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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
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
Derivatives in reading behind bin Hisham al-Bazzar Morphological study
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One of the main criteria taken by the reader in the correct reading of a statement is the standard morphological, Vabv Eetmisah from the rest of science that examines the word andchanges therein lead to new meanings, which is the rule months in Morphology, every increase in construction lead to an increase in meaning.
Who took behind with the likes of ten readers Morphology a way to show the most rightly reading, to perform the desired effect, it has committed as committed behind bin Hisham statement argument morphological under which the clear sense of the formula of distinguished from Matheladtha of formulas feature to perform their intended meaning. And here that God Almighty was meant to each formula is contained in verse without

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Sun Jan 01 2023
Journal Name
Journal Of Engineering
Optimization of Locations for Bioswales Stormwater Management Using BMP Siting Tool - Case Study of Sulaymaniyah City-KRG-Iraq
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Today, urban Stormwater management is one of the main concerns of municipalities and stakeholders. Drought and water scarcity made rainwater harvesting one of the main steps toward climate change adaptation. Due to the deterioration of the quality of urban runoff and the increase of impermeable urban land use, the treatment of urban runoff is essential. Best Management Practice (BMP) and Low Impact Development (LID) approaches are necessary to combat climate change consequences by improving the quantity and quality of water resources. The application of Bioswales along urban streets and roadways can reduce the stress on water resources, recharge groundwater and prevent groundwater pollution. While Sulaymaniyah City has a

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Sat Dec 31 2022
Journal Name
Al-kindy College Medical Journal
Changing the Trends in Surgery during the COVID-19 Times: An Experience from the Eastern Uttar Pradesh State, India: CHANGING TRENDS IN SURGERY DURING COVID TIMES
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Background: The COVID-19 pandemic has an immense effect not only on the social and economic lives of people but also on the surgical lives of surgeons, residents, nursing staff, and patients as well as ground level staff. Amidst this COVID pandemic, emergency surgeries were being done but at a decreased rate, whereas elective cases depended on the will of hospitals, surgeons, and patients. Study aims to promulgate a "Neo–Surgical Check Box" by amalgamating the WHO surgical checklist and the results obtained from the questionnaires.

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Publication Date
Wed Dec 25 2019
Journal Name
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Euphrates River extends about 125 km within the study area located in Annassiriyah City, Dhi Qar Governorate, Iraq. The impact of the seven hydraulic structures on the discharge capacity of the Euphrates River needs to be considered. The main objectives of this research are to increase the discharge capacity of Euphrates River within Annassiriyah City during flood seasons and study the impact of these hydraulic structures on the river capacity by using HEC-RAS 5.0.3 software. Five scenarios were simulated to study the different current condition of Euphrates River within Annassiriyah City. Other additional four scenarios were implemented through river training to increase the river capacity to 1300 m³/s; it is the flood

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Wed Aug 31 2022
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Acute Appendicitis and Multisystemic Inflammatory Syndrome due to COVID-19: a Case Report and Literature Review
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The prevalence of gastrointestinal symptoms of COVID-19 is variable with different types of presentations. Some of them many present with manifestations mimicking surgical emergencies. Yet, the pathophysiology of acute abdomen in the context of COVID-19 remains unclear. We present a case of a previously healthy child who presented with acute appendicitis with multisystemic inflammatory syndrome. We also highlight the necessity of considering the gastrointestinal symptoms of COVID-19 infection in pediatric patients in order to avoid misdiagnosis and further complications.

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The Archaeological Surveying in Wadi Al – yabis in Jordan (( Athnoarchology study ))
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mountain to the jorden river , the surveying of this valley about 186 KM , and the
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sea level . This study lay to appear the historical important and to study the variation
of environment and population which happened in the different periods , in the
beginning the Paleolithic until the later period , and to understand the environment ,
political and economical circumstances , which it can to influenced or limited in
human behavior from choosing , the settlement sits and than ( we could ) knowledge
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Tue Sep 20 2022
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ELECTRONIC LEARNING IN MEDICAL EDUCATION IN THE ERA OF COVID-19: ACADEMIC STAFF PERSPECTIVES
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Electronic learning was used as a substitute method for learning during the COVID-19 pandemic to conduct scientific materials and perform student assessment; this study aimed to investigate academic staff opinions toward electronic education. A cross-sectional study with a web-based questionnaire distributed to academic staff in different medical colleges in Iraq. After de-identification, data were collected and analyzed with statistical software to determine the significance between variables. A total of 256 participants were enrolled in the study: 83% were not satisfied or neutral to online learning, 80% showed a poor benefit from delivery of the practical electronic knowledge and 25% for theoretical sessions with a significant difference

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Scopus
Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Rightness in Evalating Basra and Kufa’s Views in The Work Of Al _ Anbary, Al - Insaf Fi Masael Al - Khilaf
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This paper deals with the Kufis and basris agreements in Abo Al _ Barakat Al _ anbary’s
work “ Al- Insaf Fi Masael Al - Khilaf.It attempts to settle the disputes and find out the right
views.
The book presents the issnes that the two schools of Kufa and Basra dispute upon and try to
evaluate them so as to support the correct ones .The present researcher has noticed that the
author of the above work was not always right or accurate in picturing a number of issues as
disputable whereas they implicitly shared the same views .Accordingly ,this papor sheds light
on such cases and drew acadernic researchers, attention to the invalidity of Al –anbary’s
misjudged views.

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Publication Date
Wed Jan 30 2013
Journal Name
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Electrocardiographic changes among beta-thalassemic major patients in ibn al-baladi thalassemia center-Baghdad
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thalassemia major is due to multiple blood
transfusions rather than the disease itself, which
is due to iron overload.
Cardiomyopathy is the most common cardiac
defect that occurs with iron overload. Pricarditis,
congestive heart failure and arrhythmias are due
to hemosidrosis and chronic aneamia.
Aim of the study: to demonstrate the prevalence
and types of electrocardiographic changes among
thalassemic patients with aged over ten years old.

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Asthmatic Patients’ Quality Of Life in Jordan Fadel Hazza' Ali al-Mahameed.*
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Abstract A descriptive study was conducted in Al-Bashir teaching hospital in Amman city from 15th May 2004 to 15th August 2004 , in order to "Assess the adult asthmatic patients’ quality of life (QOL). Objective: This study aimed at identifying the domains of (Environmental, Physical, Daily Living Activity, Drug and Medication, Psychological , and Social), Methodology : A Purposive (Non-Probability) sample of (100) adult asthmatic patients visited the emergency department and outpatient clinic of chest department in Al-bashir hospital .A Questionnaire was constructed for the purpose of the study, and compris

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