CHAPTER ONE

1.0.0 INTRODUCTION

1.0.1 MEDICAL LABORATORY; The Medical Laboratory Section is a department

where daily test are done on clinical or medical specimen so as to get more information
about the health condition of the patient(s) as pertaining diagnosis, treatment and
prevention of disease. There are many sections in a Medical Laboratory such as the
hematology section, microbiology section, chemical pathology section, serology THE
/immunology section, virology section and several others. After the patient is checked by
the doctor, the test(s) to be carried out are written down in a request form and is sent to
the laboratory for the test. The test is done in the laboratory and the result is sent back to
the doctor for treatment if needs arises.
1.0.2 LABORATORY RULES AND REGULATIONS
For any organization to work effectively, there should be laid down principles guiding the
activities of each sections of that organization. The basic laboratory rules and regulation
are listed below.
All laboratory work must be done with a laboratory coat or apron.
Every experiment involving flammable gas should be done in a fume cupboard.
No eating or drinking in the laboratory.
No playing or smoking in the laboratory.
Every used laboratory kit or instrument should be discarded or disinfected after use.
All laboratory reagents should be stored under a suitable temperature.
Wash your hand carefully when you leave.
Beware of glass especially if it is broken and then dispose of it safely.
Keep long hair tied back.
Keep your work area tidy and clean up any spills including water on the floor.

1.0.3 BRIEF HISTORY OF SIWES

The students industrial work experience scheme (SIWES) was initiated by the industrial
training fund (ITF) in 1973 as a means or measure to bridge the gap between theory and
practical experience which was found missing in the Nigerian education system.
Industrial training fund (ITF) was established by decree 47 of the 1971 constitution as a
federal parastatal and charged with the responsibility of promoting and encouraging the
acquisition of skills in commerce and industries, with the view of generating
indigenously trained manpower, sufficient enough to meet the needs of the economy.
The scheme has broadened the scope and otherwise a number of institutions incorporated
into the scheme is ever increasing just as the population of students increases. For the
continuous sustenance of the scheme, various organisations such as the Federal
Government, Industrial Trust Fund (ITF) in collaboration with agencies such the
National University Commission (NUC), employers of labour and higher institutions, all
have specific and important role in the management of the scheme. However, due to the
additional burden, the scheme brought the ITF through the years. The federal
government withdrew its funding of the scheme in 1979. This withdrawal existed till

1
 July 1985, when the federal government reverted to the operation of the scheme to ITF
to fully fund it again.
1.0.4 PHILOSOPHY OF SIWES
To bridge the gap between theories and practice (National University Commission 1996)
1.0.5 AIM AND OBJECTIVES OF SIWES
1.0.6 AIM: To expose students to machines and equipment, professional work methods and
ways of safeguarding the work areas and workers in industries and other organisations.
1.0.7 OBJECTIVES:
. To provide an avenue for students in Nigerian Universities to acquire industrial skills and
experience in the course of their study.
. To prepare students for industrial work situations they are likely to meet after graduation.
. To expose students to work method and techniques in handling equipments and machinery
that may not be available in the universities
. Make transition from the university to the world of work easier and thus enhances students
contact for later job placement.
. Provide students with the opportunity to apply their theoretical knowledge in real world
situations thereby bridging the gap between theory and practice.
. Enlist and strengthens employer`s involvement of the entire educational process of
preparing university graduates for employment in the industry.

2
 CHAPTER TWO

2.1.0 HISTORY OF BAFAWAT BIOMEDICAL DIAGNOSTIC LABORATORY

LAFIA, NASARAWA STATE.
Bafawat Biomedical Diagnostic Laboratory Centre is a privately held medical facility with
state of the art modern diagnostic equipment and dedicated skilled personnel. They are
ready to attend to all your diagnostic needs. They are set to Nigerians healthier by
providing a fast accurate and reliable diagnosis.
They also bring the widest pathology test range. And they are working very hard to be the
definition of excellence in diagnostic medicine in Nigeria. They are involved in carrying
out Microbiology test, Immunoassay test, chemical pathology test, Hematology.
2.1.1 VISION STATEMENT
“To make a positive impact in healthcare through leadership that will assure excellence in
the practice of medicine.
2.1.3 MISSION STATEMENT
“To inspire hope, contribute health wellbeing by providing the best care to every patient
through integrated molecular practice and research.

3
 CHAPTER THREE

3.1.0 MAJOR SECTIONS OF BAFAWAT BIOMEDICAL DIAGNOSTIC

LABORATORY
3.1.1 MICROBIOLOGY LAB
Microbiology laboratory at Bafawat offers the services of diagnostic aerobic and anaerobic
bacteriology, parasitology, virology and mycobacteriology.
3.1.2 The Aerobic Bacteriology Section
Isolates and identifies clinically significant microorganisms from clinical samples or
specimens and performs antimicrobial susceptibility testing on these bacterial pathogens.
These functions are performed with the vitek-2 automated instruments; Additional
reference identification and susceptibility testing methods for other, more fastidious
bacterial agents are also available to performs blood culture using the BactiAlert system,
which provides continuous monitoring of blood samples for the entire seven day
incubation period. It performs amplified probe test for detection of Neisseria
gonorrhoeae and Chlamydia trachomatis in urogenital specimens. It performs “real
time” PCR on nares swab specimens and other specimen types are available for rapid
detection/identification of methicillin-resistant strains of staphylococcus aureus
(MRSA). It performs isolation and characterization of clinically significant anaerobic
bacteria. For these purpose, the laboratory is equipped with a glove box, cabinets, an
incubator, and a water bath.

