H Syndrome: Three New Cases from Morocco.

A 19-year-old girl presented with symmetric and bilateral hyperpigmentation, an indurated lesion that initially appeared on the axillary fold at the age of 14, which then extended to the lower back, anterior aspect of both thighs, and popliteal fold. No hypertrichosis was observed (Figure 1).The patient was the youngest of the four children, born from the first-degree consanguineous marriage. She was born at full term and weighed 2,420 g at birth. No similar patient was present in the family. The patient experienced delayed motor acquisition and stature growth (3rd percentile) until the age of 4. Right hypoacusis was diagnosed at the age of 6. She developed hallux valgus, flexion contracture of the fin-gers and toes, barrel deformity of the anterior thorax, and recurrent fever. The laboratory tests, including fasting blood glucose, -triglycerides, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were normal. Her abdominal, pelvic, and transthoracic ultrasound scans were normal, with no hepatosplenomegaly, lymphadenopathy, or cardiac abnormalities. Histologic analysis demonstrated patchy acanthosis of the epidermis, with orthokeratotic hyperkeratosis. Keratinocyte hyperpigmentation and spongiosis at certain areas were observed with moder-ate inflammation because of the infiltration of lymphocytes, histiocytes, and plasma cells. Immunohistochemical analysis showed macrosialin (CD68+) and common gamma chain (γc) CD132. Germline mutations in the SLC29A3 gene were not analyzed. The patient was prescribed dermocorticoids with depigmentation therapy, which demonstrated moderate clinical evolution.

Minerals and trace element compositions of some seaweeds from the Marchica lagoon, North-East Mediterranean coast of Morocco.

The objective of the present study was to evaluate the mineral and heavy metals composition of different seaweeds growing in Marchica lagoon. To this end, green seaweeds, red seaweeds, and brown seaweeds were collected from three different stations in the Marchica lagoon. The highest concentration of Ca was measured in Centroceras clavulatum (17.12 ± 0.60), K in Caulerpa prolifera (15.17 ± 0.20), Na in Gracilaria dura (4.16 ± 0.03) and Hypnea musciformis (4.09 ± 0.03), Mg in Ulva rigida (2.80 ± 0.06), and the highest concentration of P was registered in Ulva intestinalis (3658 ± 14). Centroceras clavulatum and Gracilaria dura had the highest Al, Fe, and Sr levels. Cystoseira compressa had the highest As (53.8 mg/kg) and Rb (43 mg/kg). These findings suggest that seaweeds collected from Marchica lagoon could be used as potential sources of minerals and trace elements in seaweed-based products for human and animal nutrition alike.

Prevalence and risk factors associated with uncontrolled blood pressure in rural areas in Settat City, Morocco.

Introduction: high blood pressure, commonly known as hypertension, is one of the most widespread chronic diseases in the world. It is a serious problem whose management is essential to maintain stable blood pressure levels in the short term, and to prevent neuro-cardio-vascular complications in the long term. This study aims firstly to explore the characteristics of uncontrolled blood pressure among patient´s residents of rural areas in Settat City, and secondly to determine its prevalence and identify associated risk factors. Methods: this is a cross-sectional, descriptive, and analytical study which took place between March and August 2023, and targeted a population of hypertensive patients following up at primary healthcare facilities in rural areas in Settat City. A questionnaire was developed and evaluated to ensure its reliability before being administered to study participants, anthropometric measurements and blood pressure readings were also taken. Results: four hundred hypertensive patients were surveyed, 53% (212) of whom had uncontrolled blood pressure, with a mean age of 56.94 (±13.10 years), and a marked female preponderance, illustrated by 72.3% (289) were female. The risk factors associated with uncontrolled blood pressure were: male gender (aOR: 2.53, 95% CI 1.13-5.65), monthly income (aOR: 5.64, 95% CI 3.04-10.46), diabetes (aOR: 3.16, 95% CI 1.77-5.63), monotherapy (aOR: 8.42, 95% CI 2.85-24.90), poor compliance with medication (aOR: 7.48, 95% CI 4.21-13.29), and stress (aOR: 2.22, 95% CI 1.14-4.33). Conclusion: the level of blood pressure control was unsatisfactory in this population, underscoring the imperative of educating hypertensive patients about management measures and reinforcing the quality of primary health services.

