A TECHNICAL REPORT ON

STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME (SIWES)

AT

ST. ANDREW’S HOSPITAL WARRI,

DELTA STATE

BY

ORJI KELECHI CHINECHEREM

MATRIC NUMBER: (CFB/20/21/265793)

SUBMITTED TO:

DEPARTMENT OF MEDICAL BIOCHEMISTRY

FACULTY OF BASIC MEDICAL SCIENCES

DELTA STATE UNIVERSITY, ABRAKA, DELTA STATE

IN PARTIAL FULFILLMENT FOR THE REQUIREMENT OF THE AWARD

OF BACHELOR OF SCIENCE (B.sc) DEGREE IN MEDICAL
BIOCHEMISTRY

NOVEMBER, 2022

1
 A TECHNICAL REPORT ON

STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME (SIWES)

UNDERTAKEN AT:

ST. ANDREW’S HOSPITAL WARRI,

DELTA STATE

BY

ORJI KELECHI CHINECHEREM

MATRIC NUMBER (CFB/20/21/265793)

2
 CERTIFICATION

This is to certify that ORJI KELECHI CHINECHEREM, MATRIC NO: CFB//20/21/265793 of the
Department of Medical Biochemistry, Faculty of Basic Medical Science, Delta State University, Delta State,
Nigeria, have successfully undergone my Six (6) months industrial training exercise with the health centre of
Delta state Universityabraka, Delta state..

___________________________ _______________
ORJI KELECHI CHINECHEREM DR. AWHIN PROSPER E.
(Student) (IT Coordinator)

___________________

DR. MORDI C.JOSEPH

(Head of Department)

3
 DEDICATION
This work is dedicated to the God Almighty for bringing me this far beyond my
expectations and for making this training a success.

4
 ACKNOWLEDGEMENT

I acknowledge my beloved mom Mrs. Confidence N. Orji for her support and
dedication to see that I make it this far, I pray she eat the fruit of their labour. Also,
my appreciation goes to the organizers of the SIWES program for the opportunity to
be exposed to field work, it is really a great priviledge. And to all the staff at the St.
Andrew’s Hospital Warri, Delta state, I'm grateful for the training, corrections,
guidance and support. I acknowledge my supervisor during the course of the SIWES
program Dr. Ahwin E. P for dispensing and impacting knowledge on me; this helped
me greatly during the program.

I also acknowledge my SIWES colleagues, you all made my stay in the

Hospital a wonderful one; it would have been boring without you, thank you. Lastly,
I appreciate my family and everyone that contributed in one way or the other to the
success of my industrial work experience scheme. May you all succeed in your
endeavors

