ORGANIZATIONAL CHART OF CRUTECH MEDICAL CENTER

CROSS RIVER UNIVERSITY OF TECHNOLOGY

DIRECTOR OF MEDICAL SERVICE (DMS)

DEPUTY DIRECTOR OF MEDICAL SERVICE AND MEDICAL SUPRITENDENT

(OGOJA CAMPUS)
MEDICAL CENTER

MEDICAL SUPRINTENDENTS

MEDICAL CENTER (OBUBRA) MEDICAL CENTER (OKUKU) CAMPUS

MEDICAL OFFICERS
(ALL FOUR CAMPUSES)

NURSING UNIT LABORATORY UNIT MEDICAL RECORD UNI DENTAL UNIT

CHIEF MATRON LAB SCIENTIST (HOD) PRINCIPAL MEDICAL RECORDER PRINCIPAL DENTAL OFFICER

METRON IN CHARGE OF WARDS

LAB TECHNISIANS RADIOGRAPY UNIT

CHIEF NURSING OFFICER (CNO)

SENIOR NURSING OFFICER (SNO) PRINCIPAL RADIOGRAPHIC TECHNICIAN

NURSING OFFICERS (N.O)

SENIOR NURING ATTENDANTS AMBULANCE DRIVER UNIT

HEAD LAB ATTENDANCE

HEAD NURSING ATTENDANT AMBULANCE DRIVER

1
Brief History of CRUTECH MEDICAL CENTER

CRUTECH MEDICAL CENTER in 1973 alongside the school then known as college of
Technology located at target. It was headed by Dr. Udo idiok as Director of Medica Service
After some years, the school name was changed from college of Technology to polytechnic due
to the position of the state and its location was shifted to Ekpo Abasi. During the period, the
Medical Center was headed by Dr. Ebong then Dr. Etim, Dr. Eyo, Dr. Kaiser, and now
Dr.Briggs who is still acting till date.

2
preparation of buffer salts (TRIS Buffer)
Oh on this day I was taught how to prepare Buffalo sauce which is a solution that is used in
routine analysis you know test.
It is also used as an electrolyte buffers are used by biochemists to control pH in the
physiological range
TRIS buffer Salt (TBS) is an excel wash buffer for many tpes of immune essays\

MATERIALS USED FOR TRIS BUFFER PREPARATION

 Measuring cylinder
 Distilled water
 Buffer salt
PROCEDURES FOR TRIS BUFFER
To measure 1000ml of water
Add 4.8g of buffer salt into the measured water.
Note: it works by allowing the samples to migrate in the electrophoresis machine
Label and stone in the fridge to maintain it potency

Phlebotomy
Is defined as the process of removing or withdrawing blood with a needle, usually from vein.
The term phlebotomy breaks down into phlebos meaning vein and tome meaning cutting. This
may seem like unusual name considering there is is no actual cutting involved, however, a
needle must break or cut the skin in order to access a blood vessel. Health car professional who
practice this are called phlebotomist.

Phlebotomy is also a medical field that involves the drawing of blood the patient for diagnostic
or therapeutic purposes

Types
There are two main types of phlebotomy
Vein phlebotomy
Capillary phlebotomy

Vein phlebotomy is the most common type of phlebotomy it involves taking blood froom a vein
usually the arm.

Capillary phlebotomy is less common than vein puncture, but It can be used when vein are not
accessible or if a lager amount or blood is needed. It involves taking from small vessel in te skin
such as finger or toe

Categories of phlebotomy
Phlebotomy can be divided into two categories
Therapeutic phlebotomy
Diagnostic phlebotomy

Therapeutic phlebotomy is used to treat condition like iron overloaded or polycythemia vera
Diagnostic phlebotomy is used to test for codition like anemia or bleeding disorders

3
Why is phlebotomy used
Phlebotomy is used for a variety of reasons such as:
It can be used to diagnose and treat medical conditions
It can be also used to monitor a patients progress after treatment or to screen for certain diseases
or condiions
It some cases, phlebotomy may be used as a preventive measures. For example, ir may be used
to remove excess iron from the body before it can cause damage

Mateials used
A successfulll vein puncture and capillary puncture requires the following tools:

Tourniquests
Needles (a straight needle or a butterfly/wiged needle)
Lancets
Cotton wool
Syringe
Adaptors
Vacuum tubes
Antisceptics
Gloves
Bandages
Cnauae

Procedures
Assemble equipment and include needle and syring or vacuum tube. Depending on which is to
be used
Perform hand hygiene (it using soap and water dry hands with simple towel)
Identiying and prepare the patient (collecting patient information for documentation)
Selotape site, preferably at the antecubical area (i.e the band of the elbow)
Apply a tourniquest, about 4-5 fingers width. Above the selected vein puncture site
Ask the patient to form a fist so that the veins are mor prominent
Put on well-fitting nonsteril gloves
Disintegrate the site using 70% isopopy/alcohol for 30sec and allow to dry completely
Auchor the vein by holding the patients arn and planning a thumb below the vein puncture site
Enter the vein softly at 20-30 angle.
Once sufficient blood has been collected, realease the tourniquet before withdrawing the needle..
Withdraw the needle gently and the give the patient a clean or dry cotton-wool ball to apply to
the site with gently pressure.
Put the collected blood sample in a test tube or an elongated bottle (sample EDTA).
Discard the used needle and syringe or blood sampleing device into a puncture resistance
container
Level the sample with the patient’s name for accuracy
Remove gloves place them on the general waste perform hand hygiene. It using soap anf water
dry hand with single-use towels

