Scolicidal Agent Research Articles

Synthesis of Silver Nanoparticles Using Haplophyllum robustum Bge. Extract: Antibacterial, Antifungal, and Scolicidal activity against Echinococcus granulosus Protoscolices

Background: Silver nanoparticles (AgNPs) biosynthesized via the deployment of plant extractives have garnered much attention, especially due to their antimicrobial properties. Herein, the green synthesis of silver nanoparticles has been accomplished using the aqueous extract of Haplophyllum robustum, which includes a study of its antibacterial, antifungal, and scolicidal activity. Methods: The preparative process was followed by characterization using UV-Vis spectroscopy, and the ensuing spherical AgNPs of average size 7-25 nm were identified by Dynamic Light Scattering (DLS), X-Ray Diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), and Transmission Electron Microscopy (TEM). The antibacterial, antifungal, and scolicidal activities of AgNPs were assessed by deploying disc diffusion and microdilution methods against four standard bacteria and four typical Candida species and liver hydatid cyst protoscoleces, where they exhibited good biological activity. Results: The results showed that the greener synthesis of silver nanoparticles using the aqueous extract of renewable and abundant H. robustum plant is a simple, inexpensive, and safer alternative that does not use any toxic or harmful substances. Conclusion: Thus, with minimal or no side effects, this approach to AgNPs bodes well for their appliances as antibacterial, antifungal, and scolicidal agents.

Zinc oxide/barite nanocomposite from Trachyspermum ammi plant extract: A novel agent against protoscolices of Echinococcusgranulosus

Hydatid disease is a shared illness between humans and livestock that impacts the health of both humans and animals, and it also presents considerable risks to the global economy. The current study aims to synthesize zinc oxide nanoparticles (ZnO NPs) and zinc oxide/barite nanocomposites (ZnO/Brt NC) modified with chitosan (ZnO/Brt/Chit NC), using aqueous extract of the Trachyspermum ammi plant and a chemical method. The scolicidal effect, IC50, and mRNA expression of the caspase-3 gene on protoscolices were measured using Real-time PCR to identify nanomaterials (NMs) with superior biological efficacy against hydatid cyst protoscolices. The characteristics of these NMs were examined using techniques such as XRD, FTIR, FE-SEM, EDS, DLS, ZP, and PDI. Colloidal sizes for ZnO NPs, ZnO/Brt NC, and ZnO/Brt/Chit NC synthesized via the green method, and ZnO/Brt NC and chemically-synthesized ZnO/Brt/Chit NC were found to be 28.18, 68.10, 106.60, 85.90, and 165.60 nm, respectively. These NCs, which possess crystalline structures and spherical morphology, have been stabilized on a barite substrate. The zeta potential obtained for the green-synthesized NCs is −22.80 mV, and for those synthesized chemically, it is −19.70 mV. Results indicate that ZnO NPs and green-synthesized ZnO/Brt NC have the strongest scolicidal effect. At a concentration of 200 mg/mL, ZnO NPs achieved 100 % lethality in 60 min and ZnO/Brt NC in 30 min. The IC50 values for ZnO NPs and ZnO/Brt NC were 858.3 and 1205 μg/mL, respectively. In contrast, chemically-synthesized and chitosan-modified NCs showed a weaker scolicidal effect. At a concentration of 0.5 mg/mL, a significant increase in caspase-3 gene expression was observed for ZnO NPs (6.66 ± 0.94), (p = 0.003) and green-synthesized ZnO/Brt NC (5.06 ± 1.27), (p = 0.02), suggesting these NMs could be effective scolicidal agents In vivo conditions.

High potency of linalool-zinc oxide nanocomposite as a new agent for cystic echinococcosis treatment.

