my complete SIWES report

TECHNICAL REPORT

ON

STUDENT INDUSTRIAL WORK EXPERIENCE

SCHEME (SIWES)

UNDERTAKEN 

AT

 TUNGER-MAJE PRIMARY HEALTH CARE CENTER SULEJA, NIGER STATE

BY

Salisu isyaku

MATRIC NO.: FPN/SAS/ND/2017/1927

SUBMITTED TO

THE DEPARTMENT OF SCIENCE LABORATORY TECHNOLOGY

SCHOOL OF APPLIEED SCIENCE 

FEDERA POLYTECHNIC NASARAWA, PMB 001,

NASARAWA, NASARAWA STATE, 

IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF NATIONAL DIPLOMA IN SCIENCE LABORATORY TECHNOLOGY

AUGUST, 2016/DECEMBER, 2016

CERTIFICATION

I certify that I have read, supervised and accepted the siwes technical report written and submitted by SALISU ISYAKU in partial fulfillment of the requirement for the award of national diploma (ND) in science laboratory technology (SLT) of the federal polytechnic nasarawa, nasarawa state.

_____________________________ _____________________________

 Signature and date students signature and date

(Siwes coordinator)

Department of science laboratory technology 

Federal polytechnic nasaraw.

LETTER OF TRANSMITTAL

School of applied science,

Federal polytechnic nasarawa,

Nasarawa state.

12th march 2017.

Department of science laboratory technology

Federal polytechnic nasarawa

Through 

The industrial training unit 

federal polytechnic                  

The head of department (HOD)

Sir,

THE REPORT OF THE 2016/2017 INDUSTRIAL ATTACHMENT

In compliance with the policy which established the authority of the NBTE/FPN, that the student after successful completion of their industrial training give a detailed report their work experience scheme, I now have the pleasure of submitting this report covering my four months industrial attachment from 22 august, 2016 -23 December, 2016 primary health  Center suleja.

Yours faithfully

Salisu isyaku 

FPN/SAS/ND/SLT/2016/1874.

CIRCULATION OF INFORMATION

This report is hereby submitted for circulation, information, necessary action and record purpose by the following people:

Head of department 

Science laboratory technology 

Federal polytechnic nasarawa

The director 

Industrial training unit

Federal polytechnic nasarawa

The librarian 

Federal polytechnic nasarawa

Nasarawa state.

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.

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 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, Microfilaria, Widal  (Typhoid test), Genotype, HIV, etc. These sections have exposed me to the precautions, rules and regulations of the laboratory, how to diagnose patients and how the tests are being analyzed.

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.

TABLE OF CONTENTS

Title page

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

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

Report Overview ………………………………………………………….......... iii

Circulation of information ……………………………………………………….iv

1.0 About the Industrial Training Fund (I.T.F)…………………………… 

1.1 About SIWES (Student Industrial Training Fund)………………… 

1.2     Scope……………………………………………………………….. 

1.3 Aim and Objective of S.I.W.E.S…………………………………… 

1.4 History and Background of Tunger-maje primary health care center

1.4 Organizations’ Chart and Organogram……………………………..

2.0 The Laboratory…………………………………………………………... 

2.1 Introduction to the Laboratory…………………………………….... 

2.2 Safety Rules in the Laboratory………………………………………

2.3 Emergency in the Laboratory……………………………………….. 

2.4 Hazardous Materials………………………………………………… 

2.5 Hazardous Equipment…………………………………………...…. 

2.6 Laboratory Equipment and their Uses……………………………… 

3.0 The Laboratory Sections and Various Tests Performed……………….. 

3.1 The Phlebotomy Department………………………………………… 

3.2 Hematology and Immunohematology (Blood Bank) Section……… 

3.3 Serology Section ………………………………………………….…. 

3.4 Clinical Biochemistry Section …………………………………….… 

3.5 Clinical Microbiology Section………………………………….……. 

3.6 Microscopy, Culture and Sensitivity Tests …………………….…….. 

4.0 Summary, Challenges Encountered, Recommendation and 

Conclusion………………………………………………………………..…. 

4.1 Summary……………………………………………………….……... 

4.2 Challenges Encountered ……………………………………………… 

4.3 Conclusion ………………………………………………………….… 

4.4 Recommendation …………………………………………………...… 

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

1.3 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 HISTORY AND BACKGROUND OF ORILE AGEGE GENERAL HOSPITAL

God’s glory medical laboratory diagnostic center was established in 1999 by the NIGER STATE GOVERNMENT to enhance and promote the health services render by the Niger State Health Service Commission (NSHSC).

        It started as a laboratory center and became a primary health care center. Since establishment it has delivered quality services to the residents of Niger State

COMPANY’S VISION

To be a world class human resource agency, ensuring the delivery of qualitative health care services for the people

COMPANY’S MISSION

To provide highly skilled and motivated staff with the right attitude to deliver efficient and effective health care to community

CORE VALUES

Medical excellence based on knowledge, skills and first rate human relations

Passions

Knowledge based hard work

Trust

Persistence

Imagination

Timeliness

Integrity

Professionalism

SCOPE OF SERVICE

Tunger maje primary health care center provides the following services to people:

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 involving female reproductive organs and provision of care for both pregnant and non-pregnant patients

Ophthalmology

This branch of medicine deals with the diseases and surgery of the visual pathways including the eyes, hair, and areas surrounding the eyes, such as lachrymal system and eyelids

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.

VCT

Voluntary Counseling and Testing (VCT) for HIV

1.5 ORGANISATION’S CHART AND ORGANOGRAM

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).

3.0 THE LABORATORY SECTIONS AND VARIOUS TESTS PERFORMED

3.1 THE PHLEBOTOMY DEPARTMENT

The Phlebotomy procedure facilitates obtaining good quality specimens on the correct patient for further analysis in the laboratory

3.1.1 IDENTIFICATION OF MATERIALS USED IN THE PHLEBOTOMY AND USES

Personal Protective Equipment

Phlebotomy Uniform: Serve as protective to the body

Disposable gloves/Hand Gel: For protection against spillage

Needles: Used to make incision

Needle holders: For holding needle or also known as venoject 

Vacutainers, Vacutainer holder or Syringe: Serves as blood drawer

Sample bottles according to Order of Draw:

EDTA (Ethylene Diamine Tetra Acetic Acid)

Alkaline phosphatas -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.

 

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.

70% Alcohol swabs: Used as a disinfectant for the area in which incision is to be made.

Micropore tape: To aid hemeostatis

Dental rolls

Adhesive dressing

Racks

Disposable waste bins

Cotton wool Pillow or other support: Used for supporting the arm for easy blood flow

3.1.2 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 venepuncture. 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 venepuncture.

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 venepuncture 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 venepuncture site has stopped apply Micropore tape tightly over the cotton wool.

The procedure is now complete and the patient can leave.

 3.1.3 PHLEBOTOMY DIAGRAMS 

 

3.2 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.

 Equipment/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

3.2.5 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 then (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 the 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 Gonadotropin (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 be 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.

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

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

4.1 SUMMARY OF ATTACHMENT ACTIVITIES

During my period at the tunger maje primary health care center as a SIWES student, i catalogued 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, 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 tunger maje primary health care center was 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 program has achieved its primary objective.

As a result of the program, I am now more confident to build my future career which I have already started with god’s glory medical laboratory diagnostic center.

4.4 RECOMMENDATIONS

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 equipment 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.