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Bench Aids for the Morphological Diagnosis of Anaemia
  1. M Howard

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    World Health Organisation, 2001. (£25.00.) ISBN 92 4 1545322 1.

    This is not a book but a collection of seven tough laminated sheets contained in a robust card envelope. The sheets are printed on both sides and contain a combination of text and colour photomicrographs. As one would expect from a World Health Organisation publication the bench aids are for global consumption. Thus, the authors have made introductory and advisory comments regarding laboratory investigations that are pertinent to users both in the high technology laboratories of the Western World and also in the less well equipped developing countries. Of the total 14 sides, five contain largely text. The subjects include a summary of the causes of anaemia, a glossary of morphological terms, recommended laboratory investigations for various types of anaemia, and general comments on the preparation of blood films and care of the microscope. These sections are well written and require only a fairly basic knowledge of English for comprehension.

    Overall, the authors (three UK haematologists) have done a very good job and one’s immediate impression is of a colourful and user friendly diagnostic aid. I do have a few criticisms. Although the causes of anaemia are summarised it seems a little odd to exclude a classification of anaemia on the basis of red cell size—for instance, although we have a few suggested tests for macrocytic anaemia there is no list of causes of macrocytosis. This seems an odd omission in what is a fairly basic bench top aid for anaemia diagnosis. The photomicrographs are generally of a high quality, but a few are not, and do not clearly demonstrate the alleged abnormality. There are blank spaces on some of the pages, which could easily have been filled by useful additional illustrations. The miscellaneous page contains a rather odd selection of abnormalities and might have been better used by including some views of parasites (although as the authors point out there is a coexistent bench aid package for malaria). On the page headed “leukocytes in stained blood films” there is an illustration of all the usual leucocytes but also a picture of a clump of plasma cells, which appears to imply that plasma cells are routinely present in the blood film. There are occasional typographical errors and in one of the plates the legend does not correspond precisely to the micrograph, which might cause confusion to the uninitiated.

    In essence this is a well produced, simple diagnostic aid for anaemia. I think it will be most useful in developing countries, where it is being marketed at a reduced price, and where presumably access to more sophisticated atlases and CD ROM packages is very limited. In developed countries, more senior haematology staff and morphologists would find it of little use, but it should be helpful to those learning morphology. The emphasis on the preparation of blood films and the correct use of the microscope is a useful corrective. By my calculation the price in the developed world is £25 and I think this represents good value. We will keep a copy on the bench top in our laboratory and I suspect it will be very well used.

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