scholarly journals Referral Pattern and Haematological Disorders in a Tertiary Hospital

2021 ◽  
Vol 4 (1) ◽  
pp. 61-69
Author(s):  
AM Onoja ◽  
AI Nwannadi ◽  
AT Onoja ◽  
IH Aba ◽  
E Jatau ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Bone Marrow Aspiration ◽  
Tertiary Hospital ◽  
Blood Film ◽  
University Teaching ◽  
Full Blood Count ◽  
Age Group ◽  
Haematological Disorder ◽  
Haematological Disorders ◽  
Very High

This study aimed to determine the pattern of referrals and haematological disorders at Benue State University Teaching Hospital. This was a retrospective study of records of a total of 222 adults and Paediatric patients suspected to have haematological disorders, seen and referred from different clinics and wards within and outside the study facility to the Haematologists for evaluation between June 2012 to July 2019 inclusive. These patients were clerked by the Haematologists, peripheral blood samples were taken for full blood count, red cell indices, reticulocyte count and peripheral blood film examination. Bone Marrow Aspiration was done on all the patients and the slides examined. Where indicated, further flowcytometry was done for complete diagnosis. Of the 222 referred, 127 (57.2%) were males while 95(42.8%) were females, with M:F ratio of 1.3:1. The age range of patients was 3 to 95 years with median age of 36.5 years. Those in the age group of 16-35 years constituted the majority 81(36.5%), while the least 5(2.3%) referred cases were in the age group of 76 years and above. The highest referral to the Haematologists was 40(18%) in 2015 and 2018 each. The bulk of referrals to the Haematologist was from Medicine 103(46.4%), followed by referrals from General Outpatient Department (GOPD) 29(13.1%) and then Paediatrics 27(12.2%), the least was from Ear Nose and Throat (ENT). The main indication for referral was Unexplained Anaemia 68(30.6%), followed by Splenomegaly 26(11.7%). One hundred and eighty (81.1%) of the total referred cases had at least an established haematological disorder. The most common haematological disorder established from the total referred cases was Combined Iron Deficiency Anaemia and Megaloblastic Anaemia (IDA/MA) 52(23.4%). This was followed by Chronic Lymphocytic Leukaemia (CLL) 23(10.4%). In conclusion, referrals from other physicians to the Haematologists have very high likelihood of haematological disorder. We recommend that attending Haematologists treat all referred cases with very high index of suspicion so as not to miss a potentially life threatening haematological disorder.

scholarly journals BONE MARROW STUDY IN CASES OF HAEMATOLOGICAL DISORDERS

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Atul C. Mujumdar ◽  
Dr. Akash C Chhabra
Keyword(s):  
Bone Marrow ◽  
Peripheral Blood ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Parasitic Infections ◽  
Trephine Biopsy ◽  
Blood Picture ◽  
Hematological Disorders ◽  
Tissue Paper ◽  
Haematological Disorders