5
LIST OF FIGURES

Figure 3.1: Anticoagulated containers

Figure 3.2: Spectrophotometer

Figure 3.3: Semi-Auto Chemistry Analyzer

Figure 3.4: Immunoassay Analyzer

Figure 3.5: Test tubes

Figure 3.6: Micro- Haematocrit Centrifuge

Figure 3.7: Fields stain

Figure 3.8: Microscope slides

Figure 3.9: Haematology Analyzer

Figure 3.10: A Glucometer

LIST OF TABLES

Table 4.1: A WIDAL result

Table 4.2: Interpretation of Blood Group Result for all possible Results

Table 4.3: Donor and recipient compatibility in blood diffusion

Table 4.4: Reagents used for glucose test

6
 TABLE OF CONTENT

FRONT PAGE

TITLE PAGE

CERTIFICATION

DEDICATION

ACKNOWLEDGEMENT

LIST OF FIGURES

LIST OF TABLES

TABLE OF CONTENT

ABSTRACT

CHAPTER ONE

1.1 HISTORY OF SIWES

1 2. OBJECTIVES OF SIWES

CHAPTER TWO

2.1 BRIEF HISTORY OF ST. ANDREW’S HOSPITAL WARRI, DELTA STATE.

CHAPTER THREE

3.0 THE MEDICAL LABORATORY

3.1 SAFETY AND MAINTENANCE OF A MEDICAL LABORATORY

3.2 SAFETY LABORATORY PRECAUTIONS

CHAPTER FOUR
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4.0 TESTS CARRIED OUT IN THE LABORATORY

4.1 SEROLOGY TESTS

4.1 MALARIA PARASITE (MP) TEST

4.2 WIDAL

4.3 FULL BLOOD COUNT TEST

4.4 BLOOD GROUPING

4.5 URINALYSIS TEST

4.6 BLOOD SUGAR TEST

4.7 ERYTHROCYTE SEDIMENTATION RATE (ESR)

4.8 C-REACTIVE PROTEIN TEST

4.9 THYROID FUNCTION TEST

4.10 TOTAL CHOLESTEROL TEST

4.11 HAEMOGLOBIN A1C

CHAPTER FIVE

5.1 Challenges encountered during my SIWES program in Delta State University

Health centre site II Abraka Delta State

5.2 Conclusion

5.3 Recommendation

REFERENCES

ABSTRACT

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 The industrial training policy was introduced by Federal Government of
Nigeria in 1973. It has become a necessary pre-condition of graduation. The program
is developed under the guidance of the Ministry of Education. This is an excellent
bridge between theoretical and practical education. SIWES is working on designing
proper programs for exposing students to the industrial workplace environment. It is
all about the development of occupational competence. This report contains the
history and the objectives of SIWES, the description of my place of my internship,
Delta State University Health center site II, Abraka, Delta state, the various
establishments in the organization and the period of my internship.

This report highlights the work done during the period of my industrial
attachment; some of which include; Laboratory equipment and their uses, several tests
carried out, etc. Also the challenges I encountered during my SIWES program and
suggestion for further Improvement are ascribed in the report.

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 CHAPTER ONE

INTRODUCTION

1.1 HISTORY OF STUDENT INDUSTRIAL WORK EXPERIENCE SCHEME

(SIWES)

SIWES was established by ITF (Industrial Training Funds) in the year 1973 to
solve the problem of lack of adequate proper skills for employment of tertiary
institution graduates by Nigerian Industries. The Students’ Industrial Work
Experience Scheme (SIWES) was founded to be a skill training program to help
expose and prepare students of universities, polytechnics and colleges of education for
the industrial work situation to be met after graduation. This scheme serves as a
smooth transition from the classroom to the world of work and further helps in the
application of knowledge. The scheme provides students with the opportunity of
acquainting and exposing themselves to the experience required in handling and
managing of equipment and machinery that are usually not made available in their
institutions.

The ITF organization (Industrial Training Fund) made a decision to help all
interested Nigerian students and established the SIWES program. It was officially
approved and presented by the Federal Government in 1974. The scheme was solely
funded by the ITF during its formative years but as the financial involvement became
unbearable to the fund, it withdrew from the scheme in 1978. In 1979, the federal
government handed over the management of the scheme to both the National
Universities Commission (NUC) and the National Board for Technical Education
(NBTE).

Later, in November 1984, the federal government revert the management and
implementation of the scheme to ITF. In July 1985, it was taken over by the Industrial
Training Fund (ITF) while the funding was solely borne by the federal government.
(Culled from Job Specifications on Students Industrial Work Experience Scheme)

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 1.2. OBJECTIVES OF SIWES

SIWES is strategized for skill acquisition. It is in fact designed to prepare and expose
students of universities, polytechnics and colleges of education to the real-life work
situation they would be engaged in after graduation. Therefore, SIWES is a key factor
required to inject and help keep alive industrialization and economic development in
the nation through the introduction and practical teaching of scientific and
technological skills to students.

Objectives of the Students Industrial Work Experience Scheme includes:

1. Provide an avenue for students to acquire industrial skills for experience during
their course of study

2. Expose students to work methods and techniques that may not be available during
their course of study.

3. Bridging the gap between theory and practice by providing a platform to apply
knowledge learnt in school to real work situations

4. Enabling the easier and smoother transition from school by equipping students’
with better contact for future work placement

5. Introduce students to real work atmosphere so that they know what they would
most likely meet once they graduate.

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 CHAPTER TWO

2.1 BRIEF HISTORY OF ST ANDREW’S HOSPITAL, WARRI, DELTA

STATE.

St. Andrew’s Hospital is a world class healthcare center founded by St. Andrew’s
Cathedral and Diocese of Warri Anglican Communion to provide general healthcare,
accident and emergency care, medical laboratory services and more. The hospital is
located at No. 39 Robert road Warri, Delta State. The firm is managed by Rev Friday
Udorefe.

CHAPTER THREE

3.0 THE MEDICAL LABORATORY

Medical laboratory is where tests are carried out of clinical samples (such as blood,
urine, semen, and swab) in order to get information about the health status of a
patient as pertaining to the diagnosis, treatment and prevention of diseases.
3.1 SAFETY AND MAINTENANCE OF A MEDICAL LABORATORY
 The laboratory must be spacious enough for easy movement and safe
adjustment of machines.
 Broken glasses and trails of wire must be avoided.
 The temperature of the laboratory should be about 160C.
 There must be first aid box for emergency cases in the laboratory.
 There must be good ventilation in the laboratory.
 The laboratory must be neat always.

