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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 10 2023
Journal Name
College Of Islamic Sciences
The Approach of Sheikh Abdul Qadir Al-Muhajir in Proving the Existence of God through his book (Rafa’ Al-Hajib fi Sharh ethbat Al-Wajib) An analytical study
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This research is drawn from a doctoral dissertation, studying the approach of Sheikh Abd al-Qadir al-Muhajir al-Sanandji al-Kurdi (1303 AH) on the issue of proving the existence of God Almighty.
Sheikh Abd al-Qadir al-Sanandji was one of the scholars well versed in mental sciences. He has many books, all of them in the sciences of speech and wisdom, and among his books is the book (Raising the Eyebrow in Explanation of Ithbat al-Wajib), which is still a manuscript that has not been printed.
Through this book, the researcher studied the evidence of Sheikh Abdul Qadir to prove the existence of God Almighty, and compared it with the evidence of philosophers and theologians.
At the beginning, he presented a study on the import

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The adequacy of the methods used in the collection of tax debt in Iraq: Applied research in the General Authority for Taxation
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If the sovereignty of the state is reflected in the taxation of its citizens, this sovereignty can not be completed and completed only if it works on its part to collect its debts, whether voluntary or compulsory, and the debt of the debt arises from the will of the individual and the will of the state alone, The existing management of seizure and collection is based on an unequal relationship between the State and the debtor from which the obligation arises. Naturally, this relationship has obligations and rights on both parties. The researcher used a set of studies and previous research, books and other sources related to the subject of research. This was done through the theoretical and practical aspects, which focused on direct and i

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Publication Date
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
Thu Jun 11 2020
Journal Name
American Journal Of Infectious Diseases
Prevalence of Urinary Tract Infections and Associated Risk Factors Among Patients Attending Medical City Hospital in Baghdad City, Iraq
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Abstract: Urinary Tract Infections (UTIs) are the most common bacterial infection in humans and a major cause of morbidity and they are the most common cause of hospital visits worldwide. Proper knowledge in identifying factors associated with urinary tract infection may allow the intervention to easily control of the disease in a timely manner. Therefore, the purpose of the study is determining the prevalence of UTI, diagnosis of causative bacterial agents and identifying the factors associated to the urinary tract infection among patients attending Medical City Hospital in Baghdad, Iraq. A total of 237, morning mid-stream urine samples were collected aseptically and the samples were diagnosed according to the standard methods. I

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Publication Date
Tue Dec 16 2008
Journal Name
Journal Of Planner And Development
The relationship between the uses of land and the network of movement and roads (study area, Najaf city)
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The interaction in the city is reflected in the movement of people motivated by their activities and their economic and social goals, which include many variables subject to the planning process in the interpretation of this movement and the mapping of trends of transport intensity through the concept of transport function and its functional relationships with the uses of the earth in the sustainability and effectiveness of the movement of transport and Economic activity and population movement. Transport planners are concerned with the requirements of land use, which are linked to and included in the transport planning process as a factor for the future transport needs. There is a strong relationship between the transport system

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Thu Jun 01 2017
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Journal Of The College Of Languages (jcl)
Body Language in the Poetry of Ibn Al-Jayab Al-Farnati
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Language is a means of communication among the human beings. Every language that distinguish them from others. However, there is language common that is common of all human beings without discrimination and expression of ideas. Perhaps it is more honest that the usual language.

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Sat Jan 01 2011
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Iraqi Journal Of Physics
Natural radioactivity survey in Al-Jabal Al-Gharbi Mountain Region Libya
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The measurement of natural radioactivity in a given region or country is essential to provide a reference base-line map to follow up a possible variation in future. In order to perform such measurement, the natural radioactivity was measured in different locations. The locations (50 sites) were distributed over Al-Jabal Al-Gharbi Mountain, starting from the city Al-Azeeziah in the eastern part to Wazen on the Tunisian border in the west. The measurements showed obvious variation from one site to another. The levels were fluctuating from (12.8 counts/minute) in Bir-Ayad to (45.7 counts/minute) in Gherian.
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Publication Date
Mon Jan 02 2017
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Al-academy
Functionalizing Iron Ore in sculptures ( Salih Al-Quraghuli / Ahmed Al-Bahrani)
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The sculpture composing of iron materials is being considered most important raw material that has been used by the modern artist ,especially period of post –modernism. The works of the two artists ( SALIH AL-QARAGHULI and AHMED AL-BAHRANI) the most important works that entailed to be studied for being using iron material in most of their sculpturing works; in works of Al-Quraghuli, we find ores composing of iron wires , animals threads and remaining of trash and to be assembled in a sculptured text with unique style in Arab Home. Moreover, we find huge works of (al-Bahrani) represented into formations characterized with its ironic flexibility, its abstracted engineering forms. Al-Bahrani solely has used iron plates represented in its

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Publication Date
Fri Dec 01 2023
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Iraqi Journal Of Physics
Fatigue and Tensile Characteristics for Composite Materials Used in Prosthetic Socket
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In this research, the use of natural materials like wool and cannabis as intermediate reinforcement for prosthetic limbs due to their comfort, affordability, and local availability was discussed. As part of this study on below-the-knee (BK) prosthetic sockets, two sets of samples were made using a vacuum method. These sets were made of natural fiber-reinforced polymer composites with lamination 80:20: group (Y) had 4 perlon, 1 wool 4 perlon, and group (G) had 4 perlon, 1 cannabis 4 perlon. The two groups were compared with a socket made of polypropylene. Tensile testing was used to determine the mechanical characteristics of the socket materials. The Y group has a yield stress of 17 MPs, an ultimate strength of 18.75 MPa, and an elastic

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Publication Date
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
content Analysis for Some Type of Pillows used in Iraqi houses
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content Analysis for Some Type of Pillows used in Iraqi houses

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