TECHNICAL REPORT

ON

STUDENT INDUSTRIAL WORK EXPERIENCE

SCHEME (SIWES)

UNDERTAKEN AT

GENERAL HOSPITAL AZARE BAUCHI STATE

BY

NAME: MAIMUNA MUSA NINGI

MATRIC NO: BASUG/UG/SCI/MCB/19/000

SUBMITTED TO
DEPARTMENT OF MICROBIOLOGY BAUCHI STATE
UNIVERSITY,GADAU BAUCHI STATE

IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR

THE AWARD OF BACHELOR OF SCIENCE (BSC)
MICROBIOLOGY
 CERTIFICATION
This is to certify that, this technical report is the concise reflection of the students industrial

work experience scheme {SIWES} by MAIMUNA MUSA NINGI

BASUG/UG/SCI/19/18/00 In accordance with the department of Microbiology, Faculty of

science as part of the prerequisite for the award of B.Sc in Microbiology.

_____________________________ _____________________________
Student’s Signature Supervisor’s Signature

i
 DEDICATION

This report is dedicated to the almighty God, the giver and sustainer of life, for
His unconditional love and mercy granted to me throughout the period of my
Industrial Training.

ii
 ACKNOWLEDGEMENTS

I give thanks to Almighty God, who gave me the gift of life, and made
everything possible.

This acknowledgement would be incomplete if I fail to express my

gratitude to my lovely family most especially my parents, for their parental and
financial support to my success. My appreciation also goes to all Staff Clinical
Laboratory Department and the entire managements General Hospital Azare.

iii
 REPORT OVERVIEW

The Student Industrial Work Experience Scheme established by the

Federal Government of Nigeria was aimed at exposing student of higher
institution to acquire industrial skill and practical experience in their approved
course of study and also to prepare students for the industrial work situation
which they are likely to meet after graduation. This technical report is based on
the experiences gained during my four months of Industrial Training at General
Hospital Azare Bauchi State

This report highlights how patients are being managed and also the
several test carried out for patients such as: Full Blood Count (FBC), Packed
Cell Volume(PCV),White Blood Cell Count, Differential Count, Stool
Examination, Widal (Typhoid test), Genotype, HIV, e.t.c. I was opportuned to
work in five (4) sections which are Hematology/Immunohematology Section,
Serology Section, Clinical Microbiology Section, and Chemical Pathology
Section. These sections have exposed me to the precautions, rules and
regulations of the laboratory, how to diagnose patients and how the tests are
being analysed.

Most importantly, it describes the activities and my experience gained

during the period of the training, it also stated the problems encountered and
also gave suggestion for improvement of the scheme.

iv
 TABLE OF CONTENTS

Title page

Certification …………………………………………………………................. i

Dedication ……………………………………………………………………… ii

Acknowledgements …………………………………………………………….. iii

Report Overview ………………………………………………………….......... iv

CHAPTER ONE
1.0 About the Industrial Training Fund (I.T.F)…………………………… 1-3
1.1 About SIWES (Student Industrial Training Fund)………………… 1
1.2 Scope……………………………………………………………….. 1-2
1.3 Aim and Objective of S.I.W.E.S…………………………………… 2-3
1.4 Brief History Of General Hospital Azare…………2-3
CHAPTER TWO
2.0 The Laboratory…………………………………………………………... 4-6
2.1 Introduction to the Laboratory…………………………………….... 4-5
2.2 Safety Rules in the Laboratory……………………………………… 5
2.3 Emergency in the Laboratory……………………………………….. 5
2.4 Hazardous Materials………………………………………………… 5
2.5 Hazardous Equipments…………………………………………...…. 5
2.6 Laboratory Equipments and their Uses……………………………… 5-6

CHAPTER THREE
3.0 The Laboratory Sections and Various Tests Performed……………….. 7-28
3.1 Hematology and Immunohematolgy (Blood Bank) Sectio……… 12-16
3.2 Serology Section ………………………………………………….…. 17-19
3.3 Clinical Biochemistry Section …………………………………….… 19-22
3.4 Clinical Microbiology Section………………………………….……. 22-28
3.5 Microscopy, Culture and Sensitivity Tests …………………….…….. 28

CHAPTER FOUR
4.0 Summary, Challenges Encountered, Recommendation and
Conclusion………………………………………………………………..…. 29
4.1 Summary……………………………………………………….……... 29
4.2 Challenges Encountered ……………………………………………… 29
4.3 Conclusion ………………………………………………………….… 29
4.4 Recommendation …………………………………………………...… 29
 CHAPTER ONE

1.0 ABOUT THE INDUSTRIAL TRAINING FUND (I.T.F)

In October 1971, the federal government established the Industrial Training Fund
(I.T.F). In its policy statement no.1 published in 1973, a clause was inserted dealing with
the issue of practical skills among the locally trained professionals in the tertiary
institutions especially the Universities of Technology, Monotechnics, Polytechnics,
Colleges of Education and Technical Colleges. Section 15 of the policy statement states
clearly that “Great emphasis will be placed on assisting certain products of the post-
secondary school system to adapt or orientate easily to their possible post graduation job
environments”, subsequently leading to the launch of a scheme know as the Student’s
Industrial work Experience Scheme(SIWES).

1.1 ABOUT SIWES

The S.I.W.E.S. was launched in 1973 by the Industrial Training Fund (I.T.F) as a
programme designed to impart the undergraduate of the nation’s tertiary institutions
studying various professional courses with the practical methods of performing
professional functions to real life situations on site, in the office or even the factory and
how they apply themselves mentally, intellectually and physically in relation to what they
have been taught in the classrooms theoretically. It works with the following professional
bodies to function effectively across the tertiary institutions nationwide. These are the
Nigeria University Commission (N.U.C), National Board for Technical Education
(N.B.T.E.) and the National Commission for Colleges of Education (N.C.C.E.). Thus,
equipping the students with the necessary skills and technical knowledge to make them
highly competitive and professional individuals in the Labour Market

1.2 SCOPE
The scheme as conducted by the Industrial Training Fund (I.T.F) through their
representative liaison units and offices situated within the various institution and in major
cities or towns in Nigeria with the necessary industrial rudiments needed to corroborate,
practicalize and then actualize the required technical knowledge. The Industrial Training
experience not only puts them in real life situations buts also exposes their practical
knowledge of the course of study, consequently perfecting this knowledge thereby
producing very competent and versatile professionals.