4
A TECHNICAL REPORT ON STUDENT INDUSTRIAL WORK EXPERIENCE
SCHEME (SIWES)

UNDERTAKEN AT
UNICROSS MEDICAL CENTER CALABAR CAMPUS.

SUBMITTED TO
THE SIWES COORDINATOR
DEPARTMENT OF MICROBIOLOGY
FACULTY OF SCIENCE
OBAFEMI AWOLOWO UNIVERSITY ILE-IFE

BY
ADOR JOB AKOMAYE
19/MCB/007
COURSE CODE: MCB 399

IN PARTIAL FULFILLMENT OF THE AWARD OF A BACHELOR OF

SCIENCE DEGREE (B.SC) IN MICROBIOLOGY
UNIVERSITY OF CROSS RIVER STATE.

OCTOBER, 202

5
 CERTIFICATION

This is to certify that ADOR JOB AKOMAYE with the Reg Number 19/MCB/007 in the
Department of Microbiology, Faculty of Biological Science, University of Cross River
State, wrote this SIWES report on completion of this Industrial Training at CRUTECH
MEDICAL CENTER CALABAR.

__________________ ____________________
SIWES Coordinator Student
MR. SYLVESTER OPULA ADOR JOB AKOMAYE
(Signature) (Signature)

6
 ACKNOWLEDGEMENT

My Profound Gratitude goes to God Almighty who kept me safe and granted me good health
throughout my Industrial Training Period.

My Appreciation also goes to the Industrial training fund for their foresight in putting this
program in place.

I acknowledge my Parents Mr. /Mrs. Ador Ferdinard Agba for their immense support and
prayers towards me during my training and also am very grateful to my HOD of the Lab, Mrs.
Coco Bassey, my Uncles, Brothers, Sisters, Friends and colleagues for their support morally,
academically, financially and otherwise.

7
 TABLE OF CONTENTS

Title Page
Letter of Transmittal......................................................................................i
Dedication.....................................................................................................ii
Acknowledgement........................................................................................iii
Table of Content.............................................................................................iv
Chapter 1
1.1 Brief history of SIWES and Objectives of SIWES...............................1-2
1.2 Structural organization of STANDARD MEDICAL DIAGONOSTIC
LABORATORY, EDE, OSUN
STATE.....................................................................................3
Chapter 2
2.1 General Laboratory Equipments...........................................................3-4
2.2 Care and Safety in the Laboratory........................................................5-6
Chapter 3
3.1 Microbiology laboratory.....................................................................7-21
Chapter 4
4.1 Hematology...........................................................................................21-
Chapter 5
5.1 Chemical Pathology………………………………………………….
Chapter 6
6.1 Experience gained and problems encountered during the period of the SIWES
program........................................................................................................37
6.2 Recommendation……………………………………………………...
6.3 Conclusion…………………………………………………………….
6.4 Appendix……………………………………………………………..
6.5 References……………………………………………………………

8
 CHAPTER ONE
INTRODUCTION

1.1 BRIEF HISTORY OF S.I.W.E.S.

SIWES was established in 1973 by the Industrial Training Fund (ITF) as one of
her programmes. It was designed to give Nigerian students studying occupationally-
related courses in higher institutions the experience that would supplement their
theoretical learning in order to solve the problem of lack of adequate practical skills
preparatory for employment in industries by Nigerian graduates of tertiary institutions.

The Scheme exposes students to industry based skills necessary for a smooth transition
from the classroom to the world of work. It affords students of tertiary institutions the
opportunity of being familiarized and exposed to the needed experience in handling
machinery and equipment which are usually not available in the educational institutions.
Participation in SIWES has become a necessary pre-condition for the award of
Diploma and Degree certificates in specific disciplines in most institutions of higher
learning in the country, in accordance with the education policy of government.

Usually there are three modules: The first module is for two months and this is
taken by all 200- level Engineering and Food Technology students in University. This
module of industrial Training is designed to expose the students to engineering and
technology operations at the shop floor level. The second module is for three months.
This is for the 300-level students of Engineering, Food Technology, Geography,
Biochemistry, Nursing, Pharmacy, Geology, Physics, and Library Science. The third
module is however for six months and it is taken by 400-level students of Engineering,
Food Technology, Botany, Microbiology, Industrial Chemistry, Computer Science,
Zoology, Agriculture and Physiotherapy.
SIWES is operated by the ITF, the coordinating agencies (NUC, NCCE, NBTE),
employers of labor and the institutions concerned (universities and
polytechnics).Funded by the Federal Government of Nigeria.
Beneficiaries-Undergraduates students of the following: Agriculture, Engineering,
Technology, Environmental, Science, Education, Medical Science and Pure and Applied
Sciences.