12
  There must be good illumination with no glare.
 The equipment and machines must be clean/dusted after each use or when
necessary.
 Good disposal system must be present.
 There should be no entertainment of visitors.
 A good storage system must be available.
 Tests must be carried out with maximum attention.
3.2 SAFETY LABORATORY PRECAUTIONS
 Laboratory coat should be worn during laboratory routine work.
 Clinical disposable gloves are recommended for all manipulation involving
samples such as blood, stool and urine which must be put on during all tests
and cleaning of hands with sanitizers after each test.
 Work bench surfaces should be decontaminated with suitable disinfectant at
least once a day and after any spill of viable or potential infectious material.
 Hands should be washed thoroughly with disinfectants, soap and water after
handling infectious materials and before leaving the laboratory.
 Cuts, scratches, sores and other lesion on the hands and other exposed part of
the body should be covered with adhesives tapes.
 There should be no eating, drinking, smoking, application of cosmetics and
other personal items in the laboratory.
 There should be no pipetting by mouth, rubber bulbs or other pipetting
equipment should be used.
 The laboratory must be kept clean and free of unnecessary materials.
 All plugged equipment must be removed from electric sockets after daily
activities.
 Working materials should not be taken home.
 After every test used materials should be disposed into the biohazard boxes
and bags.
3.3 IMPORTANCE OF MEDICAL TESTS IN THE LABORATORY
 Medical test reveals the health status of the body.
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  It brings about quick recovery.
 It helps the doctor to diagnose easily.
 It reveals the causes of diseases or infection.
 It prevents drug abuse.
3.4 LABORATORY EQUIPMENT AND THEIR USES

Anti-coagulated sample containers: Most anticoagulants commonly used acts by

removing the calcium ions present in the blood which is required for coagulation
processes . The anticoagulants binds with the calcium and thus prevents blood from
clotting.

TYPES OF ANTICOAGULANT SAMPLE CONTAINERS

1. EDTA[ETHYLENEDIAMINETETRAACETIC ACID]: They are of three

types, namely EDTA- Na2, EDTA-K2, EDTA-K3. it inhibits clotting by
removing calcium and from there blood.
2. FLOURIDE OXALATE: Fluorides and oxalates are regarded as relatively
weak anticoagulants that are added to preserve blood glucose. They function to
inhibit enolase enzyme and thereby prevent glycolysis.
3. LITHIUM HEPARIN: This is used as an in vitro anticoagulant for routine
chemistry tests. It activates antithrombins, this blocking the coagulation
cascade of the blood sample.

14
 Figure 3.1: Anticoagulated sample containers

 Spectrometer: An optical instrument for measuring the absorption of light by

chemical substances; typically it will plot a graph of absorption versus
wavelength or frequency, and the patterns produced are used to identify the
substances present, and their internal structure.

Figure 3.2: Spectrometer

 Semi-auto chemistry analyzer: This is used for performing routine chemistry

tests, hormonal assay, electrolytes, therapeutic drugs, and drug enzyme
investigations.

15
 Figure 3.3: Semi-auto chemistry analyzer

 Immunoassay Analyzer: This is used to identify and detect the concentration

of specific substances in a sample, usually using an antibody as a reagent.

Figure 3.4: Immunoassay Analyzer

Test tubes: are used for holding solutions.

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 Figure 3.5: Test tubes

Microhematocrit Centrifuge: This is used for determination of volume fractions of

erythrocytes in blood and for separation of micro volumes of blood and solutions.

Figure 3.6: Microhematocrit centrifuge

Field stain: This is a histological method for staining of blood smears. It is used for
staining thick blood films in order to discover malaria parasites.

17
 Figure 3.7: Field stain

Microscope slide: This is a this flat piece of glass, typically 75 by 26mm and about
1mm thick, used to hold objects for examination under a microscope.

Figure 3.8: Microscope slide

Hematology Analyzer: This is used to count blood cells, classify leucocytes, and
determine hemoglobin levels. The detection principle included two principle which
are the electrical and optical principles

18
 Figure 3.9: Hematology Analyzer

Glucometer: This is a device used to measure the concentration of glucose in the

blood.

Figure 3.10: Glucometer

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 CHAPTER FOUR

TESTS CARRIED OUT IN THE LABORATORY

4.1 MALARIA PARASITE (MP) TEST

PRINCIPLE:

Malaria parasites can be detected when a blood is stained with field stain A A and B
which dots out these parasites as they are present in the cell when viewed under the
microscope.

