The possibility of predicting the mass transfer controlled CaCO3 scale removal   rate has been investigated.

Experiments were carried out using chelating agents as a cleaning solution at different time and Reynolds’s number. The results of CaCO3 scale removal or (mass transfer rate) (as it is the controlling process) are compared with proposed model of prandtl’s and Taylor particularly based on the concept of analogy among momentum and mass transfer.

Correlation for the variation of Sherwood number ( or mass transfer rate ) with Reynolds’s number have been obtained .

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of Educational And Psychological Researches
The impact of the model and follows on the collection and Retention of fifth grade students (oiterary) in history
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The first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He

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Publication Date
Fri Jan 01 2021
Journal Name
E3s Web Of Conferences
Experimental Investigation of Bearing Capacity of Screw Piles and Excess Porewater Pressure in Soft Clay under Static Axial Loading
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In this study, the behavior of screw piles models with continuous helix was studied by conducting laboratory experimental tests on a single screw pile that has several aspect ratios (L/D) under the influence of static axial compression loads. The screw piles were inserted in a soft soil that has a unit weight of 18.72 kN/m3 and moisture content of 30.19%. Also, the soil has a liquid limit of 55% and a plasticity index of 32%. A physical laboratory model was designed to investigate the ultimate compression capacity of the screw pile and measure the generated porewater pressure during the loading process. The bedding soil was prepared according to the field unit weight and moisture content and the failure load was assumed correspondin

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Using Cubing Technique in the Iraqi EFL Secondary Students' Composition Writing, Vocabulary, and Meta-Cognitive Awareness
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Abstract

The aim of this research is to determine how well the Cubing Technique affects the Iraqi EFL students' composition writing, vocabulary, and meta-cognitive awareness of writing strategies. The sample of (64) secondary-school female students in the fifth grade is drawn from two classrooms and split into two equal groups: the experimental group and the control group, each of which consists of (32) students. A quasi-experimental design is applied. The performance test and Meta-cognitive Writing Strategies questionnaire are given as a pre-test for equalizing the two groups after ensuring their validity and reliability. Then, they are administrated as a posttest in both groups. According to the results, the si

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
Verbal formulas in Turgut Özakman’s play Oh Those Young: Turgut Özakman'ın "Ah Şu Gençler" Başlıklı Tiyatrosunda Fiil Kiplerinin İncelenmesi
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  The study sheds lights on the simple verbal formulas with its particular time suffixes as found in the Turgut Özakman’s play These Crazy Turks.

     The introduction of the study sheds light on the life of the author and playwright, as well as traces the different types of the verbal formulas in Turkish language.

     Oh Those Young is one of the most significant products of the Turkish literature of the young and Children where the literary messages of the playwright are addressed in a simple comic sarcastic style. Hence, the play, that has been studied and acted by many students and academics, drives its importance from this particular course of action.

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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
The Level of Educational Supervisors' Practices of Their Supervisory Duties According to The Requirements of Comprehensive Quality in Oman
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The research aims to identify the level of educational supervisors' practices of their supervisory duties according to the requirements of comprehensive quality from the viewpoint of teachers in Oman. Moreover, identify the differences between the responses of the sample about these practices, which are attributed to gender, and years of experience. Thus, a questionnaire was administered to teachers, consisting of (48) items distributed on (5) main fields related to the educational supervisor's practices. The sample consisted of (220) teachers who were randomly chosen from the schools in Dhofar region. Data were analyzed using means, standard divisions, T-test, and One Way ANOVA. The research concluded that the level of educational super

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Publication Date
Wed Sep 20 2023
Journal Name
Journal Of Applied And Natural Science
Detection of some virulence genes (esp, agg, gelE, CylA) in Enterococcus faecalis isolated from different clinical cases at Baghdad
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The virulent genes are the key players in the ability of the bacterium to cause disease. The products of such genes that facilitate the successful colonization and survival of the bacterium in or cause damage to the host are pathogenicity determinants. This study aimed to investigate the prevalence of virulence factors (esp, agg, gelE, CylA) in E. faecalis isolated from diverse human clinical collected in Iraqi patient , as well as to assess their ability to form biofilm and to determine their haemolytic and gelatinase activities. Thirty-two isolates of bacteria Enterococcus faecalis were obtained, including 15 isolates (46.87%) of the urine, 6 isolates (18.75%) for each of the stool and uterine secretions, and 5 isolates (15.62%) of the wo

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Advanced Pharmacy Education And Research
Estimation of the healing effects of the topical use of MEBO and hyaluronic acid gel in the burned rats
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Exposing the dorsal superficial skin of rats to partial-depth burn leads to bacterial and microbes Invasion. Topical treatment is required in most superficial burn cases Moist exposed burn ointment (MEBO) protects wounds from infection and enhances healing without any harmful effects of purified chemicals is caused. The topical using of HA gel in rat models with full and partial thickness surgical wounds shows enhancement in wound repair. In this study, we compared the healing efficacy of topical use of hyaluronic acid gel products with MEBO as standard management in rats that were exposed to a partial-thickness burn. The experiment included twenty-four (24) adult albino rats of male sex with weight (150-220 gm) of 3 months’ age divided i

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Publication Date
Wed Jul 01 2015
Journal Name
Drug Design, Development And Therapy
Effect of Clausena excavata Burm. f. (Rutaceae) leaf&amp;nbsp;extract on wound healing and antioxidant activity in rats
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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Engineering
Investigation the Optimum Combined Dosages of Date Seeds Powder as Natural Coagulant with Chemical Coagulants in Domestic Wastewater Pretreatment
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The pretreatment process can be considered one of the important processes in wastewater treatment, especially coagulation process to decrease the strength of many pollutants. This paper focused on using powdered date seeds as natural coagulant in addition to chemical coagulants (alum and ferric chloride) to find the optimum dosage of each coagulant that makes efficient removal of turbidity and chemical oxygen demand (COD) from domestic wastewater as a pretreatment process, then finding the optimum combined dosages of date seeds with alum, date seeds with ferric chloride that make efficient removal for both pollutants. Concerning turbidity, the optimum dosage for date seeds, alum and ferric chloride were 40 mg/l (79%), 70

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