MLT-%20II

VOCATIONAL HIGHER SECONDARY

TEACHER’S SOURCEBOOK

MEDICAL LABORATORY TECHNICIAN COURSE

Second Year

GOVERNMENT OF KERALAGENERAL EDCUATION DEPARTMENT

STATE COUNCIL OF EDUCATIONAL RESEARCH AND TRAINING (SCERT)Poojappura, Thiruvananthapuram

TEACHER’S SOURCEBOOK

VHSE - Medical Laboratary Technician (MLT)Course Second YearPrepared by:State Council of Educational Research &Training (SCERT), VidhyabhavanPoojappura, Thiruvananthapuram -12KeralaE-mail: [email protected]

Type setting by:SCERT Computer Lab.

Printed at:

©Government of KeralaDepartment of EducationSCERT - 2006

This Teacher’s Sourcebook on Medical Laboratary Technician courseis introduces the teacher to the main principles and practices of therevised pedagogy which is activity-based, process-oriented andlearner-centred.

The realisation that learning is not mere storing information in memoryand that real learning is construction of knowledge throughobservation, comparison, classification and analysis has led us to givea new thrust to the teaching-learning process at Vocational HigherSecondary level to make it more meaningful and learner-friendly.

This sourcebook has been developed primarily for the benefit of teacherswho teach Medical Laboratary Technician course at Vocational HigherSecondary level. The subject matter has been dealt with utmost care,in tune with the revised curriculum and pedagogic principles. It ishoped that this book will enable the teacher to provide suitable learningactivities for effective learning.

The success of the approach depends upon the vision and commitmentof the teacher. They are expected to make use of this sourcebook at allstages of their teaching process. It is also expected that the teacherwould seek help and guidance from other sources like libraries andwebsites.

Hope that this sourcebook will help the teacher to develop the skillsand experience required for effective classroom transaction.

Creative criticism and suggestions for improvement are most welcome.

With regards,

Thiruvananthapuram Dr E. Valsala Kumar July, 2006 Director

SCERT, Kerala

Foreword

Dear Teachers,

CONTENTS

Part I

I General Approach ....................................................................... 06II Learning strategies ....................................................................... 26III Curriculum objectives .................................................................. 36

IV Syllabus ......................................................................................... 41V Planning ........................................................................................ 55

VI Evaluation .................................................................................... 60

Part II Unit Wise Analysis

Unit - 1 - Laboratory Ethics and Management

Laboratory Ethics and Management ............................................. 73

Unit - 2 - Haematology

1. Introduction to haematology......................................................... 84

2. Total cell counts ............................................................................ 903. Examination of blood smear......................................................... 97

4. Haemoglobin estimation ............................................................. 103

5. Packed cell volume ..................................................................... 1076. Red cell indices ........................................................................... 111

7. Erythrocyte sedimentation rate ................................................... 114

8. Coagulation studies ..................................................................... 1199. Special investigations .................................................................. 123

Unit - 3 - Clinical Pathology

1. Introduction to clinical pathology ............................................... 128

2. Urine analysis .............................................................................. 1323. Stool examination ....................................................................... 138

4. Sputum examination ................................................................... 141

5. Semen analysis ............................................................................ 1446. CSF examination ......................................................................... 148

Unit - 4 - Immuno Haematology and Blood Banking

1. Introduction to immuno haematology and blood banking .......... 153

2. Blood group systems ................................................................... 155

3. Blood grouping ............................................................................160

4. Coomb’s test ................................................................................1665. Cross matching ............................................................................169

6. Blood transfusion .........................................................................172

Unit - 5 - Biochemistry

1. Introduction to biochemistry .......................................................1772. Instruments used in biochemistry ................................................182

3. Estimation of blood glucose ........................................................188

4. Estimation of protein ..................................................................1935. Estimation of NPN substances ...................................................196

6. Estimation of lipids .....................................................................199

7. Liver function tests ......................................................................2038. Renal function tests .....................................................................206

9. Automation and quality control ...................................................209

Unit - 6 - Histotechnology and Cytology

1. Introduction to histotechnology ..................................................214

2. Introduction to cytology ..............................................................219

Part III Practical Evaluation ..........................................................................222

Part IV Appendix .............................................................................................223

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GENERAL APPROACH

Significance of vocational education

The ultimate aim of education is human refinement. Education should enable the learnerto formulate a positive outlook towards life and to accept a stand which suits the wellbeing of the society and the individual as well.

The attitude and potential to work has determined the destiny, progress and culturaldevelopment of the human race. As we all are aware, the objective of education is toform a society and individuals having a positive work culture. The educational processexpected in and outside our formal schools should concentrate upon inculcating concepts,abilities, attitudes and values in tune with these work culture. Hence vocationalisededucation cannot be isolated from the main stream of education. In another sense, everyeducational process should be vocationalised. However due to our inability to utilize theresources wisely, scarcity of job opportunities is a severe issue of the present society. Forovercoming this deep crisis, emergent techniques have to be sorted out and appropriateresearches have to be seriously carried out. It is in this sense that the content andmethodology of Vocational Higher Secondary Education have to be approached. Theneed for meaningful linkages between the world of work and world of education is wellrecognized. The essence of the recommendations made by various commissions andcommittees is that the vocationalisation should be the main feature of the future systemof education at the higher secondary stage, it can be extended to school level also.

Vocational Education is the system of education which intends to prepare students foridentified occupations , opening several areas of activities.

The Vocational Higher Secondary course envisaged as a part of the National Policy onEducation with the noble idea of securing a job along with education. The relevance ofvocational education is very great in this age of unemployment. This education system,which ensures a job along with higher education stands aloof from other systems ofeducation.

This education imparts the life skills required by the youth to enter the world of workand assuming the responsibilities of adulthood. As per the expert meeting report (2001)of UNESCO, the life skills are grouped under 4 categories. They are

1. skills for personal fulfilment

2. skills for living in society

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3. skills for dealing with changing economies

4. skills for dealing with changing work patterns.

Vocational Education ensures fulfillment of manpower requirement for nationaldevelopment and for social security for the citizens through self-employment. It alsohelps to reduce the migration of rural youth to urban areas and thus helps in ruraldevelopment.

The learners of Vocational Education get an opportunity to avail one year apprenticeshiptraining in industries to improve their practical skill. During the course of study, on thejob training (OJT) for 10 days in a year is arranged to improve the skill and efficiency ofthe learner. This education system motivates the attitude towards self –employmentthrough Production/ Service cum Training Centres. (PTC)

Objectives of vocational education

The National policy on education has accorded very high priority to the program ofvocationalisation of education, considering the following objectives.

1. To fulfill national goals of development and the removal of unemployment andpoverty.

2. To impart education relevant to increased production and productivity, economicdevelopment and individual prosperity.

3. To make available skilled work force at all levels to alleviate the rural unemploymentand for the development of nation.

4. To develop environmental awareness to ensure sustainable development.

5. To develop vocational aptitude, work culture, values and attitudes of the learnersso as to enrich the productivity of the nation.

6. To develop entrepreneurial competencies and skills of learners for self relianceand to undertake gainful self employment.

7. To facilitate the expansion of higher education and explore future opportunitiesthrough innovative guidance and programmes.

8. To develop vocational competencies, creative thinking in the related areas andfacilitate training.

9. To create awareness on mental, physical and social health.

10. To acquire awareness about different job areas and to provide background foracquiring higher level training in subjects concerned.

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LEARNING

Learning is construction of knowledge through a continuous mental process. It is anadvancement through adding and correcting in the light of comparing the new issue withthe previously learned concepts. It is an intellectual process rather than the merememorization of facts. Learning is a conglomeration of a variety of activities like problemsolving, finding out co-rrelations, prediction, arriving at conclusions, rational as well ascritical thinking, finding applications, grouping for other possibilities and extracting thecrux when opportunities are provided for intellectual processes learning will becomeeffective and intellectual ability will get strengthened.

Theoretical foundations of learning

Education is the best device that can be adopted for creation of a new society. It shouldbe democratic in content and process and should acknowledge the rights of the learner.It should also provide opportunity for better citizenship training. The concept of equalityat all areas should get recognition in theory and practice. There should be consciousprogramme of action to develop nationality, humanness and love against theencroachment of sectarianism of caste and religion. The learner should become cognisantof the implications of privatisation, liberalisation, globalisation etc.

They should develop a discrimination to use the acquired learning as a liberative weapon.

They should be able to view education and life with the perspective of social well being.

A basic awareness of all the subjects needed for life is essential for all students.

The remnants of perspectives formed in us during the colonial period still influence oureducational philosophy. The solution to the present day perplexities of the society whichapproaches education on the basis of competitions and marketisation is only acomprehensive view of life.

It is high time that education was recognized on the basis of the philosophy of humaneducation. The human approach to education has to reflect in its content, learning processand outlook. The perspective of ‘learning to be’ and ‘learning to live’ together as expressedby the UNESCO and the concepts of existential, intrapersonal and interpersonalintelligence.

The basis of new approaches on curriculum and teaching- learning process are derivedfrom the developments tookplace in the east and west of the world.

When we begin to see the learner at the centre of the learning process, the teaching processhas to be changed timely. It is the result of the rapid growth and development of Science

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and Technology and Pedagogy. If we want to undergo the changing process, we have toimbibe the modern hypothesis regarding learner that they have

1 Great curiosity

2 Good imagination

3 Numerous other qualities and interests

4 Independent individuality

5 Interest in free thinking and working In a fearless atmosphere.

6 Interest in enquiring and questioning.

7 Ability to reach conclusions after logical thinking.

8 Ability for manifest arid establish freely the conclusions arrived at.

9 Interest for recognition in the society.

10 Determination to face the interference of society and make components whichis a part of social life.

When we consider the learning system, the domains to be stressed in education accordingto the modern development becomes relevant.

The knowledge domain consists of

1 Facts

2 Ideas

2 Laws

3 The temporary conclusions and principles used presently by scientists.

The learning is a process. The continuous procedures we undergo to reach a particulargoal is process. The skills which are parts of the process to analyze the collected ideasand proofs and come to a conclusion is called process skills. Some important processskills are, the skills;

1 To observe

2 To collect data and record

3 To classify

4 To measure and prepare charts

5 To experiment

6 To predict

7 To recognize and control the variables

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8 To raise questions

9 To generalize

10 To form a hypothesis and check.

11 To conclude

12 To communicate

13 To predict and infer

14 To use tools.

In addition to this, consider the skills related to creative domain also, they are skills:

1 To visualize

2 To connect facts and ideas in new ways.

3 To find out new and uncommon uses of objects

4 To fantasize

5 To dream

6 To develop creative isolated thoughts

Again, the following factors consisting in the Attitudinal domain are also important as;

1 Self confidence

2 Love for scientific knowledge

3 Attitude to know and value history

4 Respect human emotions

5 Decide with reasonable present problems

6 Take logical decisions regarding personal values

As regards the application domain the important factors are the ability to:

1 observe in daily life examples of ideas acquired.

2 take the help of scientific process to solve the problems of daily life.

3 choose a scientific life style

4 connect the ideas acquired with other subjects.

5 integrate the subjects with other subjects.

Some basic stands have to be taken on the new scientific knowledge about intelligencelearning and teaching. When such basic concepts are accepted changes are required in thefollowing factors.

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1 The vision, approach, structure and content of the curriculum.

2 The vision, approach, structure and content of the textbooks.

3 Role of the teacher and the learner.

4 Learner atmosphere, learning materials and learning techniques.

Some scientific perspectives accepted by modem world in Educational Psychology aregiven below.

Constructivism

This approach puts forward the concept that the learner constructs knowledge. Newknowledge is constructed when ideas are examined and practiced in new situations relatingthem with the previously acquired knowledge and experience. That is assimilated into thecognitive structure of one’s knowledge. This method which gives priority to criticalthinking and problem solving provides opportunity for self motivated learning.

Social Constructivism

Social constructivism is a branch of constructivism. Knowledge is formed, spread andimbibed and it becomes relevant in a social environment. Interactive learning, grouplearning, co-operative participatory learning, all these are concepts put forward by socialconstructivism.

The main propounders of constructivism are Piaget, Vygotsky and Bruner.

Discovery learning and interactive learning have prime importance. Learning takes placeas a part of the attempt for problem solving. The activities of a learner who confrontscognitive disequilibrium in a learning situation when he tries to overcome it leads to therenewal of cognitive structure. It is through this process construction of new knowledge,the assimilation of them takes place. Observation and enquiry are unavoidable factors.The learner advances towards new areas of acquisition of knowledge where he tries tocompare his new findings with the existing concepts.

Learning is a live mental process. Rather than the ability for memorization of facts cognitiveprocess has to be given emphasis. The process of problem analysis, elucidation, criticalthinking, rational thinking, finding out correlation, prediction, hypothesis formation,application, probing for other possibilities, extracting the crux and other processes areof critical importance in learning.

Constructivism gives greater predominance to co-operative learning. Social and culturalfactors influence learning. Sharing of knowledge and experience among learners, collectiveenquiry, assessment and improvement, group activity and collaborative learning by sharingresponsibilities with the objective of public activity, provide opportunity for effective

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learning.

In learning internal motivation is more important than external motivation. The learnershould have interest and initiative in learning. Learning situation should be capable offorming a sense of ownership in the learner regarding the learning process.

Learning is not a linear process. It progresses in a spiralled way advancing deeper andwider.

NEW CONCEPTS OF LEARNING

1. Discovery Learning

The teacher has to create a motivating atmosphere for the learner to discover conceptsand facts, instead of listening always. Creating occasion to progress towards discovery ispreferred. Instead of telling everything before and compelling to initiate the models,situations are to be created to help the children act models as themselves.

2. Learning by discussion

Discussion leads to learning is Burner’s theory. Here discussion is not opposing eachother. It is a sharing on the plane of ideas. New ideas are arrived at by seeking explanations,by mutual giving and taking of ideas and by problem solving.

3. Problem solving and learning

Only when the learner feels that some thing is a problem to be solved that he takes theresponsibility of learning it. It is an inborn tendency to act to solve a problem that causescognitive disequilibrium in a particular area. It is also needed to have confidence that oneis capable of doing it. The problems are to be presented in consideration of the abilityand level of attainment of the learner.

4. Collaborative learning

This is the learning in which the responsibilities are distributed among the members ofthe group keeping common learning objectives. The common responsibility of the groupwill be successful only if each member discharges his duties. All the members will reach astage of sharing the result of learning, equally through the activity with mutualunderstanding. The teachers who arrange collaborative learning will have to make clearthe responsibilities to be discharged. This is possible through the discussion with thelearners. Collaborative learning will help to avoid the situations of one person workingfor the whole group.

5. Co-operative learning

This is the learning in which the learners help one another. Those who have moreknowledge, experience and competency, will help others. By this exchange of resources

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the learners develop a plane of social system in learning also. As there are no high upsand low ones according to status among the learners they can ask the fellow studentsdoubts and for helps without any hesitation or in hesitation. Care should be taken not tolead this seeking of help to mechanical copying. It should be on the basis of actual needs.So even while encouraging this exchange of ideas, among the members of the groupcautious acceptance is to be observed as a convention. There should be an understandingthat satisfactory responses should come from each member and that the achievement ofthe group will be assessed on the basis of the achievement of all the members

6. Zone of Proximal Development

Vygotsky observes that there is a stage of achievement where a learner can reach byhimself and another higher zone where he can reach with the help of his teachers, peersand elders. Even though some of them can fulfill the learning activity by themselves thereis the possibility of a higher excellence. If appropriate help is provided every learner canbetter himself.

7. Scaffolding

It is natural that the learner may not be able to complete his work if he does not getsupport at the proper time. The learner may require the help of the teacher in severallearning activities. Here helping means to make the learner complete the activity takingresponsibility by himself. The teacher has to keep in mind the objective of enabling thelearner to take the responsibility and to make it successful.

8. Learning - An active mental process

Learning being a cognitive process, the teacher needs to know cognitive processes tofacilitate the creation of learning opportunities. Learning can be made effective byproviding learning experiences involving mental processes like

1 Retrieves/recollects/retells information2 Readily makes connections to new information based on past experiences

and formulates initial ideas /concepts.3 Detects similarities and differences

4 Classifies/categories/organizes information approximately.5 Translates/transfer knowledge or understanding and applies them in a new

situation.6 Establishes cause-effect relationships

7 Makes connections/relates prior knowledge to new information/appliesreasoning and draw inferences

8 Communicates knowledge/understanding through different media.

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9 Imagines/fantasies/designs/predicts based on received information

10 Judges /appraises/evaluates the merits or demerits of an idea/develops ownsolutions to a problem.

9. Intrinsic Motivation

Intrinsic motivation is given more importance than extrinsic motivation. The teacher hasto arouse the internal motivation of the learner. A person internally motivated alone canimmerse in learning and own its responsibility.

10. Multiple intelligence

The Theory of Multiple Intelligence put forward by Howard Gardener has created aturning point in the field of education. The National curriculum documents hasrecommended that the curriculum is to be designed taking into consideration of thistheory.

MAIN FACTORS OF THE INTELLECT

1. Verbal/linguistic Intelligence

Ability to read and write, making linguistic creations, ability to lecture competence toeffective communication, all these come under this. This can be developed by engagingin language games and by teaching others.

2. Logical/mathematical Intelligence

Thinking rationally with causes and effect relation and finding out patterns and relationscome under this area. Finding out relations, explaining things, sequential and arithmeticalcalculations etc. are capable of developing this area of intelligence.

3. Visual/spatial Intelligence

In those who are able to visualize models and bringing what is in the imagination intovisual form and in philosophers, designers and sculptors this area of intelligence isdeveloped. The activities like modeling using clay and pulp, making of art equipments,sculpture, and giving illustrations to stories can help the development of this ability.

4. Bodily Kinaesthetic Intelligence

The activities using body language come under this. This area of intelligence is moredeveloped in dancers and actors who are able to express ideas through body movementsand in experts in sports, gymnastics etc.

5. Musical Intelligence

This is an area of intelligence which is highly developed in those who are able to recognizethe different elements of music in musicians and in those who can here and enjoy songs.

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Playing musical instruments, imitating the songs of musicians, listening silently to therhythms and activities like this are capable of developing this area of intelligence.

6. Interpersonal Intelligence

Those in whom this area of intelligence is developed show qualities of leadership andbehave with others in a noble manner. They are capable of understanding the thought orothers and carrying on activities like discussion successfully.

7. Intrapersonal Intelligence

This is the ability to understand oneself. These people can recognize their own abilitiesand disabilities. Writing diaries truthfully and in an analyzing way and assessing the ideasand activities of others will help developing this areas of intelligence

8. Naturalistic Intelligence

A great interest in the flora and fauna of the nature, love towards fellow beings interest inspiritual and natural factors will be capable of developing this area.

9. Existential Intelligence

The ability to see and distinguish our own existence as a part of the universe, ability todistinguish the meaning and meaninglessness of life, the ability to realize the ultimatenature of mental and physical existences, all these are the peculiarities of this faculty ofintelligence.

EMOTIONAL QUOTIENT

The concept of emotional intelligence put forward by Daniel Golman is used in framingthe new curriculum. The fact that one’s Emotional Quotient (E.Q) is the greatest factoraffecting success in life is now widely accepted. The teacher who aims to focus on improvingthe emotional intelligence of students need to concentrate on the following.

i) Ability to take decisions

Rather than imposing decision on students while planning and executing activities, thestudents may be allowed to take part in the decision making process. Taking decisionsthrough open discussion in the class, inviting students suggestions on common problemsetc. are habits to be cultivated.

ii) Ability to reach consensus

• When different opinions, ideas and positions arise, the students may be giventhe responsibility to reach a consensus.

• Imagining what would be the course of action in some situtations, allowing tointervene in a healthy way in problems between individuals.

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iii) Problem solving

• Developing the idea that there is reason and solution to any problem.

• Training in finding reasons for problems.

• Suggesting solutions through individual or group efforts.

• Discussing social problems.

• Analyzing the shortcomings in methods to solve problems.

Whether plastic can be banned within school premises can be given as a problem. Groupdiscussion will provide reasons and solutions. Problems, which can influence classroomlearning and for which the learner can actively contribute solution needs to be posed

1 Self criticism, evaluation

2 Ability to face problem-situation in life

3 Thinking what one would do if placed in the situation of others, how one wouldrespond to certain experiences of others - All these foster the growth of emotionalintelligence.

iv) Life skills

Life skills need to be given a prominent place in education. W.H.O. has listed : skillsrequired for-success in life.

1 Self awareness

2 Empathy

3 Inter personal relations

4 Communication

5 Critical thinking

6 Creative thinking

7 Decision making

8 Problem solving

9 Coping with emotion

10 Coping with stress

THE NEW CURRICULUM ADDRESSES THESE AREAS.

Knowing the characteristics of the learner, role of the teacher and how to use the teachershandbook help the teacher to plan and effectively implement learning activities.

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Role of a Teacher

In the earlier approach the teacher was mainly depending on the lecture method forteaching. But in the new method of education the student centered approach is givenmore importance than the teacher centered approach. Under this changed scenario theteacher has to perform the following roles in the classroom.

The teacher should be

1 A facilitator of learning

2 A guide to the overall development of the student

3 A good observer and motivator

4 Able to consider the activities, needs, special features and age group of students athigher secondary level.

5 Able to understand the limitations of learner and their learning problems.

6 An instructional material developer

7 A good communicator

8 An innovator

9 Able to raise leadership qualities and self confidence of the learner

10 An authoritarian in the concerned subject

11 Able to arrest and sustain the attention of the learner

12 Able to bring out and encourage the inborn talents.

13 A resource manger to ensure the optimum utilization of resources.

14 A systematic record keeper

15 A controller to issue guidance to the students

16 A person with high level of practical competency

17 Able to correlate area of study with familiar environmental situations

18 A self evaluator and good listener

19 Able to create awareness in social problems

20 A person with democratic and humanitarian approach

21 A professionalist as well as philosopher

22 A good evaluator

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23 A good organizer and a friend.

24 A co-learner as well as co-researcher25 Able to give assistance and advice in placement needs and self employment by

giving moral and technical support26 Able to keep moral values

27 A person equipped with skill for using new techniques of learning28 Optimistic and impartial

Child friendly Class Room Atmosphere

Learning can be effective and enjoyable only when the class atmosphere isaccording to the new conception of learning and the characteristics of vocational teacher.

1 Class and seating are arranged in an attractive way

2 Democratic nature is upheld

3 Always active

4 Students interact with teachers without fear

5 Opportunity for a variety of activities

6 Students allowed to involve interesting group activities

7 Learning speed, learning style and different levels of attitudes are considered. Helpis extended whenever needed.

8 Sufficient instructional materials are available

9 There is freedom of expression, students share their ideas and experiences

10 Students are given acceptance and encouragement

11 Healthy atmosphere

12 Needs of each student is given consideration. Happy and energetic atmosphere

13 Teachers work considering the rights of students

14 Prtoblems handled in a patient way

15 Teachers work at all events from the students view point

There will be students of various ability levels in any class because of learning style,learning speed, varying exposure to language experiences, physical ad psychologicalproblems and varying socio-cultural background.

The learning experiences provided must help to bring the low activities to an expectedlevel and extended the breadth and depth of the skills of the high activities.

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By repeating experiences, introducing variations in a learning experience to suit differentlevels and if needed, formulating additional experiences the problem of varying abilitylevels can be tackled.

Role of Learner

The learner in second year has undergone a learner centered and process oriented learningexperience up to first year. The learner at this age is in awakening stage and he is enthusiasticabout environment. He needs recognition and encouragement from environment andalso recognize as a grown up man. He is adequately competent to select vocational subjectsaccording to his aptitude and interact and to acquire higher education and profession ashe wishes. The aspirations about future life is framed in this particular age for seeingnational and international job opportunities. Some of the peculiarities of learner at thisstage are

1 Physical, intellectual and emotional plans have intensive changes during the age andtheir reflections can be observed

2 Ability to enquire discover and establish cause effect relationship betweenphenomena

3 Readiness to undertake challenges

4 Capacity to shoulder leadership roles

5 Attempt to interpret oneself

6 Susceptibility to different pressures

7 Doubts, anxieties and eagerness about sex

8 Imaging for social recognition

Needs of Learner

1 To make acquaintance with a job or self employment through vocational education

2 To acquire more knowledge in the concerned area through higher education

3 To recognize and encourage the peculiar personality of the later adolescent period

4 To enable him to defend against the unfavorable circumstances without any help

Role of learner

1 Active participant in the learning process

2 Act as a researcher

3 Sharer of information

4 Sharer of responsibilities

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5 Collect information

6 Takes leadership

7 Involves in group work

8 Act as a co-participant

9 Observes his environment

10 Experiments and realises

11 Make interpretations and draw inferences

12 Mould himself in to an active contributor for the welfare of the society

Evaluation

In vocational higher secondary education, a new approach to education and evaluationshould be made. Evaluation must be a systematic and continuous process. As thecurriculum is based on vocational stream, capacity building is a most important part andit should be evaluated accordingly. The technical skills, interest in the particular field,communication skill, analysis organizing and presentation skills etc have to be evaluated.The personal and social qualities also have to be evaluated. Therefore, evaluation shouldbe transparent, continuous and comprehensive.

Supporting System

In learner centered vocational education, a learning methodology has to be organizedand a proper learning atmosphere is to be provided. Many organizations can support thelearning activity. They are:-

1. School Resource Group (SRG)

Comprising all teachers (vocational and non vocational) instructors, and lab assistantswith academic head as the group leader.

2. School Support Group (SSG)

Comprising PTA president, members of local bodies, members of social clubs, subjectexperts etc who can contribute guidance /technology /infrastructure /financial assistanceetc.

3. Parent Teacher Association (PTA)

Can provide adequate funds for field trips, production cum training centers (PCTC),exhibition, On Job training (OJT) etc.

4. Local bodies

Grama Panchayat, District Panchayat and Block Panchayat can provide infrastructure ie,class rooms, laboratory, library, seminar hall, audiovisual equipments etc.

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5. Subject club

All vocational teachers handling same vocational subjects should form a subject club atregional level or district level. This will helps to share the knowledge and practical facilities,production and marketing of materials, service etc.

6. Nodal School

Based on the excellency, district wise nodal schools may be selected to providefacilities like central library, museums, video conferencing etc.

7. Institution Industry Interaction Project (III P)

This should be implemented in every institution to update knowledge. This also helps forOJT , PCTC and field visit.

Monitoring system

Education is a sort of journey from darkness to light satisfying the needs and the wantsof the individual and the society. The modernization of education through activity orientedsystem enhances free thinking and working in a fearless atmosphere. It is a qualitativeprocess not a quantitative one. This necessitates a proper monitoring system. The systemof monitoring should have the following features.

1) It must be transparent.

2) It must enrich the ideas of the facilitator through innovative process.

3) It must be time bound and rational.

4) It must motive the facilitator to adopt new strategies.

5) It must be recordable and ensure effective feedback for the effective monitoring ofthe system, three levels of the mechanism should be setup.

1. School level monitoring group.

2. Regional level monitoring group.

3. State level monitoring group

Moreover a social auditing system is advisable to achieve the objective effectively.

FEATURES OF LEARNING PROCESS IN THE NEW SYSTEMOF EDUCATION

In the new system of education the learning process should be modified in such a way as

to enable the learner to construct the knowledge of his own through observation, co-

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operation, problem solving, social interaction etc. The learning process should consider

the nature ability, social setup, inborn talents and subject selected by the learner. Therefore

the learning process should be:

1 A continuous mental process

2 Simple learner must feel that he is able to undertake the task

3 Enable the learner to attain the curriculum objective

4 Interesting

5 Suitable to the age and attitude of the learner

6 Future possibilities

7 Enable group activity

8 Challenging

9 Time bound

10 Constructive and curiosity developing

11 Possibilities for evaluation

12 Capacity to generate independent thinking

13 Ability to enquire discover and establish cause effect relationship betweenphenomena.

Learning Aids

To make the teaching and learning process simple and effective , certain learning aids andnecessary use of such aids for transacting a complex idea make the class room live andstudents get more and more involved. The advances in science and technology may beeffectively utilized for this purpose. Some of the learning aids listed below.

1 Multimedia

2 Over Head Projector

3 Computer

4 Internet

5 Liquid Crystal display Projector

6 TV, VCD, DVD and tape recorders

7 Working models

8 Charts

9 Slides

10 Video Conferencing facility

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11 Library

12 Text book

13 Source book

Society

The new educational policy uplifts the social commitment of the learner. Therefore thesociety can also give some valuable contributions in this changing situation. The newsystem also ensures that the learner can perform certain useful services for the bettermentof society. The social obligations can be illustrated as follows.

