Tunable Polymeric Mixed Micellar Nanoassemblies of Lutrol F127/Gelucire 44/14 for Oral Delivery of Praziquantel: A Promising Nanovector against Hymenolepis nana in Experimentally-Infected Rats.

Hymenolepiasis represents a parasitic infection of common prevalence in pediatrics with intimidating impacts, particularly amongst immunocompromised patients. The present work aimed to snowball the curative outcomes of the current mainstay of hymenolepiasis chemotherapy, praziquantel (PRZ), through assembly of polymeric mixed micelles (PMMs). Such innovative nano-cargo could consolidate PRZ hydrosolubility, extend its circulation time and eventually upraise its bioavailability, thus accomplishing a nanoparadigm for hymenolepiasis tackling at lower dose levels. For consummating this goal, PRZ-PMMs were tailored via thin-film hydration technique integrating a binary system of Lutrol F127 and Gelucire 44/14. Box-Behnken design was planned for optimizing the nanoformulation variables employing Design-Expert® software. Also, in Hymenolepis nana-infected rats, the pharmacodynamics of the optimal micellar formulation versus the analogous crude PRZ suspension were scrutinized on the 1st and 3rd days after administration of a single oral dose (12.5 or 25 mg/kg). Moreover, in vitro ovicidal activity of the monitored formulations was estimated utilizing Fuchsin vital stain. Furthermore, the in vivo pharmacokinetics were assessed in rats. The optimum PRZ-PMMs disclosed conciliation between thermodynamic and kinetic stability, high entrapment efficiency (86.29%), spherical nanosized morphology (15.18 nm), and controlled-release characteristics over 24 h (78.22%). 1H NMR studies verified PRZ assimilation within the micellar core. Additionally, the in vivo results highlighted a significant boosted efficacy of PRZ-PMMs manifested by fecal eggs output and worm burden reduction, which was clearly evident at the lesser PRZ dose, besides a reversed effect for the intestinal histological disruptions. At 50 µg/mL, PRZ-PMMs increased the percent of non-viable eggs to 100% versus 47% for crude PRZ, whilst shell destruction and loss of embryo were only clear with the applied nano-cargo. Moreover, superior bioavailability by 3.43-fold with elongated residence time was measured for PRZ-PMMs compared to PRZ suspension. Practically, our results unravel the potential of PRZ-PMMs as an oral promising tolerable lower dose nanoplatform for more competent PRZ mass chemotherapy.

Assessment of the efficacy of thymol against Toxocara vitulorum in experimentally infected rats.

The effect of thymol and ivermectin on the development and embryonation of Toxocara vitulorum (T. vitulorum) eggs, as well as their migration in albino rats was investigated both in vitro and in vivo. A total of forty male albino rats were divided into four groups for an in vivo experiment. The first group was uninfected; the second group was infected but left untreated; the third group was infected and received thymol at a dose of 40 mg/kg; and the fourth group was infected and received ivermectin (0.2 mg/kg). In vitro, thymol inhibited the development of Toxocara larvae within the eggs. However, ivermectin, produced inconsistent results. The in vivo results indicated that the recovery rates of Toxocara larvae from the liver and lungs on day 7 post-infection were significantly lower in the thymol or ivermectin-treated groups than in the infected untreated control. Albumin levels were significantly increased in the thymol-treated group as compared to the positive control and ivermectin groups. Nitric oxide, IL-4, and IFN- levels in the serum of the thymol or ivermectin-treated groups were significantly lower than that of the positive control group. Histopathological examination demonstrated that thymol and ivermectin were effective in reducing larval load, reducing the number and size of granulomas in the absence of larvae, and improving tissue architecture. The current study concluded that thymol possessed anti-Toxocara activity in a rat model. Additionally, thymol possessed ovicidal properties and may be used as a disinfectant.

Can thick-shelled eggs of Capillaria philippinensis embryonate within the host?

