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Cost-effectiveness of on-demand rFVIIa vs prophylactic emicizumab in hemophilia a with inhibitors: clinical, QoL, and ICER-based field insights
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Abstract<sec> <title>Objective

To evaluate the cost-effectiveness of emicizumab compared to recombinant activated factor VII (rFVIIa) in Iraqi patients with hemophilia A and inhibitors.

Method

A retrospective cost-effectiveness analysis was conducted on 46 male patients with hemophilia A and inhibitors treated at a public children’s hospital in Baghdad. Data collection was conducted between November 2024 and March 2025. Clinical and economic data were retrospectively collected for a 12-month follow-up for each of rFVIIa and then emicizumab, including bleeding episodes, emergency visits, treatment costs, and health-related quality of life assessed via EQ-5D-5L (adults) and EQ-5D-Y-3 L proxy (children). Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios were calculated.

Results

Emicizumab improved mean utility scores from 0.10 to 1.00 in children and from 0.32 to 0.89 in adults, corresponding to an incremental cost of –$2726.36 and –$4304.78 per QALY, respectively (indicating cost savings). Annual bleeding episodes dropped from 8.70 to 0, saving $282.04 per episode. Hospitalization costs decreased significantly, resulting in a total saving of $286650.41 per hospitalization prevented. Use of emicizumab also reduced overall healthcare resource utilization, eliminating emergency department visits, and minimizing diagnostic procedures.

Conclusion

Emicizumab delivers substantial clinical and economic benefits over rFVIIa. Its capacity to enhance quality of life while reducing treatment costs positions it as a cost-effective option for adults and children with hemophilia A and inhibitors in resource-constrained settings. Health authorities should prioritize emicizumab over rFVIIa for patients with hemophilia A and inhibitors, due to its superior efficacy and cost-effectiveness.

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Engineering
Calculating Production Rate of each Branch of a Multilateral Well Using Multi-Segment Well Model: Field Example
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Multilateral wells require a sophisticated type of well model to be applied in reservoir simulators to represent them. The model must be able to determine the flow rate of each fluid and the pressure throughout the well. The production rate calculations are very important because they give an indication about some main issues associated with multi-lateral wells such as one branch may produce water or gas before others, no production rate from one branch, and selecting the best location of a new branch for development process easily.                                &nbsp

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Publication Date
Tue Sep 30 2025
Journal Name
Gsc Advanced Research And Reviews
A comprehensive review of metal-organic framework based biosensors for detection of reactive oxygen species and hydrogen peroxide in biomedical applications
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Metal-organic frameworks (MOFs) have emerged as revolutionary materials for developing advanced biosensors, especially for detecting reactive oxygen species (ROS) and hydrogen peroxide (H₂O₂) in biomedical applications. This comprehensive review explores the current state-of-the-art in MOF-based biosensors, covering fundamental principles, design strategies, performance features, and clinical uses. MOFs offer unique benefits, including exceptional porosity (up to 10,400 m²/g), tunable structures, biocompatibility, and natural enzyme-mimicking properties, making them ideal platforms for sensitive and selective detection of ROS and H₂O₂. Recent advances have shown significant improvements in detection capabilities, with limit

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Publication Date
Thu May 05 2022
Journal Name
Al-kindy College Medical Journal
Safety profile of immediate post-partum intrauterine device insertion during caesarean delivery – a clinical trial with three years of follow up: Utility of Immediate Post Placental Insertion of Intrauterine Device During Cesarean Delivery
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Background: Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq.

Objectives: To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women.

Subjects and Methods: A single arm clinical trial included 150 eligible women who attended Al-‎Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospita

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Publication Date
Tue Oct 01 2019
Journal Name
Biochemical And Cellular Archives
THE EFFECT OF TWIST EXPRESSION ON THE DEVELOPMENT OF CERVICAL CARCINOMA IN A GROUP OF IRAQI WOMEN INFECTED WITH HPV
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Cervical carcinoma represent the second predominant cancer in female and there is a strong correlation between cervical cancer and the infection with high-risk types of HPV and expression the viral oncogenes. EMT is viewed as a vital advance in carcinoma development and ensuing metastasis. To evaluate correlation between the expression of Twist and HPV16 infection in a group of Iraqi patients with cervical carcinoma. A total of forty paraffin blocks included in this study which were divided into 30 sample of cervical cancer infected with HPV16and 10 sample of normal cervical tissues. The samples were subjected to immunohistochemical technique using Anti-Twist2 polyclonal antibody. The obtained data from this study indicate that majority of

