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.

Influence of salinity, nitrogen and phosphorus concentrations on the physiological and biochemical characteristics of two Chlorophyceae isolated from Fez freshwater, Morocco.

Microalgae are widely exploited for numerous biotechnology applications, including biofuels. In this context, Chlamydomonas debaryana and Chlorococcum sp. were isolated from Fez freshwater (Morocco), and their growth and lipid and carbohydrate production were assessed at different concentrations of NaCl, NaNO3, and K2HPO4. The results indicate a small positive variation in growth parameters linked to nutrient enrichment, with no considerable variation in carbohydrate and lipid levels in both algae. Moreover, a negative variation was recorded at increased salinity and nutrient limitation, accompanied by lipid and carbohydrate accumulation. Chlorococcum sp. showed better adaptation to salt stress below 200 mM NaCl. Furthermore, its growth and biomass productivity were strongly reduced by nitrogen depletion, and its lipid production reached 47.64% DW at 3.52 mM NaNO3. As for Chlamydomonas debaryana, a substantial reduction in growth was induced by nutrient depletion, a maximal carbohydrate level was produced at less than 8.82 mM NaNO3 (40.59% DW). The effect of phosphorus was less significant. However, a concentration of 0.115 mM K2HPO4 increased lipid and carbohydrate content without compromising biomass productivity. The results suggest that growing the two Chlorophyceae under these conditions seems interesting for biofuel production, but the loss of biomass requires a more efficient strategy to maximize lipid and carbohydrate accumulation without loss of productivity.

Multiple sclerosis in Morocco: Epidemiological, clinical, and therapeutic profile.

OBJECTIVE: This study aims to describe the clinical, therapeutic, and epidemiological profiles of MS patients in Morocco. METHODS: This descriptive study involved 170 patients representing four Morocco regions. We collected the data using an electronic survey. RESULTS: The results show female dominance in patients with MS. Besides, most patients present with relapsing-remitting MS (RRMS). The main clinical symptoms reported by patients are fatigue, cognitive issues, spasticity, bowel or bladder complaints, and visual issues. Furthermore, the findings show that almost half of the patients use Interferon bêta-1a and azathioprine as disease-modifying therapies; 60.5 % use traditional and complementary medicine, of which 30.6 % use cupping, 30 % recite the Holy Quran, and 28.2 % use apitherapy. The findings show that there is a statistically significant relationship between specific MS factors such as professional activity (p = 0.0071), degree of satisfaction with treatment (p = 0.005), stress (p = 0.014), and the frequency of relapses. CONCLUSIONS: In addition to DMT, patients also use traditional and complementary medicine. There is also a relationship between some epidemiological characteristics and the frequency of relapses in patients with MS.

Antibacterial activity of essential oils of Salvia Officinalis growing in Morocco.

Background: The bacterial infections treatment is complicated by antibiotic resistance. In this fact, the need for new therapeutic approaches to control bacterial infections is crucial. Therefore, discovering new antibiotics from medicinal plants, able to kill drug-resistant bacteria, is essential to saving modern medicine. Objective: This study was to evaluate the in vitro antibacterial activity of Salvia officinalis essential oil (SoEO) growing in Morocco. Material and methods: The essential oil was extracted by hydro distillation, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by agar dilution method. The essential oil was analyzed by Fourier-transform infrared spectroscopy (FTIR) and fractionated/purified using column chromatography followed by thin-layer chromatography (TLC). Results: The results revealed that SoEO showed higher antimicrobial activity against Enterococcus faecalis and Citrobacter freundii. Fourier-transform infrared spectroscopy (FTIR) analysis, and purification/fractionation of SoEO, indicates that the most polar fraction F6 is the active fraction of SoEO. This finding can be explained by the existence of polar compounds in this fraction including alcohols, and phenols as thymol, eugenol, globulol, and spathulenol. Conclusions: It can be conclude that alcohols and phenols from Salvia officinalis essential oil (SoEO) have promising antibacterial activity. This action can offer a great possibility of the application of SoEO in the treatment of bacterial diseases.