1 To enrich social values, aptitude and ability in learner

2 To develop entrepreneurial aptitude and ability which helps social welfare and selfemployment

3 New system of education adopts OJT, PTC etc as part of vocational curriculumwhich helps to make close contact with the society.

4 The resources available from our society can be positively utilized to conveneseminars, interview etc.

5 Social organizations can help learners to make their education socially committed.

6 The social clubs like NSS, Tourism Club, Eco Club, Energy Club etc functioning inschools can make direct link with the society.

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MM

SUBJECT APPROACH

Modern developments in the field of medical science and information technology have

caused a methodological upliftment in medical education. In recent years, the extension

of health and laboratory services into rural areas demand, more laboratory personals.

This has led to the introduction of MLT course at Higher Secondary level. As a result of

this, VHSE-MLT is one of the most sought for courses among the various vocational

courses offered in the state. It makes the learners capable enough to achieve better health

care on the basis of modern medical science, which in turn will be beneficial to the

society.

Medical Laboratory Technology is one of the most developing branches in the field of

modern medicine. Clinical laboratory tests have become a key element in most diagnos-

tic procedures. The innovative methodology and the use of technologically updated

instrumentation have made the field more inevitable. As trained workers comprise most

of the work force in a medical laboratory, the curriculum provided is highly practical

oriented.

The curriculum for second year of the VHSE-MLT course coveres subjects like Labora-

tory Management and ethics, Haemotology, Clinical pathology, Immunohaematology

and blood banking, Biochemistry and Histotechnology and Cytology. The new system

of learner centered approach to transact MLT is found to be most suitable as we came

across the first year of the course. The second year curriculum is also highly practical

oriented and life oriented. So possibility of every learning strategy should be considered

to transact the curriculum. It makes the learner confident to perform routine laboratory

tests and management of a clinical laboratory. Apart from the above objectives, learners

are expectecd to develop positive attitudes and values along with the development of

various skills.

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COURSE OBJECTIVES

l To have a basic knowledge about the structure and function of the human body in

health and disease.

l To familiarize the important microbial and parasitic diseases and their diagnosis.

l To be able to handle and investigate various clinical specimens properly.

l To be able to operate and take care of various laboratory equipments.

l To develop ability to perform and interpret various diagnostic investigations.

l To understand the duties and responsibilities of a lab technician/lab assistant.

l To study medical ethics and understand the management of a clinical laboratory.

l To acquire the ability to run a diagnostic laboratory as a part of self-employment

or to work as a lab technician as an employee.

l To acquire ability for time bound completion of task.

l To give awareness among the public about various health hazards.

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LEARNING STRATEGIES

In the modern era of globalization the introduction of new technologies ensureonly the survival of the fittest. So it becomes a necessity to equip the leaners to facethe growing challenges in the competitive world. Hence the traditional approach tolearning is no more relevant in the present context. The teacher should use instructionaltechniques that motivate the students to construct his own knowledge. Now thelearners are not passive listeners, but they are the active participants in the constructionof knowledge. Here the teacher – student interaction should be given muchimportance.

In the new instructional strategy while selecting the methods of teaching, the socialand psychological aspects of the learner is to be taken into consideration. The givenactivities for learning are only suggested ones. It can be altered according to thediscretion of the teacher.

To obtain the objectives, the new system of education is introduced in the VocationalHigher Secondary Education for attaining the objectives of the courses in this system,we can adopt the following strategies.

I. Assignment

Assignment is some specific work assigned to the students as a part of their academicenrichment. There are learning activities undertaken as a continuation of class room activities torealize the curriculum objectives to a broader extent . They should be completed in time boundmanner. They help to lead learner to higher level of learning from the present status. Challengingassignment can motivate the students to involve in group dynamics and achieve fruitful results.The teachers may at as a guide.

Assignment may be given on individuals or group basis. Assignment includes preparationof notes, preparation of charts, models, collection of materials from institutions etc. Assignmentsdevelop skills of reference, observation, enquire reporting etc. It ensures the effective utilizationof leisure time of the students.

II. Seminar

Seminar is a learning strategy involving an in-depth analysis of specific topic, preparation of apaper and presentation . The paper is presented by either one student or a group of students.After the presentation, there will be a discussion/ interaction in which all the students can participate. The students get an opportunity to clear their doubts and make clarification. Seminar helps todevelop communication skill and overcome stage fright.

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Stages

1. Selection of Topic: The topic of seminar should be relevant to the subject of study

2. Assignment of topic to individuals students or team: The topic may be assignedto one student or to a group of students.

3. Collection of relevant information: Information required for seminar can becollected from various sources namely books, magazines, internet, institutions, placeand persons.

4. Preparation of draft paper: Based on the information collected the student mayprepare a draft paper and submit it to the teachers for comments. Revise the draftpaper based on the comments of the teachers. The refined draft is submitted forapproval.

5. Program scheduling: The date, time and venue of the seminar is fixed. A seminarleader may be selected from the students

6. Seminar paper presentation: The student/ students shall present the paper in theseminar. The teacher may function as the moderator during the initial stages.

7. Discussion / Interaction: A number of respondents from the students make commentson the topic. This will be followed by a general discussion. All the group membersshould actively participate in discussion.

8. Summing up deliberation: The moderator sums up the deliberation

9. Evaluation / Feed back: Both teachers and students evaluate the programme.

10. Preparation of final report: A final seminar report is prepared covering all theadditional points discussed and consolidated.

III. Panel Discussion

It is a learning strategy in which a panel of experts are allowed to discuss a specific subject underthe control and direction of a moderator. Subjects can be divided according to the number ofpanel members. Number of panel members are fixed according to subdivision of points in thesubject. Relevant materials and handout may be given in advance to the learners. The monitor ormoderator introduces the subject of discussion and invites a panel member to start the discussion.Each panel member is invited for discussion afterwards. After briefing by the panel members thequestions are raised from the audience and the panel members give suitable answer to them. Areport should be submitted by each learner to the moderator.

IV. Project

Project is a self-learning strategy which can exert great influence on the overall development ofthe learner. Project as learning strategy is to be selected where a problem arises in any part of thecurriculum. The students may be divided into groups and assigned different aspects of the problem.

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Each group works independently .Specific aspects of the problem such as data collection,classification, analysis, report preparation and presentation is to be undertaken by each of themembers. Even though the work is divided among the members, it must be ensured that theexecution of each and every activity is done with the active participation of all. After analyzingdata collected from different sources, the learner arrives at a conclusion that can help to solve theproblem. Thereby learner learns the topic though his own activity. The other advantage of thislearning activities is that it helps the learner to scientifically handle any problematic situation. Ithelps in the development of scientific thinking and thereby builds up the students aptitude for thesubject.

Stages of the project

1. Selection of a topic

The project selected should be related to the curriculum and it should not be a project forprojects sake. The topic or problem should arise from the curriculum.

2. Planning of the Project

(a) Hypothesizing: Hypothesizing means making assumptions based on the availableprimary information.

(b) Methods and Technique : The methods and Technique should be based on the aimand Hypothesizing of the Project. The nature of the project, suitability of the tools,and the methods of learning should be related to each other.

3. Collection and Tabulation of Data

The data may be primary, secondary or tertiary. Either census or sampling method can be usedbased on the objective of the project. Suitable questionnaires are to be prepared for thecollection of primary data.

The collected data is to be classified and tabulated so as to make it easily understandable.

4. Analysis of data and formulation of conclusion

By analyzing the data, the reliability of the hypothesis can be examined. Preparation of graphsand diagrams and maps will positively help the analysis. The similarities, relations and differencesgathered from the analyzed information would tell whether the hypothesis should be accepted orrejected.

5. Preparation of Report

The cover page should have the title of the project, the period of study, name (s) of investigator/group, and the address of the school. The report should be structured in the following order.

1. Title

2. Preface

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3. Hypothesis and aim

4. Methodology

5. Sources of data

6. Analysis and conclusion

7. Suggestions (if any)

8. References

9. Appendices (Questionnaire, Observation schedule, check list Etc.)

6. Presentation of the Project

When the project is presented , the learner is being evaluated and accepted. It is through thispresentation that ideas are shared with others in the class and society.

The project methods promotes scientific self learning and makes him capable of solving theproblem arising in real life situations.

V. Debate

Debate is a hot and interesting learning activities. A debate can be organized only on a topic onwhich there is difference of opinion. Therefore a topic suitable for debate has to be chosen.

Debate can be on relevant topic that is different and interesting to the students and relevant tosociety. Students with different opinions have to be identified for discussion. Those who havesimilar opinion should join together to form a side . Those who hold the opposite view with formthe other side. It would be ideal to write down the topic of the debate and displayed in advance.There should also a person to control debate.

Students should be given opportunity to absorb the ideas obtained from discussion and debate,develop the idea through reading and study, and to express them through writing or other means

Stage of Debate

1. Topic Selection

2. Selection of panels keeping in balance with intelligence, gender etc.

3. Selection of moderator

4. Collection of information guided by the teacher

5. Conducting the debate under the control of moderator by avoiding any sort ofpersonal conflicts

6. Conclusion by the moderator expressing his final version or verdict.

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VI. Case Study

A case may be a person, institution or a community case study is an in-depth analysis of an actualevent or situation. It presents real pictures of situation with facts, objective information or data.Learners analyses the case to interpret, predict and resolve issues associated with it. The casestudy provides the learner an opportunity to analyse and apply concepts, data and theory taughtfrom the class. Learners can work individually or in groups.

By studying realistic cases in the classroom, students develop new insights into the solution ofspecific on – the – job problem and also acquire knowledge of the latest concepts and principlesused in problem solving.

Case may be presented by the teachers or may be provided in print form.

A simple case study may have the following steps

1. Collection of data

2. Conversion of data into information

3. Analysis of the case in groups

4. Presentation of the finding by each group leader.

5. Evaluation

In addition to the above mentioned learning strategy there are many other learning strategieswhich can be used in appropriate situations to enrich leaning process such as problem solving,Role play, brain storming, debate etc.

VII. Brain Storming

This is the best method for solving creative problems. It facilitates generation of ideas quickly.Rules for conducting Brain storming.

1. No response is wrong. So welcome every response.

2. Welcome as many responses as possible

3. No criticism is allowed

4. Allow to work on others idea

Steps in Brain storming

1. Presentation of the problem

2. Provide relevant information

3. Record the ideas put forth by the participants

4. Combine similar ideas

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5. Evaluate each idea and solution

6. Selection of the best solution

If brainstorming is used as an instruction strategy, the last step is not essential

VIII. Discussion

Discussion is essential for the student to share new finding, idea and conclusion at each stage oflearning with fellow students and teachers. In general discussion the teachers should guide thediscussion through questioning and summarizing. The major steps involved are

1. Introduction initiated by the teacher

2. Development of discussion by giving lead points and follow up interactions

3. Transaction stage in which the key points are reviewed by the teacher and

4. Summarizing stage in which teacher provides additional support materials to ensurethe achievement of the objectives

IX. Group Discussion

Group discussion is an ideal method to develop cooperation, democratic attitude, friendlinessand compromising attitude which are the ultimate aims of education. During group discussionthe teacher may observe each group and it needed help them to channel the discussion towardsthe common objectives. All students may be given opportunity to take part and express theirideas within a time limit. The conclusion reached may be entered by each student. A grouprepresentative must present this during consolidation in which the teacher may correct or addinformations to ensure that all the relevant ideas have been covered

X. Collection

Collection is a continuous learning activity, which ensures complete participation of students.The collected item may be materials, pictures, charts, ideas, data etc. Collection providesdirect experience to learn. An exhibition of collected materials will help to strengthen the concept.

XI. Practical works

Experimentation contains the process skill in an integrated way. In the new approach of curriculumthe student forms idea and comes to conclusion through process. The term ‘Practical ‘whenassociated with a science subject usually means an experiment. The objective of doing anexperiment is to explore new ideas through investigation only. Its main purpose is to verifysome principles associated with theory. The subjects end here. But this is not the case with‘Vocational Practical’

The ultimate goal of a Vocational Education is to generate skill through continuous practicealong with investigation and invention. Continuous practice transforms the unskilled to the skilled.This is the significance and importance of practical in the Vocational stream. Hence it is very

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crucial that Vocational teachers as well as instructor should understand the importance of vocationalpractical and act accordingly.

XII. Quiz

Quiz programmes can be used as an interesting class room tool for transaction of curriculumobjectives as well as to evaluate the effectiveness of transaction and achievement of students.

For conducting a quiz programme a topic should be selected based on the above objective

The students are asked to prepare questions based on the topic individually. The next day / nexthour the students are grouped into 3-4 groups randomly. A question is raised by a particularteam and the other teams to answer them if they can answer the question they get points for thatif all other teams fail to answer the question raised by the 1St team the 1st team answer thequestion and explain the background if necessary. All the teams get equal number of chances toask the question . Time limit is also prescribed for the conduction of the programme. The teamwho scores maximum points wins

All the participants can make notes on the questions asked, answers and their explanationswhich help them in learning

XIII. Models

Models are used in learning process. It enhance the leaning experience. This is based on the‘seeing is believing”. It helps the learner a chance to see feel the model presented . Still modelsand working models help the students to understand the structure, working principles, actualoperation etc.

Several steps are involved

1. Locating the problem

2. The teacher should plan the type of model according to co’s

3. Grouping the students

4. Briefing the tasks

l Aim

l Need

l Material required

l Source & Materials

l Cost of materials

l Division of Labour

l Guidance

l Fixing of a time limit

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5. Presentation by each group about

l How the models were prepared

l Details of - Expenses

l Working and principles

l Finally documentation of the process

6. Evaluation

l By the other groups

l Later a consolidation by teachers are to be done.

XIV. Games

Class rooms can be made attractive by introducing different types of games. Games should beinteresting as well as informative. Some of suitable games are

1. Odd man out

2. Cross word puzzles

3. Match the following

4. Aswamedham

5. Link game – Answer using clues.

XV. Survey

This strategy involves collection of data from the group under study (book, person, materialsetc.) It develops the social interaction and communication ability of the learner. It also provides ascope for discovery learning.

Step involved in survey

1 Objective of survey

2 Selection of area for survey/sampling frame

3 Selection of survey method

Direct method

With help of questionnaire/schedule

1 Tabulation and analysis

2 Consolidation and Presentation

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XVI. Exhibition

It is a learning strategy by which the learner can get a chance to show the skill developed. Itprovides the intrinsic motivation and exposure.

Exhibition item can be conducted either individually or as a group task. It can be conducted atschool / Regional/State/National level. Necessary publicity and other arrangements can beprovided. Presentation, documentation, participation and innovative skills of the learner can beevaluated.

XVII. Interview

Interview is one of the important learning strategies taking the help of a resource person. Interviewis an inner view. It provides opinion and information about a topic.

An interview is conducted by the following steps

1. How to introduce a problem?

2. Invite a resource person

3. Decide the questions by learners

4. Decide the time, place etc.

5. How to discuss?

6. How many students to participate?

7. Implementation of the interview

8. Conclusion (Facilitator)

Items required

1 Interview Schedule

2 List of questions prepared by learners Selection of students, selected names sequenceof question

XVIII. Field Visit

Field visit is an inevitable vocational tool to be implemented in vocational Higher SecondaryEducation. This helps the students to familarise with the modern technologies and new situationin a different atmosphere. It provides learning though viewing. It is based on the principle thatseeing is better than having. It enables the learning to retain the learned information longer and tomake the subject more interesting. It motivates and give more confidence in his/her particularvocation.

The facilitator should identify suitable center/ institution/site. Get prior permission from theauthorities before conducting the field visit. Give instructions to the learners for collection data/

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information/materials/specimens. Teacher may assign different duties to learners by working themdifferent groups.

Each learner should take utmost care and interest during the visit. He/She should observe andinteract at the center/ institution where the field visit is conducted

After the visit, learner should acquire the ability to apply the ideas/concepts in his future carrier.Each learner should submit a detailed report about the field visit.

XIX. Demonstration

Though demonstration we can present an item/product and emphasis its features very effectively.

Eg:- To understand the functioning of a computer

1. Material/Item/Process

2. Demonstration

3. Venue

4. Additional requirements depending upon the nature of the item

Demonstration Process

1. Introduction about the item/Material

2. Principles – Working

3. Operation

4. Components

5. Merits of the item

XX. Chart display

It is also one of the important teaching aids. It can be used in every activities of a learningprocess.

Chart display is a written or pictorial representation of idea or concept. It is abbreviate, brief andclear. It is prepared by study

Benefits

1. A learner gets clear idea about the concept

2. The leaner can retain the ideas in his mind for longer periods

3. A complicated idea can be simplified though a chart

Cheap method of teaching aid.

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Unit I - Laboratory ethics and Management1. To understand the role of Laboratory in health care, duties , responsibilities and

code of ethics of laboratory technician through discussion, fields visit, role play,brain storming, demonstration etc., and prepare notes and field visit report.

2. To understand how to plan and organize a routine laboratory and to familarise withthe purchasing of laboratory materials through discussion, project, field visit chartand model preparation, collection and prepare report/record/file etc.

3. To understand laboratory safety, personal care, handling and storage of chemicals,laboratory hazards and first aid through discussion, demonstration, seminar, fieldvisit, assignment and prepare notes/record/report.

Unit 2 - Hematology1. Introduction to hematology

4. To understand the different methods of blood collection and to develop skill in per-forming capillary and venous blood collection technique through discussion, dem-onstration, practical work and prepare record/report.

5. To understand about different anticoagulants for blood collection and to prepareEDTA anticoagulated bottle through discussion, demonstration, assignment, practi-cal work, flow chart preparation and prepare notes/record

2. Total Cell Count

6. To understand the different methods of cell counting and to acquire skill to performtotal and absolute blood cell counting by discussion, practical work, demonstration,field visit and prepare notes/ record.

3. Examination of blood smear

7. To understand and develop skill to perform differential leucocyte count and periph-eral smear examination through discussion, demonstration/practical work, chartpreparation and prepare notes/record.

4. Haemoglobin estimation

8. To understand and to perform Sahli’s and Cyanmethaemoglobin estimation throughdemonstration, practical, survey, discussion and prepare note and record.

5. Packed Cell Volume

9. To understand and to perform PCV through discussion, demonstration and practi-cal work, prepare notes/record.

Curriculum Objectives

37

6. Red Cell Indices

10 . To acquire an idea about red cell indices through discussion comparison, calculationand prepare notes.

7. Erythrocyte Sedimentation Rate

11. To understand and perform ESR by Westergren’s method through discussion, dem-onstration, practical work, prepares notes and record.

8. Coagulation studies

12. To understand various coagulation tests like BT, CT, PT and to perform Duke’s orIvy’s method, Lee & White method, Capillary tube method through discussion,demonstration and practical work prepare note/record.

9. Special Investigations

13 To understand about reticulocyte and reticulocyte count through discussion, dem-onstration and prepares note.

14. To acquire basic idea about Osmotic fragility test (OFT), LE Cell test and Sicklingtest through discussion, reference, demonstration etc., and prepare notes.

Unit 3 - Clinical Pathology

1. Introduction to clinical Pathology

15. To have an idea about the importance of Clinical Pathology and types of specimenused through discussion, demonstration, field visit and prepare report.

2. Urine Analysis

16. To understand collection, normal and abnormal constituents, physical, chemical andmicroscopic examination of urine through discussion, quiz, field visit, demonstration,practical work, comparison, prepare notes, diary, record /report and Assignment.

17. To get an idea about the importance of pregnancy test and to perform the card testthrough discussion, demonstration, practical work, prepare notes and record.

3. Stool Examination

18. To understand the importance, sample collection and to perform macroscopic andchemical examination of stool by discussion, demonstration, practical work, pre-pares notes, report and assignment.

4. Sputum Examination

19. To understand the importance, collection of sputum and to perform macroscopicand microscopic examination of sputum through discussion, demonstration, practi-cal work, prepares note and record.

38

5. Semen Analysis

20. To understand the importance, sample collection and to perform macroscopic, mi-croscopic and chemical examination of semen through discussion, practical workprepares record and note.

6 CSF Examination

21. To understand the importance, collection, macroscopic examination and biochemi-cal examination of CSF through discussion, demonstration, field visit and preparenotes.

Unit 4 - Immuno Hematology and Blood Banking

1. Introduction to Immuno hematology

22. To acquire basic idea about the antigen antibody and historical aspects of bloodbanking through discussion, reference and prepare notes.

2. Blood group system

23. To understand ABO and Rh blood group system and to have basic idea aboutBombay blood group, HDN and blood group inheritance through discussion, refer-ence, demonstration, assignment, chart preparation, prepare notes.

3. Blood grouping

24. To understand the basic principles of blood grouping - forward and reverse group-ing and different methods through discussion, demonstration and reference

25. To perform ABO and Rh typing by slide method and tube method through demon-stration, practical work, camp, prepare record/report.

4. Coomb’s Test

26. To acquire basic idea about the importance and different types of Coomb’s testthrough discussion, reference, demonstration, field visit and prepare notes/report.

5. Cross matching

27. To familiarise with importance and different methods of cross matching through dis-cussion, demonstration, reference, fields visit and prepare note/report.

6. Blood Transfusion

28. To get an idea about the importance of blood transfusion and understand aboutscreening of donor, anticoagulants, blood collection, procedure and storage throughdiscussion, reference, field visit, demonstration etc., and prepare note/record anddevelops a positive attitude to donate blood to the needy ones.

29. To identify different components used for blood transfusion and transfusion reac-tions through discussion, reference, field visit etc., and prepare notes/record.

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Unit 5 - Biochemistry1. Introduction to biochemistry

30. To acquire an idea of the importance of biochemistry and different types of solutionsand to perform cleaning of glass wares and preparation of chromic acid solutionthrough discussion, demonstration, practical work prepare notes/record.

2. Instruments used in Biochemistry

31. To acquaint with the use and care of analytical balance, centrifuge and distillationapparatus through discussion, demonstration and prepare notes/record.

32. To understand the principle, parts, working, use and care of colorimeter and to havean idea about spectrophotometer, flame photometer and micropipette through dis-cussion, reference, demonstration, practical work, prepare notes/record.

3. Estimation of Blood Sugar

33 To acquaint with the different types of blood samples, anticoagulants used and dif-ferent methods for blood sugar estimation through discussion, reference and pre-pare notes

34 To perform blood sugar estimation by O.Toludine and GOD-POD method throughdemonstration practical work prepare record/report.

35. To get an idea about glucose challenge test and glucose tolerance test through dis-cussion, reference and prepare notes.

4. Estimation of Proteins

36. To acquire idea of plasma proteins and to perform total protein estimation by Biuretmethod, Albumin estimation by BCG method through discussion, reference, practi-cal work etc., prepare record/report.

5. Estimation of NPN Substances

37. To get an idea about the different NPN substances and to perform blood urea(Berthlot method) and creatinine estimation (Alkaline Picrate Method) through dis-cussion, reference, demonstration, practical work and record/report.

6. Estimation of Lipids

38. To acquire an idea about different classes of lipoprotein, their clinical significanceand to perform cholesterol estimation (enzymatic method) through discussion, ref-erence, demonstration, practical work and prepare notes/record.

7. Liver Function Tests

39. To get an idea about the importance of Liver Function Tests, various Liver FunctionTests and able to perform serum bilirubin estimation through discussion, reference,demonstration prepares note/record.

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8. Renal Function Test

40. To get an idea about Renal Function tests, various renal function tests, urea andcreatinine clearance test through discussion, reference and prepare notes.

9. Automation and quality Control

41 To understand the term automation and have a general idea about automation inbiochemistry through discussion, reference, field visit and prepare record/report.

42. To understand the need of quality control and method for attaining quality controlthrough discussion, reference, field visit and prepare record/report.

Unit 6 - Histotechnology and Cytology1. Introduction of Histotechnology

43. To acquire a basic idea about collection, reception and labeling of specimens in ahistopathology Lab through discussion, demonstration, field visit and prepares note.

44. To get a brief idea about different steps in tissue processing, sectioning, staining,mounting and automatic tissue processor and prepare notes.

2. Cytology

45. To get a basic idea about the uses of cytology, different types of specimen, methodsof collection, fixation and the commonly used cytological staining through discus-sion, demonstration, field visit and prepare notes.

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Second year

Unit Name of Unit Theory Practical Field TotalNo. hrs. hrs. visit/OJT hrs.

I Laboratory ethics and management 10 hrs. 20 hrs. 10 hrs 40 hrs.

II Haematology 40 hrs. 140 hrs. 20 hrs 200 hrs

III Clinical pathology 25 hrs. 50 hrs. 20 hrs 95 hrs

IV Immuno haematology and blood banking 20 hrs. 10 hrs. 20 hrs. 50 hrs

V Biochemistry 35 hrs. 100 hrs. 20 hrs. 155 hrs

VI Histotechnology and cytology 10 hrs. - 10 hrs 20 hrs

Total 140 hrs. 320 hrs. 100 hrs 560 hrs

Vocational Higher Secondary EducationMEDICAL LABORATORY TECHNICIAN COURSE

SYLLABUS

42

Unit - 1Second Year

Sl. No. Chapter Name Theory Practicalhrs. hrs.

1. Laboratory ethics and management 10 hrs. 20 hrs.Field visit - 10 hrs.Total 10 hrs. 30 hrs.

Laboratory ethics and management

Unit - 2Sl. No. Chapter Name Theory Practical

hrs. hrs.1. Introduction to haematology 5 hrs. 10 hrs.2. Total cell counts 7 hrs. 45 hrs.3. Examination of blood smear 5 hrs. 30 hrs.4. Haemoglobin estimation 5 hrs. 24 hrs.5. Packed cell volume 3 hrs. 12 hrs.6. Red cell indices 2 hrs. -7. Erythrocyte sedimentation rate 4 hrs. 15 hrs.8. Coagulation studies 4 hrs. 4 hrs.9. Special investigations 5 hrs. -

Field visit - 20 hrs.Total 40 hrs. 160 hrs

Haematology


hrs. hrs.1. Introduction to clinical pathology 1 hr. -2. Urine analysis 12 hrs. 30 hrs.3. Stool examination 5 hrs. 10 hrs.4. Sputum examination 2 hrs. 5 hrs.5. Semen analysis 3 hrs. 5 hrs.6. CSF examination 2 hrs. -


Clinical pathology

43


hrs. hrs.1. Introduction to immuno haematology

and blood banking 3 hrs. -2. Blood group systems 4 hrs. -3. Blood grouping 4 hrs. 8 hrs.4. Coomb’s test 3 hrs. -5. Cross matching 2 hrs. -6. Blood transfusion 4 hrs. 2 hrs.


Immunohaematology andblood banking


hrs. hrs.1. Introduction to biochemistry 2 hrs. 8 hrs.2. Instruments used in biochemistry 4 hrs. 8 hrs.3. Estimation of blood glucose 5 hrs. 24 hrs.4. Estimation of proteins 4 hrs. 12 hrs.5. Estimation of NPN substances 5 hrs. 24 hrs.6. Estimation of lipids 4 hrs. 12 hrs.7. Liver function tests 4 hrs. 12 hrs.8. Renal function test 4 hrs. -9. Automation and quality control 3 hrs. -

Field visit - 20 hrsTotal 35 hrs. 120 hrs

Biochemistry


hrs. hrs.1. Introduction to Histotechnolgoy 8 hrs. -2. Introduction to Cytology 2 hrs. -

Field visit 10 hrs.Total 10 hrs. 10 hrs.

Histotechnology and Cytology

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Unit - 1 Laboratory ethics and management

Unit - 2 Haematology

1. Laboratory ethics and management 10 hrs.- Role of laboratory in health care.- Duties and responsibilities of lab technicians.

- Code of ethics of laboratory technician.

- Planning and organization of routine lab.

- Lab safety and personal care.

- Handling and storage of chemicals.

- Laboratory hazards

Biohazards, electrical hazards, chemical hazards, cuts and wounds

- First aid practice.

- Method of ordering, purchasing and utilization of supplies.

1. Introduction to haematology 5 hrs.- Introduction.

- Methods for collection of blood.

- Capillary and venous blood collection.- procedure and precautions.

- Anti-coagulants and its classification.

- Explain each anticogulant in detail - EDTA, sodiumcitrate, oxalates, Heparin fluorideoxalate mixture, ACD, CPD, CPD - A

2. Total cell counts 7 hrs.- Introduction

- Different methods - manual and automated.

- Manual method of cell counting.

