Chapter one

1.0 Introduction :

This report covers what i learned in Immunology routine laboratory unit and phlebotomy
unit.during my six (6) months SIWES programme at University of Maiduguri Teaching
Hospital(UMTH) these includes,how some mechines like centrifuge and rotary shaker works
and the principle behind them,fridges and their function,explanation of many daily
investigation (tests)within the laboratory,explanation of phlebotomy units in respect of their
specific work and functions.

1.1 History of the firm

The University of Maiduguri Teaching Hospital,was officially commissioned by former President

Aliyu Shehu Shagari on the 23rd july 1983,the hospital now has total bed capacity of 1200 with
17 clinical and 14 non clinical departments,serving a population of over 30 million in North East
Geopolitical Zone.Designated by federal government of Nigeria as centre of excellence in
Immunology and Infectious Diseases.it also gained recognition from international bodies and
public institution such as ,Harvard school of public Health,the World Health Organization and so
on.UMTH is training medical and Health related profession students,provide health services to
patients.

1.2 organisation chart :

1.3 various department and functions.

Immunology routine laboratory unit and functions : This unit focuses on investigation that has
to do with antigen - antibody reaction mostly investigation like Hiv,hapatitis,T.B ,H
pylori,montoux,running routine and advanced .

Phlebotomy unit and functions

 Collection of sample
 Sample registration and labelling
 Distribution of result

CHEMICAL PATHOLOGY UNIT

This is the unit in the laboratory where chemical analyses of body fluids are
being carried out. Several tests are carried out in this unit these include:

1. Urea.

2. Blood glucose.

Chapter two

2.0 introduction :

Under immunology department,immunology routine laboratory and phlebotomy is where i was

posted, and took my sex (6) months SIWES training completely.the activities were divided into
two (2),with their subdivision or other activities.

i. immunology routine laboratory unit.

ii. phlebotomy unit.
2.1 immunology routine laboratory unit.

The activities i took during first four (4) months of my SIWES programme were .....these are;

i. Laboratory guide
ii. Mechines
iii. Frigdes
iv. HIV test
v. Montoux test
vi. Hapatitis Test
vii. Brucella test
viii. Helicobacter pylori (H.pylori)
ix. Qualitative test for syphilis

2.1.2 Laboratory guide :

This is the basic things one is required to read comprehensively and taking it into practice.these
are;

Laboratory safety precaution : this includes,

i. wearing a lab coat,canvas,goggle,handgloves.

ii. Do not eat,drink or smock in the Laboratory.
iii. keep working area neat and well organised.
iv. switching off an electric instruments after used .
v. Report any accident immediately.

Common Laboratory Hazard : This includes,infectious,burns,toxic chemical,electric

shock,prick and cut.

The role of Medical Laboratory Services :

The medical laboratory services play a vital role in the promotion, curative and preventive
aspects of a nation's health delivery system. The followings are the roles ;
1. Treating patients and monitoring their response to treatment.

2. Monitoring the development and spread of infectious and dangerous pathogens (disease
causing organisms).

3. Deciding effective control measures against major prevalent diseases.

4. Deciding health priorities and allocating resources.

5. Carryout routine and advanced laboratory tests using standard laboratory methods.

6. Apply problem strategies to administrative, technical and research problems.

7. Conduct community base researches in collaboration with other categories of health

professionals.

2.1.3 Mechines

There are three (3) mechines,in Immunology routine laboratory that i came in contact with
during my SIWES training.these are as follows ;

 Centrifuge Mechine.
 Rotary shaker.
 Biosafety Cabinet.
1) Centrifuge Mechine

Description :

This machine can be described based on it structure and functions,the mechine consist of eight
(8) inner holes,that a sample can be fixed in it,it has start and stop control and adjustable speed
.the principle,functions and sample to be spin can be discussed below ;

Principle of centrifuge Mechine : the Mechine works at a speed of 300 rpm to 1500 rpm using
electric current.

Function of centrifuge Mechine :

 To spin Blood sample and obtain serum in it.

 To separate sample based on densities.
Sample to spin
 Blood sample usually in Immunology routine laboratory.

2) Rotary shaker Mechine : it works using electric current by vibranting a given sample.
Function :

 To mix sample.
 To agitate.
Sample placed on rotary shaker :
 Plastic Micro tile for Brucella test
 Plastic Micro tile for Rheumatoid factor test.

3) Biosafety Cabinet

Function :
 Protect workers against biological agent.
 Protect environment against infection.

