Original Article

Evaluation of the Protoscolicidal Effectiveness of Hypertonic Saline, Silver Nitrate, Ethanol, Using Sponge Pad Method and Injecting into Fertile Hydatid Cysts


Background: We aimed to evaluate currently protoscolices agents by using two methods including injection and impregnated sponges with protoscolices agents.

Methods: Hypertonic saline 20%, silver nitrate 0.5% and Ethanol 96% were injected into sheep hydatid cysts. Then, after different exposure times (5, 10, and 15 min), the protoscolices were aspirated from the cyst and viability of the protoscolices were evaluated microscopically using vital staining. In the second part, the live protoscolices were sprayed on the soaked sponge with the mentioned protoscolicidal agents. After different exposure times live protoscolices were counted microscopically. One-way ANOVA and Tukey tests were used for showing difference significant between studied groups.

Results: Cyst injection method showed that ethanol, Nacl and AgNo3 have 80%, 60% and 6% protoscolocidal efficacy, respectively (P<0.05). In sponge method the most and fastest protoscolocidal efficacy were observed in all used protoscolicidal agents.

Conclusion: Ethanol and NaCl and AgNo3 with sponge method is more effective than the injection of protoscolices agents in the cyst.

1. Siracusano A, Delunardo F, Teggi A, Ortona E. Host-parasite relationship in cystic echinococcosis: An evolving story. Clin Dev Immunol. 2012;2012:639362.
2. Wen H, Vuitton L, Tuxun T, Li J, Vuitton DA, Zhang W, McManus DP. Echinococcosis: Advances in the 21st century. Clin Microbiol Rev. 2019;32(2):e00075-18.
3. Adas G, Arikan S, Kemik O, Oner A, Sahip N, Karatepe O. Use of albendazole sulfoxide, albendazole sulfone, and combined solutions as scolicidal agents on hydatid cysts (in vitro study). World J Gastroenterol. 2009;15(1):112-6.
4. Busto Bea V, Barrio Andrés J, Almohalla Álvarez C. [liver hydatid disease: Still a problem]. Med Clin (Barc). 2016;146:367-371.
5. Beigh AB, Darzi MM, Bashir S, Shah A, Shah SA. Gross and histopathological alterations associated with cystic echinococcosis in small ruminants. J Parasit Dis. 2017;41:1028-1033.
6. Velasco-Tirado V, Alonso-Sardón M, Lopez-Bernus A, et al. Medical treatment of cystic echinococcosis: Systematic review and meta-analysis. BMC Infect Dis. 2018;18:306.
7. Aminpour S, Rafiei A, Jelowdar A, Kouchak M. Evaluation of the protoscolicidal effects of albendazole and albendazole loaded solid lipid nanoparticles. Iran J Parasitol. 2019;14:127-135.
8. Gavara CG, López-Andújar R, Ibáñez TB, et al. Review of the treatment of liver hydatid cysts. World J Gastroenterol. 2015;21:124-31.
9. Norouzi R, Ataei A, Hejazy M, Noreddin A, El Zowalaty MEJIJoN. Scolicidal effects of nanoparticles against hydatid cyst protoscolices in vitro. Int J Nanomedicine. 2020;15:1095-1100.
10. Hosseini SV, Ghanbarzadeh K, Barzin Z, Sadjjadi SM, Tanideh N, Mehrabani D. In vitro protoscolicidal effects of hypertonic glucose on protoscolices of hydatid cyst. Korean J Parasitol. 2006;44:239-42.
11. Shnawa BHJJoPRI. Advances in the use of nanoparticles as anti-cystic echinococcosis agents: A review article. Journal of Pharmaceutical Research International. 2018;24:1-14.
12. Borazan E, Gökalp MA, Zer Y, Aksoy N, Aytekin A, Yılmaz LJEJoM. Time-related comparison of scolicidal activity of the different substances used in hydatid cyst. East J Med. 2019;24:457-462.
13. Sharafi SM, Sefiddashti RR, Sanei B, Yousefi M, Darani HY. Scolicidal agents for protoscolices of Echinococcus granulosus hydatid cyst: Review of literature. J Res Med Sci. 2017;22:92.
14. Khan MSA, Ansari IM, Jaiswal AK, Sahai S. Surgical management of hydatid cysts of liver by using different scolicidal agents. World Journal of Biology and Medical Sciences. 2015;2:10-16.
15. Saidi F. A new approach to the surgical treatment of hydatid cyst. Ann R Coll Surg Engl. 1977;59:115-8.
16. Besim H, Karayalcin K, Hamamci O, Güngör C, Korkmaz A. Scolicidal agents in hydatid cyst surgery. HPB Surg. 1998;10:347-351.
17. Kayaalp C, Balkan M, Aydin C, et al. Hypertonic saline in hydatid disease. World J Surg. 2001;25:975-979.
18. Yetim I, Erzurumlu K, Hokelek M, et al. Results of alcohol and albendazole injections in hepatic hydatidosis: Experimental study. J Gastroenterol Hepatol. 2005;20:1442-1447.
19. Tappeh KH EA, Mahmudloo R, Mohammadzadeh H, Tahermaram M, Mousavi SJ. Effect of different concentrations of hypertonic saline at different times on protoscoleces of hydatid cyst isolated from liver and lung. Turkiye Parazitol Derg. 2011;35:148‐150.
20. Mahmoudvand H, Harandi MF, Shakibaie M, Aflatoonian MR, ZiaAli N, Makki MS, Jahanbakhsh S. Scolicidal effects of biogenic selenium nanoparticles against protoscolices of hydatid cysts. Int J Surg. 2014;12:399-403.
IssueVol 17 No 2 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijpa.v17i2.9540
Hydatidosis Protoscolocidal agents Echinococcus granolusus

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How to Cite
Fakharzadeh Jahromi K, Rafiei A, Rahdar M, Bahreini A. Evaluation of the Protoscolicidal Effectiveness of Hypertonic Saline, Silver Nitrate, Ethanol, Using Sponge Pad Method and Injecting into Fertile Hydatid Cysts. Iran J Parasitol. 2022;17(2):223-230.