DOI: https://doi.org/10.53350/pjmhs20221611700 ORIGINAL ARTICLE 700 P J M H S Vol. 16, No. 11, November, 2022 Frequency of Aplastic Anemia Among Adults Patient with Pancytopenia: A Cross-Sectional Study Design FARHAN ZEB 1 , SAQIB PERVEZ 2 , ASIF KHAN 3 , MUDASSAR BILAL 4 , BUSHRA KHAN 5 , AMARJEENA KHAN 6 1 FCPS medicine Medical officer RHC shewaswabi 2 FCPS Medicine Medical officer Tehsil Headquarter Hospital Puran, Shangla. 3 PGR cardiology Institute: PIC Peshawar 4 PGR medicine dhq hospital DIKHAN 5 WMO RHC shewaswabi 6 Medical officer pic peshawar Corresponding author: Farhan Zeb, Email: drfarhanzeb@gmail.com ABSTRACT Objective: To determine the frequency aplastic anemia among adult patients with pancytopenia. Place and duration of study:The study is conducted at Department of Medicine, MTI-Lady Reading Hospital, Peshawar and the duration of study is From 25-04-2018 to 25-10-2018. Material and Method: It is a Descriptive cross sectional study design having sample size of 135 patients, this study using 95% confidence level and 7% margin of error, under WHO software for sample size determination. The sampling technique we have used in this study is the non-probability consecutive sampling. All adult patients with newly diagnosed pancytopenia of any duration, Age group above 18 years to 60 years belongs to any gender are included in this study design. SPSS 23 was used to evaluate all the data.Mean and Standard Deviation was calculated frequency and percentages were calculated. Using the chi square test results are examine the effect modification. A p-value of 0.05 or below was considered significant. Results: At the MTI-Lady Reading Hospital in Peshawar's Department of General Medicine, 135 patients participated in this study. According to descriptive data, the mean and SDs for age were recorded as 55+12.85 and 3+1.18, respectively. In the 18– 30 age range, there were 27 (20%) patients, whereas the 31–60 age group had 108 (80%) individuals. In a similar manner, 44 (32.59%) patients were recorded as female and 91 (67.40%) patients were recorded as male. According to frequency and prevalence rate for aplastic anaemia, 103 (76.29%) patients were identified as having this condition. Practical Implications: The current study's objective is to determine the prevalence of aplastic anaemia in people with adult pancytopenia. Despite the availability of study, statistics show that the severity of aplastic anaemia varies from population to population, and pancytopenia is not uncommon in our society. Conclusion: This study evaluated that aplastic anaemia is the most prevalent cause of pancytopenia in the Khyber Pukhtunkhwa population, and that bone marrow aspiration is a recognised diagnostic method for the assessment of pancytopenia. Keywords: Aplastic anemia, Bone marrow, Megaloblastic Anemia, Pancytopenia, Bone marrow failure Syndrome, . Myelophthisic anemia, Thrombocytopenia. INTRODUCTION Aplastic anemia (AA) is a rare bone marrow failure syndrome of unknown etiology characterized by hypocellular marrow and severe persistent pancytopenia in the absence of major dysplastic signs or marrow fibrosis 1 . Different epidemiological studies are conducted to determine the comprehensive incidence of aplastic anemia, providing result of an increase in population with 2-3 times higher ratio in asian countries 2 .Pediatric apalstic anemia seen more frequently in adolescents and young adults 3 . Hypocellularity and bone marrow aplasia are thought to be primarily triggered by immune-mediated death of hematopoietic stem cells 4 . Compared to adults, paediatric patients with acquired AA had better results 5 . Pancytopenia refers to a reduction below normal values of all 3 peripheral blood lineages i.e. leukocytes, platelets and erythrocytes 6 . Pancytopenia may be acquired inherited (genetic but not necessarily present at birth) 7 .The pathogenesis of pancytopenia is either a failure of production of hematopoietic progenitors or peripheral destruction of cellular element due to infection, immune mediated damage or hypersplenism 8 . Pancytopenia requires microscopic examination of a bone marrow biopsy specimen and a marrow aspirate to assess overall cellularity and morphology 6 . Bone Marrow Examination is one of the important diagnostic procedures for many hematological disorders. A decrease in all three cell lines is the most common manifestation of bone marrow failure. Aplastic or hypoplastic anemia can be idiopathic in nature, or it can develop from secondary causes. Myelodysplastic anemia also can cause pancytopenia. Myelophthisic anemia may result from marrow destruction because of tumor invasion or granulomas. Patient morbidity and mortality are increased by bone marrow failure that prevents the production of one, two, or all three blood cell lines. Low amounts of mature blood cells contribute to the morbidity and mortality of pancytopenia. A high-output heart failure and tiredness might result from severe anaemia. Infections with bacteria and fungi can be more likely to affect people who have neutropenia. Spontaneous bleeding and haemorrhage can occured by thrombocytopenia. Severe pancytopenia is a medical emergency, requiring rapid institution of definitive therapy (ie, early determination of supportive care and bone marrow transplant candidates). Aplastic anemia is a syndrome of bone marrow failure characterized by peripheral pancytopenia and marrow hypoplasia (see the image below). Although the anemia is often normocytic, mild macrocytosis can also be observed in association with stress erythropoiesis and elevated fetal hemoglobin levels. Operational Definitions: Pancytopenia: A patient is said to have Pancytopenia, when peripheral smear of blood shows all of the following features;  Hemoglobin< 10g/dl  Total leucocyte count < 4,000  Platelets < 150,000  Reticulocyte count <2% Aplastic anemia: Hypocellularity i.e. decrease in the hematopoetic cells below 70% of the bone marrow on bone marrow aspiration. MATERIAL AND METHODS The study is conducted at Department of Medicine, MTI-Lady Reading Hospital, Peshawar and the duration of study is From 25- 04-2018 to 25-10-2018. It is a Descriptive cross sectional study design having sample size of 135 patients, this study using 95% confidence level and 7% margin of error, under WHO software for sample size determination. The sampling technique we have used in this study is the non-probability consecutive sampling. All adult patients with