Ethnobotanical survey on herbal remedies for the management of type 2 diabetes in the Casablanca-Settat region, Morocco.

BACKGROUND: Morocco faces a substantial public health challenge due to diabetes mellitus, affecting 12.4% of adults in 2023. The Moroccan population makes extensive use of phytotherapy and traditional medicine to address the difficulties this chronic condition poses. The aim of this study is to document the use of medicinal plants in traditional medicine for managing type 2 diabetes in the provinces of the Casablanca-Settat region. METHODS: The study employed a semi-structured questionnaire for data collection. A study was conducted between August 1st and September 30th, 2023, and 244 individuals diagnosed with diabetes were invited to take part in the research, all of whom used at least one medicinal plant to manage type 2 diabetes, by visiting primary healthcare facilities in Morocco. The analysis included the use of Relative Frequency of Citation (RFC) to scrutinize the data. RESULTS: A total of 47 plant species belonging to 25 families were documented. Notably, the Apiaceae, Lamiaceae, and Fabaceae families were frequently mentioned in the context of treating type 2 diabetes in Morocco. Prominent among the cited plant species were Sesamum indicum L., Lepidium sativum L., followed by Foeniculum vulgare Mill., and Rosmarinus officinalis L. Seeds emerged as the plant part most commonly mentioned, with infusion being the prevailing preparation method and oral consumption being the most frequently depicted method of administration. CONCLUSION: This research underscores the practicality of incorporating traditional medicine into the healthcare framework of the Casablanca-Settat region. The findings not only offer valuable documentation but also have a vital function in safeguarding knowledge regarding the utilization of medicinal plants in this locality. Moreover, they provide opportunities to delve deeper into the phytochemical and pharmacological potential of these plants.

The evolution of the criteria for identifying the new concept of `Neonatal Near Miss`: a systematic review.

BACKGROUND: The concept of Near Miss, has been used in the field of obstetrics as a tool for assessing and improving the quality of care. However, there is no standardized definition or international criteria for identifying neonatal near misses. The current review aims to investigate the development of the neonatal near miss concept based on the results of studies conducted so far on neonatal near misses and their identification criteria. RESULTS: Sixty-two articles were retrieved by the electronic search, and after examination of different abstracts and reading of full texts, 17 articles were considered eligible meeting our inclusion criteria. All selected articles varied in terms of concept definition and criteria used. Neonatal Near Miss was defined as any newborn with pragmatic and/or management criteria who survived the first 27 days of life. All studies reviewed showed a Neonatal Near Miss rate that was 2.6 to 10 times higher than the neonatal mortality rate. CONCLUSIONS: Neonatal Near Miss is a new concept that is currently being debated. There is a need for universal consensus on the definition and its identification criteria. Further efforts are needed to standardize the definition of this concept, including the development of criteria that can be assessed in a neonatal care setting. This is to improve the quality of neonatal care in every setting, regardless of the local level.

Study of the Prevalence of Obesity and Its Association with Maternal and Neonatal Characteristics and Morbidity Profile in a Population of Moroccan Pregnant Women.

Obesity is a real public health problem whose prevalence continues to increase throughout the world. It affects all age groups and does not spare pregnant women. This work aims to determine the prevalence of obesity and to study its association with maternal and neonatal characteristics and the morbidity profile of pregnancy. This is a descriptive and cross-sectional study carried out in the maternity ward of the prefectural hospital center called "Sidi Lahcen" in Témara, Morocco, over a 12-month period. Maternal and neonatal data are collected through a preestablished questionnaire, and anthropometric parameters were recorded. 390 participants, aged between 18 and 43 years, were included in this study, with a prevalence of overweight and obesity of 34.9% and 41%, respectively. Correlation results revealed that the prevalence of overweight and obesity was significantly elevated in women over 25 years (p < 0.001). The rate of caesarean section was four times higher in obese women compared to women of normal weight (53.8% versus 12.8%; p=0.018). The over-term was significantly high in the obese group compared to the nonobese group (33.8% versus 20.2%; p=0.013). A statistically significant positive correlation was found between gestational body mass index and newborn birth weight (r = 0.29; p < 0.001) as well as a high prevalence of macrosomia in newborns of comparatively obese women compared to newborns of nonobese women (17.6% versus 9.6%; p=0.041). The correlation analysis with the morbidity profile showed a significantly high preponderance of gestational diabetes, anemia, and toxemia of pregnancy in the obese group compared to the normal group (p < 0.001). This study clearly demonstrated that obesity during pregnancy is associated with higher risks of maternal and neonatal complications, the management of which places a burden on the health system as well as families. These data reinforce the need to improve antenatal care for the prevention of obesity and its preventable complications.