1.3 AIM AND OBJECTIVE OF S.I.W.E.S

The aim of S.I.W.E.S is to bridge the gap between the level of knowledge acquired in
tertiary institutions and the practical application of such knowledge in the field of work.
The Objectives are:
 To provide an avenue for students in industries of higher learning to acquire industrial
skills and experience in their course of study.
 To prepare students for the work situations they are to meet after graduation.
 To expose students to work methods and techniques in handling equipment and
machinery that may not available in the educational institution.
 To make transition from school to the world of work easier and enhance students
contact for later job placements.
 To improve student’s interpersonal relationship with others in their field.
  To prove students an opportunity to apply his/her knowledge in real work situation,
thereby bridging the gap between college work and actual practice
1.4 HISTORICAL BACKGROUND OF GENERAL HOSPITAL
AZARE
General Hospital Azare was established in the year 2008 during the administration of

former Bauchi State governor DR mal.isah yuguda (MatawallanBauchi).General hospital

Azare is located at south east of Katagum local government, Bauchi state, with existence of

various unit, which are as follows: Administration block, Maternity ward, Laboratory

department, Theatre, Eye clinic, Health office, Pharmacy, A&E (Accident & Emergency),

pediatric ward, male and female wards etc. Each ward consists of bedside rows and they have

ability to occupy a maximum number of 24 patients.

The SIWES programmed was conducted at General Hospital Azare (GHA) which is a government
establishment with a laboratories scientist work. The programmed has lasted for the period of 24
weeks. The aim of this report is to summarize the various activities, test/investigation that has
been carried out at laboratory department of General Hospital Azare Bauchi state.
 CHAPTER TWO

2.0 THE LABORATORY

2.1 INTRODUCTION TO THE LABORATORY
A laboratory is a facility that provides controlled conditions in which scientific
researches, experiments, and measurements, may be performed. Hence the medical
laboratory is a laboratory where tests are carried out on clinical specimens in other to get
information about a patient’s health.

There are three sections in the laboratory, they are; Clinical Microbiology section,
Hematology/Serology section, and Clinical Biochemistry section. The overall significance
of the laboratory diagnosis is that they guide towards the administration most effective
therapy so as to restore a proper health on the patient. Laboratory safety precautions and
ethics

2.2 SAFETY RULES IN THE LABORATORY

Every laboratory is expected to adopt a code of bio-safety principles and work practice
which should be enforced and adhere to strictly by workers and visitors. All specimens
coming into and from the laboratory are being assumed to be potentially infectious and
harmful and that is why the below precautions are ensured to be taken to avoid
contamination and laboratory hazard.

 Avoid disrupting laboratory activities you must TURN OFF all cell phones and pagers:
their use is prohibited.
 All persons in laboratories, including students, staff, and visitors, shall wear safety
glasses, goggles, or face shields at all times where potential eye hazards exist
 Eating, drinking, chewing gum, and applying cosmetics are prohibited laboratory.
 Do not store food or beverages in the same refrigerators or freezers with chemicals,
biohazards, or radioactive materials.
 Never conduct unauthorized experiments or engage in horseplay in a laboratory. Please
immediately report any unsafe behaviour to the instructor.
 Wear appropriate clothing. In particular, you must wear closed-toed shoes (i.e., NO
sandals or flip-flops!) in the laboratory. If you have a long hair, tie it back. Avoid
wearing dangling jewellery.
 Wearing an iPod, Bluetooth, or any other device that interferes with hearing is not
allowed.
 Never pipette anything by mouth.
 The work area must be kept clean and uncluttered. All chemicals should be labelled and
stored properly.
 The hazards of chemicals used should be known (e.g., corrosiveness, flammability,
reactivity, stability, and toxicity).
 Always pay attention to your surroundings and be aware of what others are doing.
Always be courteous.
 Remove contaminated gloves before touching common use devices (door knobs,
faucets, equipment); discard gloves before leaving the laboratory.
  Always wash hands and arms with antibacterial soap and water before leaving the
laboratory.

In conclusion, maintaining safety in the laboratory largely rest on the shoulder of

the laboratory workers. Adequate safety and good laboratory practice can be avoided
irrespective of the location, staff strength and availability of sophisticated safety cabinets
in the laboratory. What are required are highly standards of hygiene by the laboratory
workers to achieve good results in their daily occupational practice.

2.3 EMERGENCY IN THE LABORATORY

 Know where to find the nearest exit in case of fire or other emergency.
 Know the whereabouts of the nearest fire extinguisher, fire blanket, first aid kit, eye
wash equipment, shower and telephone.
 In case of fire, clear out of the laboratory first, and then call an emergency number.
2.4 HAZARDOUS MATERIALS
 Both liquid and dry chemicals can be flammable, poisonous, carcinogenic, etc. Pay
attention to special instructions, such as to; work with a substance only in a fume
hood.
 Biological hazards include bacteria and body fluids, such as blood. Handle with
appropriate care, and dispose of biological hazards as instructed.
 Dispose of hazardous materials as instructed. Never put anything down the sink
without checking with an instructor.
 Clean up spills and broken glass. Don't handle broken glass with your bare hands. Use
a broom and dustpan, and throw away all broken glass and disposable glass pipettes,
coverslips, and other sharp or easily breakable glass in a container for glass disposal
only. Notify the instructor immediately of all incidents.
2.5 HAZARDOUS EQUIPMENTS
 If appropriate, turn off equipment that isn't being used.
 Do not use a Bunsen burner unless instructed to do so.
 Keep liquids and chemicals, especially flammable materials, well away from any heat
source or electrical equipment.
 If any electrical equipment is malfunctioning, making strange noises, sparking,
smoking, or smells "funny," do not attempt to shut it off or unplug it. Get an instructor
immediately. It is imperative that the instructor know of any equipment problems.
2.6 LABORATORY EQUIPMENTS AND THEIR USES

 Microscope: Is used to examine samples and to analyze their contents that are not
visible to the naked eye. It is used to count pathogen and other cells and to view under
x10, x40, and x100 objectives.

 Autoclave: For Sterilization

 Centrifuge: Is used for spinning specimen e.g. urine to enable separation into
constituents or components e.g. blood into serum and plasma.

 Refrigerator: Provides suitable temperature for storage and preservation of reagents,

unused media, blood samples etc.
 Bunsen burner: Serves as the source of heat for sterilizing wire loop, surgical forceps
and other metal instruments to be used for analysis.

 Weighing Balance: Use for measurement.

 Wire loop: It is used for streaking specimen on culture plates and it can also be used for
making smear of samples on slides.

 Lancet: It is a sterile needle used to prick the thumb for the collection of blood
samples.

 Capillary tube: It is used for the collection of blood samples to determine the packed
cell volume.

 Universal bottle: used for sample collection e.g. urine, stool, semen

 Glass slide: It is used for the preparation of samples to be viewed directly under the
microscope.

 Sterile swab stick: Is used for the collection of samples to directly from the sight of
infection e.g. Ear, nose, vagina, cervix, etc.

 Sampling bottles: They are bottles used for the collection of blood samples e.g.
universal bottle, fluoride oxalate bottle, Ethylene-Di-amine-Tetra acetic Acid bottle
(EDTA), Lithium Heparin bottle, plain bottle.

 Incubator: used for culturing or drying of microorganism.

 Micro heamatocrit centrifuge machine: it is used to spin sample for the analysis of
packed cell volume of blood sample.