This current in vitro, ex vivo, and in vivo research aims to evaluate and analyze the linalool-zinc oxide nanocomposite (Lin-ZNP) for treating cystic echinococcosis. Lin-ZNP was synthesized using an ethanolic solution of polyvinyl alcohol. The protoscolicidal effects of Lin-ZNP were tested on hydatid cyst protoscoleces (PTS) in both in vitro and ex vivo by eosin exclusion test. The study also examined the impact on caspase-3 gene expression and the external structure of PTS. The in vivo effect was measured by examining hydatid cysts' quantity, dimensions, and weight in mice intraperitoneally infected with 0.5 mL of PTS solution containing 1,000 PTS. The antioxidant and inflammatory cytokine gene expression levels were examined using real-time PCR. Lin-ZNP significantly (P < 0.001) killed the PTS in both in vitro and ex vivo in a dose- and time-dependent manner. The treated PTS exhibited creases and protrusions as a result of bleb formation and upregulation in the gene expression of caspase-3. Upon treatment with Lin-ZNP, there was a significant (P < 0.001) reduction in the number, diameter, and weight of the hydatid cysts. Treatment with Lin-ZNP nanocomposite led to a significant increase in the expression of antioxidant genes and a notable decrease in oxidative stress markers, and the expression levels of IL-4 and IL-10. Lin-ZNP has the potential to act as a scolicidal agent and demonstrates promise in controlling hydatid cysts in a mouse model, attributed to its antioxidant and anti-inflammatory properties. However, additional studies in clinical trials are needed to confirm the use of Lin-ZNP for treating hydatidosis.

Laparoscopic Management of Abdominal Echinococcosis: A Technical Report on Surgical Techniques and Outcomes.

This technical report explores the efficacy and methodology of laparoscopic surgery for treating abdominal echinococcosis, a parasitic infection caused by Echinococcus granulosus. We highlight the zoonotic nature of the disease, which predominantly affects the liver and occasionally other organs, noting the challenge of its asymptomatic progression that complicates timely diagnosis and intervention. We detail our surgical technique using a standard laparoscopy kit to address abdominal hydatid cysts, emphasizing the critical importance of preventing cyst rupture and spillage to avoid recurrence and anaphylactic shock. We discuss considerations for opting for laparoscopy over open surgery, such as reduced postoperative morbidity, faster patient recovery, and lower costs, while also acknowledging limitations like restricted instrument movement and the absence of haptic feedback. We advocate hypertonic saline as the preferred scolicidal agent and strategies to minimize spillage and manage the residual cavity. In conclusion, we assert that laparoscopy offers a viable and effective treatment option for abdominal echinococcosis, emphasizing that optimizing outcomes for this benign condition hinges on careful patient selection and a conservative surgical approach.

Comparison of the Scolicidal Activity of Two Leaves Extracts of Myrtus communis from Algeria Against Echinococcus granulosus Sensu Lato Protoscoleces.

During cystic echinococcosis surgery, the use of scolicidal agents such as hypertonic saline (20%) aims to reduce the risk of infection recurrence, but most of the used agents are associated with undesirable side effects. Therefore, the use of natural scolicidal agents such as medicinal plant extracts could reduce these medical issues. The present study aimed to compare in vitro the scolicidal activity between two extracts of the medicinal plant Myrtus communis from Algeria against Echinococcus granulosus sensu lato protoscoleces. Theethanolic and aqueous extraction of plant leaveswas performed. Phytochemical analysis by gas chromatography-tandem mass spectrometry (GC-MS/MS), determination of total phenolic and flavonoid contents, and in vitro antioxidant activity by DPPH were evaluated for both extracts. Finally, the in vitro scolicidal activity was tested by different concentrations. The viability was evaluated by the eosin exclusion test. Thephytochemical analysis revealed 28 components for the ethanolic extract and 44 components for the aqueous extract. The major components were 2'-hydroxy-5'-methoxyacetophenone and 4-amino-2-methylphenol, respectively. The total phenolic and flavonoid contents were 45.9 ± 0.085mg of gallic acid equivalent per g of extract (GAE/g E) and 16.5 ± 0.004mg of quercetin equivalent per g (QE/g E) for the ethanolic extract, and 36.5 ± 0.016mg GAE/g E and 18.2 ± 0.023mg QE/g E for the aqueous extract, respectively. Furthermore, ethanolic and aqueous extracts of M. communis gave a value of IC50 = 0.009 ± 0.0004mg/ml and IC50 = 0.012 ± 0.0003mg/ml for theantioxidant activity, respectively. The in vitro scolicidal activity with concentrations of 50, 75, 100, and 150mg/ml was tested for 5, 10, 15, and 30min, and 5, 10, 15, 30, 60, 90, and 120min for ethanolic and aqueous extracts, respectively. The mortality rate of protoscoleces at concentrations of 100 and 150mg/ml was 98.8 and 100%, respectively, after 5min of exposure to the ethanolic extract, while this rate was 100% at the same concentrations only after 60min of exposure to theaqueous extract. The ethanolic extract showed a stronger scolicidal activity against E. granulosus s.l protoscoleces than the aqueous extract. In the future, otherinvestigations are necessary to elucidate the mechanism of action and the possible toxicity on human cells. Moreover, experimental animal studies are required to investigate the efficacy of different extracts of this plant and its components as natural anti-parasitic alternatives for the treatment of human cystic echinococcosis.

