Protective Effect of Phoenix dactylifera L. Seeds against Paracetamol-Induced Hepatotoxicity in Rats: A Comparison with Vitamin C.

Phoenix dactylifera L. (date palm) seeds have been mentioned in the Moroccan pharmacopoeia as efficient remedies against a wide range of diseases including hepatic and gastrointestinal disorders and countless infections. The current work was performed to assess the phenolic profile and hepatoprotective potential of two date seed varieties, locally known as Jihl and Majhoul, aqueous extracts against paracetamol- (PCM-) driven liver toxicity in 42 Wistar rats. The polyphenol profile was built by means of an HPLC analysis. Hepatic damage was provoked by exposing rats to PCM at a dose of 1.5 g/kg once a week. Besides PCM, Jihl and Majhoul date seed extracts (200 and 400 mg/kg) were administered orally in a day-to-day routine. Our findings showed that among the examined polyphenol compounds, p-coumaric acid, quercetin, caffeic acid, and rutin were the most abundant phytochemicals. Date pits significantly (p < 0.001) stabilized the PCM-driven alterations in liver function parameters (AST, ALT, ALP, LDH, total protein, direct bilirubin, and total bilirubin). Moreover, Phoenix dactylifera pits enhanced considerably (p < 0.001) the activities of antioxidant enzymes (SOD, CAT, and GPx) as well as the level of reduced glutathione (GSH). The established hepatoprotective effect may be due to the date seeds antioxidant effect and their ability to trap free radicals. The main outcomes of the present study could validate the traditional use of these date seeds to manage various health conditions.

Argan Oil as an Effective Nutri-Therapeutic Agent in Metabolic Syndrome: A Preclinical Study.

The present study aims at examining the effects of argan oil on the three main cardiovascular risk factors associated with metabolic syndrome (hypertension, insulin resistance and obesity) and on one of its main complications, neuropathic pain. Male Sprague-Dawley rats had free access to a drinking solution containing 10% d-glucose or tap water for 12 weeks. The effect of argan oil was compared to that of corn oil given daily by gavage during 12 weeks in glucose-fed rats. Glucose-fed rats showed increases in systolic blood pressure, epididymal fat, plasma levels of triglycerides, leptin, glucose and insulin, insulin resistance, tactile and cold allodynia in association with a rise in superoxide anion production and NADPH oxidase activity in the thoracic aorta, epididymal fat and gastrocnemius muscle. Glucose-fed rats also showed rises in B1 receptor protein expression in aorta and gastrocnemius muscle. Argan oil prevented or significantly reduced all those anomalies with an induction in plasma adiponectin levels. In contrast, the same treatment with corn oil had a positive impact only on triglycerides, leptin, adiponectin and insulin resistance. These data are the first to suggest that argan oil is an effective nutri-therapeutic agent to prevent the cardiovascular risk factors and complications associated with metabolic syndrome.

Benefits of Argan Oil on Human Health-May 4-6 2017, Errachidia, Morocco.

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Mitochondrial oxidative energy metabolism in guanethidine-induced sympathectomized ducklings.

Here we investigate the possible involvement of the sympathetic nervous system in the respiratory properties of intermyofibrillar and subsarcolemmal mitochondrial populations from heart and gastrocnemius muscles. Mitochondrial oxidative phosphorylation was assessed polarographically by using succinate (plus rotenone), and ascorbate plus N,N,N',N'-tetramethyl-p-phenyl-enediamine (plus antimycin) as respiratory substrates. We report that chronic chemical sympathectomy with guanethidine (150 mg/kg, daily for 3 weeks) induced a marked decrease in whole body metabolic and heart rates, in plasma metabolites (fatty acids and glucose) and norepinephrine levels. Guanethidine treatment decreased mainly the oxidative phosphorylation capacity of subsarcolemmal mitochondria in heart, irrespective of the substrate used. In contrast, both mitochondrial populations were affected by the treatment in skeletal muscle. This suggests that sympathetic nervous system activity can alter the energetic status of muscle cells, and to some extent play a thermogenic role in birds.

Mercurial risk from dental amalgam use in a population of Moroccan dentists: A latent class regression approach.

