STUDENTS’ INDUSTRIAL WORK EXPERIENCE

SCHEME (SIWES)
AT

NATIONAL ASSEMBLY CLINIC THREE ARMS ZONE P.M.P 141 MAITAMA

F.C.T ABUJA

BY

MUHAMMED SIMBIYAT
2081700074

A SIWES REPORT SUBMITTED TO THE

DEPARTMENT OF BIOCHEMISTRY ,FEDERAL
UNIVERSITY OF LAFIA,NIGERIA

IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE

AWARD OF BACHELOR OF SCIENCE ([Link]) DEGREE IN BIOCHEMISTRY

NOVEMBER,2021

i
DECLARATION

I MUHAMMED SIMBIYAT 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
National Assembly Clinic, Abuja. I therefore submit the report work as partial fulfillment
of the requirements for the Student Industrial Work Experience Scheme (SIWES) of the
Federal University Lafia

MUHAMMED SIMBIYAT NOVEMBER , 2021

ii
APPROVAL PAGE

This SIWES report has been read and approved as meeting part of the requirements of the Department
of Biochemistry, Faculty of Science, Federal University of Lafia, Nigeria, for the award of Bachelor of
Science (B. Sc.) Degree in Biochemistry.

….……………………………….. …………………………..

MR ADEDOTUN ADEFOLALU Signature and Date

SIWES COORDINATOR

….………………………………….. …………………………….

Dr. ABUBAKAR MUHAMMAD Signature and Date

Ag. Head of Department

iii
 DEDICATION

This student industrial work experience scheme ( SIWES) is dedicated to my lovely

parent for their unfading love, care and support. And their love and passion for
knowledge which is undoubtedly an attitude of never give up toward leaning. To the all
staff, interns & IT student of national assembly clinic laboratory to be precisely, for their
care and willingness to teach at all time and also to my beloved siblings whose prayer
and support keep me going.

iv
 ACKNOWLEDGEMENT

My special and sincere gratitude goes to God almighty for keeping me alive and making
my SIWES program a huge success.

I want to say a very big thanks to my lovely parents Mr. and Mrs. Muhammad Abdullahi
my wonderful siblings for their prayer and financial support toward my educational
pursuit.

I wish to register my profound Appreciation to the HOD National Assembly Clinic

Laboratory the person of MR. COROS BITRUS MADAKI and the entire Staff of
National Assembly Laboratory, for making my Industrial Training interesting, Educative
and worthwhile.

I appreciate the Department of Biochemistry Federal University of lafia, my HOD and

supervisor in person of

v
vi
 ABSTRACT

This technical report is based on the experience gained during my five months of
Industrial training at National Assembly Clinic. This report highlight how activities and
my patient are being managed and also the several tests carried out for patient including
Widal test (typhoid test), Malaria parasite test (MP), FBS (fasten blood sugar), pregnancy
test, Urinalysis and urine MCS (Microscopy Culture and Sensitivity) Helicobacter pylori
test, blood grouping test, Full Blood Count (FBC) etc. The laboratory is divided into six
sections/benches which including reception and phlebotomy section/bench, Microbiology
section/bench, Serology section/bench, chemical pathology section/bench, Hematology
section/bench and automation section/bench This report contain safety precautions,
rules and regulations, patient’s diagnosis, and the various test analyses. Most importantly
is to describe the activities and my experience gained during the period of the training.

vii
 ORGANOGRAM OF THE
ORGANIZATION

TABLE OF CONTENTS

Tittle page - - - - - - - - - i

Approval page - - - - - - - - - ii

Declaration - - - - - - - - --- - - iii

Dedication - - - - - - - - iv

Acknowledgement - - - - - - - - - v

Abstract - - - - - - - - - vi
Table of contents - - - - - - - - - vii- viii

CHAPTER ONE

viii
1.0 Introduction to SIWES - - - - - - - 1

1.1 Agencies Involved in the Management of SIWES and their Functions - 1

1.2 Aim of SIWES - - - - - - - - 2

1.3 Objective of SIWES - - - - - - - - 2

CHAPTER TWO

2.0 Brief History and Background of National Assembly Clinic - - 3

2.1 The Vision - - - - - - - - - 4

2.2 Mission Statement - - - - - - - - 4

2.3 Values - - - - - - - - - - 4
CHAPTER THREE

3.0 Industrial Base Experience - - - - - - - 5

3.1 Introduction to the Medical Laboratory - - - - - 5

3.2 Laboratory Ethics, Rules, Safety, and Precautions - - - - 5

3.3 Medical Laboratory Ethics - - - - - - - 5

3.4 Laboratory Rules, Safety and Precaution - - - - - 6

3.5. National Assembly Medical Laboratory Division - - - - 6

3.5.1 Reception and Phlebotomy Section - - - - - 6

3.5.2 Phlebotomy Bench/Section - - - - - - 6-7

3.5.3 Automation Bench/Section - - - - - - 8-11

3.5.4 Chemistry Bench/Section - - - - - - - 11-12

3.5.5 Hematology Bench/Section - - - - - - 12

ix
3.5.6 Microbiology Bench/Section - - - - - - 12-14

3.5.7 Serology Bench/Section - - - - - - - 14-16

CHAPTER FOUR

3.6 Recommendation - - - - - - - - 17

4.1 Conclusion - - - - - - - - - 18

References - - - - - - - - - 19

x
 CHAPTER ONE

1.0 INTRODUCTION TO SIWES

The SIWES program started in 1973/1974 as Student Industrial Training (SIT). It was
established as a result of complaints from industries about the practical deficiencies of the
nation's higher institution graduates. Industrial training (IT) often refers to as student industrial
work experience scheme (SIWES) is a vital feature of all professional and technical program in
most part of the world. Though it is practical under different names such as teaching practice,
practical experience and house-manship, depending on the type of institution and convenience.
Basically students industrial work experience scheme (SIWES) is aimed at bridging the Gap
between the theoretical aspect of learning and the actual practical acquisition of this knowledge
which further exposes the student to the practical aspect of their course study (Akpan, Gregory;
2015). More so, it was constructed to educate and exposes students to various
instrument/equipment, standard operating procedure, skills and techniques relevant to their
courses of study .the student's industrial work experience scheme was introduced by the
industrial training fund (ITF) IN 1973, a federal organization established by the decree 47 skills
needed for employment in industries by Nigeria graduate of tertiary institution. The scheme is
funded by the federal Government of Nigeria

1.1 AGENCIES INVOLVED IN THE MANAGEMENT OF SIWES AND THEIR

FUNCTIONS

The bodies involved are: The Federal Government, Industrial Training Fund (ITF). Other
supervising agents are: National University Commission (NUC), National Board for Technical
Education (NBTE) and National Council for Colleges of Education (NCCE).