Comparison of different Pancreatic cancer treatments: a three-year retrospective study in the oncology center of Tangier university hospital, Morocco.

BACKGROUND: Pancreatic cancer is among the most lethal malignancies, with a 5-year overall survival (OS) of less than 10% for all stages. The present study aims to evaluate the epidemiological and clinical characteristics, as well as the results of different treatments of patients diagnosed and treated between 2019 and 2021 in the Oncology Center of Tangier, University Hospital, Morocco. METHODS: To compare the evolution of the pancreatic cancer between the different chemotherapy regimens, a retrospective study was performed using data collected over a period of 3 years. For each patient, the data were described and statistically analyzed in the dedicated operating sheet. RESULTS: 55 pancreatic cancer patients were included in this study, and the median follow up was 3 months. The mean age of patients was 59.5 ± 10.3 years (extremes 34-79) and the sex ratio male/female was 0.9. Most patients were diagnosed with adenocarcinoma (92.3%), but metastatic stage was the most frequent (56.4%). The surgery was applied to 16.36% of patients. 10.9% of patients have received adjuvant chemotherapy and 76.4% received palliative chemotherapy. Chemotherapy regimens included mainly Gemcitabine and Folfirinox. The median OS was significantly longer for patients treated with Folfirinox versus Gemcitabine (6 months versus 3 months, p-value < 0.016). The median OS for patients that received Folfirinox and Gemcitabine successively (19.7 months) was significantly longer compared to patients that received a monotherapy with either Folfirinox or Gemcitabine alone (p-value < 0.016). CONCLUSION: These findings reinforce the use of advanced methods for earlier detection of pancreatic cancer and the development of effective immunotherapies or more targeted therapies.

Chemical Composition and Larvicidal Properties of Essential Oils from Wild and Cultivated Artemisia campestris L., an Endemic Plant in Morocco.

The Asteraceae family is well known for its toxic and repellent activity against mosquitoes. In this study, essential oils (EOs) extracted from the aerial parts of both wild and cultivated Artemisia campestris L. plants were tested for larvicidal activity against Culex pipiens (Diptera: Culicidae), a pest mosquito widely suspected to be the vector responsible for West Nile virus transmission. The research aims at comparing the chemical composition and insecticidal activity of cultivated and wild A. campestris EOs. The EOs were obtained by hydrodistillation from the plant's aerial parts and were analyzed using GC-MS. Furthermore, the larviciding experiment was carried out following the standard WHO protocol. The result showed that wild and cultivated plant EOs differed only quantitatively, while the qualitative profile revealed a nearly identical chemical composition. Camphor (18.98%), car-3-en-5-one (11.25%), thujone (6.36%), chrysanthenone (6.24%), filifolone (4.56%), and borneol (3.56%) dominate the wild plant EO. Camphor (21.01%), car-3-en-5-one (17%), chrysanthenone (10.15%), filifolone (7.90%), borneol (3.38%), and thujone (3.08%) are the major compounds of the cultivated plant. Cultivation did not affect the EO production since the yield of the cultivated plant was 0.5 ± 0.1% and 0.6 ± 0.2% for the wild plant. The cultivated A. campestris EO had the highest insecticidal activity (LC50 = 9.79 µg/ml), and no significant difference was noticed between wild and cultivated A. campestris EO in terms of LC90. These findings could pave the way for a new method of producing biocides to control major disease vectors and offer a potential alternative for pest control.

Use of new Indices for the Assessment of Air Quality in the Safi Region (Morocco) using Lichen Biomonitoring of Air Contamination by Trace Elements.

