The Use of Traditional and Complementary Medicine Among Patients With Multiple Sclerosis in Morocco.

BACKGROUND: Multiple sclerosis (MS) is an acquired chronic, autoimmune, and neurodegenerative disease of the central nervous system. In addition to conventional MS therapy, patients are interested in traditional and complementary medicine (T&CM). Our study aims to describe the use of T&CM in a cohort of Moroccan patients with MS. METHODS: A quantitative descriptive study was adopted to study this subject. For data collection, we opted for an anonymous questionnaire for 98 patients with MS. We gathered data via an electronic survey, using multivariable analysis to examine the effect of specific factors on T&CM use. Data collection took place from March 2022 to June 2022. RESULTS: The results show that 52% of patients use T&CM. Of those, 29.6% use cupping, 23.5% recite the Holy Quran, 15.3% use phytotherapy, 13.2% use apitherapy, and 10.2% use acupuncture. In addition, 66.3% of the surveyed respondents stated that alternative medicine positively affects their health. Finally, 49.1% of surveyed patients who use alternative medicine are between 30 and 40 years old. The results also show that the rate of T&CM use is higher in patients with progressive MS (OR = 2.540) and patients without financial access to disease-modifying therapy (OR = 2.100). CONCLUSIONS: This study invites us to consider societal, cultural, and economic factors when studying the use of T&CM among people with MS. Further research is needed to understand the motivations for using T&CM.

A Comprehensive Pathophysiologic, Histologic, and Biochemical Analysis of Buthus paris (C. L. Koch, 1839) Venom.

INTRODUCTION: Buthus species, including B paris, are classified as one of the most dangerous scorpion genera in Morocco, implicated in several cases of human death. Our objective is to characterize, for the first time, the toxicity and histopathologic and biochemical impacts of B paris venom. METHODS: We investigated the experimental pathophysiology of B paris venom by examining histologic changes in vital organs (heart, kidneys, liver, and lungs) and assessing biochemical enzymatic markers (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, urea, and creatinine) in mice injected subcutaneously with 2 doses of 400 and 450 mg·kg-1. RESULTS: Our results showed that the subcutaneous median lethal dose of B paris venom was around 0.52 mg·kg-1. Histologic findings revealed significant tissue damage in the previously mentioned vital organs, confirmed through biochemical analysis indicating impaired heart and liver functions. Additionally, an increase in urea, creatinine, and glucose levels occurred following B paris venom injection. CONCLUSION: Our findings show that B paris venom exhibits a high level of experimental toxicity. These results highlight the potentially lethal nature of this venom and emphasize the potential medical importance of this species.

Molecular diversity assessed by MALDI mass spectrometry of two scorpion species venom from two different locations in Morocco.

Scorpion venom is a cocktail of molecules whose composition is remarkably plastic, controlled by several factors. The Moroccan scorpion fauna is characterized by its richness and high rate of endemism and the venom molecular variability of many species is not yet well characterized. The aim of the present study was to highlight the molecular variability of the venom composition of Androctonus amoreuxi and Buthacus stockmanni (endemic species), both belonging to the Buthidae family, collected from two Moroccan regions, Zagora and Tan-tan. Characterization of the molecular mass fingerprints (MFPs) of each specimen was performed by Matrix-assisted laser desorption ionization-mass spectrometry (MALDI-MS) using a sandwich (Sand) and a dried-droplet (DD) sample preparation and dilutions. Considering these two methods, a total of 828 ion signals were detected, and Sand method produced more adducts (56%) than DD (44%). We observed interspecific variations in the venom composition between these two species showing they share 235 ion signals, while 226 and 367 are specific for these two species, respectively. Moreover, B. stockmanni specimens showed a clear difference in their MFPs between the two geographical areas studied, suggesting intraspecific variations. Moreover, specimens from each population also show an intraspecific variability. In addition, for the same individual, a variation in the venom composition was also recorded depending on the milking frequency. Our results confirmed the presence of characteristic components in each extracted venom sample. In conclusion, MFPs assessed by MALDI-MS represent a fast, non-supervised, sensitive, reliable and cost-efficient approach for taxonomic identification and molecular variability characterization. This study undoubtedly represents a step forward for understanding the scorpion venom plasticity, intra/inter variations, and their temporal and geographical variability.

Clinical, epidemiological and faunistic characterization of scorpionism in Azilal, Central High Atlas (Morocco).