Barriers to Oral PrEP: A Qualitative Study of Female Sex Workers, PrEP Prescribers, Policymakers, and Community Advocates in Morocco.

In 2017, Morocco became the first Arab country to incorporate pre-exposure prophylaxis (PrEP) in its HIV-prevention program. Yet no research has been published on PrEP from Morocco. Although female sex workers are one of the target populations of PrEP in Morocco, their enrollment in PrEP is lower than men who have sex with men. In this study, we conducted 38 semi-structured interviews with female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. We also investigated preferences for daily oral, vaginal ring, and long-acting injectable PrEP. A reflexive thematic analysis revealed seven themes: PrEP stigma; stigmatization and criminalization of sex work; one size doesn't fit all; knowledge and misconceptions about PrEP; economic burden; inconvenience of PrEP pills; and preferred PrEP modalities. This paper discusses the implications of the findings for increasing access and use of PrEP in Morocco.

Factors that Influence Uptake of Oral PrEP among Female Sex Workers One of the most recent scientific advancements in the history of the HIV pandemic was the introduction of pre-exposure prophylaxis (PrEP). However, the uptake of PrEP in the Arab world is low. In this paper we interviewed female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. Several barriers were identified including stigma attached to PrEP, misconceptions about PrEP, and financial burden. Although most female sex workers in our study were interested in using PrEP, the delivery methods of PrEP should be tailored to fit the lifestyle and personal circumstances of potential users.

Future projection of droughts in Morocco and potential impact on agriculture.

The present study evaluates the future drought hazard in Morocco using a Multi-Model Ensemble (MME) approach. First, the artificial neural network-based MME is constructed using the General Circulation Models (GCMs) from the Climate Models Intercomparison Project phase 6 (CMIP6) which are most successful in representing the historical temperature and precipitation values. Next, the future changes in the precipitation, Potential EvapoTranspiration (PET) calculated using temperatures data, aridity index, and drought indices calculated via the Standardized Precipitation Evapotranspiration Index (SPEI) values were projected for the historical period 1980-2014, near future 2025-2050, mid future 2051-2075, and far future 2076-2100. The obtained results indicate that there will be a decrease in values of the precipitation and an increase in values of the PET, leading to an increase in aridity risk for Morocco. The future projections using the SPEI results show that the average index values will mostly be in the drought zone, indicating that the drought severity will increase. The spatial analysis of SPEI values in different regions of Morocco demonstrates that the northern part of the country has relatively more drought occurrences, and drought severity tends to increase with each passing period. The study also reveals that drought severity will significantly increase after 2050 in the Shared Socio-economic Pathways 5-8.5 (SSP5-8.5) scenario. The research concludes that the increase in drought severity will significantly impact Morocco's water resources, agriculture and food security among others.

Antimicrobial activities of essential oils of plants species from Morocco against some microbial strains.

BACKGROUND: Essential oils have important antibacterial activities and can successfully replace antibiotics, which show their inefficiency, especially against fungi and multi-resistant bacteria. OBJECTIVE: The main purpose of our research was to investigate the antibacterial and antifungal activity of essential oils from fifteen plants harvested in the Taroudant region. MATERIAL AND METHODS: In this work, the essential oils were extracted by hydrodistillation using a Clevenger-type apparatus. The method of disc diffusion in agar medium (aromatogram) is the one used to evaluate the activity of these essential oils against four pathogenic bacteria (Staphylococcus aureus, Escherichia coli, Bacillus sp., and Enterococcus cloacae) and two yeasts (Candida albicans and Cryptococcus neoformans). RESULTS: Our findings, show that all of the plants' leaves yielded extremely aromatic essential oils that differed in look and color. Furthermore, the 93.33% of the fifteen essential oils that were evaluated proved to be effective against at least one kind of bacteria or fungus. This suggests that the proportion of essential oils with no antibacterial action was rather low, at around 7%. Our data also showed that the freshness or dryness of the plant at the time of harvest could affect the extraction rate of essential oils. This screening showed us that these essential oils present inhibitory activities towards the studied Gram+ bacteria, as well as a resistance against Gram-, in particular Enterococcus cloacae. CONCLUSION: These essential oils can therefore be used in the prevention and treatment of certain infectious diseases and to fight against bacteria that are multi-resistant to the usual antibiotics.