This study aims to use environmental indices as complementary tools to other air quality biomonitoring techniques. The concentrations of trace elements Hg, Se, V, Mo, and Ba were analyzed by ICP-MS in four lichens: Xanthoria calcicola, Xanthoria parietina, Ramalina pollinaria, and Ramalina lacera. To assess the contamination of lichens by trace elements, different environmental indices were calculated: Contamination Index (Ic), Contamination Factor (CF), Pollution Load Index (PLI) and Enrichment Factor (EF). The results revealed that the genus Ramalina has a low tolerance to polymetallic pollution with a PLI not exceeding 0.44. The genus Xanthoria seems more resistant to polymetallic pollution with a maximum PLI of 2.58. The calculation of the enrichment factor revealed a very strong enrichment of the lichens in Mo, Hg and Se with a maximum content in Ba which reflects a strong metallic contamination of various origins especially in the urban and industrial areas of the region.

Antidiabetic and Antidyslipidemic Effects of Artemisia mesatlantica, an Endemic Plant from Morocco.

AIMS: The study aimed to assess the antihyperglycemic and antidyslipidemic activities of Artemisia mesatlantica. BACKGROUND: Artemisia mesatlantica is an endemic plant of Morocco used in traditional medicine as an alternative treatment for diabetes. OBJECTIVE: The study was designed to examine the antihyperglycemic and antidyslipidemicability of aqueous extract of Artemisia mesatlantica (AMAE) in experimental animal models. METHODS: The effect of the single and repeated oral administration (7 days of treatment) of AMAE (60 mg/kg) on blood glucose and lipid profile were assessed in normal and streptozotocin-induced diabetic rats. Furthermore, to confirm the antidyslipidemic effect of Artemisia mesatlantica, a model of hyperlipidemia induced by tyloxapol (Triton WR-1339) in rats was used. RESULTS: The AMAE (60 mg/kg) was able to significantly reduce glycaemia, improve lipid profile and increase hepatic glycogen content in STZ-induced diabetic rats. In addition, pretreatment of rats for 7 consecutive days with an aqueous extract of Artemisia mesatlantica (600 mg/kg) prior to tyloxapol injection prevented increases in plasma levels of total cholesterol, triglycerides and LDL-c. CONCLUSION: From these observed results, it can be deduced that Artemisia mesatlantica possesses remarkable antidiabetic and antihyperlipidemic properties.

Consumption of food supplements in the Fes-Meknes region (Morocco); profiles and typology.

Background: The consumption of food supplements is increasing. This evolution is due to several factors, including nutritional deficiencies in the population, a sedentary lifestyle, and a decrease in physical activity. In addition, stress and an active lifestyle led to several dysfunctions (fatigue, deconcentration) that food supplements can help to overcome. Objective: This study aimed to determine the profiles of food supplement consumers in the Fes-Meknes region (Morocco), distribution, and production of these products. In addition, this survey aimed to evaluate consumers' knowledge of food supplements as part of their self-medication. Material and methods: The present study was conducted in the form of a survey using a questionnaire composed of two parts. The first part provides information on the socio-demographic status of respondents, including gender, age, and level of education. The second part concerned various information on the consumption of food supplements. Results: The results obtained showed that of the 498 subjects, 68.88% declared that they had already consumed the food supplements. The study revealed the predominance of the female gender at 69.68% and the age group 21-30 years (80.32%). Among the reasons for consumption, improving general health comes first with 56.29%. Our results also showed high consumption of vitamins (44.04%) and minerals (24.79%), next come proteins and plant extracts at 16.62% and 14.54% respectively. The consumption of food supplements is most often done on the advice of a doctor or dietician with 43.60%, and the pharmacy and para-pharmacy remains the main distribution channel at 75.78%. Conclusion: The present survey allowed us to update the current situation of food supplement consumption and a way of regulatory monitoring and more control for an organization of the sector.

Assessing the performance of a waste management system towards a circular economy in the Global South: The case of Marrakech (Morocco).