Toxicity of geranium oil, geraniol and their nanoemulsions on protoscoleces of hydatid cyst under in vitro conditions

Surgery is the main efficacious treatment for many cases of cystic echinococcosis by removing Echinococcus granulosus cysts. However, to reduce risk of cyst spillage and insemination of the content, using a scolicidal agent is crucial. Considering side effects of available scolicidals, and growing nano-technological approaches in novel pharmaceuticals, the present study aimed to find out the scolicidal activity of geraniol (GL), geranium oil (GM), and their developed nanoemulsions (Nano-GL and Nano-GM) on the protoscoleces of E. granulosus. Nanoemulsions were developed by ultrasonication emulsification and characterised by dynamic light scattering method (DLS). The scolicidal effect of GL, GM, Nano-GL, and Nano-GM at different concentrations of 1, 2.5, 5, 10, 25, and 50 µg/mL were determined after 0.5, 1, and 2 hours of incubation. Mortality rates were measured by eosin exclusion test. The average droplet size for Nano-GM and Nano-GL were 124.8 and 88.59 nm, respectively. After one hour of exposure, all tested concentrations of GL and Nano-GL resulted in higher than 90% mortality rates, while GM and Nano-GM killed 70.66% and 90.33% of protoscoleces, respectively. Based on 50% lethal concentration, Nano-GL was significantly more potent than Nano-GM (LC50: 4.52 vs 102.95 μg/mL). Results of scanning electron microscopy revealed tegumental disruption in the treated protoscoleces. This study described an easily applicable and eco-friendly procedure of nano-formulating functional phytochemicals, showing promising scolicidal activity in vitro. The developed formulations, especially Nano-GL, showed the characteristics of an ideal scolicidal agent. Further studies are needed to assess in vivo efficacy and safety of this formulation

Scolicidal and apoptotic effects of phyto- and chemically synthesized silver/boehmite nanocomposites on Echinococcus granulosus protoscoleces

Cystic hydatid disease (CHD) is a zoonotic disease caused by the larval stage of Echinococcus granulosus (E. granulosus). This study aimed to synthesize silver nanoparticles (Ag NPs), silver boehmite nanocomposite (Ag/Bhm NC), and silver boehmite nanocomposite modified with chitosan (Ag/Bhm/Chit NC) using Rosmarinus officinalis (R. officinalis) extract and chemical method, and to evaluate their scolicidal and apoptotic effects on protoscoleces (PSCs) in vitro. The nanomaterials (NMs) were characterized by XRD, FTIR, FESEM, EDS, DLS, PDI, and zeta potential (ZP). The NMs were tested against PSCs at different concentrations (0.2–1.6 mg/mL) and exposure times (10–60 min). The size of Ag NPs, phytosynthesized Ag/Bhm NC, Ag/Bhm/Chit NC, and chemically synthesized Ag/Bhm NC were 25.55, 43, 72.3, and 60.8 nm, respectively. Ag NPs and phytosynthesized Ag/Bhm NC showed the highest scolicidal effect, with 65.34 % and 51.60 % mortality rate at 1.6 mg/mL and 60 min, respectively. Caspase-3 mRNA expression was higher in PSCs treated with Ag NPs and Ag/Bhm NC than in control groups (P < 0.05). Phytosynthesized Ag/Bhm NC had stronger scolicidal and apoptotic effect than chemically synthesized Ag/Bhm NC. Ag/Bhm/Chit NC had a weaker scolicidal effect but higher gene expression than Ag/Bhm NC. In conclusion, this study demonstrates the potential of phytosynthesized Ag NPs and Ag/Bhm NC as effective scolicidal and apoptotic agents against PSCs of hydatid cysts, which may be useful for the treatment of this disease.

