CHAPTER ONE

1.0 Introduction

The Student Industrial Work Experience Scheme (SIWES) is a skill training program
designed to expose and prepare students of Universities, Polytechnics/Colleges of
Technology/Colleges of Agriculture and Colleges of Education for the industrial work
situation they are likely to meet after graduation (SIWES Operational Guidelines, 2008).

Students’ Industrial Work Experience Scheme (SIWES) was established by Industrial

Training Fund (ITF) in 1973 to solve the problem of inadequate practical skills needed by
Nigerian graduates of tertiary institutions to prepare them for employment in industries
(Industrial Training Fund, 2008).

It is a platform that allows students to learn some practical and technical rudiments about
their field of study that ordinarily they will not be able to learn under the normal classroom
learning environment. It offers students the opportunity of interacting with the industrial
environment while still undergoing their academic studies.

Working in a clinical laboratory could be an excellent career option, if one is interested in a

medical job that does not require direct patient care or continual patient interaction. Some
medical laboratories are housed in medical facilities such as a large hospital or clinic. Other
medical laboratories are corporate owned laboratories that charge medical facilities for
processing laboratory work as an outsourced service. Other medical laboratories may be
university or government healthcare providers.

Medical laboratories are often well-lit, sterile environments with a lot of high technology
equipment for viewing and analyzing microscopic samples of human tissue or bodily fluids.
Working in a medical laboratory entails many hours of sitting or standing, peering into
microscopes or utilizing biomedical equipment to process slides and specimens.

Additionally, some type of computer software will most likely be used for documentation
purposes. Depending on the role and the types of specimen being handled in the laboratory,
protective covering such as gloves, goggles, masks or laboratory coat may be required.

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1.1 Aims of Industrial Training Programme

The industrial training scheme is aimed at the following:

a) To provide students with an opportunity to apply the theoretical knowledge in real

work situation, thereby bridging the gap between university work and actual
practice.
b) To provide avenues for the students in Nigeria universities to acquire industrial
skills and experience in their course of study.
c) To give students the opportunity to know their area of specialization.
d) To prepare students for the work situation they are in likely to meet after
graduation.
e) To expose students to work method and techniques in handling equipments and
machinery that they not be available in the universities.

1.2 Objectives of the Report

a) To pull all practical skills into a written work.
b) To keep this written work for future references

1.3 Role of Students during SIWES

Student Industrial Work Experience Scheme, SIWES is an essential part and the core course
for presentation of a B-tech award in various tertiary institutions. It is a core programme that
integrates students with the practical aspect of the theoretical structures of the curriculum. As
it is, it affords the students an exposure to easier learning and skills in various places of
attachment. It is therefore important that students involved play certain important roles to
achieve their aims and objectives in their various places of attachments.
However, the following are required as roles of students during SIWES in their place of
attachment:
a) Students are to abide by every rules and regulation governing their respective place of
attachment.
b) Students are expected to be good representative of their schools. In terms of neatness,
punctuality, attentiveness, learning, good communication, observation, ability to draw
inferences, among others.
c) Students are expected to be neat.

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 d) Students are expected to be punctual.
e) Students are expected to be attentive to whatever their instructor/boss teaches them as
the case may be.
f) Students are expected to have good communication with their bosses.
g) Students to avoid all unofficial activities.
h) Students are expected to be observant.
i) Students are expected to draw useful inference of whatever happens in their
temporary workplace etc.

1.4 The Logbook

A logbook is an important document which is a permanent record of your progress through

the training programme. Both the student and the employer receive a short in-service training
session from the program Development Officer regarding the proper method for completing
the logbook. The program Development Officer verifies that courses are successfully
completed from an official transcript of marks and records verification of courses in the
logbook. The SIWES supervisor from school validates the performance of each work
experience and confirms that the competence has been achieved. The student is also required
to verify the performance of each work experience completed under the SIWES supervisor.
The employer confirms the total number of hours of work spent by the student in the
occupation.

1.5 Scope of Report

The scope of the report is to ensure that the purpose of the industrial experience is
accomplished and documented.

1.6 Objective of Report

The objective of the report is to ensure that details of the experience are presented,
documented as regards the responsibilities and information acquired during the industrial
training.

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 CHAPTER TWO
2.0 General Overview of the Organization
2.1 Brief History of the Organization

Intermed Diagnostic Services is located at 5, Abiodun Odukoya Street, beside Mama Gold,
Mowe, Ogun state. The Centre has various units which includes reception, x-ray unit,
medical laboratory unit, scan unit e.tc. It is made accessible to every individual and family
especially pregnant women in a community through means acceptable to them and with full
participation. It is financially affordable for the community.

The laboratory is capable of carrying our routine diagnostics and also a few
complicated laboratory procedures, nonetheless the laboratory is upgraded to meet the
teeming population it serves with the introduction of various automated machines to facilitate
quick delivery of test results. The centre operates to ensure diagnosis of different diseases and
handling of other health related hazards. Present in the centre are secretaries, marketing
manager, radiographers, scientist, medical laboratory technician along with highly educated
and vast medical laboratory technologists who possess advanced skills in medical laboratory
practices.

