Periprosthetic joint infection (PJI) is one of the devastating complications after primary total knee arthroplasty (TKA), which increases the financial burden on patients and affects their quality of life as well. 1-4) Despite modern modalities for preventing infection, the incidence of PJI is 1%-2% after knee replacement surgery. 5,6) As the burden of the lower limb arthroplasty procedure is frequently increasing in the elderly population, the economic burden of PJI is steadily increasing as well. 7) The actual cost of treating patients with PJI is difficult to determine because it depends on multiple factors such as the specific type of treatment given to a patient, bacteria-specific antibiotics, and patient's comorbidities. The spectrum of economic burden comprises inpatient cost as well as outpatient cost, which includes costs for follow-up visits, rehabilitation, and medication. PJI is a dilemma especially in developing countries such as Pakistan. According to the World Bank's classification, Pakistan belongs to the lower-middle-income group. 8) The management of PJI varies from an extended course of antibiotics to surgical debridement, which places massive

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Context: Guillain-Barré syndrome (GBS) is an acute inflammatory neuropathy and has several electrophysiological subtypes and clinical variants. Treatment is mainly supportive and immunotherapy is given to shorten the disease course. Aims: The aim of this study was to define the outcome of GBS with plasmapheresis and to determine its clinical spectrum. Materials and Methods: The prospective study was done at Mayo Hospital, Lahore, for 1 year from November 2020 to November 2021. The diagnosis of GBS was made on Brighton criteria for GBS. The outcome of therapy was assessed at 3 and 6 months, using the Medical Research Council Scale and Hughes Functional Grading Scale (HFGS). Results: A total of 50 patients were enrolled in the study. Twenty-seven (54%) were males and 23 (46%) were females. Seventeen (34%) had acute motor axonal neuropathy, 16 (32%) had acute motor and sensory axonal neuropathy, 15 (30%) had acute inflammatory demyelinating polyradiculoneuropathy, and 2 (4%) had Miller-Fisher syndrome. Plasmapheresis was done in all patients. HFGS score was assessed at discharge, at 3 months, and after 6 months of illness onset. The improvement in mean HFGS score was 2.79 ± 0.41 at 3 months and 1.94 ± 0.25 at 6 months of symptoms onset from the mean score of 3.46 ± 0.93 at the time of discharge from the hospital. Conclusion: Excellent outcome was observed after plasmapheresis. Majority of participants were able to walk without support at the 6-month follow-up. Plasmapheresis should be initiated early in the management of GBS where intravenous immunoglobulins are costly.

BACKGROUND: The financial burden of prosthetic joint infection after joint replacement in developed