Prevalence of liver fibrosis and cirrhosis in 699 Moroccan patients with chronic hepatitis C.

INTRODUCTION: chronic hepatitis C (CHC) can cause severe complications, including fibrosis and cirrhosis. Very little is known about the prevalence of these complications in the Moroccan population. METHODS: the prevalence of liver fibrosis and cirrhosis using a non-invasive blood test (FibroTest and ActiTest) was studied in 699 Moroccan patients with CHC for 4 years (from January 2014 to December 2017). The serum immunological markers: α2-macroglobulin, haptoglobin, apolipoprotein A1 were analyzed nephelometrically on BN ProSpec® System. The serum biochemical markers: γ-glutamyltransferase, alanine aminotransferase, and bilirubin were performed using the VITROS® Chemistry System Ortho Clinical Diagnostic. A 699 patients with CHC were identified. RESULTS: the overall prevalence of cirrhosis (F4) was estimated at 31.8%. Thirteen point nine percent (13.9%) of patients with cirrhosis had a risk of developing esophageal varices and a 3.3% risk of developing primary liver cancer. The association between cirrhosis and age showed an increase in prevalence after age 55 years old [OR=7.68(95%CI=4.9-12.2); p<0.0001]. No significant association for cirrhosis was found for sex. CONCLUSION: according to the results of FibroTest, 32% of patients with CHC had cirrhosis. The older age was independently associated with liver cirrhosis.

Study of Clinical and Biological Characteristics of Moroccan Covid-19 Patients With and Without Olfactory and/or Gustatory Dysfunction.

BACKGROUND: The epidemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), presents a significant and urgent threat to global health. This alarming viral infection, declared as pandemic by the WHO in February 2020, has resulted millions of infected patients and thousands of deaths around the world. In Morocco, despite the efforts made by the authorities, the SARS-CoV-2 continues to spread and constitutes a burden of morbidity and mortality. The objective of this study is to describe clinical characteristics of COVID-19 Moroccan patients and to establish the relationship between specific clinical symptoms, namely ageusia and/or anosmia, with these characteristics. METHODS: We performed a descriptive, non-interventional cross-sectional study analyzing data from 108 patients admitted to the VINCI clinic, Casablanca (Morocco). The database includes 39 parameters including epidemiological characteristics, anthropometric measurements and biological analyzes. RESULTS: The average of age of the patients was 43.80 ± 15.75 years with a sex ratio of 1:1. The mean body mass index of the patients was 25.54 ± 4.63 Kg/m2. The majority of patients had, at least, one comorbidity and among 75% symptomatic patients, about 50% had, at least, three symptoms namely, fever (40.7%), cough (39.8%), myalgia (28.7%), and anosmia and/or ageusia (20.4%). From biological analyzes, we noticed lymphopenia and an elevated protein C reactive and lactate dehydrogenases levels in 24.1, 36.1, and 35.2% of patients, respectively. A disturbance in liver function markers was observed in 15.7% of cases. For the other hemostasis parameters, high levels of prothrombin and platelets were reported in 14.6 and 14.8% of patients, respectively. Comparisons related to the presence of anosmia and/or ageusia did not show any difference for demographic and anthropometric characteristics, while a possibility of a significant difference was revealed for certain biological parameters, particularly the levels of lymphocytes, D-dimer and troponin. CONCLUSION: This study provides significant findings that will be used not only to supplement previous studies carried out in Morocco in order to resume the epidemiological situation in comparison with other countries, but also to improve the quality of the diagnosis of COVID-19 patients by identifying all the symptoms of the disease and better understanding its clinical outcomes.

Energy and Macronutrients Intakes among Childbearing Age Women Living in the Urban Area of Morocco: A Cross-Sectional Study.