9
 Duration - Four months for polytechnics and Colleges of Education , and six
months for the Universities.
A SURVEY OF THE INSTITUTIONS PARTICIPATING IN SIWES

Universities 59
Polytechnics 85
Colleges of Education 62
Total 206

This survey was carried out year 2008.

1.1 OBJECTIVES OF SIWES

SIWES is a program organized for students of higher institutions to acquire practical

knowledge of their various discipline in a real standard establishment different from the
kind of experience or knowledge gained within the four walls of the classroom or school
laboratory.

10
11
 CHAPTER THREE

3.1 GENERAL LABORATORY EQUIPMENTS AND USES

THE LIGHT MICROSCOPE

The microscope employs a hollow, extremely intense cone of light concentrated on the
specimen. The field of view of the objective lens lies in the hollow, dark portion of the
cone and picks up only scattered light from the object. The clear portions of the specimen
appear as a dark background, and the minute objects under study glow brightly against
the dark field. This form of illumination is useful for transparent, unstained biological
material and for minute objects that cannot be seen in normal illumination under the
microscope.
AUTOCLAVE
The autoclave is effective equipment used for steam sterilization at pressures above the
atmospheric pressure. Thus, it is possible to steam at higher temperature then the boiling
point, which a lot of microorganisms cannot withstand. Autoclaving is the most effective
method for sterilizing culture media. When sterilizing culture media with autoclave, we
do so at 1.05Kg per square centimeter for 15 minutes to eliminate contaminations.
REFRIGERATOR
This is used to preserve samples, reagents etc, which are used for daily analysis and
cannot be exhausted at once. The refrigerator helps provide optimum environment for
materials to be preserved.
INCUBATOR
The incubator is mainly used to incubate culture media as microbes have different
optimum temperatures for growth and reproduction. The temperature of an incubator can
be set to the preferred temperatures.
WATER BATH
This is required to incubate bottle of culture media, liquids in flasks or other large
Containers, and when incubating samples in the test tube racks.
WEIGHING BALANCE
This is a delicate instrument used for weighing essential, reagent, stains and culture

12
media that requires adequate weighing.

WIRE LOOP
Made up of a thick metallic lower part and a straight thin upper metallic part curved into a
small circle usually made up of platinum. Wire loop is used generally for inoculating samples
and picking colonies sterilized by flaming red hot before, during and after use. It is always
better to use the sides of the loop rather than the apex during inoculation.
GLASS SLIDES
Used for preparation of slides for microscopy. Sterilization is by flooding with alcohol and
flaming off excess alcohol.
COVER SLIPS
This is use for covering wet smears of preparations. It is sterilized by flooding with alcohol
and flaming off excess alcohol.
PETRI DISH
Used for the preparation of culture media. It is usually bought sterilized. The disposable type
cannot used a second time while the glass ware type can be reused be usually sterilized by
autoclaving.
FORCEPS
A pair of forceps is a metallic object used for handing hot object or contaminated materials. It
is sterilized by flaming red hot.
Others include:
Other Laboratory equipments include includes sterilized slide, Giemsa Stain, needle,
syringe, ethanol, sterilized bottle, agar (MacConkey or Chocolate), Gram positive, Gram
negative sensitivity kit , cotton wool, EDTA, microscope, oil immersion, ethanol,
sterilized slides, swab sticks, cotton wool, spirit, giemsa stain, lancets, surgical blades, oil
immersion, pipette, light microscope, hot plate (dryer), centrifuge, hand gloves,
microhaematocrit centrifuge, capillary tubes for measuring PCV, sealant,
microhaematocrit reader, anaerobic jar, test tubes, bottles, water bath, weighing balance,
microscope, pipette, beakers, bio safety cabinet, cotton

13
14
2.1 SAFE WORKING PRACTICES IN A MEDICAL LABORATORY
The following are some of the important points which apply when working with
infectious materials:
1. Never mouth-pipette. Use safe measuring and dispensing devices.
2. Do not eat, drink, smoke, store food, or apply cosmetics in the working area
of the laboratory.
3. Use an aseptic technique when handling specimens and cultures.
4. Always wash your hands after handling an infectious material in the
laboratory, when leaving the laboratory and before attending to
patients. Cover any open wound with a water proof dressing.
5. Wear appropriate protective clothing when working in the laboratory.
Ensure it is decontaminated and laundered correctly.
6. Wear protective gloves and when indicated a face mask, for all procedures
involving direct contact with infectious materials. When wearing gloves,
the hands should be washed with the gloves on, particularly before doing
ant clerical work.
7. Centrifuge safely to avoid creating aerosols. Know what to do should
a breakage occur when centrifuging.
8. Avoid practices which could result in needle stick injury.
9. Do not use chipped or cracked glassware and always deal with a
breakage immediately and safely.
10. Avoid spillages by using racks to hold containers, work neatly and keep
the bench surface free of any unnecessary materials.
11. Decontaminate working surfaces at the end of each day’s work and following
any spillage of any infectious fluid.
12. Report to the laboratory officer in charge, any spillage or other
accident involving exposure to infectious material.
13. Know how to decontaminate specimens and other infectious materials.
14. Use and control an autoclave correctly.