ULTRASOUND-GUIDED PERCUTANEOUS TREATMENT OF HEPATIC HYDATIDOSIS IN TWO RED-SHANKED DOUC LANGURS (PYGATHRIX NEMAEUS).

Hydatid disease caused by Echinococcus ortleppi is a major cause of morbidity and mortality for critically endangered captive langurs in northern Vietnam. The most common sites for hydatid cyst development are the liver and the lungs. Chemotherapy trials with albendazole alone or in combination with praziquantel in these langurs had varying results and in most cases were ineffective. Ultrasound-guided percutaneous aspiration of cystic fluid followed by instillation and re-aspiration of a scolicidal agent (PAIR technique), has gained importance in the treatment of active hepatic cysts in humans and in many cases is preferred over surgical and endoscopic approaches. The PAIR technique was used in two red-shanked douc langurs (Pygathrix nemaeus) for the treatment of unilocular active hepatic cysts. The technique was found to be fairly easy to perform, safe, and effective and should be a useful treatment tool for hepatic hydatidosis in langurs and other nonhuman primate species.

Multiple, Extensive Cardiac and Pulmonary Hydatid Cysts Managed by a Single-stage Surgical Removal: A Case Report

Background: Echinococcosis is a zoonotic infection that is characterised clinically by the development of hydatid cysts in different organs, mainly the liver and lungs. Cardiac involvement is rare but can lead to serious and fatal complications. Case Report: We report a rare challenging case of multiple, extensive cardiac and pulmonary Echinococcal cysts that were treated by successful single-stage surgical resection via median sternotomy without additional thoracic incisions. Conclusion: This article highlights the rare presentation of multiple, extensive cardiac and pulmonary Echinococcal cysts and how to overcome diagnostic challenges in the era of modern diagnostic imaging. Surgical removal remains the mainstay treatment, and a single-stage surgical approach is feasible in capable centres. Perioperative chemotherapy with Albendazole and the intraoperative use of scolicidal agents improved immediate surgical outcomes, although long-term effects could not be established in this case due to loss of follow-up.

Effect of Alhagi maurorum Hydroalcoholic Extract on Preventing Secondary Hydatid Cysts in BALB/c Mice

Background: Surgery is the main treatment for hydatid cyst disease, during which the spillage of live protoscoleces is a major cause of hydatidosis recurrence. Scolicidal agents are used to prevent this problem. However, they may have some unpleasant side effects. Objectives: This study assessed the scolicidal effects of Alhagi maurorum hydroalcoholic extract on developing secondary cysts in BALB/c mice infected with Echinococcus granulosus parasites. Methods: BALB/c mice were inoculated intraperitoneally with viable protoscoleces. One month after the infection, the mice were randomly divided into 4 groups (7 per group). Group 1 (control group) was orally administered PBS daily. Group 2 was orally administered albendazole daily (150 mg/kg). Group 3 was orally administered Alhagi maurorum hydroalcoholic extract daily (500 mg/kg). Group 4 was orally administered Alhagi maurorum hydroalcoholic extract daily (250 mg/kg). After 6 weeks of treatment, the weight (g), size (mm), number, and fertility of hydatid cysts were measured after the euthanasia and necropsy of all mice. Results: The weight (g), size (mm), and the number of cysts was significantly lower in the groups receiving 500 mg/kg Alhagi maurorum hydroalcoholic extract, 250 mg/kg Alhagi maurorum hydroalcoholic extract, and 150 mg/kg albendazole than in the control group (P &lt; 0.05). The fertility percentage of hydatid cysts did not show a significant difference between the four groups (P &gt; 0.05). Moreover, there were no statistically significant differences in the parasitological parameters between the three groups: Alhagi maurorum hydroalcoholic extract 500 mg/kg, Alhagi maurorum hydroalcoholic extract 250 mg/kg, and albendazole 150 mg/kg (P &gt; 0.05). Conclusions: The findings demonstrated the effect of Alhagi maurorum hydroalcoholic extract against protoscoleces in BALB/c mice. However, cellular and molecular research should be carried out to gain a deeper understanding of the various effects of this extract on hydatid cysts.

