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   2021| November  | Volume 14 | Issue 11  
    Online since November 30, 2021

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Recent emergence and outbreak of rotavirus gastroenteritis in Samoa: A scoping review of risk factors, containment measures and public health preparedness
Lawal Olatunde Olayemi, Vicky Yemoh, Alec Ekeroma
November 2021, 14(11):479-485
Diarrheal diseases have been known to cause death in many children below the age of five years, and rotavirus infection represents a major health problem in the world today, particularly in developing countries. The recent outbreak of rotavirus gastroenteritis in Samoa led to the introduction of her debut national immunization program on rotavirus vaccination for infants. Despite the introduction of anti-viral and anti-emetic drugs as of the containment approaches towards the virus, risk factors, preventive measures and public health preparedness against rotavirus infection are poorly understood in Samoa. This review aims to use available evidence on rotavirus literature to elucidate and map preventive strategies for the recently emerged rotavirus infections in Samoa. We conducted a search strategy using online medical literature databases and retrieval systems. A designated set of keywords such as rotavirus, gastroenteritis, outbreak, risk factors, containment measures, vaccination and Samoa were inserted in electronic databases to retrieve articles. The databases included PubMed, Google Scholar, MEDLINE, Scinapse, and EBSCO host. Findings from this review addressed the impact of rotavirus infection, associated threats and other preventive measures. Introducing useful health frameworks in pursuing possible methods such as improved water quality, exclusive breast feeding, improved laboratory diagnostics and outbreak surveillance, may be essential in addressing alternate approaches towards containment of the disease in Samoa and other Pacific Island Countries and Territories.
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Vaccine induced thrombotic thrombocytopenia: Coagulation after administration of COVID-19 vaccine
Cokorda Agung Wahyu Purnamasidhi, I Komang Hotra Adiputra, Giovanca Verentzia Purnama, Richard Christian Suteja, I Gede Purna Weisnawa
November 2021, 14(11):477-478
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Post COVID-19 mucormycosis: A case series
Mala Vinod Kaneria, Kallappa Baligeri, Abhijeet Budhe
November 2021, 14(11):517-524
Objective: To evaluate the associated factors between COVID-19 and mucormycosis. Methods: Twenty-two patients of COVID-19 associated mucormycosis (including 3 asymptomatic patients who were cured of COVID-19) from a single medical unit of our institute were included. A detailed history was noted, with special emphasis on the time of onset of mucormycosis symptoms, presence of comorbidities, including new onset diabetes, severity of COVID-19, oxygen requirement, details of receipt of steroids and immunomodulators such as tocilizumab, imaging findings, including the number of sinuses involved, bony erosions, orbital and cerebral involvement, microscopy, culture and histopathology reports and antifungals given. Surgical interventions including number of debridements, orbital exenteration, maxillectomy, and the vaccination status were noted. Results: All 22 patients had rhino-orbital cerebral mucormycosis, 27.27% in the first wave and 72.73% during the second wave. Diabetes was the commonest comorbidity, and 40.91% patients were newly detected diabetics. The time of presentation in relation to their COVID-19 symptoms was 8-15 days (average 12.5 days). Ten out of 22 (45.45%) had asymptomatic or mild COVID-19 and 40.91% did not require supplemental oxygen. Five out of 22 (22.73%) did not receive steroids. Twelve out of 22 (54.55%) had orbital involvement, 3 (13.64%) had palatal ulcer and 4 (18.18%) had cerebral involvement and all these had progressed in spite of treatment with appropriate antifungals. Conclusions: COVID-19 associated mucormycosis is a frequent, lethal, post COVID-19 complication, occurring even in mild and asymptomatic cases who have not received steroids or oxygen.
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Tick-borne pathogens in Iran: A meta-analysis
Mehdi Khoobdel, Amir Sajad Jafari, Zakkyeh Telmadarraiy, Mohammad Mehdi Sedaghat, Hasan Bakhshi
November 2021, 14(11):486-504
Objective: Different studies have been performed on the prevalence of tick-borne pathogens in different areas of Iran; however, as far as our knowledge, there is no regional meta-analysis available for consideration and estimation of tick species infected with different pathogens in Iran. Methods: In this review, among different databases, a total of 95 publications were included, and the infection of different tick species to different tick-borne pathogens was determined; furthermore, presence of pathogens (with 95% confidence intervals) in tick vectors was calculated separately for each province, using Comprehensive Meta-Analysis version 2 (Biostat, USA). Results: Totally, among all 95 studies, 5 673 out of 33 521 investigated ticks were positive according to different detection methods. Overall estimated presence of pathogens in tick vectors in Iran was 8.6% (95% CI 7.0%-10.6%, P<0.001). Of all 46 species of ticks in 10 genera in Iran, 28 species in 9 genera, including Alveonasus, Argas, Boophilus, Dermacentor, Haemaphysalis, Hyalomma, Ixodes, Ornithodoros, and Rhipicephalus were infected with at least 20 pathogens in 10 genera including Aegyptianella, Anaplasma, Babesia, Borrelia, Brucella, Orthonairovirus [Crimean- Congo hemorrhagic fever virus (CCHFV)], Coxiella, Ehrlichia, Rickettsia and Theileria in 26 provinces of Iran. The presence of pathogens in ticks collected in western Iran was more than other regions. Hyalomma anatolicum (20.35%), Rhipicephalus sanguineus (15.00%), and Rhipicephalus bursa (14.08%) were the most prevalent infected ticks for different pathogens. In addition, most literatures were related to CCHFV and Theileria/Babesia spp. Conclusions: Public health and veterinary professionals should be aware of diagnosing possible diseases or outbreaks in vertebrates.
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Intracellular calcium ions facilitate dengue virus entry into endothelial cells and compromise endothelial barrier integrity
Meng-Hooi Shu, Pooi-Fong Wong, Sing-Sin Sam, Shih-Keng Loong, Boon-Teong Teoh, Sazaly AbuBakar
November 2021, 14(11):505-516
Objective: To investigate the involvement of Ca2+ in dengue virus (DENV)-infected human umbilical vein endothelial cells (HUVECs) and the disruption of endothelial integrity. Methods: HUVECs were infected with DENV-2 in the presence of intracellular Ca2+ or endoplasmic reticulum Ca2+ chelators. Virus infectivity was measured by focus-forming assay and quantitative RT-PCR. Intracellular Ca2+ was measured using Fluo-4-AM dye. VE-cadherin and focal adhesion kinase (FAK) expressions were investigated by immunofluorescence and immunoblotting assays, respectively. Results: DENV infection increased intracellular cytosolic Ca2+ levels and caused disassembly of the adherens junction protein, VE- cadherin as evidenced by decreased VE-cadherin expression at the periphery of DENV-2 infected HUVECs. Depletion of intracellular Ca2+ stores, particularly those of the endoplasmic reticulum Ca2+, significantly decreased DENV yield in HUVECs. Decreased virus yield following the depletion of intracellular Ca2+ was caused by the inhibition of viral entry into HUVECs and not the inhibition of viral binding or attachment. DENV-2 infection also resulted in Ca2+-dependent activation of FAK. Conclusions: Intracellular Ca2+ is required for the early phases of DENV infection in endothelial cells. Increased cytosolic Ca2+ levels in endothelial cells during DENV infection activated FAK, disrupted adherens junctions and compromised barrier integrity. Thus, Ca2+ plays an important role in DENV infection in endothelial cells.
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