Introduction: There are various disorders in formation of blood in body. Bone marrow is one of them which involved variety of hematological and nonhematological disorders. Hematological disorders include myeloproliferative neoplasm (MPN), acute leukemia, hemato-lymphoid neoplasm and nutritional deficiency diseases whereas nonhematological disorders include infectious diseases infiltrating the bone marrow such as parasitic infections, tuberculosis and metastatic deposits. Bone marrows present various diseases with various clinical symptoms with the involvement of blood but peripheral blood picture alone does not reflect the nature of disease process. Depending upon the suspected diagnosis from clinical features and peripheral blood examination, that indication for bone marrow examination can be done. Examination of Bone marrow is useful in the diagnosis of both hematological and non-hematological disorders. The most important techniques used for the diagnosis of hematological disorders are trephine biopsy and bone marrow aspiration. For the interpretation of the disorder of bone marrow history, clinical finding, peripheral blood picture and other laboratory findings are required. Usually Bone marrow aspiration (BMA) alone is sufficient for the diagnosis of nutritional anaemias, most of the acute leukaemias and Immune thrombocytopenias. Diagnosis such as Trephine biopsy provides important diagnostic information myelofibrosis, granulomatous disease and bone marrow infiltration. Bone marrow aspiration is useful in making out better individual cell morphology whereas biopsy is useful in bone marrow architectural pattern and distribution. Bone marrow is nor mocellular or hypercellula resulting from ineffective hematopoiesis, increased peripheral destruction and bone marrow invasion. Therefore, bone marrow examination is extremely helpful to identify the cause of pancytopenia. Aim: The main aim of this study is to evaluate the cytological and histological pattern of various hematological disorders in bone marrow aspiration and trephine biopsy respectively. Material and Methods: During the period of 1 year 100 patient with the cases of haematological disorders were included in this study. Routinely stain like Leishman stain is used for bone marrow aspiration. Haematoxylin and eosin stain is also used for trephine biopsy. For all the cases reticulocyte count, peripheral smears, sickling test and complete hemogram were done. Special stains PAS Stain (Periodic acid schiff) was done for all ALL, AML and gauchers disease. In ALL cases Block positivity is shown. In gauchers disease, a gaucher cell shows wrinkled tissue paper appearance with PAS positivity. Reticulin stain was done in myelofibrosis and metastatic deposits. In myelofibrosis, trephine biopsy shows increase in reticulin network with coarse fibrils. Result: In all the cases bone marrow aspiration was done and among them 40 cases trephine biopsy were done. Out of total patients 57 were male and 43 were female.  And the mean age was found as 32.6 years. The findings of the bone marrow were examination. At the time of study period 50% of the study have anemias and they are predominantly megaloblastic followed by aplastic/ hypoplastic anemias. Other three cases include two metastatic deposits and one storage disorder (Gaucher’s Disease). Conclusion: Bone marrow examination is important to diagnosis, prognosis or evaluate therapeutic response for a variety of hematologic and non-hematologic problems. Nowadays, Bone marrow aspiration & bone marrow biopsy are used routinely as diagnostic procedures because it is easier and does not require advance equipments. Therefore both the procedures are complementary to each other which are helpful in further investigation and management. Keywords: Bone marrow aspiration, Trephine biopsy, Pancytopenia, Megaloblastic Anemia

Introduction to haematology

2020 ◽  
pp. 5169-5171
Author(s):  
Chris Hatton
Keyword(s):  
Bone Marrow ◽  
Weight Loss ◽  
Diagnostic Tests ◽  
Blood Count ◽  
Modern Medicine ◽  
Blood Film ◽  
Full Blood Count ◽  
Cellular Infiltration ◽  
Haematological Disorder ◽  
History Of

Haematology is the study of the composition, function, and diseases of the blood. The approach to a patient suspected of having a haematological disorder begins with taking a history (particularly noting fatigue, weight loss, fever, and history of bleeding) and performing a clinical examination (looking for signs of anaemia, infection, bleeding, and signs of cellular infiltration causing splenomegaly and/or lymphadenopathy). Key investigations include a full blood count, a blood film, and (in selected cases) examination of the bone marrow. Further diagnostic tests now routinely performed on blood and marrow samples include immunophenotyping and cytogenetic and molecular analysis. Mutational signatures may be diagnostically useful and potentially define treatment, keeping haematology in the vanguard of advances in modern medicine.

Diagnosis and investigation in haematology

2018 ◽  
Author(s):  
Chris Bunch
Keyword(s):  
Bone Marrow ◽  
Blood Count ◽  
Iliac Crest ◽  
Bone Marrow Examination ◽  
Needle Aspiration ◽  
Blood Film ◽  
Full Blood Count ◽  
Clinical Context ◽  
Posterior Iliac Crest ◽  
Haematological Disorders

This chapter addresses the interpretation of the full blood count, blood film, bone marrow examination, and related tests in the diagnosis of haematological disorders. Examination of a stained blood film, which should always be requested if a blood count abnormality cannot readily be explained by the clinical context, may give clues to the cause of the abnormality or prove diagnostic. Examination of the bone marrow is essential to the proper evaluation and diagnosis of many haematological disorders. The simplest form of marrow examination involves needle aspiration of marrow cells from the posterior iliac crest; smears are made and stained in the same way as a blood film. Bone marrow can also be biopsied for histological examination, at the same time as marrow aspiration.