Epidemiological aspects of the association of the hypertriglyceridemic waist phenotype with metabolic syndrome and cardiovascular risk factors in Morocco. Case the Amazigh population from a geographic region called Souss.

BACKGROUND: The global prevalence of metabolic syndrome (MetS) increases susceptibility to non-communicable diseases such as obesity, type 2 diabetes, and cardiovascular disease, posing significant health risks. Effective prevention and management require objective tools. The hypertriglyceridemic waist (TG+WC+) phenotype is proposed as a less expensive approach to identify individuals with metabolic syndrome and other cardiovascular risk factors. OBJECTIVE: The current aim of this investigation is to study the epidemiological characteristics of the hypertriglyceridemic waist phenotype and their correlations with cardiovascular risk factors and MetS in the Moroccan Amazigh ethnic group from the Souss region of Morocco. MATERIAL AND METHODS: A total of 827 Amazigh adults from the Sousse region of Morocco were divided into four distinct phenotype groups: TG-WC-, TG+WC-, TG-WC+, and TG+WC+ (normal TG- or high TG+ triglycerides/normal WC- or high WC+ waist circumference). The association of the different phenotypes with MetS and other cardiovascular risk factors was established by logistic regression analysis. RESULTS: The prevalence of the TG+WC+ phenotype was 27.7% and varied according to age group and sex. Among subjects with the TG+WC+ phenotype, most were 41-60 years old (53.3%) and in women (74.2%). Participants with the TG+WC+ phenotype had the highest prevalence of dyslipidemia (87.3%), hypoHDLaemia (69.9%), and general obesity (37.12%). The three phenotypes TG-WC-, TG+WC- and TG-WC+ were less associated with MetS and other cardiovascular risk factors. Moreover, people with the TG+WC+ phenotype had a very high odds ratio for MetS. CONCLUSION: These findings suggest that the TG+WC+ phenotype exhibits a robust correlation with MetS and additional variables connected to cardiovascular risk. The TG+WC+ phenotype serves as a valuable clinical instrument for detecting individuals vulnerable to MetS and cardiovascular diseases.

Detailed Phytochemical Composition, Cyto-/Hepatotoxicity, and Antioxidant/Anti-Inflammatory Profile of Moroccan Spices: A Study on Coriander, Caraway, and Mystical Cumin.

Coriander, caraway, and mystical cumin are famous for their aromatic properties and widely used in Moroccan cuisine. The nutritional/phytochemical composition of their seeds (used for food flavoring and preservation) were compared. Their antioxidant, anti-inflammatory, cytotoxic and hepatotoxic effects were also explored. The fat content was similar among the samples (13%), with monounsaturated fatty acids being predominant. The coriander and mystical cumin seeds were extremely rich in C18:1n9c (81 and 85%, respectively) while, in the caraway, C18:1n12 (25%) was found together with C18:1n9c (32%). The caraway seeds also presented a higher proportion of C18:2n6c (34%) than the other seeds (13 and 8%, correspondingly). γ-Tocotrienol was the major vitamin E form in all the samples. The caraway seeds contained double the amount of protein (~18%) compared to the other seeds (~8%) but, qualitatively, the amino acid profiles among all seeds were similar. The seeds were also rich in dietary fiber (40-53%); however, differences were found in their fiber profiles. Caraway showed the highest antioxidant profile and anti-inflammatory activity and an LC-DAD-ESI/MSn analysis revealed great differences in the phenolic profiles of the samples. Cytotoxicity (NCI-H460, AGS, MCF-7, and CaCo2) and hepatotoxicity (RAW 264.7) were not observed. In sum, besides their flavoring/preservation properties, these seeds are also relevant source of bioactive compounds with health-promoting activities.

Drivers and Barriers Influencing Adherence to the Mediterranean Diet: A Comparative Study across Five Countries.

