Hypertonic Saline in Hydatid Disease

Abstract

The objective of this study was to determine the scolicidal effects of saline in different concentrations using different exposure times and to examine whether hypertonic saline can be used to irrigate the abdomen when there is a free intraperitoneal perforation of hydatid disease. Various concentrations of saline solutions (0.09%, 3.0%, 6.5%, 10%, 15%, 20%, 25%, 30%) were added to concentrated echinococcus granulosus sediments for the following times: 1, 2, 3, 4, 5, 10, 15, 30, 45, and 60 minutes. Normal (0.09%), 3.0%, and 6.5% saline resulted in high viability ratios after 60 minutes' exposure. Complete lethality for 10%, 15%, 20%, 25%, and 30% saline occurred at the end of 75, 10, 6, 3, and 3 minutes, respectively. During the second part of the study, 20 Sprague-Dawley rats were used for abdominal saline irrigation in four groups: 30% NaCl for 3 minutes; 20% NaCl for 6 minutes; intravenous isotonic dextrose water and furosemide plus 30% NaCl irrigation for 3 minutes; the same prophylactic therapy plus 20% NaCl irrigation for 6 minutes. Sodium and chloride values rose significantly (20-30%) shortly after hypertonic saline irrigation in each group (p < 0.01). Support with isotonic dextrose and furosemide before irrigation did not have any beneficial effect on biochemical values or mortality. The 24- and 48-hour mortality rates were 70% and 90%, respectively. These studies illustrate that the scolicidal effect of hypertonic saline is limited in low concentrations, but an increase in the concentration can augment its adverse effects. Peritoneal irrigation with hypertonic saline should be avoided for intraabdominal perforated hydatid disease. Therefore, we concluded that hypertonic saline is not a good scolicidal agent to prevent recurrence of hydatid disease.

Cucurbita maxima (Pumpkin) seeds: Scolicidal activity and preventive efficacy of its extract on experimental hydatidosis in mice

“…Several experimental studies conducted for finding such scolicidal, previously. For instance, hypertonic saline (25), silver nitrate (26), and chlorhexidine gluconate (27) (28), Zingiber officinale R (14). Have a significant scolicidal activity.…”

Evaluation on Scolicidal Efficacy of Propolis

“…Propolis was found to be fully effective on protoscoleces with only 1 g/ml concentration at the end of 3 min. This exposure time is significantly shorter than 20% hypertonic saline, the scolicidal agent widely used especially for PAIR which needs at least 6 min for scolicidal activity [20] . An ideal scolicidal agent should also be nontoxic.…”

“…Kayaalp et al [20] emphasized that hypertonic saline was a dangerous agent for washing out normal tissues because of acute hypernatremia leading to convulsions, intracranial bleeding, necrosis and myelinolysis. In their experimental study, 90% of rats died within 2 days because of hypernatremia.…”

The scolocidal effect of propolis on protoscoleces and daugther cysts

“…Avoiding spillage of the cyst contents and the use of effective scolicidal agents are essential to lessen the recurrence rate. Inadequate scolocidal concentration or exposure time, inadequate evacuation of the hydatid membranes, and dilutions of scolocidal agent by the cyst fluid are the main causes of diminished scolocidal effect [2][3][4][5] . Thus, the search for new alternative scolocidal agents is necessary, such as natural products.…”

“…For this reason, avoiding spillage of the cyst contents and the use of effective scolocidal agents are essential to lessen the recurrance rate. So, the scolocidal effects of some chemicals have been studied by researhers in Turkey [2][3][4][5] .…”