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A TECHNICAL REPORT ON

STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME (SIWES)

UNDERTAKEN AT
RAYLIFE GLOBAL HOSPITAL AND DIAGNOSTIC KUBWA, ABUJA.

FROM
5TH JUNE - 10TH NOVEMBER 2023.

WRITTEN BY:
ABU ISAIAH OJONUGWA
(MATRIC NO:21BC1003)

COURSE CODE: BCH 3

SUPERVISED
BY:
DR. FRANCIS ATANU

SUBMITTED TO THE DEPARTMENT OF BIOCHEMISTRY PRINCE


ABUBAKAR AUDU UNIVERSITY, KOGI STATE.
FACULTY OF NATURAL SCIENCES.

IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE


AWARD OF DEGREE IN
BACHELOR OF SCIENCES (B.Sc.) HONS IN BIOCHEMISTRY.
DECLARATION

I ABU ISAIAH OJONUGWA, declare that this technical report was written by me. It comprises
of the summary of all the work done during my period of attachment in Raylife Global Hospital
and Diagnostic. I therefore submit the report work as partial fulfillment of the requirements for
the Student Industrial Work Experience Scheme of Prince Abubakar Audu University, Kogi
State.
CERTIFICATION

I ABU ISAIAH OJONUGWA with matriculation number 21BC1003 hereby certify that I
underwent six(6) full months of Industrial Training Programme at Raylife Global Hospital and
Diagnostic and that this report is written by me to the best of the practical knowledge I gained
during the course of the training programme.
ACKNOWLEDGEMENTS

All praise and thanks be to God Almighty for sparing my life, and also for the opportunity and
good health status granted to me to successfully complete this program.

My sincere appreciation and gratitude goes to my parents and family members for
Their incessant support financially, morally and otherwise, may God reward them and make
Heaven their final destination.

I will like to acknowledge the entire staff of Department of Biochemistry, Prince Abubakar Audu
University Kogi State for their tireless efforts and support at all times.

Also, to the entire staff of Laboratory Department, Raylife Global Hospital and Diagnostic,
Abuja especially my super mentor, a teacher and also a friend, Mr. Luka Abednego and all other
people who helped in one way or the other, may God reward you abundantly
DEDICATION

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

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 six(6) months of Industrial Training at, Raylife
Global Hospital and Diagnostic Abuja State.

This report highlights how patients are being managed and also the several tests carried out for
patients. I was opportuned to work in five (5) units which are Reception, a unit that deals with
specimens collection, and results are being issued or dispatched in this unit, Hematology unit
were I learnt different tests such as Packed Cell Volume (PCV), Widal (Typhoid test), Genotype,
Blood Gropuing test, and different tests such as RVS, HCG, HBsAg, HCV, H. pylori, VDRL, etc. I
also learnt different tests in Microbiology unit which includes Urinalysis, MP, etc and in
Chemical Pathology unit I learnt tests such as RBS, FBS, etc and Phlebotomy unit were the
blood is being collected. 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.
SOME USED ABBREVIATIONS IN THIS REPORT

EDTA: Ethylene diamine tetraacetic acid


RVS: Retroviral screening
H. Pylori: Helicobacter pylori
MP: Malaria Parasites
PCV: Packed cell volume
HBsAg: Hepatitis B surface antigen
HCV: Hepatitis C
VDRL: Veneral diseases research laboratory
HCG: Human Chorionic Gonadotrophin
TABLE OF CONTENTS

Title page
Declaration ........................................................................................................................i
Certification ......………………………………..................................................................... ii
Acknowledgement …......……………………………………...............………....................... iii
Dedication .............…………………………….................................................................... iv
Abstract ……..………………….…………............................................................................v

CHAPTER ONE
1.0 Introduction ...…........................................................................................................1
1.1 Overview of SIWES (Student Industrial Training Fund)…………..............................1
1.2 Objectives of the SIWE...…...................................................................................2
1.3 Importance of S.I.W.E.S…....................................................................................2
1.4 Roles of bodies involved in the management of SIWES programme...........................2-6
1.4 History and Background of Raylife Global Hospital and Diagnostic...........................6-8

CHAPTER TWO
2.0 The Laboratory…………………………………………………………………….............9
2.1 Introduction to the Laboratory….............................................................................9
2.2 Safety Rules in the Laboratory……..........................................................................10
2.3 Emergency in the Laboratory….....................................................................................10
2.4 Hazardous Materials…...........................................................................................10
2.5 Hazardous Equipments….......................................................................................10
2.6 Laboratory Equipments and their Uses…...............................................................10-12