4
3.1.3 LABORATORY EQUIPMENT
In the laboratory, different instrument are used; some has general purpose while some have
specific. Below are some laboratory equipment and their uses.
3.1.4 TEST TUBE
This is a glass cylindrical instrument used in the laboratory to hold the blood sample for
analysis and examination.
3.1.5 MICROSCOPE
This is an optical device for viewing micro-organisms and other pathological substances that
cannot be viewed with the ordinary eye.
3.1.6 ANAEROBIC JAR
This is the instrument that is use to grow micro-organism that fails to grow or die in an
aerobic condition.
3.1.7 REFRIGERATOR
The refrigerator is a machine used to store laboratory sample and reagent that are below
normal room temperature.
3.1.8 BLOOD BANK REFRIGERATOR
It is a machine that is use to save keep collected blood bags which can be use in blood
transfusion.
3.1.9 PIPETTE
This is made of a rubber material and is graduated in milliliters. It is use to measure specific
volume liquid sample like blood and reagents.
3.2.0 SYRINGE/NEEDLE
It is use to collect blood sample from patient.
3.2.1 KITS
These are various kits stripes used for test like OBT, VDRL, RVST, PT, HBSAg etc.
3.2.2 CENTRIFUGE
It is use to separate liquid of different densities. Separating the blood plasma
from the red blood cell, white blood cell and platelet.
3.2.3 GLUCOMETER
A device for testing blood sugar level of a patient.
3.2.4 MICRO-HAEMATOCRIT CENTRIFUGE
It is a machine used to separate blood components in a small capillary tube for
the essence of knowing the volume of the red blood cell in a patient.
3.2.5 MICRO-HAEMATOCRIT READER
This is use for reading out the percentage composition of the red blood cell in
the body.
3.2.6 BLOOD BAG
A bag containing anticoagulant in which blood is collected into and stored for
the purpose of blood transfusion.

5
 CHAPTER FOUR

4.1.0 PARASITOLOGY SECTION

Provides services for the diagnosis of various parasitic infection; it also have agreat deal
in expertise and in providing diagnostic parasitology services to hospitals and clinics.
Specimens submitted for parasitology test include stool specimen for the detection of
pathogenic amoeba and flagellate, and for detection/identification of ova belonging to
various nematodes (roundworm), cestode (tapeworms), and trematode (flukes) species.
Blood samples are also submitted for the diagnosis and identification of malaria parasites.

4.1.1 MALARIA PARASITE (MP) TEST

Malaria presents a diagnostic challenge to laboratories in most countries. The mainstay of
malaria diagnosis has been the microscopic examination of the blood utilizing blood
films and malaria parasite kits (Rapid Diagnostic Test kits). Although blood is the
sample most frequently used to make a diagnosis, both saliva and urine have been
investigated as alternative, less invasive specimen. Plasmodium species is the causative
organism that causes malaria parasite. One becomes infected if bitten by an infected
female anopheles mosquito. The Plasmodium species are;
1. Plasmodium vivax,
2. Plasmodium falciparum,
3. Plasmodium ovale, and
4. Plasmodium malariae.
It is the trophozoides of Plasmodium species that causes harm to man. The trophozoides
is the form of a sporozoan protozoan in the feeding stage of the malaria parasite, this
stage occur in the human red blood cells. Symptoms of malaria include fever, headache,
vomiting, high body temperature etc. The breeding site for mosquitoes include streams,
stagnant dirty water, bushes, and many more. If this breeding sites are destroyed, the rate
of malaria disease will be reduced.
4.1.2 AIM: To determine the presence of plasmodium species in the human blood.
4.1.3 MATERIALS REQUIRED:
1. Whole blood specimen,
2. Sterilized lancet,
3. Cotton wool and field stain A and B, and
4. Microscope.

4.1.4 PROCEDURES
i. Smear blood specimen on a clean grease free disinfected slide
ii. Allow to air dry for 20 minutes
iii. Flood the smear with field stain A for 60 seconds and wash the stain off with
water and also counter stain field stain B for 60 seconds and wash off with
gentle stream of water.
iv. Allow to air dry again for 10 minutes
v. Focus using X10 and add immersion oil then confirm under the microscope

6
with X100.
4.1.5 RESULT:
The result is positive if a ring shape of Plasmodium is seen.
The result is negative if the ring is not seen.

4.1.6 MICROFILARIA TEST

The microfilaria sometimes abbreviated MF, is an early stage in the life cycle of
certain parasite nematodes in the family Onchocercidae. In some species of
Onchocercidae, the release of microfilaria by the adult female is periodic
occurring daily at a particular time of the day or night. This timing increases the
chance that they will be picked up by a blood feeding arthropod vector, like
the mosquito and the deer fly as vector for Wuchereria bancrofti and Loa loa
respectively which are often more active at certain time of the day. Eight
known filarial nematodes use human as their definitive host. These are divided
into three groups according to the niche within the body they occupy.
1) Lymphatic filariasis is caused by the worms Wuchereria bancrofti, Brugia
timori and Brugia malayi. These worms occupy the lymphatic system including the
nodes; in chronic cases, these worms leads to disease called elephantiasis.
2) Subcutaneous filariasis is caused by Loa loa (the swollen eye worm), Mansonella
streptocerca, and Onchocerca vovulus. These worms occupy the subcutaneous layer of
the skin in the fat layer. Loa loa causes filariasis (itching of the eye) while Onchocerca
vovulus cause river blindness or Onchocerciasis.
3) Serous cavity filariasis is caused by the worms Mansonella perstans and Mansonella
ozzardi, which occupy the serous cavity of the abdomen. The microfilaria test can be
done using the blood and the skin snip sample.
4.1.7 AIM: To determine the presence of microfilaria parasite in the blood and the
subcutaneous layer of the skin.
4.1.8 MATERIALS REQUIRED: Glass slide, cover slip, blood lancet, surgical blade,
blood sample, microscope, and normal saline.

