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Purpose To assess the use of oral chloral hydrate (CH) sedation in uncooperative children to perform a precise cycloplegic retinoscopy and a thorough dilated fundus examination in an outpatient strabismus and nystagmus clinic. Patients and methods A prospective study was conducted on 114 uncooperative children (119 sedation episodes) who were attending the strabismus and nystagmus outpatient clinic at Menoufia University Hospital. Children were sedated by the first dose of CH (50 mg/kg). A second dose, half-strength of the first dose, was given if no adequate sedation occurred after 30 min. The degree of sedation was graded into five categories: excellent, good, fair, poor, and failure. All demographic characteristics, sedation success, failure, and adverse events were reported and statistically analyzed. Results The mean age of children was 23.38 months (range: 5.16–62.06), and their weight ranged from 6.5 to 22 kg. The total CH dose ranged from 325 to 1500 mg. A total of 78 sedation episodes were reported by a single dose, and 41 by two doses. The percentage of the grade of sedation in our 119 episodes was as follows: excellent (56.3%), good (9.2%), fair (28.6%), poor (2.5%), and failure (3.4%). The overall success of one dose was 65.5%, which increased to 96.6% by a second supplemental dose. The most common complication was vomiting (13.4%). Other complications included prolonged drowsiness (one case) and paradoxical agitation (two cases). Spearman correlation showed a significant positive correlation between the degree of sedation and the total dose of CH (r=0.603, P<0.001). Conclusion According to our study, the use of CH was found to have a high success rate with two doses, without major adverse events. [ABSTRACT FROM AUTHOR]

Background and objective: Emergence agitation is a common phenomenon in children recovering from general anesthesia. An emergence agitation reaction increases the risk of injuring the surgical repair, the patient, and the caregivers. Thus, we aim to explore the efficacy of melatonin premedication on emergence agitation in children undergoing herniorrhaphy surgeries. Patients and methods: A randomized prospective triple-blinded trial was conducted on 117 children with herniorrhaphy surgeries conducted at the Anesthesia, ICU, and Pain Management Department, Menoufia University hospitals from April 2022 to July 2023. Results: Yale preoperative scale at the start did not significantly differ among the studied groups (P>0.05). However, the Yale preoperative scale at 1 was significantly higher in group 1 with a mean of 10.2±1.9 than in group 2 (9.5±1.4) and group 3 (5.9±1.4) (P<0.001). The agitation score at 5 h was significantly higher among group 1 with a mean of 2.77±0.67 than group 2 (2.56±0.64) and group 3 (2.03 ±0.96) (P<0.001). Also, agitation scores at 10 and 15 h were significantly higher in group 1 (3.36±0.63, 4.2±0.66) than in group 2 (3.2±0.66, 3.79±0.73) and group 3 (1.74±0.88, 2.03±1.04), respectively (P<0.001). Conclusion: Melatonin premedication decreased the agitation scale postoperatively. The decrease was significantly higher in high doses in preventing emergence agitation in children. High-dose melatonin compared with low dose might have a significant effect in preventing emergence agitation. [ABSTRACT FROM AUTHOR]

Lactic acid bacteria (LAB) are of major concern due to their health benefits. Fermented food products comprise variable LAB demonstrating probiotic properties. Discovering and evaluating new probiotics in fermented food products poses a global economic and health importance. Therefore, the present work aimed to investigate and evaluate the probiotic potentials of LAB strains isolated from Egyptian fermented food. In this study, we isolated and functionally characterized 100 bacterial strains isolated from different Egyptian fermented food sources as probiotics. Only four LAB strains amongst the isolated LAB showed probiotic attributes and are considered to be safe for their implementation as feed or dietary supplements. Additionally, they were shown to exert antimicrobial activities against pathogenic bacteria and anticancer effects against the colon cancer cell line Caco-2. The Enterococcus massiliensis IS06 strain was exclusively reported in this study as a probiotic strain with high antimicrobial, antioxidant, and anti-colon cancer activity. Hitherto, few studies have focused on elucidating the impact of probiotic supplementation in vivo. Therefore, in the current study, the safety of the four strains was tested in vivo through the supplementation of rats with potential probiotic strains for 21 days. The results revealed that probiotic bacterial supplementation in rats did not adversely affect the general health of rats. The Lactiplantibacillus plantarum IS07 strain significantly increased the growth performance of rats. Furthermore, the four strains exhibited increased levels of antioxidants such as superoxide dismutase and glutathione in vivo. Consistently, all strains also showed high antioxidant activity of the superoxide dismutase enzyme in vitro. Overall, these findings demonstrated that these isolated potential probiotics harbor desirable characteristics and can be applied widely as feed additives for animals or as dietary supplements for humans to exert their health benefits and combat serious diseases. [ABSTRACT FROM AUTHOR]