BACKGROUND: Dentists using dental amalgam are chronically exposed to low doses of elemental mercury. The complex toxico-kinetics of this systemic toxicant results in polymorphic and variable clinical phenotypes. In this context, adapted statistical methods are required to highlight potential adverse effects of occupational mercury exposure on dentists' health. OBJECTIVE: The present study aims to analyze the distribution of self-reported subjective symptoms, commonly associated with chronic mercury poisoning, according to occupational mercury exposure in a population of Moroccan liberal dentists. METHODS: In order to achieve the defined objectives, a three-step latent class regression was fitted. First a latent class analysis was performed to cluster the studied population according to their declared symptoms. Dentists were then classified in the defined latent classes based on their posterior probabilities. Finally, a logistic regression is fitted to identify predictors associated with the latent classes' membership. RESULTS: The final obtained model showed acceptable calibration and discrimination. Its interpretation revealed that the increase of the frequency of amalgam use was associated with significant higher odds of belonging to the high risk latent class. CONCLUSIONS: The present study represents an initial step towards the development of diagnosis model that predict clinical profiles according to occupational mercury exposure.

Sun Exposure Score and Vitamin D Levels in Moroccan Women of Childbearing Age.

Sunlight exposure is an essential source of vitamin D for many humans. However, hypovitaminosis D is a global public health problem. This study aimed to develop and validate a sun exposure score (SES) and correlate it with serum 25-hydroxyvitamin D levels in women of childbearing age. One hundred and sixty women aged 18 to 45 years residing in Meknes, Morocco, were included. A questionnaire estimating the sun exposure score and blood analysis of serum 25-OHD concentration were performed. The questionnaire's reliability and construct validity were evaluated using Cronbach's alpha and factor analysis. Spearman's test was used to assess the correlation between SES and 25-OHD levels. The score's reliability and construct validity were good, with Cronbach's alpha values >0.70 and factorial saturation ranging from 0.696 to 0.948. Serum 25-OHD levels were significantly associated with the total sun exposure score, and all SES domains (Rho was 0.615 (p < 0.0001), 0.307 (p < 0.0001), 0.605 (p < 0.0001), and 0.424 (p < 0.0001) for total SES, indoor exposure domain, outdoor exposure domain, and sun protection practice domain, respectively). In addition, median 25-OHD levels increased significantly when sun exposure was changed from insufficient to sufficient (p < 0.0001). The results suggest that the sun exposure score could be used as a clinical tool to assess vitamin D levels in women of childbearing age.

Prevalence of epilepsy in Morocco: A population-based study.

OBJECTIVE: In Morocco, there was a lack of data related to the epidemiology of epilepsy. This data serves as a useful basis for the development of any national intervention or action program against epilepsy in Morocco. Through this study, we aimed to estimate the active and lifetime prevalence of epilepsy in Morocco. METHODS: We collected data from eight out of 12 Moroccan regions in two steps: In the screening step, we first used a nationwide telephone diagnosis questionnaire and in the second stage, a team of physicians under the direction of an epileptologist conducted a confirmative survey for suspected cases. We fixed the confidence interval at α = 5% and the precision at 0.02. RESULTS: Up to 3184 responded positively to our invitation to participate in this study and were able to answer the questions of the first diagnostic questionnaire. In the diagnostic phase, physicians in neurology reinterviewed all 86 suspected cases using a confirmative diagnosis questionnaire, and 63 persons were confirmed as having lifetime epilepsy and 56 with active epilepsy. The mean age (Mean ± SD) of persons with epilepsy was 35.53 years (±21.36). The prevalence of lifetime and active epilepsy were 19.8 (19.6-20.0) and 17.6 (17.5-17.8) per 1000 (95% confidence interval), respectively. SIGNIFICANCE: This is the first study to estimate the active and lifetime prevalence of epilepsy in Morocco according to the international recommendations of the ILAE. The prevalence of lifetime and active epilepsy were 19.8 (15-24.6) and 17.6 (13.3-22.8) per 1000, respectively. We included both children and elderly subjects. The rates of active and lifetime population epilepsy prevalence in Morocco ranged between Asian and sub-Saharan Africa low- and middle-income countries.

The Moroccan MoCA test: Translation, cultural adaptation, and validation.