Over the last few decades, there have been significant dietary and lifestyle changes worldwide. In Morocco, these changes have led to serious nutritional disorders and increased risk of morbidity and mortality particularly among vulnerable groups such as women of childbearing age. We aimed to assess the average daily energy and macronutrient intakes and to investigate their association with socioeconomic factors and weight status among women aged 19-49 years in urban areas. A total of 542 women attending public health centers were recruited. Socioeconomic and demographic data were collected using a questionnaire. Anthropometric measurements were taken using standardized equipment. Food consumption data were obtained through the 24-hour dietary recall method, and the macronutrient composition of foods was estimated based on the Moroccan food composition table and the Nutrilog software. The average daily energy intake among the study population was 1591 kcal, composed of 56% from carbohydrates, 28% from fats, and 16% from protein. Reported energy intake by the majority of women (81.5%) was lower than recommended daily allowances for energy. There was a significant positive correlation between educational level and energy (p=0.001), carbohydrates (p=0.001), proteins (p=0.004), and fats intakes (p=0.032), respectively. A significant negative association of household size with protein intakes was also observed (p=0.034). Carbohydrates, proteins, and fats intakes tended to decrease; however, these associations were not statistically significant. Further studies and appropriate interventions are needed to address the trends in energy and macronutrients intakes in the development of policy initiatives aimed at nutrition education and chronic disease prevention among childbearing age women.

Association of Obesity and Socioeconomic Status among Women of Childbearing Age Living in Urban Area of Morocco.

Worldwide, obesity is considered as an important public health problem. This study aims to explore the social and economic factors associated with overweight and obesity among women of childbearing age residing in the urban area of Morocco. This is a descriptive and analytical study conducted among women (N=240), aged between 15 and 49 years. At recruitment, socioeconomic status (SES) of each participant was assessed, anthropometric parameters were recorded, and body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR) were measured to assess overweight and obesity. Data regarding skipped meals (breakfast, lunch, and dinner) were collected using an adapted questionnaire. The prevalence of overweight and obesity among women of childbearing age was 29.9% and 15.4%, respectively, while for abdominal obesity, the prevalence of overweight and obesity was, respectively, 39.9% and 60.1%. The results indicate that the prevalence of overweight and obesity among women is higher in women aged over 30. A significant association was shown between education level and both BMI and WHR (r1=-0.23, r2=-0.17, p < 0.05), respectively, and there is also a significant correlation between household size and WHR abdominal obesity (r=0.21, p=0.05). Our results reinforce the necessity to improve the access of all social classes in Morocco to reliable information on the determinants and consequences of obesity and to develop plans for adequate prevention and management of obesity.

The impact of maternal socio-demographic characteristics on breastfeeding knowledge and practices: An experience from Casablanca, Morocco.

BACKGROUND: Breastfeeding is universally recognized by the World Health Organization as the best way of feeding infants. Therefore, several countries have initiated health promotion interventions to support successful breastfeeding based on the factors influencing breastfeeding outcomes. OBJECTIVE: To examine the association between the knowledge of breastfeeding and maternal socioeconomic and demographic characteristics, and to determine any impact on child nutritional status. METHODS: A cross-sectional study using both qualitative and quantitative methods was conducted with mothers of infants aged six- to twenty-four months. Data was collected by a semi-structured questionnaire and face-to-face, in-depth interviews with mothers to get an insight into their breastfeeding perceptions and experiences. Educational achievement and occupational class were used as indicators of socio-demographic status. Nutritional status was assessed by anthropometric measurements. RESULTS: A significant relationship between exclusive breastfeeding and the mother's education (P < .001) and socio-economic status (P < .001) has been highlighted. A significant link was pointed out between breastfeeding and length-for-age Z score (LAZ) (P < .001), and weight-for-age Z score (WAZ) (P = .005). Moreover, a strong association was found between maternal employment and exclusive breastfeeding (P < .001). CONCLUSIONS: Our findings shed some light on challenges faced by mothers, as well as an association between socio-demographic characteristics and practices for facilitating exclusive breastfeeding to guide the mothers in breastfeeding management.

Risk factors associated with a breast cancer in a population of Moroccan women whose age is less than 40 years: a case control study.

INTRODUCTION: Breast cancer is the most common cancer in morocco women were it occupies the first place in term of incidence and mortality. The aim of the present paper is to evaluate the risk factors associated with a breast cancer in a population of Moroccan women. METHODS: A case-control study was conducted with population women whose age is less than 40 years during 2008-2010 at the National Institute of Oncology of Rabat. These women were interviewed for Epidemiological information and risk factor for breast cancer. RESULTS: Included in this study were 124 cases and 148 age matched controls. No statistically significant case-control difference was found for the early age of menarche (OR = 2.474; CI 95%: 1.354- 4.521), and family antecedents of first degree of breast cancer (OR = 11.556; 95% CI: 2.548-52.411). However physical activity (OR = 0.507; 95% CI: 0.339 -0.757) early maternity age (OR = 0.212; 95% CI: 0.087 - 0.514), multiparity (OR = 0.742; 95% CI: 0.359 -1.539) and breastfeeding than 6 months (OR = 0.739; 95% CI: 0.357 -1.523) appear as significant protective factors. CONCLUSION: This study show the criminalization of only part of the known risk factors of breast cancer in this age group and confirms the probable protective role of physical activity and factors related to life reproductive women in our study (early childbearing, multiparity and lactation).

