DEDICATION

I want to dedicate this SIWES report to God Almighty the owner of my life for his love and

grace and for seeimg me through the whole six month of my SIWES program.

My appreciation also goes to my parents; Mr. And Mrs. Fasinu and my wonderful siblings

for their support financially, spiritually, mentally and morally during the period of the SIWES

and also for their encouragement and advice to press on when I was losing all my strength.

May God bless them richly.

I also want to appreciate my dear friend Odewusi Taiwo for her love and support in terms of

prayer and finance and for being there always. God bless you dear. And my father Pastor

Joseph-Josh Adefisan, my mother Sister Damilola and a father and brother Pastor Philip

Nudamajo and thier families for their prayers ,love, support and words of encouragement.

And also Adegbesan Paul for his time, love, care, and everything. God bless them all.

Lastly, my appreciation goes to the SIWES coordinator and other departmental IT

coordinators for dishing out all that I and my colleagues needed to know concerning

internship even before we started at all.

Thank you all. God bless you richly.

1
 ACKNOWLEDGEMENT

I acknowledge God for who he is in my life and for his protection every time. Thank

you father.

My profound gratitude also goes to Mr. Obafebi Tunde, the chief laboratory technician and

owner of the Decure Medical Laboratory, thank you for the great experience i had with you

and for givimg me the necessary practical knowledge I need in my field of study.

Special thanks to a friend, teacher and a partner Darien S. A. for all his encouragements,

prayers, motivations, love and care through the struggle. God bless you dear.

TABLE OF CONTENTS

Dedication

Acknowledgement

Table of contents

Abstract

CHAPTER ONE

INTRODUCTION

1.1 About Students’ Industrial Work Experience Scheme

1.2 Objectives of Students’ Industrial Work Experience Scheme

2

CHAPTER TWO
DESCRIPTION OF THE ESTABLISHMENT OF ATTACHMENT

2.1 About Decure Medical Laboratory

CHAPTER THREE

3.1 WORKDONE

3.2 EQUIPMENTS, REAGENTS AND THEIR PREPARATION

3.3 Serology bench

Widal Test (typhoid)

Veneral Disease Research Laboratory (VDRL) Test

Pregnancy Test (Human Chorionic Gonadotropin,HCG) Test

Hepatitis B surface antigen (HbSAg) test.

Human Immunodeficiency Virus (HIV) Test

3.4 Haematology And Blood Group Bench

Packed Cell Volume (PCV) Test

White Cell Count (WCC) Test

Erythrocyte Sedimentation Rate (ESR) Test

Genotype Testing

Blood Grouping

3.5 Urine M/C/S (Microscopy, Culture And Sensitivity) And Urinalysis Bench

3.6 Wound M/C/S (Microscopy, Culture and Sensitivity) Bench

3.7 Seminal Fluid Analysis (SFA) Bench

3
3.8 Acid Fast Bacilli (AFB) Bench

3.9 Malaria Parasite Bench

3.10 Mantoux Test (Tuberculine Skin Testing)

CHAPTER FOUR

4.1 Experience gained

4.2 Challenges encountered

CHAPTER FIVE

5.1 Observation

5.2 Conclusion

4
 ABSTRACT

This report entails the entirety of my Students’ Industrial Work Experience Scheme

(SIWES) at Decure Medical Laboratory. I also explained in details the activities carried out in

various work benches and the experience I gained. The Students’ Industrial Work Experience

Scheme (SIWES) was introduced in Nigeria by the decree No. 46 of 1971 for students in

higher institution of higher learning and is designed to give a practical knowledge of their

various disciplines to the students. It is a program that is geared towards impacting practical

skills into the students thereby helping them to have a better understanding of the theories

they have learnt in the four walls of the classrooms. This is achieved by attaching them to

various establishments that are relevant to their discipline. It is also aimed at exposing the

students to the working environment in order for them to imbibe the working culture and the

ethics that are not necessarily related to their discipline so that as they acquire skills relating

directly to their discipline. They are also built up for the nation building and at the end of their

study they will be able to make effective contribution to the labour force of the nation.

5
 CHAPTER ONE

INTRODUCTION

1.1 ABOUT THE STUDENTS’ INDUSTRIAL WORK EXPERIENCE SCHEME

(SIWES)

SIWES was established by ITF in 1973 to solve the problem of lack of adequate practical

skills preparatory for employment in industries by Nigerian graduates of tertiary institutions.