2.2 Theoretical review of the organization

A laboratory is a place, building or a part of a building used for scientific related works that
may be hazardous to personnel who are required to work there. The works conducted in a
laboratory may include teaching or learning, research, clinical or diagnostic testing and
analysis. A laboratory may have associated areas including preparation, instrumentation,
decontamination, wash-up and storage rooms, or a workshop in an engineering area (e.g.
mechanical, electrical, aeronautical and civil engineering). A medical or clinical laboratory is
a laboratory where tests are usually carried out on specimens to obtain information about the
health of a patient as pertaining to the diagnosis, treatment, and prevention of disease.
Laboratories are commonly used for scientific disciplines ranging from biology
microbiology, biochemistry, chemistry, histology physics, botany, zoology, medicine,
psychology, dentistry, engineering, agriculture and veterinary science (Nkwa, 2009).

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 GENERAL MANAGER

BRANCH MANAGER

MARKETING MANAGER

RADIOGRAPHER SCIENTIST/TECHNICIAN

SECRETARY

FRONT DESK

CLEANER

Figure 1: Organogram of the Laboratory

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2.3 Laboratory equipment and uses
1. Needle and syringe: It is used for blood collection from a patient

2. Test tube: It is used for collection of liquid samples such as blood, urine for centrifugation
and biochemical tests such as indole test.

3. Hand gloves: it is used for protection of hand while working in the laboratory.

4. Tourniquet: It is used to cause an artificial venous stasis by applying pressure through this
rubber tube. It leads to engorgement of the veins allowing them to be seen well. It is also used
for intravenous injections and cannulation.

5. Measuring cylinder: It is used for measuring chemicals and water.

6. Micro pipette: It is used to withdraw and dispense liquid samples and reagents.

7. Anticoagulant sample bottle: It is used to collect or prevent coagulation of blood samples

8. Forceps: It is used to hold materials such as antibiotic discs, test tubes from centrifuge.

9. Centrifuge: This is a device that separates particles (cells, parasites, casts, bacteria and
blood components) suspended in fluid (urine, blood) into denser and lighter segments by
exerting a force (centrifugal force) greater than that of gravity. The centrifugal force increases
with the speed of rotation. Its unit is revolution per minute (rpm), e.g. 5000/rpm for 5
minutes. The centrifuge is used to obtain plasma and serum from blood and can be used to
perform parasite concentration techniques.

10. Spectrophotometer: This machine utilizes the principle of spectrophotometer- it measures

the light absorption or transmittance of a chemical substance at a particular wavelength, to
determine the absorbing substance’s concentration. The spectrophotometer covers the
ultraviolet, visible and infrared ranges of the electromagnetic spectrum.

11. Microscope: It is used for viewing and examining samples that cannot be seen with naked
eyes for example parasites, red blood cells, white blood cells, and microorganism. e.t.c.

12. Autoclave: This is a valuable piece of equipment for sterilizing articles and media by
steam under pressure. The autoclave is usually operated at 121ºC for 15 minutes.

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13. Universal bottle: It is used for collection of clinical samples such as urine, stool,
cerebrospinal fluid, semen sample, and so on.

2.3.1 Routine laboratory operation

The main routine operations within the laboratory include:
I. General sanitation.
II. Bottle washing.

 General disinfection and sterilization

The environment of the centre must be given proper sanitation and cleaning. These operations
are done in established routine using constantly monitored procedures by supervisors. This
ensures that sanitation and cleaning are effective to prevent the growth of yeast, mould and
bacteria. The supervisor also ensures that all workers have their nails cut short, keeps no
beards and no use of electronics during working hours, and lab coat are wore during
operation.

 Bottle washing
Bottles used for carrying out experiments are washed using wash basins, de-ionized water,
and disinfectant and bottle brush. The water in the washing basin is mixed with dissolved
soda and the temperature of the water was ensured not to be lesser than 75 o C, while that of
rinsing water to be less than 60 o C. The bottles spend up to like 5 minutes inside before
coming out properly washed.

2.3.2 Laboratory management

A laboratory is a room set aside for carrying out the practical aspects of the theoretical works
done earlier in the classroom. It is equipped with various apparatus and as such is guided by
some rules which are aimed at preventing accident and laboratory infection.

2.3.3 Laboratory hazard

Hazards are problems of attack from reagent or chemicals used, especially when handled
carelessly. Every specimen brought to the laboratory is highly infectious. The following are
types of hazards:

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  Physical Hazards: This include exposure to broken test tubes, uncapped syringe,
blade and any other sharp objects, fire accident through electrical appliances, electric
shock etc.
 Chemical Hazards: This involves exposure to chemicals and reagents that can cause
damage. Damages are caused by chemicals such as corrosive chemicals, inflammable
chemicals, explosive chemicals, poisonous chemicals.
 Biological Hazards: These results from specimen samples which are brought into the
laboratory science (Nkwa, 2009).