Lactic acid bacteria (LAB) are of major concern due to their health benefits. Fermented food products comprise variable LAB demonstrating probiotic properties. Discovering and evaluating new probiotics in fermented food products poses a global economic and health importance. Therefore, the present work aimed to investigate and evaluate the probiotic potentials of LAB strains isolated from Egyptian fermented food. In this study, we isolated and functionally characterized 100 bacterial strains isolated from different Egyptian fermented food sources as probiotics. Only four LAB strains amongst the isolated LAB showed probiotic attributes and are considered to be safe for their implementation as feed or dietary supplements. Additionally, they were shown to exert antimicrobial activities against pathogenic bacteria and anticancer effects against the colon cancer cell line Caco-2. The Enterococcus massiliensis IS06 strain was exclusively reported in this study as a probiotic strain with high antimicrobial, antioxidant, and anti-colon cancer activity. Hitherto, few studies have focused on elucidating the impact of probiotic supplementation in vivo. Therefore, in the current study, the safety of the four strains was tested in vivo through the supplementation of rats with potential probiotic strains for 21 days. The results revealed that probiotic bacterial supplementation in rats did not adversely affect the general health of rats. The Lactiplantibacillus plantarum IS07 strain significantly increased the growth performance of rats. Furthermore, the four strains exhibited increased levels of antioxidants such as superoxide dismutase and glutathione in vivo. Consistently, all strains also showed high antioxidant activity of the superoxide dismutase enzyme in vitro. Overall, these findings demonstrated that these isolated potential probiotics harbor desirable characteristics and can be applied widely as feed additives for animals or as dietary supplements for humans to exert their health benefits and combat serious diseases. [ABSTRACT FROM AUTHOR]

Methoxylated bromodiphenyl ethers (MeO-BDEs), marine natural products, can be demethylated by cytochrome P450 to produce hydroxylated bromodiphenyl ethers (OH-BDEs), potentially toxic metabolites that are also formed by hydroxylation of BDE flame retardants. The OH-BDEs may be detoxified by glucuronidation and sulfonation. This study examined the demethylation of 6-MeO-BDE47, 2′-MeO-BDE68 and 4′-MeO-BDE68, in hepatic microsomes from the red snapper, Lutjanus campechanus , a marine fish likely to be exposed naturally to MeO-BDEs, and the channel catfish, Ictalurus punctatus , a freshwater fish in which pathways of xenobiotic biotransformation have been studied. We further studied the glucuronidation and sulfonation of the resulting OH-BDEs as well as of 6-OH-2′-MeO-BDE68 in hepatic microsomes and cytosol fractions of these fish. The three studied biotransformation pathways were active in both species, with high individual variability. The range of activities overlapped in the two species. Demethylation of MeO-BDEs, studied in the concentration range 10–500 μM, followed Michaelis-Menten kinetics in both fish species, however enzyme efficiencies were low, ranging from 0.024 to 0.334 μL min.mg protein. Conjugation of the studied OH-BDEs followed Michaelis-Menten kinetics in the concentration ranges 1–50 μM (glucuronidation) or 2.5–100 μM (sulfonation). These OH-BDEs were readily glucuronidated and sulfonated in the fish livers of both species, with enzyme efficiencies one to three orders of magnitude higher than for demethylation of the precursor MeO-BDEs. The relatively low efficiencies of demethylation of the MeO-BDEs, compared with higher efficiencies for OH-BDE conjugation, suggests that MeO-BDEs are more likely than OH-BDEs to bioaccumulate in tissues of exposed fish. • Demethylation of MeO-BDE natural products was slow in marine and freshwater fish. • Me-OBDEs are likely to bioaccumulate in exposed fish due to slow biotransformation. • The resulting OH-BDE metabolites were efficiently glucuronidated and sulfonated. • The demethylated OH-BDEs metabolites, have lower potential for bioaccumulation. [ABSTRACT FROM AUTHOR]