 Water bath: Use as heating apparatus

 Micro haematocrit reader: used to read the packed cell volume in percentage.

 Tourniquet: it is tightened on patient hand in the collection of blood sample in order to

get a prominent vein before incision.

 Needle and Syringe: It is used for the collection of blood samples.

 Macro centrifuge machine: It is used for the separation of blood samples in order to
get the plasma and also used for the separation of urine sample so as to get the
supernatant and the specimen

 Glucometer: used to check for the sugar level in the body with the aid of its strip.

 Hematology analyzer: Is used for the analysis of Full Blood Count (FBC).
 CHAPTER THREE

3.0 THE LABORATORY SECTIONS AND VARIOUS TESTS PERFORMED

3.1 HEMATOLOGY AND IMMUNOHEMATOLGY (BLOOD BANK) SECTION

In hematology section, the analysis is carried out using the whole blood sample of patient
for diagnosis of hematological diseases and abnormalities. Blood samples are collected in
EDTA bottle for analysis.
Immunohematology Section Also known as the blood bank performs tests to provide
blood and blood products to patients for transfusion purposes. The blood bank
technologist relies on the phlebotomist to perform identification of the patient without
error, since patients will die if given the wrong blood type. The analyses carried out in
these sections include: Packed cell volume, Full blood count, Erythrocyte sedimentation
rate (ESR), Blood film for microfilaria and ABO/D (Rh) typing, Antigen typing, Blood
grouping, Cross matching, respectively.

3.2.1 MATERIALS USED IN HAEMATOLOGY AND IMMUNOHEMATOLOGY

SECTION
Pipette, Haematocrit centrifuge machine for PCV, Haematocrit centrifuge reader for PCV,
Micro Haematocrit analyzer for Full Blood Count, Macro, Microscope, Microscopy slide,
Electrophoresis machine, Cover slip, Bunsen burner, Plasticine, Sterile capillary tube,
Wash bottle, Westergren tubes, Stop watch, Test tubes, Refrigerator, Racks, Various
disposable waste bins, Tiles, Scissors, Ethylene diamine tetra acetic acid (EDTA),
Leishman stain, Normal saline, Water, Antisera for blood group, Buffer solution, Oil
immersion.

3.2.2 COMPLETE BLOOD COUNT (CBC) TEST

 Introduction: The complete blood count of a blood sample helps to know the total cell
in the whole blood. It determines the total haematocrit (HCT), hemoglobin (HGB), red
blood cell (RBC) count, white blood cell (WBC) count, platelet count, mean
corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC),
mean corpuscular volume (MCV), differential (DIFF)-done on a blood smear

 Aim: To deduce the total counts of all blood components

 Equipments/Apparatus: Hematology analyzer, whole blood sample in an EDTA

bottle.
  Procedure: Blood sample was collected into an EDTA bottle (Lavender Stoppered
Tube) through venipuncture and was mixed with anticoagulant by inverting the bottle
gently 8 times. The blood sample was placed under the hematology analyzer sensitive
probe. The probe button was pressed so that the probe can pick the sample into the
machine for analysis. The result was displayed on the screen of the machine and then
printed out.

 Conclusion: The count of platelet, white blood cell and differentials, haemoglobin,
granulocyte and all other cells in the blood samples was determined

3.2.3 PACKED CELL VOLUME (PCV) TEST

 Introduction: The packed cell volume is the volume occupied by the packed red cell
after a volume of anti-coagulated venous blood is fully centrifuged into plasma and red
blood cell. The volume of packed cell is expressed as a percentage of the original
volume of the blood.
 Aim: To estimate the relative mass of red blood cells present in a blood sample in
percentage volume.
 Equipments/Materials: Haematocrit reader, Bunsen burner, Micro haematocrit
centrifuge, Heparinised capillary tube, whole blood in an anticoagulant bottle (EDTA),
Micro haematocrit reader, an absorbent cotton wool.
  Procedures: The blood sample was collected into an EDTA bottle. The heparinized
capillary tube was filled to 2/3 length of the tube from the blood sample and One end of
the tube was sealed with flame using the Bunsen burner, then absorbent cotton wool
was used in cleaning the tube before placing in the centrifuge. The sealed tube was
placed in the micro- haematocrit centrifuge machine, thereby placing the sealed end
outward to touch the base of the spinner. The sealed tube was spun in the haematocrit
centrifuge at 12,000/13,000rpm for 5 minutes. The spun tube was placed on the micro
haematocrit reader to read the result in percentage, positioned in slot so that the base
line intersects the base of red cells and tube holder was moved so that the top line
intersects the top of plasma, then knob was adjusted so that the middle line intersects
the top of red cell.

The percentage packed cell volume on the scale was read.

 Result: Adult: Normal range for male 37-50%

Normal range for female 35-45%
Children: Normal Range 29-41%

 Conclusion:
Factors affecting the accuracy of PCV are; Unsteady power supply, Poor blood sample
collection, Parallax error while reading the result on the haematocrit reader, Incorrect
blood to anticoagulant ratio, Over spinning of the blood in the centrifuge, Lysing of the
blood by flame or delay in spinning

Bio- medical significance: Low PCV value indicate shortage of blood

3.2.4 ERYTHROCYTE SEDIMENTATION RATE (ESR)

 Introduction: Erythrocyte Sedimentation rate test is used to detect inflammation
infections, cancer, and autoimmune diseases; it is also use to monitor whether an illness
is responding to treatment. It is a screening test so cannot be used to diagnose a specific
disorder

 Aim: To determine the rate of inflammation of blood using Westergren method.

 Equipment/Apparatus: Sodium Citrate bottle, ESR rack, Westergren glass rod.

  Procedure: Blood sample was collected into an EDTA bottle and inverted 8 times to
enable the action of the additive and then poured into the Westergren tube containing
sodium citrate and was mixed gently again by inverting the tube 8 time. The Westergren
glass rod was forced into the tube and blood rises to zero mark. The sample was placed
in a vertical stand on the ESR rack and timed for one-hour. The result was recorded just
after one-hour in millimeters

 Result: The normal range of the sedimentation in adult

Men under 50 years………………………..less than 15mm/hr
Men over 50 years………………………….less than 20mm/hr
Women under 50 years………………..........less than 20mm/hr
Women over 50 years……………………….less than 30mm/hr
The normal range of the sedimentation in children
New born ………………………………………… less than 2mm/hr
Neonatal to puberty ……………………………..3- 13mm/hr

 Conclusion: The ESR test does not diagnose a particular kind of infection but rather tell
if further medication should be given. It is usually done to indicate if there are abnormal
proteins in the body
3.2.5 BLOOD GROUPING AND GENOTYPING TEST
 Introduction: Blood grouping of the A B O system is determined with Anti-A, Anti-B,
and Anti-D sera, which form agglutination complex with antibodies found in the blood
sample.