2.3.4 Laboratory rules and regulations

The rules and regulations to be observed in the laboratory are explained below:

i. Use of Protective Cloth: Protective clothing such as laboratory coats, disposable

gloves and nose masks etc. play important roles in the prevention of contact with
pathogens. These clothing serve as a protective functions against infectious agents in
case of spillage
ii. Careful Handling of Specimen: Extreme care must be taken against occurrence such
as spillage of specimen and other samples to prevent transmission of dangerous and
contagious infectious (Nkwa, 2009).
iii. Good Personal Hygiene: In the prevention of laboratory infections, good personal
hygiene must be observed like;: cutting nails short, washing hands with detergent
before and after work (effective hand washing technique) and regular cleaning of
laboratory wears.
iv. Frequent disinfection of work, benches and cleaning of spills: Benches on which
laboratory works are carried out should be cleaned immediately with soap and water
before and after use with concentrated disinfectants. All containing disinfectants such
as alcohol or an antiseptic (Nkwa, 2009).

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 2.4 Laboratory Safety Precautions

i Wear appropriate protective clothing at all times i.e. a clean laboratory coat (buttoned up)
plus safety glasses if there is any risk to the eyes.
ii Take care when handling glass wares.
iii Never smoke, eat or drink in the laboratory because of the risk of contamination by
inhalation or ingestion.
iv Work in a logical, tidy manner and minimize risks by thinking ahead.
v Laboratory bench must always be clean.
vi Flammable substance should be carried out in a fire prove room.
vii Visitors are not allowed in laboratory.
viii Wash your hands immediately after collection sample.
ix Put off all electrical appliances when not in use.
x Label samples immediately they are collected.
xi Do not make or receive calls in the laboratory.
xii Dispose waste in appropriate containers.

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 CHAPTER THREE

3.0 Brief description of work done

This chapter discussed various laboratory principles learnt, techniques and major
experimental work that I partook in, during the SIWES program, principle learnt and
experience gathered among other things.

3.1 Hematology
Hematology is a medical related terminology/branch of medicine that deals with the study of
the cause, diagnosis, treatment, and prevention of diseases related to blood. It studies the
possible infections and analysis associated with blood samples and its components such as
blood cells, hemoglobin, blood proteins, bone marrow, platelet, blood vessels, spleen and the
mechanism of coagulation. The major sample handled by a hematologist is the blood sample.

3.1.1 Blood sample collection

Blood samples for analysis may be obtained from veins, arteries or capillaries. Venous blood
is usually the specimen of choice and venipuncture (phlebotomy) is the method for obtaining
this specimen.

3.1.2 Capillary blood collection

Capillary blood is mainly used when the patient is an infant or young child and the volume
required is small. It is also used to monitor anemia during pregnancy and post-operatively
and for thick film preparation for malaria parasite as anticoagulant blood is more easily
washed from slides during staining. Materials needed are wet swab (containing ethanol), dry
swab, capillary tube or pipette, blood lancet or needle.

 Procedure:
i. Ensure the punctured area is warm to allow the blood to flow freely.
ii. The area is cleansed with 70% ethanol and allows drying.
iii. A rapid sufficiently deep puncture with sterile picker or blood lancet is made to allow
the free flow of blood
iv. The first drop of blood is wiped away with dry swab the next few drops for the test.
v. Press with a piece of dry swab when sufficient blood has been collected.

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3.1.3 Venipuncture
This is collection of blood samples through the vein. The median cubital vein in the
antecubital fossa or crook of elbow is the preferred site for collection of venous blood in
adults, because the vein is both large and close to the surface of the skin. Collection of
venous blood is facilitated by palpation. The area around the intended puncture site should be
cleansed and not touched until the venipuncture has been completed. After the skin is
cleansed, a tourniquet is applied 10-15 cm above the intended puncture site to obstruct the
return of venous blood to the heart or to avoid distend veins and to increase the pressure of
blood flow at that particular site. Many hematology and serology tests require unclothed
blood specimens. Such a blood sample can be obtained by collecting it into a tube containing
an anticoagulant. There are various kinds of anticoagulants used for these purpose. They
include;
 EDTA
 Lithium heparin
 Fluoride oxalate
 Sodium citrate

3.2 Laboratory Tests and Analysis

The various tests conducted at the laboratory include;
i. ABO blood grouping and blood banking

ii. Malaria test.

iii. HIV test.

iv. Widal reaction.

v. Pregnancy test.

vi. Urine culture.

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3.2.1 ABO blood grouping
Blood grouping is the classification of blood based on the presence or absence of two
inherited antigenic substances on the surface of red blood cells (RBCs). The ABO and Rh are
the major, clinically significant and the most important of all the blood group systems. The
ABO blood group system was first discovered by Karl Landsteiner in 1900. The human ABO
blood group system is divided into the following four major groups depending on the antigen
present on the surface of their red blood cells:
1. A group
2. B group
3. AB group
4. O group
The associated Anti A and Anti B antibodies usually belong to IgM class of
immunoglobulin’s. The Rhesus system (Rh) is the second most important blood group system
in humans. The most significant and immunogenic Rhesus antigen is the RhD antigen. The
individuals carrying the Rh antigen are considered to have positive blood group whereas
those individuals that lack this antigen are considered to have negative blood group
(Prescott J. and Eddy S, 1996).
The ABO and Rh blood grouping system is based on agglutination reaction. When red blood
cells carrying one or both the antigens are exposed to the corresponding antibodies they
interact with each other to form visible agglutination or clumping. The ABO blood group
antigens are O-linked glycoproteins in which the terminal sugar residues exposed at the cell
surface of the red blood cells determine whether the antigen is A or B. Blood group A
individuals have A antigens on RBCs and anti-B antibodies in serum. Similarly, blood group
B individuals have B antigens on RBCs and anti-A antibodies in serum. Blood group AB
individuals have both A and B antigens on RBCs and neither anti-A nor anti-B antibodies in
serum. Whereas, blood group O individuals have neither A antigens nor B antigens, but
possess both anti-A and anti-B antibodies in serum. The Rh antigens are transmembrane
proteins in which the loops exposed on the surface of red blood cells interact with the
corresponding antibodies (Prescott J. and Eddy S, 1996).