4.1.9 PROCEDURE FOR MICROFILARIA BLOOD TEST

i. Get the materials ready.
ii. Clean the patient’s thumb with a wet swab.
iii. Prick the thumb with a blood lancet and wipe the first drop of blood with a
cotton wool.
iv. Apply pressure to cause blood drop on the glass slide.
v. Make a smear and cover it with a cover slip avoiding air bubbles
vi. View the prepared slide under the microscope using X10.

4.2.0 RESULT: Movement of filariasis confirms positive and non movement

confirms negative.

4.2.1 PROCEDURE FOR MICROFILARIA SKIN SNIP TEST

i. Clean the shoulder region of the patient with a wet swab.

7
ii. Use the blood lancet to raise a small thin layer of the skin.
iii. Use the surgical blade to cut the layer.
iv. Place the layer on a glass slide and add one drop of normal saline.
v. Place the prepared slide in a cool place at a normal temperature for 30
minutes, for the microfilaria to migrate into the normal saline.
vi. View under the microscope using X10 and X40.

4.2.2 RESULT: Positive when microfilaria swims in the normal saline and negative when
none swims.

8
 CHAPTER FIVE
5.1.0 THE VIROLOGY SECTION

Provides services to aid in the diagnosis of viral infections. Performs culture methods for
several usage viral agents and enzymes immunoassay test are used for detection of
several non-cultivable viral agents such as rotavirus. It performs HIV-1 antibody encyme
immunoassays syphilis serology, and culture for Trichomonas vaginalis
5.1.1 HEPATITIS
Hepatitis is an inflammation of the liver, most commonly caused by a viral infection.
There are five main hepatitis viruses referred to as type A, B, C, D, and E. These five
types are of great concern because of the burden of illness and death they cause and the
potential for outbreaks and epidemic spread. In particular, types B and C leads to chronic
disease in hundreds of millions of people and together are the most common cause of
liver cirrhosis and cancer. Hepatitis A and E are typically caused by ingestion of
contaminated food or water. Hepatitis B, C, and D usually occur as a result of potential
contact with infected body fluids. Common modes of transmission for these viruses
include transfuse of contaminated blood or blood products, invasive medical procedure
using contaminated equipment and Hepatitis B is transmitted from mother to baby at
child birth, from family member to child, and also by sexual contact. Acute infection
may occur with limited or no symptoms. Hepatitis A virus (HAV) is present in the stool
of an infected person and is most often transmitted through consumption of
contaminated water or food. Certain sexual practices can also spread hepatitis A virus.
Infections are in many cases mild, with most people making a full recovery and
remained immune from further HAV infections. However, HAV infections can also be
severe and life threatening. Most hepatitis B virus (HBV) is transmitted through
exposure to infective blood, semen and other body fluids. HBV can be transmitted from
infected mothers to infants at the time of birth and through sexual intercourse. It also
occur through transfusions of HBV contaminated blood and blood product and
contaminated injections during medical procedures. A safe and effective vaccine is
available to prevent HBV. Hepatitis C virus (HCV) is mostly transmitted through
exposure to infective blood. Sexual transmission is also possible but is much less
common. There is no vaccine for HCV. The hepatitis D virus (HDV) infection occurs
only in those who are infected with HBV.

5.1.2 AIM: To determine whether an individual have hepatitis or not. Materials required:
Serum or plasma, hepatitis test strip.

5.1.3 PROCEDURE:
i. Put on gloves and laboratory apron or coat.
ii. The blood of the patient is got through vein puncture.
iii. The blood is spun to get the serum or plasma.
iv. Dip the hepatitis kits strip into the serum. Allow for 5 – 6 minutes.
v. Watch for pink line(s) to appear.
5.1.4 RESULTS: A double line will appear if positive but single line if negative.

9
 CHAPTER SIX
6.1.0 CHEMISTRY SECTION
6.1.1 URINALYSIS
Urinalysis is a test done to analyze the urine and determine its constituent, it detect the
presence of some abnormal make-up of the urine which could be as a result of an
inflammation or perforation of the kidney or any other urinary organ. The urinalysis test
strips are in different ranges which are combi-2, combi-9 and combi-11. The combi-11
test strip determine the presence of the following substances in the urine,
i. Urobilinogen
ii. Glucose
iii. Bilirubin
iv. Ketones
v. Specific gravity
vi. Blood
vii. pH
viii. Protein
ix. Nitrites
x. Leukocytes
xi. Ascorbic acid
Also the physical appearance of the urine is taken note of, that is, by checking the colour
and the appearance whether it is clear or cloudy.
6.1.2 AIM: To determine the urine constituent and deposits.

6.1.3 MATERIALS REQUIRED: Fresh urine sample, combi-11 test strip, and combi-11
colour chart.

6.1.4 PROCEDURES:
i. Give a disinfected container to the patient for the urine sample.
ii. When the urine sample is brought
iii. Put on hand gloves and lab coat.
iv. Collect the urine sample and dip the combi-11 test strip into the urine.
v. Check for result on the combi-11 colour chart.

