• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.75-80
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• 2021

Purpose: Appendicitis is the most frequent urgency in pediatric age; the aim of this study was to investigate the association of quarantine for severe acute respiratory syndrome coronavirus 2 pandemic and the incidence of pediatric appendicitis in a specific macro area. Methods: We retrospectively analyzed the medical records of consecutive patients who underwent surgical exploration for acute appendicitis in the period March-April since 2014. This specific quarantine period was divided into two phases as indicated by National government. Patient data, demographics, characteristics and outcomes were studied and evaluated comparing patients treated during quarantine especially phase 1 vs. phase 2 (March-April 2020). Results: After reviewing medical charts following the inclusion and exclusion criteria, 155 patients were studied; focusing on the final outcome, it is possible to show a decreased amount of appendicitis during phase 1 and a progressive increase during phase 2; respect to previous years, there was a statistical increase in severity of appendicitis during quarantine (gangrenous vs. phlegmonous appendicitis). Conclusion: During this specific quarantine there was a reduction in appendicitis and a progressive increase during phase 2. These results offer new perspective among disease incidences during lockdown.

• CELLMED
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• v.10 no.4
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• pp.29.1-29.6
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• 2020

COVID-19 (Corona Virus Disease-2019) is an infectious respiratory disease caused by the most recently discovered coronavirus, SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona virus-2). This new viral disease was unknown before the outbreak began in Wuhan, China, in December 2019. As of November 16th 2020, it affects about 54.3 million populations, death troll increased to 1.32 million cases in worldwide. Whereas in India 8.85 cases are infected with COVID-19, of which 1, 30, 112 cases were died. Till now there has been no specific anti-virus drug or vaccines are available for the treatment of this disease, the supportive care and non-specific treatment to the symptoms of the patient are the only options in Biomedicine, the entire world turns its attention towards alternative medicine or Traditional medicine. Siddha medicine is one of the primordial systems of medicine practiced in the southern part of India, it dealt a lot about pandemic, and its management. This review provides an insight into Pandemic in Siddha system and its management in both ancient history and modern history, National and state level Government policies related to current pandemic, World Health Organization (WHO) guidelines on usage of unproven drug during infectious disease outbreak, Preparedness of Siddha system during a pandemic outbreak Challenges and Recommendations.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.5
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• pp.422-431
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• 2022

Purpose: At the beginning of the Coronavirus disease (COVID-19) epidemic, physicians paid close attention to children with chronic diseases to prevent transmission or a severe course of infection. We aimed to measure the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels in children with chronic gastrointestinal and liver diseases to analyze the risk factors for infection and its interaction with their primary disease. Methods: This cross-sectional study analyzed SARS-CoV-2 antibody levels in patients with gastrointestinal and liver diseases (n=141) and in healthy children (n=48) between January and February 2021. Results: During the pandemic, 10 patients (7%) and 1 child (2%) had confirmed COVID-19 infection (p=0.2). The SARS-CoV-2 antibody test was positive in 36 patients (25.5%) and 11 children (22.9%) (p=0.7). SARS-CoV-2 antibody positivity was found in 20.4%, 26.6%, 33.3%, and 33.3% of patients with chronic liver diseases, chronic gastrointestinal tract diseases, cystic fibrosis, and liver transplantation recipients, respectively (p>0.05, patients vs. healthy children). Risk factors for SARS-CoV-2 antibody positivity were COVID-19-related symptoms (47.2% vs. 14.2%, p=0.00004) and close contact with SARS-CoV-2 polymerase chain reaction-positive patients (69.4% vs. 9%, p<0.00001). The use, number, and type of immunosuppressants and primary diagnosis were not associated with SARS-CoV-2 antibody positivity. The frequency of disease activation/flare was not significant in patients with (8.3%) or without (14.2%) antibody positivity (p=0.35). Conclusion: SARS-CoV-2 antibodies in children with chronic gastrointestinal and liver diseases are similar to that in healthy children. Close follow-up is important to understand the long-term effects of past COVID-19 infection in these children.

