Synergistic Efficacy of Methanolic Extract of <i>Nerium oleander</i> Leaf Combined with Praziquantel against Hydatid Cyst Protoscolices

Hydatid disease is a serious disease that is widespread worldwide. Its harm to humans is significant. There is a need to discover and develop new treatments in conjunction with the evolution of the parasite. Hydatid cysts were collected from the Al-Diwaniyah General Hospital, Surgery Department and transferred to the laboratory. Protoscolices were extracted for in vitro effects by preparing different concentrations of each therapeutic compound (5, 30, and 50 mg/mL) for 5, 10, 20, and 30 min. The synergistic compound (niosomes loaded by methanolic extract of N. oleander leaves with praziquantel) showed complete eradication of 100% at concentrations of 30 mg/ ml and 50 mg/ml in periods specified in the experiment Niosomes loaded with the methanolic extract of oleander leaves also achieved excellent results as a delivery vehicle of the plant extract to increase its effectiveness in eliminating protoscolices at a concentration of 50 mg/ml in the 20th minute from the beginning of the experiment. The synergistic compound outperformed all the therapeutic compounds studied in terms of the rates of in vitro eradication of protoscolices. The synergistic combination of methanolic extract of N. oleander leaves and praziquantel was highly effective in eradicating protoscoleces. However, it showed dispersion according to the standard deviation values; therefore, its effect is not stable, and it is suitable for use in cases of acute infections. Niosomes loaded with methanolic extract of N. oleander leaves were highly efficient in killing protoscolices, and their effect was stable and balanced, which makes it possible to propose them as a suitable treatment for many cases of infection.