The province of Azilal is one of the most scorpion-infested areas in Morocco. The current study aims to investigate the clinical and epidemiological characteristics of scorpion envenomation in the Azilal province, as well as to contribute to the study of its scorpio-faunistic diversity. We examined clinical and epidemiological data from 5684 scorpion stings recorded between 2017 and 2021. Prospections on the ground were carried out in the study area. The species were identified using the taxonomic keys. Distribution maps of inventoried species have been created using SIG. 5684 scorpions stings were reported in the study area, with 18 cases of deaths. Most of the cases was reported in the summer especially at night (64%). A positive significant correlation was found between scorpion stings incidence and season (P < 0.005; r = 0.56). A positive correlation was found between scorpion stings incidence and mortality (r = 0.09). Pediatric mortality was higher compared to lethality in adults (P < 0.05). A positive correlation was found between the number of stung children (Age <15 years) and the number of patients presenting clinical signs of severe envenomation (Class III) (r = 0.40). The percentage of patients that use traditional remedies was significantly higher in the rural areas (P < 0.05). Most scorpion stings occurred in human habitat (54.5%) or in their neighbourhood (24.5%). Six species were identified in the study area. The findings of this study have highlighted the extent of scorpion envenomation and have elucidated certain characteristics of the scorpio-faunistic biodiversity in the Azilal province.

Epidemiological, toxicological and physiopathological characteristics of scorpion stings and their management in Morocco: A literature review.

All around the world, scorpion envenomation represents a public health issue. In Morocco, it represents the first cause of poisoning. The aim of this review is to highlight the epidemiological, toxicological and physiopathological characteristics of scorpion stings and envenomation in Morocco as well as their management. According to the bibliography, the most areas affected by scorpion stings and envenomation are those in the center and south of Morocco. Lethality rate is more important in children than adult. Age, admission class, season, serum venom concentration, and the time elapsed between the scorpion sting and medical intervention are risk factors for a poor prognosis. Until now, we have only known the LD50 of 14 scorpion species from three genera: Androctonus, Buthus and Hottentota, and only 6 species, out of 61 moroccan scorpions, have been assessed for their venom toxicity on mice organs. The venom of harmful moroccan scorpions induces several histopathological changes in the myocardium, brain, liver, pulmonary alveoli, and kidneys in rats, as well as severe consequences in the lungs with intra-alveolar hemorrhage. There was also a significant increase in serum enzyme levels of aspartate transaminase (AST), alanine transaminase (ALT), creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), as well as high levels of plasma albumin, creatine and glucose. In the absence of a specific treatment, the management of scorpion envenomation is based only on symptomatic therapy. We noted a widely use of traditional remedies. Despite the magnitude of the scorpion problem in Morocco, it remains understudied and continues to claim lives, particularly given the lack of an efficient etiological cure.

Epidemiological and faunistic characterization of scorpionism in the Beni Mellal-Khenifra region, Central Morocco.

Scorpionism is a serious public health problem in several parts of the world including Morocco, where is considered as the first cause of intoxication. The Beni Mellal-Khenifra region is one of the most affected regions by this health problem. The aim of this study is to describe the epidemiological and faunistic characteristics of scorpionism in this area. A retrospective epidemiological study was conducted based on the data of 16,388 cases of scorpion stings recorded between 2016 and 2020. In the laboratory, the collected scorpions were determined morphologically based on the valid taxonomic keys. Statistical and descriptive analyses were performed using Excel 2016. Statistical significance was determined by P-value < 0.05. The study comprised 16,388 stung patients. The scorpion stings incidence was 123.58 cases/100,000 population/year and was significantly higher at Azilal province (217.69 cases/100,000 population/year). We found a positive correlation between the scorpion stings incidence and the percentage of the rural population (r = 0.72) and between the scorpion stings incidence and the number of harmful species found in each province (r = 0.69). The general lethality rate was on average of 0.30% with a higher rate in Fquih Ben Salah province (0.63%) followed by Azilal province (0.32%). Children have the highest lethality than adults (p < 0.05). In the study area, eight species were identified, belonging to the families Buthidae and Scorpionidae, including dangerous species. Scorpionism is a real health problem in the Beni Mellal-Khenifra region, which is a rich and diverse area of scorpion fauna. Our findings can be useful for better understanding the problem of scorpionism in this region in order to better control it.