6.1.5 OCCULT BLOOD TEST (OBT)

Occult Blood Test is known as Fecal Occult Blood Testing (FOBT). FOBT is a testing that
is performed on samples of stool in other to detect occult blood (blood that is not visible
to the naked eye) in otherwise normal-coloured stool. Fecal occult blood usually is a
result of slow bleeding from inside the upper or lower gastrointestinal tract. The slow
bleed does not change the colour of the stool or result in visible bright red blood.
Therefore, the blood is found only by testing the stool for blood in the laboratory. A
fecal occult blood test is done primarily to detect or prevent colon cancer in people
without intestinal symptoms. Cancers of the colon are common and frequently produce
fecal occult blood long before they cause other symptoms such as abdominal pain, rectal
bleeding or changes in bowel habits.

10
 6.1.6 AIMS: To detect hidden blood in the stool. Materials required: Stool sample, fecal
occult blood test strip

6.1.7 PROCEDURE:
i. Collect the stool sample from the patient.
ii. Use a small rod to pick the stool from the container into the FOBT strip
diluents.
iii. Shake to dissolve the stool into the diluent.
iv. Pipette the dissolve stool unto the strip at the space provided.
v. Wait and watch for the line(s) to appear

6.1.8 RESULT: A double line proves positive while a single line proves negative.

6.1.9 LUTEINIZING HORMONE:

6.2.0 URINE OVULATION TEST
The one step LH urine ovulation test is fast and easy to use. It is a qualitative test that
can predict when there is a LH (luteinizing Hormone) surge, and in turn when you are
likely to ovulate. Ovulation is the release of an egg from the ovary. The egg then passes
into the fallopian tube where it is ready to be fertilized. A baby is conceived when the
male sperm successfully fertilizes the female egg. When a woman is about to ovulate,
her body releases a large amount of a hormone called L.H. (Luteinizing Hormone). L.H.
is always present in your urine but the levels increase (surge) in the middle of your cycle,
causing you to release an egg from the ovary. The test detects the sharp increase in LH
concentration in urine, the so called “LH surge” which precedes ovulation. Conception is
most likely to occur within 36 hours following the LH surge.
6.2.1 WHEN TO BEGIN TESTING
First, you must determine the length of your menstrual cycle. This is the number of days
from the first day of your menstrual bleeding to the day before your next bleeding begins
again, count the first day of bleeding as day 1. Calculate what the usual length of your
menstrual cycle has been over the last few months. Once you have worked out the length
of your cycle refer to the chart to determine on which day of your menstrual cycle you
should begin testing. Example: If your cycle is normally 28 days, the calendar below
shows you how to work out when day 11 is. S M T W T F S 1 2 3 (Day 1) 4 5 6 7 8 9 10
11 12 13 (Day 11) 14 15 16 17 18 19 20 21 22 23 24 25 25 27 28 29 30 31 SAMPLE
CALENDAR 3: The first day of menstrual bleeding (day 1) 13: The day to begin
ovulation testing (day 11)

6.2.2 SPECIMEN COLLECTION:

Once you have identified what day you should begin testing you should then begin to
collect your urine on a daily basis.
Do not use first morning urine samples as LH is synthesized in your body early in the
morning. It will not show up in your urine until later in the day.
The best time to collect your urine is between 10am -8pm. Pick a regular time that suits
you best.

11
 Collect urine at about the same time each day. Reduce liquid intake about 2 hours before
collecting your urine as a diluted urine sample can prevent the test from detecting LH
surge.

6.2.3 TEST PROCEDURE:

i. Determine the day to begin testing.
ii. Collect urine sample in a clean and dry container.
iii. To begin testing, open the sealed pouch and remove the strip. Do not
remove the strip until you are ready to begin testing. With the arrows pointing downwards
towards the urine, place the test strip vertically (straight) into the urine sample, for at
least 10 seconds. DO NOT allow the urine to go above the MARK level line.
iv. Remove the strip from the urine and place on a clean, dry surface. For best results
you should read the results at 10 minutes.
v. Wait for coloured bands to appear. Depending on the concentration of LH in the urine
specimen, positive results may be observed in as short as 40 seconds. However, to
confirm negative results, the complete reaction time of 10 minutes is required. Results
obtained after 30 minutes may be considered invalid.

6.2.4 INTERPRETATION OF RESULTS:

After each test, you must decide if you are having a L.H. surge. To determine your result
you must compare the colour intensity of the test band to the control band. The control
band is used to compare the test band against and also confirms that you have completed
the test correctly. Positive for L.H. surge If two colour bands are visible and the test band
is of almost equal or greater colour intensity (darker) than the control band, this is a
positive result and a good indication that the L.H. surge is occurring. You should ovulate
within the next 24-36 hours. Sexual intercourse is advised at anytime after the first
positive test. Negative for L.H. surge If two bands are visible but the test band is of a less
intense colour (paler) than the control band or cannot be seen, this means the L.H. level
is at or near its normal level and that the surge is not in progress. You should continue
with daily testing. Invalid result If no control band appears within 5 minutes, the result is
invalid and should be ignored. A visible control line is needed in all cases to confirm a
proper test result. Repeat test with a new test kit.

12
 CHAPTER SEVEN
7.1.0 PHLENBOTOMY

7.1.1COLLECTION OF BLOOD SAMPLE ; The volume of the blood to be collected

and the method involved in the collection is determined by the type of test to be carried
out on a patient. The following are the various ways by which blood can be collected in
the laboratory for examination.
7.1.2 MATERIALS REQUIRED: Wet swab, sterile syringe/needle and tourniquet.
7.1.3 PROCEDURES:
Finger prick Venous puncture: This is the method used when a large volume of
blood is needed for the particular test(s) about (2-5mls) such as Widal (fever)
test, serum PT, etc. Pressure is applied to the area for puncture e.g. the hand.
The tourniquet is tied on the hand for about 5cm away from the place to be
punctured.
Clean the area with wet swab or alcohol to disinfect it and locate a convenient
vein.
The needle is inserted into the vein to puncture through and pull the syringe to
draw blood into the syringe.
Loose the tourniquet and withdraw the needle.

