Study of the effect of plasmapheresis on some hematological parameters in patients with myasthesia gravis and Guillain-Barre syndrome

Prothrombin time [P.T.], partial thromboplastin time [P.T.T.], platelet count, fibrinogen level, antithrombin III level [AT III], hemoglobin cocentration, total red cell count, hematocrit and total leukocytic count were measured in 9 adult patients with Guillain-Barre syndrome and in 9 adult patients with myasthenia gravis before and 15 minutes after plasma-exchange procedure. Physiological saline and fresh frozen plasma were used as a replacement fluid. Significant prolongation of P.T. and P.T.T. with reduction of platelet count associated with a significant decrease of fibrinogen and AT III levels [functionally AT III was not affected] were observed after plasma exchange procedure without any hemostatic complications. Hemoglobin concentrations were decreased in patients with Guillain-Barre syndrome while other parameters were not affected in both groups. In conclusion plasmapharesis with fresh frozen plasma and saline is a safe procedure as long as the frequency of exchange-transfusion is adjusted. Frequent check of coagulation parameters before plasma pharesis is essential especially in hemo statically compromized patients and addition of some coagulation factors to other replacement fluids as albumin may be needed as the latter is devoid of these factors

Hepatitis B virus infection among health care personnel

Health care personnel are at a great risk of hepatitis B virus infection. The study included 350 subjects divided into 2 groups. Control group : included 100 apparentty healthy individuals. Health care personnel group included 250 subjects, 29 physicians, 46 surgeons, 24 dentists, 23 clinical pathologists, 28 gynaecologists, 60 nurses, 15 laboratory technicians and 25 hospital workers. Detection of hepatitis B virus seromarkers was carried out using ELISA technique. The infection rate was higher in health care personnel than control group. The highest prevalence of infection was among laboratory technicians, followed by hospital workers then nurses and finally medical personnel. Surgeons showed the highest prevalence of hepatitis B markers followed by physicians and clinical pathologists and finally dentists. Hepatitis B markers were not detected in gynaecologists. There was no significant difference between control group and health care personnel group regarding HBeAg while the difference was significant regarding anti-HBe and anti-HBc [IgG between the two groups]. The infection rate was higher in females than males, with highest prevalence between 18-20 years and lowest was between 25-30 years. There was, also, significant exposure rate according to the period of empolyment in hospitals. It is concluded that 66% of health care personnel were negative for hepatitis B seromarkers and they are it risk of acquiring infection and will benefit from vaccination. Continuous monitoring of high risk group is recommended and education of technicians, hospital workers and nurses of the mode of transmission of the virus and methods of protection are important