AIM:

To determine Plasmodium spp in an individual

Materials:

Blood sample, glass slide, microscope, reagent field stain A and B, distilled water,
wet & dry swab, and lancet.

PROCEDURE:

The patient's thumb was cleaned with wet swab to degerm and pricked with a lancet.
The blood sample was placed on a glass slide and a thick smear was made. It was
allowed to dry and then, one side was stained with field stain A for 2 secs then rinsed
with clean water. It was immediately counterstained with field stain B for 3 secs then
rinsed with clean water to prevent fibrin. This was then placed on a rack and allowed

20
to dry for some minutes. Finally, 2 drops of immersion oil were dropped on the
prepared sample before examining under the microscope under X100 magnification.

4.2 WIDAL TEST

The Widal test is a serological test used to detect antibodies produced in response to
Salmonella infection in a patient’s serum. The bacterium Salmonella typhi causes
general weakness, high fever, a rash of red spots on the chest and abdomen, chills,
sweating, and in serious cases of inflammation of the spleen, bones, delirium and
erosion of the intestinal wall leading to haemorrhage.

It is transmitted through food or drinking water contaminated by the faeces or urine of

patients or carriers.

Widal test is used to diagnose typhoid and paratyphoid fever depending on the
antibody-antigen interaction. The patient’s serum or plasma is tested for the O and H
antibodies (agglutinins) against the following commercially available antigen
suspension (usually coloured suspensions).

O is for the somatic antigen and H for flagellated antigen. The commercially prepared
antigens are: Salmonella typhi O, Salmonella paratyphi A-O, Salmonella paratyphi B-
O, Salmonella paratyphi C-O, Salmonella typhi H, Salmonella paratyphi A-H,
Salmonella paratyphi B-H and Salmonella paratyphi C-H.

PRINCIPLE:

Patient suffering from typhoid fever possesses antibodies in their serum which can
react and agglutinate serial doubling dilutions of killed, coloured Salmonella antigens
in a slide agglutination test.

MATERIALS AND EQUIPMENT: Syringe and needle, test tube, micropipette,

glass slide or white porcelain tile, Centrifuge, methylated spirit, cotton wool,
tourniquet, latex gloves and Reagent kits.

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AIM:To detect the presence of antibodies against salmonella organism that causes
paratyphoid (typhoid fever).

SAMPLE:blood

PROCEDURE:A vein was located and the site was cleaned with methylated spirit
(acting as an antiseptic). A tourniquet was wrapped around the patients’ upper arm, to
apply pressure to the area and make the vein swell with blood. A syringe’s needle was
inserted gently into the vein, just below the skin and the blood collected in a syringe,
and the tourniquet was released from the hand. Once the blood had been collected, the
needle was removed and the puncture site covered with a cotton wool to stop
bleeding.

The blood was released into a 5ml test tube and is centrifuged 4000rev/min for 5
minutes. All reagents and serum samples were brought to room temperature. A
micropipette was used to collect the plasma and was placed drop by drop on a white
porcelain tile according to the number of reagent vials. Using pipette, 20μl of the
patient plasma was added onto 8 cells of the white porcelain tile.

One drop (50μl) of each antigens suspension (Salmonella typhi O, Salmonella

paratyphi AO, BO, CO, and Salmonella typhi H, Salmonella paratyphi AH, BH and
CH) was added to the respective cells on the tile. They were mixed together with the
flat end of the dispensing pipettes. The slide was rocked gently for three minute with
respect to time.

Results were read thereafter, under high intensity light.

OBSERVATION:

Visible agglutination on any spot indicates presence of Salmonella antibodies

(reactive) while no visible agglutination on spots indicates absence of Salmonella
antibodies (non-reactive).

RESULT

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Table 4.1: A WIDAL result

WIDAL O H
S. Typhi 1/40 1/320
S. Paratyphi A 1/20 1/20
S. Paratyphi B 1/80 1/160
S. paratyphi C 1/160 1/80
The comment would be;

Titre value ≥ 1/80 is clinically significant for E. fever [Enteric fever].

Interpretation of Results:

Results were based on the degree of agglutination per time

Positive Result

Highly reactive = 1/320 (agglutination visible before 30seconds).

Very reactive = 1/160 (agglutination visible within 1-2 minutes).

Reactive = 1/80 (agglutination visible after 2 minutes).

Negative Result

Non-significant = 1/40 (faint agglutination visible after 3 minutes).

Non-significant = 1/20 (very faint agglutination visible after 3 minutes).