Green Synthesis, Characterization, and Antiparasitic Effects of Gold Nanoparticles against Echinococcus granulosus Protoscoleces.

Echinococcosis, or hydatidosis, is one of the most important zoonotic diseases, which is initiated by the larval stage in the clasts of Echinococcus granulosus. For the treatment of hydatidosis, surgery is still the preferred method and the first line of treatment for symptomatic patients. Unfortunately, most of the scolicidal agents that are injected inside cysts during hydatid cyst surgery have side effects, including leaking out of the cyst and adverse effects on the living tissue of the host, such as necrosis of liver cells, which limits their use. This work was carried out to study the lethal effect of green synthesized gold nanoparticles (Au-NCs) against hydatid cyst protoscoleces. Au-NCs were green synthesized using the Saturja khuzestanica extract. Au-NCs were characterized by UV-visible absorbance assay, electron microscopy analysis, X-ray diffraction (XRD), and Fourier transform infrared (FTIR) spectroscopy. Scolicidal properties of Au-NCs (1-5 mg/mL) were studied against protoscoleces for 10-60 min. The effect of Au-NCs on the expression level of the caspase-3 gene as well as the ultrastructural examination was studied by real-time PCR and scanning electron microscopy (SEM). The cytotoxicity of Au-NCs on hepatocellular carcinoma (HepG2) and normal embryonic kidney (HEK293) cell lines was also studied by the cell viability assay. The obtained Au-NCs are cubes and have an average size of 20-30 nm. The highest scolicidal efficacy was observed at 5 mg/mL with 100% mortality after 20 min of treatment for hydatid cyst protoscoleces. In ex vivo, Au-NCs required more incubation time, indicating more protoscolicidal effects. Au-NCs markedly upregulated the gene level of caspase-3 in protoscoleces; whereas they changed the ultra-structure of protoscoleces by weakening and disintegrating the cell wall, wrinkles, and protrusions due to the formation of blebs. We showed the effective in vitro and ex vivo scolicidal effects of Au-NCs against hydatid cyst protoscoleces by provoking the apoptosis process of caspase-3 activation and changing the ultrastructure of protoscoleces with no significant cytotoxicity against human normal cells. However, additional studies should be conducted to determine the possible harmful side effects and accurate efficacy.

Hypochlorous Acid: A Novel Agent Against Echinococcus granulosus Protoscoleces.

We aimed to determine the scolicidal effect of hypochlorous acid and its efficiency at different concentrations. We tested the effectiveness of hypochlorous acid in-vitro on sterile gauze at different concentrations in test tubes. In addition, we compared its effectiveness with the scolicidal activity of other agents, povidone-iodine 10% and chlorhexidine-gluconate 0.04%. Hypochlorous acid was 100% effective in 5 minutes at 1/1 (200 ppm/mL), 1/10 (20 ppm/ml), and 1/100 (2 ppm/mL) concentrations and in 10 minutes at 1/1000 (0.2 ppm/mL) concentration. Povidone-iodine 10%, and chlorhexidine-gluconate 0.04% were studied undiluted and were effective at all study times. Hypochlorous acid maintained the same scolicidal activity on gauze at all study times at the described dilutions. Hypochlorous acid is an effective scolicidal agent in 5 minutes at even 1/100 concentrations. In addition, it maintains the same scolicidal activity on gauze used in surgery to wall the surgical site.

Eugenol Essential Oil and Nanoemulsion as Antihydatic Agents with Antifibrotic and Immunomodulatory Effects in Cystic Echinococcosis.

