Crystal structure of (1S,2R,4R,9S,11S,-12R)-9α-hydroxy-4,8-dimethyl-12-[(thio-morpholin-4-yl)methyl]-3,14-dioxatri-cyclo[9.3.0.02,4]tetradec-7-en-13-one

The authors thank the Unit of Support for Technical and Scientific Research (UATRS, CNRST) for the X-ray measurements.Peer reviewedPublisher PD

12-Anilinomethyl-9α-hy­droxy-4,8-dimethyl-3,14-dioxatricyclo­[9.3.0.02,4]tetra­dec-7-en-13-one

The title compound, C21H27NO4, was synthesized from 9α-hy­droxy­parthenolide, which was isolated from the chloro­form extract of the aerial parts of Anvillea radiata. The asymmetric unit contains two independent mol­ecules. In each, the ten-membered ring displays an approximative chair-chair conformation. Each of the five-membered rings adopts a flattened envelope conformation, the C(H)—C—C(H) atoms representing the flap lie out of the mean plane through the remaining four atoms by 0.443 (2) and 0.553 (2) Å. The dihedral angle between the least-squares planes through the ten- and five-membered rings in the two mol­ecules are similar [22.54 (17) and 23.39 (14)°]. In the crystal, mol­ecules are linked by O—H⋯O, O—H⋯N and N—H⋯O hydrogen bonds

5,9-Dihy­droxy-9-methyl-3,6-dimethyl­ene-3a,4,5,6,6a,7,8,9,9a,9b-deca­hydro­azuleno[4,5-b]furan-2(3H)-one

The title compound, C15H20O4, was synthesized from 9α-hy­droxy­parthenolide (9α-hy­droxy-4,8-dimethyl-12-methyl­ene-3,14-dioxatricyclo­[9.3.0.02,4]tetra­dec-7-en-13-one), which was isolated from the chloro­form extract of the aerial parts of Anvillea radiata. The seven-membered ring has a chair conformation, while the five-membered rings display twisted conformations. The dihedral angle between the seven-membered ring and the lactone ring is 21.69 (10)°. In the crystal, mol­ecules are linked into chains propagating along the c axis by inter­molecular O—H⋯O hydrogen bonds; an intra­molecular O—H⋯O link also occurs

Methyl 2-(3a,8a-dimethyl-4-oxodeca­hydro­azulen-6-yl)acrylate

The title compound, C16H24O3, was synthesized from ilicic acid, which was isolated from the aerial part of Inula viscosa­ (L) Aiton [or Dittrichia viscosa­ (L) Greuter]. The asymmetric unit contains two independent mol­ecules, in each of which the seven-membered ring shows a chair conformation, whereas the five-membered ring presents disorder. In the two molecules, three C atoms in the five-membered ring are disordered over two positions with site-occupancy factors of 0.53/0.47 and 0.83/0.17. The dihedral angle between the two rings is different in the two mol­ecules [31.7 (3) and 47.7 (7)°]. The crystal structure is stabilized by weak inter­molecular C—H⋯O hydrogen-bond inter­actions

Digestive cancers in Morocco: Fez-Boulemane region

Introduction: To describe the epidemiological and pathological aspects of gastrointestinal cancers in Fez-Boulemane. Methods: This was a retrospective descriptive study of 1120 gastrointestinal cancers diagnosed between 2004 and 2010 in the department of Pathology of Hassan II University Hospital in Fez Morocco. Results: The average age of our patients was 53 years with a male predominance in 52% of cases. Digestive cancers in this study are distinguished by the predominance of colorectal and stomach location. Conclusion: Gastrointestinal cancers are the most frequent cancer in our region. An epidemiological monitoring program is needed.Pan African Medical Journal 2012; 13:4

Hypertension and type 2 diabetes: a cross-sectional study in Morocco (EPIDIAM Study)

Background: In Morocco, there are no studies that focused on the hypertension and its associated risk factors through patients with type 2 diabetes. Different findings show that the frequency of type 2 diabetes has risen rapidly in Morocco. The main objective of this study was to assess the prevalence of hypertension and its associated risk factors among a group of patients with type 2 diabetes and to examine the level of control of hypertension among type 2 diabetic patients with hypertension. Methods: A cross-sectional study was carried out on 525 type 2 diabetics in three Moroccan regions. The structured questionnaire was used to gather information on sociodemographic variables, history of hypertension, use of anti-hypertensive medications and duration of diabetes. Anthropometric measurements including weight and height were measured by trained staff. Blood pressure was measured using standardized sphygmomanometers. Results: The prevalence of hypertension was 70.4%. The logistic regression indicated that hypertension was positively associated with age (p<10-4), BMI (p<0.0002) and duration of diabetes (p Conclusion: Hypertension is a common co-morbidity among Moroccan diabetic patients with high rate of ignorance of hypertension among study subjects. The focus must be on patients and family education, counseling and behavioral interventions designed to modify lifestyle such as increasing physical activity and adopting recommended dietary changes, as well as compliance with medications