CHAPTER THREE
3.0 The Laboratory Sections and Various Tests Performed….............................................13
3.1 Sections in the Premier Clinic Laboratory.................................................................13
3.2 Reception Unit......................................................................................................13-15
3.1 The Phlebotomy Section......................................................................................15-19
3.2 Hematology Section…......................................................................................20-24
3.3 Serology Section …...........................................................................................24-27
3.4 Chemistry Section ….................................................................................................27-28
3.5 Microbiology Section…....................................................................................28-42

CHAPTER FOUR
4.0 Summary, Challenges Encountered, Recommendation and Conclusion.....................43
4.1 Summary….........................................................................................................43
4.2 Challenges Encountered …………………………….................................................43
4.3 Conclusion ….......................................................................................................43
4.4 Recommendation ….............................................................................................43
4.5 References...........................................................................................................44
CHAPTER ONE

1.0 INTRODUCTION

1.1 OVERVIEW OF SIWES

In the earlier stage of science and technology education in Nigeria, students were
graduating from their respective institution without any technical knowledge or working
experience. It was in this view that students undergoing science and technology related courses
were mandated for students in different institution in the view of widening their horizons so as to
enable them have technical knowledge or working experience before graduating from their
various institutions.
The student industrial Work Experience Scheme (SIWES) was established by the
industrial Training Fund in (ITF) 1973 to enable students of tertiary institution have basic
technical knowledge of industrial works base on their course of study before the completion of
their program in their respective institutions. The scheme was designed to expose students to
industrial environment and enable them develop occupational competencies so that they can
readily contribute their quota to national economic and technological development after
graduation.
The major background behind the embarkment of students in SIWES was to expose them
to the industrial environment and enable them develop occupational competencies so that they
can readily contribute their quota to national economic and technological development after
graduation. The major benefit accruing to students who participate conscientiously in Students
Industrial Work Experience Scheme (SIWES) are the skills and competencies they acquire. The
relevant production skills remain a part of the recipients of industrial training as life-long
assets which cannot be taken away from them. This is because the knowledge and skills acquired
through training are internalized and become relevant when required to perform jobs or
functions.

1.2 OBJECTIVES OF SIWES


The Industrial Training Fund’s policy Document No. 1 of 1973 which established SIWES
outlined the objectives of the scheme. The objectives are to:
• Provide an avenue for students in higher institutions of higher learning to acquire
industrial skills and experiences during their courses of study.
• Prepare students for industrial work situations that they are likely to meet after
graduation.
• Expose students to work methods and techniques in handling equipment and machinery
that may not be available in their institutions.
• Make the transition from school to the world of work easier and enhance students’
contact for later job placements.
• Provide students with the opportunities to apply their educational knowledge in real work
situations, thereby bridging the gap between theory and practice.
• Enlist and strengthen employers’ involvement in the entire educational process through
SIWES.
1.3 IMPORTANCE OF SIWES
 It provides students with an opportunity to apply their theoretical knowledge in real life
situations.
 It exposes students to more practical work methods and techniques.
 It strengthens links between the employers, universities and industrial training fund (ITF)
 It also prepares the students for the labour market after graduation.