13
 CHAPTER EIGHT

8.1.0 HAEMATOLOGY SECTION:

8.1.1 PACKED CELL VOLUME (PCV)

This is the fraction of whole blood volume that consists of red blood cells. The PCV test is
carried out to determine the percentage of the red blood cells in the body. If the
percentage of the red blood cells is below 30%, the need for blood transfusion will
become imperative. Reference values for blood range (Red Blood Cells) are;

Normal blood ranges for males....................................................40-52%

Normal blood ranges for female....................................................34-48%

Low blood range.............................................................................33% below

High blood range...........................................................................56% above

Critical range................................................................................. ≤18%

8.1.2 MATERIALS USED: Wet swab, lancet, haeparinized capillary tube, haemotocrit
centrifuge, micro-haematocrit reader and plasticine.
8.1.3 PROCEDURES:
The patient’s finger is cleaned with swab dipped in an alcohol.
The finger is pricked with sterilized lancet. The first drop of blood is cleaned
before another drop is collected into the haeparinized capillary tube.
One side of the capillary tube is sealed using plasticin
The blood in the capillary tube is spun using the haematocrit centrifuge for 10
minutes.
Result obtained: The red blood cells in the capillary tube will be separated
from the serum after spinning. The PCV is read using the micro-haematocrit
reader. The result is recorded in percentage.

8.1.4 FASTING AND RANDOM BLOOD SUGAR

A blood glucose test measures the amount of a sugar called glucose in a
sample of your blood. Random and Fasting blood sugar (RBS and FBS) test are
test which are done to determine the level of glucose or sugar in the blood.
The difference between Random Blood Sugar and Fasting Blood Sugar, the
patient is not expected to eat for at least 8 hours, while in the case of Random
Blood Sugar; the patient may eat whatever he/she wants before the test can
be conducted. The normal range for Fasting Blood Sugar is (60 – 100)mg/dL
and the normal range for Random Blood Sugar is (72 – 154.8)mg/dL. Any of the
14
value above the given normal range means that the patient has diabetes
(excess sugar in the blood).
8.1.5 MATERIALS REQUIRED: Wet and dry swab, test strip, blood sample and
glucometer.
8.1.6 PROCEDURES:
After the glucometer is switch on, the Acu-check strip is inserted.
The patient’s thumb is cleaned using the wet swab then pricked using the
lancet the first drop is wipe off with a dry swab and the thumb is pressed.
When pressed, a drop of blood is allowed to drop at the front top of the test
strip. It is allowed for few seconds while the results displays on the LCD screen.
The result is recorded in milligram per decilitre (mg/dL).

8.1.7 BLOOD GROUP TEST

Blood typing is used to determine an individual’s blood group, to establish
whether a person is blood group A, B, AB, or O and whether he/she is Rhesus
positive or Rhesus negative. It is an antigen-antibody reaction. Blood typing
may be used to: Ensure compatibility between the blood type of a person who
requires a transfusion of blood or blood components and the ABO and Rhesus
type of the unit blood that will be transfused.
Determine compatibility between a pregnant woman and her developing baby
Determine the blood group of potential blood donors at a collection facility.
Determine the blood group of a potential recipient. MATERIALS REQUIRED:
Wet swab, lancet or sterile needle, tile, anti- A, B, AB, and D anti-sera.
8.1.8 PROCEDURES:
The patient’s finger is cleaned with swab and pricked.
The first blood is cleaned
8.1.9 BLOOD TRANSFUSION
Blood transfusion is generally the process of receiving blood products into
one’s circulation intravenously. Transfusions are used for various medical
conditions to replace lost components of the blood. A blood transfusion is the
transfer of blood or blood products from one person (donor) into another
person’s bloodstream (recipient). This is usually a life saving act to replace
blood cells or blood products lost through severe bleeding, during surgery
when blood loss occur or to increase the blood count in an anaemic patient.
Before blood is transfused, the blood group of the patient and the donor must
be the same to avoid clumping of the patient’s blood which is due to
unmatched anti-body to antigen reaction. The table below illustrates
compatible and non-compatible Blood group of a recipient Donor’s blood A B
AB O A + - + - B - + + - AB - - + - O + + + + Note: + Indicates compatibility –
Indicates non-compatibility

8.2.0 MATERIALS REQUIRED

Anticoagulant, blood bag, cotton wool, and blood transfusion set.
8.2.1 PROCEDURES:

15
The donor is made to lie relaxed on the bed, a suitable vein is located and
pierced with the flow set attached to the blood bag.
The blood enters the blood bag until its volume becomes about 450mls.
The tourniquet is untied from the donor’s hand.
The flow set is removed from the donor’s vein and the area covered with
cotton wool. The blood bag is shaking to mix the blood with the anticoagulant
to avoid clotting. The blood bag is labelled approximately with the donor’s
number. The blood is transfused to the patient or stored in the blood bank for
future use.