3.2.2 Rhesus factor

Rh (Rhesus) factor is found on the RBC’s surface in most people. Like A and B, this is also
an antigen and those who have it are called Rh+. Those who lack the antigen on the surface
of RBCs are called Rh-. A person with Rh- blood does not have Rh antibodies naturally in the
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blood plasma. But a person with Rh- blood can develop Rh antibodies in the blood plasma if
he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the
production of Rh antibodies (as the immune system is triggered by the presence of an
unknown antigen in the system). A person with Rh+ blood can receive blood from a person
with Rh- blood without any problems.

Principle behind blood tests

Compatibility between the blood groups of donor and recipient determines the success of a
blood transfusion. The ABO and Rhesus blood groups are looked at while conducting the
test. In a diagnostic laboratory, monoclonal antibodies are available for A, B and Rh antigen.
Monoclonal antibody against Antigen A (also called Anti-A), comes in a small bottles with
droppers; the monoclonal suspension being blue in colour. Anti-B comes in yellow colour.
Anti-D (monoclonal antibody against Rh) is colourless. All the colour codes are universal
standards. When the monoclonal antibodies are added one by one to wells that contain the
test sample (blood from patient), if the RBCs in that particular sample carry the
corresponding Antigen, clumps can be observed in the corresponding wells. A drop of blood
is left without adding any of the antibodies; it is used as a control in the experiment. The
monoclonal antibody bottles should be stored in a refrigerator. It is recommended to tilt the
bottle a couple of times before use in order to re-suspend the antibodies that have settled at
the bottom of the bottle.

3.2.3 Procedure for Blood Grouping

1. Dangle the hand down to increase the flow of blood in the fingers.
2. Clean the fingertip to be pierced with spirit or 70% alcohol (usually ring or middle finger).
3. With the help of the sterile lancet, pierce the fingertip and place one drop of blood in each
of the cavities.
4. Add one drop of antiserum into each cavity
5. Mix each blood drop and the antiserum using a fresh mixing stick.
6. Observe agglutination in the form of fine red granules within 30 seconds. Anti Rh D takes
slightly longer time to agglutinate compared to Anti A and Anti B.

3.2.4 Interpretation of results

 If agglutination is observed when blood is mixed with Anti A reagent, then the
individual is said to have blood group A.

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  If agglutination is observed when blood is mixed with Anti B reagent, then the
individual is said to have blood group B.

 If agglutination is observed when blood is mixed with Anti A and Anti B reagent,
then the individual is said to have blood group AB.

 If no agglutination is observed when blood is mixed with Anti A and Anti B reagent,
then the individual is said to have blood group O.

 If agglutination is observed when blood is mixed with Anti RhD reagent, then the
individual is said to have positive Rh factor. If no agglutination is observed when
blood is mixed with Anti RhD reagent, then the individual is said to have negative Rh
factor.

In type O blood, neither substance is present on the cells, but the individual is capable of

forming antibodies directed against the red cells containing substances A or B. If blood type

A is transfused into a person with B blood type, antibodies in the recipient will destroy the

transfused A red cell. Because O type blood has neither substance on its red cells, it can be

given successfully to almost any person. Persons with blood type AB have no antibody and

can receive any of the four types of blood, thus, blood type O and AB are called universal

donor and universal recipient respectively.

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Figure 2: Interpretation of blood group test results (University of Science and Technology

Publications, Okitipupa, Nigeria).

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Table 1: Antigens and Antibodies in human blood group

Blood type Antigen present Antibody present in Receptor Donour

serum

A A Anti-B A and O A and AB

B B Anti-A B and O B and AB

AB A and B Neither Anti-A AB,A,B and AB only

nor Anti-B O

O Neither Anti-A O O,A,B and

and Anti-B AB

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  Principle

In order to ensure that no antigen-antibody reaction lead to agglutination, Blood is firstly

selected for patient on a basis of ABO and Rh group. However, it could be possible that the

patient could have an antibody to any of the other groups. The cross matching procedure is

carried out to ensure that there is compatibility between the patient serum and red blood cells

from the potential done unit. Donor cells and the patient serum are reacted together under

conditions, which will result into agglutination of cells, which have reacted with the antibody.

Blood grouping of the ABO system is determined with Anti-B, Anti-A, Anti-AB, Anti-D

sera which forms agglutination complex with antibodies found in the blood sample. Before

blood transfusion, it must be ensured that the donor blood is compatible with the receptor

blood, otherwise agglutination can occur which may lead to death. The blood group of the

patient is determined using the patient’s whole blood. Materials used are: Blood, Pasteur’s

pipette, lancet blade, cotton wool, stopwatch, reagents; Anti-A, Anti-B, Anti AB and Anti-D

sera.

