Yahya Cherrah

Les plantes anxiolytiques au Maroc. Études ethnobotanique et ethno-pharmacologique

RésuméUne étude ethnobotanique a été menée au Maroc en vue de recenser à l’échelle nationale les plantes médicinales utilisées en médecine traditionnelle marocaine dans le traitement de l’anxiété. 70 herboristes ont été interrogés individuellement et ont livré chacun les espèces végétales utilisées pour combattre les troubles anxieux. 77 espèces médicinales réparties sur 43 familles ont été ainsi signalées et identifiées. L’analyse statistique des données de l’enquête ethnobotanique a permis d’inventorier une vingtaine de plantes citées majoritairement. Les feuilles constituent la partie la plus utilisée, généralement sous forme d’infusion. Ont été également analysées les données concernant le niveau de connaissances des herboristes, qui ont une de moyenne d’âge entre 35 et 55 ans. 69% d’entre eux ont accepté de discuter de leur profil, 79% ont une expérience de plus d’une décennie, 46% sont bacheliers, 65% suivent des formations continues et 37% se soignent et soignent leurs familles uniquement par les plantes.AbstractAn ethnobotanical study was conducted in Morocco in order to identify at the national level medicinal plants used in traditional Moroccan medicine in the treatment of anxiety. Seventy (70) herbalists were interviewed individually and each delivered the plants used to combat anxiety disorders. Sixty-seven (77) medicinal species spread over 43 families have been reported and identified. Statistical analysis of data from the ethnobotanical investigation has inventory twenty priority plants. The leaves are the most used part, usually in the form of infusion. Were also analyzed data on the profile of herbalists whose average age of between 35 and 55 years, 69% of them have agreed to discuss their profile, 79% have an experience of over a decade, 46% are graduate, 65% undergo continuous training, and 37 treat and care for their families only by plants.

Evaluation of the cost of cervical cancer at the National Institute of Oncology, Rabat

Introduction The Cervical Cancer (CC) is one of the heavy and costly diseases for the population and the health system. We want to know through this study, the first in Morocco, the annual cost of the treatment of this disease at the National Institute of Oncology (NIO) in Rabat, we also want to explore the possibility of flat-rate management of this disease in order to standardize medical practices and improve reimbursement by health insurance funds. Methods 550 patients were treated for their cervical cancer in the Rabats NIO. Data of all of medical and surgical services offered to patients were collected from the NIO registry. The cost of care was assessed using the method of micro-costing. We will focus to the total direct cost of all the services lavished to patients in NIO. Results The global cost was about US

Étude phytochimique et activité antifongique in vitro des huiles essentielles de quatre espèces du genre Nepeta du Maroc

1,429,673 with an average estimated at US

Toxicité aiguë et activité anti-inflammatoire des graines de Delphinium staphysagria

2,599 ± US

Multivariate statistical process control in product quality review assessment – A case study

839. Radiotherapy accounts for 55% of total costs, followed by brachytherapy (27%) and surgery (7%). This three services plus chemotherapy influence the overall cost of care (p <0.001). Other services (radiology, laboratory tests and consultations) represent only 10%. The overall cost is influenced by the stage of the disease, this cost decreased significantly evolving in the stage of CC (p <0.001). Conclusion The standardization of medical practices is essential to the equity and efficiency in access to care. The flat-rate or lump sum by stage of disease is possible and interesting for standardizing medical practices and improving the services of the health insurance plan.

Cost of Treatment of Cerebral Aneurysm Embolization: Study of Associated Factors.

