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The aim of this study was to determine the prevalence of herbal medicines (HM) use among diabetic patients in Oriental Morocco, in order to establish an updated inventory of HM consumption and determine the predictive factors of their use in our patients. We conducted a cross-sectional study during three months from March, 2013 to May, 2013 including all diabetic patients consulting at the Department of Endocrinology and Metabolism of Mohammed VI University Hospital in Oujda. The study included 279 diabetics (200 women and 79 men). The prevalence of HM use was 54.8%. Females were 3.25 times more likely to use HM. All patients did not inform spontaneously their physicians about HM use. More than fifty species belonging to 29 families were used by our population. The five most common HM used were Salvia officinalis (Labiaceae), Trigonella feoenum graecum (Leguminosae), Olea europea (Oleaceae), Artemisia herba-alba (Asteraceae) and Origanum vulgare (Lamiaceae). Besides, education level (p = 0.027), menopause (p = 0.027), type 2 diabetes (p = 0.05) and taking both oral hypoglycaemic agents and insulin injection (p = 0.043) are significant factors associated with HM use. HM is very common among diabetic patients. There is an urgent need for health education regarding the use of herbs in conjunction with conventional medicines. Clinical and randomized trials may be needed in the future to assess the efficacy and the safety of the reported herbs.

The rarity of endocarditis due to Klebsiella species limits its recognition. We report the case of a 63-year-old man, known to have a tight calcified aortic stenosis presenting with acute heart failure associated with high fever. Klebsiella oxytoca endocarditis was diagnosed based on three sets of positive blood cultures together with fluttering vegetation (11 mm × 14 mm) on the middle segment of the anterior leaflet of the mitral valve. After 6 weeks of intravenous ceftriaxone and gentamicin bi-therapy, the patient had completely recovered. This case illustrates how sporadic this condition is, for which early assessment and proper treatment are crucial to enhance the short outcomes.

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