10α-Hy­droxy-13-{[4-(4-meth­oxy­phen­yl)piperazin-1-yl]meth­yl}-4,9-dimethyl-3,8,15-trioxatetra­cyclo­[10.3.0.02,4.07,9]penta­decan-14-one

The title compound, C26H36N2O6, was synthesized from 9α-hy­droxy­parthenolide (9α-hy­droxy-4,8-dimethyl-12-methylen-3,14-dioxa-tricyclo­[9.3.0.02,4]tetra­dec-7-en-13-one), which was isolated from the chloro­form extract of the aerial parts of Anvillea radiata. The mol­ecule is built up from fused five- and ten-membered rings with two additional ep­oxy ring systems and a meth­oxy­phenyl­piperazine group as a substituent. The ten-membered ring adopts an approximate chair–chair conformation, while the piperazine ring displays a chair conformation and the five-membered ring shows an envelope conformation with the C atom closest to the hy­droxy group forming the flap. The mol­ecular conformation is determined by an O—H⋯N hydrogen bond between the hy­droxy group and a piperazine N atom. The crystal structure is built up by weak C—H⋯O inter­actions

12-{[4-(2-Fluoro­phen­yl)piperazin-1-yl]­meth­yl}-9α-hy­droxy-4,8-dimethyl-3,14-dioxatricyclo­[9.3.0.02,4]tetra­dec-7-en-13-one

The title compound, C25H33FN2O4, was synthesized from 9α-hy­droxy­parthenolide (9α-hy­droxy-4,8-dimethyl-12-methyl­ene-3,14-dioxatricyclo­[9.3.0.02,4]tetra­dec-7-en-13-one), which was isolated from the chloro­form extract of the aerial parts of Anvillea radiata. The asymmetric unit contains two independent mol­ecules. In each mol­ecule, the ten-membered ring displays an approximative chair–chair conformation. Each of the piperazine rings adopts a perfect chair conformation, while both lactone rings show an envelope conformation, one with the C atom bearing the piperazin-1-ylmethyl group as the flap, the other with the junction C atom not attached to the ring O atom as the flap. The dihedral angles between the least-squares planes through the ten- and five-membered rings in the two mol­ecules are similar [19.1 (3) and 16.2 (3)°]. An intra­molecular O—H⋯N hydrogen bond stabilizes the mol­ecular conformation. The crystal packing is stabilized by C—H⋯O hydrogen bonds

L’observance thérapeutique dans les dermatoses chroniques: à propos de 200 cas

Introduction: L'observance thérapeutique est la capacité à prendre correctement son traitement, tel qu'il est prescrit par le médecin. Elle est peu étudiée en dermatologie.Méthodes: Le but de notre étude est d'évaluer l'observance chez les patients suivis au service de  dermatologie du Centre Hospitalier Universitaire Hassan II de Fès pour une dermatose chronique et de rechercher les facteurs liés à une mauvaise observance à travers une étude incluant 200 patients suivis depuis au moins 6 mois. L'évaluation de l'observance s'est faite essentiellement à l'aide d'un entretien et les facteurs liés à l'observance ont été recherchés par un questionnaire. Résultats: 68% de nos patients étaient observant, la mauvaise observance était associée à un niveau socio économique et d'étude bas, à une vie solitaire, à une durée de suivi longue, aux effets secondaires et au coût élevé des traitements, à l'absence d'efficacité, à une faible visibilité des lésions, à une  ordonnance complexe, à une explication faible de la maladie, et à des difficultés d'accès à la consultation. Le taux d'observance retrouvé dans notre étude est un taux satisfaisant selon les données de la  littérature, notre étude a confirmée certaines facteurs connues et a mis le point sur d'autres facteurs peu étudiés tel un traitement traditionnel associé, la part de chaque forme de traitement dans le respect de l'ordonnance, les dermatoses les plus touchées par les difficulté d'observance a savoir les dermatoses bulleuses et le psoriasis, et l'intérêt du pharmacien. Conclusion: Cette analyse de la fréquence de ce phénomène et des facteurs essentiels qui l'influencent permet de cibler la prise en charge à travers une personnalisation de l'entretien médical, une adaptation du suivi au contexte de nos patients et à la nature de notre institution de santé.Key words: Observance thérapeutique, dermatose chronique, suivi

Métastases choroïdiennes bilatérales d’origine inconnue: à propos d’un cas

Nous rapportons l'observation d'un patient de 52 ans sans antécédents pathologiques notables, qui présente depuis 10 mois un flou visuel de l'œil droit et des métamorphopsies au niveau de l'œil gauche, suivies de troubles visuels très gênants et baisse importante de l'acuité visuel du coté droit, motivant une consultation. Le bilan oculaire a mis en évidence des métastases choroïdiennes bilatérales ; le bilan d'extension révèle des métastases multifocales dont le site primitif est inconnu, notre patient a décédé durant les jours d'explorations