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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
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Directly Observed Therapy Short Course (DOTs) Program Therapy in Treatment of Tuberculosis in Al-Sader City 2003-2005
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Objectives: Assessment outcome of DOTS (Directly observed therapy short course) program in Al-Sader City
Sector that was established by the WHO.
Methodology: Three cohorts groups of patients attending Baghdad TB institute and TB center in Al-Sader city
were followed retrospectively. The 1st cohort included (314) patients registered in year (2003), the 2nd cohort
included (327) patients registered in year (2004), the 3rd cohort included (321) patients registered in year
(2005). The collected data were analyzed for case detection, treatment outcomes, retreatment outcomes,
treatment success, and retreatment success in regard to time, age and sex.
Results: The following rates were extracted for the three cohort: Case det

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Publication Date
Sun Jun 27 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Practices of Early Childhood’s Mothers Regarding Toilet Training at Primary Health Care Centers in Al-Rusafa District in Baghdad City
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Objective(s): To assess the practices of early childhood’s mothers regarding toilet training and to find out the relationship between mothers’ practices and their socio-demographic characteristics and their children’s demographic characteristics.
Methodology: A descriptive study is conducted at primary health care centers in Al-Rusafa District in Baghdad City for the period of September 19th 2020 to March 16th 2021. Non probability “convenient” sample of (225) early childhood’s mothers is selected. A questionnaire format is designed and composed of two parts: the first part includes mothers’ socio-demographic characteristics and their children and the second part includes structured close-ended questions to assess the p

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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Nursing Performance Concerning Nasogastric Tube in Neonatal Intensive Care Unit at al-Batool Teaching Hospital in Baqubah City
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Objectives: The study aim to evaluate nursing performance during nasogastric tube feeding in neonatal intensive care unit. Methodology: A descriptive study was carried out in Neonatal Intensive Care Unit at al–Batool Teaching Hospital, for the purpose of evaluate of quality of nursing performance for premature baby during nasogastric tube feeding in neonatal intensive care unit. The study consumed the period from 4th of December 2017 to the 24nd of April 2018, Non-probability purposive sample of (25) nurses working in the neonatal intensive care unit. The data were collected through the use of Observational instrument which consist of socio-demographic characteristics, quality of nursing care. Results: The study shows that the majority

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Publication Date
Tue Mar 30 2021
Journal Name
Baghdad Science Journal
Aquatic Oligochaeta (Annalida:Clitellata) as Bio Indication for Sediment Quality Assessment in Tigris River Within Baghdad City /Iraq
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Aquatic Oligochaeta is an important group of Macroinvertebrates that has been very remarkable as bioindicators for assessing water pollution and determining its degree in water bodies. Hence, the idea of the current study aims at studying the impact of Baghdad effluents on the Tigris River by using oligochaetes community as bioindicators . For this purpose, four sites along the inside of Baghdad has been chosen. Site S1 has been located upstream, site S2 and S3 has been at midstream and site S4 at the downstream of the River.This investigation has used different types of biological indicators, including the  percentage of oligochaeta  within benthic invertebrates, which ranged from 49.2-51.28%. The highest percentage of the tubificid w

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Book of Musaka (by Imam Abu al-Qasim Abdul-Karim Muhammad ibn Abd al-Karim al-Rafii)
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Al-Aziz's book was chosen as a subject for research as it is one of the important books in the Islamic world in general and the Shafi'i school in particular and its author Imam Abdul Karim bin Mohammed bin Abdul Karim Al-Rafi's, who in the doctrine of the jurisprudence has made prominent lines and left behind invaluable scientific treasures in the service of religion. Its importance is summarized as follows:
1. Being an explanation of the book (brief) of the argument of Islam Imam Ghazali (God's mercy), one of the five books adopted in Shafi'i jurisprudence.
2. His work is Imam Abu al-Qasim al-Rafii known for the brilliance of the investigation and the power of weighting in the doctrine.
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Publication Date
Fri Dec 30 2022
Journal Name
Journal Of The College Of Education For Women
The Death Scene in the "Ayniyah" Poems of Abi Thuayib Al-Huthali and Suda bint Shamardal: A Contrastive Study
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This study is an objective literary study of the poems of Abu Dhu'ayb Al-Hudhali and Su'da Bint Al-Shamrdal. It aims to shed light on the philosophy of death in the poems, and the way this philosophy is treated by both poets. Thus, the main prominent poetic images have been addressed and the outstanding ones have been singled out. The study further investigates the intertextuality with other poetic verses and Quranic verses and reviews the deviation in their semantic, syntactic, and phonetic types. The study adopts the historical approach to examine the occasion of the poems by referring to several historical sources that indicate the seniority. It also adopts the and descriptive-analytical approach represented by the use of content anal

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Publication Date
Mon Sep 25 2023
Journal Name
International Journal Of Energy Production And Management
Reducing Energy Consumption in Iraqi Campuses with Passive Building Strategies: A Case Study at Al-Khwarizmi College of Engineering
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University campuses in Iraq are substantial energy consumers, with consumption increasing significantly during periods of high temperatures, underscoring the necessity to enhance their energy performance. Energy simulation tools offer valuable insights into evaluating and improving the energy efficiency of buildings. This study focuses on simulating passive architectural design for three selected buildings at Al-Khwarizmi College of Engineering (AKCOE) to examine the effectiveness of their cooling systems. DesignBuilder software was employed, and climatic data for a year in Baghdad was collected to assess the influence of passive architectural strategies on the thermal performance of the targeted buildings. The simulations revealed that the

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Al-Rawandi and His Book “Rahat Il-Sudoor and Ayat Il-Suroor” A historical Study in Content and Style
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The Rwandan author of comfort chests and verse pleasure of the most important historians of the Seljuks in the sixth century AH / twelfth century and belongs to the mostly ethnic scientists family has won favor with the Sultans of the Seljuks until he became the most famous Markhém is his main source of research sources with respect to the political and social history the Seljuks and the relationship of the Seljuk sultans of the Abbasid caliphs in Baghdad.
The book included the history of the Seljuks from the time of statehood in the fifth century AH / atheist century AD until the death of the Sultan Tgrl bin Arslan year 590 AH / 1193 AD and then shed Akhawarzmeyen, and touched the author at the end of the book in separate chapters t

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Factors Affecting Attaching Ruling to Its Cause (Illah) or to Its Reason (Hikmah): A Study in Usul Al Fiqh
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There is a theoretical controversy in the books of Usul al-Fiqh, in the past and the present, about whether the ruling should be attached to its reason (al-Hikmah), or its apparent and stable cause (al-Illah). Looking at the practical cases of the jurists, we found them sometimes attaching rulings to its reason, and sometimes to its cause, so there is a need to know the factors that affect their choices. By extrapolation, the researcher reached at nine factors that affect referring the ruling to its cause or to its reason in jurisprudential cases.

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Publication Date
Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
What the linguists commented on, "I do not know" in the dictionary of Lisan al-Arab, a semantic study
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Absitract

This research was interested in studying the phrase “I don’t know” in the Lisan al-Arab dictionary, and Lisan al-Arab was based on collecting its material from five dictionaries, including: Tahdhib al-Lugha, al-Muqamah, al-Sahih, and the footnotes of Ibn Berri, al-Nihaya and Gharib al-Hadith. The objection to this phrase, and the discussion of its various implications among linguists and the clarification of the closest and most famous content to it according to the data presented to the researcher in his research journey, and to reach this goal, the research division into a preface, five demands and a conclusion and followed the list of sources and references. To define the lexicon of Lisan al-Ar

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