The functions of these Agencies above include among others to:

 Ensure adequate funding of the scheme;

 Establish SIWES and accredit SIWWES unit in the approved institutions;
 Formulate policies and guideline for participating bodies and institutions as well as
appointing SIWES coordinators and supporting staff;
 Supervise students at their places of attachment and sign their lob-book and IT forms;
 Ensure payment of allowances for the students and supervisor.
 Vet and process student’s log-book and forward same to ITF Area office;

1
1.2 AIM OF SIWES

Provide students with an opportunity to apply their theoretical knowledge in real work
institution, thereby bridging the gap between theory and practical.

1.3 OBJECTIVE OF SIWES

a. To expose students to work methods and techniques for handling equipment and
machinery that may not be available in their institutions.

b. To provide an avenue for students in Nigerian tertiary institutions to acquire

industrial skills and experience in the course of study.

c. Prepare students for industrial work situations that they are likely to meet after
graduation.

d. Make the transition from school to the world of work easier and enhance students’
contacts for later job placements in the labour market.

e. Enlist and strengthen employers’ involvement in the entire educational process and
prepare students for employment in Industry and Commerce (Information and
Guideline for SIWES, 2002).

2
 CHAPTER TWO

2.0 BRIEF HISTORY AND BACKGROUND OF NATIONAL ASSEMBLY CLINIC

National assembly Clinic was established in 1992, with the provisional concept of
comprehensive healthcare delivery to address the health need of legislators, staffs and their
family. Referrals at that time mainly were cases needing investigations and specialists attention.

In 1992-1993, National assembly Clinic was a two (2) room accommodation at the international
conference center, the staff strength was eight (8) in number, consisting of two (2) doctors, two
(2) pharmacists, and four (4) nurses.

In 1993-1996 the staff strength increased to sixteen (16) in numbers with the employment of
eight (8) junior staffs.

In 1997-1999 the National assembly Clinic moved to the present Annex 1 building and the to
the white house basement, the Dental clinic was established at the Annex, the staff strength rose
to forty-three (43) in number; and the clinic space expanded to fifteen rooms.

Since 2000 till date the staff strength has risen to nineteen-four (94) in number, with
Department upgraded, rendering more services such as optometry, physiotherapy and
laboratory services. Our Vision and Mission statement are being actualized.

Today there is an impatient facility at No. 1 Ikot Ekpene close of Garki Area 11, where the
wellness Clinic is about taking off, with staff members having been trained on Emergency
medical Care, Manual Vacuum Aspiration Techniques, to reduce mortality and injuries due to
unsafe abortions.

Refresher course have been organized for nurses to upgrade their obstetric knowledge, four
medical Doctors are getting specialist training in Family Health internal Medicine, Public
Health and Radiology.

Three Dental surgeons are getting specialist training and modern equipment have been acquired
to meet the objective of improving access to health care.

Immunization unit and Public Health department has been established, Anti-natal care service
rendered, Nephrology and Gynecology division are provided.

3
2.1 THE VISION

A center that is Excellent and Equitable in Health Care Delivery to the Legislature.

2.2 MISSION STATEMENT

To be Disciplined Professionals that offer Efficient, Effective and Quality Health Care Service.

2.3 VALUES

All employees of the National Assembly clinic/laboratory are expected to imbibe the following
corporate values: accountability, commitment, diligence, empathy, integrity, loyalty,
patriotism, transparency and trust.

4
 CHAPTER THREE

3.0 INDUSTRIAL BASE EXPERIENCE

3.1 INTRODUCTION TO THE MEDICAL LABORATORY

The laboratory is one of the most important parts of clinic/hospital. The laboratory is where
patient's samples are collected and examined in order to diagnose diseases or run routine tests.
(The prescriptions) treatment given to a patient is based on his/her laboratory test results, and
false or careless interpreted results can be hazardous to a patient's health. Thus, the importance
of the medical laboratory cannot be overemphasized; therefore the relevance of medical
laboratory scientist should not and can never be neglected

3.2 LABORATORY EHICS, RULES, SAFTY, AND PRECAUTIONS

The Laboratory is a place of discovery, investigation and learning. However, by the very nature
of laboratory work it can be a place of danger if proper precautions are not taken care of. While
every effort has been made to eliminate the use of explosive, highly toxic and carcinogenic
substances in the laboratory there are certain unavoidable hazards associated with the use of
chemicals and glass wares and handling of specimen.

3.3 MEDICAL LABORATORY ETHICS

Guidance for professional ethics of medical laboratory ethics was adopted in the year 1996.

The ethics include practices and attitude that characterized professional and responsible medical
laboratory service.

a. The Laboratory attendant must always respect the life and dignity of human being;
b. The Laboratory attendant must treat all biological materials with care and respect;
c. The Laboratory attendant must not disclose the results of investigation to a patient or any
unauthorized person;
d. The Laboratory attendant must not consume alcohol or take drugs that could harm His/her
performance during laboratory working hours or when on emergency duties;
e. The Laboratory attendant must always adhere strictly to safety precaution and always
ensure patient and others are not put in risk;
f. The Laboratory attendant must not indulge his/her self in any unprofessional act that could
be detrimental to wellbeing of the patient for the purpose of knowledge or personal gain.