Waste management is essential for the safety and wellbeing of any society; it also helps to tackle global problems, such as climate change and resource scarcity. To support the evolution of waste management systems (WMSs) towards a circular economy (CE), assessment methods are applied. This paper shows, using the case of Marrakech (Morocco), how a novel holistic approach called WMS development stage concept (WMS-DSC) is applied to assess WMSs and determine measures promoting a CE. The approach enables a simplified derivation of measures that are useful to municipal decision makers and consists of five stages; stage 1 is equal to a WMS lacking essential WM elements and stage 5 describes a functioning CE. The approach was specifically designed to be transferable to other Global South cities through the categorization into these universal stages. The results from the WMS-DSC show that components related to energy recovery and waste recycling are classified in stage 1. For the latter, a slight development towards stage 2 can be assumed due to the planned activities in Marrakech. The components "collection and transport" and "prevention and reuse" are mainly in stage 2. Nevertheless, the components "governance", "sector and market" and "waste disposal" are assigned to stages 2 and 3 with a stronger trend towards stage 4. The results show that in Marrakech and Morocco, CE is still in its infancy, and with this current state, it is hard to achieve. However, 33 measures were determined to improve the WMS of Marrakech and promote a CE.

Chemical Characterization and Several Bioactivities of Cladanthus mixtus from Morocco.

The purpose of this work was to investigate, for the first time to our knowledge, the chemical composition and bioactivity of methanolic extracts (roots, stems, leaves, and flowers) from Cladanthus mixtus (L.) Chevall. that grows wild in northern Morocco (the Tangier-Tetouan-Al Hoceima region). The phenolic and flavonoid contents were determined by spectrophotometer methods, and the composition of derivatized methanolic extracts from C. mixtus using N-O-bis(trimethylsilyl) trifluoroacetamide (BSTFA) was analyzed by gas chromatography-mass spectrometry (GC-MS). The antioxidant activity was carried out by applying the 2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and DPPH (2,2-diphenyl-1-picrylhydrazyl) tests. The micro-dilution technique was chosen to investigate the antimicrobial activity of methanolic extracts against two bacterial strains and three fungal species. The results showed that the values of total phenolic and flavonoid contents were found to be higher in flower extracts (30.55 ± 0.85 mg of gallic acid equivalents (GAE)/g of dried weight (DW) and 26.00 ±1.34 mg of quercetin equivalents (QE)/g DW, respectively). Other groups of chemical compounds were revealed by GC-MS, such as carbohydrates (27.25-64.87%), fatty acids (1.58-9.08%), organic acids (11.81-18.82%), and amino acids (1.26-7.10%). Root and flower methanolic extracts showed the highest antioxidant activity using ABTS (39.49 mg of Trolox equivalents (TE)/g DW) and DPPH (36.23 mg TE/g DW), respectively. A positive correlation between antioxidant activity and polyphenol and flavonoid amounts was found. Antibacterial tests showed that the best activity was presented by the leaf extract against Staphylococcus aureus (minimum inhibitory concentration (MIC) = minimum bactericidal concentration (MBC) = 20 mg/mL) and Escherichia coli (MIC of 30 mg/mL and MBC of 35 mg/mL). S. aureus was more sensitive to the extracts compared to E. coli. All extracts showed antifungal activity against Trichophyton rubrum, with the best efficacy reported by the flower and leaf extracts (MIC = 1.25 mg/mL and minimum fungicidal concentration (MFC) = 2.5 mg/mL). In general, extracts of C. mixtus appeared less effective against Candida albicans and Aspergillus fumigatus.

Diversity of Medicinal Plants Used by the Local Communities of the Coastal Plateau of Safi Province (Morocco).