15
 Dispose laboratory waste safely.

CHAPTER THREE

In Standard Medical Diagnostics Laboratory, where I underwent my SIWES program,

we have the following sections:
Reception, Chemical Pathology, Hematology, Microbiology laboratory

3.1 MICROBIOLOGY LABORATORY

In this laboratory the following tests are carried
out
 Urine Analysis, MCS
 Malaria Parasite Test
 Stool microscopy
 Blood Microfilaria

16
3.21 URINE ANALYSIS, MCS
URINE BENCH
Pathogens that could be found
Bacteria
 Gram positive: Staphylococcus, Haemolytic Streptococci
 Gram negative: Escherichia coli, Proteus species, Pseudomonas,
Aeruginosa, Klebsiella strains, Salmonella typhi, Neisseria gonorrheae
The following activities are carried out on the urine bench:
Urine macroscopy i.e. Appearance which includes the color, turbidity etc. The
microscopy to check out for possible parasite. Then culture of urine samples.
URINE MACROSCOPY AND MICROSCOPY
Some other urine parasites include Wucheraria brancoftii, Onchocerca etc.
Collection of urine
Urine is collected in clean universal bottles. The mid part of the first early morning
sample is preferred.
MACROSCOPIC EXAMINATION
Appearance: the normal urine color should be either amber or yellow. Other colors could
be red brown black or white.
Turbidity: it could be slightly turbid, turbid or
clear. MICROSCOPIC EXAMINATION
Note: You culture before you spin the urine samples in the centrifuge to
avoid contamination the samples.
The urine samples are poured inside test tubes and labeled with the laboratory number of
the patient. It is then arranged inside the centrifuge and allowed to spin for 10minutes,
so as to separate the urine into layers.

17
The supernatant part of the spinned urine is then disposed off into a container containing
a disinfectant and then the sediment is placed on the glass slide. The sediment of urine
sample on the slide is covered with a cover slip and then examined under the
microscope. The following could be seen under the microscope: bacteria cells, epithelial
cells, cellular casts, red blood cells and white blood cells.
HOW TO CULTURE URINE
Culture on Cysteine Lactose Electrolyte Deficiency Agar (C.L.E.D) and MacConkey
agar (both are differential agar) which differentiate between lactose and non-lactose
fermenting organisms. C.L.E.D does not allow swarming of Proteus.
A sterile wire loop is used to culture
urine. PROCEDURE-
Dip a wire loop inside the universal tube containing the urine (open the cork of the tube
with the side of your palm and keep holding the cover while you dip the wire loop into
the urine) and then inoculate your plate. The inoculation is done by introducing urine
into the plate and making a smear, from the inoculums a primary and secondary
streaking is made.
To make the primary streaking, spread from the inoculums at angle 90 and the secondary
streaking is done by spreading from the primary streaking. Then incubate overnight -that
is putting inoculated plate in the incubator at 350C for 18-24 hours. The plate can then be
read the next day. On CLED, the lactose and non-lactose fermenting organisms are
checked and then confirmed on MacConkey agar.
For lactose fermenting organisms, the colonial appearance is recorded and then the gram
staining is done. If it is gram negative, the organism present could either be Klebsiella or
Escherichia coli. Biochemical test can then be done by inoculating citrate, urea and
peptone water. The peptone water is used for sensitivity test on nutrient agar (DST); the
plate is then incubated at 370C and also the urea and citrate for 12-18 hours (overnight).
Klebsiella is evident if citrate is positive or urea is positive.
Citrate is positive when it is blue in color whereas urea is negative when it is yellow and
positive when it is red. Citrate is negative and urea is negative when Escherichia coli is
evident.

18
FOR NON-LACTOSE FERMENTERS, oxidase test is done. Positive oxidase test
shows evidence of Pseudomonas species in urine while negative oxidase test shows
evidence of Salmonella, Shigella, Proteus, Vibrio cholerae. Biochemical test is then
done for these organisms.

3.22 MALARIA PARASITE TEST

Malaria is a serious disease caused by a parasite. Malaria parasite are tiny single-celled like
forms. They live and reproduce in the red blood cells of human. This destroys the reed blood
cells. Which makes you sick.
In some cases, people get malaria when they are bitten by mosquitoes that are infected with the
parasite.