1.4 ROLES OF BODIES INVOLVED IN THE MANAGEMENT OF SIWES


PROGRAMME
The Federal Government, the Industrial Training Fund (ITF), the Supervising Agencies –
National Universities Commission (NUC), the National Board for Technical Education (NBTE),
National Commission for Colleges of Education (NCCE), Employers of Labour and Institutions
have specific roles assigned to them in the management of the SIWES Programme. The roles are
as follows: -
Federal Government
 To provide adequate funds to the Industrial Training Fund through the Federal Ministry
of Industries for the Scheme.
 To make it mandatory for all Ministries, companies and Parastatals to offer places for the
attachment of students in accordance with the provisions of Decree No. 47 of 1971 as
amended in 1990.
The Industrial Training Fund (ITF)
The Fund is to:
 Formulate policies and guidelines on SIWES for distribution to all the SIWES
participating bodies, institutions and companies involved in the scheme.
 Regularly organize orientation programmes for students prior to their attachment.
 Receive and process Master and Placement Lists from the Institution and Supervising
Agencies, i.e. (NUC, NBTE, NCCE);
 Disburse Supervisory and Students allowances
 Organize biennial SIWES National Conference and Annual SIWES Review Meeting;
 Provide insurance cover for students on attachment;
 Provide logistics and materials necessary for effective administration of the scheme, such
documents as – ITF Form 8, ITF Form 8A the SPE 1and SIP A forms.
 Ensure the visitation (tours) of ITF officers to the Supervising Agencies, Institutions,
Employers and students on attachment.
 Vet and process students’ logbooks and ITF form 8.
The supervising agencies (NUC, NBTE AND NCCE)
These Agencies are to:
 Ensure the establishment and accreditation of SIWES Units in institutions under their
jurisdiction;
 Direct for the appointment of full-time SIWES coordinators
 Ensure adequate funding of the SIWES units in all the institutions.
 Vet and approve master and placement lists of students from participating institutions and
forward same to the ITF;
 Develop, monitor and review job-specifications in collaboration with the institutions
towards the maintenance of National minimum Academic Standard for all the
programmes approved for SIWES.
 Liaise with ITF and participate in the biennial SIWES National Conference and other
relevant SIWES seminars, conferences and workshops.
 Continuously monitor and review the job specifications of all the courses
 Research into the development of SIWES in line with advances in technological
development;
 Regularly review courses qualified for SIWES in collaboration with other bodies;
 Liaise with the ITF, to ensure the implementation of all Federal Government policies on
the scheme.
The institutions
The Institutions are to:
 Establish SIWES coordinating Units with a Separate Account, adequately staffed and
funded to ensure effective operation of the Scheme.
 Appoint SIWES coordinators, and supporting staff.
 Prepare and submit six copies of Master Lists not later than 31st March and six copies of
Placement lists not later than 31st May of each SIWES year to the ITF. All submissions
must be made through the Supervising Agencies. However two advanced copies should
be sent to the ITF.
 Apply job-specifications as prepared for all the accredited courses and award appropriate
credit units in accordance with Federal Government minimum academic standard
guidelines;
 Identify placement opportunities for students’ attachment with Employers;
 Supervise students at their places of attachment and sign their log-books;
 Organize orientation courses in collaboration with the ITF for their students;
 Submit comprehensive reports on the scheme to ITF through their Supervising Agencies
on ITF Form 8A at the end of every year’s programme.
 Ensure payment of outstanding allowances and render all returns to the ITF during the
SIWES year.
 Submit all completed ITF form 8 to the nearest ITF Area Office.
The employers
 To collaborate with the institutions in the preparation of job specifications for the
approved courses for SIWES;
 To accept students for Industrial Attachment as stipulated in ITF Decree No. 47 as
amended (1990).
 To provide welfare services – e.g. medication and pay for hospitalization of students
while on attachment whenever the need arises;
 To participate fully in the assessment of programmes/students by completing the
necessary instruments – e.g. ITF form 8, logbook etc.
 To allow students have access to their facilities;
 To appoint an Industry-based Supervisor for students on attachment.
The students
 To attend institution’s SIWES orientation programme before going on attachment.
 To be obedient to constituted authorities and adhere strictly to all rules and regulations of
the Organization where the student is attached.
 To be regular and punctual at respective places of attachment.
 To avoid change of place of attachment, except in special circumstances which must be
determined and approved by their institution’s supervisor, the employer and the ITF;
 To complete SPE – 1 form and get it endorsed by their employers who will forward same
to the ITF;
 To record all training activities and other assignments in the log-book and complete ITF
Form-8 to ensure proper assessments.
 To be diligent, honest, conscientious, take pride in the protection of employer’s property
throughout the attachment period.
1.4 BRIEF HISTORY OF RAYLIFE GLOBAL HOSPITAL AND DIAGNOSTIC ABUJA
Raylife Global Hospital and Diagnostic was established in June, 2020. It is a Private
Hospital owned Dr Anthony Okoh Ewere (a Gynecologist). The Hospital started with 2 beds, 1
theater and 1 consultant. The Hospital now has 10 beds, 2 full time Doctors, 6 Nurses, and a
functional laboratory with 1 staff, 1 Pharmacists.
There were also 1 delivery room, emergency room, and 1 consulting room.
1.4.1 RAYLIFE GLOBAL HOSPITAL AND DIAGNOSTIC DEPARTMENTS AND
THEIR FUNCTION
Premier Clinic provides the following services to people:
 ENT (Ear, Nose, and Throat)
The branch of medicine that specializes in diagnosis and treatment of ear, nose, throat and
head and neck disorders.
 Laboratory
This is where tests are done on clinical specimens in order to get information about
the health of a patient as pertaining to the diagnosis, treatment and prevention of
disease.
 Obstetrics and gynecology
The entire scope of clinical pathology involves female reproductive organs and
provision of care for both pregnant and non pregnant patients.
 Pediatrics
The branch of medicine that deals with the medical care of infants, children, and
adolescents.
 Pharmacy
Charged with ensuring the safe and effective use of pharmaceutical drugs, the scope
of pharmacy practice includes more traditional roles such as compounding and
dispensing medications and it also includes more modern services related to health
care including clinical services reviewing medications for safety and efficacy and
providing drug information.
 Surgery
A medical specialty that uses operative manual and instrumental techniques on a
patient to investigate and/or treat a pathological condition such as disease or
injury to help improve bodily function or appearance.
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.