8.2.2 COMPATIBILITY TEST

Compatibility test is a test done to determine the blood match of the donor
and the recipient before blood transfusion can be done for a patient.
8.2.3 MATERIALS REQUIRED
2mls of donor’s whole blood, 2mls of patient’s whole blood, a clean grease
free slide, a clean cover slip, microscope and Pasteur pipette and normal
saline.
8.2.4 PROCEDURES
Using three drops of normal saline, wash the donor’s red blood cells three
times by centrifuging.
Discard the supernatant at every step took.
On clean grease free slide a drop of washed donor’s red blood cells was placed.
A drop of patient serum or plasma was added and mixed properly. It was
covered with a cover slip avoiding air bubble and over floating.
Focus with X10 and confirm with X40 .
8.2.5 Result: Cells separated evenly (compatible), and incompatible when cells
are in clumps all over the field.
NOTE: The test can also be done macroscopically.

16
 CHAPTER NINE

9.1.0 ERYTHROCYTE SEDIMENTATION RATE (ESR)

The erythrocyte sedimentation rate (ESR), also called a sedimentation rate or
Westergren ESR, and is the rate at which red blood cells sediment in a period
of one hour. It is a common hematology test, and is a non-specific test that has
being used for many years to help detect inflammation associated with
conditions such as infections, cancers, tuberculosis, and autoimmune disease.
ESR is said to be a non-specific test because an elevated result often indicates
the presence of inflammation but does not tell the health practitioner exactly
where the inflammation is in the body or what is causing it. ESR test is use to
diagnose certain specific inflammatory disease such as temporal arthritis.
Systemic vasculitis and polymyalgia rheumatica. A significantly elevated ESR is
one the main test results used to support the diagnosis. The test may also be
used to monitor disease activity and response to therapy in both of the above
disease as well as some others, such as systemic lupus erythematosus (SLE).
The test is perform either by using Westergren method or Wintrobe method.
The anti-coagulated blood in either of the tubes undergoes three major stages
of sedimentation, which are;
1) Stacks of red cells formation (Rouleaux formation). This stage occurs in the first 10
minutes.
2) The stage of sedimentation or settling: The stage will occur within 40 minutes.
3) This is the stage at which sedimentation slows and cells start to pack at the bottom of the
tube. It is called packing stage. It will happen for 10 minutes after the first – two stages.
Principle: The erythrocyte sedimentation rate (ESR), also called the sed rate, measures
the settling of erythrocytes in diluted human plasma over a specified time period. This
numeric value is determined (in millimetre per hour) by measuring the distance from the
bottom of the surface meniscus to the top of erythrocyte sedimentation in a vertical
column containing diluted whole blood that has remained perpendicular to its base for 60
minutes. Various factors affect the ESR, such as red blood cell size and shape, plasma
fibrinogen, and globulin levels, as well as mechanical and technical factors.

9.1.1 SPECIMEN
Fresh anticoagulated blood collected in EDTA. Blood should be at room temperature and
should be no more than 2 hours old. If anticoagulated blood is refrigerated, the test must
be set up within 6 hours. Hemolyzed specimens cannot be used.
9.1.2 REAGENTS, SUPPLIES, AND EQUIPMENT
1. Westergren tubes
2. Westergren rack
3. Disposable pipets
4. 0.5 ml sodium citrate or EDTA in puncture ready vials
5. Leveling plate for holding the Westergren rack
6. Timer

17
9.1.3 PROCEDURE
Collect 2mls of whole blood and pour it into an anticoagulant container,
example EDTA or Sodium citrate.
Label the puncture ready vial with the patient’s name. Also label the
Westergren tube near the top of the tube.
Remove cap from the puncture ready vial and add well mixed blood up to the
line.
Replace cap and invert 8 times making sure the blood and saline are well
mixed.
Carefully insert the Westergren tube into plungeable vial cap of blood/diluents
mixture twisting as you push the tube down. Use caution not to use excessive
force when placing the vial into the tube. If excessive force is used, blood can
spew out of the top of the vial.
Place the tube in the Westergren rack to a vertical position and leave
undisturbed for 1 hour.
Set timer for 1 hour.
After 1 hour has passed, immediately read the distance in millimetres from the
bottom of the plasma meniscus to the top of the sediment erythrocytes. Do
not include the Buffy coat, layer of white cells and platelets at the interface of
red cells and plasma, in this measurement.
Record your results, kit lot, and expiration date on the report sheet.

9.1.4 REPORTING RESULTS:

Normal Range: Adult male: 0 – 10 mm/hr

Adult female: 0 – 15 mm/hr
Children: 0 – 10 mm/hr

9.1.5 PROCEDURE
Notes:
Age of Specimen: Specimen must be less than 2 hours at room temperature,
less than 6 hours at 2 – 6°C.
Temperature: Environmental temperature and specimen must be between 20-
25°C when testing is performed. Elevated temperatures falsely elevate the ESR.
Incorrect ratio of blood to diluents.
Excess anticoagulant causes the red blood cells to shrink, resulting in a
decreased ESR.
Bubbles in the Westergren tube, results in a decreased ESR.
Tilting of the Westergren tube accelerates the fall of the erythrocytes (an angle
of even 3 will increase the rate by as much as 30%)
Vibration (ex. nearby centrifuge) can falsely elevate the ESR.
Plasma and red blood cells abnormalities affect sedimentation rate.
Haemolysis of the specimen causes a decrease in the ESR.

18
 CHAPTER TEN
10.1.0 SPUTUM ACID-FAST BACILLI (AFB) SMEAR AFB
Smear refers to the microscopic examination of a fluorochrome stain of clinical
specimen (mycobacterium). The sputum stain for mycobacterium is a laboratory test
performed on a sample of the patient’s sputum. It is also known as an acid-fast bacillus
stain (AFB) or a tuberculosis (TB) smear. The test is commonly ordered by the doctor to
find out if a patient has tuberculosis or another type of mycobacterium infection. Most
mycobacterium is known to be acid-fast, which means they hold unto the dye when
washed in an acid solution.
10.1.1 MATERIALS REQUIRED: Sputum, glass slide, carbol fuschin, acid alcohol,
methylene blue, distilled water and microscope.