- Mention the different - types of counting chambers.

- Explain improved neubauer counting chamber in detail.

- Dilution method - Pipette dilution and bulk diluation.- RBC pipette, WBC pipetts.

45

- Principle, diluting fluid, procedure, calculation, normal value and interpretation of- RBC count, WBC count, Platelet count, Absolute eosinophil count.

- Automated technique (Brief only)

3. Examination of blood smear 5 hrs.- Preparation of blood smear.

- Characteristics of an ideal smear.

- Factors influencing an ideal smear.

- Staining- Romanowsky stains- Preparation of Leishman’s stain- Leishman’s staining procedure

- Differential leucocyte count- Counting technique- Normal value and clinical significance

- Peripheral smear examination- RBC- Normal size, shape, colour

- Hypochromatia, hyperchromatia- Abnormal RBC

-WBC- Name the abnormal WBCs.-Platelets - Normal and arrangement.

4. Haemoglobin estimation 5 hrs.- Name the different methods of Hb estimation.

- Principle, requirments, procedure, advantage, disadvantage and normal value of sahli’sacid haematin method in detail.

- Principle, requirements, procedure, calculation, normal value, advantage, disadvantageand interpretation of cyanmeth haemoglobin method - clinical significance.

- Preparation of standard graph of cyanmeth method.

5. Packed cell volume 3 hrs.- Introduction to packed cell volume.

- Method of doing PCV - macro method and micro method.

- Explain the principle, requirements, procedure, normal value and interpretation ofWintrobe’s method.

6. Red cell indices 2 hrs.- Importance, calculation and normal value of MCV, MCH, MCHC and MCD.

46

7. Erythrocyte sedimentation rate 4 hrs.- Introduction.

- Different methods of ESR determination: Westergren’s method, Wintrobe’s method.

- Describe the principle, requirments, procedure, normal value and interpretation of ESRby Westergren’s method.

- Stages of ESR.

- Factors affecting ESR.

- Clinical significance.

8. Coagulation studies 4 hrs.- Review of coagulation.

- Coagulation factors.

- Name the various cogulation tests.

- Explain:- Bleeding time by Ivy’s method and its interpretation- Clotting time by Capillary tube method and Lee & White method.- Prothrombin time by Quick’s one stage method.

9. Special investigations 5 hrs.- Know about reticulocyte and reticulocyte count.

- Supravital staining, counting, calculation, normal value and interpretation.

- Basic description of osmotic fragility test.

- Basic knowledge of auto immune disease and LE cell test.

Unit - 3 Clinical pathology

1. Introduction to clinical pathology 1 hrs.- Importance of clinical pathology.

- Different types of samples used.

2. Urine analysis 12 hrs.- Collection of urine sample - different types of samples.

- Brief description of normal and abnormal constituents of urine.

- Examination of urine.

- Physical examination.

47

- Volume, colour, specific gravity and reaction.

- Chemical examination.

Principle, reagents, procedure and interpretation of common abnormal constituentssuch as:

Sugar - By Benedict’s test

Protein - By Heat and acetic acid test

Ketone bodies - By Rothera’s test

Bile Pigment - By Fouchet’s test

Bile salt - By Hay’s test

Urobilinogen - By Ehrlich’s test

Blood - By Benzidine test

- Microscopic examination of urine

- preparation of urine for microscopic examination.

- demonstration of crystals, cells and casts.

- Pregnency test

- Importance of test

- Name different methods

- Procedure of card test

3. Stool examination 5 hrs.- Importance of stool examination

- Sample collection

- Macroscopic examination

- Consistency, Colour, Mucus and Parasites

- Microscopic examination

- Saline preparation

- Iodine preparation

- Concentration by saline floatation

- Chemical examination

- Occult blood - Benzidine test

- Reducing substances - Benedict’s test

48

4. Sputum examination 2 hrs.- Importance of sputum examination.

- Sample collection


- Consistency and Colour


- AFB staining

- Gram’s staining

5. Semen analysis 3 hrs.- Importance of semen analysis

- Sample collection


- Volume, viscosity, colour, reaction and liquefaction time


- Motility

- Total sperm count

- Morphology of spermatozoa

- Other cells

- Chemical examination

- Name the different tests - Fructose, Acid phosphatase

6. CSF examination 2 hrs.- Importance of CSF examination.

- Mention the method of CSF collection.


- colour, turbidity and appearance


- total count, differential count, Gram’s staining and AFB staining

- Bio-chemical examination

- Name different tests done - sugar, protein and chloride

49

1. Introduction to immuno haematology 3 hrs.- Mention the different types of antigen and antibody.- Introduction to blood banking - Historical aspects.

2. Blood group system 4 hrs.- Mention different blood group system.- Explain ABO blood group system.- Brief idea about Bombay blood group.- Explain Rh system.- Brief description of HDN.- Elementary knowledge of inheritance of blood group.

3. Blood grouping 4 hrs.- Basic principles of blood grouping.- Brief description of forward and reverse typing.- Methods for ABO and Rh typing (slide, tube and tile technique)

4. Coomb’s test 3 hrs.- Importance of Coomb’s test.- Mention different methods DCT and ICT.

5. Cross matching 2 hrs.- Clinical importance of cross matching.- Mention the different method of cross matching (Tube method).

- Saline phase, Albumin phase, AHG phase.

6. Blood transfusion 4 hrs.- Importance of blood transfusion.- Criteria for screening of donor.- Mention the anticoagulant for blood collection.- Explain blood collection procedure.- Brief description of blood storage.- Blood components

- Mention different components used for blood transfusion.- Whole blood, packed cell, cryoprecipitate, platelet rich plasma and fresh frozen plasma.

- Transfusion recations

- Name transfusion reactions.

Unit - 4Immuno haematology

and blood banking

50

1. Introduction to bio-chemistry 2 hrs.- Importance of bio-chemistry.

- Brief discussion on different types of solution - Percentage solution, Molar solution,Normal solution, Standard solution and Saturated solution.

- Cleaning of glassware

- General cleaning.

- Chromic acid solution.

2. Instruments used in biochemistry 4 hrs.- Use and care of analytical balance, centrifuge and distillation apparatus,

- Explain the principle, parts, working use and care of colorimeter.

- Familiarise with Spectrophotometer, Flame photometer, Micropipettes.

3. Estimation of blood sugar 5 hrs.- Estimation of blood glucose.

- Collection of blood for sugar estimation.

- Anticoagulant used.

- Familiarise the term FBS, RBS and PPBS.

- Name different method for blood sugar estimation.

- Explain the principle, requirements, procedure, normal value and clinical significance ofblood sugar estimation.

- O-Toludine method

- GODPOD method

- Brief description of

- Glucose challenge test and Glucose tolerance test.

4. Estimation of proteins 4 hrs.- Introduction to plasma protein.

- Explain the principle, reagents (name only), procedure and calculation of total protein byBiuret method.

- Explain the principle, reagents (name only), procedure and calculation for the estimationof albumin by BCG method.

- Normal value and clinical significance of total protein and albumin.

Unit - 5 Bio-chemistry

51

5. Estimation of NPN substances 5 hrs.- Mention the different NPN substances and its importance.

- Mention the different methods of blood urea estimation.

- Explain the principle, procedure and calculation of blood urea estimation by Berthlotmethod.

- Normal value and clinical significance of blood urea.

- Mention the different methods of serum creatinine estimation.

- Explain the principle, procedure and calculation of serum creatinine estimation by alkalinepicrate method.

- Mention normal value and clinical significance of serum creatinine.

6. Estimation of Lipids 4 hrs.- Mention different classes of lipoproteins and their clinical significance.

- Explain the principle, procedure and calculation of serum cholesterol by enzymaticmethod. (cholesterol - esterase - dehydrogenase)

- Normal value and clinical significance of serum cholesterol

7. Liver function tests 4 hrs.- Importance of LFT.

- Name different liver function tests

- Explain Malloy and Evelyn method for Bilirubin estimation.

- Mention its normal value and clinical significance.

8. Renal function test 4 hrs.- Importance of RFT.

- Name different renal function tests.

- Brief description of urea clearance and creatinine clearance test.

9. Automation and quality control 3 hrs.- Understand the term automation

- General idea about automation in bio-chemistry.

- Need of quality control

- Method for attaining Q.C.

52

1. Introduction of Histotechnology 8 hrs.- Mention the important steps in the preperation of a tissue for microscopic examination

(brief idea only)

- Collection, reception and labelling.

- Fixation (routine formalin fixative only), dehydration, clearing, impregnation, embedding and section cutting.

- Name the common staining and mounting method.

- Brief description about automatic tissue processor.

2. Introduction to Cytology 2 hrs.- Mention the uses of cytology, specimens, name the methods of collection and fixation of

a smear.

- Name the commonly used staining method in cytology.

Unit - 6 Histotechnology and Cytology

53

Second YearSl. Practical hoursNo.

I. Laboratory ethics and management1. Demonstration of common signs and symbols used in clinical laboratory. 82. Familiarise with different types of request/report forms and method of 4

reporting.3. Familiarise with maintenance of stock registers - consumable and 4

nonconsumable.4. Familiarise with the layout plans of a basic laboratory. 4

Field visit 10Total 30

II. Haematology1. Blood collection technique - capillary and venous blood collection 62. Preparation of EDTA auticoagulated bottles 43. Haemocytometer - familiarise with RBC pipette, WBC pipette, 12

improved neubauer counting chamber4. Preparation of normal saline 45. Preparation of Tuerk’s fluid 46. Total RBC count. 67. Total WBC count 68. Total platelet count. 79. Absolute eosinophil count. 610. Preparation of blood smear. 711. Preparation of Leishman’s stain. 612. Differential leucocyte count. 1513. Demonstration of abnormal blood cells by photographs or slides. 214. Haemoglobin estimation - Sahli’s method. 1215. Hemoglobin estimation - cyanmethaemoglobin method. 1216. Packed cell volume - Wintrobe’s method. 1217. Preparation of 3.8% sodium citrate. 318. Erythrocyte sedimentation rate - Westergren’s method. 1219. Bleeding time - Duke’s or Ivy’s method. 220. Clotting time - capillary tube method. 2


54

III Clinical Pathology1. Preparation of 5% acetic acid solution. 22. Physical examination of urine. 43. Chemical examination of urine. 164. Microscopic examination of urine. 65. Demonstration of pregnancy test in urine. 26. Macroscopic examination of stool 27. Microscopic examination of stool 48. Chemical examination of stool (occult blood and reducing substances) 49. Sputum examination. 510. Semen analysis 5

Field visit 20Total hours 70

IV. Immunohematology and blood banking1. ABO grouping and Rh typing - slide method. 32. ABO grouping and Rh typing - tube method 53. Demonstration of blood collection equipments - blood bag. 2


V. Biochemistry1. Preparation of chromic acid solution. 32. Cleaning of glass wares. 53. Colurimeter - parts, operation and care. 84. Estimation of glucose (O-toluidine method) 125. Estimation of glucose (GOD-POD method) 126. Estimation of total protein (Biurete method) 67. Estimation of albumin (BCG method) 68. Estimation of urea (Berthlot method) 129. Estimation of serum creatinine (alkaline picrate method) 1210. Estimation of serum cholesterol (enzymatic method) 1211. Estimation of serum bilirubin (Malloy - Evelyn method) 12


VI Histotechnology and CytologyField visit 10Total 10

55

PLANNINGYEAR PLAN – II YEAR

Chapter Name Theory Practical Month Plannedto teach

Unit 1. Laboratory Ethics & Management1. Laboratory Management & Ethics 10 Hrs 20 Hrs June

Unit 2. Haematology1. Haematology 5 Hrs 10 Hrs June2. Total cell counts 7 Hrs 45 Hrs June3. Examination of blood smear 5 Hrs 30 Hrs July4. Haemoglobin estimation 5 Hrs 24 Hrs July5. Packed cell volume 3 Hrs 12 Hrs July6. Red cell indices 2 Hrs - July7. Erythrocyte sedimentation rate 4 Hrs 15 Hrs August8. Coagulation studies 4 Hrs 4 Hrs August9. Special investigations 5 Hrs - September

Unit 3. Clinical Pathology1. Introduction to Clinical Pathology 1 Hr - September2. Urine analysis 12 Hrs 30 Hrs September3. Stool examination 5 Hrs 10 Hrs October4. Sputum examination 2 Hrs 5 Hrs October5. Semen examination 3 Hrs 5 Hrs October6. CSF examination 2 Hrs - October

Unit 4. Immuno Haematology & Blood Banking1. Introduction 3 Hrs - October2. Blood grouping systems 4 Hrs - November3. Blood grouping 4 Hrs 8 Hrs November4. Coomb’s test 3 Hrs - November5. Cross matching 2 Hrs - November6. Blood transfusion 4 Hrs 2 Hrs November

Unit 5. Biochemistry1. Introduction to Biochemistry 2 Hrs 8 Hrs December2. Instruments used in Biochemistry 4 Hrs 8 Hrs December3. Estimation of blood glucose 5 Hrs 24 Hrs December4. Estimation of proteins 4 Hrs 12 Hrs January5. Estimation of NPN substances 5 Hrs 24 Hrs January6. Estimation of Lipids 4 Hrs 12 Hrs January7 Liver function tests 4 Hrs 12 Hrs January8 Renal function tests 4 Hrs - January9 Automation & quality control 3 Hrs - January

Unit 6. Histotechnology & Cytology1. Introduction to Histotechnology 8 Hrs - February2. Introduction to Cytology 2 Hrs - February

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60

Evaluation is a systematic process of collecting, analyzing, synthesizing and interpreting evidencesof students’ progress and achievements both in cognitive and non-cognitive areas of learning.Evaluation has to play significant role in making the learning process more effective. It providesdiverse experiences to the learners, keeping in view the skill to be attained continuously by them.

As the curriculum is based on a particular vocation the selected stream is the most important partand it should be evaluated accordingly. Technical skills, interest and devotion in the field, com-munication skills, organizational and presentation skills are to be evaluated. Evaluation of thepersonal and social qualities also should be done. So the evaluation should be continuous andcomprehensive.

Terminal or Term End Evaluation (TE)

It is the written form of evaluation aimed at evaluating the facts, concepts and ideas gained bythe learner. The test should not be aimed to evaluate the memory alone. Questions are framed insuch a way that the learners are able to apply different mental process while answering. TheTerminal Evaluation questions give more emphasis on application, analysis and synthesis level.

The maximum scores for TE is 80 and the minimum is 24 (30%). The questions should beformulated taking into consideration the time required to read, think, understand and write an-swers. These aspects should be considered while fixing the scores also. To avoid blind guessing,multiple choice and application level questions may be mixed. The total number of questions mayvary from time to time. All the questions should be based on the curricular objectives. Openended questions may be included. Choice questions, if included also should be based on thesame curricular objectives.

Continuous and comprehensive evaluation (CCE)

Our traditional evaluation methods measure only the memory and recollection capacity of thelearner. To eliminate/ overcome the limitation the evaluation should be done on multi dimensionalways by measuring multiple intellectual capacities of the learner. So it is better to evaluate thelearner in a continuous and comprehensive manner. CCE helps the learner to understand anddevelop his own progress and to develop adequate strategies for further improvement.

Merits

1. Assess the all round development of the learner on a continuous basis through avariety of activities.

2. Effective feed back is possible

3. Remedial diagnostic teaching is possible

4. Process as well as products are assessed.

EVALUATION

61

A series of learning activities are grouped into five major thrust areas as follows

Investigative activities

Activities which create a spirit of enquiry, investigation and a mind for research in the learnerbelong to this group.

For example.

1. Study project

2. Case study

3. Field study

Interactive activities

Activities which improve the communication skill, activities of sharing ideas, etc.

For example

1. Seminar

2. Panel discussion

3. Debate

4. Group discussion

Assigned task

Activities assigned to the learners to enrich/ strengthen the concept and ideas.

For example

1. Assignment

2. Collections

Performance task (Tests)

Activities related to the achievements of the learner.

For example

1. Class test (oral/ written/ performance test)

2. Quiz

3. Open book examination

4. Interview

5. Group testing

62

Practical based activities

For example

1. Preparation of working model

2. Album

3. Improvisation

From the above five groups of activities, the teacher has the freedom to choose anythree areas for evaluation purpose.

Sl.No. Stages Criteria Score Total Scores

1. Planning

2. Datacollection

3. Analysis andinference

4. ReportPresentation

5. Viva-Voice

Planning Relevance of the study Identificationof problem Ability to select aPVppropriatetools, ability to select suitable bearing method.

Ability to collect sufficient and relevant data.Ability to classify and arrange data for analy-sis. Reliability and authenticity of the datacollected.

Ability to analyses the data Systematic ar-rangements. Ability to draw inferences basedon analysis. Ability to give suggestions basedon inference.

Ability to present in logical and sequentialorder, authenticity of report, time boundcompletion.

Knowledge of content and process.

Ability to analyses data.

Ability to justify inference.

Ability to explain.

Strategies and methods adopted.

4/3/2/1

4/3/2/1

4/3/2/1

4/3/2/1

4/3/2/1

CE Items

1. Study Project

63

Case Study

Sl.No Criteria Score

1. Identifying the problem 43/2/1

2. Approach to the problem 43/2/1

3. Time bound Action 43/2/1

4. Analysis of the problem 43/2/1

5. Problem solving / Reporting 43/2/1

Field study


1. Attitude and readiness towards the task 4/3/2/1

2. Capacity for Observation 4/3/2/1

3. Data collection 4/3/2/1

4. Application of ideas 4/3/2/1

5. Documentation / Recording 4/3/2/1

Assignment


1. Awareness of the content 4/3/2/1

2. Comprehensiveness of the content 4/3/2/1

3. Systematic and sequential arrangement 4/3/2/1

4. Observation/suggestion/views/judgment/evaluation 4/3/2/1

5. Timely Submission

Seminar


1. Planning and Organization 4/3/2/1

2. Collection and data / content 4/3/2/1

3. Observation / appraisal and clarity 4/3/2/1

4. Content knowledge 4/3/2/1

5. Presentation 4/3/2/1

64

Debate


1. Readiness to participate 4/3/2/1

2. Depth of subject knowledge 4/3/2/1

3. Communication skill 4/3/2/1

4. Ability to justify the stand 4/3/2/1

5. Presentation 4/3/2/1

Group Discussion


1. Readiness to participate 4/3/2/1

2. Depth of subject knowledge 4/3/2/1


4. Ability to justify in a democratic way 4/3/2/1

5. Leadership quality 4/3/2/1

Interview


1. Planning 4/3/2/1

2. Preparation of Questions 4/3/2/1


4. Participation 4/3/2/1

5. Report preparation 4/3/2/1

Practical Evaluation (PE)

The goal of vocational Education is to generate skills through continuous practices along withinvestigation and innovations. Continuous and comprehensive practice transforms the unskilledlearner to a skilled one. This is the importance and significance of vocational practicals.

PE is done to evaluate the practical skills achieved by the learner in the concerned vocationalsubject Total Scores for PE is 150 and minimum is 60 score ie 40%. Practical Examination isconducted for a batch of 8 learners having 6 hours duration.

Practical evaluation should be done taking into account the whole practicals included in thecurriculum since learning of practical skills is a continuous process through out the period ofstudy.

65

Vocational Competency Evaluation (VCE)

Vocational Competency Evaluation is to evaluate the vocational skill and aptitude developed bythe students during the learning process. This is a system to judiciously evaluate the requiredvalue addition and consequent capacity building in the concerned vocational curriculum. Thevocational education is aimed at developing interest, skills and devotion in specific vocationalfields. As other evaluation components like CE. PE and TE cannot assess the vocationalcompetencies and professional skills, acquired by the students an internship evaluation (IE)components has been introduced to meet this requirement.

Internship evaluation should be done based on the following components like regularity andpunctuality, value addition and capacity building.

1. Regularity and punctuality

Regularity and punctuality has vital role in vocational education learning continuous process, theregular presence of the learner is must for attaining maximum efficiency.

2. Value Addition

Value addition is the qualitative measure of the learner’s interest, devotion perseverance andefficiency. Value addition can be evaluated through conducting field visits/ vocational survey. Theexperiences gained through field visit / vocational survey increases the level of intrinsic motivationand positive attitude towards the vocational field and thereby increase his value as asemiprofessional.

3. Capacity Building

It gives a quantitative measure of the student’s skill in graded area exposure. Capacity buildingcan be evaluated through conducting the following activities.

1. OJT / Simulated experiment

2. Performance – camp/exhibition/clinic

3. Performance – PCT/Service cum Training center.

These components help the learner to practise the acquired skills in the real situation and therebyincreasing self-confidence and promoting self reliance.

Vocational Competency Evaluation Indicators

No Items Scores

1. Regularity and punctuality 10

2. Field visit / survey (anyone) vocational project 20

3. OJT/Simulated experiment performance – Camp/exhibition/clinicPerformance – PSCTC (anyone)/Practical skills 20

Total 50

66

1. Regularity and punctuality can be assessed by using attendance of the learner and timebound completion of tasks. It is evaluated by using 5 point grading system.

Rating sclae

Sl.No. Item 1 2 3 4 5

1. Regularity Never After Equally Most of the time Alwaysregular regular regular regular

2. Punctuality Never Often Usually Most of the time Alwaysregular punctual punctual punctual punctual

Item Evaluation indicators Scores Score

Field visit

Value addition 1. Attitude and readiness towards the task 4/3/2/12. Capacity for observation 4/3/2/13. Data collection 4/3/2/14. Application of ideas 4/3/2/15. Documentation/recording 4/3/2/1

OrSurvey1. Planning 4/3/2/12. Data collection 4/3/2/13. Consolidation of data and analysis 4/3/2/14. Drawing inference 4/3/2/15. Reporting 4/3/2/1

Capacity OJT/Simulated experimentBuilding 1. Involvement/participation 4/3/2/1

2. Skills in doing work/ communication skills 4/3/2/13. Time bound action 4/3/2/14. Capacity for observation, analysis and innovation 4/3/2/15. Documentation, recording and display 4/3/2/1

OrPerformance in camp/exhibition/clinic1. Ability for planning and organizing 4/3/2/12. Mastery of subject 4/3/2/13. Ability for communication 4/3/2/14. Innovation 4/3/2/15. Involvement/social commitment 4/3/2/1

Or

67

Performance in production/service cumtraining center (PSCTC)1. Mastery of vocational skills 4/3/2/12. Managerial capacity 4/3/2/13. Promoting self confidence 4/3/2/14. Innovation approach 4/3/2/1

5. Promoting self reliance 4/3/2/1

Consolidated Statement of VCECourse : MLT Year:Class:

Consolidated Grade Record of Vocational Subjects

Course : MLT Year:Class:

Roll. Name of CE TE Grade PE Grade IE GradeNo Pupil 20 80 150 50

Vocational Theory Vocational Practical VCE

Total 100

Roll No Name of Regularity of Value addition Capacity Total GradePupil Punctuality Building Score

(10) (20) (20) (50)

68

Course : MLTYear :

Name of Subjects Term Term Mini.Score

Part I1. English

2. GFC

Part II Voc. Theory

Voc. Practical

VCE

Paper IIIPaper I Physics

Paper IIChemistry

Paper IIIBiology

CETETotalGrade

CETETotalGrade

CETETotalGrade

TotalGrade

IEGrade

CETEPETotalGrade

CETEPETotalGrade

CETEPETotalGrade

I II III I II III

Ist Year II Year

MaxScore

LEARNER EVALUATION PROFILE

69

Con

solid

ated

Sta

tem

ent o

f CE

Cou

rse

:C

lass

:

Sl. N

oN

ame

CE

item

sE

valu

atio

n In

dica

tors

Tot

al (2

0)T

otal

(60)

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rage

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(20)

12

34

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VHSE - MLT - Sourcebook

70

UNIT WISE ANALYSIS


71

LABORATORY ETHICS ANDMANAGEMENT

INTRODUCTION

Medical Laboratory Tests have become a key elementin most diagnostic procedures. The effectiveness of

laboratory medicine in patient care largely depends onethics of the technician. Without the glimpse of ethicsone cannot attain independent professional competency.

This unit enables the learner to get idea about theduties, laboratory ethics, how to manage a clinicallaboratory and role of medical laboratory in health

care. Through this unit the learner become capable insafe laboratory practice and to overcome undue situationif any. An ideal laboratory technician shall consider

his or her profession as one dedicated to the society.The idea obtained from this unit mould the student asa perfect laboratory technician in his/her career.

UNIT1


72

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t I -

Lab

orat

ory

ethi

cs a

nd M

anag

emen

t

1.To

und

ersta

nd th

e rol

e of L

abo-

rato

ry in

hea

lth c

are,

dut

ies ,

re-

spon

sibili

ties a

nd c

ode

of e

thic

sof

labo

rato

ry te

chni

cian

thro

ugh

disc

ussio

n, f

ield

visi

t, ro

le p

lay,

brai

n st

orm

ing,

dem

onst

ratio

net

c., a

nd p

repa

re n

otes

and

field

visit

repo

rt.

2.To

und

ersta

nd h

ow to

pla

n an

dor

gani

ze a

rout

ine l

abor

ator

y an

dto

fam

ilaris

e w

ith th

e pu

rcha

sing

of la

bora

tory

mat

eria

ls th

roug

hdi

scus

sion

, pr

ojec

t, fie

ld v

isit

char

t an

d m

odel

pre

para

tion,

colle

ctio

n an

d pr

epar

e re

port/

reco

rd/fi

le e

tc.

3.To

und

ersta

nd la

bora

tory

safe

ty,

pers

onal

care

, han

dlin

g an

d sto

r-ag

e of

che

mic

als,

lab

orat

ory

haza

rds a

nd fi

rst a

id th

roug

h di

s-cu

ssio

n, d

emon

strat

ion,

sem

inar

,fie

ld v

isit,

assig

nmen

t an

d pr

e-pa

re n

otes

/reco

rd/re

port.

•R

ole

of la

bora

tory

in

heal

th c

are

•D

utie

s an

d re

spon

si-bi

litie

s of

lab

orat

ory

tech

nici

an•

Cod

e of

eth

ics

ofla

bora

tory

tech

nici

an.

•Pl

anni

ng a

nd o

rgan

iz-

ing

of ro

utin

e la

bora

-to

ry•

Purc

hasin

g of

Lab

ora-

tory

mat

eria

ls•

Diff

eren

t typ

es o

f re

-po

rt fo

rms

•La

bora

tory

saf

ety

•Pe

rson

al c

are

•C

omm

on

sym

bols

and

sign

s us

ed i

n a

labo

rato

ry•

Han

dlin

g an

d sto

rage

of c

hem

ical

s•

Labo

rato

ry h

azar

ds•

Firs

t aid

Dis

cuss

ion,

fi

eld

visit

, Dem

onstr

atio

n,ro

le

play

, B

rain

storm

ing

Dis

cuss

ion,

pro

ject

,ch

art

and

mod

elpr

epar

atio

n, c

olle

c-tio

n, F

ield

visi

t

Dis

cuss

ion,

D

em-

onstr

atio

n, S

emin

ar,

Fiel

d V

isit,

Cha

rtPr

epar

atio

n, A

s-sig

nmen

t

Ref

eren

cebo

oks

Ref

eren

ceB

ook

Cha

rt

Ref

eren

ceB

ook,

Cha

rt

Prep

ared

note

s re

port

Prep

ared

note

s, p

roje

ctre

port,

Fiel

d vi

sitre

port

Prep

ared

char

t Se

mi-

nar R

epor

tD

iary

Not

es, r

epor

t

Not

es R

epor

t on

proj

ect

Rep

ort

on fi

eld

visit

Perf

ecti

on

ofch

art,

Parti

cipa

-tio

n in

disc

ussio

n,pe

rfec

tion

of

sem

inar

rep

ort,

perfe

ctio

n in

as-

signm

ent

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

ukhe

rjee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es,

by B

arba

ra H

.Es

tridg

e

Cha

pter

- 1:

Lab

orat

ory

ethi

cs a

nd M

anag

emen

t


73

Curriculum Objectives1. To understand the role of Laboratory in health care, duties , responsibilities and

code of ethics of laboratory technician through discussion, field visit, role play,brain storming, demonstration etc., and prepare notes and field visit report.

2. To understand how to plan and organize a routine laboratory and to familarisewith the purchasing of laboratory materials through discussion, project, field visit,chart and model preparation, collection and prepare report/record/file etc.

3. To understand laboratory safety, personal care, handling and storage of chemi-cals, laboratory hazards and first aid through discussion, demonstration, semi-nar, field visit, assignment and prepare notes/record/report.