Given the global decline in adherence to the Mediterranean Diet (MD), even within its native region, it is key to identify the factors influencing this trend to mitigate the negative health outcomes associated with westernized diets. To this end, 4025 individuals (49.6% women, 42.6 ± 14.2 y/o) from Greece, Italy, Morocco, Slovenia, and Tunisia remotely completed a series of measures assessing motives, attitudes, and psychosocial factors related to MD adherence, which was evaluated using the MEDAS questionnaire. The results suggested medium-to-low adherence across all countries, with the highest adherence in Italy and Morocco and the lowest in Slovenia. Structural equation modeling revealed that positive attitudes toward the healthiness of food were the strongest predictors of adherence, whereas picky eating was a significant negative predictor in all countries except Greece. Adherence to the MD was positively influenced by health motivations in Morocco and weight control in Slovenia and Greece, while sensory appeal negatively influenced adherence in Italy. Additionally, price and convenience were significant barriers in Tunisia and Greece, whereas a preference for local and seasonal foods promoted adherence in Morocco and Greece. Overall, our findings underscore the need for country-specific interventions and policies that address distinct local factors and motivations to ease favorable shifts in dietary patterns toward MD principles.

Epidemiological profile of dermatophytes at the parasitology-mycology laboratory at Mohammed VI University Hospital in Oujda.

BACKGROUND: dermatophytoses are a current fungal infection, caused by keratinophilic fungi (dermatophytes) able to invade the nails, hair and skin of humans and animals. AIM: the aim of this study was to establish the epidemiological and mycological profile of dermatophytes isolated in the parasitology-mycology laboratory of the Mohammed VI University Hospital in Oujda. METHODS: this is a 48-month retrospective study from January 2019 to December 2022.The study includes samples taken or sent to our parasitology-mycology laboratory for mycological study. A direct examination and culture were performed on each biological specimen. Species identification was based on macroscopic and microscopic colony criteria. RESULTS: in the present report we reviewed 950 mycological samples. Dermatophytes were isolated in 505 (53.15%) cases. The most common infections were tinea unguium (n=353; 69.90%), followed by tinea corporis (n=123; 5.74%) and tinea capitis (n=29; 5.98%). Trichophyton rubrum was the most frequently incriminated species. CONCLUSION: dermatophytes are the most frequent mycoses in humans. They are generally benign and often develop in a chronic and frequently recurrent pattern. Mycological examination is essential. It confirms the fungal origin and isolates the species responsible, in order to identify the source of contamination and implement an appropriate treatment.

Real-time AIoT platform for monitoring and prediction of air quality in Southwestern Morocco.

Urbanization and industrialization have led to a significant increase in air pollution, posing a severe environmental and public health threat. Accurate forecasting of air quality is crucial for policymakers to implement effective interventions. This study presents a novel AIoT platform specifically designed for PM2.5 monitoring in Southwestern Morocco. The platform utilizes low-cost sensors to collect air quality data, transmitted via WiFi/3G for analysis and prediction on a central server. We focused on identifying optimal features for PM2.5 prediction using Minimum Redundancy Maximum Relevance (mRMR) and LightGBM Recursive Feature Elimination (LightGBM-RFE) techniques. Furthermore, Bayesian optimization was employed to fine-tune hyperparameters of popular machine learning models for the most accurate PM2.5 concentration forecasts. Model performance was evaluated using Root Mean Square Error (RMSE), Mean Absolute Error (MAE), and the coefficient of determination (R2). Our results demonstrate that the LightGBM model achieved superior performance in PM2.5 prediction, with a significant reduction in RMSE compared to other evaluated models. This study highlights the potential of AIoT platforms coupled with advanced feature selection and hyperparameter optimization for effective air quality monitoring and forecasting.

Veterinary perspectives on the urbanization of leishmaniosis in Morocco.