Objectives: Evaluation of ultrasound-guided (USG) adductor canal block (ACB) or femoral nerve block (FNB) for enhanced recovery in arthroscopic anterior cruciate ligament (ACL) repair, and their analgesic efficacy postoperatively. Background: USG ACB and USG FNB are getting more consideration for enhanced recovery in arthroscopic ACL repair. Methods: A prospective randomized double-blind work was performed on eighty adult individuals assigned into two equal groups scheduled for elective arthroscopic ACL repair using spinal anesthesia. Group A (n=40): obtained USG ACB with bupivacaine 0.125% in total volume of 20 ml. Group B (n=40): received USG FNB with bupivacaine 0.125 in total volume of 20 ml. The role of those blocks in enhanced recovery after arthroscopic (ACL) repair is assessed by the length of the patient's hospital stay as a primary outcome. The analgesic efficacy of those blocks was assessed by visual analog scale (VAS), time for the postoperative first analgesic requirement, total opioid consumption as post-operative additional analgesia, and post-operative hemodynamics (mean blood pressure and heart rate) as a secondary outcome. Results: Hospital stay was substantially decreased in group A contrasted to in group B (P value = 0.001). VAS score was decreased in group A contrasted to group B with statistical significance on 4, 8, and 12 hours postoperatively with P value = 0.001, 0.026, 0.031 respectively. It was statistically insignificantly between both groups on admission at the post-anesthesia care unit (PACU), 16, 20, and 24 hours postoperatively with P values = 0.254, 0.074, 0.114, and 0.725 respectively. Time to first analgesic request was substantially prolonged in group A contrasted to group B (P value <0.001). Total consumption of morphine was substantially decreased in group A contrasted to group B (P value < 0.001). Conclusion: Our findings revealed that USG ACB provides better postoperative enhanced recovery as shown by a lower hospital stay and superior post-operative analgesic effects via lower VAS score, time for the postoperative first analgesic requirement, total opioid consumption, patients' vital parameters and satisfaction in first 24h post-operative than USG FNB in arthroscopic ACL repair. [ABSTRACT FROM AUTHOR]

R3858 --> There are two sources of hydroxylated bromodiphenyl ethers in aquatic environments, biotransformation products of bromodiphenyl ether (BDE) flame retardants, and natural products biosynthesized by marine bacteria. Regardless of source, BDEs and their hydroxylated metabolites (OH‐BDEs) are lipophilic molecules that can bioaccumulate in animals. OH‐BDEs are potential substrates for glucuronidation and sulfonation, as demonstrated with human liver samples (Cisneros et. al. Chemosphere, 226, 132‐139, 2019). The objective of the present study was to determine how well fish can eliminate selected OH‐BDEs by glucuronidation. The four OH‐BDEs studied here were natural products, 4‐OH‐BDE47, 2'‐OH‐BDE68, 6‐OH‐2'MeO‐BDE68 or closely related to natural products, 4'‐OH‐BDE68. Liver microsomes were prepared from laboratory‐maintained adult Channel Catfish, Ictalurus punctatus, two females and one male, held in freshwater tanks, and from wild‐caught adult Red Snapper, Lutjanus campechanus, from the Gulf of Mexico, two females and two males. To determine rates of glucuronidation, uridine‐diphosphate‐14C‐glucuronic acid (UDPGA), 1 mM, was incubated with liver microsomes, 0.05 mg, in the presence of 0.1M Tris‐Cl buffer, pH 7.6, magnesium chloride, 5 mM, and varying concentrations of OH‐BDE, 2.5 to 50 µM for 5 min. The amount of protein and incubation time were determined from preliminary studies to show linear formation of the glucuronide products. After 5 min, reactions were stopped by addition of tetrabutylammonium dihydrogen phosphate and acetic acid, and the ion‐pair of the glucuronide was extracted into ethyl acetate for determination of 14C, following a previously published procedure. In both fish species, the rates of glucuronidation with increasing substrate concentration followed Michaelis‐Menten kinetics. The Km values for the OH‐BDEs ranged from 3 to 35 µM and were generally somewhat lower in the catfish than the red snapper, though this only reached statistical significance, p<0.05, for 2'‐OH‐BDE68. Vmax values ranged from 0.9 to 5.4 nmol glucuronide per min per mg protein and for each substrate were variable between individual fish. Mean glucuronidation enzyme efficiency was highest for 2'‐OH‐BDE68 in the channel catfish, 715 ± 119 µL.min‐1.mg‐1 (mean ± S.D., n = 3), significantly higher than for red snapper, 239 ± 74 µL.min‐1.mg‐1 (n=4). The lowest glucuronidation efficiencies were found for 6‐OH‐BDE47, 145 ± 57 µL.min‐1.mg‐1, n=3 in Channel Catfish and 68 ± 37 µL.min‐1.mg‐1, n=4, in Red Snapper. Because of the variability, the efficiencies of 6‐OH‐BDE47 glucuronidation were similar between the two species. The glucuronidation efficiencies reported here for two fish species are of similar orders of magnitude to those observed with human liver microsomes. Both fish species were able to efficiently catalyze glucuronidation of the studied OH‐BDEs, suggesting these compounds should be readily excreted from exposed Channel Catfish or Red Snapper. [ABSTRACT FROM AUTHOR]