3.3 Malaria Parasite Test

Rapid diagnostic tests or RDTs are method used to test whether a person with malaria like
symptoms actually has malaria. Malaria parasites produce proteins called antigens. RDTs
detect these malarial antigens in a person’s blood. If malaria antigens are present, the person
will test positive. If malaria antigens are not present the person will test negative. Different
types of RDTs detect different antigens of malarial parasites. RDTs offer the potential to
provide accurate and timely diagnosis, reaching those previously unable to access good
quality microscopy services. The RDT works through the lateral flow or Immuno-
chromatographic strip method and signifies the presence of antigens by a color
change/formation of bands on an absorbing nitrocellulose strip. The three main groups of
antigens detected by commercially available RDTs are:

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1. Histidine-rich protein 2 (HRP-2), specific to Plasmodium falciparum: It is an abundant
soluble, heat stable antigen that is present in the cytoplasm and membrane of infected
erythrocytes.

2. Parasite specific plasmodium lactate dehydrogenase (Pldh), currently available as P.

falciparum specific, pan-specific, and Plasmodium vivax-specific.

3. Aldolase (pan-specific): These two antigens are conserved major enzymes in the glycolytic
pathway of malaria parasites, they are abundant and are soluble in the parasite.
Note: Pan-specific means that the RDT detects all the four types of plasmodia that infect
humans.

3.3.1 Principle of rapid diagnostic test

RDTs for the detection of malaria antigens are based on the immune-chromatographic test
principle. These RDTs capture parasite antigen from peripheral blood using monoclonal
antibodies prepared against a malaria antigen target and conjugated to gold particles in a
mobile phase. Test area contains immobilized monoclonal antibody, which captures the Ag-
Ab complex giving a visible line. Malaria antigens currently targeted by RDT are HRP-2,
Pldh, and Plasmodium aldolase.

Materials required are listed below:

i. New unopened test packet

ii. New unopened alcohol swab

iii. New unopened lancet

iv. New pair of disposable gloves

v. Buffer

vi. Timer

vii. Sharps box

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3.3.2 Test instructions
1. Check the expiry date on the test packet.

2. Put on the gloves (Use new gloves for each patient).

3. Open the test kit packet and remove, test pad, capillary tube and Desiccant sachet.

4. Write the patient’s name on the test.

5. Open the alcohol swab. Grasp the 4th finger on the patient’s left hand. Clean the finger
with the alcohol swab. Allow the finger to dry before pricking.

6. Open the lancet. Prick patient’s finger to get a drop of blood. Do not allow the tip of the
lancet to touch anything before pricking the patient’s finger.

7. Discard the lancet in the Sharps Box immediately after pricking finger. Do not set the
lancet down before discarding it.

8. Use the capillary tube to collect the drop of blood.

9. Use the capillary tube to put the drop of blood into the square hole marked “A”.

10. Discard the capillary tube in the Sharps Box.

11. Add buffer into the round hole marked “B”.

12. Wait for 15 minutes after adding buffer.

13. Read the results (see below)

14. Dispose of the used gloves, alcohol swab, desiccant sachet and packaging in a non-sharps
waster container.

15. Record the test results in your register. Dispose of cassette in non-sharps waste container.

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3.3.3 Advantages of rapid diagnostic test for malaria diagnosis
1. RDTs can provide parasite-based diagnosis in places where microscopy is not possible or
practical.

2. RDTs can be used to distinguish fevers caused by malaria parasites from those caused by
other illnesses, such as meningitis and acute respiratory infection (that cause symptoms
similar to malaria). RDTs can thus help to target anti-malarial treatment (ACTs) to patients
who really have malaria. When RDTs shows that febrile patient does not have malaria, that
patient is more likely to seek diagnosis and treatment for the illness he/she does have.

3. It helps to avoid unnecessary use of ACTs on patients who do not have malaria. This will
help to prevent or delay drug resistance, making ACTs effective for a longer period.

4. Relatively easy (with minimal training required) and rapid (giving timely results)

5. Little or no manipulation of sample required, can be performed in places without

laboratories

6. Most of the RDTs do not require refrigeration, hence tests can be performed where there is
no power supply

7. Uses whole blood (prick or venous blood prick preferred)

3.4 Retroviral Screening

HIV infection affects the immune system resulting in its weakness called immunodeficiency.
Immune system provides the body’s defense against the microorganisms (such as bacteria,
viruses, fungi that penetrate the skin and mucous membranes and cause disease in a healthy
person, the immune system produces antibodies to fight off or kill those microorganism
thereby preventing the occurrence of disease. In an immune-deficient individual this ability to
combat disease causing germ is lost by the following mechanism:
Human immunodeficiency virus (HIV) infects and eventually destroy the lymphocyte and
monocyte of the immune system. These cells carry the CD4+ antigen on their surface (CD4+
lymphocytes). HIV having special affinity for the CD4 antigen enters and infects CD4+
lymphocytes resulting in killing of many CD4+ lymphocytes. This slowly leads to persistent

20
progressive and profound impairment of the immune system, making an individual
susceptible to opportunistic infections and conditions such as cancer.
Determine HIV–1/2 Ag/Ab is an in-vitro, visually read, qualitative immunoassay for the
simultaneous detection of Human Immunodeficiency Virus Type 1 (HIV-1) p24 antigen (Ag)
and antibodies (Ab) to HIV Type 1 and Type 2 (HIV-1 and HIV-2) in human serum, plasma,
capillary (fingerstick) whole blood or venipuncture (venous) whole blood. It is intended for
use as a point-of-care test to aid in the diagnosis of infection with HIV-1 and HIV-2,
including an acute HIV-1 infection, and may distinguish acute HIV-1 infection from
established HIV-1 infection when the specimen is positive for HIV-1 p24 antigen and
negative for anti-HIV-1 and anti-HIV-2 antibodies.