TYPES OF MALARIA PARASITE

 Pasmodium Falciparum (or P. Falciparum)
 Plasmodium Malariae (or P.malariae)
 Plasmodium Vivax (or P.vivax)
 Plasmodium Knowlesi (P. knowlesi)

TYPES OF MALARIA TEST

There are two types of blood test to diagnose malaria

 Rapid Diagnostic Test (RDT)

 Blood Smear Test

BLOOD SMEAR TEST

Some parasites that could be detected in the blood are: Plasmodia, Trypanosomes,
Leishmania, filarial worms.
SPECIMEN- A one meter in blood diameter of the blood film of the patient.
Specific identification of parasites requires a permanent stain. For permanent staining,
two types of blood films can be prepared. Thick films allow a larger volume of blood to
be examined, thus making it easier to detect light infections with fewer parasites, while
species identification is difficult. Thin films are necessary to see the morphological
characteristics of the parasites and to identify them.
PROCEDURES
PRECAUTION: It is necessary for one to be very careful while collecting and preparing
blood samples. A number of parasitological, bacterial and viral diseases can be
transmitted through blood. Blood film should be prepared preferably within one hour of
collection.
The time of collection should be mentioned on the specimen as well as on the result sheet
and also the laboratory number for correlation.
It is preferable to prepare blood films with fresh blood without anticoagulant. If it is not
possible, blood pant coagulated with EDTA (10mg/5ml) should be used.
Step1
An absolutely clean, grease-free slide, well-washed slide cleaned with 70% ethanol is
19
 recommended (at Standard Medical Diagnostics Laboratory new slides are used). The
slide is labeled with the patient’s laboratory number.
Step 2
Swab the top of the patient’s third finger or thumb with cotton wool soaked with
ethylated spirit to disinfect and clean the possible micro organisms present on the
surface of the skin.
Step 3
Prick the point cleaned with a sterilized lancet and discard immediately.
Step 4
Apply pressure on the lower side of the top with your own hand so the blood would be
able to come out in few trickles as a drop or two will be placed on either sides of the
slide since the laboratory number labeled on the slide will be in the middle.
Step 5
You prepare a thick blood film for the malaria parasite test. To make a thick blood film,
place two or three small drops of fresh blood without anticoagulant on a clean slide with
a sterilized end of another slide. Mix the drops in a circular motion over an area about
two centimeters in diameter, (continue mixing for about thirty seconds to prevent
formation of fibrin strands that may obscure the parasites after staining, if anti-
coagulated blood is used, it is not necessary to continue mixing for thirty seconds).
Step 6
Allow the film to dry in air at room temperature on a dryer (hotplate) to fix the film.
Step 7
After drying, the slide is placed directly into an aqueous stain called Giemsa stain to
make the thick blood film to lyses the red blood cells and to remove hemoglobin so that
the parasites can be easily detected

TROPHOZOITE OF MALARIA PARASITE AS VIEWED UNDER THE LIGHT

MICROSCOPE.
Trophozoite is the growing form of the parasite in the peripheral blood of man after the
invasion of the red blood cells by merozites. When the mature schizonts rupture the
merozites penetrate the red blood cells and develop into trophozoites.
Immature trophozoites are concave disc appearing as ring forms in stained preparation. It
consists of;
1. A rod-shaped nucleus (chromatin dot) stained red.
2. A peripheral rim of cytoplasm that stains blue and
3. An unstained clear area or vacuole in the centre that pushes the chromatin
dot to the periphery of the cytoplasm.
4. Three stages of the asexual life cycle occur in man, namely the
trophozoites, schizont and the gametocytes.
The parasites reside in the peripheral red blood cells. Each species is identified on two
basic parameters.
1. Appearance of the infected red blood cells.
20
 2. Appearance of the parasite.

Results: Malaria Parasite

Chromatin of parasite: Dark red
Cytoplasm of parasite: Blue
Schuffner’s clots: Red
Maurer’s dots: Red-mauve

3.23 STOOL MICROSCOPY

Three protozoan parasites which may be found in human stool are:
- Rhizopodea (amoebae) e.g. Entamoeba histolytica
- Zoomastigophora (flagellates) e.g. Giarelia Intesinalis
- Ciliatea (ciliates) e.g. Balantidium coli

EXAMININATION OF FAECES
It is viewed under light microscope at x10 and x40
First you view macroscopically for the following: Form, color, Smell, consistency,
presence of blood, and mucus, nematode, tapeworm, and segments.
When viewed under the microscope in normal saline
 You place a drop of normal saline on a thin slide with the pipette in the
normal saline bottle.
 Pick a tiny bit of the stool sample and make a smear in the normal saline with it.
 View under the light microscope for cellular exudates such as helminthes
egg, protozoa cyst, and actual larva of nematode worms.
 When viewed under the microscope in iodine it is the same process as listed in
the first two steps above, just use iodine in this case and not normal saline.
When viewed under the light microscope, stained protozoa cysts are more visible. Other
things that could be seen under the microscope are: fat globules, undigested starch,
vegetable cells, and air bubbles. Cysts can be concentrated by the formal ether technique
or by a simple floatation in concentrated zinc sulphate

21
 CHAPTER FOUR

4.1 HAEMATOLOGY LABORATORY

In this laboratory, the following tests are carried out
 Blood Group
 Pregnancy Test
 Widal Agglutination Reaction
 Packed Cell Volume
 Human Immune Deficiency Virus (HIV) Screening

4.11 BLOOD GROUP TEST

Analysis
A needle is inserted into the vein and blood into a tube. During the procedure, the elastic
band used is reserved to restore circulation. Once the blood has been collected, the
needle is removed and a band aid or gauze is applied.

