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La maladie de Huntington une affection neurodégénérative rare 1686

La maladie de Huntington, anciennement appelée chorée de Huntington, se caractérise par une perte des cellules nerveuses dans certaines parties du cerveau. C’est une affection dégénérative rare et héréditaire qui se déclare généralement à l’âge adulte par des troubles moteurs, cognitifs et psychiatriques qui s’aggravent progressivement. La maladie touche de 5 à 10 personnes, selon les études statistiques, pour 100 000 individus. .La prévalence est identique pour les hommes et les femmes, 1/ CAUSES ET SYMPTÔMES DU TROUBLE La maladie est due à une déficience au niveau d’un gène codant pour la huntingtine, une protéine indispensable au bon fonctionnement des neurones se trouvant en particulier au niveau de la base du cerveau. La maladie est transmise sous un mode autosomique dominant ; quand une personne est touchée, il y a un risque sur deux pour que chacun de ses descendants soit touché. La maladie se déclare souvent entre 30 et 50 ans par des troubles moteurs, dont notamment la chorée : des mouvements anormaux, brusques, saccadés, involontaires des 4 membres. Il s’y associe un trouble de l’équilibre et des troubles de la parole. Plus précisément, Le symptôme le plus visible, la chorée, se traduit, chez 90 % des malades, par des mouvements brusques, imprévisibles et involontaires qui vont gagner progressivement tous les muscles.. .La chorée est principalement favorisée par la fatigue, mais aussi par le stress, les émotions ou encore la concentration. Elle disparaît le plus souvent pendant le sommeil. Les autres symptômes moteurs consistent en des postures anormales,, la rigidité musculaire, une lenteur des mouvements volontaires. . Le retentissement de la maladie est souvent important sur sur les actes de la vie quotidienne avec des troubles de la mastication, de la déglutition, de l’équilibre et des déformations articulaires... On arrive au bout d'un ,certain temps jusqu’à une impossibilité d’effectuer certains mouvements, de se déplacer seul, de se nourrir et même de communiquer. Il y a également un ralentissement du traitement des informations, des difficultés de planifier les actions et avec le temps apparaissent des troubles de la mémoire et de concentration. Une démence peut s’installer. 2/ UN DIAGNOSTIC GENETIQUE ET CLINIQUE Le diagnostic de la maladie s'établit à partir des observations cliniques.. Un test génétique (une analyse du gène de la huntingtine par un prélèvement sanguin) permet de confirmer définitivement le diagnostic. 3/ DES TRAITEMENTS POUR RALENTIR LA PROGRESSION DE LA PATHOLOGIE Actuellement, il n’existe pas de traitement curatif contre cette affection, mais des traitements symptomatiques permettent de diminuer les signes moteurs, psychiatriques et les troubles du sommeil. Antidépresseurs, thymorégulateurs, anxiolytiques, somnifères et neuroleptiques antipsychotiques sont employés pour réduire les troubles psychiatriques ainsi que des stabilisateurs de dopamine et des neuroleptiques contre les mouvements choréiques. La kinésithérapie et l’orthophonie sont nécessaires et efficaces.Des traitements par greffe de cellules embryonnaires ou génétiquement modifiées sont en cours d’évaluation. 