Syllabus

F Role of laboratory in health care.

F Duties and responsibilities of lab technicians.

F Code of ethics of laboratory technician.

F Planning and organization of routine lab.

F Lab safety and personal care.

F Handling and storage of chemicals.

F Laboratory hazards

Biohazards, electrical hazards, chemical hazards, cuts and wounds

F First aid practice.

F Method of ordering, purchasing and utilization of supplies.

Practical

l Demonstration of common signs and symbols used in clinical laboratory.

l Familiarise with different types of request/report forms and method of reporting.

l Familiarise with maintenance of stock registers - consumable and nonconsumable.

l Familiarise with the layout plans of a basic laboratory.

Unit

1 LABORATORY ETHICSAND MANAGEMENT

Chapter

1


74

Role of Laboratory in Health Care

Students have the previous knowledge about a Medical Laboratory. But he has littleknowledge about the importance of laboratory in health care. Brainstorming willhelp to elaborate the above idea.

Learning activity: BrainstormingTeacher creates a situation for brain storming by asking some questions like

l What are the common diseases you know?

l Do all the disease shows common symptoms?

l Among these which are having common symptoms?

Teacher initiates brainstorming by providing questions like

l Can we identify these diseases by their symptoms?

l Can a doctor diagnose a disease with mere symptoms?

Teacher facilities the brainstorming by stating

Some diseases can be diagnosed by observable symptoms but in many cases it is notpossible. How diagnosis is possible in such cases?

Elicites response. Facilitator consolidates that

l Laboratory is a key element in the diagnostic procedure.

l Without laboratory, proper diagnosis is not possible.

Outcome

The learner attains clear idea about the role of laboratory in health care

Duties and Responsibilities of Laboratory Technician and code of ethics

Learning Activity: Role play and guided discussion

One among the learner is asked to act a role of laboratory technician who has a roughattitude during blood collection after a proper guidance from the teacher. Then anotherlearner is asked to act a role of a laboratory technician who approach the patient in apleasant way. After the role play the learners compare the behaviour of the two andasked to select the best among them. Continue the session by pointing the criteria fora good laboratory technician.

A group discussion follows by giving handouts to three groups- one group is providedwith handout containing duties of laboratory technician, responsibilities to the secondand code of ethics to the third group. One learner among the group presents theconsolidated points. Finally a poster containing the duties and responsibilities andcode of ethics is prepared and demonstrated in the laboratory.


75

Discussion pointsl What are the duties of a laboratory technician?l What are the responsibilities of a laboratory technician?l Code of ethics.

Consolidationl Dedication of high standard of performance.l Commitment towards the profession.l Central features of a medical laboratory is the technician.l Considerate during sample collection.l Honest, reliable, accurate, organizational skill.

Other suggested activities

l Field visit

l Discussion

Outcome

l The learner got idea about the importance of laboratory Ethics.l Awareness on duties and responsibilities of laboratory technician.l Poster preparation on duties, responsibilities and code of ethics.

CE

l Participation in group discussion.l Oral test.

Planning and Organisation of a routine laboratory

Co. 2 To understand how to plan and organize a routine laboratory and to familarisewith the purchasing of laboratory materials through discussion, project, fieldvisit, chart and model preparation, collection and prepare report/record/fileetc.

Syllabus

l Planning and organisation of routine lab.l Method of ordering, purchasing and utilisation of supplies.

Practicall Familarise with different types of request/report forms and methods of

reporting.

l Familarise with maintenance of stock register, consumable and non-consumable.

l Lay out plans of a basic laboratory.


76

Learning Activity: Project

Project may be a vested strategy to transact this topic. After a general discussionabout planning of a laboratory, students are grouped to four, then give properinstructions to execute project on planning and organisation of routine clinicallaboratory.

Stages of the Project

1. Identify a problem

2. Defining a probolem

Aim is to prepare a project report on planning a well organized routineclinical laboratory.

3. Planning - data to be collected- sources of data- methodology and tools- materials- time- Duties

4. Execution- Data collection- Recording- Preparation and analysis

5. Project report6. Project presentation

Field VisitThe basic group of students visit routine laboratories and collect datas like

Planning(a) Data to be collected

l Spacel Constructional details (arrangement of rooms)l Ventilationl Electric supply systeml Fresh water supplyl Waste disposal/drainagel Equipments

(b) Organizationl Administration


77

l Staff pattern

l Purchase details

l Maintenance

l Communication (written, verbal)

l Quality control

l Publicity

After field visit and reference, tabulate the collected data.

Tabulation of Data

l Invoice format

l Requisition forms

l Report forms

l Sample copy of laboratory records

l Layout plan or form

l Test requisition form

l Stock register

Analysis

Collected data are classified and analysed.

Conclusion

A conclusion is made after the analysis of data.

Project Report

l Title

l Introduction

l Aims/objectives

l Hypothesis

l Method of study

l Data collected

l Analysis

l Conclusion

l Suggestion (if any)


78

l Reference

l Appendix

Project diary can also be evaluated.


l Reference, CD,MM, Model preparation, Chart preparation.

Out come

l Got concrete idea about planning and how to manage a clinical laboratoryl Project report – each learner should have a comprehensive project report

CE

l Project report

l Perfection in collection of report forms

Personal Care

Co. 3 To understand laboratory safety, personal care, handling and storage of chemi-cals, laboratory hazards and first aid through discussion, demonstration, semi-nar, field visit, assignment and prepare notes/record/report.

Syllabus

l Lab safety and personal care.l Handling and storage of chemicals.

l Laboratory hazardsBiohazards, electrical hazards, chemical hazards, cuts and wounds

l First aid practice.

Practical

Demonstration of common signs and symbols used in a clinical laboratory.

Learning Activity: Discussion

A general discussion is started by asking a question. Why laboratory personal arewearing overcoats? Collect responses from the learners about the purpose of doingso. Discussion is extended to the area of Laboratory safety and personal care.

Discussion points

l What are the hygienic habits?

l Proper arrangement of laboratory glass wares and other materials.

l Proper maintenance of equipments.


79

l Safe and proper laboratory practices.

l Need for vaccination to laboratory personnel.

l General health of laboratory personnel.

Consolidation

l The hygenic habits include washing of hands after work, avoiding mouthpipetting, cleaning of work benches etc.

l Misplacement and overcrowding of glass wares and other laboratorymaterials leads to laboratory accidents

Outcome

l Awareness about personal carel Identify the common Sign and symbols used in medical laboratory

CE

l Oral test

PE

l Presentation of drawings of common signs and symbols used in medicallaboratory

TE

Here are some signs and symbols commonly used in medical laboratory. Identify themeanings of these symbols?

Handling and storage of chemicals

Learning Activity - 2 Self experimentation

l Divide the learners into four groups.l Provide set of reagents including acid, alkali, photosensitive chemicals,

poisonous chemicals, explosive chemicals, hygroscopic substances etc.l Instruct the learner to arrange them according to their own idea.


80

l Members of the group are allowed to discuss the logic behind their modeof arrangement.

l Other groups repeat the same procedure.l The scaffolder along with the learner analyse the merits and demerits of

their methods.

Consolidation Pointsl Generally reagents are arranged alphabetically for easy location of reagent.l Inflammable chemicals should be kept away from fire.l Corrosive chemicals like strong acids and alkali should be kept on the lowest

part of cupboard.

Out comel Awareness about handling and storage of chemicals

CEl Oral test

TEl A laboratory technician arranged certain chemicals in the following way.

Can you agree with this mode of arrangement. If not, suggest the correctway of arranging chemicalsa. Alcohols kept on open cupboards.b. Strong acids are kept in lower shelves.c. Hygroscopic chemicals are kept in the refrigerator.d. Leishman stain kept in ordinary glass bottles.

Laboratory Hazards and First Aid

Learning Activity - 3 Seminarl Teacher introduce a common incident occurring in routine laboratory. For

example, a student doing Benedict’s test in the laboratory. As a part of thisexperiment when he heats the boiling tube containing Benedict’s reagent andurine over a Bunsen burner. It breaks and the leaner gets injury. Teacher asks,

l Suggest the first aid given to the injured learner?After getting response the teacher illustrates that like this there are many other hazardstaking place in a routine laboratory and which need first aid.

l Why these types of hazards happen in our laboratory?l What are the precautions to be taken to avoid them?

Through these types of questions, the learners are attracted to the seminar subject.


81

ProcessTopic: Laboratory Hazards and First Aid

Sub topic: 1. Biological Hazards and First Aid2. Electrical Hazards and First Aid3. Chemical Hazards and First Aid4. Physical Hazards and First Aid

PlanningLearners are grouped into four. Information may be collected from Reference bookslike laboratory manual for tropical countries by Monica Cheesborough. Text Bookof Medical Laboratory Technician by Kanai.L.Mukerji or from inter net etc. Thenprepare rough seminar paper. Teacher correct the seminar paper and instructed touse chart, transparency, OHP, power point etc.Then fix a convenient date for seminar invitation and make necessary arrangement forthe seminar.

PresentationOne of the team member from each group will present their subtopics in the seminar.After presentation a conclusion is made and every learner should prepare seminarreport.

Other suggested activityAssignment, Role-play

Out come

l Awareness about the seriousness of laboratory hazards to laboratorypersonnel.

l Idea about first aid

l Seminar report

CEl Seminar report

TEl Laboratory personnel Usually wear white coat and gloves while working.

Give reasons

l Suppose your co-worker fell down unconscious after an electric shock whileusing a water bath. Write your immediate action.


82

HAEMATOLOGY

INTRODUCTION

Haematology is an important branch of clinicalmedicine. As the changes occurring during diseasedconditions are reflected in the blood, haematological testsplay a major role in the diagnosis of several diseasesand assessing the patient’s progress. Haematologicaltests are regularly performed as part of every patientsinitial laboratory investigation. Performing accuratehaematological tests however requires repeated practice.So a student undergoing medical laboratory techniciancourse should have a thorough knowledge about thetechnique and interpretation of various routinehaematological tests. Many of the techniques requiresadequate skill and experience in the use of instruments.

Students have acquired enough knowledge about thecomposition of plasma and formed elements in theircourse of first year. The content of this unit includesan understanding of blood collection, routine tests likeDC, Total RBC count, Total WBC count, Absoluteeosinophil count, ESR, PCV, Hb estimation and toget a basic idea about special investigations likereticulocyte count, osmotic fragility test, LE cell test,and sickling test and coagulation studies. In recent years,especially in advanced laboratories the manual methodsare replacing by automated techniques. So afamilarisation about the automated techniques inhaematology is also included.

After completing this unit the student should acquireconfidence and enough practical skill for doing routinehaematological tests.

UNIT2


8383

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 2 -

Hem

atol

ogy

1. I

ntro

duct

ion

to h

aem

atol

ogy

4.T

o un

ders

tand

the

dif

fere

ntm

etho

ds o

f blo

od co

llect

ion

and

to d

evel

op s

kill

in p

erfo

rmin

gca

pilla

ry a

nd v

enou

s blo

od c

ol-

lect

ion

tech

niqu

e th

roug

h di

s-cu

ssio

n, d

emon

strat

ion,

pra

cti-

cal

wor

k an

d pr

epar

e re

cord

/re

port.

5.To

und

erst

and

abou

t di

ffer

ent

antic

oagu

lant

s for

blo

od c

olle

c-tio

n an

d to

pre

pare

ED

TA a

nti-

coag

ulat

ed b

ottle

thr

ough

dis

-cu

ssio

n, d

emon

strat

ion,

ass

ign-

men

t, pr

actic

al w

ork,

flow

cha

rtpr

epar

atio

n an

d pr

epar

e no

tes/

reco

rd.

•D

iffer

ent

met

hods

of

bloo

d co

llect

ion

tech

-ni

que

•C

apill

ary

and

veno

usbl

ood

colle

ctio

nte

chni

que

•Pr

ecau

tions

•Im

porta

nce

ofan

ticoa

gula

nts

•Pr

oced

ure

for E

DTA

antic

oagu

late

d b

ottle

prep

arat

ion

Dem

onst

ratio

nPr

actic

al w

ork

Disc

ussio

n, D

em-

onstr

atio

n, P

ract

i-ca

l wor

k, A

ssig

n-m

ent

Ref

eren

ceB

ooks

Cha

rtM

ater

ials

for

prac

tical

wor

k

Ref

eren

ceB

ooks

Mat

eria

ls fo

rpr

actic

alw

ork

Prep

ared

note

s R

ecor

dof

pra

ctic

alw

ork

Not

es,

Rec

ord

Perf

ectio

n of

note

pre

para

-tio

n, p

ract

ical

skill

, per

fect

ion

of re

cord

Prac

tical

skill

reco

rd/n

otes

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Prac

tical

Hae

mat

olog

y,by

Dac

ie

Labo

rato

rym

anua

l for

tropi

cal

coun

tries

, by

Mon

ica

Che

esbo

roug

h,V

ol. I

Text

Boo

k of

Med

ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r


84

IntroductionBlood is an important specimen in which various haematological as well asbiochemical investigations are done. The accuracy of results largely dependson properly collected specimen and the anticoagulant used. Through thischapter the learner attains practical skill in capillary and venous bloodcollection and understands the precautions to be taken. This chapter alsodeals with different anticoagulants and preparation of EDTA anticoagulantbottle.

Curriculum Objectives1. To understand the different methods of blood collection and to develop skill in

performing capillary and venous blood collection technique through discussion,demonstration, practical work and prepare record/report.

2. To understand about different anticoagulants for blood collection and to prepareEDTA anticoagulated bottle through discussion, demonstration, assignment, prac-tical work, flow chart preparation and prepare notes/record.

Syllabus

F Introduction.

F Methods for collection of blood.

F Capillary and venous blood collection. - procedure and precautions.

F Anti-coagulants and its classification.

F Explain each anticogulant in detail - EDTA, sodiumcitrate, oxalates, Heparin

fluoride oxalate mixture, ACD, CPD, CPD - A

Practical

l Blood collection technique - capillary and venous blood collection

l Preparation of EDTA anticoagulated bottles

Unit

2 INTRODUCTION TOHAEMATOLOGY

Chapter

1


8585

Capillary and Venous Blood Collection

Learning Activity: Discussion and practical

Materials

Lancet, syringe, needle, cotton, tourniquet, spirit etc

Process

Blood collection is a live activity done on human body. Learners should not practicethis procedure without a technical supervision. So a live demonstration and discussionis essential before practising the capillary and venous blood collection.

Divide the learners into five groups. Teacher demonstrates blood collection procedureinfront of each group. Teacher asks some questions to evaluate learners observationlike,

l Sites for capillary blood collection.

l Which vein is selected for blood collection?

l How will you sterilize the area selected for blood collection?

Let the students collect blood each other and allow them to practice. Record thework done and submit.

Outcome

l Attaines skill to perform venipuncture and capillary puncture

l Submission of the record on work done

PE

l Skill in blood collection

TE

1. While doing venipuncture a tourniquet is applied on the upper arm. Givereason.

2. A sample of blood collected by a technician was found to be haemolysed.Write the reasons and its remedy.

AnticoagulantsCo. 2 To understand about different anticoagulants for blood collection and to pre-

pare EDTA anticoagulated bottle through discussion, demonstration, assign-ment, practical work, flow chart preparation and prepare notes/record.

Syllabusl Anti-coagulants and its classification.

l Explain each anticogulant in detail - EDTA, sodiumcitrate, oxalates, Heparin, fluorideoxalate mixture, ACD, CPD, CPD - A


86

Practical: Preparation of EDTA anticoagulant bottle

Learning Activity: Dicussion after demonstration

Materials: Test tubes, anticoagulant, blood etc

Instruct the learners to transfer collected fresh blood in two similar test tubes-onewith anticoagulant and other without anticoagulant. Teacher ask a question:

Can you observe any change occurring in these test tubes?

Elicite response.

Consolidation

Certain chemical substances can prevent the process of coagulation.

Learning Activity: Demonstration, assignment and flow chart preparation

Materials

- Reference book

- Textbook of practical haematology by Daicie.

- Wintrobe’s Haematology

- Hand book of Medical Laboratory Technology - CMC Vellore

Process

Teacher demonstrates 2 or 3 available different anticoagulants (dry and wet) and asksthem to enumerate the difference. A preliminary discussion is held.

The points to be discussed.

l Different types of anticoagulants.

l It’s mode of action.

l Application of each.

l Merits and demerits

l Suggests reference materials

l Instruct them to refer relevant books and prepare an assignment report.

l Evaluate the assignment report.

Outcome

• Understand about different anticoagulants

l Classify anticoagulants

l Assignment


8787

CE

l Assignment

l Class test

TE

1. Complete the flow chart

2. Complete the following pair

l ESR – sodium citrate ; Glucose estimation ..................................................

l Coagulation studies – sodium citrate ; blood bank ......................................

Preparation of EDTA anticoagulant bottles

Learning Activity - 3: Demonstration and practical

Process

Learners already have an idea about the concentration of EDTA required to preventclotting of blood. After recollecting this idea teacher asks a question.

Can you suggest any easy method for taking such a small quantity of anticoagulant inseveral bottles?

Teacher elicits response and concludes . Then a demonstration is made on thepreparation of EDTA anticoagulant bottles. Learners practice the same until perfectskill is attained. Record the work done.

Outcome

l Attained skill in preparing EDTA anticoagulant bottles

l Record of work done.

eg. Heparin

Artificial

eg.

Anticoagulant


88

Cur

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8989

Unit

2 TOTAL CELL COUNTSChapter

2

IntroductionEnumeration of formed elements of blood has a key role in the diagnosisof several diseases. Students have previous knowledge about the formedelements of blood. This chapter deals with the manual method of total cellcounts and gives an idea about automated method of cell counting.

Curriculum Objectives1. To understand the different methods of cell counting and to acquire skill to per-

form total and absolute blood cell counting by discussion, practical work, dem-onstration, field visit and prepare notes/ record.

Syllabus

F Introduction

F Different methods - manual and automated.

F Manual method of cell counting.

F Mention the different - types of counting chambers.

F Explain improved neubauer counting chamber in detail.

F Dilution method - Pipette dilution and bulk dilution. - RBC pipette, WBC pipette.

F Principle, diluting fluid, procedure, calculation, normal value and interpretation of- RBC count, WBC count, Platelet count, Absolute eosinophil count.

F Automated technique (Brief only)

Practical

l Haemocytometer - familiarize with RBC pipette, WBC pipette, ImprovedNeubauer counting chamber

l Preparation of normal saline

l Preparation of Tuerk’s fluid


90

l Total RBC count

l Total WBC count

l Total platelet count

l Absolute eosinophil count

Counting methods

l Manual

l Automated

Learning Activity - 1: Dicussion

l Learner already have an idea about blood cells.

Teacher initiates a general discussion by asking questions like,

l What is the significance of cell count?

l What are the methods?

l What are the different types of blood cells?

Teacher elicites response

Consolidation

l Importance of blood cell counting in diagnostic field.

l Comparison of manual and automated methods.

Outcome

l Got idea about manual and automated technique of cell counting

CE

l Oral test

Haemocytometer

Learning Activity - 2: Demonstration

Materials

- Counting chambers, (Improved Neubauer Counting chamber) microscope,chart, reference books

Process

Learners are instructed to focus the haemocytometer under microscope and to notethe details available for them. Provide relevant text books and chart and then have ageneral discussion on haemocytometer.


9191

Learners are grouped into four and give RBC and WBC pipette. Learners note thefeatures and compare these two pipette, then prepare a note or chart and submit.Teacher consolidates the points from four groups and ask to prepare notes.

Discussion points

l Features (surface, ruled area, grooves and ridges)

l Ruled area, RBC, WBC areas

l Different types of counting chambers

l Different types of blood diluting pipettes

l What is the need of blood dilution?

Outcome

l Got thorough understanding about the different components ofhaemocytometer

l Prepared notes

CE

l Oral test

PE

l Identification of different components of haemocytometer

TE

Prepare a comparison chart with the help of the following diagram

1. WBC pipette

2. RBC pipette

WBC pipette

RBC pipette


92

Consolidation

l Knowledge of different counting chambers.

l Commonly used counting chamber is imporved neubauer counting cheambar.

l Improved Neubauer counting chamber

l Comparison of WBC and RBC pipette

l Counting is easier when the cells are discrete


l Field visit, Reference

Dilution and charging for counting

Learning Activity - 3: Demonstration and practice

Materials

- Haemocytometer , diluting fluids, microscope etc

Process

Bulk dilution and pipette dilution method are demonstrated by the teacher to thestudents. The learner acquires skill in dilution and charging by practice. Teacher assuresthat students had attained perfection in practical skill and record the work done.


l Field visit, reference CDOutcome

l Acquires skill in dilution of blood and charging of counting chamber

l Record of work donePE

l Perfection in practical skillTE

l Ravi took blood up to the ‘1’ mark and diluting fluid up to ‘11’ mark of aWBC pipette. Write the dilution of blood he made?

Blood cell counting

Learning Activity - 4: Practical

Materials

- Counting chamber, diluting fluid, microscope etc


9393

Process

Teacher tests the previous knowledge of students by asking different questions like,

l What are the different types of blood cells?

l How they are counted?

l What are the methods?

Teacher then leads a general discussion based on following points.

l Purpose of dilution

l Counting chamber

l Ruled area

l Dilution

l Charging

Teacher demonstrates the method of each cell counting before the students. Let thestudents practise the different total cell counts. Teacher ensures that the learner hasacquired enough practise. Calculate and report the results, normal value, interpretationof different cell counts are obtained through reference. After the practical the learnerprepares record and submit.

Outcome

l Capable to do total RBC count, total WBC count, Platelet count, andeosinophil count.

l Record on work done and reporting of result

CE

l Class test

l Oral test

PE

l Skill in practical work

TEMatch the following

A B C

RBC count Dunger’s fluid 1.5-4.5 lakhs/mm3

WBC count 1% ammonium oxalate 40-440 cells/mm3

Platelet count Daicie’s fluid 4.5-5.5 million/mm3

Absolute eosinophil count Tuerk’s fluid 5000-11000/mm3


94


l Reference on multimedia

l Interview with expert

Automated technique

Learning Activity - 4: Field visit

Process

Organize a field visit to an automated laboratory after proper planning. Data collectedduring field visit is discussed in the classroom. The consolidated points are enumeratedas note and submitted.


l Demonstration through CD, MM and discussion


9595

Cur

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um o

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tives

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xam

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96

Unit

2 EXAMINATION OFBLOOD SMEAR

Chapter

3

IntroductionExamination of blood smear is probably the most important laboratorytest for the diagnosis of various diseases. A well-made peripheral bloodsmear makes the examination easier. Through this chapter the learnerattains perfect skill in smear preparation, staining, and differential leucocytecount and an idea about abnormal blood cells

Curriculum Objectives7. To understand and develop skill to perform differential leucocyte count and pe-

ripheral smear examination through discussion, demonstration/practical work,chart preparation and prepare notes/record.

Syllabus

F Preparation of blood smear.

F Characteristics of an ideal smear.

F Factors influencing an ideal smear.

F Staining- Romanowsky stains- Preparation of Leishman’s stain- Leishman’s staining procedure

F Differential leucocyte count- Counting technique- Normal value and clinical significance

F Peripheral smear examination

F RBC- Normal size, shape, colour- Hypochromastia, hyperchromastia- Abnormal RBC

F WBC- Name the abnormal WBCs.

F Platelets - Normal and arrangement


9797

Practical

l Preparation of blood smear

l Preparation of Leishman’s stain

l Differential leucocyte count

l Demonstration of abnormal blood cells - by photographs or slides

Smear preparation

Learning Activity - 1: General discussion

Conduct a general discussion on the importance of smear preparation. Discussionincludes:

l Importance of examination of blood smear

l Thin smear and thick smear

l Uses of blood smear

Consolidate the points obtained through discussion and prepare notes.


Materials

- Slide, spreader, blood etc

Process

Group the learners in to four groups. Demonstrate live practical on smear preparationbefore the four groups. Allow the learners to perform the test individually. Teacherensures that the learner has acquired enough practical skill on smear preparation.Record the work done and submit.


l Demonstration of chart of ideal smear.

Staining

Learning Activity - 1: General discussion

Process

Learner have got previous knowledge about the term differential staining andimportance of staining. Recollect and sharpen their idea through general discussion inclassroom. Discussion is continued and conclude as Leishman stain is the mostcommonly used stain in the laboratory.

Discussion points

l What is stain?


98

l Use of staining

l Examples of differential staining

l Principle of Romanowsky stain

l Examples of Romanowsky stains

l Importance of Leishman stain

Consolidation

l Stains impart colour to cells

l Leishman staining helps in the good performance of differential counting.

Differential counting

Learning Activity - 1: Discussion and Practical Work

Materials

- Materials for Leishman stain, blood smear, microscope etc.

Process

Make a general discussion about the importance of differential count (Preparation ofLeishman stain, staining and counting) Each learner does the practical with differentblood sample. Record the work done / report and submit. Teacher leads a discussionto make the idea clear

l Group students in to four according to their result obtained in the abovepractical

l Give reference book to four groups

l Ask them to interpret their results on normal value and clinical significance.

l Teacher consolidate and students prepare note.

Peripheral smear examination

Learning Activity - 1: Discussion and demonstration

Materials

l Photographs, slides of normal and abnormal blood cells.

Process

l Divide the students in to 5 groups

l Name them as monocyte, lymphocyte, neutrophil, eosinophil and basophil.

l Provide photographs of normal and abnormal blood cells to each group.Each groups is instructed to compare the difference between normal andabnormal cells.


9999

Discussion Points

l Different types of RBC - Size, Colour

l Abnormal WBC

l Parasites seen in the smear

l Approximate WBC count

l Platelets

Consolidation

l Anisocytosis, Poikilocytosis, hyperchromic and hypochroimc

l Blast cells

l Blood parasites

l

l

Concrete idea can be obtained through demonstration of stained peripheral smear


l Practical Work, Multimedia, field visit, interview with experts

Outcome

l Skill in ideal smear preparation

l Idea about different haematological stains

l Skill in performing Leishman staining and D.C.

l Record of work done / Report.

l Prepared notes on normal value and clinical significance of D.C.

Evaluation

CE

l Class test

l Oral test

l Quiz

PE



100

TE

1. Diagram

Choose the ideal smear from the above three. Justify your answer.

2. Complete the following staining procedure

1. Cover the air dried smear using Leishman’s stain. Keep for 2 - 3 minutes.

2. .........................................................................................................................

3. Mix well and keep for 7-10 minutes

4. .........................................................................................................................

5. Clean the bottom side of the slide.

6. .........................................................................................................................

A

B

C


101101

Cur

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102

Unit

2 HAEMOGLOBINESTIMATION

Chapter

4

IntroductionAnaemia is a major health problem especially in women. Further haemoglobinvalue drops during pregnancy. Monitoring Hb concentration became aninevitable part of routine haematological tests. At the end of this chapter,the learners attain practical skill in performing Hb - estimation by Sahli'smethod and cyanmethaemoglobin method.

Curriculum Objectives8. To understand and to perform Sahli’s and Cyanmethaemoglobin estimation through

demonstration, practical, survey, discussion and prepare note and record.

Syllabus

F Name the different methods of Hb estimation.

F Principle, requirments, procedure, advantage, disadvantage and normal value ofSahli’s acid haematin method in detail.

F Principle, requirements, procedure, calculation, normal value, advantage,disadvantage and interpretation of cyanmethaemoglobin method - clinicalsignificance.

F Preparation of standard graph of cyanmeth method.

Practical

l Haemoglobin estimation – Sahli’s method

l Haemoglobin estimation – Cyanmethaemoglobin method

Learning Activity - 1: Discussion

While examining patients doctors usually check the eyelid mucosa. Teacher asksquestion

l What is the purpose?

l A discussion is made on it. With the previous knowledge of the learners,teacher direct the discussion about the haemoglobin, its estimation andimportance.


103103

Discussion Points

l What is haemoglobin?

l Importance of haemoglobin estimation

l Functions of haemoglobin

l Different methods of haemoglobin estimation

Consolidation

l Haemoglobin is the respiratory pigment in blood.

l Essential to detect anemia.

l Transport of oxygen, colour of blood etc.

l Sahli’s method, Cyanmethaemoglobin method, physical, chemical andgasometric methods.

Learning Activity - 1: Practical Work

Materials required

- Sahli’s haemoglobinometer, N/10HCl, Drabkin’s solution, colorimeter,blood etc.

