Background: The chemical agents applied to reduce the complications of hydatid cyst surgery are not free of side effects. Formononetin (FMN), as a natural isoflavone, has been shown to have various therapeutic benefits. Objectives: We studied the in vitro and ex vivo protoscolicidal activity and cellular mechanisms of FMN against hydatid cyst protoscoleces. Methods: Formononetin at 75, 150, and 300 μg/mL was mixed with hydatid cyst protoscoleces (103/mL), and the viability was determined in 5 to 60 min through eosin staining assay. The effect of FMN on caspase-3 activity was tested through a commercial colorimetric protease kit. In addition, the penetrability of the plasma membrane of protoscoleces after exposure to FMN was also determined by the SYTOX assay. Results: Formononetin at 300 μg/mL completely destroyed hydatid cyst protoscoleces after 30 minutes. While at 150 μg/mL, after 60 minutes of contact, 100% of protoscoleces were eliminated. By ex vivo assay, FMN showed its antiparasitic effect for longer periods. Based on these results, FMN at 300 μg/mL concentration completely eliminated hydatid cyst protoscoleces after 60 minutes of exposure. While at a concentration of 150 μg/mL after 60 minutes, 89.6% of protoscoleces were destroyed. Formononetin noticeably increased (P < 0.001) the activity of caspase-3 and the permeability of protoscoleces dose-dependently. Conclusions: Formononetin as a natural product showed promising effects on the protoscoleces of hydatid cysts, indicating that it can be considered a valuable scolicidal agent. However, additional investigations are necessary to evaluate its efficacy in animal models and human subjects.

Alcohol induced cirrhosis prevalence has increased worldwide of late and has added markedly to the global burden of diseases. However, research involving quality of life as treatment outcome for alcoholic liver disease is limited. The primary objective of the study was to evaluate the health related quality of life and factors affecting it in alcoholic liver disease patients. Secondary objective was to analyze mental health status and prescription pattern in alcoholic liver disease patients. Patients, eligible to participate, were briefed regarding the purpose of the study and informed consent was obtained. Self-designed case report form and validated questionnaires were used to record information on physical, mental and emotional functioning of the patient. The study included 51 patients. It was found that majority had low quality of life scores with role limitation due to physical health (5.39 ± 16.9) domain being the most affected. It was also found that the symptom fatigue caused the most hindrance to patient’s daily activities (1.31± 1.20). Most of the patients reported having mild depression (50.98%). Prescription analysis showed that diuretics (74.50%) and drugs for hepatic encephalopathy were the most commonly used drugs. The present study found that alcoholic liver disease considerably impaired health related quality of life and identified the contributing factors as presence of complication, age, severity of disease and symptoms like fatigue and abdominal pain. Hence, evaluating factors affecting quality of life and prescription patterns help identify targets for novel treatment strategies.