scholarly journals Schistosomiasis of the Appendix in a Tertiary Hospital in Northern Nigeria: A 22-Year Review

2014 ◽  
Vol 6 (01) ◽  
pp. 018-021 ◽  
Author(s):  
Saad A Ahmed ◽  
Umar Mohammed ◽  
Robert B Sanda ◽  
Jerry Makama ◽  
Mohammed S Shehu ◽  
...  
Keyword(s):  
Neglected Tropical Diseases ◽  
Age Groups ◽  
Granulomatous Inflammation ◽  
Tertiary Hospital ◽  
The Body ◽  
University Teaching ◽  
Tropical Diseases ◽  
Age Group ◽  
Pathology Laboratory ◽  
Bowel Motion

ABSTRACT Background: Schistosomiasis is one of the neglected tropical diseases caused by a trematode, Schistosoma spp, and affects many systems in the body including the gastrointestinal tract. Schistosomiasis of the appendix is a well-recognized disease and presents as a chronic granulomatous inflammation. This study aims to document the frequency and pattern of distribution of schistosomal appendicitis in our environment. Materials and Methods: This is a retrospective histopathological review of schistosomiasis of the appendix in the Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria - Nigeria, between January 1, 1991 to December 31, 2012. Results: Within the study period, there were 1,464 appendectomy specimens histologically examined in the Pathology Laboratory. Thirty of these, representing 2.1%, were diagnosed as schistosomiasis of the appendix. The male:female ratio was 6.5:1 and peak age incidence was in the 20-29 years age group. Abdominal pains, vomiting and fever were seen in 23 (76.7%) and altered bowel motion in seven (23.3%) patients. Conclusion: This study showed that schistosomiasis of the appendix is not rare and that its presentation is similar to other forms of appendicitis. There is a need to focus on the prevention of schistosomiasis in order to reduce morbidity among these economically viable age groups.

scholarly journals Hyperferritinemia in a Case of Soft Tissue Sarcoma

2021 ◽  
pp. 19-23
Author(s):  
Tanya Pruthi ◽  
Bimal K. Agrawal ◽  
Shiv Pankaj Khanna ◽  
Jaskaran Bazad ◽  
Mini Bhatnagar
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Serum Ferritin ◽  
Peripheral Blood ◽  
Blood Film ◽  
Elderly Male ◽  
Peripheral Blood Film ◽  
Very High

An elderly male presented with symptoms suggestive of anemia. During workup for the same he was found to have very high levels of serum Ferritin along with a normocytic, normochromic peripheral blood film and no other apparent cause for hyperferritinemia .A swelling which incidentally found on his shin was further investigated by FNAC confirmed presence of soft tissue sarcoma.

scholarly journals Prevalence and Nature of Adult Hematological Malignancies Using Bone Marrow Aspiration Cytology in a Tertiary Health Facility: A Seven Year Retrospective Review

2021 ◽  
Vol 2 (1) ◽  
pp. 39-45
Author(s):  
AM Onoja ◽  
SA Otene ◽  
AT Onoja ◽  
IN Ibrahim ◽  
A Mke ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Retrospective Review ◽  
Hodgkin’S Lymphoma ◽  
Treatment Options ◽  
Bone Marrow Aspiration ◽  
University Teaching ◽  
Hodgkin's Lymphoma ◽  
State University ◽  
Haematological Disorders ◽  
Clinic Medical