Process

Teacher starts a general discussion about the principle, requirements, procedure, normalvalue, calculation and clinical significance of Sahli’s and Cyanmethaemoglobin methods.Learners are grouped into four groups. Teacher demonstrates the practical beforeeach groups. Allow the students to repeat the tests individually until they get sufficientskill. The teacher ensures that the students acquired the skill. The findings are recordedand submitted

l Teacher asks the students to prepare note on normal value and clinicalsignificance of haemoglobin estimation by reference.


Survey – Screening of school children for anaemia.

Out come

l Realizes the importance of haemoglobin estimation

l Able to do haemoglobin estimation by Sahli’s method and Cyanmethaemoglobin methods skillfully.

l Record on work done/ report

l Prepared notes based on normal value and clinical significance.


104

Evaluation

CE

l Class test

l Oral test

l Prepared notes

PE


TE

1. A 14 year old girl complaining about fatigue and breathlessness approachthe doctor. Can you guess the most appropriate test the doctor willrecommend? Give the details of performing the test

2. Different methods are available for haemoglobin estimation. Can you suggestthe method recommended by WHO along with its merits and demerits.


105105

Cur

ricul

um o

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tives

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eria

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rPr

actic

alw

ork


106

Unit

2 PACKED CELLVOLUME

Chapter

5

IntroductionDetermination of packed cell volume is a simple method of estimating thered blood cell mass in blood. Students already have an idea about thedifferent layers formed when anticoagulated blood is centrifuged. Throughthis chapter the learner understands about the importance of PCV, clinicalsignificance and attains skill to perform PCV.

Curriculum Objectives9. To understand and to perform PCV through discussion, demonstration and prac-

tical work, prepare notes/record.

Syllabus

F Introduction to packed cell volume.

F Method of doing PCV - macro method and micro method.

F Explain the principle, requirements, procedure, normal value and interpretationof Wintrobe’s method.

Practical

l Packed cell volume – Wintrobe’s method

Learning Activity - 1: Practical Work

Materials

l PCV tube

l Blood

l Pasteur pipette

l Centrifuge

Process

Teacher tests previous knowledge about the components of blood. Initiate a generaldiscussion on

l The formation of different layers when anticoagulated blood is centrifuged


107107

l Teacher demonstrates the process

Continue discussion to lead the idea.

l Volume of packed red cells can be calculated if a calibrated tube and standardcentrifugation is used.

Now teacher demonstrates the process of the practical

l Each learner does the practical till he/she attains the perfect skill

l Prepare a report of the practical

Discussion points

l Different layers

l Buffy coat

l Different methods for PCV

Consolidation

l Plasma, buffy coat and RBCs

l Buffy coat consists of white blood cells and platelets

l Micro and macromethods.

Interpretation and normal value of PCV

Learning Activity - 2: Discussion with hand out

Materials

- Hand outs on normal value and interpretation.

Process

Teacher divides the students into 2 groups. Assigns task for each group.

l Group 1 – Those obtained higher values than normal in the above practical

l Group 2 – Those obtained lower values than normal in the above practical

Give hand out to each group. Instruct each group to compare the results they obtainedwith the handouts.

l Teacher guides the group discussion on the clinical significance of the PCV

l Groups presents their findings.

l Teacher consolidates

l Each learner prepares a note on the discussion.

Out come

l Got idea about the importance of PCV


108

l Able to do PCV by Wintrobe’s method

l Record on work done / report

l Note based on discussion about normal value and clinical significance

Evaluation

CE

l Class test

l Oral test

l Prepared notes.

PE

l Skill in practical

TE

l Haematocrit (PCV) is a commonly performed test in haematologylaboratory having many applications. Enumerate the various applications.


109109

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

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efer

ence

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rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 2 -

Hem

atol

ogy

6. R

ed C

ell I

ndic

es

10 .

To ac

quire

an id

ea ab

out r

ed ce

llin

dice

s thr

ough

disc

ussio

n, co

m-

paris

on, c

alcu

latio

n an

d pr

epar

eno

tes.

•Im

porta

nce,

cal

cula

-tio

n, N

orm

al v

alue

of

MC

V, M

CH

, MC

HC

and

MC

D

Disc

ussio

nC

ompa

rison

Cal

cula

tion

Perf

ectio

n of

note

pre

per-

atio

nPa

rtici

patio

n in

disc

ussi

onPe

rfec

tion

ofpr

actic

al

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

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Prac

tical

Hae

mat

olog

y,by

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ie

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rato

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anua

l for

tropi

cal

coun

tries

, by

Mon

ica

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esbo

rrou

gh,

Vol

. I

Text

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ical

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chno

logy

, by

Praf

ul B

.G

odka

r

Ref

eren

cebo

oks

Not

epr

epar

atio

n


110

Unit

2 RED CELL INDICESChapter

6

IntroductionRed cell indices is an important aid to the physician in diagnosing varioustypes of anaemia. Automated electronic counters can give accurate valueson red cell indices. This chapter familiarises with the calculation of red cellindices from the results obtained by manual procedures.


10 . To acquire an idea about red cell indices through discussion comparison, calcu-lation and prepare notes.

Syllabus

F Importance, calculation and normal value of MCV, MCH, MCHC and MCD.

Learning Activity - 1: Discussion and reference

Materials

- Reference Books

- Practical Physiology – G.K.Pal, Pravati Pal

- Medical laboratory Technology - Volume I - Mukerjee

Process

Teachers starts a general discussion by recollecting the previous knowledge aboutPCV, Haemoglobin estimation and total count. The discussion continue to calculatethe MCH,MCHC, MCV &MCD using reference books. A brief note is prepared andsubmitted

Discussion points

l What are the red cell indices?

l Calculation of red cell indices

l Normal value

l Importance of red cell indices


111111

Consolidation

l Red cell indices include MCH,MCHC, MCV &MCD

l Formula for calculating the red cell indicesl

l

Out come

l Got idea about the importance of red cell indices

l Able to calculate red cell indices

l Prepared notes

Evaluation

CE

l Oral test

l Prepared note

TE

l Here is the haematological report of a patient suffering from anemia

Haemoglobin concentration - 9gm%

PCV - 28 %

Red cell count - 3.2 millions/Millimeter3

ESR - 24 millimeter/1st one hour

Calculate MCV and MCH from the above data


112

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 2 -

Hem

atol

ogy

7. E

ryth

rocy

te se

dim

enta

tion

rate

11 .

To u

nder

stand

and

perfo

rm E

SRby

W

este

rgre

n’s

met

hod

thro

ugh

disc

ussio

n, d

emon

stra-

tion,

pra

ctic

al w

ork,

pre

pare

note

s an

d re

cord

.

•D

iffer

ent

met

hods

of

ESR

det

erm

inat

ion

•Pr

inci

ple,

Req

uire

-m

ents

, pre

para

tion

of3.

8% T

risod

ium

cit-

rate

•Pr

oced

ure

•N

orm

al v

alue

, int

er-

pret

atio

n an

d cl

inic

alsi

gini

fanc

e of

Wes

terg

ren'

s m

etho

d•

Stag

es, f

acto

rs af

fect

-in

g ES

R

Gui

ded,

dis

cuss

ion

Prac

tical

wor

k

Dem

onst

ratio

n

Parti

cipa

tion

indi

scus

sion

Perf

ectio

n of

prac

tical

Perfe

ctio

n in

obse

rvat

ion

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Prac

tical

Hea

mat

olog

y,by

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ie

Labo

rato

rym

anua

l for

tropi

cal

coun

tries

, by

Mon

ica

Che

esbo

rrou

gh,

Vol

. I

Text

Boo

k of

Med

ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r

Ref

eren

cebo

oks

Mat

eria

ls fo

rPr

actic

alw

ork

Prac

tical

skill

Rec

ord,

not

e


113113

Unit

2ERYTHROCYTE

SEDIMENTATIONRATE

Chapter

7

IntroductionLearners already have the concept of sedimentation. The rate of red cellsedimentation can give valuable information about the state of health ofthe body. This chapter deals with the technique of ESR determination,stages of ESR, factors affecting ESR and its clinical significance.


11. To understand and perform ESR by Westergren’s method through discussion,demonstration, practical work, prepares notes and record.

Syllabus

F Introduction.

F Different methods of ESR determination: Westergren’s method, Wintrobe’smethod.

F Describe the principle, requirments, procedure, normal value and interpretationof ESR by Westergren’s method.

F Stages of ESR.

F Factors affecting ESR.

F Clinical significance.

Practical

l Preparation of 3.8% sodium citrate

l Erythrocyte sedimentation rate – Westestergren’s methods

Learning Activity - 1: Guided discussion with hand out

Materials

Hand outs on importance and clinical significance of ESR

- Divide the students into 4 groups


114

- Supply the hand outs to each group

- Teacher can assist the group when ever necessary

- One among the group presents their consolidation points

- Discussion points are consolidated by teacher

- Notes are prepared by each students

-

Discussion points

l What is prognosis?

l Importance of ESR

l What are the different methods for ESR estimation

Consolidation

l Idea about difference between diagnosis and prognosis

l ESR is the test for prognosis

l Idea about different methods of ESR estimation

Other Suggested activities

l Reference

l Interview with experts


Materials required

- ESR tube – Westergren’s

- Anticoagulant (Trisodium citrate 3.8%)

- Blood etc.

Process

l Teacher demonstrates the mixing of blood with anticoagulant and how thetube is filled and the method of setting on the stand

l Set an alarm clock for one hour

l Ask the learner to observe the changes.

l Teacher ask to note the length of plasma column which is reported as ESRvalue

l The learners are allowed to perform the ESR test until practical skill hasattained

l Record the work done and report


115115

Other suggested activity – Field visit, OJT

Learning Activity - 3: Discussion with Hand outs

Materials

Handout on factors affecting ESR, stages, normal value and interpretation

- Divide the students into 4 groups

- Supply the handouts to each group

- Teacher facilitates group discussion where ever necessary

- One among the groups presents the points

- Teacher consolidates and learner prepare notes.

Discussion Points

l Physiological factors affecting ESR

l Technical factors

l Stages of ESR

l Normal value

l Interpretation

Consolidation

l Red cell factor and plasma factors

l Temperature, time, anticoagulant used

l Length of ESR tube

l Inclination of the tube

l

l


l Reference

l CD, MM

Out come

l Got an idea about the importance and significance of ESR

l Acquired skill in performing ESR

l Prepared notes

l Record of work done


116

Evaluation

CE

l Class Test

l Prepared note

PE


TE

l “ESR is a prognostic test rather than diagnostic” Explain the abovestatement with the help of example

2. ESR test is based on the principle of sedimentation, the process of solidparticles settling to the bottom of a liquid. Several factors affect the ESR.Enlist the factors affecting the rate of erythrocyte sedimentation in a bloodsample.


117117

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 2 -

Hem

atol

ogy

8. C

oagu

latio

n st

udie

s

12.

To u

nder

stand

var

ious

coa

gula

-tio

n te

sts li

ke B

T, C

T, P

T an

d to

perf

orm

D

uke’

s or

Iv

y’s

met

hod,

Lee

& W

hite

met

hod,

Cap

illar

y tu

be m

etho

d th

roug

hdi

scus

sion

, de

mon

stra

tion

and

prac

tical

wor

k pr

epar

e no

te/

reco

rd.

•Pr

oces

s of

coa

gula

-tio

n•

Coa

gula

tion

fact

ors

•N

ame

the

vario

us c

o-ag

ulat

ion

tests

•B

leed

ing

Tim

e by

Ivy's

or D

uke's

met

hod

and

its in

terp

reta

tions

•C

lotti

ng

Tim

e by

Cap

illar

y tu

be a

ndL

ee

and

Whi

tem

etho

d•

PT

by

Qui

ck's

met

hod

Disc

ussio

n

Dem

onst

ratio

n

Prac

tical

wor

k

Perfe

ctio

n in

prac

tical

,Pa

rtici

patio

n in

disc

ussio

n,Pe

rfect

ion

inde

mon

strat

ion,

OT

Med

ical

Labo

rato

ryTe

chno

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Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

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bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

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Prac

tical

Haa

mat

olog

y,by

Dac

ie

Labo

rato

rym

anua

l for

tropi

cal

coun

tries

, by

Mon

ica

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esbo

roug

h,V

ol. I

Text

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k of

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ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r

Mat

eria

ls fo

rpr

actic

al

Ref

eren

cebo

oks

Prac

tical

skill

Not

eRec

ord


118

Unit

2COAGULATION

STUDIESChapter

8

IntroductionLearners already have an idea about the coagulation of blood. Patientsprepared for surgery are routinely tested for normal haemostasis and patientshaving bleeding disorders are regularly monitored. Through this chapter thelearners realises their role in investigation of bleeding disorders and attainsskill in performing bleeding time test and clotting time test.


12. To understand various coagulation tests like BT, CT, PT and to perform Duke’sor Ivy’s method, Lee & White method, Capillary tube method through discus-sion, demonstration and practical work prepare note/record.

Syllabus

F Review of coagulation.

F Coagulation factors.

F Name the various cogulation tests.

F Explain:- Bleeding time by Ivy’s method and its interpretation- Clotting time by Capillary tube method and Lee & White method.- Prothrombin time by Quick’s one stage method.

Practical

l Bleeding time – Duke’s or Ivy’s methodl Clotting time – Capillary tube method

Learning Activity - 1: Discussion and practical

Materials

- Hand out on bleeding time, clotting time and prothrombin time

- Teacher initiates a discussion after recollecting coagulation factors andcoagulation.


119119

Process

l Divide the students into 3 groups

l Give handout on bleeding time to first group, clotting time to second andprothombin time to the third.

l Instruct each group to go through and discuss the hand out

l One student from each group presents their discussion points

l After completing the presentation, teacher consolidates the discussion pointsand learner prepares note

Discussion points

l Process of coagulation

l Importance of coagulation studies

l Clotting time test, bleeding time test, prothrombin test

Consolidation

l Blood cells and coagulation factors are involved in coagulation

l Coagulation studies help in the diagnosis of bleeding disorders.

Other Suggested Activities

l Reference , field visit , interview with technical experts


Materials

- Materials for bleeding time test, clotting time test, prothrombin test

Process

Teacher demonstrates the test – bleeding time test, clotting time test, prothrombintest in front of the learners. The learners are allowed to perform the test afterobservation till practical skill has obtained. Record and report the finding


l Field visit, reference

Out come

l Got an idea about process of coagulation and importance of coagulation

l Gained skill for doing bleeding time test and clotting time test

l Prepared note

l Record of practical work


120

Evaluation

CE

l Oral test

l Class test

l Prepared note

PE


TE

l If a patient with bleeding disorder approaches you for laboratoryinvestigation, what are the tests you would perform up on him


121121

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 2 -

Hem

atol

ogy

9. S

peci

al I

nves

tigat

ions

13To

und

ersta

nd ab

out r

etic

uloc

yte

and

retic

uloc

yte

coun

t th

roug

hdi

scus

sion,

dem

onstr

atio

n a

ndpr

epar

es n

ote.

14.

To ac

quire

bas

ic id

ea ab

out O

s-m

otic

fra

gilit

y te

st (

OFT

), LE

Cel

l te

st a

nd S

ickl

ing

test

thro

ugh

disc

ussi

on,

refe

renc

e,de

mon

stra

tion

etc.

, and

pre

pare

note

s.

•R

etic

uloc

yte

•Su

pra

vita

l sta

inin

g•

Ret

icul

ocyt

e co

unt

•C

alcu

latio

n•

Nor

mal

val

ue•

Inte

rpre

tatio

n

•O

smot

ic f

ragi

lity

test

(scr

eeni

ng te

st)•

Nam

e au

to I

mm

une

dise

ase

•Pr

oced

ure

LE

cel

lte

st•

Proc

edur

e of

Sic

klin

gte

st

Disc

ussio

n

Dem

onst

ratio

n

Disc

ussio

nR

efer

ence

Dem

onst

ratio

n

Perf

ectio

n on

note

pre

para

-tio

n

Perf

ectio

n on

note

pre

para

-tio

n

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Prac

tical

Hea

mat

olog

y,by

Dac

ie

Labo

rato

rym

anua

l for

tropi

cal

coun

tries

, by

Mon

ica

Che

esbo

roug

h,V

ol. I

Text

Boo

k of

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ical

Labo

rato

ryTe

chno

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, by

Praf

ul B

.G

odka

r

Ref

eren

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oks

Ref

eren

cebo

oks

Not

e

Not

e


122

Unit

2SPECIAL

INVESTIGATIONSChapter

9

IntroductionThough not routinely done special investigations has a role in the diagnosisof haematological disorders. This chapter gives familarisation of importantspecial haematological tests. It helps to extend the students knowledge abouthaematology.


13. To understand about reticulocyte and reticulocyte count through discussion, dem-onstration and prepares note.

Syllabus

F Know about reticulocyte and reticulocyte count.

F Supravital staining, counting, calculation, normal value and interpretation.

Learning Activity - 1: Discussion after demonstration

l Teacher shows the photographs of reticulocyte and normal red bloodcells

l Teacher asks to compare the two and comment on the difference observed

l Teacher consolidates discussion points

l Discussion continues on the importance of reticulocyte and its count

l Prepare notes

Discussion Points

l Difference between RBC and Reticulocyte

l Reticulocyte count

Consolidation

l Precursor of RBC, non nucleated cell etc.

l Reticulocyte count related to erythropoetic activity

l


123123

Other suggested activity

l Reference, Multimedia

Learning Activity - 2: Demonstration after discussion

Materials

- Hand outs

- Supravital stain

- Blood smear etc.

Process

l Conduct an oral test based on reticulocyte

l Divide the students in to 4 groups according to score obtained

(Each group should contain learners getting high scores and low scores )

l Give the hand out containing adequate information about the method,calculation, normal value and interpretation of reticulocyte count to eachgroup

l Teacher guide the discussion

l One among each group presents the consolidated points

l Teacher performs a live demonstration to get a clear idea about reticulocytecount.

l Record and submit

Discussion points

l Supravital staining

l Procedure of staining

l Technique of counting

l Interpretation

Consolidation

l Staining in a living condition is supravital staining

l

l

l

Outcome

l Got an idea about reticulocyte


124

l Acquired basic idea about different steps in reticulocyte count

l Prepared note

CE

l Class Test

l Prepared note

TE

l Reticulocyte counting is done mainly to monitor the treatment response ofanemia. Write down the main steps of reticulocyte counting.

Osmotic fragility test, LE cell test and sickling testC.O. 14 To acquire basic idea about Osmotic fragility test (OFT), LE Cell test and

Sickling test through discussion, reference, demonstration etc., and pre-pare notes.

Syllabus

F Basic description of osmotic fragility test.

F Basic knowledge of auto immune disease and LE cell test.

Learning Activity - 1: Discussion after giving hand outs

l Teacher divide the students into three groups

l Each group are given handouts containing brief note about Osmotic FragilityTest, LE Cell test and Sickling Test.

l Students are asked to discuss the matter

l Teacher assists the group during discussion

l One student from each groups present the consolidated points.

l Teacher consolidates the topic with relevant points

l Note is prepared by each student and submit.

Discussion points

l Osmotic Fragility Test

l LE Cell test

l Sickling Test.

Consolidation

l Brief idea about Osmotic Fragility Test, LE Cell test and Sickling Test.

l


125125

Outcome

l Got an idea about Osmotic Fragility Test, LE Cell test and Sickling Test.

l Prepared notes

Evaluations

l Class Test

l Oral Test

l Prepared note

TE

Match the following

A B C

1. Osmotic Fragility Test SLE Sodium metabisulphite

2. LE Cell test Spherocytosis ANA

3. Sickling Test Sicklecell anaemia Hypotonic saline


126

CLINICAL PATHOLOGY

INTRODUCTION

Examination of body fluids other than blood is includedin clinical pathology. Clinical pathology investigationslike urine analysis, stool examination, sputumexamination etc. are routinely done in clinicallaboratories. Technicians working in clinical pathologylaboratory are required to examine various body fluidsand it primarily focuses on physical examination,microscopy and chemical examination.

At the end of this unit learner get thorough practicalskill in urine analysis, stool examination, sputumexamination, and semen analysis. Field visit andOJT help to give an exposure on CSF examinationalso.

UNIT3


127127

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 3 -

Clin

ical

Pat

holo

gy

1. I

ntro

duct

ion

to c

linic

al

Pat

holo

gy

15.

To h

ave

an id

ea a

bout

the

im-

porta

nce

of C

linic

al P

atho

logy

and

type

s of

spe

cim

en u

sed

thro

ugh

disc

ussio

n, d

emon

stra-

tion,

fie

ld v

isit a

nd p

repa

re r

e-po

rt.

•Im

porta

nce

of c

linic

alpa

thol

ogy

•D

iffe

rent

typ

es o

fsp

ecim

en

Disc

ussio

nFi

eld

visit

Dem

onst

ratio

n

Perf

ectio

n of

note

dia

ryPa

rtici

patio

n in

disc

ussi

on

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. II,

Kan

aiL.

Muk

erje

e

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Text

Boo

k of

Med

ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r

Mat

eria

ls fo

rde

mon

stra

-tio

n

Not

eD

iary


128


15. To have an idea about the importance of Clinical Pathology and types of speci-men used through discussion, demonstration, field visit and prepare report.

Syllabus

F Importance of clinical pathology.

F Different types of samples used.

Learning Activity - 1 : Field Visit

Materials

l Field Visit Plan

Process

l Plan a field visit to a nearby clinical pathology laboratory for gettinginformation about the importance of clinical pathology in medicine anddifferent types of specimen used in a clinical laboratory. A general discussionis needed to plan the field visit and confirm the full involvement of students.During which the following things should be noted

Point for planning

l Mode of conveyance

l Permission from the authority and school

l Diary for recording data

l Time and date

l Instruction to students

Consolidation

l After a field visit a general discussion should be done to evaluate andconsolidate the observed things from laboratory and prepare notes.

Unit

3INTRODUCTION

TO CLINICALPATHOLOGY

Chapter

1


129129

Other suggeted activities

l Reference, CD, discussion

Outcome

l Basic knowledge about the importance of clinical pathology in medicaldiagnosis.

CE

l Field visit diary, oral test.

VCE

l Field visit.


130

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 3 -

Clin

ical

Pat

holo

gy

2. U

rine

Ana

lysi

s16

.To

und

ersta

nd co

llect

ion,

nor

mal

and

abno

rmal

con

stit

uent

s,ph

ysic

al c

hem

ical

and

mic

ro-

scop

ic e

xam

inat

ion

of u

rine

thro

ugh

disc

ussi

on, q

uiz,

fie

ldvi

sit,

dem

onst

ratio

n, p

ract

ical

wor

k, c

ompa

riso

n, p

repa

reno

tes,

diar

y re

cord

/rep

ort a

ndA

ssig

nmen

t.

17.

To g

et a

n id

ea a

bout

the

impo

r-ta

nce

of p

regn

ancy

test

and

tope

rfor

m t

he c

ard

test

thr

ough

disc

ussio

n, d

emon

strat

ion,

pra

c-tic

al w

ork,

pre

pare

s no

tes

and

reco

rd.

•U

rine

colle

ctio

n•

Type

s of s

ampl

es•

Pres

erva

tion

•N

orm

al a

nd a

bnor

-m

al c

onsti

tuen

ts•

Phys

ical

exa

min

atio

n•

Che

mic

al e

xam

ina-

tion

•M

icro

scop

ic e

xam

i-na

tion

•Pr

egna

ncy

test

•Im

porta

nce

•N

ame

of d

iffer

ent

met

hods

•Pr

oced

ure

of c

ard

test

Disc

ussio

n

Dem

onst

ratio

n

Ass

ignm

ent

Qui

z

Prac

tical

Disc

ussio

n

Dem

onst

ratio

nPr

actic

al w

ork

Perf

ectio

n of

note

Rec

ord

Dia

ryPe

rfect

ion

inpr

actic

al

Perf

ectio

n of

prac

tical

wor

kPe

rfec

tion

ofre

cord

wor

k

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. II,

Kan

aiL.

Muk

erje

e

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Text

Boo

k of

Med

ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r

Cha

rtR

efer

ence

book

sM

ater

ials

for

prac

tical

s

Ref

eren

cebo

oks,

Mat

eria

ls fo

rpr

actic

al

Rec

ord

Prac

tical

Ski

llFi

eld

visit

Dia

ryN

ote

Prac

tical

skill

reco

rd


131131

Introduction

Examination of urine is an inevitable procedure for the abnormalities ofkidney function and the urinary tract. It can also give information aboutdiseases that affects even outside the urinary tract .The easy availability ofthe specimen makes urine analysis a basic investigation. The learners shouldget a thorough practical skill in analysing a sample of urine and understandthe interpretation of various tests. Practical classes and OJT help to attainthis skill.


16. To understand collection, normal and abnormal constituents, physical chemicaland microscopic examination of urine through discussion, quiz, field visit, dem-onstration, practical work, comparison, prepare notes, diary record /report andAssignment.

17. To get an idea about the importance of pregnancy test and to perform the cardtest through discussion, demonstration, practical work, prepares notes and record.

Syllabus

F Collection of urine sample - different types of samples.

F Brief description of normal and abnormal constituents of urine.

F Examination of urine.

F Physical examination.

F Volume, colour, specific gravity and reaction.

F Chemical examination.

Principle, reagents, procedure and interpretation of common abnormal constituentssuch as:

Sugar - by Benedict’s test

Protein - by Heat and acetic acid test

Unit

3 URINE ANALYSISChapter

2


132

Ketone bodies - by Rothera’s test

Bile Pigment - by Fouchet’s test

Bile salt - by Hay’s test

Urobilinogen - by Ehrlich’s test

Blood - by Benzidine test

F Microscopic examination of urine

- preparation of urine for microscopic examination.

- demonstration of crystals, cells and casts.

F Pregnency test

- Importance of test

- Name different methods

- Procedure of card test

Practical

l Preparation of 5% acetic acid solution

l Physical examination of urine

l Chemical examination of urine

l Microscopic examination of urine

Learning Activity - 1 : Discussion

Material

l Reference books

Process

l First recollect the idea about urine from the previous knowledge. by askingquestions. Teacher consolidates that urine is the common sample reachingclinical pathology laboratory, it has a major role in the diagnosis of differentclinical conditions. Different methods of urine collection, containers usedfor collection etc are discussed.

Discussion points

l Importance of urine as a clinical specimen

l Different collection techniques

l Different types of urine sample

l Preservatives used.


133133

Consolidation

l Relevance of urine sample as clinical specimens – diagnostic

l Idea about different collection techniques

l Early morning, midstream, clean catch specimen etc.

l Idea about urine preservation and preservatives used.

Learning Activity - 2 : Practical and comparison

Material

l Materials for practical work

Process

l Teacher give a live demonstration of physical, Chemical and microscopicexamination of urine.

l Provide the students with different samples showing variable results

l Ask to perform the practicals until perfection in practical skill is attained

l Arrange a visit to a hospital or well equipped laboratory to extend andstrengthen the idea


Learning Activity - 3 : Assignment on physical, chemical and microscopic examination of urine

Process

A preliminary discussion including the major points like,

l Physical Examination

l Chemical Examination

l Microscopic Examinations of urine

l Clinical significance of tests

Teacher explains the above point and suggest reference materials like

l Medical Laboratory Technology by Kanai: Mukerjee

l Clinical diagnosis and Management by laboratory methods - Todd andSanford

Instruct them to refer the relevant books and ask to prepare assignment report. Teacherevaluates the assignment report made individually.


134

Outcome

l Skill to perform routine urine analysis.

l Record/report

l Assignment

CE

l Assignment note

l Class test

l Oral test

PE

l Physical, chemical, microscopic examination of urine.

TE

Match the following

A B C

Sugar Rothera’s test Starvation/fasting

Protein Hay’s test Obstructive joundice

Ketone body Benedict’s test Diabetes mellitus

Bile salt Heat and acetic acid test kidney disease

VCE

l Field visit

Pregnancy TestCO.17 To get an idea about the importance of pregnancy test and to perform the

card test through discussion, demonstration, practical work, prepares notesand record.

Practical

l Demonstration of Pregnancy test in urine

Learning Activity - 2 : Discussion and demonstration

Process

Teacher initiates discussion by asking a question.

How will you detect pregnancy in early stage?


135135

l Teacher elicits their response and directs the discussion to importance ofurine sample and hormones related to pregnancy.

l The scaffolder illustrate the importance of HCG in pregnancy

l Teachers demonstrates the method of pregnancy test by card test

l Students record the work done and observation and submit

Consolidation

l Pregnancy can be confirmed by detecting HCG in urine in early stages.

l Methods of pregnancy test in urine

l Skill to perform pregnancy (card)

Outcome

l Able to perform pregnanacy test (card)

l Record the procedure

VCE

l Hospital visit.


