Setup and management of pathological laboratory

ORGANISATION AND MANAGEMENT OF PATHOLOGY LABORATORY

Sections within the clinical pathology laboratory

The following are the various sections within the clinical pathology section.

1. Reception, patient information and lab information system
2. Phlebotomy area and patient examination room.
3. Hematology and coagulation section
4. Clinical biochemistry
5. Clinical microbiology, immunology, serology
6. Histopathology
7. Cytology section
8. Blood banking
9. Clinical pathology
10. Urine examination section
11. Stool examination section
12. Body fluid section section

PHLEBOTOMY AREA

1. Acid citrate dextrose (ACD)
2. Adhesive tape and dry cotton swab
3. Alcohol / Methylated spirit soaked swabs (70 % Alcohol, sevelon etc.)
4. Blood culture tubes
5. Buffer citrate
6. Capillary tube
7. Cotton
8. Disposable sterile needles – 18-20 gauge for adults and 23 gauge for children.
9. Disposable sterile syringes – 2 ml, 5 ml and 10 ml.
10. EDTA powder
11. Heparin
12. Labels or striker
13. Needle Destroyer 
14. Sample container
15. Sodium fluoride
16. Sodium citrate for ESR
17. Sterile plain test tube – for biochemical assay.
18. Sterile bottle / vials / glass tube with anticoagulant (EDTA, heparin, buffered citrate)
19. Swabs
20. Test tube racks
21. Tourniquet – rubber tubing of 2-5 mm before and 30-60 cm length.
22. Tray

23. Test Requisition Form (TRF)
24. Vacutainer tubes (available in capacity of 0.5 to 9 ml – special needle with a tube holder, the rubber stopper is color coded to distinguish whether the tube a specific anticoagulant or is a plain tube.)

HEMATOLOGY AND COAGULATION SECTION

Instrumentation

1. ABD group plate
2. Beckman Coulter L H-250  ( Fully automated Hematology Cell Counter)
3. Beckman Coulter L H-500  ( Fully automated Hematology Cell Counter)
4. Beckman Coulter L H-750  ( Fully automated Hematology Cell Counter
5. Blood mixer
6. Blood cell counter
7. BT / CT watch
8. Centrifuge – table model
9. Cell counter
10. Chemical balance
11. Conical flask (100 ml, 250 ml)
12. Cover slips of size 22 x 40 mm
13. Digital photometer (colorimeter)
14. Digital Balance
15. Microscope – Compound with low and high power objective.
16. Microscope lamp
17. Hand tally counter
18. Hb pipette set shills
19. RBC pipette
20. WBC pipette
21. Water baths with thermometer
22. Washing bottles
23. Refrigerators – For storing diagnostic kits, reagents and samples
24. Incubator with thermostatic control
25. Graduated pipettes of various sizes.
26. Pasture pipettes and blood cell pipettes
27. Pipette stain
28. Slide box (wooden)
29. Staining rack
30. Slide stain (slide rack)  
31. PT / APTT Machine
32. Test tubes of various sizes
33. Glass beakers of different sizes.
34. Test tube racks of different specifications.
35. Test tube brush
36. Time – Electronic or mechanical.
37. Tissue paper
38. Stop watch
39. Wash bottles
40. Filter papers
41. EDTA powder
42. Glass slides
43. Cover slips of size 22 x 40 mm
44. Labels
45. Disposable lancet
46. Horizontal slide rack for staining slides
47. Spectrophotometer
48. Micropipette (50 μl, 1000 μl) with stain
49. Micro tips (Large, small size)
50. Levy’s counting chamber with improved Neubauer ruling
51. Westergren’s pipette and rack or ESR – pipette stain
52. Wintrobe’s / PCV (Hct) tubes with  stain
53.  Microhematocrit tubes
54. Graph paper
55. Gloves
56. Mask (Paper, Cloth – Mask)    
57. Disposable lancet
58. Oil Emerson (Cedar wood oil, Paraffin oil or, Synthetic oils like Shillaber’s oil)
59. Mounting media – DPX or Entallan.
60. Punching machine 
61. Stapler
62. Hb panicle
63. Sysmex KX-21  (Automated Hematology Cell Counter)
64. Dignostic (Semi- automated instrument for Coagulation)

Reagents used:

65. Drabkin’s solution
66. Various diluting fluids
67. 1 % Brilliant cresyl blue
68. Leishman power
69. 100 % pure acetone free methyl alcohol
70. Buffer water
71. PAS stain – Periodic acid and Shifts reagent
72. Sudan black B stock solution    
73. Peroxides reagent
74. 10 % potassium Ferro cyanide
75. Neutral red
76. N / 10 HCl
77. Absolute alcohol
78. Concentration HCL
79. 10 % formalin, 40 % formaldehyde
80. Distilled water
81. Thromboplastin reagent
82. Calcium chloride – 0.25 mol / L
83. APTT reagent
84. Thrombin reagent
85. Urea – 5 mol / L
86. Control plasma
87. Normal plasma
88. Normal saline (N / S)
89. Aged serum
90. Adsorbed plasma
91. Retilocyte count reagent (brilliant crystal blue)
92. Factor VIII and Factor IX deficient plasma
93. Giemsa Stain                           (Method – Romanowsky Stain , Storage  RT)
94. Leishman Stain                        (Method – Romanowsky Stain , Storage  RT)   
95. Field stain solution-A             (Method – Romanowsky Stain , Storage  RT)   
96. Field stain solution-B              (Method – Romanowsky Stain , Storage  RT)   
97. Weiss Buffer   (Method – Buffer for Giemsa & Leishman Stains, Storage  RT)       
98. Multi Det 10X            (Method – Neutral Laboratory Reagent, Storage  RT)   
99. D-dimer test kits 

BLOOD BANK

Donor lab (side lab) attached to the reception

Where donor Hemoglobin estimation is done.