2.4 Frigdes :

During the course of my posting i also learned that ,there are two (2) types of fridges,these
are;
 Sample Frigde.
 Reagent Frigde.
(1) sample Frigde : works at temperature of -34 to 350c daily.this fridge is using electric
current to generate a degree of coolness.
Functions of sample Fridge :
 It Used to keep a specimen and to be used at any time.
 Protect sample from been demage or contaminated.

Sample that are kept in sample Fridge

 PSA sample
 Blood sample
 viral load sample

(2) Reagent Fridge : also works at temperature of 34 to 350c daily.

Reagent kept in Reagent Fridge includes ;

 Brucella Abortus reagent

 Rheumatoid Factor reagent
 purified protein derivative (PPD) injection

2.1.4 HIV test :

 During my training i also learned and practiced the followings methods of HIV test.this
methods can be used sequentially one after another,they are;

i. Determine
ii. Unigold
iii. Stat pack

(1) Determine method : this method can be achieved using strip.

(2) Unigold method : positive result shown by Determine,one can proceed to unigold for
comfirmatory his/her work.

(3) Stat pack method : this comes at the end,serving as a judge between Determine and
unigold when the two methods failed to give same result.

How can we carry out Hiv test ?

One can carry out the test by the followings ways :

Tittle :Hiv test using Determine.

Aims : To detect the presence of Hiv in a given sample.

Material used : Determine strip,pasture pepitte,requist form,centrifuge

Mechine,serum,handgloves.

principle : in vitro antigen -antibody reaction,the strip is coated with a specific antigen.

Procedure :

 All materials were assembled on routine bench.

 Write client identification number on the strip.
 The blood sample was centrifugated,serum was obtain .
 Using a pepitte drop 2 to 3 specimen into strip pad .
 Allow it to flow by immuno-chromotographic movement.
 The result will be observed after 10 -15 minutes.
 The strip has test and control site indicated by line .

Result interpretation :

 One line at control site indicate :Negative Result.

 The Appearance of two lines in both test and control site indicate :positive Result
 When no line apppears or there is redish spread colour indicate :invalid Result
 2.1.5 Montoux :

This test is samply test for tuberculosis (T.B),it can be carry out by the following ways:

Tittle : montoux test.

Aims : To detect the presence of antibody against tuberclosis.

Materials used : purified protein derivative (PPD),insulin syringe,pen,70% isopropyl

alcohol,mater rular.

Principle : when o.1ml of PPD is innoculated in the fore arm after 48 to 72 hours,an
induration will appear.

Procedure :

 All materials were assembled on routine bench.

 Allow the reagent to attain room temperature.
 Clean the innoculation point with 70% alcohol before injection.
 0.1m of PPD was innoculated intradermally on a clean area of fore arm .
 The point were marked circularly using marker or pen.
 The patient was then given an instruction not to touch,not to scratch the marked area
within 72 hours of innoculation.
 The patient will come after 72 hours of injection,for measurement.

Interpretation of Result ,using mater rular

 0 -5mm induration : Negative

 6 - 10mm induration :Positive

2.1.6 Hapatitis test

During my training was given a comprehensive lecture notes about hapatitis disease and
shown,practiced how the test will conducted,the followings a brief description of my learned
experience.

Common causes of Hapatitis

i. a viral infection
ii. Heavy alcohol used
iii. Toxins
iv. Medication abuse

Hapatitis test
The test can be carry out through the following processes ;

Tille : Hapatitis B surface antigen (HBSAG) test .

Materials used : HBSAG strip,pasture pepitte,serum,handgloves ,requist form.

Aims : To detect presence of antibodies against the virus .

Principle : antigen - antibody reaction.

Procedure :

 All materials were assembled on routine bench.

 Write client identification number on the strip.
 Add 75ul of serum were drop .
 Allow it move by capillary action.
 After 10 to 15 minutes the result was observed.

Result interpretation

 Appearance of one line at control site indicate : Negative Result

 Appearance of two lines at both test and control site indicate: Positive Result
 No line apppears indicate : invalid Result

2.1.7 Brucella test :

Tittle : Brucella test

Aim : To detect the presence of antibody against Brucella in a given sample.

Materals used : white micro tile,serum,micro pepitte,pepitte tips, positive control,negative

control,Brucella Abortus reagent,applicator stick .

Procedure :

 Assembled all materials on routine bench.