PURPOSE: Dementia includes all the symptoms associated with declining mental and cognitive skills, resulting in an inability to perform daily activities. OBJECTIVES: We aimed to translate and adapt the Montréal Cognitive Assessment (MoCA) test into the Moroccan cultural context. We compared the sensitivity and specificity between MoCA and Mini-Mental State of Folstein (MMS) in the screening of dementia. MATERIALS AND METHODS: The participants in this study were residents in the Fez-Meknes region and over 50 years old. We performed translation and adaptation of the English MoCA 8.1 version into all Moroccan languages: Darija, Tamazight in its three variants (Tachelhit, Tarifit, Atlas Tamazight), and Arabic. We validated Moroccan MoCA according to the Beaton et al. instructions. RESULTS: The sensitivity, specificity, and alpha Cronbach of the MoCA test were 88.5, 93.8%, and 0.87, while they were 90.2, 90.8%, and 0.79 for the MMS test. CONCLUSION: The Moroccan MoCA test had high sensitivity, specificity, and internal reliability compared to the MMS test. The availability of the MoCA in the Moroccan language will be helpful in the screening of dementia and research studies in Morocco and other countries.

Factors Associated with COVID-19 Vaccine Acceptance in Morocco: Applying the Health Belief Model.

To identify factors that influenced Moroccans' intention to get a COVID-19 vaccine, a cross-sectional survey among a Moroccan sample was conducted based on Health Belief Model constructs. Participants' sociodemographic characteristics, perceived susceptibility, perceived severity, perceived barriers, perceived benefits, self-efficacy, cues to action, and intention to receive vaccine data were collected and analyzed using a structural equation model (SEM). The survey was completed by 3800 individuals; 57.2% were men, 44.5% were aged 30 to 44, and 44.6% were married. After controlling for confounders, being a woman and having a chronic disease were associated with higher acceptance of the COVID-19 vaccine. The strongest predictor for the intention of receiving a vaccine was participants who were married. Most of the HBM constructs were shown to be significantly associated with vaccine acceptance. Susceptibility and Benefits were the strongest predictors of acceptance of the COVID-19 vaccine (standardized path coefficient, SPC = 0.23), followed by Severity (SPC = 0.22). Conversely, given the negative correlation between barriers and intention (SPC = -0.08), it is necessary to maintain a high level of transparency regarding the vaccines' safety. Our study provides guidance for an implementation of vaccination strategies, intending to bolster the overall COVID-19 immunization program.

Modeling Subjective Symptoms Related to Micro-Hydrargyrism in a Population of Moroccan Dentists.

BACKGROUND: The ability of mercury to deposit throughout the body and alter a wide range of molecular and cellular pathways results in a polymorphic and complex clinical phenotype with over 250 possible symptoms. However, some of them are recurrently cited as evoking chronic mercury poisoning. In this light, dentists users of dental amalgams are chronically exposed to mercury so that in-depth epidemiological investigations and adapted statistical methods are required to highlight adverse effects of this exposure. METHODS: In order to study the health impact of the occupational mercury exposure in a population of liberal dentists practicing in two Moroccan regions, a list of eighteen subjective symptoms commonly associated with micro-hydrargyrism was drawn up. Then, seven statisctical models adapted to count data were fitted. Finally, three methods were used to compare their relative performance in order to choose the most appropriate one. RESULTS: The adopted logical path, from the response variable selection till models' comparison, led us to lean towards quasi-Poisson regression as the best way to predict the number of symptoms declared by dentists according to mercury exposure. CONCLUSIONS: Interpretation of the selected model allowed us to conclude that the reduction of dental amalgam use allows the reduction of subjective symptoms related to mercury exposure.

[Mercury exposure and dentists' health status in two regions of centrall Morocco: descriptive cross-sectional survey]. / Exposition au mercure et état de santé des médecins dentistes de deux régions du centre du Maroc: enquête transversale descriptive.

INTRODUCTION: mercury exposure is recognized as a worldwide public health concern. However, the effect of long-term exposure to low-doses of this heavy metal is still subject to debate. Due to the use of mercury in dental amalgam, dental health care professionals are chronically exposed to low-doses of this metal. In this context, we have conducted a descriptive cross-sectional survey among liberal dentists in two regions of the center of Morocco. In parallel, the global health status of participants was investigated to assess the relevance of a subsequent etiological survey. METHODS: data were collected through a self-reported questionnaire. Occupational exposure of dentists to mercury was evaluated based on their use of dental amalgam. Moreover, the other common factors increasing the background pollution or inducing exposure peaks were also investigated. On the other hand, smoking, vaccination, fish consumption, and the number of dental amalgam in mouth were considered as non-occupational exposure sources. Finally, the self-reported global health problems of participants were collected. RESULTS: 192 dentists were included in the present study. Seventy-six percent (76.04%) of them declared using dental amalgam in their practice. Moreover, the presence of dental amalgam in mouth was identified as the main non-occupational source of exposure to mercury (63.45% of participants). Finally, most of participants (46.35%) have expressed neuropsychological complaints. CONCLUSION: altogether, our results revealed a real mercury exposure in the studied population. Thus, effective preventive measures should be promoted to minimize the mercury exposure in dental offices. Moreover, an etiological study will be of great interest to reveal the impact of mercury exposure in this population.