Non-reactive = No visible agglutination.

4.3 FULL BLOOD COUNT (HAEMATOLOGY) TESTS

Hematology is defined as the study of blood and it is primarily concerned with the
study of formed and unformed elements present in the blood, the detection of changes
in it with the evaluation of the constituents.

23
AIM: To look for abnormalities in the blood, such as unusually high or low number
of blood cells.

PRINCIPLES: This test counts the total number of red cells, white cells and platelets
in the sample and determines the ratio of red cells to serum. It also determines the
count of each of the white cell subsets.

MTERIALS: Patient’s whole blood sample, hematocrit analyzer.

PROCEDURES: Power on and turn on the hematocrit analyzer.

- Input the basic information of the patient.

- Aspirate the whole blood into the analyzer.

- The machine runs the test after which the result is displayed on the screen.

PARAMETERS: PCV, Total white blood cells, neutrophils, lymphocytes,

monocytes, eosinophils, pasophils and platelet.

4.4 BLOOD GROUPING

Blood grouping (also called blood typing), is a type of technique involving antigens-
antibody interactions is a classification of blood based on the presence or absence of
inherited antigenic substances on the surface of red blood cells (RBCs).

Antigens are cluster of chemical groups capable of inducing production of specific

antibodies while antibodies are substances that fight against infection in the body by a
non-covalent association. These antigens may be proteins, carbohydrates,
glycoproteins, or glycolipids, depending on the blood group system. Some of these
antigens are also present on the surface of other types of cells of various tissues. The
major antigens are A, B, and the Rhesus antigens.

Several of these red blood cell surface antigens can stem from one allele (or very
closely linked genes) and collectively form a blood group system. Blood types are
inherited and represent contributions from both parents. A person’s ABO blood group
24
depends on the A, B, or O gene (located on chromosome 9) inherited from each
parent.

AIM: to determine blood type

SAMPLE:blood

Materials and equipment: swab, EDTA bottle, pipette, tile, syringe & needle,
tourniquet, antisera (Anti A, B and O).

PROCEDURE:

A drop of anti-A, anti-B and a drop of anti-D reagents were placed separately on a
labelled slide or tile. A drop of test red cell suspension was then added to each drop of
the typing antiserum

The cells and reagents were mixed using a clean stick, spreading each mixture evenly
on the tile over an area of 10-15 mm diameter. The tile was tilted and left for 2
minutes at room temperature (22°-24°C), and observed for agglutination (as a result
of antigen-antibody reaction).

The Result was recorded.

Interpretation of Results:

I. A patient is group A, that is possesses antigen A on the surface of their red

cells, when there is agglutination in sample well A.
II. A patient is group B, that is possesses antigen B on the surface of their red
cells, when there is agglutination in sample well B.
III. A patient is group AB, possessing antigens A and B on the surface of their red
cells, when there is agglutination in both A and B sample wells
IV.A patient is group O, that is possesses none of antigens A and B on the surface
of their red cells, when there is no agglutination observed in A and B sample
wells

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 V. A patient is grouped Rhesus positive (Rh+) when there is perfect agglutination
in sample well D or Rhesus negative (Rh-) when there is no agglutination
observed in sample well D.

Table 4.2: Interpretation of Blood Group Result for all possible Results

ANTI-A ANTI-B ANTI-D BLOOD ANTIGEN(S ANTIBODIES

GROUP ) PRESENT PRESENT

+ - + A Rh+ A and Rh B
+ - - A Rh ̶ A B
- + + B Rh+ B and Rh A
- + - B Rh ̶ B A
- - + O Rh+ Rh A and B
- - - O Rh ̶ None A and B
+ + + AB Rh+ A, B and Rh None
+ + - AB Rh ̶ A and B None

NOTE: + means agglutination occurs

- means no agglutination

Table 4.3: Donor and recipient compatibility in blood diffusion

BLOOD GROUP DONATE TO RECEIVE FROM

A A and AB A and O
B B and AB B and O
AB AB All groups
O All groups O
4.5 URINALYSIS TEST

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Urinalysis is a diagnostic analysis of a urine sample that is used to detect and manage
a wide range of disorders, such as diabetes, liver diseases, haemolytic diseases,
urogenital and kidney disorders and metabolic abnormalities.

Urinalysis involves checking the appearance, concentration and content of urine.

Abnormal urinalysis results may point to a disease or illness.

Urine Collection and Preparation

The midstream urine is the main portion that is usually tested and it is collected by
interrupting the flow of urine after a few seconds and then collecting the middle
portion in a clean universal bottle and tested as soon as possible. Do not centrifuge,
the use of urine preservatives is not recommended.