Procedures

 Venous blood is collected into EDTA sample bottle

 Antiserum A, B, and D were placed on the white tile separately in three spots
 Three separate drops of blood were dropped unto each of the spots
 Each spot was then mixed together with the tip of a clean glass slide or
an inverted rubber pipette
 The tile was rocked for three minutes to view agglutination

22
 Results

Blood type (or blood group) is determined, in part, by the ABO blood group antigens
present on red blood cells.
A blood type (also called a blood group) is a classification of blood based on the
presence or absence of inherited antigenic substances on the surface of red blood cells
(RBCs).
These antigens may be proteins, carbohydrates, glycoproteins, or glycolipids, depending
on the blood group system. Some of these antigens are also present on the surface of
Red blood cell compatibility
• Blood group AB individuals have both A and B antigens on the surface of their RBCs,
and their blood serum does not contain any antibodies against either A or B antigen.
Therefore, an individual with type AB blood can receive blood from any group (with
AB being preferable), but can donate blood only to another type AB individual.
• Blood group A individuals have the A antigen on the surface of their RBCs, and blood
serum containing IgM antibodies against the B antigen. Therefore, a group A individual
can receive blood only from individuals of groups A or O (with A being preferable),
and can donate blood to individuals with type A or AB.

23
• Blood group B individuals have the B antigen on the surface of their RBCs, and blood
serum containing IgM antibodies against the A antigen. Therefore, a group B individual
can receive blood only from individuals of groups B or O (with B being preferable),
and can donate blood to individuals with type B or AB.
•Blood group O (or blood group zero in some countries) individuals do not have either
A or B antigens on the surface of their RBCs, but their blood serum contains IgM anti-A
antibodies and anti-B antibodies against the A and B blood group antigens. Therefore, a
group O individual can receive blood only from a group O individual, but can donate
blood to individuals of any ABO blood group (i.e. A, B, O or AB). If anyone needs a
blood transfusion in a dire emergency, and if the time taken to process the recipient's
blood would cause a detrimental delay, O Negative blood can be issued.
RBC Compatibility chart
In addition to donating to the same blood group; type O blood donors can give to A, B
and AB; blood donors of types A and B can give to AB.
Red blood cell compatibility table
Recipient[1] Donor[1]
O− O+ A− A+ B− B+ AB− AB+

O−

O+

A−

A+

B−

B+

AB−

AB+

24
Table note
1. Assumes absence of atypical antibodies that would cause an incompatibility between
donor and recipient blood, as is usual for blood selected by cross matching.

Recipients can receive plasma of the same blood group, but otherwise the donor-recipient
compatibility for blood plasma is the converse of that of RBCs: plasma extracted from
type AB blood can be transfused to individuals of any blood group; individuals of blood
group O can receive plasma from any blood group; and type O plasma can be used only
by type O recipients.

Plasma compatibility table

Recipient Donor[1]
O A B AB

AB

Table note
1. Assumes absence of strong atypical antibodies in donor plasma

Rh D antibodies are uncommon, so generally neither D negative nor D positive blood

contain anti-D antibodies. If a potential donor is found to have anti-D antibodies or any
strong atypical blood group antibody by antibody screening in the blood bank, they
would not be accepted as a donor (or in some blood banks the blood would be drawn but
the product would need to be appropriately labeled); therefore, donor blood plasma
issued by a blood bank can be selected to be free of D antibodies and free of other
atypical antibodies, and such donor plasma issued from a blood bank would be suitable
for a recipient who may be D positive or D negative, as long as blood plasma and the
recipient are ABO compatible.

25
4.12 PREGNANCY TEST

PRECAUTION
It is necessary for one to be very careful while collecting and preparing blood samples. A
number of parasitological, bacterial and viral diseases can be transmitted through blood..
The time of collection should be mentioned on the specimen as well as on the result sheet
and also the laboratory number for correlation.
STEPS INVOLVED
1. Select a sterile, dry plastic syringe of the capacity required, e.g. 2.5ml,5ml or 10ml
2. Apply a soft tubing tourniquet or Velcro arm bound to the upper arm of the patient
3. Using the index finger feel for a suitable vein, selecting a sufficiently large
straight vein that does not roll and with a direction that can be felt.
5. Cleanse the puncture site with 70% ethanol and allow drying.
6. When sufficient blood has been collected, release the tourniquet and instruct
the patient to open his or her fist.
7. Centrifuge for 3-5 minutes (RCF 12000-15000xg), using the shorter time when
the RCF is 15,000xg
8. Immediately after centrifuging, first check that there has been no leakage of
blood from the bottle or breakage.
9. Pregnancy Test is therefore carried out by inserting a pregnancy strip in the
bottle containing blood.
Most chemical tests for pregnancy look for the presence of the beta subunit of hCG or
human chorionic gonadotropin in the blood or urine . hCG can be detected in urine or
blood after implantation, which occurs six to twelve days after fertilization.[1]
Quantitative blood (serum beta) tests can detect hCG levels as low as 1 mIU/mL, while
urine tests have published detection thresholds of 20 mIU/mL to 100 mIU/mL,
depending on the brand.[7] Qualitative blood tests generally have a threshold of 25
mIU/mL, and so are less sensitive than some available home pregnancy tests. Most home
pregnancy tests are based on lateral-flow technology.
RESULTS
The strip shows whether the patient is pregnant or not if