"GenX" [ammonium perfluoro (2-methyl-3-oxahexanoate] was developed as a replacement chemical for toxic perfluorinated compounds to be used in product manufacturing. Here, we assessed developmental, mitochondrial, and behavioral toxicity endpoints in zebrafish embryos/larvae exposed to GenX. GenX exerted low toxicity to zebrafish embryos/larvae up to 20 mg/L. GenX did not affect mitochondrial oxidative phosphorylation nor ATP levels. ROS levels were reduced in larvae fish exposed to 10 and 100 µg/L, indicative of an antioxidant defense; however, ROS levels were elevated in fish exposed to 1000 µg/L. Increased expression of cox1 and sod2 in GenX exposed 7-day larvae was noted. GenX (0.1 or 1 µg/L) altered transcripts associated with neurotoxicity (elavl3, gfap , gap43 , manf, and tubb). Locomotor activity of larvae was reduced by 100 µg/L GenX, but only in light periods. Perturbations of anxiety-related behaviors in larvae were not observed with GenX exposure. These data inform risk assessments for long-lived perfluorinated chemicals of concern. • "GenX" [ammonium perfluoro (2-methyl-3-oxahexanoate] exerted low toxicity to zebrafish. • GenX did not affect mitochondrial oxidative phosphorylation nor ATP levels. • ROS levels were elevated following exposure to 1000 µg/L GenX in larval zebrafish. • Expression levels for transcripts associated with redox status and neurotoxicity were altered in larval fish. • Locomotor activity of larvae was reduced by 100 µg/L GenX, but only in light periods. [ABSTRACT FROM AUTHOR]

Background: There is no doubt about the cardiovascular complications of coronavirus disease 2019 (COVID-19). Several genetic studies have demonstrated an association between genetic variants in a region on chromosome 9p21 and in a region on chromosome 16q22 with myocardial infarction (MI) and atrial fibrillation (AF) accompanied by cerebral infarction (CI), respectively. Objectives: MI and CI susceptibility in patients with CDKN2B-AS1 and ZFHX3 polymorphisms, respectively, may have an effect on COVID-19 severity. We aimed to investigate whether there is an association between the cyclin-dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B-AS1) rs1333049 and zinc finger homeobox 3 (ZFHX3) rs2106261 single nucleotide polymorphisms (SNPs) and the degree of COVID-19 severity. Subjects and methods: This current work was carried out on 360 subjects. They were classified into three groups: 90 severe COVID-19 cases, 90 moderate COVID-19 cases and 180 age- and gender-matched healthy controls. All subjects underwent genotyping of CDKN2B-AS1 (rs1333049) and ZFHX3 (rs2106261) by real-time PCR. Results: The frequency of G/C in CDKN2B-AS1 (rs1333049) was higher in severe and moderate COVID-19 patients than in controls (71.1% and 53.3% vs. 37.8%). The frequency of the C/C of CDKN2B-AS1 (rs1333049) was higher in moderate COVID-19 patients than in controls (26.7% vs. 13.3%). There were no significant differences regarding genotype frequency and allelic distribution of ZFHX3 (rs2106261) between COVID-19 patients and healthy controls. Conclusion: CDKN2B-AS1 (rs1333049) gene polymorphism may play a role in determining the degree of COVID-19 severity. Further studies on its effect on cyclins and cyclin-dependent kinases (CDKs) [not measured in our study] may shed light on new treatment options for COVID-19. [ABSTRACT FROM AUTHOR]