3.4.1 Principle of the procedure

Determine HIV–1/2 Ag/Ab is an immuno-chromatographic test for the simultaneous and
separate qualitative detection of free HIV-1 p24 antigen and antibodies to HIV-1 and HIV-2.
The test device is a laminated strip that consists of a sample pad containing monoclonal
biotinylated anti-HIV-1 p24 antibody, a conjugate pad containing monoclonal Anti-HIV-1
p24 antibody-colloidal selenium and HIV-1 and HIV-2 recombinant antigen-colloidal
selenium, and a nitrocellulose membrane with an immobilized mixture of recombinant and
synthetic peptide HIV-1 and HIV-2 antigens in the lower test area, immobilized streptavidin
in the upper test area, and an immobilized mixture of Anti-HIV-1 antibodies, HIV-1/2
antigens, and HIV-1 p24 recombinant antigen and Anti-HIV-1 p24 monoclonal antibody in
the control area.

A specimen (venipuncture or capillary whole blood, serum, or plasma) is applied to the

sample pad (followed by chase buffer for venipuncture or fingerstick whole blood specimens)
and migrates by capillary action through the conjugate pad and then through the
nitrocellulose membrane.
If HIV-1 p24 antigen is present in the specimen, it binds with the monoclonal biotinylated
anti-HIV-1 p24 antibody from the sample pad and then with monoclonal anti-HIV-1 p24
antibody-colloidal selenium from the conjugate pad to form a complex (biotinylated
antibody-antigen-colloidal selenium-antibody). This complex migrates through the solid
phase by capillary action until it is captured by immobilized streptavidin at the upper test area
(labeled “Ag”) where it forms a single pink/red “Ag” line. If HIV-1 p24 antigen is not present
in the specimen or is below the limit of detection of the test, no pink/red Ag line is formed.

21
NOTE: The monoclonal biotinylated Anti-HIV-1 p24 antibody used in this assay does not
cross react with HIV-2 p26 antigen.

If antibodies to HIV-1 and/or HIV-2 are present in the specimen, the antibodies bind to
recombinant gp41 (HIV-1) and gp36 (HIV-2) antigen-colloidal selenium conjugates from the
conjugate pad. The complex migrates through the solid phase by capillary action until it is
captured by immobilized HIV-1 and HIV-2 synthetic peptide antigens and recombinant gp41
antigen at the lower test area (labeled “Ab”) and forms a single pink/red “Ab” line. If
antibodies to HIV-1 and/or HIV-2 are absent or are below the detection limit of detection of
the test, no pink/red Ab line is formed. (Brock, 1984)

3.4.2 Test procedure

Determine HIV-1/2 Ag/Ab combo controls should be tested prior to testing patient specimens
when a new operator performs testing, a new test kit lot is to be used, a new shipment of test
kits is received, and at periodic intervals indicated by the testing facility. Controls should be
tested in the same manner as serum or plasma samples.

3.4.3 Interpretation of test results

1. Antibody reactive (Two lines - control line and Ab line): A pink/red control line appears in
the control area and a pink/red Ab line appears in the lower test area of the test unit. The
intensity of the Ab and control lines may vary. Any visible pink/red color in both the control
and lower test areas, regardless of intensity, is considered reactive. A reactive test result
means that HIV-1 and/or HIV-2 antibodies have been detected in the specimen. The test
result is interpreted as preliminary positive for HIV-1 and/or HIV-2 antibodies.

2. Non reactive (One Line – control line): A pink/red control line appears in the control area
of the test unit, and no pink/red Ab or Ag line appears in the lower test area and the upper test
area of the test unit, respectively. A non-reactive test result means that HIV-1 or HIV-2
antibodies and HIV-1 p24 antigen were not detected in the specimen.

3. Invalid (No control line): If there is no pink/red control line in the control area of the test
unit, even if a pink/red line appears in the lower test area or the upper test area of the test unit,
the result is invalid and the test should be repeated.

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3.5 Widal Reaction Test
The Widal test is a serological technique which tests for the presence of Salmonella
antibodies in the patient’s serum. When facilities for culturing or antigen testing are not
available, the Widal test if performed reliably and interpreted with care (with clinical
findings), can be of value in diagnosing typhoid and paratyphoid in endemic areas.

3.5.1 Materials and methods

A syringe is used to obtain venous blood from the patient, and the blood is dispensed in a
centrifuge tube. The blood is centrifuged at 3000 rpm for 5 minutes.