5
3.4 LABORATORY RULES, SAFETY AND PRECAUTION

a. Always wear your laboratory coat and hand-glove when carrying out any laboratory
procedure in the laboratory;
b. Always remember to sanitize the working bench before working;
c. The laboratory benches and floor must be kept clean and neat, free of extraneous
materials and blood spillage, work bench surface should be disinfected when
investigations are completed and at the end of each day's work;
d. Do not store food or beverages in the laboratory refrigerator;
e. Inspect tubes for cracks and make sure that all bit of broken glass are removed from the
rubber cushion of the centrifuge before operation;
f. Avoid mouth pipetting do not lick label;
g. Do not touch exposed eyes Nose or skin with gloves hands;
h. All chemicals must be appropriately stored in a fine cupboard or it appropriate place;
i. Proper procedures and safety precautions should be followed when experiments are
performed;
3.5. NATIONAL ASSEMBLY MEDICAL LABORATORY DIVISIONS
The diagnosis laboratory is divided into distinct section that's separate the types of tests
performed based on the sample type and the intended result. The major sections of the
Laboratory in National Assembly Clinic and their functions are:

3.5.1 RECEPTION AND PHLEBOTOMY SECTION

The reception is the first point of call in the laboratory. It is reception that patient's request
forms are collected and registered, and it is at the reception that patient's completed tests results
are given out.

3.5.2 PHLEBOTOMY SECTION

Phlebotomy Section is the section of the laboratory that deals with the opening of vein to
withdraw blood or collection of blood from the vein, and collection of blood samples through
capillary method using lancet, And also collection of other samples like urine, stool, sputum,
swab samples, semen , in other words this section Received all type of sample.

(a) SAMPLE COLLECTION BOTTLES:- There are different sample bottles for
collecting blood samples. Vacuum containers and other bottle with different coloured cap are

6
used for different tests, based on the anticoagulant contained in them. Eg. EDTA bottle, fluoride
oxalate bottle, lithium heparin bottle, and sodium citrate bottle

(b) BLOOD SAMPLE COLLECTION:- Blood is one of the samples used for a wide range
of laboratory tests and diagnosis. Most type of blood sample collection method are
the Venous and capillary method.

(c) VENOUS BLOOD COLLECTION: This blood sample is usually collected from a
patient's vein. The blood is drawn in a syringe and put into a sample bottle to prevent clotting,
and to preserve it if not used immediately.

MATERIAL USED: Syringe, Methylated spirit, Cotton Wool, Sample Bottle, Tourniquet,
Disposable Gloves, nose mask.

PROCEDURE: The apparatus to be used were gathered and kept within reach, the patient kept
in a comfortable seat and on a good sitting position, the patient's hand checked for a prominent
vein, the tourniquet tied firmly above the site to be puncture, and the vein was palpated to make
set up, a methylated spirit-soaked Cotton swab was used to clean the site to be puncture to
disinfect the area. The site should not to be touched after sanitizing, following the above
procedure the patient is asked to make a fist. (in order to make the vein clearer). The needle of
the syringe was inserted into the vein, slanting it slightly, the blood is drawn slowly using the
plunge of the syringe, when the required/enough blood is drawn, the tourniquet is released and
the patient will be told to release the fist, the needle is pulled out gently and a dry cotton wool
swab placed on the puncture site. Pressure is applied to stop the bleeding, and the blood is
dispensed into the appropriate sample bottle, and was rocked gently to mix blood with
anticoagulant.

(c). CAPILLARY BLOOD SAMPLE COLLECTION

Capillary Blood is usually collected from a patient's finger using a lancet. In babies, capillary
blood is sometimes collected from the heel. Capillary Blood is used for tests which require little
amount of blood e.g. malaria parasite, blood group, blood genotype, and packed cell volume.

MATERIALS: Lancet, methylated spirit, cotton wool, tile/glass slide/capillary tube (depending
on the test to be conducted). And the procedure for this is usually pricking of the thumb or the
index finger.

7
3.5.3 AUTOMATION SECTION

This is the section of the laboratory that introduce you to the working pattern or principle of all
the machine in the laboratory. E.g microscope, micro-hematocrit centrifuge, autoclave, bucket
centrifuge, chemistry analyzer (selectra pro-S), incubator, hematology analyzer (FBC machine),
automatic malaria machine

(a) SELECTRA PRO S. (CHEMISTRY ANALYZER)

Chemistry Analyzer: Are medical laboratory device used to calculate the concentration of
certain substance, substance analyzed through these instrument includes certain metabolites,
electrolytes, protein , uric acid, glucose , and drugs.

PRODUCT DESCRIPTION: Chemistry analyzers can be bench top device or placed on a

cart; other systems require floor space. They are used to determine the concentration of certain
metabolites, electrolytes, protein, and drugs,

Samples are inserted in the sample rotor, and test are programmed via a keypad or bar-code
scanner. Reagents are loaded within the reagent rotor on the analyzer, and it may require a
water supply to wash curvet parts. Result are displayed on a screen, and typically there are
ports to connect to a printer or computer.

WORKING PRINCIPLE/PRINCIPLES OF OPERATION: After the tray is loaded with

samples, a pipette aspirated a precisely measured volume of diluents and Reagents are
dispensed into the reaction vessel. After the solution is mixed, by the machine it passed through
colorimeter, which measure it's absorbance, which is measured by a flow through photometer.
The analyzers then calculates the analyte’s chemical concentrations and then bring out the
result on a screen.

8
(b) MICROSCOPE

A microscope is an instrument for producing a greatly magnified image of an object, which

may be so small as to be invisible to the naked eye, that means with this instrument one can see
small object that are beyond the ordinary vision.

