• Waqar Azim
  • Shahida Parveen
  • Saadat Parveen


Background: Hemoglobin estimation is the most frequent laboratory investigation requested. Different methods include acid haematin, photometric cyanmethemoglobin estimation and automated estimation with the help of counters. Aims and objectives of the current study were to compare photometric cyanmethemoglobin method with hemoglobin estimation by Medonic automated counter. Methods: One hundred and ten adult cases were included through convenience sampling. Samples with hemolysis were excluded from the study. Blood was drawn in CP bottles. Sample was thoroughly mixed and hemoglobin estimation was done by Medonic counter as well by photometer 4010. Commercial controls were run with each batch. Results: By manual methods, results revealed mean 0.85% increase compared to automated counter. Commercial control results showed 2.3% and 2.7% coefficient of variation by Medonic counter and photometer 4010 respectively. Conclusions: It was concluded that both methods are accurate and precise, with reference range 2.61% more in manual method. It is recommended that with small samples and with parameters like hemoglobin or hemoglobin with erythrocyte sedimentation rate, manual method is cost effective and feasible. However with multiple parameters like absolute values and with very large batches, like in tertiary laboratory, automated method is time effective and feasible, provided the laboratory can bear the cost.Key Words: Hemoglobin estimation, Cell counter, Cyanmethemoglobin.


Dessparis EN. Erythropoiesis. In: Foester J, Paraskevas F, Grear JP, Rodgers GM, eds. Wintrobes clinical hematology. Williams Wilkins, Baltimore 1999; 169-227.

Wyne HE, Munawar F. Hemoglobin levels in day scholars and boarders of Fatima Jinnah Medical College. Pakistan J M Res 1997; 36(3): 113-4.

Fainbanks VF, Klee GG. Biochemical aspects of hematology. In: Burtis CA, Ashwood ER. Teitz textbook of clinical chemistry. WB Saunders Company, Philadelphia 1999; 1673-75.

Bain BJ, Bates I. Basic hematological techniques. In: Lewis SM, Bain BJ, Bates I, eds. Dacie & Lewis Practical hematology. Churchil Livingstone, Edinburg 2001; 19-46.

Daniel HR. Examination of blood. In: Beutler E, Lichtman MA, Coller BS, Kipps TJ, Seligsolin URI, eds. Williams Hematology sixth edition. McGraw Hill Medical Publishing Division 2001; 9-16.

Qureshi HJ. Comparative study of Sahli’s and Cyanmethemoglobin methods of hemoglobin estimation. Pakistan J Med Res 1999; 38(4): 149-50.

Cheesbrough M. District Laboratory Practice in tropical countries. Cambridge University Press 2000; 267-347.

Hematology section 2. The College of American Pathologists (CAP) Laboratory Accreditation Program checklists, 2000

Ward KM, Lehman CA, Leiken AM. Clinical laboratory instrumentation and automation: Principles, application and selection. Philadelphia: WB Saunders Company 1994.

Lyod PH. A scheme for evaluation of diagnostic kits. Annals of Clinical Biochemistry 1978; 15: 136-45.