Effect of Phoenix dactylifera seeds (dates) extract in triton WR-1339 and high fat diet induced hyperlipidaemia in rats: A comparison with simvastatin.

ETHNOPHARMACOLOGICAL RELEVANCE: Date seeds are widely used in Moroccan traditional medicine for treating obesity and related diseases. AIM OF THE STUDY: Two date seed varieties (Jihel and Majhoul) were assessed for their phenolic profile and lipid-lowering activity. MATERIALS AND METHODS: The polyphenolic profile was determined using HPLC-DAD. Triton-WR-1339 and high-fat diet (HFD)-induced hyperlipidaemic rats were used to evaluate the hypolipidaemic effect of date seeds extracts. Serum lipid profile was measured using automatic biochemical analyser. RESULTS: Rutin, quercetin, p-coumaric and caffeic acids were the most prevalent chemical among the analysed phenolic compounds. Serum lipids: Total cholesterol, triglycerides, low-density lipoprotein-cholesterol were lowered and high-density lipoprotein-cholesterol were increased by date seed methanolic extract (at 200 mg/kg) in triton WR1339 -induced hyperlipidaemia in experimental rats. Chronic feeding of these extracts (at 200 mg/kg), to animals concurrently fed with high fat diet (HFD) for three weeks, caused a significant (p < 0.05) decrease in serum total cholesterol, triglycerides, low-density lipoprotein-cholesterol levels and atherogenic index, while it increased serum HDL-C. Furthermore, the supplementation of date seed extract was effective in preventing body weight gain. CONCLUSIONS: These findings are suggestive of hypolipidaemic and atherosclerosis prevention roles of Jihel and Majhoul date seeds.

Phenolic profile and anti-inflammatory activity of four Moroccan date (Phoenix dactylifera L.) seed varieties.

Date (Phoenix dactylifera L.) seeds are seen as good drug to cure rheumatoid arthritis and asthma in Moroccan traditional medicine. The present research aimed to study the anti-inflammatory effect, of methanol extract of different date seed varieties using membrane stabilizing effect, nitric oxide radical scavenging activity, inhibition of protein denaturation, carrageenan-induced paw edema and croton oil induced ear edema. The polyphenolic profile was examined using HPLC-DAD. Rutin, quercetin, p-coumaric and caffeic acids were the main among the analysed phenolic compounds. Concerning the anti-inflammatory activity, the analysed date seed were significantly effective in scavenging nitric oxide free radical, in stabilisation of erythrocyte membrane and possessed a high anti denaturation effect. In agreement with this finding, date seed exhibited a profound ability to reduce paw and ear swelling induced by carrageenan and croton oil respectively. The biochemical parameters showed that date seed are able to reduce the erythrocyte sedimentation rate (ERS) and C-reactive protein (CRP) concentration in rats used in Carrageenan-induced paw edema model. The predominant phenolic compounds are the potential candidates that drive these activities and the differences observed among varieties are related to their chemical composition. These data suggest that date seeds can be explored as a therapeutic agent for the treatment of inflammatory diseases.

In Silico Evaluation of the Potential Antiarrhythmic Effect of Epigallocatechin-3-Gallate on Cardiac Channelopathies.