9
(c) AUTOCLAVE

This is equipment used in sterilizing liquid media; it is type of pressure cooker that produces
high pressure and temperature above boiling point (100°). The procedure for sterilization is that
the autoclave is set at 121°C for 15 munites

10
11
(d) BUCKET CENTRIFUGE

Centrifuges are equipment used to hasten the decomposition of substance in solution, on harvest
one settle first. The principle is based on the centrifugal force (CF), unlike the nature force of
gravity; centrifuge causes the particles in the solution to sediment faster. The speed of the
revolution varies with the size of the centrifuge and the amount of liquid being centrifuged.

(e) MICROHEAMOTOCRIT CENTRIFUGE

It Hasten the parking of the Erythrocyte, the plasma at the top of the cell in a tube it has an
outer steel cover with a rubber lock (The Safety Lid ) and a screw to fix the rotation slot plate
on which the micro capillary tube are placed. An electric timer is fixed to set the number of
revolution per minute (rpm) desired.

12
13
(f) INCUBATIOR

The is insulated metal box equipped with a mechanism that regulate it internal temperature. It is
basically used to grow microorganism of controlled temperature, they are usually set at 37° for
most microorganism.

(g) REFRIGERATOR

14
Is used for the preservation of specimen in the laboratory.

3.5.4 CHEMISTRY BENCH/SECTION

The clinical chemistry sections perform hundreds of quantitative analysis on variety body
fluids. Common chemistry Test includes testing for glucose, Urinalysis cholesterol, hormones,
and electrolytes.

(a) URINALYSIS

Urinalysis is the comprehensive analysis of urine. A urinalysis is a simple test that looks at a small
sample of urine. It can help find problems that need treatment, including infections or kidney problem.
It can also help find serious disease in the early stages, like kidney disease, diabetes, or liver disease.

A urinalysis is also called a urine test, and this urine test can include three parts which are:
15
[Link] EXAMINATION: the urine will be looked at for color and clearness. Blood may make urine look
red or the color of tea or cola. An infection may make urine look cloudy. Foamy urine can be a sign of
kidney problems.

[Link] EXAM: A small amount of urine will be looked at under a microscope to check for
things that do not belong in normal urine that cannot be seen with the naked eye, including red blood
cells, white blood cells (or pus cells), bacteria (germs), or crystals (which are formed from chemicals in
the urine and may eventually get bigger and become kidney stones).

[Link] TEST: A dipstick is a thin, plastic stick with strips of chemicals on it. It is dipped into the
urine. The strips change color if a substance is present at a level that is above normal.

TITLE: Urinalysis.

AIM: To check the chemical composition and comprehensive analysis of urine

METHOD: Using combi-9 strip (dipstick method)

MATERIALS: Combi-9 strip and urine sample.

PROCEDURES:

NOTE: The nine parameters to check on the combi-9 strip are:

[Link]

[Link]

[Link]

[Link]

[Link] (sugar)

[Link]

[Link]

[Link]

[Link] acid

16
COMBI -9 TEST KIT

PROCEDURE:

:Midstream urine was collected from the patient in a sterile universal bottle, and was centrifuged at
2500rpm (revolution per minute) for about 5 minute.

Centrifuged urine was removed and was poured out in order to obtain the sediment. The sediment
was then poured in a clean glass slide containing two drops of normal saline and was covered with a
cover slip.

The prepared smear was placed in a bright field microscope and was viewed with the ×10 Objective
lens. Thereafter it was viewed with high power lens of ×40.

Result/observation:

In urine microscopy there are different parasites which are expected to be seen; these indicate
abnormalities in the urinary tract.

The following might be found in the urine deposit

[Link] cells

[Link] cells
17
[Link]

[Link]

[Link] cells

[Link]

Schietisoma haematobium and Trichomonas vaginalis …. the result is in pluses (+) if there is a
reaction above normal or in negative and positive format if there is no reaction, the nine
parameter checked by combi-9 strip in urine are: protein, glucose, blood, nitrite, ketone,
ascorbic acid, PH, bilirubin, urobilirubin l

The Urinalysis section screens urine sample for evidence of kidney diseases liver problem,
urinary tract infection (UTI).

(b)FASTING AND RANDOM BLOOD SUGAR TEST

18
GLUCOMETER

A blood glucose test measures the amount of glucose in your blood.

Blood glucose tests are either random or fasting tests.

For a fasting blood glucose test, you can’t eat or drink anything but water for eight hours before your
test

Random blood sugar (RBS) measures blood glucose regardless of when you last ate.

Normal results

The implications of your results will depend on the type of blood glucose test used. For a fasting test, a
normal blood glucose level is between 70 and 100 milligrams per deciliter (mg/dL). For a random blood
glucose test, a normal level is usually under 125 mg/dL. However, the exact level will depend on when
you last ate.

Abnormal results

If you had a fasting blood glucose test, the following results are abnormal and indicate you may have
either prediabetes or diabetes:

* A blood glucose level of 100–125 mg/dL indicates that you have prediabetes.

* A blood glucose level of 126 mg/dL and higher indicates that you have diabetes.

PROCEDURE:FASTING AND RANDOM BLOOD SUGER

A blood glucose test measures the amount of a sugar called glucose in a sample of your blood. Random
and Fasting blood sugar (RBS and FBS) test are test which are done to determine the level of glucose
or sugar in the blood. The difference between Random Blood Sugar and Fasting Blood sugar is that, the
patient is not expected to eat for 8 hours, while in the case of Random Blood Sugar; the patient may
eat whatever he/she wants before the test can be conducted. The normal range for the fasting Blood
sugar is(70 – 100)mg/dL and the normal range for Random Blood Sugar is (80– 140)mg/dL. Any of the
values above the given normal range means that the patient has diabetes (excess sugar in the blood).

PRINCIPLE: The enzyme glucose oxidase reacts with glucose, water, and oxygen to form gluconic acid
and hydrogen peroxide.

19
Materials Required: wet and dry swab, test strip, blood sample and glucometer.

Procedures:

Fluoride/ oxalate container was labeled with the patient's name

The glucometer was switched on and the Acu-check strip was inserted.

