“REDISCOVERING ARNETH COUNT” PREVALENCE OF MEGALOBLASTIC ANEMIA IN CHRONIC METFORMIN USERS AT GOVERNMENT STANLEY HOSPITAL,CHENNAI

Recent US data estimate a 6% prevalence of biochemical B12 deficiency (serum B12,<148 pmol/ L) among adult >60 years of age who are taking metformin.Arneth count- a very simple smear test to diagnose megaloblastic anemia, is almost forgotten in modern medicine era after the advent of automated analyzer. With this background we want to check check the correlation between manifestations of vit B12 deficiency with duration of MF therapy and the correlation between Arneth index with MCV in diagnosis of Megaloblastic anemia. Our observation suggests that as the duration of metformin increase, degree of hyper segmentation of neutrophils as well as MCV tends to increase and one of the earliest, notable changes in the peripheral blood in megaloblastic processes is the appearance of hypersegmented neutrophils,so that Validity of simple Arneth count can be realized, which can be performed very easily with simple microscope in early diagnosis of megaloblastic process, which is apt even in our PHC setup