The Students Industrial Work Experience Scheme (SIWES) as conducted by the Industrial

Trust Fund (ITF) and its representative in the Federal University Of Technology, Akure

(FUTA) is to span over a period of six months. During this period, the student is expected to

record the daily activities carried out in a log book supplied by the ITF. After the program, the

student will be required to write and submit a report to the ITF and its representative in the

institution.

The Students Industrial Work Experience Scheme (SIWES) is the accepted skills training

programme, which forms part of the approved minimum academic standards in the various

degree programmes for all the Nigerian universities. It is an effort to bridge the gap existing

between theory and practice of engineering and technology, science, agriculture, medical,

management and other professional educational programmes in the Nigerian tertiary

institutions. It is aimed at exposing students to machines and equipment, professional work

methods and ways of safe-guarding the work areas and workers in industries and other

organization. The scheme is a tripartite programme, involving the students, the universities

and the industry (employers of labour). It is funded by the Federal government of Nigeria and

jointly coordinated by the industrial Training Fund (ITF) and the National Universities

commission (NUC).

The scheme exposes students to industry based skills necessary for a smooth transition from
6
the classroom to the world of work. It affords students of tertiary institutions the opportunity

of being familiarized and exposed to the needed experience in handling machinery and

equipment which are not usually available in the educational institutions.

1.2 OBJECTIVES OF THE STUDENTS’ INDUSTRIAL WORK EXPERIENCE

SCHEME

Specifically, the objectives of the Students Industrial Work Experience Scheme(SIWES)

includes:

- Prepare students for the work situation they are likely to meet after graduation

- Provide students with an opportunity to apply their theoretical knowledge in real work

situation, thereby bridging the gap between university work and actual practices.

- Provide an avenue for students in the Nigerian Universities to acquire industrial skills

and experience in their course of study

- Make the transition from the university to the world of work easier, and thus enhance

students contacts for later job placements

- To provide the students assess to equipment that would normally not be available in the

university laboratory or workshop.

- Enlist and strengthen employers’ involvement in the entire educational process of

preparing university graduates for employment in industry.

- Exposing students to work methods and techniques in handling tools, eqiupment and

machinery that may not be available in their institutions.

The relevance of the training for which a claim is made to the needs of the trainees and of

the firm and the cost-economy and effectiveness of the training is basic condition for the

payment of training reimbursement. Each training programme will be based on identified

training needs.

7
 CHAPTER TWO

DESCRIPTION OF ESTABLISHMENT OF ATTACHMENT

2.1 ABOUT DECURE MEDICAL LABORATORY

Decure Medical Laboratory is a private-owned medical centre situated at Number 4,

Apoje road , Igbaire, adjacent to the Morning Star Pharmacy , Ijebu Igbo, few blocks away

from a branch of Wema Bank at Apoje road. It is owned by an esteemed laboratory scientist

and an alumnus of our great citadel of learning; Mr. Obafebi Tunde. It is situated on a major

road and the surroundings is quite appealing. At Decure Medical Laboratory,proper attention

is being paid to the comfort of patients and delivery of excellent health services including

blood banking services.

The laboratory has two major sections; the reception and the main laboratory. The first

section of the lab is the reception where patients are received, attended to and registered in the

reception book. In cases where patients would need to bring samples to the lab, for instance,

early morning sputum sample for AFB test and semen sample for SFA test, they are

instructed on how well to produce and handle the samples in order to limit microbial

contamination. In cases of couselling the patients on how to live healthy as a diabetic patient,

how to live with HIV and what not, all these are carried out in the reception section of the

laboratory. Whereas, the main laboratory is where the major tests are being carried out. It is

also where samples for certain tests like HVS and SFA(as the case may be) are collected.

The laboratory is committed to excellence and there is a genial working environment for us

as we are being trained to provide courteous and efficient service to patients and visitors.

8
 CHAPTER THREE

3.1 WORKDONE

The routine work of microbiologists mainly includes care of patients through handling of

samples such as blood, urine, stool, sputum, semen, etc. Microbiological procedures usually

must be aseptic, and use a variety of tools such as microscopes with a combination of stains

and dyes.

3.2 EQUIPMENTS, REAGENTS AND THEIR PREPARATION

(a) Incubator: A device used to grow and maintain microbiological cultures or cell cultures.

The incubator maintains optimal temperature, humidity and other conditions such as the

carbon dioxide and oxygen content of the atmosphere inside.

(b) Pressure pot: a device used to sterilize equipments and supplies by subjecting them to

high pressure saturated steam at 121 0c for around 15 minutes depending on the size of the

load and the contents. It is used in lieu of an autoclave.

(c) Microscope: Is an instrument used to see objects that are too small for the naked eye. The

science of investigating small objects using such an instrument is called ‘microscopy’.

