Red blood cell indices and red blood cell morphology in the haematological evaluation of patients: Study from a tribal based hospital in rural India

Abstract

so as to avoid hazards of transfusion. Background: Anaemia causes impaired oxygen delivery to tissues. The first investigation done in anaemia is blood for haemoglobin%(Hb%). It can be reported within minutes using automated analyser. Peripheral blood smear (PBS) examination for assessment of red cell morphology is advised to evaluate the effect of anaemia on patient’s health. Now-a-days, automated analysers are supplied in remote hospital set-up also. But analyser results must be justified with blood smear examination findings. Objectives: General: To find out the spectrum of Hb concentration among indoor patients; Specific: To find out whether analyser derived red cell indices correspond with red cell morphology on PBS. Materials and Methods: Observational, cross-sectional, descriptive study conducted in the pathology department of a tribal based hospital. After institutional ethics committee permission the study was conducted for 1 year duration among indoor patients selecting the first complete haemogram report after admission. Hb values were categorised into 4 sub-groups (≥12 g/dl, 10–<12 g/dl, 7–<10 g/dl, <7 g/dl). Red cell indices were derived from analyser. Blood smear stained by Leishman-Giemsa was examined under light microscope. Data was analysed at the end of the study using Microsoft Excel software 2010. Results: Among 478 total cases 39.53% were male, 60.46% female (Male:Female ratio 1:1.53). 50% of total population had Hb% ≥12 g/dl which constituted 69.84% of the male and 37.02% of the female cases. Females were more in number to have abnormal red cell morphology (23.53%) compared to male (19.05%). Red cell index abnormality was almost equal in male (58.20%) and female (59.52%). More male patients had red cell morphology abnormality (54.38%) than female (34.62%) at Hb level <12g/dl. Conclusion: Red cell morphology must accompany all cases of haemogram reporting.