Traditional herbal medicine is still used for basic healthcare by a significant portion of the population in developing countries. This study aimed to explore the medicinal plant's diversity and to document related traditional knowledge in the Safi region of Morocco. We used semi-structured questionnaires to interview 222 informants living in the study area. To perform data analysis, we used quantitative indices like use value (UV), family use value (FUV), fidelity level (FL), the relative popularity level (RPL), rank of order priority (ROP), and informant consensus factor (ICF). We reported the ethnomedicinal uses of 144 medicinal plants belonging to 64 families. According to the findings, the dominating families were Lamiaceae (17 taxa), Asteraceae (15 taxa), and Apiaceae (12 taxa). The most commonly utilized plant part (48%) was leaves. The decoction was reported as the main preparation method (42%). Highly cited plant species were Marrubium vulgare (UV = 0.56), Salvia rosmarinus Spenn. (UV = 0.47), Thymus serpyllum (UV = 0.32), and Dysphania ambrosioides (UV = 0.29). Papaveraceae (FUV = 0.26), and Urticaceae (FUV= 0.23), Geraniaceae (FUV = 0.17), Oleaceae (FUV = 0.17), Lamiaceae (FUV = 0.17) had the highest family use-values. Gastrointestinal disorders (88%), respiratory diseases (85%), and anemia (66%) have the greatest ICF values. This study reveals the indigenous people's reliance on plant-derived traditional medicine to prevent, alleviate, and treat a broad range of health concerns. Our findings will provide a scientific basis for ethnomedicinal legacy conservation and further scientific investigations aimed at new natural bioactive molecules discovery.

Ethnobotanical Survey and Pharmacological Screening of Medicinal Plants Used as Antihypertensive in Sefrou Province (Middle-North of Morocco): Benefits and Challenges.

Herbal medicine was used since the old time in the treatment of different types of diseases in Sefrou province, Morocco. However, few studies have been carried out to identify local medicinal flora and to scientifically document the knowledge of the traditional use of these medicinal plants by the population. This study aims to investigate the medicinal plants in Sefrou province, record their usage in folk medicine by the population and evaluate the hypotensive effect of selected plants using in vitro vascular activity. For that, an ethnobotanical survey was conducted among the Arabs and Amazighs population of Sefrou province from January 2017 to December 2018. The survey was conducted through oral interviews with a structured questionnaire. It covered those who knew and/or used plants for medicinal purposes, retailers, and wholesalers, and also included ecological repartition as well as the mode of administration. Then we selected some plants to evaluate the antihypertensive activity based on the in vitro bioassay. A total of 134 medicinal plants belonging to 52 families were identified; 61% are wild species, 49 (36%) are cultivated and 4 (3%) are cultivated as well as spontaneous. Medicinal plants used in Sefrou folk medicine have been investigated for their antihypertensive activity. They were selected based on their usage as cardiotonic, diuretics, and other uses related to the symptoms of hypertension. Most of the plants tested in this study were found to be more sensitive to relaxing contractions induced by noradrenaline. Out of 32 species examined, 14 (44%) showed more than 50% inhibition in isolated rat aortic rings, the vasorelaxant activity of these plants used for the screening was mostly inhibited by pre-treatment with N-ω-nitro-L-arginine (L-NOArg). The plants inventoried are alleged to be active against 104 therapeutic indications. Nine common symptoms are widely treated in indigenous pharmacopeia: gastrointestinal (19 plants), renal (27 plants), broncho-pulmonary system (7 plants), skin (13 species), diabetes (12 plants), cardiovascular (13 plants), eye, ear, nose, teeth, and throat diseases (5 plants); gynecological disorders (6 plants); rheumatism and gnawing pain (11 plants). 14% (19 species) of the plant inventoried are traded on a large scale and scope and more than 90 percent of the medicinal plants purchased from Sefrou go to big cities for export. The expansion of unregulated trade and commercial use of medicinal and aromatic plants poses a major threat to biodiversity in the region. Overall, people in Sefrou hold rich knowledge of herbal medicine. The vasorelaxant activity proved for the documented plants will provide a basis for other preclinical and clinical investigations.

Determination of uranium and thorium contents in various material samples of Morocco using a new Monte Carlo code for evaluating the mean critical angle of etching of the CR-39 and LR-115 type II SSNTDs.

