Gluten contamination in labelled gluten-free, naturally gluten-free and meals in food services in low-, middle- and high-income countries: a systematic review and meta-analysis.

The gluten-free diet is based on the consumption of foods without gluten, which aims to manage celiac disease. The concern of celiac patients is that these foods should be safe. However, gluten contamination can affect these foods. The objectives of this review and meta-analysis were first, to identify articles that detected gluten contamination in gluten-free foods using validated methods. Second, to quantify the overall prevalence of gluten contamination of naturally gluten-free foods, labelled gluten-free products, and meals prepared in food services. Third, to highlight the influence of the country's income and the period of study on this prevalence. The studies were identified in Scopus, Science Direct, Web of Science, PubMed, and Google Scholar. Forty articles were included according to PRISMA guidelines. The statistical meta-analysis was performed using MedCalc 19 software. The results show that in the gluten-free foods analysed, the overall prevalence of gluten contamination was estimated at 15.12% (95% CI: 9.56%-21.70%), with more than 20 mg/kg of gluten. Naturally gluten-free foods were significantly more contaminated than labelled gluten-free products and than meals in food services (28.32%; 9.52%; 4.66% respectively; p < 0.001). Moreover, it was noticed that oats were the most contaminated food. In addition, the prevalence of gluten contamination has significantly decreased over time. The majority of the studies were carried out in upper-middle-income and high-income countries, while only one study was conducted in lower-middle income countries. Therefore, it is necessary to implement preventive actions to reduce gluten contamination, ensuring safe gluten-free foods for celiac patients, including low-income countries.

Knowledge and Practices of Food Safety among Health Care Professionals and Handlers Working in the Kitchen of a Moroccan University Hospital.

ABSTRACT: Food safety plays a key role in the prevention of foodborne illnesses. Mastery of the correct way of handling food is required especially in hospitals where meals are prepared for patients with low immune function. Food safety knowledge among doctors and dieticians is important because of the fundamental role these professionals play in transferring this knowledge to people who need it. The objective of this study was to assess food safety knowledge and practices among health care professionals and food handlers working in the kitchen of a Moroccan university hospital. This cross-sectional study included 72 doctors, dieticians, hygiene technicians, and hospital kitchen employees, who completed a questionnaire to assess their knowledge on hazard analysis critical control point (HACCP) systems, food poisoning, cross-contamination, and food storage and their practices in terms of food safety. Of the participants in this study, 56% said they had received food safety training, and 74% knew the correct definition of HACCP. The overall food safety knowledge mean score was 0.54 ± 0.15, which corresponds to 54% of questions answered correctly. The food safety knowledge areas with the highest mean scores were cross-contamination and food storage, with 0.58 ± 0.20 (58%) and 0.55 ± 0.20 (55%), respectively. The food safety knowledge scores for dieticians and hygiene technicians were higher than those for hospital kitchen workers and doctors. Knowledge about food storage was significantly associated with gender, age, occupation, and level of education (P < 0.05). Correct food practices were observed among 93% of the hospital kitchen staff and 50% of the health care professionals. These results indicate the need for preventive and corrective actions such as training and education about food safety to improve the knowledge and food safety practices of hospital professionals.

Anxiety and Depression Comorbidities in Moroccan Patients With Breast Cancer.

Background: Breast cancer is the leading cause of cancer death in women worldwide with more than 1. 7 million new cases annually. Major advances have been made in the therapeutic management of this condition in many countries. However, neuropsychiatric disorders in patients with breast cancer constitute a significant concern due to their negative impact on patient's life and on the success of therapy itself. Methodology: In this study we aimed to evaluate psychological disorders in a population of 212 Moroccan women treated for breast cancer within the Mohammed VI Center for the Treatment of Cancers of Casablanca. A questionnaire was designed to this end on the basis of different validated scales, including the Hospital Anxiety Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), and the Body Image Scale (BIS). Results: Data analysis has shown that 69.3% of participants had significant sleep disorders; 87% suffer from an anxiety-depressive syndrome (ADS), and 83.0% had significant body image dissatisfaction. A positive correlation was shown between ADS and both patients' national health insurance coverage and patients or husbands' education. Analysis further revealed that anxiety and depression were negatively correlated with different types of treatment. Similarly, both BIS and PSQI scores were positively associated with anxiety and depression disorders. Conclusion: The present investigation highlights the need to generalize and strengthen the psychological approach of patients treated for breast cancer in Morocco. We anticipate that such a strategy will alleviate suffering and promote therapy success in these patients and will diminish or prevent conjugal and familial impacts of the illness.

Anti-scorpion venom activity of Thapsia garganica methanolic extract: Histopathological and biochemical evidences.

ETHNOPHARMACOLOGICAL RELEVANCE: Thapsia garganica, is a herbal medicine traditionally used as diuretic, emetic and purgative. It is also used as anti-scorpion venom in Morocco; however, its protective effects against scorpion venom remain elusive. AIM OF THE STUDY: The present study was undertaken to evaluate anti-venom activity of T. garganica in vivo through histological and biochemical studies. MATERIALS AND METHODS: Methanolic leaves extract of T. garganica was evaluated for anti-venom activity against buthus. occitanus under in vivo conditions. Histopathological and biochemical changes in envenomed and treated mice were also examined. Phytochemical screening was conducted to estimate the major constituents whereas DPPH, ß -Carotene-linoleic acid and reducing power assays were performed to evaluate the anti-oxidant activity of T. garganica extract. RESULTS: Methanolic leaves extract of T. garganica (2g/kg) increased the survival time (> 18h) of mice injected with lethal doses of B. occitanus venom, with remarkable recovery of histology damage. Furthermore T. garganica induced a significant decreased of biochemical markers of kidney, liver and heart function. Phytochemistry screening revealed the presence of phenolic compounds, flavonoids, tannins and steroids/terpenoids, which might explain the bioactivity of the extract. It was also shown that the extract has an exceptionally high antioxidant activity compared to well-known antioxidants used as standards. CONCLUSION: The present study provides strong evidence that support the use of T. garganica as anti-scorpion venom in traditional medicine in Morocco. However, additional studies are required to isolate and identify the metabolites responsible for the activity.