(d) Centrifuge: is a laboratory equipment used to spin liquid samples, usually to seperate two

liquids of different densities.

(e) Hemocytometer (counting chamber): is a device used to perform blood counts. It consists

of a thick glass microscope slide with a grid of perpendicular lines attached in the middle.

(f) Lancet: is a scapel-like needle used to make punctures to obtain small blood specimens.

They are generally disposable.

(g) Innoculating loop: is used for streaking aseptically.

9
(h) Electrophoresis machine: is used for genotyping. It works on the principle of Rapid

movement or migration of hemoglobin of normal cell in an electric field.

(i) Petri dish: is a shallow glass or plastic cylindrical lidded dish that biologists use to

culture cells.

(j) Urine Test Strip: is a basic diagnostic instrument used to determine pathological changes

in urine in standard urinalysis. A standard urine strip may comprise up to 10 different

chemical pads or reagents which react (change colour) when immersed in a urine sample.

(k) Antibiotic Sensitivity Disc: Are antibiotic impregnated discs used an antibiotic testing.

They are using during sensitivity tests. They may include one or more of the following

antibiotics; Pefloxacin, Gentamycin, Ampiclox, Zinnacef, Amoxacilin, Rocephin,

Cirpofloxacin, Streptomycin, Septrin, Erythromycin etc.

(l) Ziehl-Neelsen Stain: Also known as the acid-fast stain is a special bacteriological stain

used to identify acid-fast organisms, mainly Mycobacterium species. Mycobacterium

tuberculosis is the most important of this group because it is responsible for tuberculosis.

Acid fast organisms like Mycobacterium contain large amounts of lipid substances within

their cell walls called ‘mycolic acids’. These acids resist staining by ordinary methods such as

Gram stain.

The reagents used are Ziehl-Neelsen carbolfuchsin, acid alcohol, and methylene blue.

Acid-fast bacilli will appear red(or pink) after staining.

(m) Turk’s solution: is used in hematology. It is composed of Gentian violet stain and 1-2%

acetic acid. The solution destroys red blood cells within a blood sample, and stains the nuclei

of the white blood cells making them easier to see and count.

(n) Normal saline: NaCl salt dissolve in 500ml of distilled water.

(o) Anti-sera: the reagents; Anti-A monoclonal reagent, Anti-B monoclonal reagent and the

Anti-D rhesus determinant have already been prepared by the manufacturer. They are used for

determining patients’ blood group

(p) Capillary tube and Microhaematocrit Reader: for running PCV (Packed Cell Volume)
10
test.

(q) Slides and Cover-slips: used when making films

(r) Pipette: for taking fluid/liquid

(s) Blood Agar: Contains mammalian blood (usually human, sheep or horse), typically at a

concentration of 5-10%. It is an enriched, differential media used to isolate fastidious

organisms and detect haemolytic activity.

(t) Chocolate Agar: Or chocolate blood agar, is a non-selective enriched growth medium.

Chocolate agar is used for growing fastidious respiratory bacteria such as Haemophilus

influenza

(u) Nutrient Agar: Is usually used for growth of non-fastidious organisms and observation of

pigment production.

(v) Sterile Swab Sticks: For taking swabs from the ear, wound, vagina, penis etc for further

testing in the laboratory.

3.3 SEROLOGY BENCH

WIDAL TEST

The widal test is a serological technique which tests for the presence of Salmonella

antibodies in a patient’s serum. When investigating typhoid, the patient’s serum is tested for

O and H antibodies (agglutinins) against antigen suspensions known as febrile antigens.

Febrile antigens are stabilized suspensions of stained killed bacteria in a buffered

solution. They are bacterial suspensions representative of a number of pathogenic

microorganisms to humans involved in some bacterial infections. These antigens are used to

detect the antibodies produced in the patient’s serum during the infection.

Materials needed; widal test kit reagents (febrile antigens), tile, stirrer, rubber pipette,

centrifuge

Procedure ;
11

◎ Collect blood sample from ypur patient in a sample bottle and spin the blood sample using

a centrifuge for 5 minutes. This is done to seperate the serum from the red blood cells.
◎ Place a drop of serum from your spinned blood using a disposable pipette in 8 circles i.e 4

for the flagella antigens and another 4 for the somatic antigens onto a glass tile.

◎ Add 1 drop of the appropriate well-shaken widal kit suspension to each circle next to the

sample to be tested.

◎ Mix the content of each circle with a disposable stirrer.

◎ Rock the tile gently by hand for about 60 seconds.

◎ Observe immediately under a suitable light source for any degree of agglutination.