 Allow the reagent to attain room temperature.
 Add one (1) drop of negative control to the first circle.
 Add one (1) drop of positive control to the second circle.
 Using stick Mix the the first circle,and the next circle using another stick .
 Add 50ul of the serum to the third circle.
 Add one drop of Brucella Abortus reagent,to the 1st,2nd and 3rd circle .
 Placed it on rotary shaker for 2 minutes.
Result interpretation
 presence of agglutination indicate : Positive Result
 absence of agglutination indicate :Negative Result

2.1.8 Helicobacter pylori

Tittle : Helicobacter pylori test (H.pylori)

Aims : To detect presence of Helicobacter in a given sample

Materals used : requist form, centrifuge,serum,H.pylori cassette,buffer,pasture

pepitte,handgloves.

Procedures :

 Spin the samples on centrifuge,and obtain serum.

 Write client identification number on the cassette.
 Add 2 to 3 drop of serum,allow it to move by rapid flow
 Observed the result after 10 to 15 minutes

Interpretation of Result

 Appearance of one line at control site indicate : Negative Result

 Appearance of two lines at both test and control site indicate: Positive Result
 No line apppears indicate : invalid Result

2.1.9 Qualitative test for syphilis

Tittle : Qualitative test for syphilis

Aims : To detect any body against treponema pallidoroseum

Materals : syphilis cassette,centrifuge Mechine,serum, pasture pepitte,handgloves.

Principles : antigen-antibody reaction

Procedures :

 All materials were assembled on routine bench.

 Write client identification number on the cassette.
 75ul of serum was drop on the sample pad of the cassette.
 Allow it to move by rapid flow
 Observed the result after 10 to 15
Interpretation of Result
  Appearance of one line at control site indicate : Negative Result
 Appearance of two lines at both test and control site indicate: Positive Result
 No line apppears indicate : invalid Result

2.2 Reception Unit

Introduction

In reception,samples are collected form patient and distributed to various department for
investigation.

The followings are the activities i took during my training in this units for good two (2)
months of my SIWES programme were .....these are;

i. Functions of reception
ii. Materials required for sample collection
iii. Functions of some materials
iv. Types of sample collected
i. Containers that are used in reception
ii. Functions of containers
iii. Methods of Blood colection
iv. Dry Blood Spot(DBS)

2.2.1 Functions of reception :

 Collection of sample
 Sample registration and labelling
 Distribution of result

2.2.2 Materal required for sample collection

 Specimen container
 Sprit/70 % alcohol
 Tourniquet
 Lancet
 Dry cotton wool
 Swab stick
 Syringe and needle
  Glass slide
 Handgloves
2.2.3 Functions of some materials
i. Needle : used to pierce a vein to gather blood
ii. Cotton : is used to stop bleeding
iii. Hub : is used to protect phlebotomist from accidental meedle stick when transfering
blood into container
iv. 70% alcohol isopropyl Used to disinfect pitching point
v. Handgloves : Protect hands against,infection
vi. Lancet :pitch,puncture a point for bleeding

2.2.4 Types of sample collected

 Blood
 Urine
 Stool
 Sputum

2.2.5 Containers that are used in reception

i. Plain container
ii. EDTA container
iii. Fluoride oxalate container
iv. Universal sterile container
(1) plain container :it has red cap, this container does not contain any anticoagulant,it is
mostly used in Immunology Laboratory.
(2) EDTA :it has purpil cap,it contains Ethylenediamine-tetraacetic-acid as
anticoagulant,this container are mostly used in Hematology, sample collected in it
includes packed cell volume(pcv),Blood grouing.
(3) Fluoride oxalate container : it has Harsh cap,it contains the anticoagulant fluoride
oxalate.
(4) universal container :this is used to collect samples like urine,stool,and sputum.
2.2.6 Methods of Blood colection
There are two (2) methods in which blood samples are collected,these methods are
carry out,differently depending on the needs of the situation and a kind of test to be
run.they are ;
i. Vein puncture method
ii. Capillary method

(1) vein puncture method :

 Procedure ;

 the patient was provided with a seat.

 assembled all material,watch out the requist form.
 the patient was asked to dose his / her palm.
 the patient for arm was tied using touniquate 3-4 inch above,the selection puncture
site
 in a circular motion the prominent vein was cleaned using 70 % alcohol.
 the needle was fixed to the hub and making the cut edge facing upward.
 insert it into the prominent vein gently,and push the container gently into the hub.
 collect the required volume of blood.
 patient palm were loose.
 draw the container,loose the tourniquet,draw the hub.

and cover the punctured area with cotton wool.

 keep the container on a rack.