The patient’s thumb was clean using the wet swab then pricked using the lancet

the first drop is wipe off with a dry swab and the thumb is pressed.

A drop of blood was allowed to drop at the front top of the test strip.

It was allowed for few seconds while the results displays on the LCD screen.

The result was recorded in milligram per deciliter (mg/dL).

(c)ERYTHROCYTE SEDIMENTATION RATE(ESR)

Erythrocyte sedimentation rate (ESR or sed rate) is a test that indirectly measures the degree of
inflammation present in the body. The test actually measures the rate of fall (sedimentation) of
erythrocytes (red blood cells) in a sample of blood that has been placed into a tall, thin, vertical tube.
Results are reported as the millimeters of clear fluid (plasma) that are present at the top portion of the
tube after one hour.

The ESR is not diagnostic; it is a non-specific test that may be elevated in a number of these different
conditions. It provides general information about the presence or absence of an inflammatory
condition.

Inflammation is part of the body’s immune response. It can be acute, developing rapidly after trauma,
injury or infection, for example, or can occur over an extended time (chronic) with conditions such as
autoimmune diseases or cancer.

AIM: ESR testing is to measure inflammatory state.

PRINCIPLE: The Erythrocyte Sedimentation Rate (ESR) expresses in mm per hour the rate at which red
blood cells settle when anti-coagulated blood is allowed to stand in a narrow tube (Westergren). It is
measured by the height of the column of clear plasma at the end of one hour.

Reagents supplies and Equipment:

20
[Link] tubes

2. Westergren rack

3. Disposable pipettes.

4. 0.5mls sodium citrate or EDTA in puncture ready vials.

5. Leveling plate for holding the westergren rack.

6. Timer

Procedure:

The materials were made available.

2mls of whole blood was collected and poured in into an anticoagulated container, example EDTA or
sodium citrate

The patient’s name was labeled on the westergren tube near the tope to the tube.

The dispette was uncap and the blood was poured into the dispette.

The cap was covered and invert 8 times making sure the blood and anticoagulant are well mixed.

The pipette was carefully placed into the dispette containing blood / diluents and the mixture was
twisted as you push the tube down.

Caution was taken inorder not to use excessive force when pushing the pipette into the dispette so
that it would not spew.

The westergren tube was placed into westergren rack at a vertical position and left undisturbed for 1
hour.

After 1 hour has passed, The distance in millimeters from the bottom of the plasma meniscus to the
top of the sediment erythrocytes was read and recorded.

Reporting Results:

Normal Range:

Adult male

0 - 10 mm/hr
21
Adult female

0 - 15 mm/hr

Children

0 - 10 mm/hr

PRECAUTIONS

22
Age of specimen: specimen must be less than 2 hour at room temperature, less than 6 hour at 2 – 6°C.

Temperature: Environmental temperature and specimen must be between 20 – 25°C when testing is
performed.

Elevated temperatures falsely elevate the ESR.

Incorrect ratio of blood to diluents. Excess anticoagulant causes the red blood cells to shrink, resulting
In a decreased ESR.

Bubbles in the westergren tube, result in a decreased ESR.

Tilting of the westergren tube accelerate the fall of the erythrocytes ( an angle of even 3• will increase
the rate by as much as 30%)

Vibration (ex. Nearby centrifuge) can falsely elevate the ESR.

Plasma and red blood cell abnormalities affect sedimentation rate.

Haemolysis of the specimen causes a decrease in the ESR.

(d)PREGNANCY TEST

AIM: To determine if a person is pregnant by checking for a particular hormone in the blood

METHOD: Using Pregnancy test strip

MATERIAL: Pregnancy test strip, EDTA bottle, 2ml blood specimen, pipette

PRINCIPLE : Pregnancy test checks the blood or urine for a hormone called human chorionic
gonadotropin(hCG). The body makes this hormone after a fertilized egg attaches to the wall of the
uterus. This usually happens about 6days after fertilization. Levels of hCG rise quickly, doubling every 2
to 3days.

PROCEDURE: A 2ml blood sample was aspirated from the vein be of a patient, it was further dispensed
(step wisely) in an EDTA containing bottle, and was centrifuge at 1000rpm for 5minute.

The serum at the top of the EDTA containing bottle was dropped into the Pregnancy test strip and was
allowed for 5minute (as stipulated in the Pregnancy test strip Manuel) for result.
23
RESULT/OBSERVATION: There two lines on the strip, first line for test and the second line for control.

If the two lines appear it means the test is positive, if the second line which is the control line appears
only it means the test is negative, but if the first line which is the test line appear only it means the
result is invalid

CONCLUSION: At the end of the experiment the determination of the visual detection of pregnancy
test was carried out properly.

3.5.5 HEMATOLOGY SECTION

Haematology is the branch of medicine concerned with the study and treatment of the blood
disorder. The hematology section perform tests that are important in diagnosis many blood
disorders such as anemia and leukemia. Whole blood and body fluids are analyzed
electronically and examined microscopically for abnormal cells and diseases of the blood.
Examples of hematology test are blood grouping, genotype test, full blood count (FBC), ESR
ETC.

(a) PACKED CELL VOLUME (PCV) TEST

MATERIAL REQUIRED: Micro-hematocrit Centrifuge, Micro-hematocrit Capillary Tubes;

Micro-hematocrit Reader; Silicon Sealant, Blood Sample in an Anticoagulant Bottle (2ml) and
Cotton Wool.

PROCEDURE:- Gently mixed the blood in the Anticoagulant bottle and dip a Micro-hematocrit
capillary tube into it and allow the blood to flow into the tube by capillary action. The level of
the tube should be 2/3 of the capillary tube length, remove the capillary tube from the bottle and
clean with a cotton wool, seal one end of the tube using silicon sealant place the capital tube in
the Micro-hematocrit centrifuge and ensure it is safety covered and balanced. Close the rid and
spin at 12,000rpm (Revolution per minute) for 5 minutes. Place the spun tubes sample on the
Micro-hematocrit reader and read.