26
  Positive (double line): the patient is pregnant
 Negative (single line): the patient is not pregnant
 Invalid: No visible band at all. The test is repeated
NOTE: For detection of hCG in urine, same procedure is followed
Precautions
 Test kit must not be beyond expiry date
 The test device must not be reused
 The test kit is for in vitro diagonostic use only

4.13 WIDAL AGGLUTINATION REACTION

Materials
Widal kit, white tile, pipette, test tube, centrifuge, stop watch, blood sample

Procedure

 Venous blood is collected into sample bottle and spun at 3000rpm for 5 minutes
 The serum is taken with the aid of a pipette and put on white tile in different spots
of 4 per row making two rows
 First row is labeled O, OA, OB, OC and the second row H, HA, HB,
HC respectively.
 Antiserum from the widal kit for each spot are released on top of the pipette
blood.
 The tile is then rocked for 3 minutes

Results

Expected results ratio:

 Highly reactive............1:320(positive)
 Very reactive...............1:160(positive)
 Weak reaction.............1:80(positive)

27
  Non Significant………1:40(negative)
 Non Significant………1:20(negative)

4.14 PACKED CELL VOLUME

Value of Test:
The packed cell volume also called haematocrit, is used to calculate the mean cell
haemaglobin concentration (MCHC) and mean cell volume (MCV). These red cell
indices are used in the investigation of anaemia. The PCV is also used to screen for
anaemia when it is not possible to measure haemaglobin, and to diagnose polychaemia
vera and to monitor its treatment. It is suitable for screening large clinic populations’ e.g.
antenatal clinics.
Specimen:
To measure the PCV, either well mixed well oxygenated EDTA anti coagulated blood
can be used or capillary blood collected into a heparinzed capillary.
Equipment:
Microhaematocrit reader, centrifuge, needle, syringe, capillary tube.
Test Method
1 .About three quarters fills either
 a plain capillary with well mixed EDTA anticoagulated blood (tested within
4 hours of collection), or
 a heparinised capillary with capillary tube
2. Seal the unfilled end, preferably using a sealant material. If unavailable, heats seal the
capillary using a small flame from a sprint or a pilot flame of a bursen burner, rotating
the end of a capillary in the flame.
3. Carefully locate the capillary in one of the numbered slots of the microhaematocrit
rotor with the sealed end against the rim gasket (to prevent breakage). Write the
number on the patient form.
4. Centrifuge for 3-5 minutes (RCF 12000-15000xg), using the shorter time when
the RCF is 15,000xg

28
5. Immediately after centrifuging, read the PCV. First check that there has been no
leakage of blood from the capillary or breakage. To read the PCV in a hand held, align
the base of the red cell column on the 0 line and the top of the plasma column on the
100line.Read off the PCV from scale. The reading point is the top of the red cell
column, just below the buffy coat layer (consisting of WBCs and platelets).
Results
Above the packed red cells is a white layer of platelets. Plasma is usually straw colored,
but if bright yellow; it is jaundiced, when colorless; it is iron deficient, when red;
haemolysis has occurred
The normal PCV range for male is 39% - 53%.
The normal PCV range for female is 35% -49%.
Factors that affect PCV result
 Quality of capillary tube
 Time and speed of centrifugation
 Spectrum collection: quantity of anticoagualant

4.15 HUMAN IMMUNE DEFICIENCY SCREENING

HIV tests are used to detect the presence of the human immunodeficiency virus in serum,
saliva, or urine. Such tests may detect HIV antibodies, antigens, or RNA.
Terminology
The window period is the time from infection until a test can detect any change.
The average window period with HIV-1 antibody tests is 22 days for subtype B.
Antigen testing cuts the window period to approximately 16 days and NAT
(Nucleic Acid Testing) further reduces this period to 12 days.
Performance of medical tests is often described in terms of:
• Sensitivity: The percentage of the results that will be positive when HIV
is present
• Specificity: The percentage of the results that will be negative when HIV is
not present.

