RESUMEN
PURPOSE: 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. METHODS: The ethanolic and aqueous extraction of plant leaves was 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. RESULTS: The phytochemical 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 ± 0.085 mg of gallic acid equivalent per g of extract (GAE/g E) and 16.5 ± 0.004 mg of quercetin equivalent per g (QE/g E) for the ethanolic extract, and 36.5 ± 0.016 mg GAE/g E and 18.2 ± 0.023 mg QE/g E for the aqueous extract, respectively. Furthermore, ethanolic and aqueous extracts of M. communis gave a value of IC50 = 0.009 ± 0.0004 mg/ml and IC50 = 0.012 ± 0.0003 mg/ml for the antioxidant activity, respectively. The in vitro scolicidal activity with concentrations of 50, 75, 100, and 150 mg/ml was tested for 5, 10, 15, and 30 min, and 5, 10, 15, 30, 60, 90, and 120 min for ethanolic and aqueous extracts, respectively. The mortality rate of protoscoleces at concentrations of 100 and 150 mg/ml was 98.8 and 100%, respectively, after 5 min of exposure to the ethanolic extract, while this rate was 100% at the same concentrations only after 60 min of exposure to the aqueous extract. CONCLUSIONS: The ethanolic extract showed a stronger scolicidal activity against E. granulosus s.l protoscoleces than the aqueous extract. In the future, other investigations 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.
Asunto(s)
Echinococcus granulosus , Myrtus , Extractos Vegetales , Hojas de la Planta , Extractos Vegetales/farmacología , Extractos Vegetales/química , Hojas de la Planta/química , Animales , Echinococcus granulosus/efectos de los fármacos , Myrtus/química , Argelia , Antioxidantes/farmacología , Antioxidantes/química , Fenoles/farmacología , Fenoles/análisis , Flavonoides/farmacología , Flavonoides/análisis , Flavonoides/química , Cromatografía de Gases y Espectrometría de Masas , Fitoquímicos/farmacología , Fitoquímicos/química , Fitoquímicos/aislamiento & purificación , Equinococosis/tratamiento farmacológico , Equinococosis/parasitologíaRESUMEN
OBJECTIVE: To determine the efficiency of the interscrotal approach to inguinoscrotal pathologies. PATIENTS AND METHODS: We report the use of the interscrotal approach in 21 boys, from September 2012 to November 2013, operated using an interscrotal access through a vertical incision on the median raphe. RESULTS: The approach was used for bilateral inguinal hernia (48%), bilateral ectopic testis (19%), torsion of the spermatic cord (19%), testicular biopsy (10%) and webbing of the penis (5%). CONCLUSION: Inter-scrotal access is an option for inguinoscrotal pathologies, with the advantages of a single incision, much less dissection and disruption of tissue, and greater comfort for the 'day-case' child.