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 of all incidents. immediately.
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.
• 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.
• 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.
• Glass slide: It is used for the preparation of samples to be viewed directly under the
microscope.
• 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.
• 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.
CHAPTER THREE

3.0 THE LABORATORY SECTIONS AND VARIOUS TESTS PERFORMED

3.1 SECTIONS IN RAYLIFE GLOBAL HOSPITAL AND DIAGNOSTIC CLINIC


LABORATORY
The laboratory department of Raylife Global Hospital and Diagnostic consists of the
following Sections, these sections are known as benches:
1. Reception

2. Phlebotomy unit

3. Hematology/Serology unit

4. Chemistry unit

5. Microbiology/Parasitology unit

These division of the laboratory into different sections or work benches makes it easier for
laboratory workers to process specimens properly and avoid contamination, it also helps a great
deal towards ensuring patients satisfaction by getting results ready as soon as possible and helps
to minimize cases of missing results.

3.2 RECEPTION UNIT

The reception is a section of the laboratory where specimens are being collected, and
results are issued or dispatched. This is the point where the patient gets his/her first contact with
the laboratory. The scientist in charge of the reception needs to be extra careful and practice good
laboratory conduct. The receptionist also needs to have a good human relation and dedication.
All specimens brought to the laboratory are collected at the reception from 8:00am –
6:00pm. Before a specimen is collected, there must be an evidence of payment presented in form
of receipt, one is attached to the request form and the duplicate copy is given to the patient. The
specimen is checked to make sure it corresponds to the one requested and it is sufficient enough
to carry out the investigation, the patient is then told when to come back for the results. The
specimen is then labelled appropriately with the patients name, age, sex, and ward. This is done
to avoid mixing up of specimens. After collection at the reception, the specimen is taken to the
appropriate bench for investigation.
At the end of specimen processing, results from each bench is taken to the reception. Below
is a summary of what is being done at the reception:
 Samples are checked for consistency and evidence of payment.
 Samples are labelled appropriately with patient’s details and input into the daily
utilization register.
 Samples are taken to respective benches for investigation/analysis.
 Results for completed investigations are collected from all benches, recorded and
dispatched to respective wards.
 For outpatients, the result is kept until when the patient comes for it.