3.5.2 Qualitative test

One drop each of undiluted patients’ serum samples for the four antigens is placed on the
circled card and one drop of each of the four Salmonella antigens are added separately and
gently rotated for one minute. Appearance of agglutination gives qualitative results. To know
the titre for each of the antigens, the test is repeated.

3.5.3 Quantitative test

A dropping pipette is used to drop 80 μl, 40 μl, 20 μl, 10 μl and 5 μl of patient’s serum each
for the four antigens on the circled card. To each series of serum specimen, one drop of
specific antigen is added to each, mixed and rotated for one minute. Agglutination in each of
these is noted. 80 μl corresponds to 1 in 20 dilutions, 40 μl to 1 in 40, 20 μl to 1 in 80, 10 μl
to 1 in 160 and 5 μl corresponds to 1 in 320 titres.

3.5.4 Interpretation and limitations of widal test

1. Timing of test is important, as antibodies begin to arise during end of first week. The titers
increase during second, third and fourth week after which it gradually declines. The test may
be negative in early part of first week.

2. Single test is usually of not much value. A rise in titre between two sera specimens is more
meaningful than a single test. If the first sample is taken late in the disease, a rise in titre may
not be demonstrable. Instead, there may be a fall in titre.

3. Baseline titre of the population must be known before attaching significance to the titers.
The antibody levels of individuals in a population of a given area give the baseline titre.

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A titre of 100 or more for O antigen is considered significant and a titre in excess of 200 for
H antigens is considered significant.

4. Patients already treated with antibiotics may not show any rise in titre, instead there may
be fall in titre. Patients treated with antibiotics in the early stages may not give positive
results.

5. Patients who have received vaccines against Salmonella may give false positive reactions.
This can be differentiated from true infection by repeating the test after a week.

3.6 Pregnancy Test

A pregnancy test is around 99 percent reliable. It works by measuring levels of a hormone
called human chorionic gonadotropin (HCG). HCG can be present in the blood and urine
approximately 10 to 14 days after conception. Pregnancy tests work by detecting human
chorionic gonadotropin (HCG).

3.6.1 Principle of pregnancy test

A pregnancy test works by measuring the amount of HCG hormone. HCG levels increase
during pregnancy. HCG is known as the pregnancy hormone, because it is produced by the
cells that form the placenta and provide nourishment to the growing embryo. It is released
when a fertilized egg attaches itself to the lining of the uterus. HCG can be present in the
blood and urine around 10 to 14 days after conception. It peaks between 8 and 11 weeks of
gestation. A negative HCG result is a level less than 5 mIU/ml (milli-international units per
milliliter). A positive HCG for pregnancy is greater than or equal to 25 mIU/ml.

3.6.2 Procedure for pregnancy test

Pregnancy tests involve testing urine or blood. A urine test can be self-administered at home,
but a medical professional must perform a blood test.
The earliest time for taking a home urine test is 14 days after possible conception, but waiting
until a missed period will give a more reliable result. Some tests on the market can be taken
earlier. This depends on how sensitive they are. It is important to read the package insert to
know the best and earliest time to take the test. The best time of day to take a urine pregnancy
test is first thing in the morning, after waking. This is because consuming a lot of liquids
before taking the test, can lead to a false negative, even if the woman is pregnant. A positive

24
home pregnancy test simply means that HCG is present in the urine, while a negative test can
have a variety of meanings.

3.6.3 Diuretics
Alcohol in the blood stream does not affect the pregnancy test because it does not interfere
with the measurement of the hormone levels. However, anyone who is trying to or expecting
to become pregnant should avoid alcohol, as it can affect fetal development. Drinking during
early pregnancy can increase the risk of miscarriage, premature birth, and low birth weight.
Negative tests can mean that there is no pregnancy, or they can mean that the test was either
taken too early to detect HCG, or that it was not done correctly.
i. If the result is positive, the woman should make an appointment to see a healthcare
professional, who can guide her about the next steps.

ii. If the result is negative, but the woman has the signs and symptoms of pregnancy, she
should test again after 1 week or ask a doctor about a blood test instead.
 Urine Testing: A home test involves placing the urine on a chemical strip and the
result I assumed to be ready in about 1 to 2 minutes, although different brands of test
may vary in the result times. The individual collects urine in a container and either
dips the pregnancy test stick into it or uses an eyedropper to place the sample on the
test strip. Alternatively, a pregnancy stick can be held in the urine stream. Depending
on the test, the result may appear as:
i. A change of colour

ii. A change in a marked line, or the appearance of a symbol, such as a plus or minus

iii. An answer in a test window, for example, the words "pregnant" or "not pregnant"

 Blood testing: There are two ways to check for pregnancy using blood:
i. A quantitative blood test which measures the exact amount of HCG present in the
blood.

ii. A qualitative test which detects whether HCG is present or not.

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3.6.4 Accuracy of pregnancy test
Some medications can affect a pregnancy test's accuracy and these include:
 Sleeping tablets

 Tranquilizers

 Anticonvulsants, including epilepsy treatments and Infertility medication

3.7 Urine Microscopy Culture

3.7.1 Urine microscopy

 Principle

To identify parasites and the bacterial cells in the urine of the individual.

