- The internship was conducted at Hope Service Clinic and Maternity from February 14th to March 14th 2022. - The objectives were to familiarize with the different diagnostic units of the laboratory and effectively participate in sample collection, processing, analysis, and patient registration. - Key departments at the hospital include outpatient, inpatient, medical, nursing, pathology. The laboratory has sections for collection, biochemistry, serology, parasitology, and bacteriology. - Tests performed include CRP, toxoplasmosis, rubella, and quality control is emphasized across pre-analytic, analytic and post-analytic phases.

1. INTENSHIP REPORT AT
HOPE SERVICE CLINIC
AND MATERNITY
ESSOS
FROM THE 14TH OF FEBRUARY TO THE 14TH
MARCH 2022
PRESENTED BY NDIGWAN EMMACULATE
<

2. INTRODUCTION
• Internship is an integral part of the program in the laboratory medicine that provide interns with
the opportunity to acquired knowledge and technical skills under the guidance of experienced
medical professionals.
• The internship provide learning experiences during which an intern should;
-Practice and acquire clinical skills
-Practice skills in problem solving
-Perform quality control procedures
-Learn and acquire new procedures
-Operate and maintain various laboratory machines and instruments
-Report accurate and precise results to supervisors
-Learn how to correlate test results to patient clinical diagnoses.

3. INTERNSHIP OBJECTIVE
A-MAIN OBJECTIVE
- To bind theory with skills
- To familiarize the medical lab students with the different unit diagnostic laboratory.
B-SPECIFIC OBJECTIVE
Students are expected to;
-Identify the different instruments in the lab,
Effectively take part in sample collection, processing and analysis,
Follow up and take part in registration of patients and patient results

4. CONTI…
• An internship provides the work experience that helps students put
their education into practice, develop their leadership skills and give
them competitive advantage as they pursue a permanent position.
It provides exposure to the real world and give you a platform to
establish critical networking connections, allow you to learn more
about yourself, equip you with more than just technical skills and
finally allow you to gain a competitive edge.
•

5. CHAPTER TWO
ADMINISTRATION STRUCTURE AND
ORGANISATION OF THR HOSPITAL
• Hope services clinic and maternity was initiated by the midwife named Mrs.
Esther Hadassah in 1991 with the intention of helping the poorest
pregnant women in the Essos neighborhood. Officially became a clinic under
the authorization of the Ministry of Public Health on February 22nd 1993 putting
a medical and paramedical team specializing in general and obstetrical medicine
at the service of patients. This clinic is apolitical and today has three components
which are the clinic and maternity, orphanage and evangelization. Hope services
also provides care that embodies medical, psychosocial, educational and spiritual
areas of an individual. It is open to all persons irrespective of tribe, race, status,
sex or religion, with emphasis on the underprivileged or prisoners, widows,
orphans, handicapped, traumatized and the homeless.

6. GEOGRAPHICAL LOCATION
• Hope Service Clinic and Maternity of Yaoundé is located in the center region,
Moundi department, district of Yaoundé iv, located in the Essos district limited to
the east by the Essos Hospital Center, in the west by the road named Mentee lido,
to the north about 900m by the Hickam base and to the south by the Pakistan
crossroad.

7. ADMINISTRATIVE ORGANISATION
• - The General Director,
• - The Executive Director,
• - Administrative Assistance,
• - The Medical Director,
• - The External Relations Department,
• - Department of Medicine,
• - Maternal and child protection [ PMI],
• - Maternity Department,
• - Neonatal Department,
• - Surgery Department,
• - Laboratory Services,
• - Pharmacy,
• - Voluntary Screening Services,
• - Imaging Service,
• - Hygiene and Sanitation Department,
• - Maintenance Service.

8. VARIOUS HOSPITAL DEPARTMENT
1- Outpatient department [ OPD]
2 -Inpatient services department
3-Medical department
4-Nursing department
5-Paramedical department
6 - Pathology

9. CHAPTER 3; MEDICAL LABORATORY AS AN INTEGRAL
PART OF THE HOSPITAL
• The laboratory of Hope Service Clinic and Maternity is divided into 5 divisions;
• I] Phlebotomy or Collection department,
• 2] Biochemistry department;
• 3] Serology and Immune Serology department;
• 4] Parasitology department;
• 5] Bacteriology department.