If testing cannot be performed within an hour after the specimen collection, the
specimen is refrigerated immediately. Refrigerated specimen is allowed to return to
room temperature before testing.

Methods of Urinalysis:

I. Visual examination
II. Microscopic examination
III. Rapid urine test (dipstick test)

VISUAL EXAMINATION

This examination involves assessment of the colour, cloudiness and concentration of

the urine.

Note: Clouded appearance, which can indicate an infection, reddish or brownish

appearance, which can indicate blood in the urine.

MICROSCOPIC EXAMINATION

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During this test, several drops of urine are viewed with a microscope. If any of the
following are observed in the above-average levels, additional testing may be
necessary:

 White blood cells (leukocytes) may be a sign of an infection.

 Red blood cells (erythrocytes) may be a sign of kidney disease, a blood
disorder or another underlying medical condition, such as bladder cancer.
 Bacteria or yeasts may indicate an infection.
 Casts – tube-shaped proteins – may form as a result of kidney disorders.
 Crystals that form from chemical in urine may be a sign of kidney stones.

MATERIALS AND EQUIPMENT:

Urine sample, hand glove, glass slide, microscope, cover slip, dropper.

PROCEDURES:

A drop of the urine sample was placed on a glass slide and covered with a cover slip.

It was then viewed with a microscope, so as to detect any bacteria, casts etc.

RAPID URINE TEST - DIPSTICK TEST(COMBI 2 & 9)

A rapid urine test (dipstick test) is the quickest way to test urine. This involves
dipping a test strip with chemicals on it into urine to detect abnormalities.

The chemical strips changes colour if certain substances are present or if their levels
are above normal.

MATERIALS AND EQUIPMENT:

Urine sample, test strip, urine test package, hand glove.

PROCEDURES:

The urine was first collected, after which the test strip with small square coloured
fields on it were dipped into the urine sample for a few seconds.
28
The fields on the test strip change colour, then the resulting colours on the fields were
compared with a colour table on the urine test package. Results were then recorded.

WHAT DIPSTICK/RAPID URINE TEST CHECKS?

Blood: The detection is based on the pseudoperoxidative activity of hemoglobin and

myoglobin, which catalyze the oxidation of an organic hydroperoxide producing a
green colour.

Urobilinogen: The test paper contains a stable diazonium salt forming reddish azo
composed with urobilinogen.

Bilirubin: A red azo compound is obtained in the presence of acid by coupling of

bilirubin with a diazonium salt.

Protein: The test zone is buffered to a constant PH value and changes colour from
yellow to greenish blue in the presence of albumin. The test is based on the “protein
error” principle of indicator.

Nitrite: Microorganisms, which are able to reduce nitrate to nitrite, are indicated
indirectly by this test. The test paper contains an amine and coupling component.

Ketone: The test is based on the principle of Legal’s test. Acetoacetic acid and
acetone form with sodium nitroprusside in alkaline medium a violet colored complex.

Ascorbic acid: The detection is based on the discoloration of Tillman’s reagent. In

the presence of ascorbic acid a colour change takes place from blue to red.

Glucose: The detection is based on the glucoseoxidase-peroxidase-chromogen

reaction. Apart from glucose, no other compound in urine is known to give a positive
reaction.

PH: The test Paper contains indicators which clearly colour between PH 5 and P H 9
(from orange to green to turquoise).

RESULT:
29
Results are obtained by direct comparison of the colour blocks printed on the bottle
label with the test strip used.

4.6 BLOOD SUGAR TEST (FASTING AND RANDOM BLOOD SUGAR)

Glucose is the major carbohydrate present in the peripheral blood. This test is carried
out to monitor the level of blood sugar (glucose) in the human body. Blood sugar
needs to be monitored and regulated as excessive blood sugar causes "hyperglycemia"
while shortage of blood sugar in the body causes "hypoglycemia" which is lethal to
human health.

Fasting blood sugar (FBS) is carried out during the early hours or the day which
patient should not have eaten or taken anything about twelve hours before the test,
while random blood sugar can be done after the early hours of the morning and after
eating.

PRINCIPLE:

Glucose is determined after enzymatic oxidation in the presence of glucose oxidase.

The hydrogen peroxide formed reacts under catalyst of peroxidase with phenol and 4-
amino phenozone, to form a red violet quinoeimine dye as indicator.