RésuméLe genre Nepeta appartient à la famille des Lamiacées. Notre objectif est de définir la composition chimique des huiles essentielles (HE) de ces quatre espèces marocaines du genre Nepeta: Nepeta tuberosa ssp reticulata, Nepeta granatensis, Nepeta cataria et Nepeta atlantica, puis de tester leur activité antifongique potentielle sur les champignons pathogènes Candida albicans (C.a), Candida tropicalis (C.t), Candida glabrata (C.g), Aspergillus niger, Microsporum canis, Microsporum gypseum et Trichophyton rubrum. L’étude de la composition chimique des HE a été réalisée grâce aux techniques de référence que sont la chromatographie en phase gazeuse (CPG), le couplage CPG-spectrométrie de masse (SM), ainsi que les méthodes classiques de chimie organique. L’étude de l’activité antifongique a été réalisée par la méthode de dilution en milieu solide. Les HE des quatre espèces analysées ont des compositions chimiques similaires, soit 25 constituants minoritaires et un constituant majoritaire de type nepetalactone, présent à des taux de 71,40 à 77,43 % dans les trois espèces de Nepeta (Atlantica, Tuberosa ssp reticulata et Cataria) et à un taux d’environ de 39,44 % chez l’espèce Granatensis. Concernant l’activité antifongique, Nepeta atlantica, Nepeta cataria et Nepata tuberosa ssp reticulata montrent une activité plus importante que Nepeta granatensis, cela nous amène à supposer que l’activité antifongique de ces espèces est corrélée directement à leur teneur en 4aα, 7α, 7aβ-nepetalactone.AbstractThe genus Nepeta, belongs to the family of Lamiaceae. In this work, our objective was to define the chemical composition of essential oils of these Moroccan four species of the genus Nepeta: Nepeta tuberosa, Nepeta granatensis, Nepeta cataria and Nepeta atlantica then test their antifungal activity potentially pathogenic fungi on Candida albicans, Candida tropicalis, Candida glabrata, Aspergillus Niger, Microsporum canis, Microsporum gypseum and Trichophyton rubrum. The study of the chemical composition of essential oils was performed using the techniques of reference that are the gas chromatography; the gas chromatography coupled mass spectroscopy as well as the usual methods of organic chemistry. The study of the antifungal activity was carried out by dilution method in solid. The essential oils of four species were analyzed similar chemical compositions, 25 constituents minority, and amajor constituent of type nepetalactone, present rates of 71.40 to 77.43% in three species of Nepeta (Atlantica, Tuberosa ssp reticulata, and Cataria) and at a rate of approximately 39.44% in the species granatensis. Concerning the antifungal activity, Nepeta atlantica, Nepeta cataria and show Nepeta tuberosa higher activity than Nepeta granatensis, this might suggest that the antifungal activity of these species is directly correlated to their content 4aα, 7α, 7aβ-nepetalactone.

Extraction et activité psychotrope de l’huile essentielle de la verveine odorante Lippia citriodora

RésuméLes graines de Delphinium staphysagria (DS) contiennent une fraction d’alcaloïdes relativement importante. La combinaison d’extraction, de gradient de pH et les conditions chromatographiques ont permis l’identification de plusieurs types d’alcaloïdes diterpénoïdes MDL (méthylène dioxylycoctonine) connus pour leur activité anti-inflammatoire. La purification de l’extrait alcaloïdique se fait par un changement de pH en présence d’un acide et d’une base. La caractérisation des alcaloïdes a été faite par les tests de Meyer et de Dragendorff, et par chromatographie sur couche mince. L’activité anti-inflammatoire a été évaluée sur des oedèmes induits par la carragénine et par traumatisme expérimental chez le rat. L’administration orale de l’extrait alcaloïdique des graines de DS à la dose de 20 mg/kg révèle une réduction du volume de patte significative de 71,4 % (oedème à la carragénine) et 64,7 % (oedème par traumatisme) comparativement au témoin et à l’indométacine (10 et 20 mg/kg, VO) respectivement. Les alcaloïdes extraits des graines de DS seraient donc potentiellement anti-inflammatoires.AbstractDelphinium staphysagria seeds (DS) contained a relatively large fraction of alkaloids. The combination of extraction, pH gradient and chromatographic condition, allowed the characterization of diterpenoid alkaloids (MDL) known for their anti-inflammatory activity. Purification of the alkaloid extract is effected via a change of pH in the presence of an acid and a base. Characterization of the alkaloids was made by the tests of Mayer and Dragendorff and by thin layer chromatography. The anti-inflammatory activity was carried out by carrageenan-induced rat paw edema and experimental traumatism in rats. Oral administration of the alkaloids extract of (DS) at the dose 20 mg/kg revealed a significant reduction 71.4% (carrageenan) and 64.7% (traumatism) paw volume compared with the control and indometacin (10 and 20 mg/kg, P.O.). The alkaloids extract of the seeds of DS therefore develop an anti-inflammatory activity.