In this paper an original Monte Carlo code for calculating the mean critical angle of etching of the CR-39 and LR-115 type II solid state nuclear track detectors SSNTD have been developed in order to determine the levels of uranium and thorium contents in a variety of natural material samples. We have also measured these concentrations via others techniques. Results obtained by the current method are more precise than those obtained by detection efficiency and isotope dilution mass spectrometry methods. The dependence of the SSNTDs means critical angles on the initial alpha particle energy and the density of the material have been investigated. A series of equations were used to calculate the mean critical angle of SSNTDs detectors and to estimate the concentrations of uranium and thorium inside studied materials.

Assessment of phytosanitary practices on the environment: case study potato of Loukkos (northwest Morocco).

Loukkos perimeter is among the most important irrigated agricultural areas in Morocco. It covers horticulture and market garden production, including potato. This crop is characterized by the intensive use of pesticides that could lead to health and ecological risks, via the food chain and contamination of natural resources, including groundwater. This study is aimed at assessing the use of pesticides in potato cultivation and their impacts on the environment and human health. Here, pesticide use was characterized by the number of treatments (NT), quantity of active substances indicator (QASI), and the treatment frequency indicator (TFI), through field surveys carried out on 50 Loukkos potato producers. The results showed that farmers use heavy pesticide treatments, mainly against late blight. We determined NT = 19 treatments, total TFI = 28.10, and QASI = 14.86 kg/ha. These values reflect a massive use of pesticides on this crop, which could therefore constitute a challenge and a major constraint for the development of sustainable agriculture in this zone, due to their negative environmental and health effects. It is, therefore, necessary to react quickly to make changes in phytosanitary practices with the aim to monitoring pesticide use via the agro-environmental indicators to reduce health and environmental impact of intensive pesticide use.

Development of WEF-P Nexus based on product-supply chain: A case study of phosphorous fertilizer industry in Morocco.

The aim of this study was to analyze various sustainability strategies for phosphate and phosphorous fertilizer production systems from the perspective of their holistic impacts on water, energy, and CO2 emissions. The study was conducted using the Water-Energy-Food (WEF) Nexus Tool 2.0, adapted to include the phosphate industry (WEF-P tool). It assesses the scenarios based on priorities identified by the Moroccan phosphate industry, such as the environmental impact of transporting phosphate rock by train and phosphate slurry by pipeline and increased desalinated water use. Results show that each scenario's sustainability can be assessed in terms of phosphate production, processes, resource (water and energy) availability, and CO2 emissions in mining and manufacturing areas. The analytical methodology of the tool is based on an integrated supply chain and life cycle assessment, which includes the production flows linking mining phosphate and manufacturing phosphorous fertilizers and their water and energy supply systems. Field surveys were used to identify the supply chain and estimate the relationships between production and resource consumption in each process. The tool is a decision-support platform that produces sustainability indices for multiple scenarios of resource allocation (water and energy) and CO2 emissions, allowing stakeholders to compare potential outcomes and formulate decisions based on their understanding of the actual trade-offs involved.

Network evolution and risk assessment of the global phosphorus trade.

Phosphorus is an essential element for food production, but the distribution of its global reserve is highly uneven. With the increasing demand for products from all sectors of the phosphorus supply chain, the international phosphorus material trade is becoming increasingly intensive. However, the evolution of the global phosphorus trade network and potential supply risks caused by the trade structure and trade stability are rarely evaluated. By employing the complex network theory, a phosphorus material trade network and a quantitative evaluation index of the trade risk using the external supply risks are proposed to evaluate the supply risk in different countries from 2000 to 2020. According to the network analysis of global phosphorus trades for phosphate rock, phosphorus fertilizer and phosphoric acid, the number of trading countries and trading links has generally increased during the last twenty years. However, the trade structure was found to be significantly altered due to the stresses on the phosphorus reserve scarcity and trade restrictions from countries such as the United States and China. Correspondingly, Morocco has become the largest phosphorus-exporting country since 2016, while India was the world's largest phosphorus-importing country between 2008 and 2015. The topological network characteristics indicate that the phosphorus trade is well connected and more stable over time, but high supply risks were also identified, especially in developing countries in Africa within their phosphate rock and phosphorus fertilizer trade, which might threaten their food security. The obtained findings would be helpful for phosphorus trading countries to manage their trade risks in a timely manner.