10. INSTRUMENTS FOUND IN THE LABORATORY AND
ITS USES
• The Laboratory of Hope Services Clinic and Maternity has the following machines
which include
• - Computer; It is used to register patient and patient results.
• - Printer; Results are printed using the printer
• - Spectrophotometer; This machine is used to measure biochemical electrolyte such as
urea, glucose, creatinine, ASAT, ALAT, Cholesterol, Triglyceride, Magnesium, Amylase,
Direct bilirubin, Total bilirubin, Uric acid.
• - Protein Analyzer; Test such as CRP, Glycated hemoglobin which measure sugar in
blood by monitoring treatment and follow up of diabetic patients.
• - Monogram machine; It measures the different ions found in the body such as
calcium, sodium, potassium, chloride.

11. CONTIN…
• - ELISA Reader and ELISA Washer; Runs test such as Chlamydia, Too plasma, and
Rubella.
• - Hemocytometer which is used to measure blood components.
• - Mixer; it homogenizes blood before passing on the hemocytometer.
• - Centrifuge which separate blood components.
• - Coulometer measures the coagulating factors e.g. Stand PTT.
• - Electrophoresis machine
• -- Incubator to culture bacteria
• - Heater to dry slides
• - Dust bin which are of three types noninfectious waste, biohazard waste and
infectious waste.

12. QUALITY CONTROL IN THE LABORATORY
• In the laboratory quality control is done in three phases, which are Pre-Analytic phase that
deals with the collection of sample, Analytic phase that cover the analysis of the sample
and the Post Analytic phase which involves rendering of results. These phases have rules in
which they operate for example in the pre analytical phase during the collection of sample
for complete ionogram, quality control begins from the collection in which the hand of
the patient is not tie.
• For the machines quality control are done on the machines by using a control sample
which gives a value that is low, high and normal and for museology test the test comes
with the controls and test lines.
• Stock inventory is done by registering everything that was commanded by the laboratory
head in a quality control register by writing the quantity demanded, the lot number, the
expiring date and do the positive and negative control and registered using the principle
FIFO which means first in, first out.

13. CLINICAL BIOCHEMISTRY TEST
• Clinical biochemistry test comprises over one third of all hospital laboratory
investigation. It is that branch of laboratory medicine in which chemical and
biochemical methods are applied to the study of disease while in theory these
embraces all non-morphological studies, in practice it is usually, though not
exclusively, confined to studies on blood and urine because of the relative ease in
obtaining such specimen although analysis is made on other body fluids such as
gastric aspirate and cerebrospinal fluid.

14. THE USE OF BIOCHEMICAL TEST
• Biochemical investigations are involved, to varying degrees, in every branch of
clinical medicine
• The result of biochemical test may be use in diagnosis and in the
monitoring of treatment.
• Biochemical taste may also be of value in screening for disease or in
accessing the prognosis once a disease has been made.
• The biochemistry laboratory is often involved in research into the
biochemical basis of disease and the clinical trials of a new drug.

15. C-REACTIVE PROTEIN
• OBJECTIVE: To determine the type of inflammation in the body.
• INTRODUCTION
• CRP is a test that measures the level of C-reactive protein in your blood. It is a protein
made by the liver and it is sent into your blood stream in response to inflammation.
Inflammation is the redness and swelling of body tissues if you have been injured or had an
infection. It can cause pain, redness, and swollen in the injured or affected area. Some
autoimmune disorders and chronic disease can also cause inflammation. Normally, you
have low level of CRP in your blood. High levels may be a sign of serious infection or other
disorders. A CRP test may be used to find or monitor conditions that cause inflammation.
•
•

16. REQUIREMENTS
• Blood sample in a dry tube
• Protein analyzer machine
• Cuvette
• Pipette
• Reagents (buffer solution, antiserum and stirrer)
• Pipette tips

17. PROCEDURE
• 1. Remove reagents and allow to attain room temperature.
• 2. Take out one cuvette put a stirrer into it and add accurately 600ul buffer solution.
• 3. Then add 2ul of whole blood ample and mix thoroughly.
• 4. Put a cuvette into the test channel of the machine. The machine automatically stirs for
one minute.
• 5. Add 60ul antiserum using the pipette and immediately press the corresponding channel
start bottom
• 6. The machine automatically displays the result after a few minutes, which is being record.
• 7. After the test take out the cuvette and discard into the box and off the machine.
• 8. This is a quantitative method.