4/ DE NOMBREUSES RECHERCHES THERAPEUTIQUES EN COURS Actuellement, une cinquantaine d’essais cliniques sont menés dans le monde pour améliorer la prise en charge des patients atteints, en particulier sur les traitements symptomatiques. Des recherches de thérapies cellulaires sont également entrprises pour implanter des cellules neuronales fonctionnelles remplaçant celles détruites par la maladie. Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار , الدكتورة خديجة موسياراختصاصية في الطب الباطني و أمراض الشيخوخة,Spécialiste en médecine interne et en Gériatrie, Présidente de l’Alliance des Maladies Rares au Maroc, رئيسة ائتلاف الأمراض النادرة المغرب, Présidente de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS),رئيسة الجمعية المغربية لأمراض المناعة الذاتية و والجهازية, vice -présidente du Groupe de l’Auto-Immunité Marocain (GEAIM). POUR EN SAVOIR PLUS : LE RÖLE CENTRAL DE LA HUNTINGTINE, DEFINITION DES MALADIES RARES, L'ALLIANCE DES MALADIES RARES AU MAROC (AMRM) I/ Le rôle central de l'Huntingtine La huntingtine est une grosse protéine nécessaire au développement embryonnaire, à la formation et le maintien du tissu cérébral. Exprimée dans tous l’organisme, elle joue un rôle important dans les relations intracellulaires, Dans la maladie de Huntington, la huntingtine est mutée et n’assure plus complètement ses fonctions physiologiques. Cela conduit à une mort neuronale progressive, qui est à l’origine de l’apparition et l’évolution des symptômes. La huntingtine mutée s’accumule enfin sous forme d’agrégats, qui constituent des marqueurs des neurones malades. II/ Les Maladies Rares Les maladies rares ont une définition internationale, c’est toute maladie qui touche moins d’une personne sur 2 000. Elles sont au nombre de 7000 à 8 000 et chaque année 200 à 300 maladies rares sont nouvellement décrites. On estime que plus de 5 % de la population mondiale serait concernée par ces maladies, soit environ 1 personne sur 20 et donc au moins1,5 millions de patients au Maroc et 3 millions en France. III/ Les Missions et actions de l’Alliance des Maladies Rares au Maroc L’Alliance a pour missions de faire connaître et reconnaître les maladies rares auprès du public, des professionnels de santé et des pouvoirs publics en informant sur leurs enjeux scientifiques, sanitaires et sociaux, par tous les moyens : presse écrite, télévision, radio, sites internet et réseaux sociaux. Elle a également pour objectifs de contribuer à l’information des médecins en organisant des colloques thématiques sur les maladies rares. Elle œuvre à aider à la création d’associations de malades dédiées à chaque maladie rare et à améliorer l’accès au diagnostic et aux soins des maladies rares. L’Alliance des Maladies Rares au Maroc (AMRM), a trois REVENDICATIONS PRINCIPALES visant à : – Donner rapidement le statut d’affection de longue durée (ALD) à un grand nombre de maladies rares et en particulier d’abord aux plus couteuses ; cela garantirait ainsi une prise en charge et un remboursement systématiques des soins à 100 % de la base de référence sécurité sociale ; – Mettre en place un statut de « médicament orphelin » pour les thérapeutiques employées dans les maladies rares offrant notamment un accès plus rapide au marché en raccourcissant les délais d’autorisation de mise sur le marché (AMM) ; – Instaurer un dépistage néonatal systématique visant à détecter des maladies rares sévères d’origine génétique, généralement chez les bébés
Dr Moussayer khadija

