Histological and biochemical study on the protective effect of losartan on rat renal cortex in experimentally induced liver failure

Hepatic ischemia/reperfusion [I/R] injury is an unavoidable problem during liver surgery that often results in acute liver failure, with its complications. Losartan may be beneficial in such conditions. This study was designed to investigate the histological and biochemical alterations that could occur in the renal cortex in case of liver cell failure and to assess the possible protective role of losartan. Thirty male albino rats were equally divided into three groups: group I [control] was equally subdivided into sham operated-untreated [Ca] and sham-operated, losartan-treated [Cb] subgroups. In group II [operated], rats were subjected to experimentally induced I/R. In group III [losartan treated], rats were subjected to a surgical procedure and treated with losartan [5 mg/kg body weight]. At the end of the experiment, blood samples were obtained for the biochemical assay. The liver was processed for assessment of antioxidant markers and for light microscope examination. Both kidneys were processed for light and electron microscope examinations. The results were morphometrically and statistically analyzed. Light microscope examination of the operated group indicated shrunken glomeruli with wide Bowman's space. Some tubules were distorted with cytoplasmic vacuoles and cellular casts, whereas others were dilated. The interstitium contained an acidophilic material, increased collagen fibers, cellular infiltration, and congested blood vessels. Ultrastructurally, podocytes had small electron-dense nuclei and fused foot processes. Some renal tubules had small heterochromatic nuclei, mitochondria with disrupted cristae, and small electron-dense bodies. The biochemical results of the same group showed the occurrence of oxidative stress and deterioration in liver and kidney functions. The treated group showed preserved structure of the renal corpuscles and tubules. Liver I/R adversely affected the renal cortex histologically and biochemically. Losartan could be promising as an adjuvant therapy before hepatic surgery for rescuing the kidney from hepatic I/R injury

effect of an educational program in improving venous catheter management practice in pediatric Cairo university hospital ICUs

Intravascular catheter related blood stream infection [BSI] is an important cause of illness and excess medical cost. In our hospital, the rate of peripheral venous catheter insertion [cannula] is 61.7% at the intensive care units, and the blood stream infection rate was 35.1% at the beginning of the study. This study was designed to conduct infection control practice training [mainly for cannula insertion practice] at neonatal and pediatric intensive care units of Cairo university pediatric hospital, with evaluation of results before and after the study. The pretest found major problems concerning the proper use of alcohol based product for hand hygiene or during skin preparation for cannula Insertion. Also shortage of infection control knowledge and medical supply [cannula device, soap, alcohol, and sterile dressing] was obvious. A significant improvement after training program was observed regarding proper cannula insertion practice [mainly hand hygiene, skin preparation, and no touch method for cannula insertion], [p value = 0.001]. The blood stream infection rate dropped from 35.1% at pre-implementation period to 23.1% at the post implementation period, with a significant decrease of blood isolates which cause intravascular catheter associated blood stream infection [Coagulase negative staphylococci, Staphylococcus aureues, Candida, and Enterococci] P value 0.004. The significant improvement of cannula insertion practice, together with the decrease of blood isolates related to catheter associated BSI, and the drop of BSI rate after the training pro gram point to the importance of the infection control education program targeted to specific problems