Dietery factor obesity microenvironnement and breast cancer.

BACKGROUND: Breast cancer is a multifactorial disease. Factors most often mentioned risks are those related to the environment, genetics, hormones and individual behaviors. Among these include alcohol, smoking, sedentary lifestyle and eating habits. Identification of eating and the role of nutritional factors may be involved in cancer risk have been studied extensively since nearly 40 years. PURPOSE: We conducted a study of breast cancer type case-control with food frequency questionnaire to assess the causal relationship between dietary factor, obesity and breast cancer risk. PATIENTS AND METHODS: female patients with breast cancer were compared to healthy controls at the National Institute of Oncology of Rabat during 2008-2010 and were interviewed for epidemiological information and for their eating habits. RESULTS: A total of 800 women were included in this study (400 cases and 400 controls). Result of univariate analysis showed that significant factors associated with the etiologie of breast cancer: high body mass index (BMI) [odds ratio (OR) =1.30; 95% confidence interval (CI), 1.25-1.37], red meat (OR =1.33; 95% CI, 1.27-1.40), processed meat (OR =1.44; 95% CI, 1.35-1.54), eggs (OR =1.20; 95% CI, 1.14-1.23), poultry (OR =0.70; 95% CI, 0.60-0.80), fish (OR =0.67; 95% CI, 0.61-0.73), fruit (OR =0.67; 95% CI, 0.62-0.72), and vegetable (OR=0.72; 95% CI, 0.67-0.78). Multivariate analysis indicated that a significantly elevated risk of contracting breast cancer was associated with higher BMI (OR =9.61; 95% CI, 6.1-15.15), red meat (OR =4.61; 95% CI, 2.26-9.44) and processed meat (OR =9.78; 95% CI, 4.73-20.24). In contrast consumption of fish (OR =0.07; 95% CI, 0.02-0.24), poultry (OR =0.61; 95% CI, 0.46-0.81), fruit (OR =0.001; 95% CI, 0.00-0.004), and vegetable (OR =0.82; 95% CI, 0.22-3.08) remained as significant beneficial factor associated with breast cancer. CONCLUSIONS: This study is rather in favour of positive association between obesity, consumption of food rich in fatty matter and breast cancer, which is consistent with data from the literature using the same type of investigation. These results encourage increased cohort studies, case-control and experimentation in order to achieve a genuine code of cancer prevention, to define with precision the positive and negative.

Lipid profile among Moroccan overweight women and breast cancer: a case-control study.

BACKGROUND: Breast cancer has become the most common type of cancer in Morocco. In 2005, 127 new cases in women, representing 33.5% of female cancers, were added to the National Center of Oncology registry. The incidence of breast cancer is higher in Morocco than in the three other Maghreb countries, and it is significantly lower than in Western countries where it stands at over 80 cases per 100,000 people. PURPOSE: This 2-year long case-control study was conducted to assess the causal relationship between the lipid profile of overweight Moroccan women and breast cancer risk. PATIENTS AND METHODS: Overweight female patients with breast cancer (n = 400) were compared to 400 healthy controls at the National Institute of Oncology of Rabat. The epidemiological data on the disease and physical activity were gathered by interviewing the patients who had their lipid profile measured (total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol). Body mass index was used to determine if patients were overweight. RESULTS: Univariate analysis revealed a significant association between breast cancer and high body mass index (odds ratio [OR] = 1.31; 95% confidence interval [CI] = 1.25-1.37), menopause (OR = 2.68; 95% CI = 2-3.55), lack of physical activity (OR = 0.26; 95% CI = 0.21-0.31), and triglyceridemia (OR = 3.78; 95% CI = 2.73-5.23). Multivariate analysis revealed that the statistically significant increase in breast cancer risk was associated with a higher body mass index (OR = 1.11; 95% CI = 1.04-1.18), menopause (OR = 9.11; 95% CI = 4.76-17.47), and high triglyceride levels (OR = 4.5; 95% CI = 2.94-6.88). However, a protective effect for physical activity was detected (OR = 0.35; 95% CI = 0.26-0.48). CONCLUSION: This study suggests that there is a connection between hypertriglyceridemia, obesity, and breast cancer risk and confirms a protective role for physical activity on breast cancer risk.