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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
Mon May 27 2019
Journal Name
Al-academy
Revival of the Heritage Using Porcelain Units Inspired by Traditional Sadou Decoration and Kufic Calligraphy in Fashion Design: تهاني ناصر العجاجي ---وجدان محمد الفليج
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The purpose of this research is to identify heritage and highlight its value by drawing on its decorative vocabulary and integrating it with the Arabic calligraphy to revive the heritage in a contemporary style, and to create decorative design units inspired by Sadou and Arabic calligraphy and to employ them in the modern fashion designs. The applied descriptive approach has been used in this research, and the research community is made of women in Riyadh area. The tools used in this research were the questionnaire and the observation. The most important results of the research are: the design of decorative units from the integration of Arabic calligraphy and the decorations of the Saduo, and the use of these units in the design of the o

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
The Literary Style of Ali Baba Chahi’s collected poems In Caves full of Daffodils: سبک ادبی مجموعه شعری «درغارهای پر از نرگس» علی باباچاهی
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Post Modern Persian poetry that is rich with visions and creations has slowly but firmly regained its statues in modern Persian literature and poetry. Ali Baba Chahi is considered one of Iran’s most prominent postmodern and post-Nimaie writer and poet.

     The present paper discusses the general style characteristics as well as the distinctive stylistic creations of Ali Baba Chahi as presented in his collected poems In Caves full of Daffodils.

      In conclusion, the study crystallizes some of the stylistic characteristics of Ali Baba Chahi as a leading figure in postmodern poetry. The study, also, provides a comprehensive critical analysis of the collection of

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Publication Date
Thu Apr 01 2021
Journal Name
Biochemical & Cellular Archives
Impacts of Starvation Stress on Biofilm Formation and expression of Virulence Genes in Mono-and Mixed-species cultures of Pseudomonas Aeruginosa and Staphylococcus aureus
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Staphylococcus aureus and Pseudomonas aeruginosa are the major globally distributed pathogens, which causes chronic and recalcitrant infections due to their capacity to produce biofilms in large part. Biofilm production represents a survival strategy in these species, allowing them to endure environmental stress by altering their gene expression to match their own survival needs. In this study, we co-cultured different clinical isolates of S. aureus and P. aeruginosa as mono- and mixed-species biofilms in a full-strength Brain Heart Infusion Broth (BHI) and in a 1000-fold diluted Brain Heart Infusion Broth (BHI/1000) using Microtiter plate assay and determination of colony-forming units. Furthermore, the effect of starvation stress on the e

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Level of Availability of Written Expression Skills Mentioned in the Arabic Language Curriculum Document Middle School Students from the Teachers' Point of View
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Abstract

The aim of the current research is to identify the level of availability of written expression skills included in the Arabic language curriculum document among middle school students from the teachers' point of view. The researcher used the descriptive approach. To analyze the data and access the research results, he used the (SPSS) program. The research was conducted during the first semester of the academic year 1442/1443 AH on a random sample of Arabic language teachers in the Bisha Education Department. They reached about (213) male and female teachers. The results revealed a number of indicators: the level of availability of written expression skills among middle school students in Bisha governorate

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Publication Date
Sat Mar 28 2026
Journal Name
Journal Of Physical Education
The relationship between decision-making time and accuracy of jump shooting among students at the college of physical education and Sports Sciences in handball
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The study aimed to analyze the nature of the relationship between decision-making time and the accuracy of shooting by jumping among handball players who are students of the fourth stage at the College of Physical Education and Sport Sciences to reveal the extent to which cognitive-motor ability contributes to improving offensive skill performance. The study adopted a descriptive approach using the method of relational relationships, and 20 players who were selected deliberately participated. The study used a reaction time system to measure decision time, as well as test the accuracy of shooting from jumping from three specific points within the attack area. The results showed that the Arithmetic mean decision time was 0.828 seconds