Dr Moussayer khadija

Dr MOUSSAYER KHADIJA الدكتورة خديجة موسيار Spécialiste en médecine interne et en Gériatrie en libéral à Casablanca. Présidente de l’Alliance Maladies Rares Maroc (AMRM) et de l’association marocaine des maladies auto-immunes et systémiques (AMMAIS), Vice-présidente du Groupe de l’Auto-Immunité Marocain (GEAIM)


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Back to School: Economic Burden for Families and Multiple Uncertainties 72

At the dawn of a new school year, an immutable reality haunts the many families concerned: the exorbitant cost of supplies and services related to education. They prepare to spend sometimes unreasonable amounts even before their children step through the school door, at all levels. The rising cost of back-to-school goes beyond just notebooks and textbooks: it extends to a set of essential or superfluous items that significantly increase the bill. There is a consensus around the financial burden of the school bag, a real headache. The average budget allocated per family for school supplies often exceeds 1500 dirhams. This figure rises even more when including uniforms, when required, transport costs, registration fees, and tuition for private schools. In some large cities, the total cost can exceed 3000 dirhams per child, a considerable economic weight for many families. But the problem is not only the high cost. The heaviness of the school bag, often cited, illustrates inflation not only financial but also material. Children’s backs and developing musculature are put under strain, raising many health concerns. Beyond the essentials—notebooks, pens, calculators, etc.—the supply lists frequently include superfluous items, often imposed by schools for unexplained reasons. These excessive demands weigh down the school bag and complicate students’ daily lives without real educational justification. In reality, we also face a system out of sync with parents' expectations and, by extension, the country’s. Some school content is outdated and problematic. Textbooks, another major expense, fail to evolve at the pace of the modernity that parents and children themselves aspire to. The modernization the country aims for is also undermined. Many families denounce persistent errors, mistakes, and content poorly adapted to modernity and their aspirations. Announced reforms, generally poorly conceived, have no impact and have always been ineffective. Criticism abounds both pedagogically and substantively: teaching materials struggle to engage students in stimulating and innovative learning. This is a major reason for the large dropout rates observed every year, and for a long time. Another recurring flaw is that, once again, the school start will be unequal: luxury for some, sacrifice for others. Officially, the school start often looks like an idyllic photo album where everything seems perfect. Yet, for the majority, it is far from a moment of excitement as it should be. Faced with an overly large educational budget, difficult choices must be made: pay rent or tuition, buy textbooks, or ensure family sustenance. These contradictions reflect a profound social divide. In short, Morocco at two speeds, denounced by His Majesty the King in the 26th Throne Speech. For many parents, school remains a theoretical right, sometimes without interest, especially in rural areas. In reality, it begins with debt that weighs heavily on daily life and sometimes jeopardizes the children's very future. This paradox, far from resolving, repeats every year, without significant measures from public authorities to lighten the burden, except for measures such as distributing school bags with a short lifespan and very meager financial aid. The quality of teachers has also increasingly raised concern for several years, especially since the so-called contract-based recruitment among unemployed degree holders was "invented," often struggling to find stable employment elsewhere. This situation has led to a qualitative decline in teaching, where many teachers are more occupied with union and social claims than with their primary mission: to instruct and transmit knowledge. The number of strike days is staggering. This contractual dynamic, far from improving the educational system, sometimes fosters instability and demotivation. Moreover, it is regrettable to note increased politicization among some teaching circles, with ideologies infiltrating beyond the pedagogical framework. These trends, often aimed at the systematic contestation of the established order, harm a serene school climate and compromise the necessary neutrality of any teaching. Children bear the cost. Thus, more than a simple issue of training or skills, the challenge posed by the quality of teachers in Morocco highlights the need for a global and courageous reform, combining improved recruitment conditions, serious academic and ongoing training, and a clear separation between politics and education. Without this, Moroccan schools risk losing even more effectiveness and credibility, to the detriment of students and the country's future. Education should not rely on the financial endurance, patience, or indifference of families, but on a coherent educational and social policy. A policy based on a clear projection of what the Moroccan citizen should be at a precise horizon. It is essential that the State and sector actors collaborate to limit costs imposed on families: reviewing supply lists to eliminate the superfluous, improving the quality and relevance of textbooks, further developing support for low-income families, deducting school-related expenses from taxes, without evading the issue of content and teacher competencies. The "price" of this school start is measured not only in dirhams but in the social divide it deepens, in the inequalities it maintains. The real obstacle to education lies in teacher competence, in curricula, and at the bookstore checkout where families must pay for their children to have even a chance to succeed. The school start is a serious matter requiring collective awareness and concrete actions to ensure that every child, regardless of family income, can access a dignified education. The time is for reform in practice, not just in speeches and postures. School is the only tool to reduce differences, guarantee social ascension, and ensure a bright future for the entire country, at a single speed.

