Guillain-Barre syndrome: Demographics, clinical profile & seasonal variation in a tertiary care centre of central India.

BACKGROUND & OBJECTIVES: Guillain-Barre syndrome (GBS) is an autoimmune disease and a recognized cause of generalized progressive paralysis worldwide. The present study was aimed to document the clinical findings, demographics and seasonal variations amongst the patients with GBS during the hospital stay. METHODS: A retrospective analysis of 66 referred cases diagnosed as GBS was conducted. Medical records and the data related to age, sex, antecedent illness, duration of symptoms before admission, muscle power graded by the Medical Research Council scale, functional scores, details of Intensive Care Unit complications and need for ventilation were obtained. The patients were divided into four seasonal groups: S1 (spring, February to April), S2 (summer, May to July), S3 (rainy, August to October) and S4 (winter, November to January) and parameters were studied. RESULTS: The mean age of the patients was 40.69 yr. Forty one (62.1%) patients had a history of preceding illness. Forty nine (74.2%) patients showed quadriparesis as most common complaint. Thirty three (50%) patients were of acute inflammatory demyelinating polyneuropathy (AIDP) variant. The highest number of GBS cases (60%) was found in S1 and S2. The maximum duration of hospital stay was observed in S3 group (mean 23 days). INTERPRETATION & CONCLUSIONS: GBS seems to affect all age groups with male preponderance. Most common antecedent event and presenting feature were flu-like illness and quadriparesis, respectively. AIDP was the most common variant. Most cases occurred from February to July (S1 and S2 group) (maximum in July) with preceding influenza and diarrhoea and maximum duration of hospital stay was observed in S3 group. Prospective studies with follow up of GBS patients need to be done to confirm findings.

A Cross-Sectional Study on Burden of Hepatitis C, Hepatitis B, HIV and Syphilis in Multi-Transfused Thalassemia Major Patients Reporting to a Government Hospital of Central India.

Need for frequent blood transfusions exposes thalassemia major patients to risk of transfusion-transmitted infections (TTIs). Screening of donor blood through national protocols for possible infections like hepatitis B and C, HIV, syphilis and malaria is considered the optimal preventive method. There is constant need to explore the effect of currently used protocols of blood-donor screening by determining the burden of TTIs in multi-transfused patients. The current study was conducted to determine the burden of TTIs among multi-transfused Thalassemia patients registered at a Government hospital of central India. Sixty-six multi-transfused Thalassemia patients reporting during a period of eight months were screened for hepatitis B and C, HIV as well as syphilis by using standard diagnostic tests. Selected clinical, socio-demographic and other characteristics were also recorded to understand the determinants of risks of these infections. The sero-prevalence of hepatitis B, hepatitis C, HIV and syphilis was 3.0, 18.2, 1.5 and 0 % respectively amongst the patients. Vaccination against hepatitis B was found to be protective. Majority of the infected patients had history of transfusion from non government blood banks. There is a considerable burden of Hepatitis C among multi-transfused Thalassemia patients. The currently used screening tests need to be revalidated or replaced to prevent false-negative diagnoses. All sectors need to optimally implement and control both, the quality of blood donors and the mandatory screening of blood and blood products against the TTIs along with prospective longitudinal data and follow up of patients.