CONSUMPTION ANALYSIS OF METFORMIN, SULFONYLUREAS, AND OTHER ANTIDIABETICS DRUGS IN MOROCCO (1991-2005)

Objective: Type 2 Diabetes is one of the chronic diseases with a high prevalence and consequently a substantial socio-economic burden in Arab countries. In this paper, we evaluated the antidiabetic drugs consumption in Morocco during the period of 1991 to 2005, drug classes used and the effect of major studies on the consumption of the biguanides.Methods: We used sales data from the subsidiaries of the Intercontinental Marketing Service Health. The consumption volume was converted to Defined Daily Dose (DDD).Results: During 1991-2005 antidiabetic drugs consumption increased from 1.37 to 4.22 DDD/1000 inhabitants/day. In 2005 the sulfonylureas were the most consumed 2.96 DDD/1000 inhabitants/day) followed by the Biguanides (1.06 DDD/1000 inhabitants/day) and glinides 0.1 DDD/1000inhabitants/day. The largest consumption share in volume was held by sulfonylureas 72.22%, followed by the biguanides 22.22%.Conclusion: This study documents progressive changes in the consumption of antidiabetic's between 1991-2005 in Morocco. However, the significant increase in the utilization of antidiabetic's drugs is not the result of increased adherence but of increased patient number, since the use of metformin as first line therapy was still suboptimal and influenced by different studies as the Campbell and UKPDS study.Â

SIMPLE HPLC-UV METHOD FOR DETERMINATION OF METFORMIN IN HUMAN PLASMA AND ERYTHROCYTES APPLICATION TO THERAPEUTIC DRUG MONITORING

Objective: The aim of this study was to develop a simple, rapid, efficient, cost effective and reproducible, stability indicating reverse phase high performance liquid chromatography method (RP-HPLC) for dosage of metformin in human plasma and erythrocytes. Methods: In this method, the plasma or erythrocyte proteins were precipitated using Perchloric acid: acetonitrile (50 % v/v) mixture and the supernatant liquid were injected into the HPLC system. The separation was achieved with a symmetry C8 column with the mobile phase containing 10 % water and 90 % sodium dihydrogen phosphate buffer (5.8 mM), the pH was adjusted to 3.8 with Phosphoric acid. The temperature was elevated to 25 °C. The detection was done by a UV detector at 232 nm. Results: The retention time was observed at around 4.412 min for metformin and 6.022 for lansoprazole an internal standard (IS). The response was linear over a range of 2-32µg ml-1, the coefficient of determination (r²) was found to be (r² =0. 9988). The lowest limit of quantification and detection was 0.1 µg/ml and 0.3 µg/ml respectively. No endogenous substances were found to interfere with the peaks of the drug. The intra-day and inter-day coefficient of variations was 2.1 % or less for all the selected concentrations. The relative errors at all the studied concentrations were 3.5 % or less. Conclusion: The HPLC method described in this article was simple, selective, reproducible, linear, and precise, it can be applied for therapeutic drug monitoring of metformin in human plasma and erythrocytes

Hypnotic Effect and GC-MS Analysis of Seeds Extracts From Algerian Nopal (Opuntia ficus-indica L.)

Context: Sleep disorders are a frequent symptom that requires prior to any prescription medication, an etiological check to eliminate any organic or psychiatric pathology that is under other treatments and that could worsen under hypnotics.The phytochemical study of Nopal affirm to be an excellent source of natural oligoelements which may improve human health and nutrition Aims: The objective of this work is to extract and analyze the lipid fraction of prickly pear seeds (Opuntia ficus–indica. L), and to determine their hypnotic activity in order to achieve a primary pharmacological screening contained in these extracts (aqueous, hydro-ethanol). Methods: GC-MS analysis of seed oil extracted by soxhlet method, and the pharmacology experiment was performed on white mice from a Swiss race Balb/cby calculating the sleep time. Results: The oil of seeds is rich in fatty-acids poly-unsaturates, Main fatty acids identified were linoleic (C18:2), oleic (C18:1), and palmitic (C16:0), palmitoleic (C16:1) acids with respective contents 81.25%, 3.70%, and 15.03%. The extract hydro-ethanolic at the 500mg / kg dose has a moderate hypnotic effect Conclusion: This study proves that the food quality of prickly pear seeds is very important and its natural source of edible oil containing of the essential fatty-acids, and can be a base for a promising work to highlight the bioactive moleculeswithhypnotic effects, myorelaxant and tranquillizing

Les décès toxiques au Maroc : bilan de 5 ans d'étude (1999-2003)