Glucose oxidase
Glucose + H2O Glucose + H2O2

AIM:

To determine the level of glucose in a patient's blood

MATERIALS:

Semi-Auto chemistry analyzer, test tubes, micropipette, incubator, distilled water,

centrifuge, forceps, dry swab, standard glucose reagent, and sample (blood serum).

Table 4.4: Reagents used for glucose test

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 Reagent Blank Standard Test sample
Glucose reagent (ml) 1 1 1
Glucose standard (µl) 10
Blood serum (µl) 10
Water (µl) 20

PROCEDURE:

The patient's blood was collected into a fluoride oxalate anticoagulated container,
mixed and centrifuged for 10 minutes. 3 test tubes were placed on a rack labelled
blank, standard, and simple test tube. 1 ml of glucose reagent was pipetted into all the
test tubes. 10 µl of standard reagent was added to the standard test tube and 10 µl of
the serum sample to the sample test tube making the blank up with distilled water.
The test tubes were shaked slightly and incubated for 10 minutes at 370C.

The test-tubes were then aspirated individually into the semi-auto chemistry analyzer
which then reads the results and displays it on the screen.

RESULT:

Normal range of FBS = 75 - 115 mg/dL

Normal range of RBS = 80 - 120 mg/dL

4.7 ERYTHROCYTE SEDIMENTATION RATE (ESR)

PRINCIPLE:

The Erythrocyte Sedimentation Rate (ESR) is a nonspecific assay used to screen for
the presence or absence of active disease. The settling of red corpuscles (red blood
cells - RBCs) is due to the differential densities of the RBCs and their medium. Most
often, an increased ESR is due to an increased amount of plasma proteins (i.e., acute
phase globulins) and less commonly to inherent characteristics of RBCs (Wintrobe
30). ESR is measured in mm/hr using the Modified Westergren Method.
31
SPECIMEN REQUIREMENTS:

Whole blood collected in EDTA is the only acceptable specimen. Specimens must be
brought to the laboratory within 4 hours of the blood draw if kept at room
temperature. Alternately, whole blood may be refrigerated and brought to the
laboratory within 12 hours of the blood draw. Clotted or hemolyzed samples are not
acceptable.

PROCEDURE:

Westergren’s method of Erythrocyte Sedimentation Rate (ESR);

The blood was mixed with anticoagulation thoroughly. The blood was injected into
the tube until it reached 0, using the help of a rubber bulb, blood was cleaned off the
inside the tube using cotton. The tube was placed upright on the stand. The pipette
was properly checked and placed vertically to ensure that it fits well to avoid leakage.
The tube was allowed to remain uninhibited for 1 hour. After 1 hour, the results were
checked.

Normal values:

For males: 0-10 mm/hr.

For females: 0-15 mm/hr.

4.8 C-REACTIVE PROTEIN

This is a protein synthesized in the liver and released into the blood stream few hours
after a tissue injury or any condition that causes inflammation.

AIM: CRP blood test is used to identify inflammation, its severity, injury, infection.
It is also used to monitor treatment.

PRINCIPLES: The test is based on the reaction between patient’s plasma containing
CRP as the antigen and the corresponding antibody coated to the treated surface of the
latex particles.
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MATERIALS: Immunoassay analyzer, patient’s plasma sample, CRP test kit,
micropipette and tips.

PROCEDURES: Power on and turn on the immunoassay analyzer, insert the ID chip
and click ID on the screen, then input the basic information of the patient.

- Pipette 10 microliter of patient’s sample into the detection buffer tube and mix
properly for 1 minute.
- Pipette 75 microliter of the mixture into the test cartridge, insert cartridge into
analyzer and click start test.
- The test results will be displayed on the screen after 3 minutes.

4.9 THYROID FUNCTION TEST

This test is done to check the function of the thyroid gland. It is also done to check for
hyperthyroidism and hypothyroidism.

AIM: To check the function of the thyroid gland.

PRINCIPLES: TSH, T4 and T3 concentrations are measured by competitive

immunoassay methods employing immunofloresence or chemiluminesence.

MATERIALS: Immunoassay analyzer, thyroid function test kit, patient’s plasma

sample, micropipette and tips.

PROCEDURES: Power on and turn on the immunoassay analyzer, insert the ID chip
and click ID on the screen, then input the basic information of the patient.

- Pipette 10 microliter of patient’s sample into the detection buffer tube and mix
properly for 1 minute.
- Pipette 75 microliter of the mixture into the test cartridge, insert cartridge into
analyzer and click start test.
- The test results will be displayed on the screen after 3 minutes.