Intestinal capillariasisis is a newly emerging parasitic disease and its outcome may be fatal if not diagnosed and treated in the proper time. The main diagnosis of intestinal capillariasis is made by identifying eggs, larvae and/or adults in the stools of infected cases. This study aimed to describe a different type of developmental stages, which is the detection of adult females carrying embryonated thick-shelled eggs in their uteri in the fecal samples of infected cases. The study included 40 Capillaria philippinensis patients admitted to the hospitals of Kasr Al-Ainy Faculty of Medicine, Cairo University and Beni-Suef University. Stool examination was performed using direct smear and the formalin-ether concentration methods. The adult stages of the parasite were detected in 35 stool samples, eggs were detected in 33 cases, 5 of them were diagnosed by detecting eggs only. We could identify three types of eggs of C. philippinensis: non-embryonated thick-shelled eggs in feces of cases, embryonated thin-shelled and embryonated thick-shelled eggs in the uteri of female worms. Only in 2 cases we were able to identify female worms with embryonated thick-shelled eggs inside their uteri. This finding has never been mentioned and may point out to a missing point in the known life cycle.

Human intestinal myiasis caused by Clogmia albipunctata larvae (Diptera: Psychodidae): First report in Egypt.

This is the first case report in Egypt and Middle East region of human intestinal myiasis caused by Clogmia albipunctata larvae. A 36-year-old male patient presented to the Outpatient Clinic of Internal Medicine in Beni-Suef University Hospital complaining of abdominal pain, bloating, and diarrhea intermittent with constipation. Patient's stool sample was referred to the Department of Medical Parasitology for examination of passed larvae and treatment prescription. Examination of larvae by light and scanning electron microscopy confirmed the morphological identification of fourth instar larvae of C. albipunctata. Human intestinal myiasis is an unusual cause of gastrointestinal manifestations.

Toxoplasma gondii in cancer patients receiving chemotherapy: seroprevalence and interferon gamma level.

Toxoplasma gondii is an opportunistic parasite causing life-threatening diseases in immune-compromised patients. The purpose of the study is to determine the seroprevalence of Toxoplasma gondii in chemotherapy receiving cancer patients in relation to different types of malignancies, and to estimate the level of interferon gamma in Toxoplasma seropositive and seronegative cancer patients and healthy controls. Anti-Toxoplasma IgG and IgM antibodies, and interferon gamma were analyzed in 120 cancer patients receiving chemotherapy (60 having hematological malignancies and 60 with solid organ tumors) and 60 healthy controls using ELISA method. Toxoplasma (IgG and IgM) were determined in (66.7% and 9.2%) of the cancer group compared to (33.3% and 6.7%) of the control group with statistical significance only in IgG seropositivity (p < 0.001, OR = 4). Patients with hematological malignancies had higher IgG seropositivity than solid organ tumors (40% vs 26.7%). The difference between the groups was statistically significant (p = 0.002, OR = 3.5). Median level of interferon gamma was in the same range between cancer patients and control group. However, it was highly elevated in Toxoplasma seropositive (76 pg/ml) than seronegative (44.5 pg/ml) cases with statistical significance (p < 0.001). T. gondii infection remains a major threat to cancer patients and still needs proper screening, diagnosis and treatment.

Case Report of Human Urinary Myiasis Caused by Clogmia albipunctata (Diptera: Psychodidae) with Morphological Description of Larva and Pupa.

BACKGROUND: Urinary myiasis is a form of myiasis caused mainly by larvae of Fannia scalaris, Musca, Sarcophaga, Lucilia, Wohlfahrtia, Calliphora, and rarely by Eristalis and Clogmia albipunctata. METHODS: This report presents a case of female patient complaining of dysuria and frequency of micturition associated with intermittent passage of small, motile, dark-colored worm-like organisms in urine. She was a married housewife aged 24 years old referred from the Tropical Outpatient Clinic of Beni-Suef University Hospital, Egypt. The patient was subjected to a full questionnaire sheet and investigations such as CBC, stool and urine analysis and urinary ultrasonography. Collected larvae and pupae from urine samples were examined macroscopically and microscopically. RESULTS: The examined larvae and pupae belonged to C. albipunctata. Ivermectin was prescribed to the patient with complaint withdrawal and complete disappearance of the larvae from urine. CONCLUSION: This study reports the first case of urinary myiasis caused by C. albipunctata in Beni-Suef Governorate, the second in Egypt and third case worldwide. The study throws some light on the medical importance and management of urinary myiasis.