29
All diagnostic tests have limitations, and sometimes their use may produce erroneous or
questionable results.
• False positive: The test incorrectly indicates that HIV is present in a non-infected
person.
• False negative: The test incorrectly indicates that HIV is absent in an
infected person.
Nonspecific reactions, hypergammaglobulinemia, or the presence of antibodies directed
to other infectious agents that may be antigenically similar to HIV can produce false
positive results. Autoimmune diseases, such as systemic lupus erythematosus, have also
rarely caused false positive results. Most false negative results are due to the window
period; other factors, such as post-exposure prophylaxis, can rarely produce false
negatives.
Rapid Antibody Tests are qualitative immunoassays intended for use as a point-of-care
test to aid in the diagnosis of HIV infection. These tests should be used in conjunction
with the clinical status, history, and risk factors of the person being tested. The
specificity of Rapid Antibody Tests in low-risk populations has not been evaluated.
These tests should be used in appropriate multi-test algorithms designed for statistical
validation of rapid HIV test results.
If no antibodies to HIV are detected, this does not mean the person has not been infected
with HIV. It may take several months after HIV infection for the antibody response to
reach detectable levels, during which time rapid testing for antibodies to HIV will not be
indicative of true infection status. For most people, HIV antibodies reach a detectable
level after two to six weeks.
Materials
Blood serum, Abort determine HIV-1 and HIV-2 test kit, and centrifuge
Procedure
 Venous blood is collected into EDTA sample bottle
 The blood is spun at 3000rpm for 10 minutes
 The strip is then immersed into blood serum with the narrow end pointing
towards the blood

30
  It must be immersed past the mark line. The strip is taken out after 3 seconds
and laid on a flat clean dry non absorbent surface.
 Water for colored band to appear
Results
Readings should be taken within 10 minutes
 Positive: Distinct color band appear on the control and test regions. This
indicates the presence of HIV-1 and HIV-2
 Negative: Only one color band appears on the control region. No apparent
band on the test region. This indicates that the patient is HIV negative
 Invalid: No visible band at all. The test is repeated

31
5.1 CHEMICAL PATHOLOGY
The following tests are carried out in Chemical pathology laboratory
 Fasting Blood Sugar
 Random Blood Sugar

5.11 FASTING BLOOD SUGAR

The fluctuation of blood sugar (red) and the sugar-lowering hormone insulin (blue) in
humans during the course of a day with three meals. One of the effects of a sugar-rich
vs a starch-rich meal is highlighted.
The blood sugar concentration or blood glucose level is the amount of glucose (sugar)
present in the blood of a human or animal. Normally, in mammals the body maintains the
blood glucose level at a reference range between about 3.6 and 5.8 mM (mmol/L). It is
tightly regulated as a part of metabolic homeostasis.
Materials
Blood sample, glucomter
NOTE: Glucometer is an instrument used to measure the glucose (sugar) level of a
patient.
Procedure
 Blood is collected from the thumb of the patient
 The blood is made to drop at the tip end of the glucometer and then left for
few minutes(about 3-5minutes)
 The reading is then taken and written down
Results
The normal range is 70-100mg/dL. If the result from the reading is very much less than
70mg/dL, the patient is said to be hypoglycemic and needs sugar transmission, if the
result is far higher than 100mg/dL the patient is said to be hyperglycemic and needs
insulin transfusion.

32
5.12 RANDOM BLOOD SUGAR
This test is similar to fasting blood sugar, the difference being that the test can be carried
out anytime on a patient (that is, whether the patient has or has not eaten is irrelevant) and
it is useful in the case of emergency.
Materials
Blood sample, glucometer
Procedure
 Blood is collected from the thumb of the patient
 The blood is made to drop at the tip end of the glucometer and then left for
few minutes (about 3-5minutes)
 The reading is then taken and written down.
Results
The normal range is 100-180mg/dL. If the result from the reading is very much less than
70mg/dL, the patient is said to be hypoglycemic and needs sugar transmission, if the
result is far higher than 100mg/dL the patient is said to be hyperglycemic and needs
insulin transfusion

33
 CHAPTER FOUR

6.1 EXPERIENCE GAINED

 I learnt almost all the practical aspects involved in medical microbiology and
also microbiology in general.
 I got to know about and learnt the use of the laboratory equipment.

 I learnt to obey all laboratory rules for my safety and that of the patients.

 I learnt to relate properly with other co-workers.

6.2 PROBLEMS ENCOUNTERED

 In most cases, safety rules are not taken into consideration and the
necessary safety gadgets and equipment are not usually in place.
 It is suggested that some form of allowance should be given to the students by
the employers as a form of encouragement and to assist in their cost of living,
basically feeding, transportation and accommodation especially in areas far from
the students’ neighborhood.
 I also would want to say that more time should be given to students for their
SIWES program.

6.3 RECOMMENDATIONS

 I propose that more time should be given to the students of microbiology

for SIWES activities
 I recommend that government should provide placements for students
undergoing SIWES in the several fields of Nigerian Economy.
 I recommend that more preference should be given to the power sector so as
to provide adequate light to various Medical laboratories in the country.

34
6.4 CONCLUSION
In conclusion this program has enabled students to gain a lot and many can now
practice the applied aspects of their various disciplines and other related areas on their
own. The program has really being

35