Bone Marrow Aspiration (BMA) is a procedure that is often used to evaluate patients with haematological disorders including haematological malignancies (HMs) which account for about 6.5% of all cancers worldwide. There is paucity of data on the prevalence and pattern of HMs from BMA cytology in Nigeria. We carried out a retrospective review to determine the prevalence and distribution of HMs among adult patients who had BMA cytology at Benue State University Teaching Hospital (BSUTH) from June 2012 to July 2019. A total of 158 BMA reports extracted from the marrow and clinic medical records were reviewed. Out of 158 adult BMA cytology reports, HMs accounted for 78(49.4%) of all haematological disorders. There was no significant gender difference. The Male 38(48.7%) to Female 40(51.3%) ratio (M:F) was 1:1.1. Their ages ranged from 16 to 85 years with the median age of 54.0 years. Out of the 78 HMs, Lymphoid neoplasms were the most prevalent 47(60.3%), the leukaemias were higher 53/78(67.9%) compared to the non-leukaemic neoplasms. Of the 53 leukaemias, those of chronic lymphoid types were more 24/53(45.3%), followed by the chronic myeloid 15/53(28.3%). Chronic lymphocytic leukaemia (CLL) was the predominant leukaemia 24/53(45.3%) as well as the most prevalent HM 24/78(30.8%), followed by chronic myeloid leukaemia (CML) 19.2%(15/78). Others were myelodysplastic syndrome (MDS) 11.5%(9/78), acute lymphoblastic leukaemia (ALL) 10.3% (8/78), multiple myeloma (MM) 10.3%(8/78), acute myeloblastic leukaemia (AML) 7.7%(6/78), non-Hodgkin's lymphoma (NHL) 6.4%(5/78), Small lymphocytic lymphoma (SLL) 2.6%(2/78) and Hodgkin's lymphoma (HL) 1.3%(1/78). In conclusion, we established high prevalence of HMs among patients who had BMA cytology evaluation at BSUTH with the preponderance of lymphoid malignancies. We advocate for inclusion of HMs in the National Health Insurance Scheme (NHIS) for full implementation and to prioritise provision of modern diagnostic equipment and treatment options for quality and optimal management of leukaemias in the center.

scholarly journals Red cell indices and peripheral blood film findings of anti-Psychotic treatment and treatment naïve Psychiatic patients in a tertiary Hospital in Nigeria.

2019 ◽  
Vol 18 (2) ◽  
pp. 196-205
Author(s):  
AO Shittu ◽  
AO Adewoye ◽  
HO Olawumi
Keyword(s):  
Peripheral Blood ◽  
Medical Science ◽  
Blood Film ◽  
Full Blood Count ◽  
Antipsychotic Treatment ◽  
Anti Psychotic ◽  
Cross Sectional ◽  
Significant Difference ◽  
Peripheral Blood Film ◽  
Abnormal Results

Background: The overall burden of morbidity and mortality from psychiatric disorders is on the rise. Holistic approach in the care of this group of patients has become inevitable. There is need for collaboration between psychiatrists and other physicians, laboratory physicians inclusive. Study design: cross sectional descriptive case- control study. Materials and method: A total of 198 patients including controls were recruited for this study. Patients with schizophrenia constituted majority of the respondents, 86.4% of antipsychotic-naïve patients and 90.9% of patients on antipsychotics. A comprehensive medical examination was carried out on every participant. On every sample, automated Full Blood Count was performed using Sysmex2000i and peripheral blood film was made and examined. Result: 51.5% and 47% of anti-psychotropicnaïve patients and patients on anti-psychotic were 18-40 and 41-60 years respectively. Male (57.6%), predominated the anti-psychotic naïve group while female (51.5%) predominated the group on anti-psychotics. Schizophrenia was the diagnosis in the majority of patients, 86.4% and 91% respectively in anti-psychotic naïve and antipsychotic treatment groups. Other diagnoses were depressive illness, substance use disorder and dementia. Of all the subjects, one (1.5%) schizophrenic patients and two (3%) of controls had abnormal haemogram results. For the schizophrenic patient with abnormal results, haematocrit was 12g/dl, MCV of 75fl and MCH of 26pg, while the two controls with abnormal results had only haematocrit deranged with value of 12.3g/d. Neutrophil hypersegmentation was seen on the film of five antipsychotic-naïve patients (7.5%) diagnosed with Schizophrenia and one (1.5%) of the controls. Macrocytosis was only seen in three (4.5%) of the five antipsychotic-naïve patients that had neutrophil hypersegmentation. Conclusion: No significant difference was noted in the Full Blood Counts among the two sets of patients and controls, although there were isolated cases of neutrohil hyperesegmentation and macrocytosis. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.196-205

scholarly journals Patterns of Psychiatric Illness over 3 years: A single Centre Inpatient Study From Nepal