Sacred Geometry 446

Sacred geometry is the study of universal patterns, proportions, and forms that shape the structure of the cosmos. Based in both mystical philosophy and natural law, it proposes that certain geometric principles—such as the circle, the triangle, the square, and the spiral—are not mere abstractions of the human mind, but archetypal patterns embedded in the very fabric of existence. From the crystalline structure of minerals to the arrangement of galaxies, from the spiraling of galaxies to the loops of a seashell, sacred geometry reveals the fundamental harmony that unites all levels of being, from the microcosm to the macrocosm. Historically, sacred geometry has been used in nearly every advanced civilization. In ancient Egypt, temples were constructed in accordance with geometrical harmonies to mirror the cosmic order and to serve as portals between the earthly and the divine. In Greece, Pythagoras and his initiates viewed numbers and forms as the essence of all reality, with the tetractys—a triangular arrangement of ten points—symbolizing the unfolding of the universe from unity into multiplicity. Platonic solids, which are the only five regular polyhedra that exist in three-dimensional space, were seen as the geometric building blocks of the classical elements: earth (cube), air (octahedron), water (icosahedron), fire (tetrahedron), and ether or spirit (dodecahedron). The circle is the most fundamental and infinite of all shapes, representing unity, eternity, and the divine source. From it arises the Vesica Piscis, formed by the intersection of two circles, symbolizing the intersection of spirit and matter, or heaven and earth. This sacred figure originates other key patterns such as the Seed of Life, Flower of Life, and Tree of Life, each a progressively complex map of creation and emanation. These patterns are found carved into sacred sites around the world, not as decoration, but as invocations of cosmic harmony encoded in symbol. At a more esoteric level, sacred geometry is not only the structure of physical matter but also the architecture of consciousness. Every line and angle becomes a glyph of spiritual truth. In the Kabbalistic Tree of Life, for example, the Sephiroth are arranged in a precise geometric pattern that mirrors the process of divine emanation from the Infinite (Ein Sof) into the manifested world. In Islamic architecture, intricate geometric mosaics reflect the infinite within the finite, pointing to the divine through abstraction and mathematical beauty. In Eastern mandalas, sacred geometry functions as both map and mirror—a diagram of the universe and a guide to inner stillness. The mystical power of sacred geometry resides in its ability to bridge the material and the metaphysical. Geometry is not only a tool for measuring space but a sacred science that unveils the divine intelligence at work in all things. To contemplate these forms is to enter a state of resonance with the universal order. When one meditates upon the proportions of a golden spiral or the interlocking symmetry of a mandala, the soul begins to remember its own original harmony. Sacred geometry is not a human invention, but a revelation—a language through which the cosmos speaks to itself. It is the alphabet of creation, the blueprint of form, and the silent song of order hidden in the chaos of appearances. Whether found in cathedrals or pinecones, in the fractal of a fern or the plan of a pyramid, these shapes serve as portals to remembrance. They whisper that behind all things lies a unified design, and to perceive it is to glimpse the mind of the divine.