24
NOTE:- When reading the Capillary tube on the reader, the lower end of the packed cell should
coincide with zero (0) mark of the Reader, and the upper line of the serum in the tube on the
reader should coincide with the 100 mark of the reader. The reading start where the serum and
red blood cell meet. The range for male is 40 to 52% while for female is 35 to 45%
respectively.

(b) BLOOD GROUPING TEST

MATERIAL REQUIRED: ABD antisera , blood grouping tile, methylated spirit,aplicator

stick,cotton wool,and lancet.

PROCEDURE:swab index finger with cotton wool soaked in 70% alcohol,prick finger with a
lancet,collect blood via capillary action,place blood on three different tile,add ABD antisera
respectively and rock for 2-3 minutes then watch for agglutination reaction.

Principle of blood grouping:The ABO and RH blood grouping system is based on agglutination
[Link] red blood cells carrying one or both antigens are exposed to corresponding anti
bodies,they interact forming visible clumps (agglutination)
25
(c)GENOTYPE TEST

ELECTROPHORESIS MACHINE

Genotype is your complete heritable genetic identity; the sum total of genes transmitted from parent
to offspring.

There are four hemoglobin genotypes (hemoglobin pairs/formations) in humans: AA, AS, SS and AC
(uncommon). SS and AC are the abnormal genotypes or the sickle cells. We all have a specific pair of
these hemoglobin in our blood which we inherited from both parents.

Knowing one's hemoglobin genotype before choosing a life partner is important because there may be
compatibility issues which could have devastating effects when it comes to conception.

Individuals with sickle cells experience severe pains in body parts where oxygen flow is compromised
due to blockage in the blood vessels.

26
AA can marry anybody

AS is better off with AA

AS and AS, AS and AC are highly discouraged (medically).

Two sickle cells = avoid conception

Aim: To determine the genotype of a patient

Principle It uses the principle of Gel electrophoresis. Different heamoglobin have different charges and
according to those charges and the amount of heamoglobin, different chains move at different speed
in gel and seperates.

Materials required: genotype machine, electrophoresis tank, cotton wool, tile, stirer, impression stick,
cellulose acetate paper, filter paper, water, blood sample.

Procedure

Blood Sample was collected from the patient and poured into an EDTA bottle

A drop of blood was placed on three different places on the tile

Water was added to each of the drop of blood to hemolyze it

Cellulose acetate paper was dipped into the buffer to moisturize it and then moisture was reduced
from the cellulose acetate paper

An impression was made on the cellulose acetate paper on a horizontal line

The cellulose acetate paper was then placed on the electrode inside the electrophoresis tank and then
covered

The genotype machine was connected to power source, switched on and then run for 15 minutes

The results was observed and recorded after 15. Minutes.

27
 Genotype Result Sample

_A _A _AA

_S _S _SS

_C _C

_ _ _ _ _

3.5.6 MICROBIOLOGY BENCH/SECTION

MICROBIOLOGY SECTION:- The microbiology section identifies microorganisms that may

be causing diseases (pathogens). The microbiology department also provides information
regarding appropriate antibiotics to use as treatment for various pathogens. On the bench I spent
one month of my Industrial training duration and was properly taught on the different
test/diagnosis carried out under the microbiology section in the laboratory I was first and
foremost taught on microbiology.

Microbiology is the study of the lowest forms of organism which are both single cell, which are
known as unicellular organism performing all the activities associated with life. In the medical
microbiology this section deals with microorganism activities as associated with life.

(a) MICROSCOPY OF UNSTAINED SMEAR

During my training period I was basically taught unstained microscopy (Direct microscopy)
which are generally known as wet mount.

URINE MICROSCOPY

Title: Urine microscopy

28
Aim: To identify the parasite e in the urinary tract

Apparatus/Reagent: Microscope ×10, ×40

Clean glass slip, Cover slip, Sterilize container, A mid-stream urine, and Normal saline.

(b) PRINCIPLE

The Urine microscope examination is a method of identifying and quantifying cells bacteria,
and other materials in the sediment of centrifuged urine. It allows ruling out or diagnosing
urinary tract infection and aids in the diagnosis of urinary tract or renal disease.

Procedure: Midstream urine was collected from the patient in a sterile container, and was
centrifuged at 2500rpm (revolution per minute) for about 5 minute.

Centrifuged urine was removed and was poured out in order to obtain the sediment. The
sediment was then poured on a clean glass slide containing two drops of normal saline and was
covered with a cover slip.

The prepared smear is placed in a bright field microscope and was viewed with the ×10
Objective lens. Thereafter it was viewed with high power lens of ×40.

Title: Urine microscopy

Aim: To identify the parasite in the urinary tract

Apparatus/Reagent:

[Link] glass slip

[Link] slip

[Link] universal bottle

4.A mid-stream urine

[Link] saline

[Link] tubes

Microscope using ×10 objective lens.

29
Principle

The Urine microscope examination is a method of identifying and quantifying cells bacteria, and other
materials in the sediment of centrifuged urine. It allows ruling out or diagnosing urinary tract infection
and aids in the diagnosis of urinary tract or renal disease.

Procedure: Midstream urine was collected from the patient in a sterile universal bottle, and was
centrifuged at 2500rpm (revolution per minute) for about 5 minute.

Centrifuged urine was removed and was poured out in order to obtain the sediment. The sediment
was then poured in a clean glass slide containing two drops of normal saline and was covered with a
cover slip.

The prepared smear was placed in a bright field microscope and was viewed with the ×10 Objective
lens. Thereafter it was viewed with high power lens of ×40.

Result/observation:

In urine microscopy there are different parasites which are expected to be seen; these indicate
abnormalities in the urinary tract.

The following might be found in the urine deposit

[Link] cells

[Link] cells

[Link]

[Link]

[Link] cells

[Link]

[Link] haematobium and Trichomonas vaginalis

30
Urine culture

Media used: CLED (cystine lactose electrolyte deficient) Agar and MacConkey Agar.

