The current study aimed to evaluate the in vitro scolicidal action 
of pumpkin seed oil (PSO) alone or combined with nitazoxanide (NTZ). 
Also, the clinical efficacy and protective effect of PSO alone or combined 
with NTZ against complications of secondary hydatidosis were detected in 
vivo. Collected protoscolices (PSCs) from camels were exposed to 
concentrations of 10 µg/ml and 750 mg/ml from NTZ and PSO, 
respectively or their combination for 5-,15-, 30- and 60-min in vitro. 
Viability reduction and ultrastructure changes were evaluated by light and 
scanning electron microscopy. Fifty-six rats were divided into eight equal 
groups: Groups1,2, negative and vehicle; group 3, received 500 PSCs of 
hydatid cyst intraperitoneally; group 4, received NTZ at a dose of 50 
mg/kg BW; group 5, received PSO at a dose of 250 mg/kg BW; groups 6-
8, animals infected as group 3 and treated as groups 4, 5 and their 
combination, respectively. Treatments continued orally for 14 days then 
samples collected for anti-echinococcus immunoglobulin G and cytokines 
estimation, hemato-biochemical study and histopathological examination. 
The combination treatment in vitro provoked greater scolicidal action and 
ultrastructural alterations in PSCs compared to the monotherapy. The 
combined treatment group produced effective scolicidal action in vivo, 
inhibited inflammatory condition, induced immunomodulatory effect and 
improved the alterations in hemato-biochemical parameters and 
histopathological picture in examined tissues. In conclusion, this treatment 
strategy may provide a new efficient and safe way for echinococcosis 
treatment in the future and may recommend the use it before, during and 
after surgical removal of hydatid cysts