Le Monde and Morocco: Deconstructing a Biased View of a Revered Monarchy... 604

The newspaper Le Monde, founded on the recommendation of General De Gaulle in the context of the Second World War in 1944, is internationally renowned for its investigative journalism and analytical capability. However, it often displays a biased approach when it focuses on the Kingdom of Morocco. The article published on August 24, 2025, titled "In Morocco, an atmosphere of end of reign for Mohammed VI," symptomatically illustrates this tendency, which deserves a response by also recalling the conflictual relationship the newspaper has had with the Kingdom almost since its inception. The impression is that it is probably the fact that Morocco is a Kingdom that bothers or disturbs the paper. The relationship to monarchy, particularly from the French left, is not unrelated to this ideological stance. For a long time, Le Monde's editorial coverage of Morocco has avoided neutrality. Since the time of Hassan II, the paper frequently adopted a critical tone, sometimes unjustly severe, offering a European reading framework that often reduced the complex Moroccan political reality to a caricature. Between interpretations disconnected from reality and unfounded insinuations, the treatment of the country has often been limited to a black-and-white vision, marginalizing the concrete nuances of its evolutions and its centuries-old history. It must be reminded that the Kingdom, as a nation-state, existed long before what is today called France. It therefore has its own codes and its own evolution and worldview. The newspaper's stance, inherited from a postcolonial reading marked by a basic socialism fixed on the image of an immutable authoritarian power and a society on the brink of upheaval. Journalists seem to relive by proxy the years before 1789. Conflations and romanticized interpretations are the rule. Returning to the article, would the King of Morocco be a misunderstood sovereign? Is the Kingdom, for its part, so little known to the journalists of "Le Monde"? Would the secular Moroccan people simply be a copy of the people of medieval France? Or is it simply an ideological stance blinding the paper? The mention of an "atmosphere of end of reign" in the recent article betrays profound ignorance coupled with a dubious hypothesis. In reality, no tangible sign of decline emerges, quite the opposite. The Moroccan people show notable attachment to their monarchy perceived as an essential pillar for stability, development, and national cohesion. A simple observation of social networks would have spared the authors from such errors, for since 1999, under the impetus of King Mohammed VI, Morocco has achieved important reforms. These are advances that took France two centuries. How can one forget to mention the country’s major achievements in such a short time: - Sustained economic growth in several strategic sectors, generating jobs and sustainable prospects. - Modernization of the family code (Moudawana), a symbol of major social progress, particularly regarding women's rights. - Adoption of a transitional justice policy favoring reconciliation and healing historical wounds. - Establishment of mandatory medical coverage, expanding access to healthcare for all. - Assertive diplomacy recognized on the African continent and internationally, demonstrating a well-thought-out, forward-looking strategy. - The Kingdom is preparing to host the Football World Cup, a sign of great trust from the international community. These successes, however glaring, are overlooked by the authors because they contradict a sensationalist narrative of monarchical decline which appeals to some French circles nostalgic, under the surface, for the monarchy they killed. The article recklessly mixes rumors, outdated clichés, and baseless hypotheses, portraying power as frozen, aging, and oppressive. The author consciously ignores the multifaceted reality of a country at the crossroads of ancient traditions and sustained modernization. The depiction of a "twilight" reign reflects a condescending gaze, reminiscent of dominant stereotypes that often reduce the Arab and African world to narratives of instability and decline. Contrary to the dark picture painted by Le Monde, contemporary Morocco under Mohammed VI pursues a dynamic trajectory, marked by concrete progress and real stakes, aligned with popular expectations. Rejection is not expressed through a distancing from the monarchy, but by a demand for thoughtful, gradual reforms that respect traditions and institutions. In this context, speaking of "end of reign" stems from a mistaken reading that distorts the actual function and role of monarchy today. Here, it is essential to claim rigorous journalism based on documentary research and pluralism, finally freeing itself from postcolonial reflexes and a condescending gaze. Morocco cannot be reduced to an exotic subject of study or a testing ground for imported scenarios. More than a relic, the monarchy embodies a central lever of a nation in motion, led by lucid and committed leadership. Le Monde’s editorial past seems to weigh heavily on its analysis of current events in Morocco. By assertively stating an "atmosphere of end of reign," the article disconnects its diagnosis from the social, economic, and political realities shaping the Kingdom. The achievements show a sincere will to articulate traditions and modernity, stability and popular aspirations, in a difficult regional environment that the country has managed with discernment. By omitting these elements, favoring unfounded rumors and finished stereotypes, the text promotes an alarmist narrative that harms both truth and constructive dialogue, feeding prejudices inherited from an outdated postcolonial vision. Thus, far from a predicted decline, Morocco traces a path based on conscientious leadership, rooted in a millennia-old history and attentive to current challenges, looking towards a hopeful future. It is time for Le Monde to renew its gaze with honesty and respect, going beyond clichés and integrating the diversity of the Moroccan voice. The arrogance of an external view must never outweigh lived reality. Readers of this newspaper, as with others when it comes to Morocco, deserve balanced, non-partisan, and open information reflecting the richness and depth of a society and a Kingdom in full transformation, faithful to its institutions and its sovereign.