Interpretation of results

Agglutination is a positive test result and indicates presence of corresponding antibody in the

patient’s serum.

No agglutination is a negative test result and indicates absence of the corresponding antibody

in the patient’s serum.

VENERAL DISEASE RESEARCH LABORATORY (VDDRL) TEST.

This test is carried out for the detection of syphilis, which is caused by the microorganism;

Treponema pallidum.

Aim : To detect the presence of Treponema pallidum in the serum sample.

Procedure :

Collect blood sample from a patient and spin for 5 minutes

Then collect the serum of the spinner blood using a rubber pipette into a small tube.

And insert the VDRL strip for testing.

Result

Positive result: the presence of double lines in the control and test regions indicate a positive

result.

Negative result: the presence of just a single line which is the control.
12

PREGNANCY TEST (HUMAN CHORIONIC GONADOTROPIN)

Human Chorionic Gonadotropin is a hormone secreted by the embryo during pregnancy.

Aim : the test is used to detect the presence of HCG hormone.

Procedure :

Immerse the pregnancy test stop into the blood sample with the arrow end pointing towards

it. Do not immerse past the "Max" line.

Take the strip out after 3 seconds and lay the strip flat on a clean, dry, non-absorbent surface.

Wait for colored bands to appear.

Depending on the concentration of hCG in the test specimen, positive results may be observed

in as short as 40 seconds. However, to confirm negative results, the complete reaction time (5

minutes) is required. Do not read results after 10 minutes.

Result

Positive result: the presence of double lines in the control and test region indicates positive

result.

Negative result: the presence of just a single line which is the control.

HEPATITIS B SURFACE ANTIGEN (HBSAG) TEST.

Hepatitis means the inflammation and eventual damage of the liver. Hepatitis B is a disease

primarily involving the liver. It is also known as serum hepatitis and is transmitted through a

number of ways such blood transfusion, tattooing, use of unsterilized needles or via saliva.

Aim : to determine the presence of hepatitis B in the liver.

Procedure :

Collect blood sample from your patient and spin for 5 minutes

Then insert the hepatitis B test strip into the serum of the sample spinned and observe.

Result

Negative result: only one color band appears indicating there’s no hepatitis b infection.

Positive result: color bands appear both on thr control and test baands indicating presence of
13
hepatitis B infection.

Invalid result: occurs when the control band is not visible.

HUMAN IMMUNODEFICIENCY VIRUS (HIV) TEST.

Aim: This test is used for the detection of HIV which is the causative agent of Acquired

Immune Deficiency Syndrome (AIDS).

Procedure:

Collect blood sample and spin for 5 minute

Open the HIV strip and keep it on the bench

Then add drops of serum from your spinner blood on it

And observe is after 3minute for your result.

Result interpretation

Negative result: only one colour band appears indicating no HIV infection.

Positive result: two colour bands appear both on the control and test band indicating presence

of HIV infection. If positive, a confirmatory test is needed to be done. (it is not done in our

laboratory).

Invalid result: when the control band is not visible.

3.4 HEMATOLOGY AND BLOOD GROUP BENCH

Hematology tests are tests carried out using blood. Hematology samples are normally

collected in a bottle containing EDTA (Ethylene Diamine Tetra Acetate). The EDTA serves

as an anticoagulant which prevents the collected blood sample from clotting.

PACKED CELL VOLUME (PCV) TEST.

It is use to check the volume percentage (%) of red blood cells in blood. It is considered an

integral part of a person’s complete blood count results, along with haemoglobin

concentration, white blood cell count and platelet count.

This test is used to determine the level/percentage of blood in a patient. The normal range of

PCV in a named individual is as follows:

14
Baby : 30-40%

Adult female : 36-48%

Adult male : 36-52%

Materials needed: capillary tube, lancet, centrifuge, microhaematocrit reader (MHR),

alcohol swab and plasticine (used to seal the capillary at one end after passing blood into it).

15
Procedure:

◎ Sterilize the patient’s finger with an alcohol swab.

◎ Prick the with a lancet.

◎ Use a capillary tube to pick the blood.

◎ Seal the end of the tube with plasticine.

◎ Put the tube in a centrifuge and spin for 5 minutes.

◎ Then put the tube on a microhematocrit reader and take the reading. If the result doesn’t

fall within the normal range, then there’s need for blood transfusion.

N.B :

Hemoglobin (Hb) = ｛PCV/3｝g/dl.

WHITE CELL COUNT (WCC) TEST.

This test is used to analyze the total number of white blood cells in a patient’s blood. Hence,

it is used to determine the level of immunity an individual has against diseases.