2015 ◽  
Vol 3 (2) ◽  
pp. 15-19
Author(s):  
S Dhungana ◽  
M Chapagai ◽  
P Tulachan ◽  
S P Ojha
Keyword(s):  
Psychiatric Illness ◽  
Psychotic Disorders ◽  
Psychiatric Patients ◽  
Descriptive Analysis ◽  
Tertiary Hospital ◽  
University Teaching ◽  
P Value ◽  
Age Group ◽  
Psychiatric Illnesses ◽  
Common Diagnosis

Introduction: Inpatient psychiatric patients are a major group of our treatment domain and they are different from outpatients in certain characteristics. In this study, we assessed the patterns of psychiatric illnesses along with socio-demographic variables in patients admitted in a psychiatry ward of a tertiary hospital over three consecutive years.Methods: This is a retrospective review of all patients admitted in psychiatry ward Tribhuvan University Teaching Hospital over a three year period between 2067 Baisakh to 2069 Chaitra (2010 April to 2013 April) by reviewing in-patient admission charts from medical records section of the hospital. Descriptive analysis was done by using SPSS version 19; Chicago, IL, with p value of <0.05 being considered statistically significant.  Results: There were a total of 881 patients admitted in the psychiatry ward during the study period (281 patients in 2067, 303 in 2068 and 297 in 2069). Patients in the age group of 20-30 years comprised the majority (n=295; 33.5%) of the total population followed by age group 10-20 years (n=239; 27.1%). Males constituted 50.3% of the total patients. Most of the patients belonged to the central developmental region (n=580; 65.8%). Brahmins comprised the majority (n=374; 42.5%) and 98.8% of the patients were Hindus. The most common diagnosis was schizophrenia and related disorders (25.5%) followed by acute and transient psychotic disorders, ATPD (14.4%). Majority of the patients (n=422; 47.9%) had hospital stay duration of 7-14 days. About 98% of patients were discharged with no cases of mortality over three years studied. Overall trend in those three years was similar except for ethnicity, diagnosis, and duration of stay (p≤0.001).Conclusion: We conclude that schizophrenia and related disorders were the most common diagnosis and 20- 30 years age group was the most commonly afflicted age- group among psychiatry inpatients. This adds insight to our understanding of predominant psychiatric illness in inpatients and how they differ from outpatients aiding in scaling of services in inpatients.J Psychiatric Association of Nepal Vol .3, No.2, 2014, pp:15-19DOI: http://dx.doi.org/10.3126/jpan.v3i2.12382 

HIGH PREVALENCE OF MALNUTRITON AND WORM INFECTION AMONG VAN KIEU AND PAKOH CHILDREN AGED 12-36 MONTHS IN DAKRONG DISTRICT, QUANG TRI PROVINCE

2012 ◽  
pp. 129-134
Author(s):  
Thi Lan Tran ◽  
Thi Huong Le ◽  
Xuan Ninh Nguyen
Keyword(s):  
Cross Sectional Study ◽  
Age Group ◽  
Infection Status ◽  
Sectional Study ◽  
Group Recommendation ◽  
Related Factors ◽  
Normal Children ◽  
Cross Sectional ◽  
High Prevalence ◽  
Very High

Objectives: Assess the nutritional status, worm infection status and some related factors among children aged 12-36 months of Dakrong district, Quang Tri province. Subject and method: A cross sectional study was carried out in 2010, in 680 children aged 12-36 months in 4 communes of Dakrong district, Quang Tri province. Results: The malnutrition rate was 55.0% for underweight, 66.5% for stunting and 16.2% for wasting. The prevalence of malnutrition increases by age group. The prevalence of worm infection was 31.6%, the highest prevalence was belong to Ascaris infection (24.6%), followed by Hookworm and Trichuris (6.5% and 6.2%, respectively). The prevalence of worm infection among children under two is very high (27.0%). The prevalence of worm infection was distributed quite equally between the malnutrition children group and normal children group. Recommendation: Early deworming forchildren from 12 months should be considered as important strategy against the malnutrition of children in Dakrong district, Quang Tri province

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