Conventional scolicidal agents are still unsatisfactory in combating hydatid disease due to their low efficacy and increased drug side effects. Therefore, novel scolicides are required. This study aimed to evaluate the antihydatic and immunomodulatory effects of eugenol essential oil (Eug) and its nanoemulsion (Eug-NE) in cystic echinococcosis (CE). Eug and Eug-NE were administered orally to CE-infected rats and compared to albendazole (ABZ). Hydatid cyst development was assessed based on organ weight and hypertrophy indicators of the infected organs, along with a histopathological and histochemical evaluation of collagen content. The immunomodulatory effects of treatment on CE were evaluated by serum cytokine levels measurement of interferon-γ (IFN-γ) and interleukin (IL)-4 and immunohistochemical (IHC) analysis of signal transducer and activator of transcription 4 (STAT4) and GATA-binding protein 3 (GATA3) markers. Eug-NE was the most effective in reducing the cyst weights, organ weights, and hypertrophy indicators and improving histopathological lesions with reduced collagen content. Eug and Eug-NE significantly increased the IFN-γ levels and decreased the IL-4 levels, while IHC analysis demonstrated a significant reduction in STAT4 and GATA3 expression in all treated groups. Eug and Eug-NE demonstrated antihydatic and preventative effects, with a substantial decrease in liver fibrosis compared to that of ABZ. Besides their promising immunomodulatory effects, their good treatment response suggests their use as alternatives or complementary scolicidal agents in hydatid cyst treatment.

PERCUTANEOUS ASPIRATION-INJECTION-REASPIRATION (PAIR) THERAPY FOR SOLITARY SPLENIC HYDATID CYST: A CASE REPORT AND CLINICAL CONSIDERATIONS

Splenic hydatidosis is a rare disease caused by the larval stage of Echinococcus granulosus. Here, we report a case of a 68-year-old patient with a single splenic hydatid cyst, discovered incidentally on an ultrasound. The patient presented with left upper quadrant pain, but was otherwise asymptomatic. Imaging studies confirmed the diagnosis of a 13.7 x 14.3 x 11.6 cm splenic hydatid cyst. The patient underwent a puncture-aspiration-injection and reaspiration (PAIR) procedure with scolicidal agents and drainage, which confirmed the presence of viable scolex. The patient was then treated with albendazole, which led to a significant clinical and radiological improvement.

Antiparasitic Effects and Cellular Mechanisms of Formononetin (a Natural Isoflavone) Against Hydatid Cyst Protoscoleces

Background: The chemical agents applied to reduce the complications of hydatid cyst surgery are not free of side effects. Formononetin (FMN), as a natural isoflavone, has been shown to have various therapeutic benefits. Objectives: We studied the in vitro and ex vivo protoscolicidal activity and cellular mechanisms of FMN against hydatid cyst protoscoleces. Methods: Formononetin at 75, 150, and 300 μg/mL was mixed with hydatid cyst protoscoleces (103/mL), and the viability was determined in 5 to 60 min through eosin staining assay. The effect of FMN on caspase-3 activity was tested through a commercial colorimetric protease kit. In addition, the penetrability of the plasma membrane of protoscoleces after exposure to FMN was also determined by the SYTOX assay. Results: Formononetin at 300 μg/mL completely destroyed hydatid cyst protoscoleces after 30 minutes. While at 150 μg/mL, after 60 minutes of contact, 100% of protoscoleces were eliminated. By ex vivo assay, FMN showed its antiparasitic effect for longer periods. Based on these results, FMN at 300 μg/mL concentration completely eliminated hydatid cyst protoscoleces after 60 minutes of exposure. While at a concentration of 150 μg/mL after 60 minutes, 89.6% of protoscoleces were destroyed. Formononetin noticeably increased (P &lt; 0.001) the activity of caspase-3 and the permeability of protoscoleces dose-dependently. Conclusions: Formononetin as a natural product showed promising effects on the protoscoleces of hydatid cysts, indicating that it can be considered a valuable scolicidal agent. However, additional investigations are necessary to evaluate its efficacy in animal models and human subjects.