Materials needed; hemocytometer (counting chamber), culture tube, microscope, cover slip,

Turk’s solution, rubber pipette and sample bottle.

Procedure:

◎ Collect blood sample into an EDTA bottle.

◎ Pipette 1 drop of blood into a culture tube.

◎ Add 19 drops of Turk’s solution to it.

◎ Charge the counting chamber and load it with the solution in the culture tube. Leave for

about 2-3 minutes before viewing it under the microscope.

◎ Count the number of cells in all 4 squares of the hemocytometer and multiply by 4 i.e

(｛A+B+C+D｝X 50 ) cells/mm^3.
16
Normal range of WCC in:

Adult (male & femal) : 4,000 cells/mm^3 - 10,000 cells/mm^3.

Children : 10,000 cells/mm^3 - 19,000 cells/mm^3.

The range is higher in infants because they have not been exposed to infections as much as

adults.

ERYTHOCYTE SEDIMENTATION RATE (ESR) TEST.

This is the rate at which red blood cells sediment in a period of one hour. It is a common

haematology test and is a non-specific measure of inflammation. To perform the test,

anticoagulated blood is placed in an upright tube, known as ‘westergren tube’, and the rate at

which the red blood cells fall is measured and reported in mm/h.

The ESR test is used to detect infection in a patient using his/her blood e.g upper respiratory

tract (URT) infection, LRT infection, toilet infection etc. “Erythrocyte” is the medical term

for RBC (Red Blood Cell), and the rate of its sedimentation in a dispette is the principle on

which the ESR test works on.

Procedure: collect 1ml of blood sample and pour into the ESR dispette tube, mix the blood

and roll it up to 0mm point of the dispette. Afterwards, put the dispette tube on the dispette

rack and allow it to stand for 1hour after which the reading can be taken.

The normal range of ESR:

Man : 0 - 10mm/hr

Woman : 0 - 15mm/hr

Pregnant woman : 0 - 20mm/hr

Baby(ies) : 0 - 5mm/hr

17
GENOTYPE TEST

Genotype test is done using a control genotype to determine the genotype of the collected

blood sample. Every individual has a genotype unique to him/her . The test is also used to

know the compatibility of 2 mates, in order to prevent future child deaths. In a case where 2

genotypes are not compatible, the mates are advised to put a peg on their relationship.

Materials needed; Blood sample, As control, cellulose acetate paper, electrophoresis

machine, Absorbent paper, little cover slip, water, micro pipette.

Procedure:        

• Wet an acetate paper with buffer solution; dry it in between folded absorbent paper.

• Place a drop each of the patient blood and the control as sample on a white tile.

• Pipette one or two drops of water on each of the dropped blood and mix thoroughly to lyses

the red blood cell.

• With the edge of a tiny cover slip, dip into the mixed blood and make bands on the acetate

paper close to the edge on a straight line.

• Place the paper in the electrophoresis machine with buffer water inside the machine and

cover.

Observation:

Bands separate after a few minutes. The component of the blood separates by

chromatographic movement on the acetate paper.

Results;

AS       -           Two bands, one on top and the other below.
18

AA      -           Two bands both above.

SS        -           Two bands both below.

BLOOD GROUPING.

Blood grouping is done using blood cells to react with blood group reagents. There are 4

different blood groups: A, B, AB and O.

Principle of test

It involves agglutination as a result of antigen-antibody reaction. The rhesus antigen is the

strongest blood group antigen after the A and B antigens. The D antigen is the strongest and

when it gives a positive (+ve) reaction anti D, it is said to be rhesus D +ve while when it gives

a negative (-ve) reaction with anti D, it is said to be rhesus D -ve.

Aim: to determine blood group and rhesus antigen.

Materials needed: blood group kit containing anti Sera A, B and D(rhesus factor) solutions

which are blue, yellow and colourless respectively, rubber pipette, grouping tile, stirrers and

blood sample.

Procedure

On a clean tile, pipette 3 drops of blood on different positions using the rubber pipette. To

the first drop of blood add anti sera A, to the second add anti sera B, and to the third add anti

sera D. Using different stirrers, mix the blood with the anti sera solutions. Rock for about 2

minutes and then observe for agglutination.

19
Patient Anti-A Anti-B Anti-D Result

1          +          -           +          A Rh’D Positive

2          +          -           -           A Rh’D Negative

3          -           +          +          B Rh’D Positive

4          -           +          -           B Rh’D Negative

5          -           -           +          O Rh’D Positive

6          -           -           -           O Rh’D Negative

7          +          +          +          AB Rh’D Positive

8          +          +          -           AB Rh’D Negative

Key:

+ = agglutination

- = no agglutination

20
3.5 URINE M/C/S (MICROSCOPY, CULTURE AND SENSITIVITY) AND

URINALYSIS BENCH.