3.2 THE PHLEBOTOMY UNIT


Phlebotomy (from the Greek words , meaning "pertaining to a blood phlebo vessel", and,
meaning "to make an incision") is the process of makin -tomy g an incision in a vein with a
needle. The procedure itself is known as a venipuncture. This section of the microbiology
laboratory collects blood samples and prepares them for test in the serology and ART
laboratories.
3.1.2 Identification of materials used in the Phlebotomy and uses
1. Personal Protective Equipment
• Disposable gloves/Hand Gel: For protection against spillage
2. Needles: Used to make incision
3. Needle holders: For holding needle or also known as venoject
4. Vacutainers, Vacutainer holder or Syringe: Serves as blood drawer
5. Sample bottles according to Order of Draw:
• EDTA (Ethylene Diamine Tetra Acetic Acid)
Alkaline phosphatase - due to chelation of metallic cofactors which inhibits the enzyme activity.
Potassium and sodium - due to the addition of potassium to the sample. Calcium and magnesium
- these are chelated by the EDTA.
EDTA is also an unsuitable additive for samples requiring bacterial culture, since the chelation of
the divalent cations inhibits the growth of bacteria. EDTA is sometimes used to prevent cells
clumping in fluid samples requiring cell counts to accompany a cytology evaluation but it does
not actually 'fix' the cells. A sample fixed in formalin or alcohol/ethanol is required for accurate
cytology examination. EDTA is not suitable for samples requiring virus isolation in
cell/tissue culture because it forms a gel when added to the cell culture medium
and this disrupts the cell monolayer.
• Plain (no anticoagulant)
Plain (or clotted) samples are used to provide serum for serology and most biochemistry
or endocrine assays. Serum is plasma without fibrinogen since the fibrinogen has been used' in
the formation of the clot.
• Lithium Heparin
Lithium heparin accelerates the action of antithrombin III which neutralizes thrombin and
thus prevents the formation of fibrin from fibrinogen (clot formation). This effect makes heparin
samples unsuitable for determination of fibrinogen or clotting factors. Lithium heparin is a
standard anticoagulant used to obtain plasma for biochemistry analysis.
Lithium heparin is the most suitable anticoagulant for the isolation of viruses in
cell/tissue culture. This anticoagulant is not suitable for haematology as the heparin alters the cell
morphology. Whilst measurement of haemoglobin and blood cell counts can be obtained using
this anticoagulant an accurate white cell differential and morphology comments are not possible.
• Fluoride/Oxalate
Fluoride/oxalate samples are used for glucose (and lactate) determination only. Sodium
fluoride functions by stabilizing the blood cell membrane and inhibiting the enzyme systems
involved in glycolysis, which prevents red blood cells metabolising any glucose present in the
sample. For this reason it is the only suitable sample for accurate glucose analysis. Fluoride is a
potent inhibitor of many enzymes and the inhibition of glycolysis tends to cause fluid shifts.
Fluoride is a weak anticoagulant on its own, so potassium oxalate (another powerful
enzyme inhibitor) is usually added to supplement its action. Other plasma or serum samples may
be used for glucose analysis ONLY if the plasma/serum is separated from the cells within 1 hour
of sample collection. Without an antiglycolytic agent, the blood glucose concentration decreases
by approximately 0.56 mmol/l per hour at 25°C.
• Sodium citrate
Sodium citrate is the standard anticoagulant for coagulation assays. Citrate functions by
chelating calcium. The effect is easily reversed by the addition of calcium to the sample. Other
anticoagulants are not suitable for coagulation assays as they interfere with coagulation factors.
Citrate also inhibits ALP, ALT and interferes with the measurement of phosphate.
6. Tourniquet: Used to search vein. Prolonged venous occlusion can cause changes in
concentrations of blood constituents. Therefore, the use of a tourniquet should be minimized. If a
tourniquet is used to search for a vein, it should be released before withdrawal of blood begins.
In any case, the use of a tourniquet should be limited to less than one minute.
7. 70% Alcohol swabs: Used as a disinfectant for the area in which incision is to be made.
8. Micropore tape: To aid hemeostatis
9. Dental rolls
10. Adhesive dressing
11. Racks
12. Disposable waste bins
13. Cotton wool Pillow or other support: Used for supporting the arm for easy blood flow

3.1.3 phlebotomy diagrams

3.1.4 Standard Operation Procedure (S.O.P) for blood collection


• The frequent point of blood collection is usually from the vein (venipuncture). The
materials for the patient’s identity must be checked before attempting venipuncture. This
must be carried out by asking the patient their Full Name and Date of Birth.
• Check that this information corresponds with that on the Request form.
• Any amendment to these details or any others on the Request form must be in accordance
with the Directorate Policy.
• Where patient details lack legibility, staff may write the correct details clearly next to
those on the form without crossing out the original details.
• If tests are requested that are unfamiliar and staff are unsure of the appropriate blood
tubes for specimens check the list ‘What tube guide’ available at each workstation or,
when necessary contact a qualified Biomedical Scientist in the appropriate department
within the Pathology Laboratory.
• Examine both arms of the patient and select the one that appears appropriate
• Ensure that the patient is comfortable and that the arm is well supported and examine
potential venipuncture.
• Ask the patient to bare an arm, ensure that the arm is well supported and apply the
tourniquet to the patient’s arm, just above the elbow and tight enough to allow two
fingers behind the strap.
• Tighten the tourniquet a little more, taking care not to pinch the skin
• Ask the patient to straighten their arm and clench their fist. This will make the vein more
prominent.
• If necessary rub the bend of the elbow to make the vein more visible.
• Feel with a fingertip for the ‘best’ vein at the bend of the elbow rather than plunge the
needle into a poor vein that looks ‘alright’.
• If this fails a suitable vein can often be found at the side of the arm on the elbow side.
• It may be necessary, on occasion to take blood from the back of hand.
• Apply the tourniquet above the elbow. The tourniquet is closed around the arm by
inserting the plastic clip into the holder and then tightened appropriately by pulling the
strap.
• Ask the patient to straighten their arm and to make a fist in order to make the veins more
prominent.
• Feel with the fingertip if necessary to locate a suitable vein to puncture.
• Ensure that equipment and blood tubes required are immediately within easy reach.
• Remove the top plastic section of a Vacutainer multi-sample needle and screw thread into
a Vacutainer needle holder.
• Disinfect site with a 70% Isopropyl alcohol swab.
• Leave for 30 seconds for the alcohol to evaporate and during this period assemble the
blood tubes required.
• Remove the cover from the multi-sample needle and discard into a clinical waste bin.
• Keeping the needle holder and attached multi-sample needle in one hand use the thumb
on the other hand to press on the vein just above the chosen entry point and pull the skin
back slightly towards you to hold the vein firmly and stretch the skin over the chosen site.
• With the needle holder and multi-sample needle almost parallel to the patient’s arm and
the needle bevel uppermost, gently push the needle into the chosen venipuncture site.
• Once in the vein hold the needle-holder steady and gently push the cap of the appropriate
blood sample tube onto the covered sample needle at the base of the inside of the needle-
holder.
• Blood should enter the sample tube and fill to the appropriate level indicated.
• Remove the sample tube from the sample needle when full and attach another sample
tube in required.
• Blood samples must be gently mixed at the earliest opportunity to ensure anticoagulation
effectiveness
• As the last blood sample tube is filling slacken the tourniquet by pressing down on the
release clip that is on the side away from the arm.
• Withdraw the needle from the vein and quickly apply a clean pad of cotton wool.
• Ask the patient to keep pressure on the cotton wool to stop further bleeding.
• Discard the needle and holder into a Sharps bin.
• Gently mix the sample tube(s).
• If the patient is unable to maintain sufficient pressure on the vene-puncture site apply this
pressure for them.
• Remove the tourniquet from the patient’s arm.
• When bleeding from the venipuncture site has stopped apply Micropore tape tightly over
the cotton wool.
• The procedure is now complete and the patient can leave.