Cytotoxic, Scolicidal, and Insecticidal Activities of Lavandula stoechas Essential Oil

Essential oils (EOs) have recently attracted more interest due to their insecticidal activities, low harmfulness, and rapid degradation in the environment. Therefore, Lavandula steochas (L. steochas) essential oil was assessed for its chemical constituents, in vitro cytotoxicity, and scolicidal, acaricidal, and insecticidal activities. Using spectrometry and gas chromatography, the components of L. steochas EOs were detected. Additionally, different oil concentrations were tested for their anticancer activities when applied to human embryonic kidney cells (HEK-293 cells) and the human breast cancer cell line MCF-7. The oil’s scolicidal activity against protoscolices of hydatid cysts was evaluated at various concentrations and exposure times. The oil’s adulticidal, larvicidal, and repelling effects on R. annulatus ticks were also investigated at various concentrations, ranging from 0.625 to 10%. Likewise, the larvicidal and pupicidal activities of L. steochas against Musca domestica were estimated at different concentrations. The analyses of L. steochas oil identified camphor as the predominant compound (58.38%). L. steochas oil showed significant cytotoxicity against cancer cells. All of the tested oil concentrations demonstrated significant scolicidal activities against the protoscoleces of hydatid cysts. L. steochas EO (essential oil) showed 100% adulticidal activity against R. annulatus at a 10% concentration with an LC50 of 2.34%, whereas the larvicidal activity was 86.67% and the LC50 was 9.11%. On the other hand, the oil showed no repellent activity against this tick’s larva. Furthermore, L. steochas EO achieved 100% larvicidal and pupicidal effects against M. domestica at a 10% concentration with LC50 values of 1.79% and 1.51%, respectively. In conclusion, the current work suggests that L. steochas EO could serve as a potential source of scolicidal, acaricidal, insecticidal, and anticancer agents.

Safety of Ultrasound-Guided Percutaneous Injection of Alcohol as a Scolicidal Agent for the Treatment of Liver Hydatid Cysts

Background: Hydatid disease is a health problem in the developing world. Percutaneous therapy with various scolicidal agents has been described; however, there is a paucity of literature on the use of absolute alcohol injection without reaspiration as a sole scolicidal agent. The study carried out in a tertiary hospital aimed to prospectively evaluate the safety and outcomes of ultrasound-guided percutaneous injection of alcohol for liver hydatid cyst. Methodology: Consecutive patients with liver hydatid cysts were evaluated with ultrasound, classified according to the WHO classification between June 2012 and January 2020. Eligible patients underwent ultrasound-guided percutaneous therapy after three courses of oral albendazole. Patients having elevated cyst fluid bilirubin levels were excluded. Patients who underwent percutaneous alcohol injection were followed up clinically and with imaging. Data were entered in Microsoft Excel spreadsheet and analyzed. Results: Fifty-two consecutive patients with hydatid cyst were evaluated during the study. Among these, 27 patients underwent percutaneous alcohol injection. Follow-up data were available for 25 patients. There was a favorable imaging outcome in 21/25 (84%). One patient developed anaphylaxis during cyst access, which was managed medically with an uneventful recovery. No instances of cholangitis or sepsis following injection were observed. Conclusion: Percutaneous alcohol injection therapy for liver hydatid cysts is a minimally invasive, safe, and an effective procedure in selected group of patients.

THE RELATIONSHIP BETWEEN CYST DIAMETER AND LONG-TERM RESULTS OF PAIR TREATMENT

Aim: The PAIR (Puncture, Aspiration, Injection of scolicidal agent, and Reaspiration) treatment is used for echinococcosis type 1 (CE1) liver hydatid cysts. The aim of this study is to show the relationship between the cyst diameter and long-term results of PAIR. Materials and Methods: Between 2016-2021, fifthy patients with 54 liver CE1 hydatid cysts who underwent PAIR treatment were included in the study. Under general anesthesia, procedures were carried out. Technical success (completing the required steps in a procedure), clinical success (absence of recurrence or major complication upon follow-up), complications, cyst cavities' long-term alterations were evaluated. Inactivation times of cysts smaller than 6 cm and larger than 6 cm were compared. Results: The long axis of the cysts was between 3 cm and 12 cm. Technical success rate was 100%. The average follow-up time was 996 ± 250 days. The cysts showed a mean volume reduction of 70.1% on follow up. The treatment was effective in 48 patients and 52 hydatid cysts. The effectiveness of the long-term treatment was 96%. Cysts smaller than 6 cm had a significantly shorter inactivation time than cysts larger than 6 cm (p=0.01). Recurrence (CE2) was detected in one patient (2 %). This patient was treated with the modified catheterization (MoCAT) technique. Major complication (abscess) was detected in one patients (2 %) and abscess was drained using the percutaneous seldinger technique. Intra-abdominal spread, anaphylaxis, or mortality did not develop in any patient. Post-procedural pain developed in 3 patients as a minor complication (6 %). Conclusion: Although the inactivation time is longer in cysts larger than 6 cm, PAIR technique used to treat liver CE 1 hydatid cysts are effective and secure.