136

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 3 -

Clin

ical

Pat

holo

gy

3. S

tool

Exa

min

atio

n

18.

To u

nder

stand

the

im

porta

nce,

sam

ple c

olle

ctio

n an

d to

per

form

mac

rosc

opic

and

che

mic

al e

x-am

inat

ion

of st

ool b

y di

scus

sion,

dem

onst

ratio

n, p

ract

ical

wor

k,pr

epar

es n

otes

, rep

ort a

nd a

s-sig

nmen

t.

•Im

porta

nce

•C

olle

ctio

n•

Mac

rosc

opic

(con

sis-

tenc

y, c

olou

r, m

ucus

and

para

site

)•

Mic

rosc

opic

(sa

line,

iodi

ne t

echn

ique

and

conc

entra

tion

by s

a-lin

e flo

atat

ion)

•C

hem

ical

exam

inat

ion

(occ

ult

bloo

d-B

enzd

ine

test

, red

uc-

ing

subs

tanc

eB

ened

ict’s

test

)

Disc

ussio

n

Dem

onst

ratio

n

Prac

tical

wor

k

Ass

ignm

ent

Perf

ectio

n of

prac

tical

wor

kPe

rfec

tion

ofre

cord

wor

k

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. II,

Kan

aiL.

Muk

erje

e

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Text

Boo

k of

Med

ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r

Mat

eria

ls fo

rpr

actic

alw

ork

Prac

tical

skill

reco

rd


137137

IntroductionStool is an important specimen reaching a clinical pathological laboratory.The examination of faeces often receives a short shrift due to handling thespecimen. This chapter aims at an understanding the importance of stoolexamination and attaining practical skill and there by eliminating handlingof the specimen with diffidence.

Curriculum Objectives18. To understand the importance, sample collection and to perform macroscopic,

microscopic and chemical examination of stool by discussion, demonstration,practical work, prepares notes, report and assignment.

Syllabus

F Importance of stool examination

F Sample collection

F Macroscopic examination

- Consistancy, Colour, Mucus and Parasites

F Microscopic examination

- Saline preparation- Iodine preparation- Concentration by saline floatation

F Chemical examination

- Occult blood - Benzidine test- Reducing substances - Benedict’s test

Practical

l Macroscopic examination of stool

l Microscopic examination of stool

l Chemical examination of stool(Occult blood and reducing substance)

Unit

3STOOL

EXAMINATIONChapter

3


138

Learning Activity - 1 : Demonstration and practical

Materialsl Stool Sample

l Microscopic slidesl Cover slip

l Microscope etcProcessTeacher starts discussion on importance of stool examination by asking same questionslike

l What is the choice of specimen collected in the cases of disease like diarrhoea,gastroenteritis, cholera, helminthes, infection etc?

l How can we collect a stool sample?l Is there any precautions need to be taken during collection?

Teachers elicits response and leads to a conclusion on thel Importance of stool examination

l Collection of stool samplel Precautions to be taken during collection

l Teachers demonstrate macroscopic, microscopic examination andconcentration technique by simple floatations technique.

l Students are asked to repeat the same until practical skill is attainedl Record the work done, finding and report

Outcomel Learners get skill to perform stool examination.

l Record on work done/findingsPE

l Macro, Micro &chemical examination of stool.

TEl A patient having diarrhoea symptoms is admitted to hospital. Stool sample

is submitted to the laboratory for examination. Suppose you are the labtechnician there.

How will you process the sample for microscopic examination?

VCEl Field visit /OJT.


139139

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 3 -

Clin

ical

Pat

holo

gy

•Sp

utum

•Im

porta

nce o

f spu

tum

•Sa

mpl

e co

llect

ion

•M

acro

scop

ic e

xam

i-na

tion,

con

sist

ency

,co

lour

•M

icro

scop

ic e

xam

i-na

tion

- AFB

, Gra

m’s

stain

ing

Disc

ussio

n

Dem

onst

ratio

n

Prac

tical

wor

k

Perf

ectio

n of

reco

rd/n

ote

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. II,

Kan

aiL.

Muk

erje

e

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Text

Boo

k of

Med

ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r

Ref

eren

ceB

ooks

Mat

eria

ls fo

rpr

actic

alw

ork

Rec

ord,

Prac

tical

skill

,no

te

4. S

putu

m E

xam

inat

ion

19.

To u

nder

stand

the

im

porta

nce,

colle

ctio

n of

sput

um a

nd to

per

-fo

rm m

acro

scop

ic a

nd m

icro

-sc

opic

exa

min

atio

n of

spu

tum

thro

ugh

disc

ussio

n, d

emon

stra-

tion,

pra

ctic

al w

ork,

pre

pare

sno

te a

nd re

cord

.


140

IntroductionExamination of sputum is a valuable means of investigating diseaeses ofthe respiratory tract especially pulmonary tuberculosis. Sputum examinationis carried out routinely as a part of eradication of tuberculosis. This chapteraims to attain practical skill in sputum examination.


19. To understand the importance, collection of sputum and to perform macroscopicand microscopic examination of sputum through discussion, demonstration, prac-tical work, prepares note and record.

Syllabus

F Importance of sputum examination.

F Sample collection


- Consistency and Colour


- AFB staining- Gram’s staining

Practical

l Sputum Examination

Material

l Handout on collection and importance of sputum.

Learning Activity - 1 : Discussion with handouts

Process

l Teacher collects the previous knowledge of the students

l Then group the students into four and give handout on importance andcollection of sputum.

Unit

3SPUTUM

EXAMINATIONChapter

4


141141

l Teacher guides the discussion whenever necessary

l The discussed points are consolidated by the teacherl Students are asked to prepare notes

Discussion pointsl Anatomy of respiratory tractl Importance of sputum

l Collection of sputum specimenConsolidation points

l Sputum examination is the confirmatory tests for pulmonary tuberculosisand early detection of some other diseases.

l Sputum specimens are collected in a wide mouthed screw capped bottles.

Sputum examination

Learning Activity - 1 : Practical after demonstration

Materials

l Sputum samplel Microscopic slides

l Stainsl Microscope etc.

Process

l Teacher demonstrates macroscopic and microscopic examination of sputum.

l Students then perform the practical until skill is attained


Outcome

l Learner achieved practical skill to perform sputum examinationl Record on work done/finding.

PEl Sputum examination

TEl A patient is supposed to have tuberculosis is admitted to the hospital and

sputum sample is reached the laboratory for investigation. Can you suggestan outline of sputum sample processing in the lab?

VCE

l Hospital visit /OJT.


142

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 3 -

Clin

ical

Pat

holo

gy

5. S

emen

Ana

lysi

s

20. T

o un

ders

tand

the

im

porta

nce,

sam

ple c

olle

ctio

n an

d to

per

form

mac

rosc

opic

, mic

rosc

opic

and

chem

ical

exa

min

atio

n of

sem

enth

roug

h di

scus

sion

, pr

actic

alw

ork,

pre

pare

s rec

ord

and

note

.

•Im

porta

nce

•Sa

mpl

e co

llect

ion

•M

acro

scop

ic e

xam

i-na

tion

(vol

ume,

visc

os-

ity, c

olou

r, re

actio

n an

dliq

uefa

ctio

n tim

e)•

Mic

rosc

opic

exa

min

a-tio

n (M

otili

ty,

Tot

alsp

erm

cou

nt,

Mor

-ph

olog

y of

spe

rmat

o-zo

a, o

ther

cel

ls)

•C

hem

ical

exa

min

atio

n•

Nam

e of t

ests

and

acid

phos

phat

se.

Disc

ussio

n

Prac

tical

wor

kPe

rfec

tion

ofpr

actic

al w

ork

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. II,

Kan

aiL.

Muk

erje

e

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Text

Boo

k of

Med

ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r

Ref

eren

cebo

okM

ater

ials

for

prac

tical

wor

k

Prac

tical

skill

reco

rd


143143

IntroductionSemen analysis being a relatively simple investigation, it became a routineprocedure of infertility investigation. Through this chapter the learners getan understanding about the importance of semen analysis and collection ofthe specimen. Practical skill is also attained in semen analysis throughpractical and OJT.


20. To understand the importance, sample collection and to perform macroscopic,microscopic and chemical examination of semen through discussion, practicalwork, prepares record and note.

Syllabus

F Importance of semen analysis

F Sample collection


- Volume, viscosity, colour, reaction and liquefaction time


- Motility

- Total sperm count

- Morphology of spermatozoa

- Other cells

F Chemical examination

- Name the different tests - fructose, acid phosphatase

Practical

l Semen analysis

Unit

3 SEMEN ANALYSISChapter

5


144

Importance and collection of semen

Learning Activity - 1 : Discussion and practical

Material

l Sample

l Microscopic slide

l Cover slip

l Counting chamber etc.

Process

Teacher tests the previous knowledge by asking certain questions like

l What is the secretion from the male reproductive organs?

l What are the functions of seminal fluid?

l What is the importance of semen analysis?

l Teacher starts discussion based on recollected points.

l Learners are asked to prepare notes

l Teacher demonstrates the method of semen analysis

l Students repeat the same until practical skill is attained

l Record work done/findings and report

Discussion points

l Importance of semen analysis

l Procedure of collection

l Precautions taken during collection

Consolidation

l Investigation of male infertility

l Medico legal cases

l Concrete idea about sample collection.


l Reference

Outcome

l Skill to perform semen analysis


145145

l Prepared notes

l Record on work done/finding

CE

l Prepared notes

l Class test/oral test

TE

l A technician instruct the patient to submitt semen samples within 30 minutesafter collection. But he submitted the sample only after one hour. How itaffects the result?


146

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 3 -

Clin

ical

Pat

holo

gy

6 C

SF E

xam

inat

ion

21. T

o un

ders

tand

the

im

porta

nce,

colle

ctio

n, m

acro

scop

ic e

xam

i-na

tion

and

bioc

hem

ical

exam

ina-

tion

of C

SF th

roug

h di

scus

sion,

dem

onst

ratio

n, f

ield

vis

it an

dpr

epar

e no

tes.

•Im

porta

nce

•C

SF c

olle

ctio

n•

Mac

rosc

opic

exa

mi-

natio

n (c

olou

r, tu

rbid

-ity

, app

eara

nce)

•M

icro

scop

ic e

xam

i-na

tion(

tota

l cou

nt, d

if-fe

rent

ial c

ount

, gra

m’s

stain

ing,

AFB

stai

ning

)•

Bio

chem

ical

exa

min

a-tio

n (n

ame

of d

iffer

ent

test

for

sug

ar, p

rote

inan

d ch

lorid

e)

Disc

ussio

n

Dem

onst

ratio

n

Fiel

d vi

sit

Perf

ectio

n of

diar

y no

te,

repo

rt

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. II,

Kan

aiL.

Muk

erje

e

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Text

Boo

k of

Med

ical

Labo

rato

ryTe

chno

logy

, by

Praf

ul B

.G

odka

r

Ref

eren

ceB

ooks

Rep

ort n

ote/

diar

y


147147

IntroductionCerebrospinal fluid is a vital specimen reaching a clinical laboratory. Becausethe specimen is precious, the specimen should be handled carefully. Thischapter gives an understanding of the CSF examination. OJT will help toattain the practical skill.


21. To understand the importance, collection, macroscopic examination and bio-chemical examination of CSF through discussion, demonstration, field visit andprepare notes.

Syllabus

F Importance of CSF examination.

F Mention the method of CSF collection.


- colour, turbidity and appearance


- total count, differential count, Gram’s staining and AFB staining

F Bio-chemical examination

- Name different tests done - sugar, protein and chloride

Learning Activity - 1 : Discussion and Demonstration

Material

l Reference books

Process

l Teachers recollect the previous knowledge about CSF by asking questionslike

l What is CSF?

l What is the importance of doing CSF examination

Unit

3 CSF EXAMINATIONChapter

6


148

l Teacher starts discussion on importance of CSF and its examination aftergiving hand out on the above content

l For that the learners are grouped into four

l The scaffolder guide the discussion and consolidates the discussed points

l Students are asked to prepare notes

Discussion points

l Importance of CSF examination

l Collection of CSF

l Macroscopic examination, microscopic examination and biochemicalexamination

Consolidation

l CSF examination reveals some diseases affecting the CNS

l Collected by Lumbar puncture

l Methods of macroscopic, microscopic and biochemical examination

l

If possible a demonstration of CSF examination is done in the laboratory. Recordthe work done and report


l Field visit and reference


149149

IMMUNOHAEMATOLOGY AND

BLOOD BANKING

INTRODUCTION

In literal terms blood bank is the BANK for BLOOD.It is a compact unit where blood is accepted from donors,processed and stored and then issued to recipients inneed as and when required. To fulfill this aim, thebasics of immuno haematology, blood group systems,important procedures in blood bank, donor selection,transfusion, blood components and transfusion reactionsare included in this unit.

People in developing countries like India have a falseconception that blood donation is detrimental to health.At the end of this unit the learner realizes that it istheir prime duty to try and remove these misgivingsand blood donation is a life saving activity. The learnersalso get practical skill in blood grouping which is oneof the prime functions of a blood bank. A field visit toa blood bank will help to give a clear idea about thevarious functions of a blood bank.

UNIT4


150

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 4 -

Im

mun

o H

emat

olog

y an

d B

lood

Ban

king

1. In

trod

uctio

n to

Imm

uno

hem

a-to

logy

22.

To a

cqui

re b

asic

idea

abo

ut th

ean

tigen

, ant

ibod

y an

d hi

storic

alas

pect

s of

bl

ood

bank

ing

thro

ugh

disc

ussi

on,

refe

renc

ean

d pr

epar

e no

tes.

•A

ntig

en a

nd a

ntib

ody

•B

lood

ban

king

•H

isto

rical

asp

ects

Disc

ussio

n

Ref

eren

ce

Perf

ectio

n of

note

pre

para

-tio

n

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Ref

eren

cebo

oks

Not

e pr

epa-

ratio

n


151151

Curriculum Objectives22. To acquire basic idea about the antigen antibody and historical aspects of blood

banking through discussion, reference and prepare notes.

Syllabus

F Mention the different types of antigen and antibody.

F Introduction to blood banking - Historical aspects.

Learning Activity - 1 : Guided discussion

Materials

- Text Book of MLT –Bohr

- Medical Laboratory Technology, Vol II, III by Kanai . L. Mukerjee

- Hand out containing the history of blood banking prepared by teacher orfrom reference book.

Process

·l Teacher tests the previous knowledge related to blood group antigen,antibodies and basic idea of immunology.

l Supply handout about the history and importance of blood banking tothree random groups of students.

·l Instruct them to discuss and present their consolidation points in chart orwritten form.

l Teacher scaffolds the discussion.

Discussion Points

l Importance of Immunohaematology

l Mile stones in Blood Banking

l Other relevant historical aspects.

Unit

4INTRODUCTION

TO IMMUNOHAEMATOLOGY

Chapter

1


152

Consolidation

l Immunohaematology – Landmark in blood transfusion

l Land Steiner’s law – Corresponding antigen and antibody doesn’t exist insame blood group.

Out comes

Learner get clear idea about

l Importance of immunohaematology

l Historical aspects of blood banking

l Complied note after guided discussion.


l Assignment, field visit.

CE

l Assignment, note, Oral test

TE

Match the following

1. William Harvey 1. Transfusion from animal to man2. Lower Richard 2. Discovered ABO system3. Denis 3. Blood circulation4. Karl Land Steiner 4. Animal to animal blood transfusion


153153

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 4 -

Im

mun

o H

emat

olog

y an

d B

lood

Ban

king

2. B

lood

gro

up s

yste

m

23.

To

unde

rsta

nd A

BO

and

Rh

bloo

d gr

oup

syste

m a

nd to

hav

eba

sic

idea

abo

ut B

omba

y bl

ood

grou

p, H

DN

and

blo

od g

roup

inhe

ritan

ce t

hrou

gh d

iscus

sion,

refe

renc

e, d

emon

stra

tion,

as-

signm

ent, c

hart

prep

arat

ion,

pre-

pare

not

es.

•N

ame

diff

eren

t bl

ood

grou

p sy

stem

•A

BO

Blo

od g

roup

sys-

tem

•R

h sy

stem

•B

omba

y bl

ood

grou

psy

stem

•In

heri

tanc

e of

blo

odgr

oup

•H

emol

ytic

dis

ease

of

new

bor

n

Disc

ussio

nD

emon

stra

tion

Ref

eren

ceA

ssig

nmen

tC

hart

prep

arat

ion

Perf

ectio

n of

note

pre

para

-tio

nA

ssig

nmne

tan

d ch

art

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Ref

eren

cebo

oks

Mat

eria

ls fo

rde

mon

stra

-tio

n an

d ch

art

prep

arat

ion

Not

e pr

epa-

ratio

nA

ssig

nmen

t


154

IntroductionDiscovery of blood groups is a major step for successful blood transfusion.Out of these different blood groups ABO system is the most important.Learners have basic idea about ABO & Rh blood groups. Here we elabo-rate the above idea and familarises about Bombay blood group, HDN andinheritance of blood group. A thorough knowledge about blood groups willbe helpful to understand the technique of blood grouping.


23. To understand ABO and Rh blood group system and to have basic idea aboutBombay blood group, HDN and blood group inheritance through discussion,reference, demonstration, assignment, chart preparation, prepare notes.

Syllabus

F Mention different blood group system.

F Explain ABO blood group system.

F Brief idea about Bombay blood group.

F Explain Rh system.

F Brief description of HDN.

F Elementary knowledge of inheritance of blood group.

Learning Activity - 1 : Chart preparation after guided discussion

Material

l Handout prepared by teacher about different blood groups

Process

l Divide the learners into three

l Group I –Distribute handout on ABO groups.

l Group II Description of Rh blood group.

Unit

4BLOOD GROUP

SYSTEMChapter

2


155155

l Group III - description of Bombay blood group

l Instruct each group to prepare consolidation points.

l Each group presents their consolidation points.

l Prepare note based on consolidation points.

l Ask to prepare a chart showing different ABO and Rh blood groups withthe possible antigen and antibody.

Discussion points

l Basic idea of human blood group

l Different types of blood groups.

l Importance of ABO, Rh and bombay blood group.

Consolidation

l Basis of human blood group system is the antigenic characters of red cells.

l Presence or absence of A or B antigen determine ABO blood group .

l ABO Blood group system is the most important blood group system .

l Bombay blood group system is the rare ‘O’ blood group,they lack H antigenand serum contain anti H antibody.

l Rh blood group system divides human population into Rh +ve and Rh-ve

l Knowledge of different blood group system is essential in safe bloodtransfusion.

Outcome

l Understand ABO and Rh system.

l Prepared note

l Prepared chart

CE

l Prepared note

l Prepared chart

l CT

Inheritance of Blood Group

Learning Activity - 2 : Assignment

Teacher tests previous knowledge about the basic principles of Genetics through oraltests.


156

Questions

l What is phenotype, Alleles?

l What is genotype?

l Dominent, recessive, equally dominent

l After oral test, teacher illustrates that the basic principles of genetics can beapplied in the inheritence of blood group system.

l Ask to prepare an individual assignment on inheritence of blood group.

Outcome

l Got idea about the inheritene of blood group.

l Assignment

CE

l Assignment

Haemolytic Disease of Newborn

Learning Activity - 3 : Chart demonstration and discussion

Material

- Flow chart showing the possibility of HDN

Ist child (Not affected)

Father (RH +ve) Mother (Rh -ve)

IInd child

Rh +ve (affected) Rh - ve (not affected)

After showing the chart teacher continue a general discussion. Discussion must involvethe following points.


157157

l What is HDN

l Importance of HDN

l Erythroblastosis foetalis.

Consolidation

l Destruction of foetal red cells by maternal immune antibodies.

l Care should be taken by Rh-ve mother before pregnancy.

Outcome

l Prepared note on ABO Rh and Bombay blood group.

l Assignment note on inheritance of blood group.

l Acquire basic knowledge about HDN and useful in future situation.

TE

l Gokul a friend of Ram, was seriously injured during an accident and admittedto a near by hospital, he need blood. The best friend Ram is ready to donateblood for him. Doctor refused his blood and explained that AB blood groupof Ram is not suitable to O blood group of Gokul. Justify on doctorscomment?

l Blood group of a person is identified as Bombay blood group. Suggest anytwo ways of safe transfusion for him in future if needed.

l Blood group of Sivans’s father and mother are A and B respectively. But hisblood group is entirely different from his father and mother and is O.

- Is it possible? Write your opinion.


158

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 4 -

Im

mun

o H

emat

olog

y an

d B

lood

Ban

king

3. B

lood

gro

upin

g24

.To

und

erst

and

the

basi

c pr

in-

cipl

es o

f bl

ood

grou

ping

- f

or-

war

d an

d re

vers

e gr

oupi

ng a

nddi

ffere

nt m

etho

ds t

hrou

gh d

is-cu

ssio

n, d

emon

strat

ion

and

ref-

eren

ce

25.

To p

erfo

rm A

BO

and

Rh

typi

ngby

sli

de m

etho

d an

d tu

bem

etho

d th

roug

h de

mon

strat

ion,

prac

tical

wor

k, c

amp,

pre

pare

reco

rd/re

port.

•B

asic

pri

ncip

les

ofbl

ood

grou

ping

•Fo

rwar

d gr

oupi

ng•

Rev

erse

gro

upin

g•

AB

O a

nd R

h ty

ping

diffe

rent

met

hods

•A

BO

and

Rh

typi

ng b

ysli

de a

nd tu

be m

etho

d

Disc

ussio

nD

emon

stra

tion

Ref

erec

e

Dem

onst

ratio

nPr

actic

al w

ork

Perf

ectio

n of

note

prep

ratio

n

Rep

ort /

reco

rd o

fw

ork

done

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Ref

eren

cebo

okM

ater

ials

for

dem

onst

ra-

tion

Mat

eria

ls fo

rde

mon

stra

-tio

n an

dpr

actic

alw

ork

Not

e pr

epa-

ratio

n, n

ote

base

d on

obse

rvat

ion

Not

e pr

epa-

ratio

n


159159

IntroductionABO grouping and RH typing of donor and recipient are the first step oflaboratory procedure in a blood bank. Students already attained the skillof perform ABO grouping and RH typing by slide method. An under-standing about the other methods of blood grouping is obtained throughthis unit.


24. To understand the basic principles of blood grouping - forward and reversegrouping and different methods through discussion, demonstration and reference

25. To perform ABO and Rh typing by slide method and tube method through dem-onstration, practical work, camp, prepare record/report.

Syllabus

F Basic principles of blood grouping.

F Brief description of forward and reverse typing.

F Methods for ABO and Rh typing (slide, tube and tile technique)

Practical

l ABO blood grouping and Rh typing slide method

l ABO blood grouping and Rh typing tube method .

Learning Activity - 3 : General discussion

Process

l Teacher recollects the previous knowledge about antigen and antibody.

l Teacher illustrates the concept that corresponding Ab doesnot co-exist inthe same blood.

l The discussion continues on the basic principles differenr blood groupingmethods.

Unit

4 BLOOD GROUPINGChapter

3


160

Discussion points

l Land steiner’s law

l Different blood grouping methods.

l Principles of forward and reverse blood grouping.

l Difference between forward and reserve blood grouping

l Most common method of blood grouping.

l Reagents for blood grouping.

Consolidation

l According to Land Steiner’s law blood group antigen and its correspondingantibody does not co-exist in the same blood.

l Blood grouping methods –forward an reserve grouping

Outcome

l Basic idea about grouping.

TE

l When serum grouping is done with patient serum. A cell, B cell and O cellgive agglutination. Identify the group? Write about the importance of thatblood group?

l Rearrange the following table

Reaction Interpretation

Anti A Anti B Group

+ - B

_ + AB

+ + O

- - A

C.O.25 To perform ABO and Rh typing by slide method and tube method throughdemonstration, practical work, camp, prepare record/report.

Learning Activity - 1 : Self experimentation

Meterials

- Blood sample

- Antiserum


161161

- Microscopic slides, test tubes etc.

Teacher instruct to do blood grouping by slide method as they done the same in firstyear.

Tube method

l Teacher demonstrate a chart showing the standard technique of bloodgrouping by tube method in the class.

l Students are asked to do the practical themselves.

l Teacher scaffolds the learner wherever necessary.

l Students record the work done and report.

l Students can also prepare a table showing the interpretation of variousobservation.

Extended Activity - 1 : Blood group detection camp

Materials

- Notices

- Group recording register.

- Report cards.

- Materials for blood grouping

- Disposible lancet

- Antisera A,B,D

- Microscopic slides

- Microscope etc

Planning

l Form a committee with principal as chairman

l The members include vocational staff, members of local body voluntaryorganization, and student respresentatives.

l A convenient date and place are to be fixed.

l Ask the students to circulate notice amoung the locality

l Collect the materials for the camp.

l Work arrangement can be done as follows.


162

RegistrationMaterials – Table, chairs, register

1. Format for register

Name of school/Voluntary organization: .............................................................

Sl Name & Address for Age Sex Blood Willingness RemarksNo. Communication with Group for donation

Phone No.

2. Issue of identification slip.

Format for identification slip

Serial No : ..................................................................

Name : ..................................................................

Age : ..................................................................

Sex : ..................................................................

Blood group : ..................................................................

The identification slip is transferred to the next. Blood collection group.

3. Collection of blood

Materials: 1. Cotton swab

2.70% alcohol

3.Disposible lancet.

4. Processing

5. Report entering

l Enter the blood group in the identification slip

l Tag the slips serially

6. Issue of report cards

Place: ...................Date: ...................


163163

The report cards should be verified and signed by the vocational teacher.

Format for report cards

Registration No & Date : ..............................................................

Name : ..............................................................

Address : ..............................................................

Age : ..............................................................

Sex : ..............................................................

Blood group : ..............................................................

Signature of Vocational teacher

7. The result obtained should be entered in the register.

8. A leaflet containing the importance of blood donation and transfusion canbe givern along with the report card

This will help to motivate and give awareness to the society about this life savingactivity.

Teacher should ensure complete participation of students in the above process.

Out come

l Skill to perform blood grouping

l Acquire skill to organize medical camp.

PE

l ABO grouping and Rh typing by slide and tube method.

l Record on work done.

VCE

l Blood group detection camp.

TE

l Local body authority ask you to submit blood group records of the near bylocality. How will you organize a blood group detection camp at your schoolfor the above purpose?


164

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 4 -

Im

mun

o H

emat

olog

y an

d B

lood

Ban

king

4. C

oom

b’s

Tes

t

26.

To a

cqui

re b

asic

idea

abo

ut th

eim

porta

nce a

nd d

iffer

ent t

ypes

of

Coo

mb’

s te

st t

hrou

gh d

iscu

s-sio

n, re

fere

nce,

dem

onstr

atio

n,fie

ld v

isit a

nd p

repa

re n

otes

/re-

port.

•C

oom

b's

test

DC

T &

ICT

(Brie

f des

crip

tion)

Disc

ussio

n

Ref

eren

ce

Dem

onst

ratio

n

Fiel

d vi

sit

Not

e pr

epar

a-tio

n R

ecor

d /

repo

rt of

fiel

dvi

sit

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Ref

eren

cebo

oks,

Mat

eria

l's fo

rde

mon

stra

-tio

n

Not

e pr

epa-

ratio

nA

ssig

nmen

t


165165

IntroductionStudents already have an idea about different blood group antibodies.Coomb’s test is a very useful technique done in a blood bank to detect weakimmunological reactions, compatibility testing and identification of sensitisedred cells. This chapter gives a brief idea about direct and indirect Coomb’stest. Field visit and OJT helps to strengthen the idea.


26. To acquire basic idea about the importance and different types of Coomb’s testthrough discussion, reference, demonstration, field visit and prepare notes/re-port.

Syllabus

F Importance of Coomb’s test.

F Mention different methods DCT and ICT.

Practical

l ABO blood grouping and Rh typing slide method

l ABO blood grouping and Rh typing tube method .

Processl Teacher illustrates the importance of coomb’s text

l Students are grouped into two

l Group I- Give hand out on DCT

l Group II- Give hand out on ICT

l Let them discuss.

l Teacher can guide the students during their discussion.

l One among the group presents their discussed points.

l Teacher consolidates and students prepare note.

Unit

4 COOMB’S TESTChapter

4


166

Discussion Points

l What is the importance of Coomb’s test?

l Two types of Coomb’s test ?

l Basic idea about DCT & ICT.