• IMMUNE NETWORK
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• v.21 no.1
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• pp.9.1-9.8
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• 2021

The most important characteristics of coronavirus disease 2019 (COVID-19) transmission that makes it difficult to control are 1) asymptomatic and presymptomatic transmission, 2) low incidence or lack of dominant systemic symptoms such as fever, 3) airborne transmission that may need a high infectious dose, and 4) super-spread events (SSEs). Patients with COVID-19 have high viral loads at symptom onset or even a few days prior to symptom onset, and most patients with COVID-19 have only mild respiratory symptoms or merely pauci-/null-symptoms. These characteristics of the virus enable it to easily spread to the community because most patients are unaware of their potential infectivity, and symptom-based control measures cannot prevent this type of transmission. Furthermore, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is also capable of airborne transmission in conditions such as aerosol-generating procedures, under-ventilated indoor spaces, and over-crowded areas. In this context, universal mask-wearing is important to prevent both outward and inward transmission until an adequate degree of herd immunity is achieved through vaccination. Lastly, the SSEs of SARS-CoV-2 transmission emphasize the importance of reducing contacts by limiting social gatherings. The above-mentioned transmission characteristics of SARS-CoV-2 have culminated in the failure of long-lasting quarantine measures, and indicate that only highly effective vaccines can keep the communities safe from this deadly, multifaceted virus.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.136-139
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• 2024

Rhabdomyolysis is a syndrome that causes various complications due to the release of substances from muscle cells, often associated with preceding infectious diseases. We report the case of a 7-year-old Korean boy with recent severe acute respiratory syndrome coronavirus 2 infection, presenting with fever, chills, and generalized body aches, diagnosed as rhabdomyolysis. Additionally, we conducted a systematic review with the aim of delineating the disease spectrum, treatment, and outcomes. We identified seven reports that met the inclusion criteria. Among the cases, 5 had fever, with creatine kinase levels ranging from 3,717 and 274,664 IU/L. Two individuals received treatment in intensive care unit, 2 underwent renal replacement therapy, and 1 case has deceased. For children with coronavirus disease 2019 infection and muscle pain, a thorough examination of urine color and an assessment of muscle enzymes through blood tests can help diagnose and treat rhabdomyolysis, a condition that might otherwise be overlooked.

• Genomics & Informatics
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• v.19 no.4
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• pp.48.1-48.10
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• 2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encodes small envelope protein (E) that plays a major role in viral assembly, release, pathogenesis, and host inflammation. Previous studies demonstrated that pyrazine ring containing amiloride analogs inhibit this protein in different types of coronavirus including SARS-CoV-1 small envelope protein E (SARS-CoV-1 E). SARS-CoV-1 E has 93.42% sequence identity with SARS-CoV-2 E and shared a conserved domain NS3/small envelope protein (NS3_envE). Amiloride analog hexamethylene amiloride (HMA) can inhibit SARS-CoV-1 E. Therefore, we performed molecular docking and dynamics simulations to explore whether amiloride analogs are effective in inhibiting SARS-CoV-2 E. To do so, SARS-CoV-1 E and SARS-CoV-2 E proteins were taken as receptors while HMA and 3-amino-5-(azepan-1-yl)-N-(diaminomethylidene)-6-pyrimidin-5-ylpyrazine-2-carboxamide (3A5NP2C) were selected as ligands. Molecular docking simulation showed higher binding affinity scores of HMA and 3A5NP2C for SARS-CoV-2 E than SARS-CoV-1 E. Moreover, HMA and 3A5NP2C engaged more amino acids in SARS-CoV-2 E. Molecular dynamics simulation for 1 ㎲ (1,000 ns) revealed that these ligands could alter the native structure of the proteins and their flexibility. Our study suggests that suitable amiloride analogs might yield a prospective drug against coronavirus disease 2019.

