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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 Jan 02 2020
Journal Name
Journal Of The College Of Languages (jcl)
The theory of distortion and eradication in modern Zionist Hebrew literature: תיאוריית העיוות והחיסול בספרות העברית הציונית החדשה
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This title may have something strange or paradoxical; it is unusual or natural to look for violence in literature, or that literature is a tool for killing through the contribution of writers and poets in generating, feeding or advocating violence. The Zionist literature belongs to the 20th century, is almost the only literature among the etiquette of peoples, which professes racism and boasts of betraying its human role, and wants to be a vehicle for terrorism domination. It also tends to be a means in the hands of killers and adventurers.   Writers of this Literature show that no solution to the Jewish problem is only by Zionist presence to replace the Palestinian presence and to build the state of "Israel" on the ruins of Pa

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Publication Date
Sun Dec 03 2017
Journal Name
Baghdad Science Journal
Measurement of Indoor Radon Gas Concentration in same Region of Baghdad Governorate Using CR-39 Nuclear Track Detector
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In this research the activity of radon gas in air in Baghad governorate,Iraq, using “alpha-emitters track registration (CR-39) track detector were measured. This measurement was done for selected areas from Baghdad Governorate, The results obtained shows that the highest average concentrations for Rn-222 is (179.077 Bq/m^3) which was recorded within Al-Shaaib city and less average concentrations was (15.79 Bq/m^3) in the nearby residential area of Baghdad International Airport and the overall average concentrations is (86.508 Bq/m^3) for these regions. Then the radon concentration was measured annual effective dose calculated from radon concentration and found in range from 0.4031 mSv/y to 4.5179 mSv /y with an average value of 2.1824 m

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Publication Date
Tue Sep 01 2020
Journal Name
Ain Shams Engineering Journal
Estimating server utilization rate in single server queuing models using an approximate solution of stiff fluid flow model
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Publication Date
Tue Sep 15 2020
Journal Name
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The Directorship Vision in Epic Drama Shows " AWNI KROMI AS AN EXAMPLE": فرحان عمران موسى-مصطفى لطيف محسن
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  The theory of the epic theater has received wide attention by filmmakers around the world because of its great impact on the artistic work of the theater and its relationship with societies, and among these directors the Iraqi directors have been influenced by the epic theater and its applications in the show.
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Publication Date
Sun Feb 22 2026
Journal Name
Pakistan Journal Of Pharmaceutical Sciences
Optimization And Development Of Ondansetron HCl Nanocrystals By Using D-Optimal Design Expert® And In-Vitro Characterization
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Background: Over the last few years, nanocrystal technology has expanded to improve the bioavailability of poorly water-soluble drugs, which is challenging. Nanocrystals (NCs) exhibit many properties, such as enhancing drug solubility, dissolution, oral absorption, and high drug loading. Ondansetron hydrochloride (ONH) is an antiemetic drug that antagonizes a serotonin 5-HT3 receptor in the peripheral and central nervous system and is widely prescribed for the management of chemotherapy and radiotherapy-induced vomiting and nausea, as well as for postoperative nausea. ONH exhibits approximately 60% bioavailability due to its poor solubility and first-pass metabolism in the liver. Its solubility is pH-dependent, its precipitates abov

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Publication Date
Tue Jun 15 2021
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Graphic narrative and its semantic value in the designs of the incident of the Taff: رغد فتاح راضي
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The concept of narration stems from the connotation of continuous communication through which narration is manifested as a message that is exchanged between the sender and the recipient, and that narration is an educational conceptual necessity, representing the philosophy of intellectual inclusion achieved in a direct speech to the mind, but it is encapsulated in a colorful frame that attracts the soul and attracts attention, and the graphic narration is a speech A visual based on the basis of interference and sequence of the event in weaving the elements in a consensual way through a continuous communication process that begins with the embodiment of an event - an important event - to the recipient, in which an intellectual employment

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Publication Date
Sat Feb 29 2020
Journal Name
Utopía Y Praxis Latinoamericana
The Impact of Fishbone Strategy in the Achievement of Chemistry and Visual Thinking Among the Seven Grade Students
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e current research aims to know the effect of fishbone strategy on achievement of chemistry and visual thinking among middle school students, the research sample consisted of 89 students divided into two experimental groups consisting of 44 students who studied fishbone strategy, and a control group that consisted of 45. A student studied in the usual way; the two groups were rewarded in a number of variables, and the researcher built two tools for the research: the first is an achievement test consisting in 30 paragraphs, and the second is a visual thinking test consisting in 18 paragraphs. Keywords: Chemistry, fishbone, seven grade, students, visual thinking..

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Sun Jun 06 2010
Journal Name
Baghdad Science Journal
Effect of the aqueous extract of Banana Fruits Peal Musa paradisiaca on Mitosis in Plant and Mammalian cells
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The aqueous extract of banana fruits peal was tested for its effect on mitosis . The root tips of Allium cepa were used as plant test system and the bone marrow cells of the albino mice Mus musculus were used as mammalians test system in vivo .Root tips of Allium cepa were treated for four hours with five concentrations of the extract (5 , 10 , 20 , 40 ,60 mg / ml.).The Metaphase was arrested in all the treatments , the highest percentage ( 100 % ) was recorded in the first concentration , the last concentration caused stickiness and clumping of the chromosomes. The treatments did not cause significant difference in the mitotic index. The peals extract (5 mg /ml) was compared with the extracts of fruits bulb, leaves and roots of

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of applying assurance engagements according to the international standard IASE (3402) in enhancing the auditing action
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Abstract:
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Publication Date
Mon Oct 07 2024
Journal Name
F1000research
Oral pre-treatment with Citronellol ameliorates Methotrexate-induced nephrotoxicity in Wistar rats via targeting oxidative stress and inflammation
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Background Methotrexate (MTX) is a classical folic acid antagonist widely used in the treatment of malignant and non-malignant disorders. However, its clinical application is often restricted by concomitant adverse effects, including renal damage. Numerous studies have highlighted the role of oxidative stress and inflammation in mediating MTX-related nephrotoxicity. Therefore, the current study aimed to explore the possible renoprotective action of Citronellol (CT), a natural compound with prominent antioxidant and anti-inflammatory activities, against nephrotoxicity induced by MTX. Methods To fulfill our objective, 24 adult male Wistar rats were randomly allocated into four groups: control, MTX, 100 mg/kg CT plus MTX and 200 mg/kg C

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