 Aim: To determine the group and the rhesus of a patient’s blood

 Equipments/Materials: Clean free grease tile, Pasteur pipette, Whole blood sample in
an EDTA bottle, distilled water, applicator stick, test tube rack, electrophoresis machine
and tank, clean white tile, cotton wool, applicator stick, cellulose filter paper, gloves.

 Reagents: Anti-A, Anti-B, Anti-D sera, Buffer for balancing, normal saline
 Procedure:
For blood Grouping: The blood sample was collected into an EDTA bottle through
venipuncture. 10ul of blood was placed 3 spots on the tile with the aid of Pasteur
pipette. The antisera A, B and D were placed carefully on each spots, ABO of the
grouping system on the tile respectively and an applicator stick was used to thoroughly
mix the drop of blood with the anti-sera one after the other without contamination. The
tile was gently rocked from side to side for 3 minutes to allow agglutination occurrence,
then result was observed.

For Genotyping: Cells were washed two to three times in a test tube containing normal
saline after which, a drop of washed cells were placed on a tile. This is followed by the
hemolysis of blood on the tile and the placement of AS and AA control using applicator
stick, after making sure that the buffer inside the electrophoresis tank covered the
electrode, the cellulose paper was placed on the tank, which is then covered and mains
(current) switched on. Reading was recorded after 5-10mins

 Result: The result for blood genotype was taken by studying the movement and
separation of hemoglobin molecule.
  Conclusion: The result was observed according to the agglutination that occurred in
each spots on the tile. Anti D determines the present of the rhesus ‘D’ factor in blood
group.
Factors that affect blood grouping are; wrong labeling of spot and confusion of anti-
sera with spots, Contamination of test card or tiles with detergents, Expired anti-sera
Bio-medical significance; Blood transfusion, Blood compatibility, Antenatal
screening#

3.3 SEROLOGY SECTION

Tests done in this department are designed to detect the body's response to the presence of
bacterial, viral, fungal, parasitic and other conditions which stimulate detectable antigen-
antibody reactions in a test system to aid in the diagnosis of the patient. Most tests
performed in this section are carried out under the principles of Immunoassay, some of
them are; Cold agglutinins (CAG) - specimen must be kept warm, Rheumatoid arthritis
(RA), VDRL, to diagnose syphilis, Pregnancy Testing, Widal
3.3.1 HBs.Ag TEST FOR HEPATITIS, VDRL (VENERAL DISEASES RESEARCH
LABORATORY) TEST FOR SYPHILIS USING STRIPS
 Introduction: HBsAG is a rapid immunochromatographic test for the qualitative
detection of Hepatitis B surface Antigen in human serum/plasma, it can be used for
prenatal or transfusion screening, and during acute infection or chronic carriage of the
Hepatitis B virus. Early detection of infection is essential for rapid initiation of adequate
treatment.
VDRL test is a screening test for syphilis. It measures substances called antibodies that
body may produce if it comes in contact with the causative agent of syphilis, which is
called Treponema pallidium
 Aim: To determine the presence or absence of hepatitis and syphilis in the body
system.
 Materials: HBsAG Test strips, VDRL test strip EDTA bottle, Centrifuge, clean test
tube
 Specimen: Serum.
 Procedure: The patient blood sample was collected into a plain bottle through
venipuncture. The blood sample was spun in a centrifuge for 5 minutes, after spinning
the serum was separated carefully into a clean test tube by the use of Pasteur pipette and
then test strip was immersed vertically into the serum for 10 minutes. The observation
was taken after 10mins.
 Result: Appearance of a line at the Control region and another at the Test indicates
positive result, while an appearance of a line at the Control region only, indicates
negative result. When there is no appearance of any line, means the test in invalid and
as to be redone using new kits
3.3.2 BLOOD PREGNANCY AND URINE PREGNANCY TEST, USING TEST STRIP.
 Introduction: A pregnancy test is done to determine if a woman is pregnant, pregnancy
hormone called the Human Chorionic Gonadotrophin (HCG) in to the blood and urine.
Pregnancy test detects the hormone HCG and confirms the pregnancy.
 Aim: to determine the presence of pregnancy hormone (HCG) in the blood and urine.
 Materials: pregnancy test strip, plain bottle, needle and syringe, wet swab, cotton wool,
centrifuge, clean test tube.
 Specimen: blood (serum) and urine
 Procedure for Blood Pregnancy Test: Patient’s blood was collected through
venipuncture into plain bottle, blood sample was spun in a centrifuge for 5 minutes, and
the serum was separated carefully into a clean test tube by the use of Pasteur pipette.
The pregnancy test strip was immersed vertically into the serum for 5 minutes. The strip
was removed and the reaction was observed.
 Procedure for Urine Pregnancy Test: The patient’s urine sample was collected into
universal sterile bottle and the pregnancy test strip saw immersed into the urine for 3
seconds, then removed and left for 5mins and the result was observed.
 Result: An appearance of a line at the Control region and another at the Test indicates
positive result, while an appearance of a line at the Control region only, indicates
negative result. When there is no appearance of any line, means the test in invalid and
as to be redone using new kits

3.3.3 WIDAL TEST

 Introduction: Typhoid fever is an infectious disease caused by the Salmonella typhi, it
is diagnosed by Widal test which employs an antigen-antibody reaction to screen for the
presence of Salmonella typhi and paratyphi antibodies in the sample serum.. the
organism is transmitted by water or food contaminated by faeces of typhoid victims or
carriers, that is a person who harbor it without showing signs and symptoms.
  Aim: To investigate the presence of Salmonella typhi and paratyphi in the serum of
patient
 Materials: Test card/white tiles, Pasteur pipette, centrifuge, antigen kit and stop watch
 Procedure: 3-5ml of blood was collected from the patient through venipuncture into a
plain bottle and the blood was spun at 3000rev per min for 5minutes so as to separate
out the plasma. A dropper was used to carefully drawn the antigen kits and a drop was
placed on each of the test card in pairs of four spots labeled O, OA, OB, OC and H, HA,
HB, HC and a drop of serum was carefully added into the antigen respectively with the
aid of Pasteur pipette and mixed together with the aid of an applicator stick the test card
was rocked gently, the rate of reaction and agglutination was observed at an interval of
30sec, 1min, 2mins, and 5mins
 Result
Reactive: visible agglutination on spot H and others indicate the present of Salmonella
antibodies
Non reactive: no visible agglutination indicates absence of Salmonella antibodies
Widal test: Positive
Highly reactive……………………………….1:320 (agglutination reaction before 60
seconds)
Very reactive……………………………….1:160(agglutination reaction before 120
seconds)
Reactive ………………………………………1:80(agglutination reaction before 180
seconds)
Widal test: Negative
Non significant…………………………………1:40
Non significant………………………………….1:20
Not reactive…………………………………….Nil
3.3.4 RETROVIRAL TEST
 Introduction: This is the diagnosis for Human Immunodeficiency Virus, an infectious
agent that causes Acquired Immunodeficiency Syndrome (AIDS), a disease that leaves
a person vulnerable to life threatening infection. HIV transmission occurs when a
person id=s exposed to body fluids infected with virus, such as blood, semen, vaginal
secretions and breast milk.
 Aim: To investigate the presence of HIV 1 and 2 in patient’s blood
 Materials: Determine kits, Unigold kit, Stat pack Buffer, Plain bottle, pipette
 Specimen used: Serum
 Procedures: The blood sample, collected in a plain bottle was centrifuged at
3000rev/min to allow separation. The serum was picked with a pipette and two drops
was placed on the sample pad of the determine kit and allowed to penetrate then left for
15min. If result proves positive, the Unigold kits would be used following the same
procedure. After using Unigold to confirm the result and proves negative the Stat pac
kit would be used to as a confirmer.