3.2 HEMATOLOGY 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.
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 SECTION


Pipette, Haematocrit centrifuge machine for PCV, Haematocrit centrifuge reader for PCV,
Microscope, Microscopy slide, Electrophoresis machine, Cover slip, Sterile capillary
tube, Wash bottle, 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 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 12,000rpm 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
3.2.3 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.
Blood grouping Anti-A Sera, Anti-B Sera and Anti-D Sera

Diagram showing results for ABO grouping

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; VDRL, to diagnose syphilis, Pregnancy Testing, Widal test.

3.3.1 HBs.Ag TEST FOR HEPATITIS, VDRL (VENERAL DISEASES RESEARCH


LABORATORY)
TEST FOR SYPHILIS USING STRIPS
• Introduction: HBs.AG 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.

Diagram showing result for rapid HBs.Ag and VDRL test

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) is present in 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 was 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.

Diagram showing result for Pregnancy test strip

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 para typhi 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 para typhi in the serum of
patient.

• Materials: Test card/white tiles, Pasteur pipette, centrifuge, antigen kit and stop watch.
• Specimen: Blood (serum)
• Principle of Widal Test
Febrile antigen is standardized suspension of stained bacteria used to identify and
quantitate specific serum antibodies developed during some febrile infection. The antigen
suspension agglutinate in the presence of the corresponding homologous antibody in the
sample tested.
• 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 white tiles 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
was 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, 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 RVS test strip determine kit and allowed to penetrate then left for 5min.

• 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 CHEMISTRY 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 hepatitis, diabetes, Urinalysis etc
Blood sample samples may collected into the Serum Separator Tube or Lithium Heparin.
Test performed in this department are:
 Blood Glucose; FBS, FBS2, RBS·
 Urinalysis
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 pancreas 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: Glucometer or Accu Check, lancet, 70% alcohol pad, Accu test trip.
Procedure: Glucometer or Accu Check was used to perform this test. The Glucometer
corresponding code strip is inserted and loaded, Patient’s thumb is disinfected using a
70% 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 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/dlforage50-60;lessthan160mg/dlforage60andolder.

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 was also used to perform RBS test. The
Glucometer corresponding code strip is inserted and loaded, Patient’s thumb is
disinfected using a 70% 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 the patient was given 75g of glucose
powder in 250ml of clean water immediately. 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: Glucose solution, Glucometer or Accu Check, lancet, 70% alcohol
pad, Accu test strip.
Procedure: Patient is asked to take 75g 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.
Results: The result for each 30mins was recorded in mg/dl

3.4.3 URINE ANALYSIS:


Specimen collection and preparation
Urine is collected in a clean, dry container that allows complete immersion of the entire fields on
the test strip. Do not add preservatives. The specimen is tested as soon as possible, with the
sample well mixed but not centrifuged. The use of fresh morning urine is recommended for
optimal nitrite tests, as well as for the valid determination of bilirubin and urobilinogen, since
these compounds are unstable when exposed to light. If immediate testing is not possible, the
sample should be kept in the refrigerator, but not frozen, and then brought to room temperature
before use in the test.(Ochei,Jetal;2000).

