Impact of different therapeutic approaches in hydatid cyst vitality and patients{u2019} morbidity / Enas Aly Elsaftawy ; Supervised Amany Ahmed Abdelaal , Manal Abdelmegeed Badawi , Samar Sayed Attia

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Parasitology

The aim of this scientific work was to assess the impact of different therapeutic approaches, including medical and surgical interventions on hepatic hydatid cyst vitality and patients' morbidity. In the current study, 40 hydatid cyst fluid samples from the included cases were processed and examined by different methods to determine viability status. 1% eosin exclusion method was used to initially test for protoscolices (PSs) viability, followed by specific fluorescent dyes to explore internal cellular kinetics in both PSs and germinal epithelium (anti-mitochondrial and anti-prohibitin antibodies). In addition to nucleic acid stains (DAPI and PI), plus morphocyto-micrometeric analysis, which were done for the cystic components, using image analyser. According to the viability reported by different means, patients received only one dose of chemotherapy recorded significantly higher viability in PSs (55-85%), followed by those treated by single PAIR plus single dose of medical treatment (25 to 45%), indicating failure of these therapeutic approaches to completely eradicate the powerful parasitic stage. While the least viability was reported, when PIAR accompanied by repeated doses of medical treatment were used (0 to 10%). This study recommended the reconsideration of the protocols, currently applied to treat cystic hepatic echinococcosis. This in order to minimize patients' suffers and recurrence from the still living PSs or germinal epithelium, however in a stationary phase, ready in the proper time to cause threatening morbidity

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