BioScientific Review

Clinical Characteristics, Causes, and Treatment Outcomes of Hydrocephalus in Children Under Six: A Retrospective Study from a Single Center in Quetta, Baluchistan

Nadia Ewaz Ali — 2025-03-05

Background. Hydrocephalus is defined by an abnormal build-up of Cerebrospinal Fluid (CSF) within the brain's ventricles. The long-term effects of hydrocephalus can range considerably and are frequently unpredictable. Due to its life-threatening nature, particularly in newborns and toddlers, the treatment of hydrocephalus is of utmost importance. The exact epidemiology of infantile hydrocephalus in Pakistan is unknown. \

Methods. This retrospective cohort study intended to examine the clinical importance of hydrocephalus patients under 6 years. Furthermore, it also addressed the potential gaps in medical knowledge on the local epidemiology, risk factors, and therapeutic methods of this condition at a tertiary care centre of Quetta Baluchistan, Pakistan.

Results. A total of 29 hydrocephalus patients (18 congenital and 11acquired) were included in the study. A comprehensive questionnaire was designed to collect the demographic and clinical information of the patients. After statistical analysis, it was determined that gender and age distribution between the two groups, congenital and acquired hydrocephalus, was similar, showing no significant differences (p=0.196, p=0.867). The most common symptoms were irritability, drowsiness, and a head growing through seizures. Moreover, sun-setting eyes also appeared commonly. Post-natal diagnosis and imaging (CT and MRI) dominated the diagnostic methods of congenital hydrocephalus. Whereas brain MRI accounted for most cases with acquired hydrocephalus. The origin of acquired hydrocephalus was frequently unknown, aqueduct stenosis was the primary cause of congenital hydrocephalus. Medical treatment, ventriculoperitoneal (VP) shunting, and ETV (Endoscopic Third Ventriculostomy) were similar in all groups. The most frequent side effect for medications and VP shunts was irritation, while the most frequent side effect for ETV operations was sore throat.

Conclusion. This study underlined the importance of early diagnosis, proper treatment, and continuous follow-up in hydrocephalus patients. Though the treatment approaches in accordance with clinical practices, the frequency of complications has necessitated continued medical care to achieve the best possible outcomes. Further research into the local epidemiology and more effective therapeutic approaches is very important to enhance care for hydrocephalus patients in the region.

Detection of Seminal Material on Hand-Washed Textile Evidence

Asad Saeed — 2025-03-14

Background. In sexual assault cases, a medical examination of the victim is often not conducted timely. This leaves the only chance to spot the ejaculate of the assailant on the victim’s clothing. Washing the victim’s clothes before the detection of semen in the forensic laboratory is a challenging task. Therefore, the current study aimed to examine the persistence of seminal material on seven different types of hand-washed fabrics using five laundry detergents.

Methods. The presence of seminal material on washed fabrics was determined using an alternate light source, acid phosphatase test, p30 test, and sperm head count.

Results. The study demonstrated that presumptive testing was not positive for most washed fabrics. A fairly large number of spermatozoa retained on a few fabrics even after 20 minutes of washing. The cotton yarn fabrics and tight weaving with warf and weft more than 100x100/inch could retain more sperms. The DNA was also isolated from sample and quantified using a Quantifiler Duo DNA quantification kit.

Conclusion. Good quality and quantity of human DNA were obtained from most of the washed fabrics, which could successfully generate the STR profile of the donor. The current study recommended using hand-washed textile items for forensic analysis in sexual assault cases.

Seroepidemiology of Human Cytomegalovirus and Human Herpesvirus 6 in a Cohort of Healthy Blood Donors from Abbottabad, Pakistan

Nayyab Iftikhar — 2025-03-21

Background. Human Cytomegalovirus (CMV) and Human Herpesvirus 6 (HHV-6) represent significant public health concerns due to their widespread prevalence and potential clinical sequelae. This study aimed to elucidate the sero-epidemiological profile of CMV and HHV-6 among a cohort of ostensibly healthy blood donors in Abbottabad, Pakistan.

Methods. A cross-sectional study was conducted from December 2021 to June 2022 at the Regional Blood Centre in Abbottabad. Initially, 1850 healthy male blood donors were recruited according to WHO criteria, with 1750 meeting eligibility after screening for high-risk behaviors and clinical symptoms. Plasma samples were assayed for anti-CMV IgG, CMV IgM, and HHV-6 IgM using ELISA kits (sensitivity: 99%, specificity: 95%), with optical density measured at 450/620 nm. Donors were stratified into four age groups (<18, 21–30, 31–40, and 41–50 years) and statistical analyses were performed using descriptive statistics and Pearson’s Chi-square test (p<0.05) in SPSS (version 25). Of the 1850 initially recruited donors, 1750 met the inclusion criteria (mean age: 28.2 years; range: 19–50 years).

Results. Initial screening revealed low prevalence rates for HBsAg (0.69%), anti-HCV (2.4%), and syphilis (1.14%), with all donors testing negative for malarial parasites and HIV. Blood group distribution was predominantly O (36%) and B (36%), with 96% of donors being Rh-positive. Overall, serological assessment demonstrated a CMV IgG seroprevalence of 90.2%, CMV IgM positivity in 5.7%, and HHV-6 IgM positivity in 8% of donors. Age-stratified analysis indicated: donors aged <18 years exhibited 80% CMV IgG positivity (with no CMV IgM or HHV-6 IgM), those aged 21–30 years 89% CMV IgG, 5.45% CMV IgM, and 9.1% HHV-6 IgM positivity; donors aged 31–40 years showed 94.2% CMV IgG, 7.69% CMV IgM, and 7.6% HHV-6 IgM positivity; while donors aged 41–50 years demonstrated universal CMV IgG positivity without detectable CMV IgM or HHV-6 IgM.

Conclusion. The elevated CMV IgG seroprevalence among Abbottabad blood donors indicates widespread viral exposure, while the lower rates of CMV IgM and HHV-6 IgM suggest infrequent recent or reactivated infections. These findings underscore the need for continued sero-epidemiological surveillance to inform and optimize regional blood safety protocols.

Development of Microbial Biofilms and Their Role in device, non-device and organ system level Infections

Farah Liaqat — 2025-03-21

Background. Microorganisms, while providing many health benefits to human beings and other living organisms, are also responsible for significant infections. They cause infections in both planktonic and biofilm modes. Biofilms, defined as architectural communities of microorganisms encased in an extracellular polymeric substance (EPS), are strongly associated with infections. According to the National Institute of Health Sciences (NIH), biofilms account for 65% of microbial infections and 80% of chronic infections.

Methods. This review examines the current literature on microbial biofilms, focusing on their formation stages, pathogenicity, resistance mechanisms, and associated infections. Data from various studies is analyzed to summarize biofilm development and its role in chronic infections.

Results. Biofilm development involves four stages: attachment, microcolony formation, maturation, and dispersion. Quorum sensing (QS) mechanisms play a critical role in biofilm development and microbial communication. Biofilms enhance microbial pathogenicity and resistance to both the immune system and commercial antibiotics. They contribute to device-associated infections, such as those in catheters, and also to non-device infections in living tissues, as well as organ-level infections that impair systemic functions.

Conclusion. A comprehensive understanding of microbial biofilms is essential for developing strategies to manage and control biofilm-associated infections. This review highlights the need for further research on the mechanisms of biofilm formation and resistance to improve infection prevention and treatment.

Keywords: biofilm development, biofilm infections, chronic infections, device infections, microbial biofilms, non-device infections