 Procedure

5 ml of the urine is transferred for spinning in a bench centrifuge at 3000 rpm for 5

minutes. The sediment is concentrated in test-tube by decanting off the supernatant. A

small drop of the sediment is placed on a clean glass slide and covered with a cover

slip as wet preparation and then mounted on the microscope. The slide is examined,

using x40 objective lens.

 Expected result

a. Epithelial cells

b. Pus cells

c. Red blood cells

d. Yeast cells

e. Trichomonas vaginalis

f. Bacterial cells

g. Crystals

h. Parasite (Schistosoma hematobium)

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The following are expected to be seen in wet preparation each constituting the medical fitness

of the patient and descriptively portraying the health status of internal organs in the patient.

3.7.2 Urine culture

 An inoculating loop was flamed over the Bunsen burner to keep it sterile and was

allowed to cool.

 The sterile inoculating loop was used to pick the inoculum and applied to a small

area (pool of inoculum) of the plate (MacConkey agar and blood agar)

 The inoculating loop was sterilized again in the Bunsen burner and allowed to

cool.

 Afterwards, the sterile inoculating loop was used to streak out the inoculums over

the media plate

 The plates were then incubated for 24 hours at 37oC.

 The culture media were removed from the incubator after 24 hours and visible

bacteria growth was observed.

 Observation

Possible Bacteria/pathogens that can be isolated from Urine samples; Klebsiella spp,

Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa etc.

 Gram Staining: this is done to identify if the bacteria is Gram positive or Gram

negative.

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Figure 3: Ovum of Schistosoma hematobium in urine deposit

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 CHAPTER FOUR
4.0 Knowledge Gained during SIWES
The period of my SIWES has broadened my knowledge on diseases that affect various organs
in the body system. I have also been able to have the practical understanding of my course on
how some diseases affect the blood and also disrupt the normal body system. Patients cannot
be placed on any drug without the laboratory scientists carrying out necessary tests in the
laboratory. The samples worked on in the laboratory were blood, urine, and sputum to
mention a few.

So far, it’s been obvious that classroom knowledge has undergone application in our
industries. Apart from the fact that the program has brought life to our educational system
which of course bears its own advantages, it has also managed to leave foot prints on the
sands of our heart most especially the experiences we were exposed to and have gathered.
Some classroom knowledge that was relevant includes courses such as;
a) Microbiology – Proper use of the laboratory and conscious sanitary efforts;
b) Biochemistry - Spectroscopy, proper use of the laboratory, safety laboratory measures
and qualitative analysis.
Some skills gained while applying some of the class room knowledge are;
i. Ability to thrive efficiently in every working environment even unfavorable ones.

ii. Proper human relating etiquettes.

iii. Ability to survive multi-tasking conditions.

Also, the privilege of being able to handle some equipment and work with little or no
supervision has greatly boosted my self-esteem to face the future challenges that may arise as
a result of my carrier.

4.1 Challenges Encountered during SIWES

The major challenge encountered was basically financial due to the long distance between my
residence and the laboratory coupled with the fact that no stipend was assigned to the SIWES
students.

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 CHAPTER FIVE
5.0 Conclusion
The Student Industrial Work Experience Scheme (SIWES) at Intermed Diagnostic Services,
Mowe, Ogun state had been very educative, interesting, productive and impacting. During the
period of my SIWES internship, I have been able to obtain practical and effective experience
that their importance is very relevant to my course of study.

With all my experience, I can boldly say that SIWES primary aims and objectives has been
achieved, because as a result of this program I have been able to familiarize myself with the
working environment and am now confident to carry out some task which are related to my
course of study without been monitored.

5.1 Recommendations
Beginning with appraisal, the initiative of the whole program so far have agreeably been one
of the best assets given to undergraduates. However, these assets are still embryonic as their
complete benefits are yet to be enjoyed. Therefore, all hands must be on deck to see to the
maturation of the benefits embedded in these initiatives both by the institution’s curriculum,
Nigerian’s industries and the SIWES program bodies.
I recommend that SIWES program should be continued as it helps in the practical application
of most works done in school and it exposes student to the norms and ethics of the Industrial
setup.

i. The duration stipulated for the program irrespective of the requirements should be
strictly adhered to.

ii. Practical measures should be made to ensure continuity and encourage the real life
experiences gathered to avoid forgetfulness.

iii. Industries should efficiently get involved in redefining the educational system by at
least providing thorough training to trainees. This gives them opportunity to select
and breed specifications essential to the company for tomorrow.

iv. Donate generous funds geared towards achieving this goal.

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v. Efficient representatives should be assigned to strictly monitor all students by solving
the problem of distant location and timing.

vi. Prepare and plan adequate and attainable incentives for trainees. This encourages the
idea of the whole program.

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 REFERENCES

Brock R. (1984). Incubation perods for paediatric AIDS patients, 336: 575-577.

Concise Medical Dictionary, (2002). “Oxford University Press” 6th edition.

Industrial Training Fund (2008). Student Industrial Work Experience Scheme

Nkwa, G. Y. (2009). Biological agents: Managing the risks in laboratories and healthcare
premises 5: 166-176.

OSUSTECH (2014). “General Guide to SIWES Students Report Writing”. Ondo State

Prescott J., Eddy S. (1996) “Principles of blood grouping”, 141: 355-390

University of Science and Technology Publications, Okitipupa, Nigeria.

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