Nadir Ali, Mohammad Azmat Khan, Masood Anwar, Mohammad Ayyub, Mansoor Nadeem, Muhammad Irfan, Asif Nadeem, Mohammad Aslam.
Clinical assistance of Bone Marrow Examination in a secondary-care hospital.
Pak Armed Forces Med J Jan ;54(1):51-3.

This study was performed to evaluate various clinical situations requiring bone marrow examination and to assess its advantages in a secondary care hospital. One hundred and five bone marrow examinations were performed from 1st April 2002 to 31st March 2003. The age ranged from 4 months to 70 years with a mean age of 32 years, 10 patients were children under the age of 15 years and 95 were adults. Male to female ratio was 3:1. Progressive pallor (26%), visceromegaly (25%), abdominal disturbances (19%), fever of unknown origin (8.5%), bleeding manifestations (8.5%), lymphadenopathy (8.5%) bone pains (5%), and suspected hematological malignancy (8.5%) were the common clinical situations where bone marrow examination was asked. Nutritional deficiency anemia constituted 61% of the bone marrow examination results. Other conditions were anemia of chronic disorder (13.5%), acute leukemia (5%), chronic leukemia (3%), multiple myeloma (2%), myelodysplastic syndrome(2 % ), congenital sideroblastic anemia(1%), storage disorder(1%) and metastatic bone disease(1%). Bone marrow examination at secondary care hospitals carries many advantages. About 80% cases can be treated in these centers and do not require referral. The disease is usually at its early stage, marrow is unaffected by any therapy and has better diagnostic value.

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