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Publication Date
Mon Jul 04 2022
Journal Name
International Journal Of Health Sciences
The association between plasma IL-6 levels and several thalassemia-related clinical features in Iraqi patients
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The present study was set to investigate the potential association between the level of Interleukin-6 (IL-6), as a key component of the pro-inflammatory response, with different thalassemia’s biological and clinical features. For this purpose, one hundred fifty blood samples were collected from 100 beta-thalassemia patients, who attended the Genetic Hematology Centre at Ibn Al- Baladi Hospital in Baghdad, Iraq, and 50 healthy subjects who were employed as a control group. IL-6 levels were estimated using an ELISA Kit, whereas other thalassemia-related clinical features (such as HbA, HbF, ferritin, blood transfusions, splenectomy status, and the history of frequent infection) were additionally assessed. The results of the present s

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Publication Date
Mon Aug 30 2021
Journal Name
Al-kindy College Medical Journal
Clinical Course and Disease`s Outcome Aspects of COVID-19 Pediatric Patients in Ibn Al-Khateeb Isolation Hospital
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Background: Corona virus disease 2019 (COVID-19) is a communicable disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December 2019 in Wuhan, China, and has since spread globally, leading to an ongoing pandemic.

Aim of study: to review the clinical, lab investigation and imaging techniques, in pediatric age group affected COVID-19 to help medical experts better understand and supply timely diagnosis and treatment.

Subjects and methods: this study is a retrospective descriptive clinical study. The medical records of patients were analyzed. Information’s recorded include demographic data, exposure history, symptoms, signs, laboratory findin

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Advanced Biotechnology And Experimental Therapeutics
Effect of fungal microbiota on RANKL and sclerostin in patients with Crohn's disease
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The etiology of Crohn's disease (CD) is still unknown. However, many factors, including a dysregulated immune system, altered microbiota, inheritance, and environmental factors, have been implicated. This work was conducted to estimate the effect of fungal microbiota on two bone mineral density markers, RANKL and sclerostin, in addition to the correlation between these markers and vitamin B12, D3, and zinc in CD patients, along with their potential effect on fungal microbiota and vice versa. Peripheral blood and carry-Blair Stool samples were collected from 88 participants (60 newly diagnosed with CD without treatment and 28 healthy controls) to detect serum levels of RANKL and sclerostin, and culture media were used to grow, isolat

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Publication Date
Mon Sep 15 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Impact of oral hygiene instructions on cytokines in smokers and vapers with gingivitis
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Background: Cigarette smoking (CS) is a periodontal disease risk factor, affecting clinical parameters such as bleeding on probing (BOP), plaque index (PI), gingival index (GI) and proinflammatory cytokines level. This study examines the impact electronic cigarette use on proinflammatory cytokines and periodontal parameters. Methods: In this non-randomized study, ninety participants diagnosed with gingivitis were assigned into three groups. examined the effect of oral hygiene instructions on periodontal parameters and inflammatory biomarkers. Thirty CS (n=30) vaping electronic-cigarettes (e-cig) (n=29), and non-smoker (NS) (n=31) was included. Clinical parameters including PI, BOP, and GI were recorded at baseline and after 3 weeks

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of The College Of Education For Women
The Developmental Role of Social Work in Reducing Social Extremism:A Field Study in Baghdad University-College of Mass Communication as a Model: محمد حميد علوان
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This study deals with the role that social work profession plays in all its fields to reduce social extremismat home, or school or within society. The study aims to: examine the historical roots of social work in the Iraqi society, investigate the objectives of the developmental role of social work, review the theories of social extremism, its characteristics, and causes, and to analyze the developmental role of social work to limit social extremism. To meet the objectives of the study, a descriptive analytical approach has been adopted. It involves using the social sampling survey method, i.e., a questionnaire tool in the University of Baghdad community-College of Media. The sample was randomly selected to include (100) students from th

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Publication Date
Mon Jan 01 2024
Journal Name
International Journal Of Research In Science And Technology
Encryption of Medical Image Based on Cascaded Design of AES Block Algorithm and Chaotic Map
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Security concerns in the transfer of medical images have drawn a lot of attention to the topic of medical picture encryption as of late. Furthermore, recent events have brought attention to the fact that medical photographs are constantly being produced and circulated online, necessitating safeguards against their inappropriate use. To improve the design of the AES algorithm standard for medical picture encryption, this research presents several new criteria. It was created so that needs for higher levels of safety and higher levels of performance could be met. First, the pixels in the image are diffused to randomly mix them up and disperse them all over the screen. Rather than using rounds, the suggested technique utilizes a cascad

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