Urine Macroscopy
The appearance of the specimen is examine macroscopically such as color (whether it is pale
amber, amber, deep amber, colorless urine, bloody or xanthochromic and their turbidity such as
(whether it is clear, slightly turbid or turbid. Cloudy urine usually has an unpleasant smell and at
times contains few red blood cells. This may be due to kidney or bladder infection, bloody and
cloudy urine may be due to red blood cells and possibly caused by bacteria or parasitic infection.

Urine Analysis using Combostiks Reagent Strips


Combostiks Reagent strips are deep-and-read test strips for in vitro Diagnostic use only for
testing of Urobillinogen, bilirubin, ketones, glucose, protein, nitrite, leukocytes, blood, pH, and
specific gravity in urine. Test result may provide information regarding the status of
carbohydrate metabolism, Kidney and liver function, acid-base balance and urinary tract
infection. It is measured by comparison of test paper attached to a plastic strip with the colour
chart blocks printed on the vial label. The strips are read visually. They can also be read
instrumentally, using urine chemistry analyzers. (Braunstein G.D.etal;1976):
Visual Test Procedure
Removefromthebottleonlystripforimmediateuseandreplacethecaptightly
1. Completely immerse reagent areas of the strip in fresh, well mixed urine. Remove the
strip immediately to avoid dissolving out the reagent areas.
2. While removing, touch the side of the strip against the rim of the urine container to
remove excess urine.
3. Compare each reagent area to its corresponding colour blocks on the colour chart and
read at the times specified. Proper read time is critical for optimal results.
4. Obtain results by direct colour chart comparison.(Catt,K.J.etal;1975).
Chemical Principles of Procedure
Urobillinogen: The test is based on Ehrlich`s reaction. Colour changes from light
orange-pink to dark pink.

Glucose: Glucose oxidase catalyzes the oxidation of glucose to form hydrogen peroxide.
The hydrogen peroxide thus formed then oxidizes a chromogen on the reaction pad by the
action of peroxidase.

Bilirubin: Azo-coupling reaction of bilirubin with a diazonium salt in an acid medium to


form an azodye. Colour changes from light tan to beige or light pink

Ketones: Legal`s test-nitroprusside reaction. Acetoacetic acid in an alkaline medium


reacts with nitroferricanide to produce a colour changes from beige to purple.

pH: Double indicator system. Indicator`s methyl red and bromothymol blue are used to
give distinct colour, changes from orange to green to blue. (pH5.0to9.0)
Blood: The test is based on the pseudo-peroxidase activity of the haemmoiety of
haemoglobin and myoglobin. The chromogen is oxidized by hydro peroxide in the
presence of haem and changes colour from yellow (orgreenishyellow) to blue.

Specific Gravity (SG): Ionic solutes present in the urine cause protons to be released
from a polyelectrolyte. As the protons are released, the pH decreases and produces colour
changes of bromothymol blue from blue-green to yellow-green.

Protein: The test area is more sensitive to albumin than to globulin, haemoglobin, Bence-
Jones proteins and mucoproteins; a negative result does not rule out the presence of these
other proteins. For urine with high specific gravity, the test area may most closely match
the trace colour block even though only normal concentrations of protein are present.
Clinical judgment is needed to evaluate the significance of trace results. False positive
result may be obtained with highly alkaline urine. Contamination of the urine specimen
with quaternary ammonium compounds may also produce false positive results.

Nitrite: The test is based on the diazotization reaction of nitrite with an aromatic amine
to produce a diazonium salt. It is followed by an azo-coupling reaction of this diazonium
salt with an aromatic compound on the reaction pad. The azo-dye produced causes a
colour change from white to pink.

Leukocyte: This test pad contains an indoxyl ester and diazonium salt. It is followed by
an azo-coupling reaction of the aromatic amine formed by leukocytes esterase with a
diazonium salt on the reaction pad. The azo dye produced causes a colour change from
beige to violet.
3.4.4 MALARIA PARASITE (MP) TEST:
There are four species of malarial parasites which can infect humans. They are
Plasmodium vivax, P. falciparum, P. malariae, P. ovale. Three stages of their asexual life
cycle occur in man, namely, trophozoite, schizont and gametocytes (male and female). In
peripheral blood, the parasites are present inside the red cells. Each species can be
identified on two basic parameters. (Ochei etal, 2000).

Preparation of blood film


For accurate examination of blood films, it is necessary to use absolutely clean grease-
free slides. Washed slides cleaned with 70% ethanol are recommended.

