Publications by authors named "Ahmed M Makhlouf"

3 Publications

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Community pharmacists' management of minor ailments in developing countries: A systematic review of types, recommendations, information gathering and counselling practices.

Int J Clin Pract 2021 Oct 2;75(10):e14424. Epub 2021 Jul 2.

Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.

Aims: To conduct a systematic review of the management of minor ailments by community pharmacists in developing countries, and to identify the specific minor ailments encountered, the medications recommended or requested and the information gathering and counselling practices.

Method: Observational studies from developing countries published in English language from inception to 2019 and report the management of minor ailments by community pharmacists were systematically searched in PubMed, ScienceDirect and Cochrane Library.

Results: Thirty full-text studies, out of 7876 retrieved and screened, were included in the systematic review. Minor ailment-induced encounters by patients with community pharmacists are generally pervasive and involve mainly verbal request for specific medicines by name (60%). The most frequent minor ailments reported were respiratory, gastrointestinal and musculoskeletal conditions, and the most common medicines recommended or requested for were cough/cold preparations, antimotility and oral rehydration preparation, and analgesic/antipyretic. Inappropriate recommendation of antibiotics were reported for acute diarrhoea and cough/colds (40%) (10/25). Community pharmacists encountered 11-30 customers with minor ailments per day, with an average of about 4.8 (1.3-20.5) minutes per encounter. None of the studies reported the availability and/or use of a specific protocol to guide the management of minor ailments. There was wide variation in the type and depth of information gathered and used for the management of minor ailments; and the counselling information provided by community pharmacists, and there was no evidence of the documentation activities related to the management of minor ailments.

Conclusions: Community pharmacists' encounter with and management of minor ailments appear extensive in developing countries and probably present an opportunity to contribute significantly to reduce disease burden and enhance public health. However, the management process is currently unstructured, unguided by a specific protocol and vary in the quality of recommendations, information gathering and counselling practices.
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October 2021

Using Padé Approximant Method to Solve the Mathematical Model of Tumor-Immune Interactions.

Annu Int Conf IEEE Eng Med Biol Soc 2020 07;2020:2467-2470

A mathematical model, in the form of a system of nonlinear ordinary differential equations, that describes the interaction between tumor cells and effective immune cells is proposed. An exact solution cannot be found to this system like many other nonlinear systems. Yet, approximate analytical solution is explored. This solution should have a large interval of convergence to be acceptable because the interaction can take many days to reach its steady state. Power series method is used to obtain a series solution. In this process, some auxiliary variables are used to transform the system of equations to polynomial form. However, this solution has a small radius of convergence, therefore, Padé approximant method is used to extend the domain of convergence. Hence, the obtained approximate analytical solution is valid over a large interval and has a remarkable accuracy when compared with numerical solution.
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July 2020

Mathematical Modelling for the Role of CD4T Cells in Tumor-Immune Interactions.

Comput Math Methods Med 2020 19;2020:7187602. Epub 2020 Feb 19.

Department of Engineering Mathematics and Physics, Faculty of Engineering, Alexandria University, Alexandria, Egypt.

Mathematical modelling has been used to study tumor-immune cell interaction. Some models were proposed to examine the effect of circulating lymphocytes, natural killer cells, and CD8T cells, but they neglected the role of CD4T cells. Other models were constructed to study the role of CD4T cells but did not consider the role of other immune cells. In this study, we propose a mathematical model, in the form of a system of nonlinear ordinary differential equations, that predicts the interaction between tumor cells and natural killer cells, CD4T cells, CD8T cells, and circulating lymphocytes with or without immunotherapy and/or chemotherapy. This system is stiff, and the Runge-Kutta method failed to solve it. Consequently, the "Adams predictor-corrector" method is used. The results reveal that the patient's immune system can overcome small tumors; however, if the tumor is large, adoptive therapy with CD4T cells can be an alternative to both CD8T cell therapy and cytokines in some cases. Moreover, CD4T cell therapy could replace chemotherapy depending upon tumor size. Even if a combination of chemotherapy and immunotherapy is necessary, using CD4T cell therapy can better reduce the dose of the associated chemotherapy compared to using combined CD8T cells and cytokine therapy. Stability analysis is performed for the studied patients. It has been found that all equilibrium points are unstable, and a condition for preventing tumor recurrence after treatment has been deduced. Finally, a bifurcation analysis is performed to study the effect of varying system parameters on the stability, and bifurcation points are specified. New equilibrium points are created or demolished at some bifurcation points, and stability is changed at some others. Hence, for systems turning to be stable, tumors can be eradicated without the possibility of recurrence. The proposed mathematical model provides a valuable tool for designing patients' treatment intervention strategies.
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January 2021