BACKGROUND: Leishmaniosis caused by Leishmania infantum, L. major and L. tropica is endemic in Morocco. Growing evidence of both human and canine Leishmania infections in urban centres has been reported. Since many forms of the disease are zoonotic, veterinarians play an important role in leishmaniosis control by intervening at the parasite host level. This study aimed to bring together One Health principles to connect canine and feline leishmaniosis epidemiology within urban centres of Morocco (Rabat and Fez) and assess the level of awareness of Moroccan veterinarians about facing this threat. METHODS: A molecular survey was conducted for Leishmania DNA detection in canine (n = 155) and feline (n = 32) whole-blood samples. Three conventional polymerase chain reaction (PCR) protocols were implemented. The first PCR aimed at identifying infected animals by targeting Leishmania spp. kinetoplast minicircle DNA (kDNA). The second and third PCR targeted the Leishmania internal transcribed spacer region (ITS-1) and the Leishmania small subunit ribosomal RNA (SSUrRNA) gene, respectively, aiming at identification of the infecting species after Sanger sequencing-positive amplicons. Total immunoglobulin G (IgG) against Leishmania spp. was evaluated in 125 dogs by enzyme-linked immunosorbent assays (ELISA) using an in-house protocol, including three Leishmania-specific antigens (SPLA, rKDDR and LicTXNPx). Sera from 25 cats were screened for total IgG to Leishmania spp. by an indirect immunofluorescence antibody test (IFAT). An online questionnaire was presented to Moroccan veterinarians addressing their knowledge and practices towards animal leishmaniosis. RESULTS: Overall, 19.4% of the dogs tested positive for Leishmania kDNA and ITS-1 and sequencing revealed infection with L. infantum among PCR-positive dogs. These animals presented a wide range of ELISA seropositivity results (16.7%, 34.9% and 51.6%) according to the tested antigens (rKDDR, SPLA and LicTXNPx, respectively). Use of kDNA-PCR revealed 12.5% cats positive to Leishmania spp. otherwise found to be seronegative by IFAT. CONCLUSIONS: A considerable prevalence of infection was identified in dogs from urban centres of Morocco. Additionally, this is the first report of feline infection with Leishmania spp. in this country and in urban settings. Moroccan veterinarians are aware that animal leishmaniosis is endemic in Morocco, representing a public health threat, and are knowledgeable about canine leishmaniosis diagnosis and treatment.

Hg, Cd, and Pb in fish of the Moulouya River, Morocco, and human health risk.

Concentrations of toxic metals (Hg, Pb, and Cd) were determined in the muscles of Lepomis macrochirus, Barbus callensis, and Barbus nasus caught from the Moulouya River of Morocco by graphite furnace (for Pb and Cd) and cold vapour (for Hg) atomic absorption spectrometry, after acid digestion. Although the concentration of metals in some species was relatively high, no health risk has been identified in comparison to the maximum limits as set by the European Commission. The order of increasing concentrations was Cd < Hg < Pb. Calculated Target Hazard Quotients and Hazard Indices were below 1, indicating that the intake of metals via consumption of the muscles of both fish species does not represent a hazard to human health.

A series of four patients with Sotos syndrome harboring novel NSD1 mutations: clinical and molecular description.

BACKGROUND: Sotos syndrome is a rare and complex genetic disorder caused by haploinsufficiency of the NSD1 gene. This syndrome is characterized by rapid early childhood growth, distinct facial features, a learning disability, and multiple other developmental and behavioral challenges. METHODS AND RESULTS: In this work, we describe four Moroccan patients with variable clinical presentations of Sotos syndrome, in whom we identified four novel NSD1 monoallelic pathogenic variants by conducting targeted Next Generation Sequencing. Genetic testing allowed us to provide a precise medical diagnosis to our patients and tailor interventions to each patient's needs. CONCLUSIONS: Being the first work describing a series of Moroccan patients with this syndrome, this case series contributes to the growing body of literature on Sotos syndrome and provides valuable insights into the clinical and molecular characteristics of this rare disorder.

Exome sequencing reveals pathogenic mutations in the LARS2 and HSD17B4 genes associated with Perrault syndrome and D-bifunctional protein deficiency in Moroccan families.

BACKGROUND: Syndromic hearing loss (SHL) is characterized by hearing impairment accompanied by other clinical manifestations, reaching over 400 syndromes. Early and accurate diagnosis is essential to understand the progression of hearing loss and associated systemic complications. METHODS AND RESULTS: In this study, we investigated the genetic etiology of sensorineural hearing loss in three Moroccan patients using whole exome sequencing (WES). The results revealed in two families Perrault syndrome caused by LARS2, p. Asn153His; p. Thr629Met compound heterozygous variants in two siblings in one family; and p. Thr522Asn, a homozygous variant in two sisters in another. The patient in the third family was diagnosed with D-bifunctional protein deficiency (D-BPD), linked to compound heterozygous mutations p. Asn457Tyr and p. Val643Argfs*5 in HSD17B4. Molecular dynamic simulation results showed that Val643Argfs*5 does not prevent HSD17B4 protein from binding to the PEX5 receptor, but further studies are recommended to verify its effect on HSD17B4 protein functionality. CONCLUSION: These results highlight the effectiveness of WES in identifying pathogenic mutations involved in heterogeneous disorders and the usefulness of bioinformatics in predicting their effects on protein structure.