Possible pathogens: Escherichia coli, Pseudomonas auriginosa, Schistosoma hematobium,

Proteus vulgaris, Staphylococcus saprophyticus, Klebsiella strains etc.

Urine test is carried out based on the diagnosis of the patient’s report form. In most cases,

the patients are queried to have UTI (Urinary Tract Infection) i.e when there is urine retention

due to the inability of the bladder to empty itself completely. Persistent or recurrent UTI can

lead to renal failure. UTIs occurs more frequently in women than in men due to shortness of

the female urethra.

Urinalysis and Microscopy

◎ The appearance of the specimen is described:

→ Colour of the specimen which could be amber, pale amber, deep amber, pale yellow or

bloody.

→ Whether it is clear, turbid or slightly turbid.

◎ A urinalysis strip is then dipped into the urine in the universal bottle and brought out

draining the urine. The strip is then used to match the urine comb for protein, specific gravity,

pH and so on, and results recorded.

◎ The urine in the bottle is then poured into a small culture tube, it is then spinned in a

centrifuge for 5 minutes.

◎ The supernatant fluid (urine) is then decanted. This is done by completely inverting the

tube, left with sediments.

◎ The sediment is then remixed by tapping the bottom of the tube.

◎ One drop of well mixed sediment is transferred to a clean slide and it is covered with a
21
coverslip.

◎ This is now viewed microscopically using x10 and x40 objective lenses to view for pus

cells, red cells, casts, epithelial cells, crystals and yeast cells if present.
Culture

◎ A sterilized wire loop which holds about 0.002ml of urine is flamed and allowed to cool

(so that the hotness from the loop doesn’t kill the microorganisms in question). It is then

dipped into the urine in the universal bottle, and used to pick a loopfull of urine.

◎ It is then innoculated on the already-prepared agar plate which could either be blood agar,

chocolate agar or McConkey agar.

◎ The plate is then incubated aerobically at 37℃ for 24 hours in an incubator.

◎ If any pathogen is seen on the culture plate after 24 hours, then sensitivity can be carried

out.

Sensitivity

◎ Subculture the plate by taking a colony with a flamed innoculating loop and streaking it

uniformly on a new plate.

◎ Place a sensitivity disk on the subcultured plate and fix the disc firmly on it.

◎ Incubate the plate for another 24 hours.

◎ Examine the plate and look out for the zone of inhibition.

N.B: the antibiotic that has the clearest zone of inhibition is one that will work best for the

infection.

22
3.6 WOUND M/C/S (MICROSCOPY, CULTURE AND SENSITIVITY) BENCH

Possible pathogens: Clostridium tetani, Staphylococcus aureus, Streptococcus pyogenes,

Escherichia coli, Pseudomonas auriginosa, Proteus species.

The essence of the M/C/S test is to detect the causative agent of an infection and the

appropriate antibiotic to be used for the treatment of such infection.

Materials needed: swab stick, alcohol swab, gloves, prepared media, sensitivity disk, glass

slide, coverslip, microscope, incubator.

Sample collection and microscopy

Gloves are worn to prevent cross-infection. It is ensured that the wound of the patient have

not been dressed so that the correct microorganism in question could be collected. The area of

the wound is cleaned with an alcohol swab and a swab stick is then used to collect pus or

discharge from the wound site.

For the microscopy of the sample, make a smear with the swab stick on a glass slide and

pipette 0.5ml of normal saline on the slide. Mix properly and cover the glass slide with a

coverslip. Afterwards, view the slide under the microscope using the x10 and x40 objective

lenses respectively.

Culture and sensitivity

Innoculate the pus/discharge on the swab stick aseptically on the prepared plate containing

blood agar. This should be cultured aerobically. Then incubate the plate for 24 hours at 37℃.

If there’s growth on the plate after 24 hours, subculture one colony from the plate by

uniformly streaking the picked colony on a new plate. Place a sensitivity disk firmly on the

subcultured plate and incubate for 24 hours. Check out for the clearest zone of inhibition and

note the antibiotics that are sensitive to and/or resistant to the infection.
23
3.7 SEMINAL FLUID ANALYSIS (SFA) TEST

Semen is usually examined to determine fertility and other sexual and reproductive health

problems found in men. Before obtaining the samples, the patient is asked to abstain from

sexual intercourse for a period of 96 days and above (3 - 5 days). This is done in order to

ensure both quality and quantity production of semen.