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Publication Date
Tue Mar 15 2016
Journal Name
Hepatology
Carboxylesterase 2 prevents liver steatosis by modulating lipolysis, endoplasmic reticulum stress, and lipogenesis and is regulated by hepatocyte nuclear factor 4 alpha in mice
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Nonalcoholic fatty liver disease (NAFLD) is a common liver disease that ranges from simple steatosis to nonalcoholic steatohepatitis (NASH). So far, the underlying mechanism remains poorly understood. Here, we show that hepatic carboxylesterase 2 (CES2) is markedly reduced in NASH patients, diabetic db/db mice, and high‐fat diet (HFD)‐fed mice. Restoration of hepatic CES2 expression in db/db or HFD‐fed mice markedly ameliorates liver steatosis and insulin resistance. In contrast, knockdown of hepatic CES2 causes liver steatosis and damage in chow‐ or Western diet‐fe

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Publication Date
Sun May 02 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The extent of adopting the dimensions of the Blue Ocean Strategy and its impact in the market share: بحث استطلاعي في شركة الحمراء للتأمين
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With the increase in competition between insurance companies in addition to the increasing numbers in the number of insurance companies, whose number decreased to (32) private companies until the end of the year (2020). The blue ocean at the level and its effects on increasing the market share. Therefore, the two researchers tested the hypothesis and the research concluded that there is a relationship A .Also the researcher put some recommendations the most prominent is that the invention is considered one of the successful strategies an d the company has to encourage the employees according to inventive thoughts

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Publication Date
Tue Aug 01 2023
Journal Name
Nauchforum
COGNITIVE ELEMENTS AND CRITERIA OF THE INFLECTIONAL SYSTEM OF RUSSIAN AND ARABIC LANGUAGUES IN THE PROCCES OF VERBAL COMMUNICATION (COGNUTIVE ANALYSIS OF LANGUAGE STRUCTURE)
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In this paper we study the selection of cognitive elements and criteria of the inflectional structure of the Russian and Arabic languages in the process of speech communication. Phonetic-physiological principle is the main parameter by which the elements and criteria of cognitive activity in the presented study are distinguished. On the basis of the above mentioned parameter, we select the investigated criteria and elements. The first criterion is semantic, reflects the accordance of the elements of thinking to sound combinations in the studied languages, and allows us to distinguish the second criterion – morphonological. The second criterion depends on the phonetic changes of these combinations occurring in the process of speech activit

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Publication Date
Sun Apr 01 2018
Journal Name
Al–bahith Al–a'alami
The propaganda content of the elements of expression in the face of the promotion of terrorist thought: (Military information of the popular crowd model)
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The propaganda war is one of the most dangerous weapons used in various conditions of war and peace within any intellectual, political or military conflict to be targeted by multiple social groups and their effects on the intellectuals to change the viewpoints at the local and global level, including the use of technical treatment of the audio and visual medium, The impact of the psychological dimensions of the arms in the confrontation and spread terror in the ranks of the enemies and in the forefront of what Iraq faces in its battle against the And the use of it as a propaganda content contributes to the development of the spirit of tranquility and tranquility in the hearts of Iraqis and the return of the right to the owners “th

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Publication Date
Wed May 01 2024
Journal Name
Biology
Lysophosphatidylcholine Acetyltransferase 2 (LPCAT2) Influences the Gene Expression of the Lipopolysaccharide Receptor Complex in Infected RAW264.7 Macrophages, Depending on the E. coli Lipopolysaccharide Serotype
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Escherichia coli (E. coli) is a frequent gram-negative bacterium that causes nosocomial infections, affecting more than 100 million patients annually worldwide. Bacterial lipopolysaccharide (LPS) from E. coli binds to toll-like receptor 4 (TLR4) and its co-receptor’s cluster of differentiation protein 14 (CD14) and myeloid differentiation factor 2 (MD2), collectively known as the LPS receptor complex. LPCAT2 participates in lipid-raft assembly by phospholipid remodelling. Previous research has proven that LPCAT2 co-localises in lipid rafts with TLR4 and regulates macrophage inflammatory response. However, no published evidence exists of the influence of LPCAT2 on the gene expression of the LPS receptor complex induced by smooth or rough b

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