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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
Wed Feb 20 2019
Journal Name
Political Sciences Journal
American hegemony over the Persian Gulf oil After the 1991 Gulf War and the Gulf War III in 2003
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Since the end of World War II, the United States of America began to look at the Gulf States and Iraq due to the possession of huge quantities of oil, after taking the American oil depletion in order to tighten control over the oil of these countries, has pursued various means, political and military, in the framework of its strategy So that it could achieve this control, which focused on control of production and prices, for the conviction that those who control oil impose control over the political decision of the countries of the world.

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Mon Apr 03 2023
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The Effectiveness of Using Cubing Technique in the Iraqi EFL Secondary Students' Composition Writing, Vocabulary, and Meta-Cognitive Awareness
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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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Wed Dec 30 2015
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College Of Islamic Sciences
The Jews of the East in the journey of Benjamin and the Andalusian Alttali (d. 586 AH): (دراسة تحليلية)
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Publication Date
Wed May 01 2019
Journal Name
The Journal Of Immunology
Protective effect of resveratrol on the integrity of alveolar and intestinal epithelial barrier in SEB-induced acute lung injury
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Evaluating the Effectiveness of Using the Kinesthetic Teaching Style by Basketball Instructors in Practical Lessons from the Students' Perspective
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Advancements and modernizations introduced into the educational and pedagogical systems have significantly impacted teaching processes and how subjects are presented and explained to students. The focus has shifted to how learners interact with the material they need to learn, providing sufficient opportunities for learning and granting them freedom and self-confidence to achieve learning objectives. The research problem stems from the researcher's experience as a lecturer in the College of Physical Education and Sports Science, particularly in teaching basketball. She observed that some instructors were deficient in using the most effective teaching methods. The researcher formulated her research question based on these observations: "What

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Publication Date
Sun Jan 01 2023
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Rock facies classification and its effect on the estimation of original oil in place based on petrophysical properties data
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The most significant function in oil exploration is determining the reservoir facies, which are based mostly on the primary features of rocks. Porosity, water saturation, and shale volume as well as sonic log and Bulk density are the types of input data utilized in Interactive Petrophysics software to compute rock facies. These data are used to create 15 clusters and four groups of rock facies. Furthermore, the accurate matching between core and well-log data is established by the neural network technique. In the current study, to evaluate the applicability of the cluster analysis approach, the result of rock facies from 29 wells derived from cluster analysis were utilized to redistribute the petrophysical properties for six units of Mishri

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Wed Jul 13 2011
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Synthesis of PEG 200-Di- Acetate ant Its Influence on the Viscosity of PEG 4000 in Different Organic Solvents
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Fri Jan 01 2016
Journal Name
Journal Of The College Of Languages (jcl)
תאור השטטל ביצירות סופרים עבריים מאת עוזר לפרופ. עדנאן שביב ג'אסם Description of Shtetl in Works of Hebrew writers
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מחקר זה עוסק בנושא (העיירה היהודית) שטטל ביצירותיהם של שני סופרים עבריים שהתמקדו בביקורת בשטטל. וזה נחשב להגבלה או למכשול לפיתוחם של היהודים, אז זה התרחש ביצירותיהם והם נתנו תשומת לב רבה לזה –לפי דעתם- גם זה נחשב להיבט בהיסטוריה והחיים של היהודים באירופה.

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Publication Date
Mon Jan 01 2024
Journal Name
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Synthesis, Characterization and Anticancer Activity of Chitosan Schiff Base / PVP Gold Nano Composite in Treating Esophageal Cancer Cell Line
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The Contribution of Design Thinking to Reducing Excessive Sensitivity to Criticism Among Athletes in Selected Track and Field Events
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