Activité psychotrope de l’huile essentielle de Nepeta amethystina

According to the Food and Drug Administration and the European Good Manufacturing Practices (GMP) guidelines, Annual Product Review (APR) is a mandatory requirement in GMP. It consists of evaluating a large collection of qualitative or quantitative data in order to verify the consistency of an existing process. According to the Code of Federal Regulation Part 11 (21 CFR 211.180), all finished products should be reviewed annually for the quality standards to determine the need of any change in specification or manufacturing of drug products. Conventional Statistical Process Control (SPC) evaluates the pharmaceutical production process by examining only the effect of a single factor at the time using a Shewharts chart. It neglects to take into account the interaction between the variables. In order to overcome this issue, Multivariate Statistical Process Control (MSPC) can be used. Our case study concerns an APR assessment, where 164 historical batches containing six active ingredients, manufactured in Morocco, were collected during one year. Each batch has been checked by assaying the six active ingredients by High Performance Liquid Chromatography according to European Pharmacopoeia monographs. The data matrix was evaluated both by SPC and MSPC. The SPC indicated that all batches are under control, while the MSPC, based on Principal Component Analysis (PCA), for the data being either autoscaled or robust scaled, showed four and seven batches, respectively, out of the Hotelling T2 95% ellipse. Also, an improvement of the capability of the process is observed without the most extreme batches. The MSPC can be used for monitoring subtle changes in the manufacturing process during an APR assessment.

CP-066 Appreciation of reduction of drug prices by policyholders of health insurance and its impact on access to drugs

BackgroundSurgical clipping or endovascular coiling are the main procedures used in the treatment of cerebral aneurysms, with a preference for endovascular coiling. In Morocco, the number of patients needing endovascular coiling is growing, but many of them do not have access to this technique. The aim of this study was to determine the main parameters associated with variations in the total cost of this procedure in order to establish the amount (lump sum) that may be reimbursed by health insurance funds.MethodsOne hundred and seventeen patients with 124 aneurysms were admitted for treatment of one or more intracranial aneurysms between January 2010 and December 2015. The overall cost of hospitalization was assessed by using the micro-costing technique. The calculation was based on the tariffs of medical procedures as defined by the Ministry of Health in Morocco. A regression analysis was used to define the correlation between the overall cost and the various parameters.ResultsUnivariate linear regression showed that the total cost was influenced by overall duration of hospitalization, ICU duration of hospitalization and size of aneurysm. On the other hand, univariate linear regression showed that the total cost was not influenced by sex, localization of aneurysm, and size of the aneurysm’s neck. However, multivariate linear regression showed that the total cost was influenced by one type of insurance health, overall duration of hospitalization, ICU duration of hospitalization, size of the aneurysm, and size of the aneurysm’s neck.ConclusionSetting a rate for reimbursement of patients who have had coiling treatment for a cerebral aneurysm should take into account the results of our study in order to limit the costs borne by patients. The parameters that influence the overall cost must be reimbursed in each case while the parameters that do not influence treatment costs could be included in a lump sum.

GM-001 Role of the pharmacist in hospital: What is the perception of health professionals?

RésuméParmi les plantes traditionnellement utilisées au Maroc pour réduire la nervosité et favoriser l’endormissement est fréquemment retrouvée la verveine odorante (Lippia citriodora H.B. et K./ V. Triphylla L’Her), connue en arabe sous le nom de louisa. Elle est utilisée traditionnellement en infusion surtout pour ses propriétés sédatives et myorelaxantes, essentiellement chez le nouveau-né.Notre travail a pour objectif d’extraire l’huile essentielle (HE) de la partie aérienne de la verveine odorante, d’identifier la composition de l’HE de cette dernière par chromatographie en phase gazeuse couplée à un spectromètre de masse et d’étudier l’activité psychotrope de l’huile essentielle (HE) grâce à une batterie de tests comportementaux utilisés en psychopharmacologie.Les résultats de cette étude démontrent une richesse de principes actifs à rapprocher du potentiel sédatif de l’HE de la verveine odorante (Lippia citriodora H.B.K), laissant prévoir une utilisation dans le traitement de l’angoisse, du stress et de l’insomnie pour son effet sédatif avec une sécurité d’emploi à des doses thérapeutiques.AbstractVerbena Lippia citriodora often called “Louisa” in Arabic is one of the most commonly used plant to treat or to relieve nervous disturbance of sleep. Prepared as herbal infusion, it’s widely used as sedative and relaxing remedy in stress, anxiety and poor sleep, mainly in the newborn.The aim of this study is to extract the essential oil from this plant, and to study its chemical composition and evaluate its toxicity and its psychotropic activity using a battery of behavioral tests used in psychopharmacology. The results obtained revealed an absence of acute toxicity. Compared to the reference, this extract had exercises sedative properties effects with regard to (compared with) the reference, and potentialise the hypnotic effect of the thiopental sodium.The results of this study demonstrate a wealth of active ingredients responsible of the sedative potential of this plant that can be utilized in the treatment of insomnia, anxiety and stress with more efficacy and safety