Efficacies and side effects of medicinal plants used by patients with cancer in Morocco: A retrospective treatment-outcome study.

ETHNOPHARMACOLOGICAL RELEVANCE: Medicinal plants have long been used as traditional medicines in Morocco. Patients with cancer frequently use medicinal plants, with a frequency ranging from 11% to 39%. No studies have evaluated these patients in the Beni Mellal-Khenifra region. AIM OF STUDY: We investigated the beneficial and adverse effects of medicinal plants used by patients with cancer in this region. METHODS: We conducted a retrospective study of the outcomes of traditional treatment with medicinal plants (retrospective treatment-outcome study: RTO) in 194 patients with cancer at the regional oncology centre of Béni Mellal. RESULTS: Beneficial effects were reported by 39% of patients. All users of the seeds of Prunus armeniaca L. reported beneficial effects (100%), followed by Curcuma longa L. (50%). We did not observe any significant difference in efficacies between the most commonly used plants (P > 0.05). Patients with cancer who had a low socioeconomic level experienced greater benefits from herbal medicines (p < 0.05). The prevalence of adverse effects was 16%. Juniperus oxycedrus L. was perceived as the most toxic plant (13 patients), as it induced significantly greater toxicity than the other plants (P < 0.05). Patients with a cancer duration of more than 12 months reported more adverse effects (p = 0.05). CONCLUSIONS: The frequency of beneficial effects was higher than that of adverse effects. Health professionals should be aware of these effects in the process of therapeutic education. Preclinical and clinical research are considered necessary for the in-depth evaluation of the efficacies and toxicities of certain plants that have shown toxic or therapeutic potential.

Medicinal plants used in the traditional treatment of diabetes in Ksar Elkebir Region (North-Western Morocco).

Introduction: the number of people with diabetes continues to increase worldwide. In Morocco, two million adults are estimated to be diabetic in 2018. The Moroccan population is known for the use of medicinal plants and natural recipes for the treatment of chronic diseases including diabetes. The present study aimed to make an inventory of plant species used in folk medicine for the treatment of diabetes mellitus by diabetic patients in Ksar Elkebir City (North-west, Morocco). Methods: an ethnobotanical study was carried out among 250 diabetic patients by means of a semi-structured questionnaire by direct interviews. Results: a total of 29 species of plants belonging to 23 families were identified. The most represented families were Lamiaceae, Apiaceae, Asteraceae, fabaceae, and Lauraceae. While the most frequently cited plant species were Olea europaea l, Trigonella foenum graecum l, Origanum compactum benth l and salvia officinalis l. Leaves were the most used part of plants and the decoction was the most cited mode of preparation used by the population included in the study. Conclusion: people with diabetes in Ksar Elkebir Region use a variety of herbal remedies in several ways to treat diabetes. This result can be an important database for the following studies to confirm the efficiency of these plants in vitro and in vivo.

Perceptions, Motivations, and Empowerment Strategies of Midwives in Rural and Remote Areas of Northern Morocco.

The shortage of midwives is a problem in rural and remote areas. This is mainly the consequence of job insecurity and difficult living conditions. The present study aimed to identify and analyse the perceptions and motivations of midwives in rural and remote areas of northern Morocco on the quality of their working life and the motivational factors and empowerment strategies they use to maintain and develop their work. It is a qualitative study that follows Van Manen's hermeneutic phenomenology approach. Three focus groups and in-depth interviews were conducted with 15 midwives from rural and remote areas. The results indicate that midwives in rural and remote areas have a negative perception of the quality of the work and their personal life because of the scarcity of basic resources, unfavourable working conditions, and the personal sacrifices they have to make to support themselves. However, some factors favour their efforts. Therefore, there is a need to promote intersectoral policies that focus on improving material and human resources, as well as the working and personal conditions of midwives and the factors that support and empower them.