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Toxicity mechanisms of per- and polyfluoroalkyl substances (PFASs), a chemical class present in diverse ecosystems, as well as many of their precursors, have been increasingly characterized in aquatic species. Perfluorooctanesulfonamide (PFOSA, C8H2F17NO2S) is a common precursor of perfluorooctane sulfonic acid (PFOS), a long-chain PFAS. Here, we assessed sub-lethal endpoints related to development, oxidative stress, transcript levels, and distance moved in zebrafish embryos and larvae following continuous exposure to PFOSA beginning at 6 h post-fertilization (hpf). PFOSA decreased survival in fish treated with 1 µg/L PFOSA; however, the effect was modest relative to the controls (difference of 10%). Exposure up to 10 µg/L PFOSA did not affect hatch rate, nor did it induce ROS in 7-day-old larvae fish. The activity of larval fish treated with 100 µg/L PFOSA was reduced relative to the solvent control. Transcripts related to oxidative stress response and apoptosis were measured and BCL2-associated X, apoptosis regulator (bax), cytochrome c, somatic (cycs), catalase (cat), superoxide dismutase 2 (sod2) were induced with high concentrations of PFOSA. Genes related to neurotoxicity were also measured and transcript levels of acetylcholinesterase (ache), elav-like RNA binding protein 3 (elavl3), growth-associated protein 43 (gap43), synapsin II (syn2a), and tubulin 3 (tubb3) were all increased in larval fish with higher PFOSA exposure. These data improve our understanding of the potential sub-lethal toxicity of PFOSA in fish species. [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]

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]