Background: Guillain-Barré syndrome (GBS) is an acute acquired autoimmune inflammatory disorder of the peripheral nerves and roots. Respiratory insufficiency is an important predictor of a poor prognosis in patients with GBS. Phrenic nerve assessment is an area of interest in GBS with respiratory failure. We aimed to analyze the characteristics of the phrenic nerve conduction study (NCS) in GBS and assess its value in predicting respiratory failure requiring ventilatory support, along with outcome assessment at 6 months as per the Hughes score. Methods: A total of 135 patients with GBS admitted to our hospital over 3 years were thoroughly evaluated by clinical examination, blood laboratory tests, and phrenic NCS. Results: Phrenic NCS abnormality was observed in 48 patients (35.6%) with statistically significant increases in phrenic sum compound muscle action potential (CMAP) latency (18.91±7.82 ms) and sum CMAP duration (44.65±6.84 ms), along with reduced sum CMAP amplitude (0.3246±0.132 mV) and sum CMAP area (3.56±2.62 mV·ms) occurring in those requiring ventilatory assistance. The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of the phrenic NCS for predicting respiratory failure in patients with GBS were 90.7%, 90.2%, 81.3%, 95.4%, 9.27, and 0.10, respectively. The results showed a statistically significant association between abnormal initial phrenic NCS scores and outcomes at 6 months. Conclusion Phrenic NCS can predict respiratory failure requiring ventilator assistance in patients with GBS. Phrenic NCS can be incorporated into routine NCS protocols to predict impending respiratory failure in patients with GBS.

Purpose: Due to COVID 19 pandemic, the treatment of cancer patients has become a dilemma for every oncologist. Cancer patients are at an increased risk of immunosuppression and have a higher risk to acquire any infection. There are individual experiences from some centers regarding the management of cancer patients during such a crisis. So we have developed our institutional strategy to balance between COVID and cancer management.Material & Methods: Radiation Oncology departmental meeting was held to prepare a consensus document on Radiotherapy schedules and department functioning during this pandemic. Results: Strategies were taken in form of following areas were steps need to be taken to decrease risk of infection, categorise treatment on the basis of priority, radiotherapy schedules modification, academic meetings and management of COVID positive patient/personnel in Radiation Oncology department. Conclusion We hope to strike the balance in overcoming both the battles and emerge as winners. Stringent long term follow up will be done for assessing the response or any unforeseen treatment related sequelae.