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The Difference in Contributing Factors and Costs Associated with Outpatient Refusal to Accept Cardiovascular Medications or Analgesics During Dispensing Process.
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Background: Study looking into cardiovascular disorders (CVD) medicines or analgesics cost-saving activities during dispensing process is lacking.

Aim: To determine differences in factors and costs associated with refused CVD medicines or analgesics during dispensing process

Method: This study was approved by Medical Research and Ethics Committee (MREC) (Registration number: NMRR-20-177-53153(IIR)). Participants receiving CVD medicines or analgesics during dispensing process were recruited via convenience sampling technique between February and March 2020 at the Specialist Pharmacy Department of Jerantut Hospital, Malaysia. Refusal to medications and its reasons were asked based on the questionnaire developed by the researchers.

Results: Overall, 175 patients participated in this survey and CVD drugs contributed toward 58.9% of the refused medicines. Those who refused CVD drugs and analgesics were significantly different in terms of gender, medications dosing frequency, refusal reasons namely side effects, medications use, intentionally skipping dose and skipping the dose when feeling well. No associations were found between forgetfulness and age with refusal to CVD drugs or painkillers. Those who refused CVD medicines had a significantly higher total daily medicines, total daily pill burden, and total number of medicines refused per prescription compared to those who refused analgesics. Cost of CVD medicines refused per prescription was significantly higher compared to analgesics, median Ringgit Malaysia (RM) 10.50 (IQR, RM 15.00) versus median RM 6.00 (IQR, 15.00), P=0.01.

Conclusion: Refusal to CVD medicines and analgesics was associated with several medication’s and patient’s factors. However, higher cost-saving was observed in those refusing CVD medicines.

 

Keywords: cardiovascular disease, analgesics, dispensing, wastage

                                                                                                                              

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Sun Apr 01 2018
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Wed Jun 29 2022
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The use of destructive weapons in wars without restrictions and controls, which eat green and dry land, pollute the environment and cause genocide, has become the problem of the times.

International conventions for the protection of the environment during armed conflicts are characterized by generality, ambiguity, and open to interpretation by the participating states in the agreement, and each state interprets these texts to serve its interests, but the Islamic Sharia stipulates the prohibition of the use of these comprehensive destructive weapons in an unambiguous manner, As stated in the Holy Quran:

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Publication Date
Fri Sep 30 2022
Journal Name
College Of Islamic Sciences
Principles of war and jihad to protect the environment and civilians in times of war in Islamic Sharia
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Research summary

Islam protects the environment and civilians in peace and war, and in international humanitarian law protection of the environment and civilians in international conflicts only. As for wars and internal conflicts, it is not within the jurisdiction of international humanitarian law. In Islamic law, the principles of protecting the environment and civilians are fixed in all wars and conflicts, whether internal or external, local. or international.

Islam laid down moral principles in war, including:

- Preserving the environment and avoiding corruption in the land by burning trees and killing animals unnecessarily.

- Not to be exposed to non-combatants, including women, boys, the elderly, the disa

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