Procedures:

[Link] out plate CLED and MacConkey agar

2. Number them using diamond pencil.

3. With a sterile wire loop obtain a loopful and inoculate on the plate by stricking.

[Link] at 37oc for 24 hours using incubator

[Link] 24 hours of inoculation, Examine and identify organisms present

NOTE: Microorganisms are identified based on the following:

[Link]

[Link]

[Link]

[Link] be identified based on the morphological appearance

The microorganisms that can be found are:

[Link] sp.

[Link] sp.

[Link] sp.

[Link]

5.E. coli

The present of any of the above organisms leads to sensitivity.

Sensitivity test

Media used: Nutrient Agar

31
Procedure

[Link] a colony with a sterile inoculating loop. The colony should not be too heavy because it can give
false negative result.

[Link] the entire plate.

[Link] the selected antibiotic disc

[Link] at 37oc for 24 hours in the incubator

The antibiotics that are resistant or sensitive to the organisms is recognized by the area of inhibition. It
is reported as S and R. where S indicate sensitivity and R indicate resistance.

Table 1: SOME ANTIBIOTICS USED IN THE LABORATORY AND THEIR SYMBOLS.

————————————————————————————————————

________________________________________________________________________]

|Chloramphenicol

|Fortum/ Ceflazziaime

|Ciprofloxacin/ Ciproxin

Gentimycin

Cephaloridine

Rocephin

Colistin Sulphate

Claforan

Zinacep

Erythromycin

Tetracyclin

Dalacine
32
Furandeta

Kanamycin

Neomycin

Penicillin

Ampicellin

Streptomycin

Septrin

AML

AUG or AMC

CA2

CIP

CN or GEN

CL

CRO

CT

CTX

CXM

TET

DA

33
N

PN or ANP

STR

SST

RESULT/OBSERVATION:- In urine microscopy there are different parasites which are

expected to be seen; these indicate abnormalities in the urinary tract.

During my attachment on this bench I observed that the pus cells are a thick fluid containing
dead tissue, cells and bacteria. The body often produces it when it's fighting off an infection,
especially infections caused by [Link] is basically counted 0-10 Hpf (High power field).

3.5.7 SEROLOGY SECTION/BENCH

Serology is the study of antigen and antibodies reaction which are present in the Blood using
serum, Serologic testing evaluates antibodies and antigens Reaction that may be indicative of
many types of infectious diseases. This is important not only confirming a diagnosis, but also in
treating and managing various conditions. Some serology test are WIDAL Test, HBsAG test,
RVS Test, HCV Test, VDRL Test, H. pylori test E.T.C.

WIDAL TESTS

AIM: To detect the causative organism of enteric Fever (typhoid and paratyphoid)

METHOD USED: Using Widal kit. (This works with the principle of antigen and antibodies).

MATERIALS: A 2ml blood sample, EDTA test tube, tourniquet, 2ml stringy, Widal kit
(containing the somatic antigen which is designated as "O" and the flagella antigen which is
designated as ''H'')
34
PRINCIPLE: Widal is a presumptive serological test for enteric fever or bundulant fever
whereby bacteria causing typhoid and protozoa causing malaria fever are mixed with a serum
containing specific antibodies obtained from an infected individual. Cases of Salmonella
infection, it is a demonstration of the presence of O-somatic antigen and H-flagella antigen.

PROCEDURE: A 2ml blood sample was aspirated from the vein of the patient; it was further
dispense in an EDTA containing bottle, and was spun at 1000rpm for 5 minutes.

The Serum at the top of the test tube

Was picked with pipette, and was dropped in eight different aliquots on a Widal tile, the same
procedure was repeated to the Widal kit, starting from the HA,-OD antigen respectively.

The serum and the anti-sera was stirred homogeneously, and were rocked for 3 minute in order
to obtain the agglutination reaction of the various titre.

RESULT: there are four common causative agent of enteric fever,

Salmonella typhi (which are under the group D),

Salmonella paratyphi A,

Salmonella paratyphi B,

Salmonella paratyphi C

The Widal reactions are recorded in respect to the above listed causative agent.

Below is a table showing the result of both the somatic and flagella antigen.

H O

S. Paratyphi A 1/20. 1/80

S. Paratyphi B 1/40. 1/320

[Link] C 1/160. 1/20

S. Typhi D 1/40 1/80

Note: Title greater than 1/80 is a significant titre

(a) HEPATITIS B SURFACE ANTIGEN (HBsAG) TEST

35
AIM: To determine the visual detection of Hepatitis B surface antigen in serum

METHOD: using HBsAg strip

MATERIALS: HBsAg strip, 2ml string, test tube, pipette tourniquet cotton wool methylated
spirit.

PRINCIPLE: Hepatitis B is a viral infection that attacks the liver and can cause both acute and
chronic disease, it is basically caused by hepatitis virus, it can caused scarring of the organ,
liver failure, and cancer.

PROCEDURE: A 2ml blood sample was aspirated from the vein be of a patient, it was further
dispensed (step wisely) in an EDTA containing bottle, and was centrifuge at 1000rpm for
5minute.

The serum at the top of the test tube was dropped into the HBsAg strip and was allowed for
10minute (as stipulated in the HBsAg strip Manuel) for result.

RESULT/OBSERVATION: Two lines on the control and test region show a positive result
while one line indicates a negative result.

(b) HEPATITIS C VIRUS (HCV)

TITTLE: Hepatitis c virus

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Hepatitis C is spread through
contact with blood from an infected person.

AIM: To detect the presence of hepatitis c virus in the blood

METHOD USED: Using Hepatitis c virus strip.... (This works with the principle of antigen and
antibody).