10.1.2 PROCEDURES
Make a circular smear of the sputum from the lungs on a grease free glass slide.
Fix the smear on the slide by passing it through the Bunsen burner 3 times, allows to cool.
Flood the smear with a strong carbol fuschin, heat the back surface of the slide to steam rise
(prevent from boiling).
Allow standing for five minutes, rinse with buffer distil water to remove excess stain,
decolourize with 3% acid alcohol briefly, rinse with a buffer distil water.
Counter stain with methylene blue for 2 minutes, rinse with water.
Clean the back surface with dry cotton wool, place on a dry rack to air dry.
Observe under microscope using X10 for focusing and X100 (adding immersion oil) for
observation.

10.1.3 RESULTS: AFB stained red Non AFB stained blue taking the colour of the counter
stain.

19
 CHAPTER ELEVEN

11.1.0 MICROSCOPY
11.1.1 STOOL MICROSCOPY
Microscopic examination of a wet mount of the stool has been the standard practice for the
laboratory diagnosis of intestinal parasitic infections. Stool microscopy is a medical test
done to determine any gastrointestinal infection, to look for parasites such as Giardia,
Eschericia coli, etc., perforation of the abdomen or any digestive tract abnormality, diseases
like taeniasis, amoebic dysentery which can be detected through the test. Protozoan
trophozoites, cysts, oocysts, helminthes eggs and larvae may be seen and identified using a
wet mount identification technique.
11.1.2 MATERIALS REQUIRED: Microscope, glass slide, cover slip, stool sample
and normal saline.
11.1.3 PROCEDURES:
Give a disinfected container to the patient.
The patient should help collect his/her stool into the container.
Add one drop of normal saline on the glass slide.
Using an applicator sticks to get the stool from the container, add it to the
normal saline and smear.
Cover the smear with a cover slip. You can seal the edge of the cover slip.
Mount the prepared slide on the microscope and view to and fro; viewing all
the areas in the cover slip.
11.1.4 RESULTS: Cyst, ova, or parasite seen is recorded.
11.1.5 URINE MICROSCOPY
A microscopic examination may be performed as part of a routine urinalysis. It
will typically be done when there are abnormal findings on the physical or
chemical examination. It is perform on urine sediment – urine that has been
centrifuged to concentrate the substances in it at the bottom of a tube. The
fluid at the top of the tube is then discarded and the deposit of the fluid
remaining are examine under a microscope. Cells, crystals and other parasites
are found and reported either as the number observed per low power field or
per high power field. In addition, some entities, if present are estimated as
‘’few’’, ‘’moderate’’, or ‘’many’’, such as epithelial cells, bacteria, crystals, red
blood cells and white blood cells.
11.1.6 PROCEDURES:
Collect the urine sample in a centrifuge tube with cap.
The centrifuge tube is then centrifuged for 5 minutes.
The supernatant is discarded and the sediment taped, a drop on a clean grease
slide.
It was covered with a clean cover slip, avoiding bubbles.
It was focused using X10 objective and confirmed with X40
11.1.7 EXPECTED RESULT: The result is recorded based on what is seen which
can be the following;
Schistosoma haematobium

20
Pus cells
Red blood cells
Epithelial cells
Trichomonas vaginalis
Spermatozoa

21
 CHAPTER TWELVE

12.1.0 SEROLOGY SECTION

Serology section in the laboratory has to do with any laboratory test or analysis that has to
do with serum.
12.1.1 RETROVIRAL SCREENING TEST (RVST)
Retrovirus is a virus that is composed not of DNA but of RNA. Retrovirus, have
an enzyme called reverse transcriptase, that gives them the unique property of
transcribing their RNA into DNA after entering a cell. The retroviral DNA can
then integrate into the chromosomal DNA of the host cell, to be expressed
there. HIV is a retrovirus. Retroviral screening test (RVST) is a test done to
detect the presence of Human Immunodeficiency Virus (HIV – 1 and HIV – 2)
antibodies in serum or plasma. HIV is a virus that causes Acquired Immune
Deficiency Syndrome (AIDS), it invades the immune system of human,
destroying the blood cells which serve as a defense mechanism to the body.
When the body immune systems are destroyed, the body becomes open to
any pathological attack. People suffering from this virus suffer symptoms like
fever, tuberculosis, weakness of the body, diarrhea, etc. Though anti-retroviral
drugs are now available to alleviate the risk of death when infected but it has
no cure at the moment.

12.1.2 AIM: To determine the presence of Human Immunodeficiency Virus

(HIV) in the blood.

12.1.3 MATERIALS REQUIRED: Determine test strip or UNIGOLD stat park test
strip, blood sample and centrifuge.

12.1.4 PROCEDURE:
Locate a suitable vein.
Disinfect the portion with a wet swab.
Collect 2mls of blood with the syringe and needle and pour it into the test
tube.
Centrifuge the blood to get a serum or plasma.
12.1.5 RESULTS: Pipette the serum onto the space provided on the Unigold strip or
determine strip.
Wait for about 5 – 6 minutes to see the pink line(s) appear on the test strip.
A double pink line will appear if positive and a single pink line appear if negative

12.1.5 VENEREAL DISEASE RESEARCH LABORATORY (VDRL) TEST

Venereal disease research Laboratory (VDRL) test is a screening test for syphilis. It
measures substances, called antibodies that a body may produce if it comes in contact
with the bacteria that cause syphilis. This bacterium is called Treponema pallidum. It is a
sexually transmitted disease that can be gotten through sexual intercourse, mother to
child at child birth, contaminated blood etc. Instead of testing for the bacteria that causes

22
 syphilis, the VDRL test checks for anti-bodies to these bacteria. Your immune system
produces a specific kind of anti-body (a type of protein) when it defends your body from
syphilis. Aim: To check the presence of anti-body produced by the body when
Treponema pallidum is present.