• Molecules and Cells
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• v.44 no.9
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• pp.680-687
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• 2021

Coronavirus disease, COVID-19 (coronavirus disease 2019), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has a higher case fatality rate in European countries than in others, especially East Asian ones. One potential explanation for this regional difference is the diversity of the viral infection efficiency. Here, we analyzed the allele frequencies of a nonsynonymous variant rs12329760 (V197M) in the TMPRSS2 gene, a key enzyme essential for viral infection and found a significant association between the COVID-19 case fatality rate and the V197M allele frequencies, using over 200,000 present-day and ancient genomic samples. East Asian countries have higher V197M allele frequencies than other regions, including European countries which correlates to their lower case fatality rates. Structural and energy calculation analysis of the V197M amino acid change showed that it destabilizes the TMPRSS2 protein, possibly negatively affecting its ACE2 and viral spike protein processing.

• IMMUNE NETWORK
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• v.21 no.6
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• pp.39.1-39.18
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• 2021

The high virulent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus that emerged in China at the end of 2019 has generated novel coronavirus disease, coronavirus disease 2019 (COVID-19), causing a pandemic worldwide. Every country has made great efforts to struggle against SARS-CoV-2 infection, including massive vaccination, immunological patients' surveillance, and the utilization of convalescence plasma for COVID-19 therapy. These efforts are associated with the attempts to increase the titers of SARS-CoV-2 neutralizing Abs (nAbs) generated either after infection or vaccination that represent the body's immune status. As there is no standard therapy for COVID-19 yet, virus eradication will mainly depend on these nAbs contents in the body. Therefore, serological nAbs neutralization assays become a requirement for researchers and clinicians to measure nAbs titers. Different platforms have been developed to evaluate nAbs titers utilizing various epitopes sources, including neutralization assays based on the live virus, pseudovirus, and neutralization assays utilizing recombinant SARS-CoV-2 S glycoprotein receptor binding site, receptor-binding domain. As a standard neutralization assay, the plaque reduction neutralization test (PRNT) requires isolation and propagation of live pathogenic SARS-CoV-2 virus conducted in a BSL-3 containment. Hence, other surrogate neutralization assays relevant to the PRNT play important alternatives that offer better safety besides facilitating high throughput analyses. This review discusses the current neutralization assay platforms used to evaluate nAbs, their techniques, advantages, and limitations.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.147-152
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• 2024

There have been several case reports of neurological manifestations in pediatrics as severe acute respiratory syndrome coronavirus-2 infection in children is being increased. We report a case of a 4-year-old boy who presented febrile seizure during follow-up in a negative pressure isolation room after confirmed coronavirus disease 2019, which has not yet been reported in Korea. He has no symptoms other than fever. The seizure was controlled after one dose of intravenous lorazepam, and there was no respiratory support during the hospitalization. He was discharged 12 days later without neurological sequelae.

• Clinical and Experimental Vaccine Research
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• v.13 no.3
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• pp.202-217
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• 2024

Structural vaccinology is pivotal in expediting vaccine design through high-throughput screening of immunogenic antigens. Leveraging the structural and functional characteristics of antigens and immune cell receptors, this approach employs protein structural comparison to identify conserved patterns in key pathogenic components. Molecular modeling techniques, including homology modeling and molecular docking, analyze specific three-dimensional (3D) structures and protein interactions and offer valuable insights into the 3D interactions and binding affinity between vaccine candidates and target proteins. In this review, we delve into the utilization of various immunoinformatics and molecular modeling tools to streamline the development of broad-protective vaccines against coronavirus disease 2019 variants. Structural vaccinology significantly enhances our understanding of molecular interactions between hosts and pathogens. By accelerating the pace of developing effective and targeted vaccines, particularly against the rapidly mutating severe acute respiratory syndrome coronavirus 2 and other prevalent infectious diseases, this approach stands at the forefront of advancing immunization strategies. The combination of computational techniques and structural insights not only facilitates the identification of potential vaccine candidates but also contributes to the rational design of vaccines, fostering a more efficient and targeted approach to combatting infectious diseases.