 Result: The appearance of a line at the Control region and another at the Test region
indicates a Positive result, while the appearance of a line on the Control region only,
and indicates a Negative result.
3.4 CLINICAL BIOCHEMISTRY SECTION
This section deals with chemical analysis of serum or plasma in which many diseases of
the major organs systems can be diagnosed such as heart attacks, hepatitis, renal failure,
diabetes, Liver function, etc Blood sample samples may collected into the Serum Separator
Tube or Lithium Heparin. Test performed in this department are:
 Blood Glucose; FBS, FBS2HPP, RBS, OGTT
 Blood lipids (fat) Cholesterol level.
 Electrolytes - sodium, potassium, CO2- (Bicarbonate), and chloride
 Uric acid
 Creatinine and Blood Urea Nitrogen (BUN)
 Liver function tests -AST, ALT, alkaline phosphatase, and bilirubin.
3.4.1 MATERIALS AND EQUIPMENTS USED IN CLINICAL BIOCHEMISTRY
SECTION
Personal Protective Equipments (PPE), Blood collection materials Different tubes like;
Lithium Heparin, Serum Separator and Fluoride Oxalate tubes, Chemical reagents and
detergents, automated machines, centrifuge, Glucometer and Accu check.

3.4.2 BLOOD GLUCOSE

Test Overview: A blood glucose test measures the amount of a type of sugar, called
glucose, in your blood. Glucose comes from carbohydrate foods. It is the main source of
energy used by the body. Insulin is a hormone that helps your body cells uses the glucose.
Insulin is produced in the pancreas and released into the blood when the amount of glucose
in the blood rises.
Normally, your blood glucose levels increase slightly after you eat. This increase causes
your pancreas to release insulin so that your blood glucose levels do not get too high.
Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves,
and blood vessels.
There are several different types of blood glucose tests.

1. Fasting blood sugar (FBS) measures blood glucose after you have not eaten for at least 8
hours and at most 14 hours. It is often the first test done to check for prediabetes and
diabetes Materials/Reagents: Fluoride Oxalate and other blood collection equipments,
Centrifuge, Insulin kit (NORUDIA® Insulin) Liquid reagent, automated machine,
Glucometer or Accu Check.
Procedure: Patients is ensured to have fasted for the required period of time before
sample collection into a Fluoride Oxalate tube, and then the blood samples are centrifuged
in order to obtain plasma. The plasma obtained was decanted into a small cap which is
then transported into the machine for analysis. The results are then deduced which is
measured in mg/dl
Normal Result: Normal result is less than or equal to 100mg/dl

2. 2-hours post-prandial blood sugar measures blood glucose exactly 2 hours after you
start eating a meal. This is not a test used to diagnose diabetes.
Procedure: After performing the same procedure for FBS sample collection, patients are
then asked to return 2hrs as soon as they start eating, then another venepucture is made and
the same procedure is repeated.
 Result: Normal results is less than 140mg/dl for people age 50 and younger; less than
150mg/dl for age 50-60; less than 160mg/dl for age 60 and older.

3. Random blood sugar (RBS) also known as casual blood glucose test. RBS measures
Blood glucose regardless of when you last ate. Several random measurements may be
taken throughout the day. Random testing is useful because glucose levels in healthy
people do not vary widely throughout the day. Blood glucose levels that vary widely may
mean a problem.
Materials/Reagents: Same materials as FBS.
Procedure: Glucometer or Accu Check are mostly used to perform this test. The
Glucometer corresponding code strip is inserted and loaded, Patient’s thumb is disinfected
using a70% alcohol pad and pricked with lancet. The blood is wiped off in order to avoid
sampling error, pressure is applied below to enable blood flow again and the blood is
placed on the strip. The result is then taken
Normal Results: 80-120mg/dl before meals and 100/140mg/dl after meals

4. Oral glucose tolerance test is used to diagnose prediabetes and diabetes. This test is a
series of blood glucose measurements taken after you drink a sweet liquid that contains
glucose. This test is commonly used to diagnose diabetes that occurs during pregnancy
(gestational diabetes). This test is not commonly used to diagnose diabetes in a person who
is not pregnant.
Materials/Reagents: : Fluoride Oxalate and other blood collection equipments,
Centrifuge, Insulin kit (NORUDIA® Insulin) Liquid reagent, automated machine, glucose
solution
Procedure: Patient is asked to take the required gram of sugar solution before sample
collection. Samples are collected five times at 30min intervals and lastly collected once
1hr after the last sample collection of 30min intervals. The result is the deduced by the
machines.
Results: 75g of glucose; fasting 92mg/dl or more; 1hr 180mg/dl or more; 2hrs 153mg/dl
or more
100g of glucose; more than or equal to 140mg/dl

5. Haemoglobin A1c (also called glycated haemoglobin) measures how much sugar
(glucose) is stuck to red blood cells. This test can be used to diagnose diabetes. It also
shows how well your diabetes has been controlled in the last 2 to 3 months and whether
your diabetes medicine needs to be changed.
Materials/Reagents: : Fluoride Oxalate and other blood collection equipments,
Centrifuge, Glycohemoglobin kit (NORUDIA® HbA1c) , automated machine, glucose
solution
Procedure: Same procedure as FBS
Result: The result of your A1c test can be used to estimate your average blood sugar level.
This is called your estimated average glucose, or eAG which ranges: (126, 154, 183, 212,
240, and 289) mg/dl

3.4.3 ELECTROLYTES TEST

Test Overview: Electrolytes are minerals found in the body tissues and blood in form of
dissolved salts which helps transfer nutrients into body cells and waste of them.
Electrolytes also maintain a healthy water balance and help stabilize body’s acid/base (pH)
 level. The main electrolytes in the body are; Sodium, and Potassium others are; CO 2-
(Bicarbonate), and chloride
3.4.4 URIC ACID TEST
Test Overview: This is a kidney or liver function test, which measures the amount of uric
acid present in a blood sample. It is produced from the natural break down of body’s cells
and from food eaten and then filtered out by the kidneys and passes out of the body in
urine but if too much is being produced in the body or the kidney is unable to filter them
normally, it becomes high and may cause solid crystals from within joint, which may lead
to a painful condition called gout. These uric crystals can build up in joint and nearby
tissues, thereby forming hard lumpy deposits called tophi
Results: Normal Range; in men 3.4 – 7.0mg/dl, in women 2.4 – 6.0mg/dl, in children 2.0 –
5.5 mg/dl