Ion channels are transmembrane proteins that allow the passage of ions according to the direction of their electrochemical gradients. Mutations in more than 30 genes encoding ion channels have been associated with an increasingly wide range of inherited cardiac arrhythmias. In this line, ion channels become one of the most important molecular targets for several classes of drugs, including antiarrhythmics. Nevertheless, antiarrhythmic drugs are usually accompanied by some serious side effects. Thus, developing new approaches could offer added values to prevent and treat the episodes of arrhythmia. In this sense, green tea catechins seem to be a promising alternative because of the significant effect of Epigallocatechin-3-Gallate (E3G) on the electrocardiographic wave forms of guinea pig hearts. Thus, the aim of this study was to evaluate the benefits-risks balance of E3G consumption in the setting of ion channel mutations linked with aberrant cardiac excitability phenotypes. Two gain-of-function mutations, Nav1.5-p.R222Q and Nav1.5-p.I141V, which are linked with cardiac hyperexcitability phenotypes were studied. Computer simulations of action potentials (APs) show that 30 µM E3G reduces and suppresses AP abnormalities characteristics of these phenotypes. These results suggest that E3G may have a beneficial effect in the setting of cardiac sodium channelopathies displaying a hyperexcitability phenotype.

Cervical cancer and HPV: Awareness and vaccine acceptability among parents in Morocco.

Cervical cancer is a major public health concern in Morocco where it represents the second most common and lethal cancer in women. Human papillomavirus (HPV) vaccines have been licensed in Morocco since 2008 but there are no available data on their acceptability. This study aimed to assess awareness of HPV and the vaccine, and to identify factors associated with acceptability of the vaccine among parents in Morocco. We carried out a questionnaire-based survey using face-to-face interviews in a sample of 852 parents (670 mothers and 182 fathers) with at least one unmarried daughter ≤26 years. We collected data within public and private health centres and clinics in four regions in Morocco between July and August 2012. The main outcome measure was parental acceptability of the HPV vaccine for their daughter(s). Responses revealed very low awareness of HPV infection (4.7%) and the HPV vaccine (14.3%). None of the participants had vaccinated their daughter(s) against HPV and vaccine acceptability was low among mothers (32%) and fathers (45%). Higher education and income, previous awareness of the HPV vaccine and endorsement of the belief that a recommendation from the Ministry of Health or a doctor to have the vaccine would be encouraging, were associated with mothers' HPV vaccine acceptability. Non-acceptability among mothers was associated with having more than two daughters, believing the vaccine was expensive, lack of information and believing that whatever happens to an individual's health is God's will. The only factor associated with the fathers' acceptability of the vaccine was the cost of the vaccine. Increasing HPV and HPV vaccine awareness through educational campaigns, along with active recommendation by physicians and a publically funded vaccination programme could increase parental acceptability of the HPV vaccine in Morocco.

French healthcare workers in geriatric healthcare settings staunchly opposed to influenza vaccination: the VESTA study.

The observational diagnosis phase of the VESTA study was aimed to determine the composite profiles of vaccinated/non-vaccinated HCWs by analyzing reasons to accept/decline influenza vaccination. Between June and September 2005, 2485 HCWs (female: 82.9%; nursing auxiliaries: 42.1%; vaccination coverage: 23.4%) from 53 French geriatric HCSs were included in the study. Cluster analysis determined 3 composite profiles: HCWs for whom information programs on vaccination can be useful (59%), HCWs staunchly opposed to vaccination (36%), and skeptical HCWs (5%). Qualitative analysis provided some aspects of influenza vaccine reluctance. Effective programs would be multidimensional and target the most susceptible group.

Assessment of healthcare worker influenza vaccination program in French geriatric wards: a cluster-randomized controlled trial.

BACKGROUND AND AIMS: The French institute for study of geriatric infection risk (ORIG) has run a multiphase multicenter study (VESTA) to develop and implement active programs promoting healthcare worker (HCW) influenza vaccination. The present article reports results after implementation of the first active program. METHOD: A cluster-randomized controlled trial was conducted from December 1 to December 15, 2005, and a total of 43 geriatric wards (3646 HCWs) were randomly assigned to two clusters. The program cluster (24 wards; 1918 HCWs) received the active program whereas no action was taken in the control cluster (19 wards; 1728 HCWs). The program was educational; its objective was to convince HCWs to be vaccinated by giving them topdown scientific information and developing a sense of altruism. Data from 1201 HCWs (63%) from the program cluster and 1144 HCWs (66%) from the control cluster were collected. RESULTS: The program failed to increase the HCW influenza vaccination rate (program: 34%; control: 32%; p>0.05), but won the faithfulness of vaccinated HCWs (5% vs 8% HCWs quitted vaccination; p<0.05). CONCLUSIONS: Resistance to active influenza vaccination programs was found. Future active programs will have to restore a climate of confidence between sources of knowledge and HCWs and promote "self-protection" in contrast with the protection of elderly people.