THEORY: Hepatitis C virus (HCV), a member of the Hepacivirus C species, is a small (55-65
nm in size), enveloped, positive-sense single stranded RNA virus of the family Flaviviridae.
The hepatitis C virus is the cause of hepatitis C and some cancers such as liver cancer
(hepatocellular carcinoma, abbreviated HC C) and lymphomas in humans.

36
Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious
liver damage. The hepatitis C virus (HCV) spreads through contaminated blood.

(c) VENERAL DISEASE RESEARCH LABORATORY ( VDRL) TEST

AIM: To determine the presence of Venereal disease research laboratory in a given blood
sample.

The venereal disease research laboratory test (VDRL) is a blood test that can identify syphilis infections.
Syphilis is one of the most common sexually transmitted infections (STIs).

A positive test result means you may have syphilis.

METHOD USED: Using VDRL strip (which works with the principle of antigen and antibody).

(d) HELICOBACTER PYLORI TEST

AIM: To detect the presence of Helicobacter. Pylori in the blood

MATERIAL: H-Pylori strip, a 2ml blood specimen, test tube tourniquet: using Helicobacter
pylori strip

Helicobacter pylori is a type of bacteria that is known to be a major cause of peptic

ulcers. H. pylori testing detects an infection of the digestive tract caused by the
bacteria to help diagnose the cause of symptoms and/or ulcers.

H. pylori infections of the digestive tract are very common, with as many as half of the
world’s population infected. However, most people with H. pylori never have any
symptoms. Still, H. pyloriinfection increases the risk of developing ulcers (peptic ulcer
disease), persistent stomach inflammation (gastritis), and gastric (stomach) cancer.
The bacteria decrease the stomach’s ability to produce mucus, making the stomach
prone to damage from digestive acid and peptic ulcers.

(e) RITRO VIRAL SCREENING TEST (RVS)

MATERIAL: RVS strip, a 2ml blood sample, test tube tourniquet.

METHOD: using RVS strip

Retrovirus is a virus that is composed not of DNA but of RNA. Retroviruses have an enzyme called
reverse transcriptase that gives them the unique property of transcribing their RNA into DNA after
37
entering a cell. The retroviral DNA can then integrate into the chromosomal DNA of the host cell to be
expressed there. HIV is a retrovirus.

Retroviral screening test (RVST) is a test done to detect the presence of human immunodeficiency virus
(HIV – 1 and HIV – 2) antibodies in serum or plasma. HIV is a virus that causes Acquired immune
deficiency syndrome (AIDS). It invade the immune system of human destroying the blood cells which
serve as a defense mechanism to the body. When the body immune systems are destroyed, the body
becomes open to any pathological attack. People suffering from this virus suffer symptoms like fever,
tuberculosis, weakness of the body, diarrhea, etc. though antiretroviral drugs are now available to
alleviate the risk of death when infected but it has no cure at the moment.

Aim: To determine the presence of human immunodeficiency virus(HIV) in the blood.

PRINCIPLE: Rapid tests are a simplified version of antibody ELISA tests. They look for HIV antibodies in
the blood. The antigens for HIV are fixed on one particular strip along the rapid test stick. Towards the
end of the testing stick are control antigens to show that the test worked.

Materials required: Determine test strip or UNIGOLD stat park test strip, blood sample and centrifuge.

Procedures:

Prominent vein was located

The area to be punctured was disinfected with a wet swab.

2mls of blood was collected with the syringe and needle and poured into the EDTA bottle

The blood sample was spun using a Centrifuge to get serum or plasma.

The serum was pipette and placed onto the space provided on the Unigold strip or determine strip.

After 5 – 6 minutes a pink line(s) was observed on the test strip.

Results: A double pink line will appear if positive and a single pink line appear if negative.

NOTE: These is for all serology Test using strip (cassette) , if the Test Line and the control
Line show up the test is valid, if the control line show up without the test is negative, if the test

38
line show up without the control line the test is invalid and All Serology test using srip follows
same procedure.

CHAPTER FOUR

3.6 RECOMMENDATION

Having followed the event of

Five (5) month of industrial training it’s important to recommend few things, Although SIWES
did achieve quiet a lot of its stated objective, nevertheless, the following recommendations are
suggested to improve the qualitative context of the program:

 I Recommend National assembly Clinic as a befitting place for student's industrial

training attachment.
 Teaching or enlightening student on how to report their practical work before posting
should be done by the laboratory SIWES coordinator
 Sending students specifically to establishment where the stipulated aims and objectives
of SIWES would be achieved should be done by the institution.
 I recommend that national assembly clinic should at least give students transport fare
to assist in student’s transportation during the period of training to motivate them.
 I recommend that the ITF intervention fund should pay student immediately they are
placed in an organization should in case the organization fails to make transport
arrangement.

4.1 CONCLUSION

The SIWES program undergone at National Assembly Clinic afforded me an in-depth exposure
to some of the practical medical aspects of biochemistry profession. I was privilege to work in
all section of the laboratory from the sample collection point to the point of analysis, I
understood that biochemist play a vital role in medical laboratory science, I was opportune to
have known the practical implementation of some biochemistry test (blood glucose estimation
and urinalysis ).

39
Besides, knowledge which I acquire in some medical laboratory diagnosis such as blood group
test, full blood count diagnosis, urinalysis, urine microscopy culture and sensitivity etc. The
program has been highly beneficial, interesting and also enlighten. However the program has
improved my communication skill. The objective of SIWES scheme undergone was however
fully achieved.

40
REFERENCES

Brooks, G.F., Carroll, K.C., Butel, J.S., Morse, S.A., and Mietzner, A. Timorthy. (2013).
Jawetz,Melnick&Adelberge’s Medical Microbiology. 26th edition U.S.A: McGraw Hill
Companies

Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St.
Louis: Saunders.

D.R. and Arora, B. (2008). Practical Microbiology. 3rd Edition. New Delhi: CBS Publishers
and Distributors Pvt Arora.

National Assembly Medical Clinic Diagnostic Laboratory

National Assembly Medical Clinic Diagnostic Laboratory IT students lecture note.

41