Due to the nature of semen samples, they are to be worked on almost immediately after they

are produced so as to get higher probability of accurate results. Hence, patients are advised to

get to the laboratory most 1hour after production of the semen so as to ensure viability of the

semen.

Production of semen is either through masturbation, use of condoms (this has to be washed

before usage to remove the powdered substance on the contraband before using it for

collection of the sample) and coitus interruptus (which is a situation where sexual intercourse

is interrupted so as direct ejaculation into a sample bottle). coitus interruptus is not usually a

preferred method because of its limitations:

→ Ejaculation may not be easily controlled.

→ Bacteria and cells from the vagina may be acquired, hence affecting the outcome of the

result.

→ The acid pH of the vaginal fluid can affect the motility of the sperm.

In order to guide the medical laboratory scientist in determining accurate results, the patient

is asked to provide the following details after presenting the sample: time of production and

submission to thelab and also the method of production.

In carrying out SFA, a lot of parameters are checked. They include:

→ Volume produced.

→ Colour: creamy-white or otherwise.

24
→ pH: normal range should be between 7 & 8.

→ Viscosity.

→ Motility of sperm cells.

→ Morphology of sperm cells.

→ Full sperm count.

Microscopy

The seminal fluid collected is placed on a gass slide using a pipette and a coverslip is placed

on the it. It is then viewed under themicroscope in order to examine certain microscopic

details such as presence of pus cells, red blood cells, epithelial cells etc. Using x10 objective

lens to check for motility rate of the sperm and x40 objective lens to check for the

morphology of the sperm cells respectively. Abnormalities in the morphology of the sperm

cells may include bent head, overlapping tails and head, swollen head, short tail , a head and

no tail, two heads and a tail etc. Normal range for sperm cell should be between 20-200

million cells.

In performing total cell count, one drop of semen is placed in 19 drops of normal saline

solution in a culture tube. The normal saline solution makes the sperm cells suspended in

order to reduce their motility and make counting easier. The solution is then charged in the

counting chamber for 2-3minutes after which the number of cells are counted. ‘Charging’

involves allowing the suspended cells to settle. If the number of sperm cells are many, only 2

squares on the chamber are counted. But if the sperm cells are few, all the squares on the

chamber are considered. The total cell count is given as:

Total sperm cell count = (cell count x 1,000,000) sperms/ml.

N.B: Pathogens usually associated with SFA are Escherichia coli, Staphylococcus aureus,

Proteus spp, Pseudomonas spp etc. Samples that are identified with pathogens are subjected

to antibiotic sensitivity testing.

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3.8 ACID FAST BACILLI (AFB) BENCH.

The acid-fast bacilli test helps to detect and identify infections caused by Mycobacterium

tuberculosis and other Mycobacterium species which are known as acid-fast bacilli, and also

to monitor the effectiveness of treatment.

AFB testing is ordered when someone has symptoms that suggests pulmonary TB. These

symptoms include:

→ chronic cough that produces sputum or phlegm with or without bloody streaks.

→ loss of appetite.

→ unexplained weight loss.

→ night sweats.

→ fever chills.

→ fatigue and tiredness.

TB is a lung infection caused by Mycobacterium tuberculosis. It is a public health risk since

it can be transmitted through the air when an infected person sneezes, coughs, speaks or sings.

Hence, TB patients are being observed by health care workers in DOTS as they take their

medicine because some patients actually contribute to the spread of drug-resistant

tuberculosis. DOTS (Directly Observed Treatment, Short-course) is a strategy used to reduce

the number of TB cases as TB is completely curable through short-course chemotherapy.

Procedures for carrying out the test

To carry out AFB test, two samples are normally collected from the suspected patient. They

are SPOT & EARLY MORNING samples respectively. The first sample is collected as the

patient presents in the lab while the second sample is to be collected 1-2 hours after rising(i.e

very early in the morning) and should be conveyed to the lab almost immediately.
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Afterwards, a smear of the two samples is made on two different slides, labelled accordingly

and air-dried.

Note: the smear must not be too thin or thick and must be centralized on the slide.
Staining and microscopy

The air-dried slides are now subjected to the Zhiel-Neelson (ZN) staining which is a

common staining technique for acid-fast bacteria. Carbolfuschin, acid alcohol and methylene

blue are used in the staining procedures as follows:

◎ Place the two slides on a staining rack

◎ Flood the slides with carbolfuschin, a pinkish primary stain

◎ Flame the slides for at least 10 minutes. Flaming is done to ensure that the cell wall of the

Mycobacterium (if present) is penetrable and the organism is able to take up the stain thereby

retaining the pink color of carbolfuschin.