In vitro, effects of Praziquantel and alcoholic and aqueous crude extracts of Citrullus colocynthis and Eucalyptus globulus on the viability of protoscoleces of Echinococcus granulosus

Iraqi flora is rich in plants and the possibility of finding new antimicrobial agents still widely ahead, therefore, the present work evaluated the effects of alcoholic and aqueous crude extracts of Citrullus colocynthis; Eucalyptus globulus leaves and Praziquantel drug (as scolicidal agents) on the viability of Echinococcus granulosus protoscoleces in vitro. Live protoscoleces obtained from the liver of naturally infected sheep. The viability of protoscoleces was determined by their motility and flame cells activity and staining method using 0.1% eosin solution. The number of viable protoscoleces was counted and distributed into test tubes (4 tubes for each treatment of different concentrations) and 2 tubes were kept as control without treatments. The percentage viability of protoscoleces was ranged between 93.7 to 95.3. Praziquantel drug reduced the survival of protoscoleces during seven sequenced days post incubation. Drug effects showed more influence in both concentrations of 450 μg/ml from day 4 and 600 μg/ml from day 3 post incubation, respectively. The methanolic extract of C. colocynthis reduced the viability of protoscoleces during eight sequenced days post incubation from 96% to zero%. The effects were marked highly in the concentrations of 300 μg/ml from day 3 post incubation. Aqueous fruit extracted decreased in the viability of protoscoleces. In the minimum used concentration (75μg/ml), the viability of protoscoleces reduced from 96% to reach zero% at day eight post incubation, whereas in the maximum concentration used (300 μg/ml), the viability reached to zero% after four days. All concentrations of leaves methanolic and aqueous extracts of E. globulus have an antiparasitic activity against the protoscoleces viability, but the greater effect was to 600 μg/ml that kill all protoscoleces in 6 days after treatment.

Is the Intraoperative Use of the Chlorhexidine Gluconate Safe for Inactivation of the Liver Hydatid Cyst?

Background: During surgical treatment of hydatidosis, spillage of live protoscolices is a major cause of secondary infection. Although some studies have suggested scolicidal agents for preventing secondary infection, no safe scolicidal agents have been introduced so far. Objectives: This study aimed to determine the minimum scolicidal concentration of chlorhexidine gluconate (Chx-Glu) with 100% fatality and evaluate its toxicity on the liver, biliary tract, and peritoneum. Methods: The minimum scolicidal concentration of Chx-Glu after 5 and 10 minutes in vitro (0.08% after 5 and 0.06% after 10 min) was determined in this study. Then, the experiments were conducted on male New Zealand rabbits (n = 30), which were divided into two groups. Under the guidance of ultrasonography, intraperitoneal, hepatic parenchyma, and gallbladder injection of Chx-Glu 0.08% and 0.06% were performed in groups A and B, respectively. Liver enzymes were checked before and 48 hours after Chx-Glu injection, and histological assessments were performed 45 days later. Results: There was no significant difference in the plasma levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and bilirubin before and after the injection (P &gt; 0.05) and after that between the two groups (P &gt; 0.05). There was no major tissue destruction based on histological study except the nonsignificant histologically focal gallbladder mucosal atrophy in two rabbits in group A and one in group B. Conclusions: Our study suggests that Chx-Glu at 0.06 - 0.08 % is a safe scolicidal agent without major tissue toxicity in the animal models that can be used to prevent secondary infection during hydatid cyst surgery.