Consolidation

l Coomb’s test is used to detect incomplete antibodies.

l Two types of Coomb’s test –DCT & ICT

Other suggested activities – reference, demonstration, field visit.

Outcome

l Basic idea about Comb’s test

l And different types of Coomb’s test.

VCE

l Field visit


167167

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 4 -

Im

mun

o H

emat

olog

y an

d B

lood

Ban

king

5. C

ross

mat

chin

g

27.

To f

amili

arise

with

im

porta

nce

and

diffe

rent

met

hods

of

cros

sm

atch

ing

thro

ugh

disc

ussi

on,

dem

onst

ratio

n, r

efer

ence

, fie

ldvi

sit a

nd p

repa

re n

ote/

repo

rt.

•Im

port

ance

of

cros

sm

atch

ing,

dif

fere

ntty

pes

of c

ross

mat

ch-

ing

•M

ajor

and

min

orm

etho

ds•

Salin

e ph

ase

•A

lbum

in p

hase

•A

HG

pha

se (

Bas

icid

ea o

nly)

Disc

ussio

n

Ref

eren

ce

Dem

onst

ratio

n

Fiel

d vi

sit

Not

e pr

epar

a-tio

nR

ecor

d /

Rep

ort o

f fie

ldvi

sit

Med

ical

Labo

rato

ryTe

chno

logy

Vol

. I, K

anai

L. M

uker

jee

Bas

ic M

edic

alLa

bora

tory

Tech

niqu

es, b

yB

arba

ra H

.Es

tridg

e

Ref

eren

cebo

oks,

Mat

eria

ls fo

rde

mon

stra

-tio

n

Not

e pr

epa-

ratio

n, n

otes

base

d on

obse

rvat

ion


168

IntroductionOne of the most critical tests performed in the blood bank is cross match-ing. Proper performance of the test avoids risk of incompatible blood trans-fusion. Through this chapter the learner gets the idea about the importanceand different methods of cross matching.


27. To familiarise with importance and different methods of cross matching throughdiscussion, demonstration, reference, fields visit and prepare note/report.

Syllabus

F Clinical importance of cross matching.

F Mention the different method of cross matching (Tube method).

- Saline phase, Albumin phase, AHG phase.

Activity - 1 : Demonstration

Material

- Blood samples of different blood group

- Microscopic slides etc

Process

l Divide the students into two groups

l One group is asked to mix blood of two different blood groups on amicroscopic slides

l The other group is asked to mix blood samples of same group.

l Let them observe.

Teacher starts a general discussion on cross matching.

Unit

4 CROSS MATHCINGChapter

5


169169

Discussion points

l What is cross matching ?

l Importance of cross matching

l Different methods of cross matching

Consolidation

l Testing compatibility between donor’s and recipient’s blood is cross matching.

l Cross matching is essential for safe blood transfusion.

l Major and minor cross matching.

l In major cross matching mix donor’s blood cell with recipients serum.

l In minor cross matching mix donor’s serum with recipient’s blood cells.

Demonstration and practical work

l Scoff older demonstrates the methods of cross matching (Salino major andminor) before the learner and instruct them to practise the procedure.

Out come

Basic idea about importanance of corss mathcing and different methods.

l Basic idea about cross matching

l Skill in performing cross matching (saline method)

PE

l Practical record. On saline method of cross matching.

l VCE Field visit:-To observe different methods of cross matching in theblood bank.

TE

l “Before blood transfusion a cross matching is necessary between the bloodof donor and recipient”. Comment on this statement.

l Compare major and minor cross matching?


170

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 4 -

Im

mun

o H

emat

olog

y an

d B

lood

Ban

king

6. B

lood

Tra

nsfu

sion

28.

To g

et a

n id

ea a

bout

the

impo

r-ta

nce

of b

lood

tra

nsfu

sion

and

unde

rsta

nd a

bout

scr

eeni

ng o

fdo

nor,

antic

oagu

lant

s, b

lood

colle

ctio

n pr

oced

ure a

nd st

orag

eth

roug

h di

scus

sion

, re

fere

nce,

field

vis

it, d

emon

stra

tion

etc.

,an

d pr

epar

e no

te/r

ecor

d an

dde

velo

p a

posi

tive

atti

tude

to

dona

te b

lood

to th

e ne

edy

ones

.

29.

To id

entif

y di

ffere

nt co

mpo

nent

sus

ed f

or b

lood

tran

sfus

ion

and

trans

fusio

n rea

ctio

ns th

roug

h di

s-cu

ssio

n, re

fere

nce,

fiel

d vi

sit et

c.,

and

prep

are

note

s/re

cord

.

•Im

porta

nce

of b

lood

trans

fusio

n.•

Scre

enin

g of

don

or•

Ant

icoa

gula

nt•

Blo

od c

olle

ctio

n•

Blo

od s

tora

ge

•D

iffer

ent

bloo

d co

m-

pone

nts

used

fo

rtra

nsfu

sion

- w

hole

blo

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ells

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171171

IntroductionThe various laboratory procedures done in the blood bank leads to safeblood transfusion. Awareness about donor selection, blood storage bloodcollection and transfusion reaction enables the students to realise the misgiv-ings about blood donation is done through this chapter. A seminar on theabove topic will elaborate the idea. A field visit is necessary to familarisethe learner with the ultimate aim of blood bank in real life situation.


28. To get an idea about the importance of blood transfusion and understand aboutscreening of donor, anticoagulants, blood collection, procedure and storagethrough discussion, reference, field visit, demonstration etc., and prepare note/record and develops a positive attitude to donate blood to the needy ones.

29. To identify different components used for blood transfusion and transfusion re-actions through discussion, reference, field visit etc., and prepare notes/record.

Syllabus

F Importance of blood transfusion.

F Criteria for screening of donor.

F Mention the anticoagulant for blood collection.

F Explain blood collection procedure.

F Brief description of blood storage.

F Blood components

- Mention different components used for blood transfusion.- Whole blood, packed cell, cryoprecipitate, platelet rich plasma and fresh frozen plasma.

F Transfusion recations

- Name transfusion reactions.

Unit

4BLOOD

TRANSFUSIONChapter

6


172

Practical

l Demonstration of blood collection equipments - blood bag.

Extended Activity - 1 : Seminar

l Distribute the following material among four groups of students

l A VHSE MLT Student Ravi, witnessed an accident case with severe bloodloss in a casualty section of a hospital. The doctor advised that the patientneeds immediate blood transfusion. Unfortunatly they cannot find out adonor. The student rushed to the blood bank and reported his willingnessfor blood donation. The blood bank authority asked about his age andrejected his willingness. They also said that there are some criteria for blooddonation. Desperately he returned home. The next day he approached hisMLT. Teacher and asked his doubts about transfusion.

l Ask the students to point out their doubts about blood transfusion

l To clarify the above doubts, the learners are introduced to a Seminar on“Blood Transfusion.”

Topic – Blood Transfusion

Subtopics

1) Importance of blood transfusion and donor screening

2) Blood collection and storage

3) Blood transfusion

4) Blood components

5) Transfusion reactions

Planning

l Learners are grouped into 5

l Ask to collect information from reference book

l Prepare a rough seminar paper

l Teacher read the rough seminar paper and make correction if necessary.

l Teacher instructs the learners to use chart, transparency, OHP, Power pointand other materials to present the seminar paper.

l Fix convenint date for seminar, invite all participants and make necessaryarrangement.

l One of the members from each group presents their subtopic in the seminar.


173173

l After presentation conduct a discussion

l Every learner should prepare seminar report and submit

l Teacher evaluates the report.

Out come

l Students become aware of social commitment of blood donation

l Basic idea about blood donation procedure.

l Seminar reports

CE

l Seminar presentation and report

TE

l After blood donation donor’s are allowed to wake’ up only after minute?Give reason?

l Blood transfusion is performed as a safe procedure after grouping and crossmatching. Even though some complications may arise as transfusion reactions.Enlist the major transfusion reactions.

l Prepare a sample notice promoting and encouraging blood donation.


Assignment, field visit.


174

INTRODUCTION TOBIOCHEMISTRY

INTRODUCTION

Biochemical tests are now an important part of thediagnostic investigation and management of patients.When used properly, biochemical tests can contributesubstantially to the overall care of the patient. Throughthis unit the learners get a clear idea about theimportance of biochemistry, attains practical skill inhandling and storage of chemicals, use of laboratoryglasswares, equipments and various estimationprocedures.

The advances in clinical biochemistry have led to asteady increase in the number and range ofinvestigations, which in turn led to automation. Thisunit also gives a basic idea about automation in clinicalbiochemistry. A test wrongly done is worst than a testnot done. So Quality Control ensures that the resultsfrom one lab should be comparable to that from anylaboratory in the world provided, that the same methodis employed. Through this unit the learners get an ideaabout the need of quality control in biochemical tests.

UNIT5


175175

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

1. I

ntro

duct

ion

to b

ioch

emis

try

30.

To a

cqui

re a

n id

ea o

f the

impo

r-ta

nce o

f bio

chem

istry

and

diffe

r-en

t typ

es o

f sol

utio

ns an

d to

per

-fo

rm cl

eani

ng o

f gla

ss w

ares

and

prep

arat

ion

of c

hrom

ic a

cid

so-

lutio

n th

roug

h di

scus

sion,

dem

-on

stra

tion,

pra

ctic

al w

ork

pre-

pare

not

es/re

cord

.

•Im

port

ance

of

bio-

chem

istry

•D

iffer

ent t

ypes

of

so-

luti

on (

Perc

enta

ge,

mol

ar,

norm

al,

stan

-da

rd a

nd sa

tura

ted

so-

lutio

n)•

Cle

anin

g of

gla

ss -

war

es•

Chr

omic

aci

d so

lutio

n

Perf

ectio

n of

note

Prac

tical

wor

kR

ecor

d

Text

boo

k of

Bio

chem

istry

by H

arol

dV

arle

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Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

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asud

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176

Introduction

Students have knowledge about different types of solutions and itsconcentrations. An accurate biochemical result largely depends on the reagentsand chemically clean glassware. Students attain practical skill in cleaning ofdifferent types of glasswares.

Curriculum Objectives30. To acquire an idea of the importance of biochemistry and different types of solu-

tions and to perform cleaning of glass wares and preparation of chromic acidsolution through discussion, demonstration, practical work, prepare notes/record.

Syllabus

F Importance of bio-chemistry.

F Brief discussion on different types of solutions - Percentage solution, Molarsolution, Normal solution, Standard solution and Saturated solution.

F Cleaning of glassware

F General cleaning.

F Chromic acid solution.

Practical

l Preparation of chromic acid solution.

l Cleaning of glass wares.

Learning Activity - 1 : Case presentation followed by guided discussion

Materials

- Reference book

- Laboratory Manual for Tropical Countries by Monica Cheesborogh Volume1- Hand book of MLT - CMC Vellore

Unit

5 BIOCHEMISTRYChapter

1


177177

Process

l Teacher supplies the photocopy of an extract from a medical journal orwritten document in the form of journal. the journal narrates an incidentfollowed by an interview of an VHSE student with a doctor.

One day while waiting at a bus stop, one VHSE student named Raju witnesseda middle aged, known diabetic patient under insulin treatment fell downunconcious. He was rushed to a hospital . Raju is very eager to know whathappened to the man . Raju went to a doctor who was his cousin and had aninterview. Their conversation is narrated below.

Raju : Good morning doctor

Doctor : Haa! Raju, morning please come in.

Raju : May I take your valuable time to clear some doubts.

Doctor : Why not? I am so pleased

Raju : Thanks doctor. Yesterday while I was waiting for my bus, I found a manwith known diabetis mellitus on insulin treatment fell down unconciousand rushed to hospital. Why this happens ?

Doctor : This may happen due to two reasons

1. His blood sugar level may be increased alarmingly due to the diabetes

2. OR his blood sugar level decreased dangerously due to overdosage ofinsulin

Raju : OK doctor. Then what is the treatment in such situation ?

doctor : Yes that is a good question. If it is due to increased sugar level , give moreamount of insulin and if it is due to fall of glucose, give glucoseimmediately

Raju : How it can be differentiated?

Doctor : Yes, that is the problem. It can be correctly diagnosied only by biochemicalinvestigation in a biochemistry laboratory.

Raju : Biochemistry? What is it?

Doctor : It is an important branch in clinical investigations which deals with chemicalreactions occuring in body and the investigations of various bodilyparameters.

Raju : I utilised a lot of your valuable time, but now I am leaving with full a mind. thank you very much doctor.


178

Doctor : OK welcome Raju.

Process

l Divide the students into four groups

l Distribute the copies of the above interview to each group

l Let them go through it

l Then ask some questions relating to it like

l What is biochemistry ?

l What is the importance of a biochemistry laboratory ?

l What may be the reason for unconcious state of the man?

Teacher can consolidate the importance of biochemistry through this activity

Out come

l Learners understand the importance of biochemistry

Different types of solutions and cleaning of glasswares


Materials

Handouts on different types of solutions

l Divide the students into five groups.

l Distribute handouts on percentage solution , molar solution , normal solution,saturated solution, standard solution etc., to each group.

l Allow a guided discussion and teacher consolidates the points and is recordedby each student.

Discussion points

l Solute, solvent and solution

l Percentage, molar, normal, standard and saturated solutions.

Consolidation points

l Solution is a mixture of solvent and dissolved solute

l Percentage solutions → W/WW/VV/V

l 1 gm molecular weight of substance of solute dissolved in 1000ml of solventin molar solution


179179

Learning Activity - 2 : Discussion and practical

Teacher starts a discussion by asking a question

l How will you clean your household utensils?

l Teacher elictes response and divert the method for cleaning of glasswares.

l Teacher demonstate the cleaning technique of used as well as new glass wares.

l Students are asked to prepare chromic acid solution.

l Students practise the method of cleaning of glasswares.

l Record the work done and submit.

Outcome

l Understand different methods of expressing the concentration of solutions.

l Able to prepare chromic acid solution.

l Able to clean new and old glasswares.

l Record of work done on a practical.

Evaluation

CE

l Oral test


180

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

2. I

nstr

umen

ts u

sed

in B

ioch

em-

istr

y

31.

To a

cqua

int

with

the

use

and

care

of a

naly

tical

bal

ance

, cen

-tri

fuge

and

dist

illat

ion

appa

ratu

sth

roug

h di

scus

sion,

dem

onstr

a-tio

n an

d pr

epar

e no

tes/

reco

rd.

32.

To

unde

rsta

nd t

he p

rinc

iple

,pa

rts, w

orki

ng, u

se a

nd c

are

ofco

lorim

eter

and

to h

ave

an id

eaab

out s

pect

roph

otom

eter

, fla

me

phot

omet

er a

nd m

icro

pipe

tteth

roug

h di

scus

sion

, re

fere

nce,

dem

onst

ratio

n, p

ract

ical

wor

k,pr

epar

e no

tes/

reco

rd.

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se a

nd c

are

of a

na-

lytic

al b

alan

ce, c

entri

-fu

ge a

nd d

istil

latio

nap

para

tus

•Pr

inci

ple,

par

ts w

ork-

ing,

use

and

car

e of

colo

rimet

er•

spec

troph

otom

eter

•Fl

ame

phot

omet

er•

mic

ropi

pette

Rec

ord/

note

Rec

ord/

note

Text

boo

k of

Bio

chem

istry

by H

arol

dV

arle

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Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

d V

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eria

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Ref

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ce


181181

Introduction

Analytical methods in clinical biochemistry are based on instrumental analysis.Many methods for quantitative analysis of blood and other fluids are basedon the principle of photometry. This chapter gives a thorough knowledgeabout the principle, parts, uses and care of colorimeter and familarise withother important photometric instruments. Use and care skill of analyticalbalance, centrifuge and distillation apparatus are also essential to do differentanalytical methods.

Curriculum Objectives31. To acquaint with the use and care of analytical balance, centrifuge and distillation

apparatus through discussion, demonstration and prepare notes/record.

32. To understand the principle, parts, working, use and care of colorimeter and tohave an idea about spectrophotometer, flame photometer and micropipette throughdiscussion, reference, demonstration, practical work, prepare notes/record.

Syllabus

F Use and care of analytical balance, centrifuge and distillation apparatus,

F Explain the principle, parts, working, use and care of colorimeter.

F Familiarise with Spectrophotometer, Flame photometer, Micropipettes.

Practical

l Colurimeter - parts, operation and care.

Learning Activity - 1 : Self identification, practical with handouts about theinstruments.

Process

l Divide the student into three groups.

l Provide first group with handout on parts ,use and care of centrifuge.

Unit

5INSTRUMENTS USED

IN BIOCHEMISTRY

Chapter

2


182

l Give handout on parts use and care of an analytical balance to the secondgroup

l Give a handout of distillation apparatus to third group.

l Let the students identify the parts and use of the instument themselves

l Teacher guide the learners during the process

l Record the work done and submit

l Inter change the instrument to ensure that all the groups use the threeinstruments.

l Teacher consolidates the discussed points on the care of these instrumentsand students prepare notes.

Outcome

l Understand the parts and use of centrifuge , analytical balance and distillationapparatus.

l Attained skill to use the above instruments.

Evaluation

CE

l Record on work done.

l Oral test

Colorimeter

Learning Activity - 1 : Experimentation

Material

- KMn04 solution

- Test tube

Process

l Teacher instruct one among the students to prepare a coloured solution(KMn 04 solution) in a test tube with a moderate concentration

l A small portion of the prepared solution is taken into another tube and addmore quantity of distilled water to make a dilute solution.

l Samples from each tube is taken in two small identical test tubes

Ask them to read a printed matter through both the solutions. Learners notes the thatit is difficult to read through concentrated solution. Teacher asks a question.


183183

l What may be the reason for this?

l Teacher elicites response and concludes that more amount of light is absorbedby darker solution.

l The experiment may be repeated with same solution taking in two differentsized test tubes.

l They also note that if the distance travelled through the solution increasesabsorbance also increases.

l This experiment gives an idea about the principle (Beer’s-Lambert’s law).

l The teacher then illustrate the law to learners.

l Learners are asked to prepare notes.

Consolidation

l Colour of solution depends on the concentration of the coloured solute

l Amount of light absorbed also depend on the intensity of colour and thelength of column of solution through which the light passes.

l Beer-Lambert’s law

Learning Activity - 2: Demonstration of colori meter and preparation ofblock diagram

Materials

- Colorimeter

- KMn04 solution prepared in activity one

Process

l Teacher demonstrates the parts and operation of colorimeter to measureconcentration of coloured solution.

l Idea obtained is clarified with the preparation of block diagram.

l Instruct the learners to practise how colorimeter is used skillfully to measurethe intensity of coloured solution.

l Record the work done.

Outcome

l Understands the principle and parts of colorimeter

l Able to use colorimeter.


184

l Prepares notes and block diagram

l Record on work done

Evaluation

CE

l Oral test

l Prepared notes and block diagram

PE

l Skill in using colorimeter

TE

Complete the following block diagram

→ → → → →

Learning Activity - 3: Discussion

Materials

- Handouts about spectrophotometer, flame photometer and micropipette.

Process

l Instruct the learner to go through the handout containing a brief but clearidea about the use and application of spectrophotometer, flame photometer,micropipette.

l Start open discussion based on the handouts.

l Prepare notes based on discussion.

Discussion points

l What is the importance of flame photometer in Biochemistry?

l What is the diffrence between micropipettes and ordinary pipettes?

l Difference between colorimeter and spectrophotometer


l Flame photometer is used to measure the concentration of metal ions.

l Micropipettes are easier and accurate than ordinary pipette, but expensive.

Slit Readout meterSample


185185

Outcome

l Learner understands about spectrophotometer ,flame photometer andmicropipette

l Prepare notes based on discussion

CE

l Oral test

TE

l Enzymatic methods uses very small quantity of serum for estimation ofdifferent constituents. Suggest a device to deliver such a very small amountof solution.

l Colorimeter and spectrophotometer are used to measure the optical densityof a solution. Give a comparison between the two


186

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

3. E

stim

atio

n of

Blo

od S

ugar

33To

acq

uain

t w

ith t

he d

iffer

ent

type

s of

blo

od s

ampl

es, a

ntic

o-ag

ulan

ts us

ed an

d di

ffere

nt m

eth-

ods

for

Blo

od s

ugar

esti

mat

ion

thro

ugh

disc

ussi

on,

refe

renc

ean

d pr

epar

e no

tes

34To

per

form

blo

od su

gar e

stim

a-tio

n by

O

.Tol

udin

e an

dG

OD

POD

met

hod

thro

ugh

dem

onst

ratio

n pr

actic

al w

ork

prep

are

reco

rd/re

port.

35.

To g

et a

n id

ea a

bout

Glu

cose

chal

leng

e te

st an

d G

luco

se to

l-er

ance

tes

t th

roug

h di

scus

sion,

refe

renc

e an

d pr

epar

e no

tes.

•T

ypes

of

bl

ood

sam

ples

-FB

S, R

BS,

PPB

S•

Ant

icoa

gula

nts u

sed

•N

ame

of

diff

eren

tm

etho

ds

•Pr

inci

ple,

re

quir

e-m

ents

, pr

oced

ure,

norm

al v

alue

and

clin

i-ca

l si

gnif

ican

ce o

fbl

ood

suga

r esti

mat

ion

•O

- To

ludi

ne m

etho

d•

GO

DPO

D m

etho

d

•G

luco

se c

halle

nge

test

•G

luco

se t

oler

ance

test

(brie

f)

Perf

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n of

note

sO

T

Rec

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T

Perf

ectio

n of

note

s

Text

boo

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Bio

chem

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by H

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Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

d V

asud

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Prep

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of n

otes

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Disc

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ence


187187

Introduction

Determination of blood sugar is one of the first and most frequently doneinvestigations in a biochemical laboratory. It is done for the diagnosis and 3management of diabetes mellitus. This chapter deals with different bloodsamples, method of blood sugar estimation, brief description of glucosechallenge test and glucose tolerance test.

Curriculum Objectives33 To acquaint with the different types of blood samples, anticoagulants used and

different methods for Blood sugar estimation through discussion, reference andprepare notes

34 To perform blood sugar estimation by O.Toludine and GODPOD method throughdemonstration practical work prepare record/report.

35. To get an idea about Glucose challenge test and Glucose tolerance test throughdiscussion, reference and prepare notes.

Syllabus

F Estimation of blood glucose.

F Collection of blood for sugar estimation.

F Anticoagulant used.

F Familiarise the term FBS, RBS and PPBS.

F Name different method for blood sugar estimation.

F Explain the principle, requirements, procedure, normal value and clinicalsignificance of blood sugar estimation.

F O-Toludine method

F GODPOD method

F Brief description of glucose challenge test and Glucose tolerance test.

Unit

5ESTIMATION OFBLOOD SUGAR

Chapter

3


188

Practical

l Estimation of glucose (O-toluidine method)

l Estimation of glucose (GOD-POD method)

Learning Activity - 1 : Group discussion

Materials

- Reference Book.

Process

l Group the learners in to three and instruct them to refer the book of relevanttopics and consolidate the points.

l First group refers the types of blood samples, second group about theanticoagulant for sugar estimation and third group different blood samplesavailable for sugar estimation.

l After discussion one member from each group will present and consolidatethe points.

l Ask the student to prepare notes from the consolidated points.

Discussion points

l What are the different types of blood sample with respect of food intake?

l What are the anticoagulants used to collect blood for sugar estimation?

l What are the different methods available for sugar estimation?

Consolidation

l Blood sample - FBS, PPBS, RBS

l Sodium fluoride oxalate mixture is the best anticoagulant of choice.

l Blood sugar estimations are based on

a) Reducing property of glucose

b) Condensation property

c) Enzymatic activity.


l Reference

Outcome

l Learner achieves basic idea about the blood sample, anticoagulant used anddifferent methods used for blood sugar estimation.


189189

Evaluation

CE

l Oral test

TE

l A man done his blood sugar estimation in a laboratary at early morning(got value 90 mg%). Due to some doubt he repeated the test at another labone or two hours after his food.(value 150mg%). Due to this wide variationsin results he checked the blood sugar value again at another lab (value115mg%) He blamed all these lab for the incorrect results, as all are errors.What is your opinion? Whether all labs are wrong? Is any other reason forthese variations. Write your comment.

Estimation of blood sugar 0-Toluidine and GOD POD

Learning Activity - 1: Discussion demonstration and practical work

Materials

- Colorimeter

- Test tubes

- Reagents

- Blood sample

- Water bath at 370C etc

Process

l Distribute the photocopy of relevant pages and ask the learner for a generaldiscussion about the principle, normal value and clinical significance of bloodsugar estimation and to prepare note.

l Bring the learner in to lab and demonstrate the different steps of bloodsugar estimation procedure

l Ask the learners to repeat the procedure several times until they acquirepractical skill to perform the test confidently and to prepare record.

Out come

l Learners attained skill in doing the practical work of blood sugar estimation.

CE

l Class test.

PE

l Skill in performing practical test.


190

TE

l Measuring blood sugar level is one of the most frequently done tests in a lab.If a known diabetic patient comes to your lab for testing blood sugar level,write the steps you will perform to find out the value.

Glucose challenge test and glucose tolerance test

Learning Activity - 1: General discussion and preparation of notes

Material

l Reference books - Clinical Biochemistry - Harold Varley, Textbook ofBichemistry, Tietz.

Process

l Supply reference books and ask the learners to note the points.

l Teacher consolidates the points.

l Ask the learners to prepare note from the consolidated point .

Discussion points

l What is the use of GCT and GTT?


l These tests are use to differentiate mild, moderate and severe diabetesmellitus and to rule out the possibility of gestational diabetes.

Out come

l Learners know the importance and use of GCT and GTT

Suggested activity

l Field visit

CE

l Oral test

TE

l GCT and GTT are done to assess the carbohydrate metabolism. Give acomparison between the two.


191191

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

4. E

stim

atio

n of

Pro

tein

s

36.

To a

cqui

re id

ea o

f pla

sma

pro-

tein

s an

d to

per

form

Tot

al p

ro-

tein

estim

atio

n by

Biu

ret m

etho

d,A

lbum

in e

stim

atio

n by

BC

Gm

etho

d th

roug

h di

scus

sion,

ref-

eren

ce, p

ract

ical

wor

k et

c., p

re-

pare

reco

rd/re

port.

•Pl

asm

a pr

otei

ns•

Nor

mal

va

lue

and

clin

ical

sig

nific

ance

of

tota

l pro

tein

and

alb

u-m

in•

Prin

cipl

e, r

eage

nts

(nam

e on

ly)

proc

e-du

re, c

alcu

latio

n of

to-

tal

prot

ein

(Biu

ret

met

hod)

and

alb

u-m

in(B

CG

met

hod)

Not

esPr

actic

al sk

illR

ecor

d/re

port

Text

boo

k of

Bio

chem

istry

by H

arol

dV

arle

y

Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

d V

asud

evan

Ref

eren

cebo

oks

Mat

eria

ls fo

rde

mon

stra

-tio

n an

dpr

actic

alw

ork

Not

e pr

epa-

ratio

nR

ecor

d/re

port

onw

ork

done

Disc

ussio

nR

efer

ence

Dem

onst

ratio

nPr

actic

al w

ork


192

Introduction

Proteins are the essential constituents of the body and serve as buildingblocks. Estimation of serum proteins is useful in the diagnosis of liverdisorders and a number of other diseases. This chapter gives anunderstanding of plasma along with the normal value and skill to performtotal protein and albumin estimation.

Curriculum Objectives36. To acquire idea of plasma proteins and to perform Total protein estimation by

Biuret method, Albumin estimation by BCG method through discussion, refer-ence, practical work, prepare record/report etc.

Syllabus

F Introduction to plasma protein.

F Explain the principle, reagents (name only), procedure and calculation of totalprotein by Biuret method.

F Explain the principle, reagents (name only), procedure and calculation for theestimation of albumin by BCG method.

F Normal value and clinical significance of total protein and albumin.

Learning Activity - 1: Discussion, demonstration and practical work.

Materials

- Hand outs

- Colorimeter

- Testtubes/pipette

- Re-agents etc.

Process

l Instruct the learners for a general discussion after giving the handouts aboutplasma proteins, its normal value and clinical; significance and ask them toprepare note.

Unit

5ESTIMATION OF

PLASMA PROTEINS

Chapter

4


193193

l Demonstrate the method of total protein estimation (Biuret method) andalbumin estimation (BCG method)

l Ask the learners to repeat the procedure by themselves until they becomeskilled and to prepare record.


l Field visit

l Reference

Out come

l Attained skill to perform total protein estimation and albumin estimationan had an idea about its clinical significance and normal value.