◎ Allow to cool and rinse the slides with water

◎ Flood the slide with acid alcohol, a decolorizer, and rinse off with water.

◎ Counter stain with methylene blue for 1min, rinse off with water and air-dry the slides.

When viewed under the microscope, positive AFB smears shows the Mycobacterium

appearing like pink rods against a blue background but there are no traces of pink in a

negative AFB smear. To view the slides under the microscope, x100 objective lens is used

and immersion oil is added on the slide to increase the visibility of the specimen to be viewed.

This is an example of a dry preparation.

In conclusion, positive AFB smears indicate a probable mycobacterial infection,hence, a

culture must be performed to confirm a diagnosis and identify the specie of Mycobacterium

present.

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3.9 MALARIA PARASITE BENCH.

This test is carried out for the detection of malaria caused by the microorganism

Plasmodium. Human malaria is caused by 5 species of Plasmodium which includes

P.falciparum, P.malariae, P.vivax, P.knowlesi and P.ovale. Malaria is still a major global

public health problem. There are few laboratory tests that can be done to detect Plasmodium

species in a blood sample, the Rapid Diagnostic Test (RDT) for malaria is discussed below.

Rapid Diagnostic Test

The test is so called because it is a much faster way of testing for malaria. Rapid diagnostic

test kits are used and results are read in less then 15 minutes. The blood sample is either a

finger-prick or plasma and could be collected in a sample bottle. An inverted cup, a blood

transfer device could be used to drop blood on the kit, a buffer solution is added to ensure

rapid movement of blood across the control and test lines.

Interpretation of results

Positive result: two lines (contol and test bands) are visible on the test kit indicating the

presence of Plasmodium species in the blood sample.

Negative result: malaria test is negative if only one line is visible on the test kit.

3.10 MANTOUX (TUBERCULIN SKIN TESTING) BENCH.

The mantoux test is a tool for the screening of tuberculosis and tuberculosis diagnosis. It is

one of the major tuberculin skin tests used around the world. Tuberculin, also known as

Purified Protein Derivative (PPD) is a combination of proteins used for the diagnosis of

tuberculosis.

A standard dose of 0.1ml of PPD is injected intradermally (between the layers of the dermis)

and read 48-72 hours later. A person who has been exposed to the injection is expected to
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mount an immune response in the skin containing the bacterial proteins, this causes an

induration or swelling in the injected site. The reaction is read by measuring the
diameter of induration across the fore arm in millimeters(mm). Erythema (redness) should not

be measured. A positive result indicates TB exposure.

 5mm or more is positive in;

HIV positive person

Person with recent contact with a TB patient

Patients with organ transplant and other immunosuppressed patients

 10mm or more is positive in;

Recent arrivals from high-prevalence countries

Injection drug users

Mycobacteriology laboratory personnel

Children less then 4 years of age

Residents and employees of high-risk congregate settings e.g prison, nursing homes,

hospitals, homeless shelters etc.

 15mm or more is positive in;

Persons with no risk factors

CHAPTER FOUR

4.1 EXPERIENCE GAINED

One of the major objectives of the Students’ Industrial Work Experience Scheme is to

provide platforms through which university students can acquire skills and experience in their

field of study. I got quite an experience medically at Decure Medical Laboratory which really

got me more exposed to the practical aspect of these things we were taught in school as I was

taught laboratory ethics and practices in every bench I worked on.

I also learnt some managerial skills, customer ethics and how to attend to patients, and also
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work ethics such as punctuality, hardwork, honesty, politeness to colleagues, patients and

their relatives.
4.2 CHALLENGES ENCOUTERED.

One of the major challenges I encountered was financial constraints and health issues but I

thank God for helping me to pull through for the period of my internship.

CHAPTER FIVE

5.1 OBSERVATION.

At the institute, students were made to go by the rules enforced on all staff by the Executive

Director of the institute, which includes signing in and out each day, attending monthly

departmental seminars and also joining staff on the field for field work when the need arises.

5.2 CONCLUSION.

The 6 months industrial training has enriched and enlarged my horizon in the world of

medical laboratory practices which might not be obtainable in my institution of learning. It

exposed me to the dangers of medical illnesses how they are diagnosed and treated and also

how to prevent them.

I had the opportunity of working with and meeting new people and how to cope with people

especially im terms of attitudes. It was a great experience after all.

Conclusively, I would say the Students’ Industrial Work Experience Scheme is much needed

for students in higher institutions of learning to enlarge their brain capacity and make them

know how to treat people with incurable disease such as HIV by making them know they

have a better life also and they are loved.

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