12.1.6 MATERIALS REQUIRED: Blood sample, syringe and needle, centrifuge and
VDRL test strip.
12.1.7 PROCEDURE:
Locate a prominent vein on the hand.
Tie the hand with tourniquet 6cm away from the place you wish to puncture.
Insert the needle into the vein, then draw the blood into the syringe, about
1ml.
Pour it into the EDTA tube and centrifuge for 5 minutes.
Pipette the serum onto the provided point on the VDRL test strip.
Wait for 5 – 6 minutes to see pink line(s) appear.
12.1.8 RESULTS: A double pink line means positive but single pink line means
negative or non reactive.

12.1.9 SERUM PREGNANCY TEST AND URINE PREGNANCY TEST

Pregnancy is a test done to know if a woman is pregnant or not. This is possible through
the presence of human chorionic gonadotrophin hormone (HCG) in the blood or urine.
The pregnancy test can be done using two basic samples which are urine and serum.
When serum is used as the test sample the presence of the human chorionic
gonadotrophin hormone can be detected in the first three weeks of pregnancy, while the
test done using and urine sample can only discover pregnancy from the first month
accurately. The human chorionic gonadotrophin hormone is produced by the placenta
shortly after the embryo attach itself to the uterine lining and build up rapidly in the
body in the few days of pregnancy.
12.2.0 AIM: To determine the presence of human chorionic gonadotrophin hormone in
urine or serum.
12.2.1 PROCEDURE USING URINE SAMPLE
Collect the urine sample.
Dip the HCG test strip into the urine.
Allow for 5 – 6 minutes.
Watch for the pink line(s) to appear
12.2.2 PROCEDURE USING SERUM
Collect the blood sample into a test tube.
Centrifuge to have a plasma or serum.
Dip the HCG test strip into the serum portion.
Watch for the pink line(s) to appear.
12.2.2 RESULTS: Double pink lines means positive and single pink line means
negative.
12.2.3 WIDAL (FEVER) TEST

23
 The Widal test is a serological test for enteric fever whereby bacteria causing typhoid
fever are mixed with serum containing specific anti-bodies from an infected individual.
The Widal is positive if Salmonella O antigen titre is more than 1:160 in an active
infection or if Salmonella H antigen titre is more than 1:160 in past infection or in
immunized persons. Enteric fever is a life threatening illness caused by infection with
the bacterium Salmonella enterica serotype typhi (Salmonella typhi), usually transmitted
through foods and drinks contaminated with fecal matter. It is associated with symptoms
that include high fever, fatique, headache, abdominal pain, diarrhea or constipation etc.
Early diagnosis and treatment are important because serious complications including
severe intestinal bleeding or perforation can develop within a few weeks.
12.2.4 AIM: To determine the presence of the bacteria causing typhoid fever in the
serum.
12.2.5 MATERIALS REQUIRED: Blood sample, salmonella O and H antigen with
salmonella paratyphi A, B, and C for O and H antigen respectively, centrifugecentrifuge
and EDTA bottle.
12.2.6 PROCEDURE:
Locate a prominent vein on a patient’s hand.
Tie the tourniquet 6cm away from the vein you wish to puncture.
Insert the needle into the vein and draw the syringe to collect blood.
Pour the blood into an EDTA bottle and spin using the centrifuge for 5 minutes.
One drop each of patient’s serum sample for the four antigen are drop on a circled card
and one drop of each of the four salmonella antigens are added separately and gently
mixed, then rocked for two minutes.
Agglutination is watch for. The appearance of agglutination gives a qualitative result.
12.2.7 PREPARATION OF NUTRIENT AGAR
Nutrient agar is a general purpose medium supporting growth of a wide range of non-
fastidious organism. It is a nutrient medium used for the cultivation of microbes. It is
frequently used for isolation and purification of cultures. Nutrient agar consists of heat-
stable digestive products of proteins (called peptones) and beef extract. Both of these
provide amino acids, minerals, and other nutrients used by a wide variety of bacteria for
growth. In addition, it contains agar as a solidifying agent.
12.2.8 PROCEDURES:
Weigh 2.8 grams of nutrient agar powder and add 100mls of deionized water.
Allow to soak for 10 minutes.
Swirl to mix.
Sterilize by autoclaving for 15 minutes.
Allow to cool to.
Mix well before pouring into plates.

24
 CHAPTER THIRTEEN

13.1.0 CONCLUSION
I have really discovered from my four months of experience that SIWES is of a great
importance; it has exposed me to a lot of medical laboratory skills, techniques, and
strategies. I learnt about the causes of many diseases, mode of infection, symptoms and
possible solution. Student Industrial Work Experience Scheme (SIWES) is of much
relevance because it exposes students to so many thing the shores of their school could
not allow them have access to. It really helps me, so other student should endeavor to
participate in this exercise.
13.1.1 RECOMMENDATION
I recommend that the technical report is physical proving of laboratory testing for
diagnosis of some disease and sickness affecting the human bodies. For this reason,
students should always seek to be trained in a well equipped or adequate establishment
to enhance proper learning of the practical methods involve in diagnosis.

25