some abnormality in the peripheral blood smears. OPD patients on clinical suspicion of a hematological disorder by the consultant incharge were also included in the study group after obtaining the detailed history, clinical examination and all relevant investigations. Patients with highly increased bleeding time and clotting time were deterred. # II. Procedure The guard on the aspiration needle was adjusted and with the boring movement, needle (salah needle) was passed perpendicularly into the cavity. After piercing the skin and the subcutaneous tissue when the needle point reached the periosteum, the needle was pushed with a boring motion into the cavity and the termination point was achieved when there was loss of resistance. Stilette was removed and a 10 ml dispovan syringe was attached to the needle to suck the marrow contents. Not more than 0.3 ml of marrow fluid was sucked in a single aspiration. Immediately, 6-8 good marrow smears were made and dried quickly with the help of a hair drier. Simultaneously, 2-3 peripheral blood smears were also made. The slides were numbered with a diamond pencil. Two marrow smears and one peripheral blood smear were taken for leishman staining while the rest of the unstained smears, after being fixed in methanol were wrapped in an aluminium foil and kept in a dry place for future use. # b) Leishman Staining of Slides Bone marrow smears and the peripheral blood smear were placed on a staining rack and leishman stain was put drop by drop on the film so as to cover it completely. After 2 minutes, double the volume of # S a) Bone Marrow Aspiration Patient and his attendants were told about the entire procedure and a written consent was taken. Complete patient preparation (xylocaine sensitivity testing, cleaning and draping) was done prior to the bone marrow aspiration. The skin over the sternum was cleaned with 70% ethyl alcohol. The skin, subcutaneous tissue and the periosteum overlying the manubrium was infiltrated with 1-1.5 ml of 2% xylocaine. Two minutes were given to achieve the effect of anaesthesia. In case of small children and uncooperative patients, sedation with diazepam was used. The site of puncture of the manubrium was opposite to the second intercostal space and slightly to one side of the midline. buffered water was added and the two were mixed together with the help of a dropper. After 20 minutes, slides of peripheral smear were washed under the running tap water and the scum was drained off while bone marrow smears were washed after 30 minutes. Back side of the slides was wiped off with a clean and dry filter paper. The slides were kept in a vertical position to drain and dry. The slides were now ready for the microscopic examination. # c) Reporting of Bone Marrow Smears Bone marrow as well as peripheral smears were first scanned with scanner (4X lens) followed by the examination under low power(10X), high power(40X) and oil immersion lenses(100X) respectively. The final reports were dispatched in the prescribed format only. # PERCENTAGE OF CASES IN EACH AGE GROUP # IV. Conclusion In this study, we found that on bone marrow aspiration the most frequently diagnosed haematological disorders 1 are Anemias 9 . Amongst the anemias, the commonest one are the Megaloblastic anemias 4,6,10 and those showing Dimorphic blood picture. Acute Leukemias 2,3,5,7,8 occupy the second position in the list including the Acute Myeloid Leukemias and Acute Lymphoblastic Leukemias with overall prevalence of leukemias being more in adults as compared to children. Hematological disorders are more common during childhood period and in the early adulthood. Commonest Leukemia in adults is Acute Myeloid Leukemia. The most common clinical presentation of Acute Leukemias is Pallor and Fever while Anemias present clinically with Pallor and Fatigue. # V. Acknowledgement Smt. Annapurna Tomar, Dr. R.K Nigam and the entire staff of the department of pathology, Gandhi Medical College, Bhopal, M.P. ![Material and Method: Bone marrow aspiration was done from Manubrium of the Sternum after injecting 2% xylocaine to the part. Bone marrow smears were prepared and stained with Leishman stain along with the simultaneous staining of the peripheral smears. A complete hemogram including Hb%, PCV, Red cell indices, platelet count, total leucocyte count and differential leucocyte count was also done by Automated cell counter. Finally, the bone marrow and peripheral smears were examined manually under oil immersion. Year 2015 © 2015 Global Journals Inc. (US) Volume XV Issue V Version I ( ) Spectrum of Disorders Diagnosed by Bone Marrow Aspiration](image-2.png "C") ![](image-3.png "") no2 : Spectrum of DisordersS.No DisorderTotalPercentage (%)1Megaloblastic Anemia5943.72Dimorphic Anemia1813.33Acute Myeloid Leukemia139.64Idiopathic Thrombocytopenic Purpura139.65Hypoplastic Marrow118.16Acute Lymphoblastic Leukemia096.67Plasma Cell Disorder032.28Myeloproliferative Disorder032.29Lymphoproliferative Disorder021.510Chronic Lymphocytic Leukemia010.7411Myelodysplastic Syndrome010.7412Leishmaniasis010.7413Hypersplenism010.74Total135100.0 noIII. Observation and Discussion1 : Indications for Bone Marrow ExaminationINDICATIONCASESNo.%Anemia Under Evaluation6246.0Pancytopenia Under evaluation2820.7Suspected Leukemia1410.4Thrombocytopenia128.9Hepatosplenomegaly Under evaluation043.0Pyrexia Under Evaluation021.5Others1310.0Total135100.0INDICATIONS FOR BONE MARROWASPIRATION46 %20.7%10.4%8.9%3%1.5%10% no3Age (Yrs) Percentage0-2041.521-4033.341-6022.2>603.0 no4SPECTRUM OF DISORDERS Megaloblastic Anemia1%2%2% 1% 1%1% 1%Dimorphic Anemia6%Acute Myeloid Leukemia8%44%10%Idiopathic Thrombocytopenic10%13%Purpura Hypoplastic MarrowAcute LymphoblasticLeukemia504030201000-2021-4041-60>60Age (Yrs)Males (%)Females (%)0-2057.142.921-4053.346.741-607030>602575 * Pattern of haematological diseases diagnosed by bone marrow examination in Yemen: a developing country experience JAl-Ghazaly AHAl-Selwi MAbdullah AKAl-Jahafi Al-Dubai W Al-Hashdi A Clin Lab Haematol 28 6 2006 Dec * Sex ratios and the risks of haematological malignancies RACartwright KAGurney AVMoorman Br. J Haematol 118 4 2002 Sep * MQKhan ASShivarudrappa SEl-Bialy MZKhawagi MMofarreh Leukemia cases in Central Hospital 89 2 1991 Feb J Indian Med Assoc. * Association of Megaloblastic Anemia with peripheral cytopenias SKhan FRaziq HQureshi JPMI 23 01 2009 * Neoplastic Lesions in Bone Marrow : a 10 year study in a Teaching Hospital LaishramSharmila ShimrayRachel ASharma PukhrambamBarindra Gayatri ASingh Meena L DurlavSharma Chandra Journal, Indian Academy Of Clinical Medicine 9 3 July-September, 2008 * Megaloblastic anemia in infancy MercedesVVda De Torregrosa MargaritaCaceres De Costas Clinical Pediatrics 3 6 1964 * Leukemia at Queen JMMukiibi CMNyirendra JOAdewuyi ELMzula EDMagombo EMMbvundula * AGE(Yrs) AND SEX(%) DISTRIBUTION OF CASES