Thick Blood Films

Procedure: To make a thick film, place two or three small drops of fresh blood without
anticoagulant on a clean slide. With a corner of another slide, mix the drops in a circular
motion over an area about 2cm in diameter. Continue mixing for about 30seconds to
prevent formation of fibrin strands that may obscure the parasites after staining. (Ochei
etal, 2000)

Thin Blood Film


Procedure: To make a thin blood film, place a drop of fresh blood on a clean grease free
slide. Place the spreader just in front of the drop of blood at 45 0 angle. Draw it back
slightly to touch the drop of blood and to allow the blood to spread along the contact line.
Push the spreader forward smoothly and rapidly, maintaining the contact between the
slide and the spreader. The smear formed should be about 3-4cm long, slightly thicker at
the base or head and thin at the tail end without ragged tails. (Ochei, J etal, 2000).
Giemsa Staining:

Giemsa stain is a Romanowsky stain that requires dilution in buffered water or buffered
saline before use. The stain is available commercially either as a concentrated stock
solution or in a powdered form (Ochei, J etal; 2000).

Giemsa stain (Stock solution):


Giemsa stain powder - 0.6g

Methanol, absolute (acetone–free) -50mls.

Glycerol -50mls.

Procedure of Staining:
1. Fix the thin blood film with absolute methanol.

2. Place both the thin and thick blood films on the staining rack.

3. Flood the slides Giemsa stain and allow to stand for 30–45minutes.

4. Wash the stain with phosphate buffer or tap water.

5. Wipe the back of the slide with cotton wool to remove excess stain.

6. Allow it to air dry in a vertical position.

7. Examine using X100 objective lens of the microscope. (Ochei J etal, 2000).

Result:
Malarial parasites

Chromatin of parasite – Dark red.

Cytoplasm of parasite - Blue.

Schuffner’s dots -Red.

Maurer’s dots -Red-mauve.


CHAPTER FOUR

4.0 SUMMARY, CHALLENGES ENCOUNTERED, AND CONCLUSION


RECOMMENDATION

4.1 SUMMARY OF ATTACHMENT ACTIVITIES


During my period at Raylife Global Hospital and Diagnostic Laboratory Abuja, as a
SIWES student, I was involved in 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 organization 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 six months industrial attachment with Raylife Global Hospital and Diagnostic 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
amsurethattheindustrialtrainingprogrammehasachieveditsprimaryobjective. As a result of the
programme, I am now more confident to build my future career which I have already started
with Raylife Global Hospital and Diagnostic Abuja.
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.
4.5 REFERENCES
1. Baker, F.J. Silverton R.E. and Pallister, C.J. (1998): Introduction to Medical Laboratory
Technology, 7th edition, Edward Around Publisher, London. Page 223
2. Batzer FR 1980: Hormonal evolution of early pregnancy, Fertil. Steril.; 34(1): page1-13

3. Braunstein GD, J Rasor, H. Danzer, D Adler, ME (1976): Wade Serum human chorionic
gonadotropin levels throughout normal pregnancy, American. J. Obstet.Gynecol.;126 (6):
Page678-681

4. Catt KJ, ML Dufau, JL Vaitukaitis (1975): Appearance of hCG in pregnancy plasma


following the initiation of implantation of the blastocyte, J. ClinEndocrinol.Metab.;40
(3):Page537-540
5. Cheesbrough, M. (1998): District Laboratory Practice in Tropical Countries. Part 1 & 2.
Cambridge University Press.Page110-114
6. Dawood MY, BBSaxena, RLandesman (1977): Human Chorionic gonadotropin and its
subunits in hydatidiform mole and choriocarcinoma, Obstet. Gynecol.; 50(2):Page172-
181
7. HowanitzPJ, Howanitz JH. Carbohydrates. In: Henry JB, ed. Clinical diagnosis and
mana-gement by laboratory methods. 17thed Philadelphia: WBsaunders 1984:165-179.

8. ITF, "Guideline for writing Industrial Training/SIWESReport,"2017

9. ITF (2011). An evaluation of the impact (SIWES) on technical skill development in


Nigeria. A Joint Study by ITF and University of Jos.

10. Jawetz, Melnick and Adelbergs, (2004): Medical Microbiology (23th edition) McGraw
Hill Companies.
11. Ochei, J. and Kolhatkar, A. (2000): Medical Laboratory Science. Theory and Practice.6th
edition Tata McGraw-Hill Pub. Company Ltd.
12. SIWES, "Introduction to Students" Industrial Work Experience Scheme
(SIWES),"2016.TietzNW, ed.Clinical guide to laboratory tests. 3 rd ed. Philadephia:
sreekumariS.KV7thedition.

13. Prescott, M. L. Harley P.J. and Klein, AD (2002): Microbiology 5th Edition. McGraw
Hill Higher Education; New York. Page 120-123

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