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.

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.

Umbilical cord blood (UCB) which is useful in supportive and definitive management of inherited and acquired disorders is usually discarded in our environment. We sought to establish reference values for some haematological parameters of UCB in Makurdi, Nigeria to assist clinicians better interpret results of haematological parameters of UCB. This was a prospective quantitative study that involved analyzing UCB of qualified women to determine its complete blood count, fetal haemoglobin concentration, clotting profile and fibrinogen concentration. Reference ranges of these parameters were thereafter calculated using normal distribution method. The effects of maternal and fetal factors on these parameters were assessed using the Student t-test and ANOVA. The mean total white blood count (TWBC) was 12.3±3.7 x 109/L. Female births had significantly higher TWBC than male births (13.2 ± 3.3 x 109/L vs 11.0 ± 3.8 x 109/L, p=0.003). Babies that weighed 3.0-3.5kg also had significantly higher TWBC (18.9x109L) than those that weighed 2.4-2.9kg (8.7x109/L) p=0.010.Female births had significantly higher haemoglobin concentration (Hb) (13.9g/dl) than male births (11.9g/dl) p=0.001. Similarly, older women aged 32-41 years had significantly higher Hb (13.4g/dl) than those aged 18-24 years (11.6g/dl) p=0.002. Also, women that had more than two children had higher Hb than those who had one or two, (14.7g/dl vs 12.3g/dl) p=0.030. Babies that weighed 3.0-3.5kg at birth also had significantly higher Hb (16.2g/dl) than babies that weighed 2.4-2.9kg (12.3g/dl), p=0.003.The reference values of the haematological parameters of cord blood in our study were similar to what was reported from other developing countries. This study has provided data on haematological parameters of UCB for clinical use in our environment and we recommend routine UCB analysis in order to aid early detection of some inherited and congenital disorder.

COVID-19 pandemic has covered all continents and virtually all countries of the world infecting millions of people with several hundred thousands of death. It was first brought to the attention of a Chinese ophthalmologist Dr Li Wenliang. The disease which was first believed to be solely associated with the lungs and respiratory system has now shown that the spectrum of organ involvement of the disease is much larger than earlier believed.  While lung and pulmonary features still account for a much larger presentation of the disease, other clinical manifestations such as  fulminant myocarditis, arteriovenous thromboembolism, disseminated intravascular coagulopathy, intracerebral haemorrhage, diarrhea, hypoxic encephalopathy, septicaemia and detection of SARS-CoV-2 particles in stool, saliva and semen of infected individuals are also becoming less infrequent. Haematologic manifestations of hypercoagulable blood are commonly reported among hospitalized COVID‐19 patients.  An elevated  D‐Dimer, that is rising  in the course of disease may signifies disease deterioration. Prolonged PT and aPTT and increased fibrin degradation products with severe thrombocytopenia have been associated with life-threatening disseminated intravascular coagulation (DIC). Physicians should therefore be on a watch out for these features in the management of patients and be ready to spot out other new surprises by the disease. This should be through deepening of curiosity by health personnel in the assessment and management of patients to spot out early surprises of COVID-19 to strengthen the sustenance of the ongoing control of the pandemic

Umbilical cord blood (UCB) which is useful in supportive and definitive management of inherited and acquired disorders is usually discarded in our environment. We sought to establish reference values for some haematological parameters of UCB in Makurdi, Nigeria to assist clinicians better interpret results of haematological parameters of UCB. This was a prospective quantitative study that involved analyzing UCB of qualified women to determine its complete blood count, fetal haemoglobin concentration, clotting profile and fibrinogen concentration. Reference ranges of these parameters were thereafter calculated using normal distribution method. The effects of maternal and fetal factors on these parameters were assessed using the Student t-test and ANOVA. The mean total white blood count (TWBC) was 12.3±3.7 x 109/L. Female births had significantly higher TWBC than male births (13.2 ± 3.3 x 109/L vs 11.0 ± 3.8 x 109/L, p=0.003). Babies that weighed 3.0-3.5kg also had significantly higher TWBC (18.9x109L) than those that weighed 2.4-2.9kg (8.7x109/L) p=0.010.Female births had significantly higher haemoglobin concentration (Hb) (13.9g/dl) than male births (11.9g/dl) p=0.001. Similarly, older women aged 32-41 years had significantly higher Hb (13.4g/dl) than those aged 18-24 years (11.6g/dl) p=0.002. Also, women that had more than two children had higher Hb than those who had one or two, (14.7g/dl vs 12.3g/dl) p=0.030. Babies that weighed 3.0-3.5kg at birth also had significantly higher Hb (16.2g/dl) than babies that weighed 2.4-2.9kg (12.3g/dl), p=0.003.The reference values of the haematological parameters of cord blood in our study were similar to what was reported from other developing countries. This study has provided data on haematological parameters of UCB for clinical use in our environment and we recommend routine UCB analysis in order to aid early detection of some inherited and congenital disorder.