CE

l Class rest

PE

l Practical skill

PE

l The total protein value of 45 yrs old man found as 5 g%. Write down theconditions you would expect such a value.


194

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

5. E

stim

atio

n of

NPN

Sub

stan

ces

37.

To g

et a

n id

ea a

bout

the

diffe

r-en

t NPN

subs

tanc

es an

d to

per

-fo

rm b

lood

ure

a (B

erth

lot

met

hod)

and

Cre

atin

ine

estim

a-tio

n (A

lkal

ine

Picr

ate

Met

hod)

thro

ugh

disc

ussi

on,

refe

renc

e,de

mon

stra

tion,

pra

ctic

al w

ork

and

reco

rd/re

port.

•D

iffer

ent

NPN

sub

-sta

nces

and

its

impo

r-ta

nce

•N

orm

al

valu

e an

dcl

inic

al s

igni

fican

ce o

fB

lood

ure

a an

d se

rum

crea

tinin

e•

Diff

eren

t m

etho

ds f

orbl

ood

urea

and

ser

umcr

eatin

ine

estim

atio

n.•

Blo

od u

rea

estim

atio

n(B

erth

lot m

etho

d)•

Seru

m c

reat

inin

e es

ti-m

atio

n (a

lkal

ine

pi-

crat

e m

etho

d)

Not

esPr

actic

al sk

illR

ecor

d

Text

boo

k of

Bio

chem

istry

by H

arol

dV

arle

y

Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

d V

asud

evan

Ref

eren

cebo

oks

Mat

eria

ls fo

rpr

actic

alw

ork

Not

es b

ased

on d

iscus

sion

and

refe

renc

eR

ecor

d of

wor

k do

ne

Disc

ussio

nR

efer

ence

Dem

onst

ratio

nPr

actic

al w

ork


195195

Introduction

Estimation of NPN substances in blood plays an important role in theevaluation of kidney function. The major NPN substances estimated areblood urea and creatinine. At the end of the chapter the student attainspractical skill in its estimation and understands the normal value and theclinical significance.

Curriculum Objectives37. To get an idea about the different NPN substances and to perform blood urea

(Berthlot method) and Creatinine estimation (Alkaline Picrate Method) throughdiscussion, reference, demonstration, practical work and record/report.

Syllabus

F Mention the different NPN substances and its importance.

F Mention the different methods of blood urea estimation.

F Explain the principle, procedure and calculation of blood urea estimation byBerthlot method.

F Normal value and clinical significance of blood urea.

F Mention the different methods of serum creatinine estimation.

F Explain the principle, procedure and calculation of serum creatinine estimationby alkaline picrate method.

F Mention normal value and clinical significance of serum creatinine.

Learning Activity - 1: Discussion, demonstration and practical work

Materials

- Photocopy of relevant page of reference book.

- Colorimeter

- Test tubes/pipettes

- Water bath at 370C etc

Unit

5ESTIMATION OF NPN

SUBSTANCES

Chapter

5


196

Process

l General discussion by referring the photocopy about NPN substances, itsimportance and clinical significance and to prepare note.

l Demonstrate the method of estimation of blood urea by Berthlot Methodand creatinine (alkaline Picrate method)

l Since the procedure is almost same in all these estimations, learners acquireskill in practical work.


l Reference

l Field visit

Out come

l Learners had a clear idea about the importance and clinical significance ofNPN substances and acquired the skill to perform the estimation of bloodurea and serum creatinine.

l Prepared note

CE

l Class test

l Oral test

PE

l Skill in performing estimation of blood urea and serum creatinine.

TE

l Usually proteins are organic compounds containing nitrogen. Write downthe nitrogen containing non-protein substances present in blood which areclinically important.

l Physician suspects that one of his patients is developing renal malfunction.Name two diagonostic methods which evaluates the functions of kidney.


197197

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

6. E

stim

atio

n L

ipid

s

38.

To a

cqui

re a

n id

ea a

bout

diff

er-

ent c

lass

es o

f lip

of p

rote

in, t

heir

clin

ical

sig

nific

ance

and

to p

er-

form

ch

olst

erol

es

tim

atio

nth

roug

h di

scus

sion

, ref

eren

ce ,

prac

tical

wor

k, i

nter

view

and

prep

are

note

s / r

ecor

d.

•D

iffe

rent

cla

sses

of

lipo

prot

ein,

thei

r clin

i-ca

l sig

nific

ance

•N

ame

diffe

rent

met

h-od

s of

cho

lest

erol

estim

atio

n•

Cho

leste

rol e

stim

atio

n(c

hole

stre

rol

este

rase

de

hy

dro

ge

na

sem

etho

d)•

Nor

mal

val

ue•

Clin

ical

sign

ifica

nce

Not

esO

TPr

actic

al sk

illR

ecor

d /

repo

rt

Text

boo

k of

Bio

chem

istry

by H

arol

dV

arle

y

Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

d V

asud

evan

Ref

eren

cebo

oks

mat

eria

ls fo

rpr

actic

alw

ork

Not

es /

reco

rd o

fw

ork

done

Disc

ussio

nR

efer

ence

Dem

onst

ratio

nPr

actic

al w

ork

inte

rvie

w


198

Introduction

Estimation of lipids especially serum cholesterol is considered as the riskfactor in coronary artery disease. It is also very useful in the investigation ofseveral other diseases. An interview with an expert is included in thischapter to give the learner a thorough understanding of the various riskfactors involved in heart diseases. The learner attains skills to performtotal cholesterol estimation.

Curriculum Objectives38. To acquire an idea about different classes of lipoprotein their clinical significance

and to perform cholesterol estimation (enzymatic method) through discussion,reference, demonstration, practical work and prepare notes/record.

Syllabus

F Mention different classes of lipoproteins and their clinical significance.

F Explain the principle, procedure and calculation of serum cholesterol by enzymaticmethod. (cholesterol - esterase - dehydrogenase)

F Normal value and clinical significance of serum cholesterol

Classes of lipoproteins and clinical significance

Learning Activity - 1: Interview

Process

l Teacher asks a question. “What are the common diseased condition causingsudden death”?

l Responses are elicited and consolidates that heart attack is the most commoncause.

l Teacher understood that learners have a lot of doubts regarding cholesterol,heart attack, life style etc.

l So arranges an interview with an expert (preferably a socially interesteddoctor)

l For that group the learners in to four and ask them to prepare the questionsto be asked.

Unit

5ESTIMATION OF

LIPIDS

Chapter

6


199199

Planning

l Invite a resource person

l Decide the questions to be asked.

l Teacher should give guidance

l Fix a convenient date, time and place.

l Decides the students who can participate.

l Implementation of interview

l Conclusion by facilitator.

l Students are asked to prepare notes based on interview

Estimation of Lipids

Learning Activity - 2: Discussion, demonstration and practical work.

Materials

- Photocopy of reference books

- Colorimeter

- Reagents

- Test tubes and pipettes

- water bath at 37o C.

Process

l Teacher leads a general discussion after referring the handouts about differenttypes of lipoprotein, clinical significance and to prepare notes.

l Demonstrate the method of cholesterol estimation (enzymatic method)

l Ask the learners to practise the procedure by themselves and to record.


l Reference

l Field visit

Outcome

l Learners would get clear idea about the types of lipoproteins, its clinicalsignificance and normal value.


200

l Learners are also able to perform the test of cholesterol estimation skillfully.

l Prepared note

l Prepared note based on interview.

Evaluation

CE

l Class test

l Prepared notes

PE

l Practical skill in cholesterol estimation in the given sample of blood.

TE

l An obese man having family history of heart attack wishes to monitor hiscondition. Which risk factor in serum is estimated? How will you performthe test?


201201

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

7. L

iver

Fun

ctio

n T

ests

39.

To g

et a

n id

ea a

bout

the

impo

r-ta

nce

of L

iver

Fun

ctio

n Te

sts,

vario

us L

iver

Fun

ctio

n Te

sts an

dab

le to

per

form

ser

um b

iliru

bin

estim

atio

n th

roug

h di

scus

sion

,re

fere

nce,

dem

onst

ratio

n pr

e-pa

res

note

/reco

rd.

•Im

porta

nce

of L

FT•

Nam

e di

ffere

nt

Live

rFu

nctio

n Te

sts•

Bili

rubi

n es

timat

ion

byM

allo

y an

d E

vely

nm

etho

d•

Nor

mal

val

ue•

Clin

ical

sign

ifica

nce

Not

esO

TPr

actic

al sk

illR

ecor

d

Text

boo

k of

Bio

chem

istry

by H

arol

dV

arle

y

Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

d V

asud

evan

Ref

eren

cebo

oks

Not

es/re

cord

of w

ork

done

Disc

ussio

nR

efer

ence

Dem

onst

ratio

nPr

actic

al w

ork


202

Introduction

Learners already have knowledge about the various functions of the liver.The study of these functions through different estimations can be done toaccess the liver function. This chapter gives a familarisation of different liverfunction tests some of them are done in previous chapters. Here the learnerattains skill to perform Bilirubin estimation.

Curriculum Objectives39. To get an idea about the importance of Liver Function Tests, various Liver Func-

tion Tests and able to perform serum bilirubin estimation through discussion,reference, demonstration, prepare notes/record.

Syllabus

F Importance of LFT.

F Name different liver function tests

F Explain Malloy and Evelyn method for Bilirubin estimation.

F Mention its normal value and clinical significance.

Learning Activity - 1: Reference, demonstration and practical work

Materials

- Reference booksa. Clinical Biochemistry by Haroldvarleyb. Medical Laboratory manual for tropical countries – monica

cheesborygh, Vol. I.c. Vasudevan’s Biochemistry (Testbook of biochemistry by

Sreemumary & Vasudevan)- Colorimeter- Reagents- Pipettes and Test tubes

Process

l Group the learners into three and allow to refer the books provided

Unit

5LIVER FUNCTION

TESTS

Chapter

7


203203

l Guide them to collect relavant and information required.

l Within each group an active discussion is made and one member from eachgroup will present their points

l Teacher consolidates the points and ask learners to prepare note from theconsolidated points

l Demonstrate the method of estimation of serum bilirubin (Malloy andEvelyn method)

l Ask to record and report


l Reference

l Field visit

Outcome

l Learners have a knowledge about various liver fuction tests, its clinicalsigificance and normal values. Learners also attained practical skill to performserum bilirubin estimation.

l Prepared note

l Record and report on bilirubin estimation

CE

l Class test

PE

l Skill in doing the serum bilirubin estimation is evaluated

TE

l Take the odd man out. Justify your answer

(a) Serum Bilurubin

(b) Serum creatinine

(c) SGOT

(d) Protein


204

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

8. R

enal

Fun

ctio

n T

ests

40.

To

get

an i

dea

abou

t R

enal

Func

tion

test

s, v

ario

us R

enal

func

tion

tests

, ure

a an

d cr

eati-

nine

cle

aran

ce te

st th

roug

h di

s-cu

ssio

n, r

efer

ence

and

pre

pare

note

s.

•Im

porta

nce

of R

FT•

Nam

e di

ffer

ent

rena

lfu

nctio

n te

sts•

Ure

a an

d cr

eatin

ine

clea

ranc

e (b

rief

de-

scrip

tion)

Not

esO

T

Text

boo

k of

Bio

chem

istry

by H

arol

dV

arle

y

Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

d V

asud

evan

Ref

eren

cebo

oks

Not

esD

iscus

sion

Ref

eren

ce


205205

Introduction

Students already have an idea about the various functions of kidney andsome of the tests, which access kidney function in the previous chapter.Besides these, this chapter also gives brief description of urea and creatinineclearance test.

Curriculum Objectives40. To get an idea about Renal Function tests, various Renal function tests, urea and

creatinine clearance test through discussion, reference and prepare notes.

Syllabus

F Importance of RFT.

F Name different renal function test.

F Brief description of urea clearance and creatinine clearance test.

Learning Activity - 1: Reference and discussion

Materials

Reference books

- Clinical Biochemsitry, Harold varley

- Medical Laboratoary Manual for Tropical Countries, Vol. I, MonicaCheseborough

- Textbook of Biochemistry, Choudhari

Process

l Group the learners in to 3 and provide reference book.

l Help learners to refer the relevant pages.

l Conduct group discussion and one member from each group will presenttheir topic.

l Teachers consolidate the points and ask to prepare note.

Unit

5RENAL FUNCTION

TESTS

Chapter

8


206


l Field visit

Outcome

l Learners get a clear idea about renal function tests, urea and CreatinineClearance test.

CE

l Class test.

l Oral test.

TE

l “Creatinine clearance test and urea clearance tests are used to assess the renalfunction”. According to you which test will give more accurate value? Justifyyour answer.


207207

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 5 -

Bio

chem

istr

y

9. A

utom

atio

n an

d qu

ality

Con

trol

41To

und

ersta

nd th

e ter

m au

tom

a-tio

n an

d ha

ve a

gene

ral i

dea a

bout

auto

mat

ion

in b

ioch

emis

try

thro

ugh

disc

ussi

on,

refe

renc

e,fie

ld v

isit

and

prep

are

reco

rd/

repo

rt.

42.

To u

nder

stand

the

need

of q

ual-

ity co

ntro

l and

met

hod

for a

ttain

-in

g qu

ality

con

trol t

hrou

gh d

is-cu

ssio

n, re

fere

nce,

fiel

d vi

sit an

dpr

epar

e re

cord

/repo

rt.

•Te

rm a

utom

atio

n•

Aut

omat

ion

in

bio-

chem

istry

•N

eed

of q

ualit

y co

n-tro

l•

Met

hod

of a

ttain

ing

qual

ity c

ontro

l

Not

esR

ecor

dR

epor

tO

T

Not

esR

ecor

dR

epor

tO

T

Text

boo

k of

Bio

chem

istry

by H

arol

dV

arle

y

Text

book

of

Bio

chem

istry

Tiet

z

Text

book

of

Bio

chem

istry

by S

reek

umar

ian

d V

asud

evan

Ref

eren

cebo

oks

Ref

eren

cebo

oks

Not

esR

ecor

d/re

port

of fi

eld

visit

Not

esR

ecor

d/re

port

of fi

eld

visit

Disc

ussio

nR

efer

ence

Fiel

d vi

sit

Disc

ussio

nR

efer

ence

Fiel

d vi

sit


208

Introduction

Study of clinical biochemistry will be incomplete without the glimpse ofautomation. Quality control is also an inevitable part of it. This chaptergives a general idea about automation and quality control in a biochemistrylaboratory.

Curriculum Objectives41. To understand the term automation and have a general idea about automation in

biochemistry through discussion, reference, field visit and prepare record/report.

42. To understand the need of quality control and method for attaining quality controlthrough discussion, reference, field visit and prepare record/report.

Syllabus

F Understand the term automation

F General idea about automation in bio-chemistry.

F Need of quality control

F Method for attaining Q.C.

Learning Activity - 1: Debate

Materials

Reference books

- Clinical Biochemistry - Harold Varley

- MLT - Kanai L. Mukherjee

Process

l Divide the learners in two groups and ask them to collect informationsfavouring the manual method by one group and favouring automation bysecond group.

l Assist the learners in collecting data.

l Select 4 pannel members from each group.

Unit

5AUTOMATION ANDQUALITY CONTROL

Chapter

9


209209

l Choose a convinent date for debate and also select a moderator (moderatormay be teacher or a selected student)

l Moderator briefs the rules of debate and programme starts by panelmembers from each group alternatively.

l Moderator notes their points from each group and consolidates (consolidationmust be in favour of automation).

l Asks the students to prepare notes from the consolidated points irrespectiveof their arguments in debate and to submit the note.

Other suggested acitivty

l Field visit

Outcome

l Learners understand the need and advantages of automation.

l Note based on debate.

CE

l Oral test

l Prepared note

l Field visit report.

TE

l In present senario mannual methods are replaced by automated method.What are the advantages?

Quality control

Learning Activity - 1: Simulated experiment

Materials

- Colorimeter

- Reagents for blood sugar estimation.

- Test tubes and pipettes

Process

l Select four learners and instruct them to perform the blood sugar estimationof the same blood.

l Compare the obtained results and ask them to give their own reasons. Whydifferent results are obtained?


210

l After noting the pointed out reasons, ask two students to repeat the estimationagain taking care of the noted points.

l Two different reslts may be obtained (if accidently same result is producedalso) and we have no surety about the accuracy of results.

l Then ask them what is the solution (remedy) in such a situation?

l The need of automation may arise here and explain them the differentmethods of quality control with the help of handouts.

Other suggested acitivties

l Field visit

l Reference

l Power point presentation

l CD

Outcome

l Learners unerstand the need and method of quality control.

CE

l Oral test

TE

l Enumerate the complications which may arise if there is no quality controlmeasures.


211211

HISTOTECHNOLOGY AND CYTOLOGY

INTRODUCTION

Although Histotechnology and Cytology is not a partof routine laboratory work, it plays an important rolein the diagnosis of diseases. The pathologist responsiblefor tissue diagnosis is heavily dependent on thecompetence of his histotechnologist. A studentundergoing MLT course at higher secondary level shouldhave a basic idea about the various steps involved inthe preparation of tissue for microscopic examination.This will help to develop skill in this field in theirfuture studies or career. This unit also gives awarenessabout automatic tissue processor.

Early detection of cancer and its prompt treatmentwidened the scope of cytological examination. This unitgives a brief idea about the various steps involved inthe preparation of cells for cytological examination.

UNIT6


212

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 6 -

His

tote

chno

logy

and

Cyt

olog

y

1.In

trod

uctio

n to

His

tote

chno

logy

43.

To a

cqui

re a

bas

ic i

dea

abou

tco

llect

ion,

rec

eptio

n an

d la

bel-

ing

of sp

ecim

ens i

n a h

istop

atho

l-og

y L

ab t

hrou

gh d

iscu

ssio

n,de

mon

stra

tion,

fie

ld v

isit

and

prep

ares

not

e.

44.

To

get a

brie

f ide

a ab

out

diffe

rent

step

s in

tissu

e pr

o-ce

ssin

g, se

ctio

ning

, sta

inin

g,m

oun-

ting

and

auto

mat

ic ti

ssue

proc

esso

r and

pre

pare

not

es.

•C

olle

ctio

n•

Rec

eptio

n•

Labe

lling

•Fi

xatio

n (ro

utin

e fo

r-m

alin

fixati

ve o

nly)

•D

ehyd

ratio

n•

Cle

arin

g•

Impr

egna

tion

•Em

bedd

ing

•Se

ctio

n cu

tting

•St

aini

ng (n

ame

only

)•

Aut

omat

ic ti

ssue

pro

-ce

ssor

Not

esFi

eld

visit

repo

rt

CT

Rep

ort o

n fie

ldvi

sitN

otes

Text

book

of

His

topa

thol

ogy

Ban

crof

it

Text

book

of

Cyt

olog

y

Kos

s

Cel

lula

rPa

thol

ogy

Tech

niqu

es b

yC

ullin

g

Ref

eren

cebo

oks

Mat

eria

ls fo

rde

mon

stra

-tio

n

Ref

eren

cebo

oks

Mat

eria

ls fo

rde

mon

stra

-tio

n

Prep

arat

ion

of n

ote

Fiel

d vi

sitre

port

Prep

arat

ion

of n

ote

Fiel

d vi

sitre

port

Dem

onst

ratio

nFi

eld

visit

Han

d ou

t dis

cus-

sion

Disc

ussio

nR

efer

ence

Dem

onst

ratio

nFi

eld

visit


213213

Curriculum Objectives43. To acquire a basic idea about collection, reception and labeling of specimens in

a histopathology Lab through discussion, demonstration, field visit and preparesnote.

44. To get a brief idea about different steps in tissue processing, sectioning, staining,mounting and automatic tissue processor and prepare notes.

Syllabus

F Mention the important steps in the preperation of a tissue for microscopicexamination (brief idea only)

F Collection, reception and labelling.

F Fixation (routine formalin fixative only), dehydration, clearing, impregnation,embedding and section cutting.

F Name the common staining and mounting method.

F Brief description about automatic tissue processor.


Materials

- Handout containing details about collection, labeling and reception ofhistopathological specimens.

Process

l Teacher illustrates the importance of histopathology in the diagnosis ofdiseases.

l Divide the learners in to three groups.

l Group I-Handout about the collection of histopathological specimens.

l Group II-Handout on labeling of histopathological specimens.

l Group III-Handout on reception of specimen in a histopathology laboratory.

Unit

6 INTRODUCTION TOHISTOTECHNOLOGY

Chapter

1


214

l Instruct each group to discuss the hand out and consolidate.

l Teacher facilitates the discussion if needed.

l One member from each group presents their consolidation.

l Instruct all students to prepare note on the above consolidation and submit.

Discussion Points

l Autopsy and biopsy.

l Use of proper fixative/adequate fixative.

l Proper labeling.

l Accompanying requisition form.

l Points to be noted during the reception of specimen.

Consolidation

l Specimens collected after death is autopsy and that collected from a livingbody is biopsy.

l Proper and adequate amount of fixative is needed while collection.

l All specimens should be properly labeled with name,IP/OP No,date ofcollection ,age ,sex type of specimen etc.


l Reference

l Field visit

Outcome

Students get basic idea about the reception & labeling of specimen reached in the labafter collection

CE

l Perfection in note preparation

l OT

VCE

l OJT/Hospital visit


215215

TE

l Suppose you are working in a Histopathology lab .You are in the charge ofreceving the Histopathological specimen. Give the points to be noted whilereceving the specimen.

Tissue processing, section cutting and stainingCO.44 To get a brief idea about different steps in tissue processing, sectioning, stain-

ing, mounting and automatic tissue processor and prepare notes.

Syllabus

F Fixation (routine formalin fixative only), dehydration, clearing, impregnation,embedding and section cutting.

F Name the common staining and mounting method.

F Brief description about automatic tissue processor.

Learning Activity - 1 : Discussion & Field visit

Materials

- Reference books - Cellular Pathological technique by Culling

- Photographs of Instruments during tissue processing and section cutting.

- Field visit plan.

Process

l Teacher illustrate a general idea about different technique in tissue processing,section cutting, automated technique, staining and mounting.

Planing of field visit

A field visit plan is prepared containing the following points

l Selection of histopathology lab to be visited.

l Date and mode of conveyance.

l Request for permission.

l Get permission from the laboratory authority.

l What are the things to be observed?

l Format for field visit report.

l Details about collection of materials if possible .

Organise a field visit as above to a histopathology laboratory. Evaluate the preparedreport and collections.


216

Main Points to be Observed

l What are the steps of tissue processing ?

l Chemicals used in the various steps of tissue processing?

l Impregnating and embedding media used.

l Automatic tissue processor.

l Instrument for section cutting.

l Which is the commonly used staining method in histopathology?


l Assignment, Multimedia, reference

Outcome

l Students got basic idea about different steps in tissue processing.

CE

l Field visit diary

VCE

l OJT/Field visit

TE

l Histotechnology involves complex process with many steps. The collectedspecimens are immediately placed in proper fixative which undergoes furthertissue processing. Enlist the steps involved in the method of processing?


217217

Cur

ricul

um o

bjec

tives

Con

tent

/Are

aA

ctiv

ities

/M

ater

ials

Prod

uct/

Eval

uatio

nR

efer

ence

Expe

rienc

esk

ill

UN

IT A

T A

GL

AN

CE

Uni

t 6 -

His

tote

chno

logy

and

Cyt

olog

y

2. C

ytol

ogy

45.

To ge

t a b

asic

idea

abou

t the

use

sof

cyt

olog

y, d

iffer

ent

type

s of

spec

imen

, met

hods

of c

olle

ctio

n,fix

atio

n an

d th

e co

mm

only

use

dcy

tolo

gica

l sta

inin

g th

roug

h di

s-cu

ssio

n, d

emon

strat

ion,

fiel

d vi

sitan

d pr

epar

e no

tes.

•A

pplic

atio

n of

cyt

ol-

ogy

•Ty

pes o

f spe

cim

en•

Met

hod

of c

olle

ctio

n•

Fixa

tion

of sm

ear

•Pa

p st

aini

ng (

nam

eon

ly)

Parti

cipa

tion

indi

scus

sion

Perf

ectio

n of

note

/dia

ry

Text

book

of

Cyt

olog

y

Kos

s

Cel

lula

rPa

thol

ogy

Tech

niqu

es b

yC

ullin

g

Ref

eren

cebo

oks

Mat

eria

ls fo

rde

mon

stra

-tio

n

Not

eR

epor

t/re

cord

of

field

visi

t

Disc

ussio

nD

emon

stra

tion

Fiel

d vi

sit


218

Curriculum Objectives45. To get a basic idea about the uses of cytology, different types of specimen, meth-

ods of collection, fixation and the commonly used cytological staining throughdiscussion, demonstration, field visit and prepare notes.

Syllabus

F Mention the uses of cytology, specimens, name the methods of collection andfixation of a smear.

F Name the commonly used staining method in cytology.

Learning Activity - 1 : Discussion with hand outs

Materials

- Hand out containing type of cytological specimens ,collection,fixation andcommon staining method.

- Reference books.

Process

l Teacher illustrates the application of cytology.

l Divide the students in to three groups.

l Distribute the hand out to each group.

Group I - Different types of specimens used in cytology.

Group II - Different methods of collection and fixation of cytological specimens.

Group III - Common staining method in cytology.

l Instruct to discuss the relevant points in the hand outs.

l Consolidate the points with the help of scaffolder.

l A member from each group presents their consolidation points.

l Students prepare notes based on the consolidation points.

Unit

6 INTRODUCTION TOCYTOLOGY

Chapter

2


219219

Discussion Points

l What are the different types of specimens?

l Methods of collection.

l Which is the fixative used?

l Which is the staining method?

Consolidation

l Different cytological specimens include blood , CSF, urine sputum, scrapings,other body fluids etc.

Outcome

l Learner get awareness about the importance of cytology & cytologicalprocess done in a cytology lab

CE

l Prepared note

VCE

l OJT/Field visit

TE

l Exfoliative cytology is a study of exfoliated cells from different parts of thebody. Enlist the main sites from which exfoliative cells are collected.


220

As Medical laboratory Technology is highly practical oriented course, practical work mustbe evaluated periodically. A score of 150 is allotted for practical evaluation and the skillattained for doing the routine tests only need to be considered for evaluation.

Distribution of scores for practical evaluation

1. Spotting/identification 20% 30 marks

2. Record book 10% 15 marks

3. Viva-voce 10% 15 marks

4. Experiment (3 nos) 60% 90 marks(Haemotology, urine analysisand biochemistry)

Total 100% 150 marks

Individual break up for experiments

Experiment details Haemotology Urine analysis Biochemistry(any one (any two (any oneexperiment) experiments) experiment)

Procedure writing 5 5 5

Technique 10 10 10

Observation/Interpretation 5 5 5

Result 5 5 5

Practical-oral 5 5 5

TOTAL 30 30 30

PRACTICAL EVALUATION


221221

Reference Websites

1. www.clinichem.com

2. www.cli-online.com

3. www.labmedics.co.uk

4. www.diagnostics.com

5. www.aacc.org

6. www.bioinstrument.com

7. www.amtl.com

8. www.finddiagnostics.org

9. www.aab.org

10. www.biomolecule.com

11. www.biotech.com

12. www.ascls.org

13. www.labtestonline.org

14. www.bd.com/vacutainer

15. www.medilib.med.utah.edu.webpath

16. www.hoslink.com/haemtul.htm

17. www.pathology.uthsca.edu/clare/haematology/lectures

APPENDIX

FORMAT FOR SUBJECT WISE EVALUATION

Sl.no

NameCCE

TE(80)

Total(100)

Grade

PE Vocational Competency Evaluation

1(20)

2(20)

3(20)

Total(60)

TotalOut of

20

1 2 3 4 5 6 Total Grade Regularityand

panchuality(10)

Valueaddition

(20)

Capacitybuilding

(20)

Total(50)

Grade

70

FORMAT FOR SCHOOL WISE SCORE SHEET

Sl.No Name English GeneralFoundation

Course

Vocational subject

CE

TE

PEVCE

Physics Chemistry Biology

CE

TE

Total

Grade

CE

TE

Total

Grade

CE

TE

Total

Grade

Total

Grade

Total

Grade

CE

TE

PE

Total

Grade

CE

TE

PE

Total

Grade

CE

TE

Total

Grade

71

MLT-%20II

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