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Background Nowadays, surgery is considered as one of the most important treatments for hydatidosis. Due to laceration, the cyst and spread of the content within it (protoscoleces) during the surgery that can put the patient at the risk of re-infection, anaphylaxis shock and even death, surgeons use some chemical drugs as protoscolicidal agents. The study is aimed to evaluate the scolicidal effects of olive ( Olea europaea L.) leaf extract on hydatid cyst protoscoleces in vitro and ex vivo . Methods After the collection of protoscoleces from sheep livers infected with fertile hydatid cysts, they were treated with various concentrations of olive leave extract (75–300 mg/mL) for 5–30 min in vitro and ex vivo . Finally, the mortality of protoscoleces was assessed by the eosin exclusion test (0.1% eosin staining). Results The mean of the mortality of protoscoleces was 100% after 10 min of incubation with the concentration of 300 mg/ml of O. europaea leaves extract. On the other hand, the mean of the mortality of protoscoleces after 20 min of incubation with the concentration of 150 mg/ml of O. europaea leaves extract was 100%. After injection of O. europaea leaves extract directly into the hydatid cyst ( ex vivo ), the mean of the mortality of protoscoleces was 100% after 12 and 25 min of incubation with the concentration of 300 and 150 mg/ml of O. europaea leaves extract, respectively; indicating that the extract requiring a further time to display a potent protoscolicidal effects. Conclusion Based on the findings of the study, it can be concluded that the extract of olive leaf had a significant scolicidal activity on hydatid cyst protoscoleces. However, further research, especially in human and animal subjects, are required to reach this conclusion.

Background One of the most important ways to cure hydatid cysts is surgery. Today, available chemical drugs have shown severe complications during hydatid cyst surgery. Here we investigated theefficacy and safety of Curcuma longa ( C. longa ) essential oil (CLEO) against hydatid cysts protoscoleces. Methods Here, the collected protoscoleces from fertile hydatid cysts were exposed to different concentrations of the CLEO (50–200 μl/mL) for 5–30 min in vitro and ex vivo. In addition, male NIH mice (48 mice) were applied to examine the safety of CLEO. Results All protoscoleces were completely killed in 5th min of treatment to the doses of 200 μl /mL of CLEO. On the other hand, in the 10th min of treatment, CLEO entirely killed 100% of protoscoleces at the dose of 100 μL/mL. Other doses of CLEO, but, revealed a postponed activity. Although CLEO at the doses of 50, and 100 μL/mL exhibited no similar effect in the ex vivo analysis; but, at the dose of 200 μL/mL and an exposure time of 5 min, approximately 100% of protoscoleces were destroyed into the cyst. We found that after intra-peritoneal injection of the CLEO for 14 days, although blood and biochemical parameters were changed; but there was no significant difference in comparison with the control group ( p > 0.05). Conclusion This research demonstrated that C. longa revealed the promising scolicidal effects against protoscoleces in vitro and in vivo, of course, after additional tests; it might be considered as an herbal scolicidal drug in order to decrease the threat of discharge of protoscoleces through hydatid cyst surgery. Nevertheless, supplementary studies will be desired to prove the current findings by examination the essential oil in a clinical setting.

Background: The present work aimed to evaluate the chemical composition of Curcuma zadoaria essential oil and to investigate its efficacy and safety against hydatid cyst protoscoleces. Methods: Collected protoscoleces from liver fertile hydatid cysts of infected sheep were exposed to different concentrations of the essential oil (75, 150, 300 μl/mL) for 5-30 min in vitro and ex vivo. Then, by using the eosin exclusion assay, the viability of protoscoleces was studied. In the next step, 24 male NMRI mice were examined to assess the toxicity of C. zadoaria essential oil by measuring the biochemical and hematological parameters. Results: Based on the obtained results, the LD50 value of intraperitoneal injection of the C. zadoaria essential oil was 1.76 mL/kg of body weight and the maximum non-fatal dose was 0.96 mL/kg of body weight. C. zadoaria essential oil had a strong proto scolicidal activity in vitro so that at the 300 and 150 μl/ml entirely eliminates the parasite after 5 and 10 minutes; whereas, weak proto scolicidal activity was observed at lower doses. Ex vivo assay, no similar effect with in vitro was observed, therefore, more time is required to show a potent proto scolicidal activity. C. zadoaria essential oil at the concentrations of 300 and 150 μl/mL after an exposure time of 7 and 12 min, killed 100% of protoscoleces within the hydatid cyst, respectively. After intraperitoneal injection of the C. zadoaria essential oil for 2 weeks, no significant difference (p > 0.05) was observed in the clinical chemistry and hematologic parameters at the doses of 0.15, 0.3, 0.6 mL/kg. Conclusion: The obtained results in vitro and ex vivo exhibited that C. zadoaria essential oil had a favorable proto scolicidal activity on hydatid cyst protoscoleces. However, more supplementary works are required to verify these findings by assessing clinical subjects.

Background However, broad adoption of herbal remedies for giardiasis is at present hampered by uncertain findings of investigation not always sufficiently powered. This study was aimed at systematically reviewing the existing literature in herbal medicines to treat giardiasis. Methods This review was carried out 06- PRISMA guideline and registered in the CAMARADES-NC3Rs Preclinical Systematic Review and Meta-Analysis Facility (SyRF) database. The search was performed in five databases which are Scopus, PubMed, Web of Science, EMBASE, and Google Scholar without time limitation for all published articles ( in vitro, in vivo , and clinical studies). The searched words and terms were: “ Giardia ”, “giardiasis”, “extract”, “essential oil”, “herbal medicines”, “anti- Giardia ”, “ In vitro”, “In vivo ”, “clinical trial” etc. Results Out of 1585 papers, 40 papers including 28 in vitro (70.0%), 7 in vivo (17.5%), 2 in vitro/ in vivo (5.0%), and 3 clinical trials (7.5%) up to 2020, met the inclusion criteria for discussion in this systematic review. The most widely used medicinal plants against Giardia infection belong to the family Lamiaceae (30.0%) followed by Asteraceae (13.5%), Apiaceae (10.5%). The most common parts used in the studies were aerial parts (45.0%) followed by leaves (27.4%) and seeds (7.5%). The aqueous extract (30.0%), essential oil (25.4%) and hydroalcholic and methanolic (10.5%) were considered as the desired approaches of herbal extraction, respectively. Conclusion The current review showed that the plant-based anti- Giardia agents are very promising as an alternative and complementary resource for treating giardiasis since had low significant toxicity. However, more studies are required to elucidate this conclusion, especially in clinical systems.