Is serum albumin a pivotal biomarker in anticipating acute pancreatitis outcomes?

This study aimed to assess the significance of serum albumin levels within 24 h of patient admission in correlation with the incidence of outcomes and mortality in patients diagnosed with acute pancreatitis. A retrospective study was conducted over a 5-year period, from January 2018 to December 2023, at the Mohammed VI University Hospital in Oujda, Morocco. The study included 371 patients diagnosed with acute pancreatitis. Hypoalbuminemia (≤ 30 g/L) was observed in 124 patients (33.4% of cases), and these patients had a higher mean age compared to those with normal albumin levels (P = 0.003). Hypoalbuminemia was significantly associated with persistent Systemic Inflammatory Response Syndrome (SIRS) (70.8% vs. 29.2%, P = 0.000), a higher BISAP score (66.7% vs. 33.3%, P = 0.000), and a higher CTSI score (51.7% vs. 48.3%, P = 0.000). Hypoalbuminemia was also associated with the presence of pleural effusion (P = 0.000). The mortality in the sample was 4.6%, and it was significantly associated with hypoalbuminemia (76.5%, P = 0.000). In conclusion, serum albumin levels within 24 h of patient admission appear to be a significant prognostic biomarker in acute pancreatitis, particularly in anticipating persistent organ failure and mortality.

De novo p.Glu61Ter mutation in GCH1 in a Moroccan patient with dopa-responsive dystonia: a case report.

Dopa-responsive dystonia (DRD) is a hereditary movement disorder due to a selective nigrostriatal dopamine deficiency. It is characterized by onset in childhood or adolescence with marked diurnal fluctuation with or without Parkinsonian features, and is caused by mutations in GCH1 gene. We report in this study the clinical and genetic features of the first DRD Moroccan patient. Using a gene panel sequencing, we identified a heterozygous nonsense variant p. Glu61Ter in GCH1. A subsequent targeted segregation analysis by Sanger sequencing validated the presence of the mutation in the patient, which was found to have occurred de novo. The objective of this study is to report the first description of DRD in Morocco, and highlights the importance of new generation sequencing technology in the reduction of medical wandering and the management of hereditary diseases.

Suicide, suicide attempts and self-harm in Moroccan prisons.

PURPOSE: High rates of suicide and self-harm are reported in prisons in Western countries, while fewer studies exist from a non-Western context. This study aims to identify rates of suicide, non-fatal suicide attempts and self-harm in Moroccan prisons and to better understand the context, methods, tools, predictors and profile of persons engaged in the acts. DESIGN/METHODOLOGY/APPROACH: The authors report findings from a mixed-methods study carried out before an intervention project. The study consists of a systematic literature review, an analysis of suicide case files, a quantitative survey on suicide attempts and self-harm, as well as interviews and focus group discussions. The authors calculate suicide, suicide attempt and self-harm rates and present descriptive data on the incidents. The authors use regression models to explore the association between the number of incidents per individual and selected predictors, adjusting for clustering by institution. FINDINGS: Over a four-year period, 29 detained persons in Morocco died by suicide (average annual suicide rate 8.7 per 100,000). Most were men under the age of 30. Hanging accounted for all but one case. In one year, 230 suicide attempts were reported. Over a three-months period, 110 self-harm cases were reported from 18 institutions, cutting being the most common method. Self-harm was significantly more prevalent among persons with a life sentence or repeated incarcerations. RESEARCH LIMITATIONS/IMPLICATIONS: To make the study manageable as part of an intervention project, the authors collected data on suicides and suicide attempts from all prisons, while data on self-harm were collected from fewer prisons and over a shorter time period. The authors did not collect comparable information from detained persons who did not die by suicide, attempt suicide or self-harm. This prevented comparative analyses. Further, it is possible that self-harm cases were not reported if they did not result in serious physical injury. Data were collected by prison staff; thus, the voice of incarcerated persons is absent. PRACTICAL IMPLICATIONS: This study provided a solid basis for designing an intervention project including the development of a national prison policy and guidelines on suicides, suicide attempts and self-harm and a country-wide training program for prison staff. It also led to a better surveillance system, allowing for trend analysis and better-informed policymaking. The qualitative results helped create an understanding of how staff may trivialize self-harm. This was integrated into the training package for staff, resulting in the creation of prison staff trainers who became the strongest advocates against the notion that self-harm was best ignored. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first published data on suicide and self-harm in Moroccan prisons. It underscores the necessity for the intervention project and gives valuable insights into suicide and self-harm in a non-Western prison context. Further research is needed to assess whether the findings are typical of the region.