(2) Capillary Method :

In this method small amount of blood are collected by pricking a finger or thumb using
lancet.the good example of this method is DBS test.

Materials used :

 lancet
 cotton
 slide or test card
 hand gloves
 70% alcohol

2.2.7 Dry Blood Spot

I was taugh and practiced that,this is a process of taking blood from new born baby or
children whose age do not supercede one and half year,whose parent were suspected to
have infected with HIV,this test are carryout after interval of months until the child attain 18
months.

Registration of DBS card start with

i. Serial number
 ii. Hospital number
iii. Name of the patient
iv. Age in month

Tittle : Dry Blood Spot

Aims :To Determine whether a child has infected with Hiv from their infected parent

Materials : Test pack ( lancet,test card 70% acohol isopropyl,cotton) requist

form,registration book pen,handgloves.

Stages :

i. First PCR -
ii. Second PCR-
iii. Third Determine

Procedure for sample collection of Dry Blood Spot

 Register the patient using requist form

 Provide seat to the patient mother.
 Ask the mother to massage or press the point to be pitch
 Clean the surface with 70% alcohol isopropyl
 Used lancet to bleed,the foot thumb
 Clean the first drop,and
 Take the subsequent ones into 1st,2nd,3rd,4th,5th circles
 Do not let it to drop out of the circle
 After that keep the card on cards stand

Chapter 3
3.o Introduction
This chapter will discuss on problems encountered during SIWES
programme,relevant of SIWES programme.
i. Patient complain
ii. Misplacement of patient result
iii. Financial problems

3.2.1 patient complain :

 Patient complain : when i was posted to result collection bench,patient come to
collect their test results,a time when the result is not out due to some issue some
patients begins to shout at me,and i try to calm them dawn,not to worry about it.

3.2.2 Misplacement of patient result :

There was a time when soldier's result was lost,the soldier was assigned to be a
collector of 7 dev result always,he came and found that his boss result was
missed,he stayed at lab ,and told us that he will not going any where unless we do
something on it.

3.2.3 Financial prolem : sacrificing our entire time to SIWES programme,became

challenge to us financially,taking long trip daily transport,but i am able to endured to
accomplished successful.

3.3 Relevance of the SIWES Programme :

 To assisted me to obtained relevant practical knowledge and working
experience. Examples : i learned different tests like
Hiv,H.pylori,montoux,Hapatitis test e.t.c
 It exposed me towards methods of handling equipments and machines which
may not be available in the educational institution. Examples,i learned how to
handle equipment like micro pepitte,and how to manipulate mechines like
centrifuge,rotary shaker.
 It help me a lot to bridge the gap between theoretical knowledge and practical
industrial work. Examples, what i learned from school help me to built another
knowledge outside the school.
 It prepared me for industrial working conditions. E.g i can work when a ever i found
mynself .

Chapter four

4.0 Introduction

In the last chapter of this report, concluding remarks and general appraisal of the
programme were presented. Also, some advices for future participants, SIWES managers,
and possible ways of improving the programme were given.

4.1 Conclusion
In conclusion this technical report taught and described many relevant areas,which
includes,introduction to immunology department,history of UMTH,organisational
chart,functions of various department,introduction to immunology routine laboratory unit
and phlebotomy,with their various activities,investigation,functions of mechines.the report
focused highly on tests,functions of materials,functions of machines,fridges,laboratory guide
and so on .

4.2 General Appraisal of the programme

4.3 Advice for future participants :

 To attend institution’s SIWES orientation programme before going on industrial

attachment.
 Comply with the employers rules and regulations.
 Keep proper records of training activities and other assignments in the logbook.
 Arrange their own accommodation during the period of attachment.
 Submit Log Books, Reports and other documents related to SIWES as required by their
institution at the end of the training period.
 Submit to ITF through their institution, Evaluation Form (ITF Form 8) completed by the
students the employer and the institution.
 Avoid changing of place of attachment except in special circumstances and with the
permission of your Centre Director and the SIWES Directorate.

4.3.2 Advice for SIWES managers

 They should be regular supervision at the site of school.

 Students required motivation,i mean,you should create an enabling environment where
by stipend will paid to those students in industry training.

4.2.1 Possible ways of improving the programme

 School should continue collaboration with industry .

 Proper supervision and guidance are required.
 Reward should be allocated to hardworking and punctual student .