3.4.5 BLOOD UREA NITROGEN AND CREATININE TEST

Test Overview: This test is used to depict the function of kidney. Blood Urea Nitrogen
and Creatinine test can be used together to find the BUN-to-Creatinine ratio and when
these substances are high in the blood it may lead to heart failure, dehydration. Blood urea
nitrogen (BUN) measures the amount of Nitrogen in your blood that comes from the waste
product urea. Urea is made when protein is broken down in your body. Urea is made in the
liver and passed out of your body in urine.
Normal Results: Blood Urea Nitrogen (BUN); Adults: 10-20mg/dl, Children: 5-8mg/dl
Blood Creatinine; Men: 0.6-1.2mg/dl, Women: 0.5-1.1mg/dl, Children; 0.4 to 1.0mg/dl
3.4.6 LIVER FUNCTION TEST
This is a group of blood tests that detects inflammation and damage to the liver and also
check how well the liver works. Liver function test includes ALT (Alanine amino trans
ferase) , AST (ASpartate aminotransferase others are PT, INR, albumin, bilirubin ALP
(Akaline phosphatase)

3.5 MICROBIOLOGY SECTION

Microbiology involves the study of microbes. Although, microorganisms are generally
beneficial and essential to life some are, however, pathogenic and cause infectious
diseases. The diagnostic microbiology laboratory is engaged in the identification of
infectious agents. These infectious agents are broadly classified as viruses, bacteria,
mycostic agents and parasites (Protozoans and Helminthes) also this section analyses
body fluids and tissues for the presence of pathogenic microorganisms primarily by
means of culture and sensitivity (C&S). Results of the C&S tell the physician the type of
organisms present as well as the particular antibiotic that would be most effective for
treatment

3.5.1 BASIC RULES FOR WORKING IN THE MICROBIOLOGY LABORATORY,

 While working in the laboratory, it is important that you must adhere to the following
basic rules;
 Be methodical and orderly in habits; keep the work area clean especially before leaving
the laboratory and disinfectant it thoroughly at the end of day.
 Wash hands frequently with soap and water
 Before leaving the laboratory, place the discarded glassware into the designated place.
  Cultures are kept under incubation and should be inspected in the morning and findings
must be carefully.
 Send the laboratory reports promptly. In case of emergency a special report is
dispatched or communicated by telephone.
3.5.2 GENERAL REMARKS
 All specimens for culture must be collected prior to the therapy. If the patient is on
antibiotic, inform the microbiologist so that he/she can take measures.
 Collect the specimen in adequate amount from the infectious site. This usually
instructed by the physician.
 Always use the sterile bottle to transporting the specimen.
 All specimen must be accompanied by a request slip with complete information, h on
the patient name, age, sex, hospital number, source of specimen and clinical information
is very important in order to choose the appropriate medium for the culture.
 Enter the details in the laboratory register and performed direct examination of the
specimen before choosing the media for the culture.
 All containers used for holding microbiological specimens must be sterilized before
used. Such as test tube, culture tube with and without cap, and plates, container to
collect sputum specimen, blood specimen for microbial culture, penicillin bottles for
collection of spinal fluid and other specimen container (universal bottle) for collection
of urine specimen and stool specimen.

3.5.2 MATERIALS/APPARATUS USED IN MICROBIOLOGY SECTION

Inoculating loop, Bunsen burner, Incubator, Weighing balance, Spatula, Microscopy slide,
Cover slip, Staining rack, Medium plates, Sensitivity disc, Forcep, Cotton wool swab.

3.5.3 INTRODUCTION LABORATORY GROWTH MEDIA

These are classified into six types: (1) Basal media, (2) Enriched media, (3) Selective
media, (4) Indicator media, (5) Transport media, and (6) Storage media.
 1. Basal Media. Basal media are those that may be used for growth (culture) of bacteria
that do not need enrichment of the media. Examples: Nutrient broth, nutrient agar and
peptone water. Staphylococcus and Enterobacteriaceae grow in these media.

2. Enriched Media. The media are enriched usually by adding blood, serum or egg.
Examples: Enriched media are blood agar and Lowenstein-Jensen media. Streptococci
grow in blood agar media.

3. Selective Media. These media favour the growth of a particular bacterium by inhibiting
the growth of undesired bacteria and allowing growth of desirable bacteria. Examples:
MacConkey agar, Lowenstein-Jensen media, tellurite media (Tellurite inhibits the growth
of most of the throat organisms except diphtheria bacilli). Antibiotic may be added to a
medium for inhibition.

4. Indicator (Differential) Media. An indicator is included in the medium. A particular

organism causes change in the indicator, e.g. blood, neutral red, tellurite. Examples: Blood
agar and MacConkey agar are indicator media.

5. Transport Media. These media are used when specie-men cannot be cultured soon
after collection. Examples: Cary-Blair medium, Amies medium, Stuart medium.

6. Storage Media. Media used for storing the bacteria for a long period of time. Examples:
Egg saline medium, chalk cooked meat broth. The survival and growth of microorganisms
depend on available and a favorable condition environment. Culture media are nutrient
solutions used in laboratories to grow microorganisms. The method for the preparation of
basic microbiology media is given below. Sterilization is at 121c for 15minutes.pH values
are 7.0 unless stated otherwise.

3.5.4 COMMON MEDIA IN ROUTINE USE

1. CLED Agar (Cysteine Lactose Electrolyte Deficient): is a non-selective differential
plating medium for the growth and enumeration of urinary tract microorganism.
Preparation: 36.0g of medium is suspended in one liter of distilled water, slowly heated
and frequently stirred. Boiled for a minute and sterilized at 121OC for 15minutes and
poured into Petri dishes. Plates were inverted when solidified for storage purposes and to
avoid moisture

2. MacConkey Agar. Most commonly used for enterobac teriaceae. It contains agar,
peptone, sodium chloride, bile salt, lactose and neutral red. It is a selective and indicator
medium:
a) Selective: as bile salt does not inhibit the growth of enterobactericeae but inhibits
growth of many other bacteria.

b) Indicator: medium as the colonies of bacteria that ferment lactose take a pink colour
due to production of acid. Acid turns the indicator neutral red to pink. These bacteria
are called 'lactose fermenter', e.g. Escherichia coll. Colourless colony indicates that
 lactose is not fermented, i.e. the bacterium is non-lactose fermenter, e.g. Salmonella.
Shigella, Vibrio.
Preparation: 50g of the Agar was suspended and measured into one liter of purified
water and mixed thoroughly and was heated with frequent agitation, then boiled for
one minute to completely dissolve the powder. The Agar was autoclaved at 121 OC for
15minutes.