Les décès toxiques sont de différentes origines, les produits incriminés sont aussi de différentes natures, ils occupent une place importante dans l'épidémiologie des mortalités au Maroc. L'objectif de notre travail est de présenter les caractéristiques et décrire la cartographie des décès toxiques au Maroc en se basant sur les résultats d'analyse du laboratoire de toxicologie médicolégale à l'Institut National d'Hygiène. Une étude rétrospective étalée sur 5 ans (janvier 1999 jusqu'à décembre 2003). Des prélèvements de sang et du contenu gastrique sont analysés à l'aide de réactions colorées, des méthodes chromatographiques (CCM, HPLC, CPG), la spectrophotométrie de masse et l'absorption atomique. Durant la période entre 1999-2003, 3536 prélèvements médicolégaux sont reçu au laboratoire dont 210 étaient positifs soit 5,9%. Les intoxications mortelles pendant la durée de notre étude étaient reportées à des intoxications accidentelles dans 46 cas (21,9%), aux suicides dans 52 cas (24,2%). Les intoxications dont l'origine est indéterminée représentent 109 cas (51,9%). La voie orale est la voie la plus rencontrée dans ces intoxications mortelles avec 108 cas (51,4%) suivie de la voie respiratoire dans 30 cas (14,3%). Un pourcentage élevé dans la ville de Rabat avec 89 cas (42,4%), suivie de Casablanca avec 23 cas (11%), puis Kenitra avec 16 cas (7,6%). La mortalité dans notre série est élevée quand il s'agit du paraphényldiamine qui vient en tête avec 44 cas (21,3%) suivi du monoxyde de carbone avec 35 cas (16,9%) et des pesticides 32 cas (15,5%) puis le phostoxin avec 20 cas (9,7%). Les décès toxiques au Maroc occupent une place non négligeable dans l'ensemble des décès. Cependant, leur nombre reste sous estimé pour plusieurs raisons, notamment le manque d'informations sur les cas de décès toxiques dans les zones rurales. Des efforts restent à fournir par les parties concernées pour déterminer la part exacte des décès toxiques dans l'épidémiologie des mortalités au Maroc et pour l'instauration d'un registre de décès

Fatal pesticides poisoning in Morocco (2000–2005)

Introduction: Acute poisoning by pesticides become more and more frequent, it's an important cause of morbidity and mortality worldwide. The aim of our study was to determine the epidemiological profile of fatal pesticide poisoning deaths in Morocco between 2000 and 2005. Materials and methods: A retrospective study, covering the period from January 2000 to December 2005 was based on database of Laboratory of Forensic Toxicology in the National Institute of Health in Morocco included all positives results in pesticides analysis. Cases were analyzed according to the following criteria: gender, age, origine, poisoning type and class of pesticide. Results: In the period of study, from total of 3104 analysis performed in the laboratory, 130 cases (4.2%) were related with fatal pesticides poisoning deaths which were classified as a suicide in 23.1% cases, as an uncertain in 75% and accidental in 1.5%. 51% of cases were related to males and 48% to females. The most represented city was Rabat with 55 cases (42.3%). Insecticides (organophosphorus, organochlorine and carbamates) were the most frequent cause of fatal pesticides poisoning (75.2%), followed by aluminum phosphide (21.5%), one case of pyrethroid and one case of coumarinic anticoagulant were found. Conclusion: In spite of the effort made in the rules of pesticides in Morocco, the government must develop a strong system which can attribute to prevent this poisoning

Chimioprophylaxie de longue durée à la méfloquine : étude des effets indésirables

Objectif. Évaluer la survenue des effets indésirables lors de la chimioprophylaxie antipaludéenne au niveau du contingent marocain en République Démocratique du Congo (RDC). Méthodes. L’enquête de type transversal, concerne les militaires du contingent marocain en RDC. Elle est réalisée via un questionnaire rempli par une équipe médicale pluridisciplinaire interrogeant les sujets dans tous les sites et les postes avancés militaires accessibles pendant la période de l’étude. Résultats. L’étude concerne 362 militaires de sexe masculin. 94 sujets (soit 25,7 %) ont déclaré un ou plusieurs effets indésirables. Ces effets sont de nature neuropsychiatrique (anxiété, irritabilité, vertiges...) [n = 76], digestive (anorexie, diarrhées, nausées...) [n = 42], cardiovasculaire (tachycardie, palpitations, précordialgies) [n = 5], musculosquelettique (arthralgie, crampes) [n = 4], cutanée (érythème, purpura) [n = 2], ou autres (n = 13). Aucun effet indésirable « inattendu » ou « grave » n’a été déclaré. L’imputabilité est « douteuse » pour 80 cas, « plausible » pour 12 cas et « vraisemblable » pour deux cas. Les enquêtés ayant des fonctions médicales et paramédicales déclarent plus d’effets indésirables. Conclusion. Lors de notre étude, la méfloquine a provoqué des effets indésirables chez un quart des sujets la recevant. La plupart des effets indésirables sont de nature neuropsychiatrique ; aucun cas d’effet indésirable « grave » n’a été relevé ce qui renforce l’intérêt de son utilisation en curatif et en préventif même pendant des traitements de prophylaxie de longue durée

Prevalence and associated factors of self-medication in worldwide pregnant women: systematic review and meta-analysis

Abstract Background Self-medication during pregnancy is of great interest. The use of drugs during pregnancy requires a careful reflection on the benefits to the mother and the risks to the fetus. Selecting a drug or drugs for treating pregnant women can be difficult for clinicians owing to the various pharmacokinetic and physiological changes encountered during pregnancy. This systematic review and meta-analysis aimed to estimate the pooled prevalence of self-medication and associated factors among women during pregnancy. Methods Searches were carried out at PubMed, Science Direct, Web of Science, and Google Scholar. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulated and analyzed qualitatively and quantitatively through meta-analysis. Results The overall prevalence of self-medication among pregnant women was 44.50% (95% CI: 38.92–50.23). Subgroup analyses showed differences in self-medication prevalence influenced by region, county income, and study design. The Heterogeneity, assessed by the statistical test I2 varied from 96 to 99% and was statistically significant. The result of this funnel plot showed that the funnel plot was symmetry with p-value = 0.36, and there is no publication bias. Conclusion The results obtained from this study showed that the prevalence of self-medication among pregnant women is relatively high. This requires effective measures and interventions to reduce self-medication. Trial registration ID =  CRD42022312333