{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:14:12Z","timestamp":1787015652133,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:00:00Z","timestamp":1695513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Peripheral Nervous Sys"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Considerable variation in clinical practice for management of Guillain\u2010Barr\u00e9 syndrome (GBS) has been observed worldwide. Diagnosis and treatment are challenging in low\u2010 and middle\u2010income countries (LMIC) due to lack of facilities and treatment availability. We aimed to evaluate current clinical practice and limitations and to provide recommendation for GBS management in low\u2010resource settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted an explanatory\u2010sequential mixed\u2010methods survey among neurologists and internists working in tertiary and secondary government hospitals in Bangladesh. There were two phases: (1) quantitative (cross\u2010sectional survey to evaluate clinical practice and limitations); (2) qualitative (key informant interview to explain certain clinical practice and provide recommendations for GBS management in LMIC). Data were analyzed by frequencies, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test and thematic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 159 physicians (65 neurologists and 94 internists), 11% and 8% physicians used Brighton and NINDS criteria respectively to diagnose GBS. Specific treatment protocols of GBS were used by 12% physicians. Overcrowding of patients, inadequate diagnostic facilities, high costs of standard therapy, and inadequate logistics and trained personnel for intensive care unit and rehabilitation services were considered major challenges for GBS management. In qualitative part, respondents recommended regular training for the physicians, development of cost\u2010effective treatment strategies and appropriate patients' referral and management guideline considering existing limitations in health service delivery and socio\u2010economic status of the country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Current study design and recommendations might be applied for other LMIC. Such data can assist policymakers to identify areas requiring urgent attention and take required action to improve GBS management in LMIC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jns.12597","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T05:59:58Z","timestamp":1694498398000},"page":"564-577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Management of Guillain\u2013Barr\u00e9 syndrome in Bangladesh: Clinical practice, limitations and recommendations for low\u2010 and middle\u2010income countries"],"prefix":"10.1111","volume":"28","author":[{"given":"Nowshin","family":"Papri","sequence":"first","affiliation":[{"name":"Laboratory of Gut\u2013Brain Axis, Infectious Diseases Division (IDD) icddr,b  Dhaka Bangladesh"},{"name":"Department of Neurology, Erasmus MC University Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0935-8079","authenticated-orcid":false,"given":"Zhahirul","family":"Islam","sequence":"additional","affiliation":[{"name":"Laboratory of Gut\u2013Brain Axis, Infectious Diseases Division (IDD) icddr,b  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulshan","family":"Ara","sequence":"additional","affiliation":[{"name":"Nutrition Research Division icddr,b  Dhaka Bangladesh"},{"name":"Department of Nutrition, Sports and Exercise University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamal","family":"Saha","sequence":"additional","affiliation":[{"name":"Laboratory of Gut\u2013Brain Axis, Infectious Diseases Division (IDD) icddr,b  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4832-6926","authenticated-orcid":false,"given":"Sonja E.","family":"Leonhard","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases Erasmus University Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert P.","family":"Endtz","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases Erasmus University Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart C.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Neurology, Erasmus MC University Medical Center  Rotterdam The Netherlands"},{"name":"Department of Immunology, Erasmus MC University Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quazi D.","family":"Mohammad","sequence":"additional","affiliation":[{"name":"National Institute of Neurosciences and Hospital  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.121"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70215-1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-021-00467-y"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1114525"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00339-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21976"},{"issue":"2","key":"e_1_2_9_8_1","first-page":"203","article-title":"Ventilatory management of respiratory failure in patients with severe Guillain\u2010Barr\u00e9 syndrome","volume":"51","author":"Aggarwal A","year":"2003","journal-title":"Neurol India"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.706"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt285"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-017-8429-8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410270707"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12189"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8027.2012.00433.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy232"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007719"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022862"},{"key":"e_1_2_9_18_1","unstructured":"AdhikaryTS MollahS.ICU facilities scanty at government hospitals of Bangladesh: intensive care units at 7 major public hospitals have only 80 beds; 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