3. Chocolate Agar or Heated Blood agar. Prepared by heating blood agar. It is used for
culture of pneumococcus, gonococcus, meningococcus and Haemophilus. Heating the
blood inactivates inhibitor of growths.
Preparation: 2litres of distilled water was added to 144g of agar powder. Autoclaving
was done at 121OC for 15minutes and cooled till 45OC then 5% of defribrinated blood was
added. Heated slowly and evenly to 65OC, cooled till 45OC and poured into plates

4. Blood Agar. Most commonly used medium. 5-10% defibrinated sheep blood is added to
melted agar at 45-50°C. Blood acts as an enrichment material and also as an indicator.
Certain bacteria when grown in blood agar produce haemolysis around their colonies.
Certain bacteria produce no haemolysis. Types of changes:
(a) Beta ( β ) haemolysis. The colony is surrounded by a clear zone of complete
haemolysis, e.g. Streptococcus pyogenes is a beta haemolytic Streptococci.
(b) Alpha (α ) haemolysis. The colony is surrounded by a zone of greenish discolouration
due to formation of biliverdin, e.g. Viridans streptococci, and
(c) Gamma ( γ ) haemolysis, or, No haemolysis. There is no change in the medium
surrounding the colony,

5. Nutrient Broth. 500 g meat, e.g. ox heart is minced and mixed with 1 litre water. 10g
peptone and 5 g sodium chloride are added, pH is adjusted to 7.3. Uses: (1) As a basal
media for the preparation of other media, (2) To study soluble products of bacteria.
 3.5.5 DISPOSAL
Once the Petri dishes have been taped shut, they should not be opened again. All
microorganisms grown during the experiment should be killed before discarding. The best
way to dispose of bacterial cultures is to pressure sterilize them in a heat stable biohazard
bag. If autoclaves or pressure cookers are not available or large enough to make this
convenient, an alternative is to bleach the plates. Saturate the plates with a 20% or "1 in 5"
household bleach solution (in other words, 1part bleach and 4 parts water). Let them sit
and soak overnight in the bleach solution before disposing of them. Please note that the
bleach solution is corrosive and needs to be thoroughly removed afterwards. In addition,
the plates can be incinerated if access to an incinerator is available.

3.5.6 PRECAUTIONS TAKEN WHEN PREPARING MEDIUM

Do not talk when pouring medium on plates and when culturing the sample on plates to
avoid contaminants as a result of unwanted bacterial or enzymes through saliva.
The degree at which we incubate any cultured sample is always at 37c to avoid the death
of the microorganism.

3.5.7 GRAM STAINING

 Introduction: In this section, the staining of bacteria as a means for identification is
done. Bacteria are being identified as Gram-Negative or Positive on the basis of their
cell wall thickness after staining. Gram positive bacteria hold the dye and appear purple
while Gram-Negative bacteria release the dye and appear red.
 Aim: To identify the gram-negative and the gram positive bacteria.
 Apparatus: Stop watch, Normal saline, Clean grease free microscopic slide, Gentian
violet, Lugol’s iodine, 95% ethyl alcohol, Neutral red, Microscope, Sterilized
inoculating loop.
 Procedure: The organism was isolated and smeared using the sterilized inoculating
loop in a drop of normal saline on a clean grease free microscopic slide. It was left to
Air-dry.
The smear was placed on a staining rack, and was flooded with Gentian violet solution
for 30seconds. It was rinsed with water. The smear was again flooded with Lugol’s
iodine for 30 seconds. It was rinsed with water and the smear was decolorized with 95%
ethyl alcohol for 30 seconds, It was rinsed with water again.
The decolorized smear was counter-stained by flooding with neutral red for 30 second
and was rinsed with water. The back of the slide was cleaned with cotton wool and
allowed to Air-dry. The slide was mounted on the microscope after air-drying and was
examined under ×100 immersion objectives. The result was recorded.
 Sensitivity Test (Result): If the bacteria are gram positive, a positive sensitive disc is
used while a negative sensitive disc is used for gram negative bacteria. A pure colony
was sub-cultured on a Nutrient medium and sensitive disc was picked with the aid of a
sterile forceps, and placed on the medium, then the plate was incubated for 24 hours at
37OC. The plate was read after 24hours of incubation to observe zone of inhibition and
resistance. Sensitivity test is also done for pathogens that grow on the media by taking a
colony of the organism, streak on the sensitivity agar and add antibiotics discs and
incubate for 24hours at 37OC.
3.5.8 PROCEDURE FOR AUTOCLAVING
 The inner element was filled with water and allowed to cover the surface of the element,
The medium were arranged in the sample bucket and the machine was covered and
screwed tightly by holding the screw opposite each other and the wing nut was screwed
tightly.

The switch on button was on and also the outlet valve was opened down so as to increase
the temperature of the steam on the workload.

It was sterilized at 121⁰C for 15minutes. The safety valve was closed at 120⁰C and at
121⁰C, button was switched off. The medium were allowed to cool for 47⁰C before
pouring in the petridish

Principle behind Autoclaving.

The principle behind these sterilization methods is based on the temperature and the type
of autoclaving operation performed. Autoclaving operation at 121⁰C is referred to as
culture media autoclave.

3.6 MICROSCOPY, CULTURE AND SENSITIVITY TESTS

Microscopy involves the examination of specimen under the microscope, Culture refers to
the microorganisms that grow on the culture medium after inoculation and incubation
while sensitivity tests determines the antibiotics which will be administered to the patients.
The cultured plates are incubated for 24hours at 37oC to facilitate the growth of the
organism and chocolate plates were incubated in a candle jar to facilitate the growth of
both aerobic and anaerobic microbes while other plates were incubated aerobically.