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This same procedure applies for the different parameters including thyroid stimulating
hormone (TSH), Thyroxine (T4), and Triiodothyronine (T3)

4.10 TOTAL CHOLESTEROL

PRINCIPLE

Cholesterol is measured enzymatically in serum or plasma in a series of coupled

reactions that hydrolyze cholesteryl esters and oxidize the 3-OH group of cholesterol.
One of the reaction byproducts, H2O2 is measured quantitatively in a peroxidase
catalyzed reaction that produces a color. Absorbance is measured at 500 nm. The
color intensity is proportional to cholesterol concentration. The reaction sequence is
as follows:

PROCEDURE:

The patient's blood was collected into a lithium heparin anticoagulated container,
mixed and centrifuged for 10 minutes. 3 test tubes were placed on a rack labelled
blank, standard, and sample test tube. 1 ml of cholesterol reagent was pipetted into all
the test tubes. 10 µl of standard reagent was added to the standard test tube and 10 µl
of the serum sample to the sample test tube making the blank up with distilled water.
The test tubes were shaked slightly and incubated for 10 minutes at 370C.

The test-tubes were then aspirated individually into the semi-auto chemistry analyzer
which then reads the results and displays it on the screen.

4.11 HAEMOGLOBIN A1C TEST

AIM: To measure ones average blood sugar levels over the past 3 months which
helps to diagnose diabetes and prediabetes conditions

PRINCIPLE: HbA1C concentrations is measured based on a specific chemical

reaction to the glycated N-terminal valine of the B-chain.

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MATERIALS: Immunoassay analyzer, HbA1C test kit, patient’s plasma sample,
micropipette and tips.

PROCEDURES: Power on and turn on the immunoassay analyzer, insert the ID chip
and click ID on the screen, then input the basic information of the patient.

- Pipette 10 microliter of patient’s sample into the detection buffer tube and mix
properly for 1 minute.
- Pipette 75 microliter of the mixture into the test cartridge, insert cartridge into
analyzer and click start test.
- The test results will be displayed on the screen after 3 minutes.

CHAPTER FIVE

5.1 CHALLENGES ENCOUNTERED DURING MY SIWES PROGRAM IN

ST. ANDREW’S HOSPITAL, WARRI, DELTA STATE.

The followings were the challenges I encountered during the program

1. Repetitions of same experiments.

2. The issue of transportation, the cost of transportation from my place to the
health center was quite exorbitant, coupled with the state of the economy.

35
 3. Supply of necessary materials/reagents was also a major problem thereby,
delaying the process of test that has to be done.

5.2 CONCLUSION

As a student of Medical biochemistry, I have been able to obtain the most relevant
and effective practical industrial training and experience in duration of 24 weeks
having been exposed to practical in-lab situations and activities. Furthermore, an
awareness of the general workplace has been developed in me and I have acquired
important behavioral and interpersonal skills with the opportunity given to me to get a
feel of the work environment and exposure as a student to the medical biochemists’
responsibilities and ethics.

5.3 RECOMMENDATION

Having realized the need for technological transformation and the fact that
technological advancement is the bedrock of any societal development, it becomes
imperative that for a society to grow, attention and commitment needs to be paid to
technology for a great economic development therefore, the university and the
government should create and improve on avenue through which various departments
will have a direct link to industries thereby facilitating the easiness for students in
securing placements in various industries.

Also, leadership oriented, entrepreneurship driven and management oriented courses

should be introduced into the curriculum, thereby creating and bringing out the best in
the students, as a well-built graduate (as against the popular half-baked graduates).

Students should see this SIWES as an opportunity to expose themselves to the

challenges of the future and endeavor to be a good ambassador of the university in
any industries they find themselves and beyond.

Finally, the world we all live in revolve on what we can do with our own hands and
not what we have imprinted on a piece of paper.

36
 REFERENCES

Beaser, R.S. and Hill, J. (1995).The Joslin guide to diabetes. New York.

Crivelli, O.M. and Rizetto, P. (1981). J. Clin – Microbiology, 14: 173 – 177.

Dacie, J.V. and Lewis, S.M. (1968). Practical haematology. London. 34: 12 – 14.

Feig, D.I., Kang, D.H and Johnson, R.J. (2008). Medical progress; uric acid and
cardiovascular risk. The New England Journal of Medicine. 359(17): 1811-1821.

Hall, R and Malia, R.G. (2003). Medical Laboratory Hematology. London, New
York. SButterworths and Co.

Hayhoe, F.G.J. and Flemans, R.J. (2002). A Color Atlas of Hematological Cytology
3rd Edition. Washington, Wolfe Publishing Ltd.

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