[Thrombolysis alert in ischemic stroke: experience of the international private clinic Al Badie in Fez (cross-sectional study of 60 cases)]. / Les alertes de thrombolyse des accidents vasculaires cérébraux ischémiques: expérience de la clinique internationale Al Badie au secteur libéral de Fès (étude transversale de 60 cas).

Intravenous thrombolysis is the standard treatment for acute ischemic stroke. We here report the cases of thrombolysis alert in the private sector in Morocco We conducted a prospective study of all patients with neurological deficit of sudden onset occurred within the first 12 hours admitted to the Emergency Department of the Al Badie international private clinic from January 2022 to September 2023. Epidemiological, clinical and etiological characteristics as well as data on outpatient and inpatient delays were collected. Sixty patients were included in the study. The average admission delay was 198.36 ± 79.23 minutes. The mean NIHSS (National Institutes of Health Stroke Scale) score was 10.41 ± 4.97. The average time for imaging was 26.68 ± 9.63 minutes. Ischaemic stroke was the most common diagnosis (85%), followed by "stroke mimics" (11.6%). Thirteen patients underwent thrombolysis with tenecteplase. The mean time from admission to the initiation of thrombolysis was 107.15 ± 24.48 minutes. Follow-up imaging at 24 hours post thrombolysis revealed symptomatic haemorrhagic transformation in 3 patients. Six patients were transferred to the Hassan II University Hospital for thrombolysis and/or mechanical thrombectomy. After 3 months, 4 patients were autonomous (Rankin score changed between 0 and 2). Our experience shows that it is imperative to reduce outpatient and inpatient delays in treatment in order to increase the proportion of patients treated with thrombolysis.

Psychoactive substance use and associated factors among Mohammed first university students, Oujda, Morocco: a cross-sectional study.

BACKGROUND: The use of psychoactive substances, including tobacco, alcohol, and others, remains a major public health problem. However, few studies have been conducted on Moroccan university students. This study aimed to assess the prevalence and associated factors of substance use among students at Mohammed First University, Oujda, Morocco. METHODS: We conducted this cross-sectional study with students enrolled at one of the Mohammed First University of Oujda's institutes as part of the 2021-202 academic year. We used a self-administered survey to collect data anonymously. We cleaned the data and then entered it into IBM SPSS Statistics 21 for analysis. Data analysis involved descriptive statistics as well as univariate and multivariate analysis. We considered a P value < 0.05 as the level of significance. RESULTS: In this study, out of 500 students we asked to complete the survey, 478 responded; the response rate was 95.6%. The average age was 21.1 ± 3.0, and the M/F sex ratio was 0.97. The lifetime prevalence of psychoactive substance use among Oujda University students was 28.7%. The most commonly used substances were tobacco (24.1%), alcohol (15.9%), cannabis (13.4%), sedatives (6.9%), stimulants (5.2%), and cocaine (4.4%). Male sex, age > 20 years, self-financing, school failure (one year repeated or more), the practice of a leisure activity, the presence of a personal medical or psychiatric history, and the presence of a family medical history were all significantly associated with the use of psychoactive substances. CONCLUSION: Our study revealed a significant prevalence of psychoactive substance use among university students in Oujda, highlighting the need for interventions at various levels. Further analytical studies are necessary to better understand the initiation and maintenance of psychoactive substance use and to identify all associated factors to enhance prevention strategies against substance use disorders.