18. RESULT INTERPRETATION
• The normal CRP levels vary from laboratories but it is generally accepted
that a value of 0.8 – 1.0mg/dl lower is normal. Most healthy adults have CRP
lower than 0.3mg/dl.

19. PROCEDURE FOR BIOCHEMICAL TEST
NAMES OF
TESTS
QUANTITY OF
REACTIVE
QUANTITY OF
SAMPLE
INCUBATION
TIME
NORMAL
VALUES
CEATININE 500UL R1
5OOUL R2
1OOUL IMMEDIATELY 0.15-1.5mg/dl
GLUCOSE 1000UL 10UL 1O minutes at
25oc
70-110mg/dl
fasting 70-
140mg/dl not
fasting
ASAT/GOT 800UL R1
200UL R2
100UL Immediately ≤ 371UL/L
≤ 371UL/L 800UL R1
200UL R2
100UL Immediately ≤ 391UL/L
CHOLESTEROL 1000UL 10UL 10 minutes at 25oc ≤ 200mg/dl
TRIGLYCERIDE 1000UL 10UL Immediately 5-50mg/dl

20. IMMUNOSEROLOGY TEST
• Immunoserology test is a variety of test that is done to identify the causative
organisms of infectious diseases. Test systems used in immunoserology have
classically included methods of detecting antigen-antibody reactions which range
from complement fixation to immunoassay methods. The test performs involved
Toxoplasma, Rubella and Chlamydia and it is done using the ELISA machine.

21. - TOXOPLASMA IGM ELISA
• PRINCIPLE OF THE TEST
• Diluted patient serum is added to wells coated with purified antigen. IgM specific
antibody, if present will bind to the antigen. All unbound materials are washed
away and the enzyme conjugate is added to bind to the antibody-antigen
complex if present. Excess enzyme conjugate is washed off and substrate is
added. The plate is incubated to allow the hydrolysis of the substrate by the
enzyme. The intensity of the color generated is proportional to the amount of
IgM specific antibody in the sample.

22. PROCEDURE
• Place the desired number of coated strips into the holder (18-260c) and gently
mix;
• Negative control, positive control and calibrator are ready to be use. Prepare
121 dilution of test sample by adding 10µl of the sample to 200µl of sample diluent
mix well;
• Dispense 100µl of diluent sera,calibrator and controls into the appropriate
wells. For the reagent blank,dispense 100µl sample diluent in 1A well position, tap the
holder to remove air bubbles from the liquid and mix well incubate for 20 min at
room temperature;
• Remove liquid from all wells. Wash wells three times with 300µl of 1x wash
buffer. Blot on absorbance paper or paper towel;
• Dispense 100µl of enzyme conjugate to each well and incubate for 200 min at

23. CONTIN…
• Remove enzyme conjugate from all wells. Wash wells three times with 300µl of 1x
wash buffer. Blot on absorbance paper or paper towel;
• Dispense 100µl of TMB substrate and incubate for 10 min at room
temperature;
• Add 100µl of stop solution;
• Read O.D at 450nm using ELSA reader within 15 min, a dual wave length is
recommended with reference filter of 600-650nm.
•

24. INTERPRETATION OF RESULT
• CONTROL O.D
• Positive control ≥0.9
• Negative control ≤0.5
• Cut off control ≤1.5
•
• INDEX INTERPRETATION
• ≤9 Negative
• 9.11 Equivocal
• ≥11 Positive

25. CHAPTER 4; FELLOW UP OF INTENSHIP OBJECTIVES
• I attained all my internship objectives at hope service clinic and maternity.
Therefore I could grade it as a 100percent

26. ; CONCLUSION AND OBSERVATION
• My stay in hope service clinic and maternity has been with so much joy because I
have really learned a lot as far as my career is concern. However, I do think that
there is some aspect of the department I could have done better and that I need
to work on. The staff of Hope Service Clinic and Maternity has really done so
much in impacting more knowledge of becoming a professional in my field of
study. One important thing that I learn there that has really change me is that in
everything that you do in life you should do it with love and passion and you
should be ever ready to learn at all time no matter how much you think you know

27. THANKS FOR YOUR KEEN ATTENTION