3.6.1 STOOL ANALYSIS

  Introduction: Stool analysis involves the collection and analysis of faecal matter to
diagnose the presence or absence of a medical condition. During the outbreak of cholera
or diarrhea,food microbiologist collect stool sample into sterile universal bottle from
victims for faecal examination in the laboratory.
 Aim: To determine cysts and ova in the stool of a patient.
 Materials/Apparatus: Clean microscopic slide, drop of saline, binocularmicroscope,
swabstick, coverslip, and a loop.
 Procedures: Sample was collected into a bottle, a drop of normal saline was mounted
on a clean microscopic slide and mixed it with a small portion of fresh faeces with a
loop. The slide was covered with a cover slip and the viewed under the low-power
objective by using *10 and *40 for clear viewing.
 Results: The results were viewed in two ways which are microscopic and macroscopic;
1. Macroscopic-----------------Hard, dark ,brown stool formed with no mucus or blood
seen.
2. Microscopic-----------------Present of Ascaris lumbricoides .
3.6.2 URINE MICROSCOPY CULTURE AND SENSITIVITY (M/C/S)
Urine for microscopy culture and sensitivity is an array of tests performed on urine
samples to examine the presence or absence of cells such as; epithelial cells, pus cells, red
blood cells, yeast cells, crystals, and bacteria. It is one of the most common methods of
medical diagnosis.
 Aim: To identify parasites and Bacteria cell in the urine of individual.
 Materials: Microscope, microscopy slide, centrifuge, inoculating loop, urine sample,
medium plates; Macconkey agar and CLED agar, Nutrient agar, Gram staining reagents,
Sensitivity disc, Incubator, source of heat.
 Procedures:
Microscopy: 5ml of the urine was transferred for spinning in a bench centrifuge at
30000rev/min for 5minutes. The sediment was concentrated in the test tube by decanting
off the supernatant.
A small drop of the sediment was placed on a clean slide covered with a cover slip as wet
preparation and then mounted on a microscope. The slide was examined using x40
objective lens.
Culture: A loopful of the sample was used to make a streak on the Agar plates.
The plates were then incubated for 24hours at 37OC. The culture media were removed
from the incubator after 24hours and visible bacteria growth was read and recorded.
Gram Staining: Primary and secondary gram staining was done on the smear of a colony
of the bacteria. This is to identify if the bacteria is Gram positive or Gram negative.
 Results:
Macroscopy: The following parameters are examined
1. Appearance: Clear, turbid ,slightly turbid,
2. Colour: Yellow, straw, Amber yellow, pale yellow.
Microscopy: Presence or absence of ; Pus cells, Epithelia cells, Red blood cells, Yeast
cells, Bacteria cells and Crystals can be seen in the wet preparation.
Culture: The following Bacteria can be isolated from Urine samples; Klebsiella spp,
Staphylococcus aureus, Coniforms

3.6.3 EAR NOSE AND THROAT, WOUND AND PUS SWAB

  Procedure: These samples are collected using a dry sterile cotton wool swab; they are
then inoculated into Chocolate and Macconkey agar. Gram staining is then carried out
on each specimen. Pathogens that are likely to be observed include;
 Wound and Pus swab: Staphylococcus aureus, Sreptococcus pyogenes, Clostridium
perfrigens
 Eye swab: Haemophilus influenza, Pseudomonas aeruginosa, Betahaemolytic
streptococcus etc.
 Ear swab: Escherichiacoli, Proteussp etc.
 Throat Swab: Throat cultures are submitted primarily for the detection of Group A
Streptococcus. When obtaining the specimen, depress the tongue with a tongue blade, and
swab the tonsillar pillars and behind the uvula including any inflamed or purulent
sitesAvoid touching the tongue, cheeks or teeth. Immediately place the swab back into the
culturette sleeve and crush the ampule

3.6.4 HIGH VAGINAL, URETHRAL AND ENDOCERVICAL SWAB.

 Test Overview: This is use to detect the causative organisms of female reproductive
system infections and their sensitivity to antibiotics.
 Procedure: A swab stick was used to collect specimen from the affected area and then
inoculated into sterile media which include Chocolate and MacConkey agar. These
plates were incubated at 37c for 24hours and were examined for any pathogenic growth,
if there is any growth then a sensitivity disc is placed on a pure culture of isolate.
 Gram staining is then carried out on each specimen, a wet preparation of the swab can
be made by dropping normal saline into the swab container and the swab stick is rubbed
on a slide covered with a slip and viewed under the microscope; pus cells, epithelial
cells, yeast cells etc can be viewed.
 Result: Possible pathogens include; Neisseria gonorrhea, Trichomonas vaginals,
Candida spp, Clostridium perfrigens etc.
3.6.5 MANTOUX SKIN TEST
 Introduction: The Mantoux test or Mendel-Mantoux test (also known as the
tuberculin sensitivity test, or PPD test for purified protein derivative) is a screening
tool for tuberculosis (TB) It is one of the major tuberculin skin tests used around the
world, largely replacing multiple-puncture tests such as the Tine test. Tuberculin is a
glycerol extract of the tubercle bacillus. Purified protein derivative (PPD) tuberculin is a
precipitate of species-nonspecific molecules obtained from filtrates of sterilized,
concentrated cultures.

 Material/Equipments: Millimeter rule, tuberculin injection, Personal protective

equipment, cotton wool.

 Procedures: A standard dose is 5 tuberculin units (TU - 0.1 ml) is injected

intradermally (between the layers of dermis) and read 48 to 72 hours later. This
intradermal injection is termed the Mantoux technique. A person who has been
exposed to the bacteria is expected to mount an immune response in the skin containing
the bacterial proteins. If a person has had a history of a positive tuberculin skin test, or
had a recent tuberculin skin test (within one year), another skin test should be used
 Result: Within two days of injection, the reaction is read by measuring the diameter of
induration (palpable raised, hardened area) across the forearm (perpendicular to the long
axis) in millimeters. If there is no induration, the result should be recorded as 0mm.
Erythema (redness) should not be measured. A tuberculin test conversion is defined as
an increase of 10 mm or more within a two-day period, regardless of age. Alternative
criteria include increases of 6, 12, 15 or 18mm.
 CHAPTER FOUR

4.0 SUMMARY, CHALLENGES ENCOUNTERED, AND CONCLUSION

RECOMMENDATION

4.1 SUMMARY OF ATTACHMENT ACTIVITIES

During my period at the Orile Agege General Hospital as a SIWES student,
cataloguing some information materials for the laboratory and I also did some activities
at the reception such as: attending to patients, confirming and examining their request
forms, entering their details into the register, detailing them concerning the test they are
to undergo and directing them to where is to be carried out.
I was later transferred to the laboratory and was introduced to the departments,
safety precautions and tests carried out in each department.

4.2 CHALLENGES ENCOUNTERED

The main problems encountered were getting placement and transportation. It was
quite challenging for me that live in far place to get to the organisation every working
day. I was not given any remuneration or allowance, other problems encountered during
the training was attending to different people with different personalities at the
reception.

4.3 CONCLUSION
My four months industrial attachment with Orile Agege General Hospital has been
one of the most interesting , productive, instructive and educative experience in my life.
Through this training, I have gained new insight and more comprehensive
understanding about the real industrial working condition and practice and also
improved my soft and functional skills.
All these valuable experiences and knowledge that I have gained were not only
acquired through the direct involvement in task but also through other aspects of the
training such as: work observation, supervision, interaction with colleagues,
supervisors, superior and other people related to the field. It also exposed me to some
certain things about medical environment. And from what I have undergone, I am sure
that the industrial training programme has achieved its primary objective.
As a result of the programme, I am now more confident to build my future career
which I have already started with Orile Agege General Hospital.

4.4 RECOMMENDATION
I recommend that all institutions or bodies involve in Student Industrial Working
Experience Scheme, should provide places for industrial attachment for Student
Industrial Training Fund and also pay some allowances to students and the company
should provide more safety equipments to prevent further environmental and health
hazards.
Also, to students that are to undergo the training, I recommend that they should take
it very seriously, because it is one of the most important parts of their studies which will
help them build a very significant and effective meaning in their career pursuit.