1. Jar containing Copper sulphate solution
2. Sterile lancet and alcohol swabs
3. Capillary tube with rubber bulbs
4. Spectrophotometer – if Hb estimation is done by Cyanmethemoglobin (CMG) method.
5. Plates for blood grouping.

Blood collection rood  

6. Donor begs, chairs and tables – Should be of appropriate size and comfortably cushioned.  
7. Bed side table.
8. A sphygmomanometer and stethoscope for recording the B.P. of the donor.
9. Clinical thermometer for recording the donor’s temperature.
10. Disposable blood collection bags and sets – These are sterile, made of PCV, easy to store and comes with donor tubing and needles (closed system) and is available in two sizes.

a). 350 ml capacity blood collection bag containing 49 ml of

     CPD-A anticoagulant.

b). 450 ml capacity blood collection bag containing 63 ml of

      CPD-A anticoagulant.

11. Disposable needles and syringes.
12. Shaking apparatus for proper mixing of anticoagulant and the blood while donor bleeding.
13. Blood bag weighing scale.
14. Heat sealer or tube sealer and aluminum clips.
15. Artery forceps and scissors.
16. Kahn tubes for collection of blood samples for typing and serological testing.
17. Emergency drugs – adrenaline, noradrenaline, mephentin, corticosteroids, metachlo peramide, IV dextrose, IV normal saline & disposable I.V infusion set.
18. Oxygen cylinders with mask gauges and pressure regulator.
19. Cotton, sterile gauze, antiseptic solution (tincture iodine, denatured spirit) and adhesive tapes.

Laboratory   

20. Microscope – Compound microscope with low and high power objectives
21. Microscope lamp.
22. Centrifuge – table model
23. Water baths – one for 37 ⁰C and another  56 ⁰C
24. Rh view box in case of  slide technique
25. Refrigerators – For storing diagnostic kits and reagents: a constant temperature of 4-6 ⁰C +/- 2 ⁰C is maintained. It is provided with digital dial thermometer and a continuos power supply.
26. Incubator with thermostatic control
27. Hand lens for observing the results of the tests conducted in tubes.
28. Graduated pipettes of various sizes.
29. Pasture pipettes.
30. Glass slides
31. Test tubes of various sizes and micrometer plates.
32. Precipitating tubes of size 6 mm x 50 mm and glass beakers of different sizes.
33. Test tube racks of different specifications.
34. Timer – Electronic or mechanical.
35. Wash bottles
36. Filter papers
37. Plain and EDTA vials
38. Chemical balance

Serology laboratory       

39.  Graduated pipettes of various sizes.
40. Mechanical shaker for serological testing for syphilis.
41. Incubator with thermostatic control.
42. Elisa reader with printer, washer and micropipettes.

Blood component preparation room

43. Refrigerated centrifuge
44. Plasma expressor
45. Dielectric sealer / tube sealer
46. Weighing device
47. Refrigerator – maintaining a constant temperature of 4-6 ⁰C +/- 2 ⁰C with attached digital dial thermometer and having a continuos power supply.
48. Air conditioner
49. Laminar air  flow bench
50. Platelet agitator with incubator (+ 20 ⁰C)
51. Deep freezer – maintaining a temperature between -30 to -60⁰C.
52. Refrigerated water bath for plasma thawing.
53. Cell separator

Quality control department

A). Chemical laboratory    

54. Precision balance
55. pH meter
56. Spectrophotometer
57. Refractometer
58. Polarimeter
59. Conductometer
60. Bench centrifuge
61. Gas burner
62. Water pumps

B). Microbiological laboratory  

63. Microscope – binocular
64. Dishes for culture fluid
65. Autoclave
66. Incubators (38 ⁰C)
67. Ultraviolet lamp (bactericidal lamp)
68. Refrigerator (4 ⁰C, 400 liters)

Reagents used in blood bank

69. Standard blood group sera – Anti- A, anti- B, and Anti- D with known controls.
70. Rh typing sera – shall be double quality and each of different brands, or if from the same supplier each supply should be of different lot numbers.
71. Reagents for serological testing for Syphilis and positive sera for control.
72. Anti human globulin serum (Coomb’s serum).
73. Bovine albumin (22%) and enzyme reagent – Used for detecting incomplete antibodies.
74. Elisa or RPHA test kits for Hepatitis B and C and for HIV testing.

Washing room  

75. Autoclave with temperature and pressure indicator and hotair oven
76. Distillation plant
77.  Ultrasonic cleaner
78. Detergent and other agents for cleaning laboratory glass ware.

Office

79. Telephones
80. Card index cabinets
81. Filling cabinets
82. Computer with printer (typewriter)
83. Stationary items
84. Donor registration card.

Workforce/staffing

The following staff positions are required. 

85. Medical officer - a medical officer with a M.D. degree in pathology (from a recognized University) and having suitable experience in transfusion medicine is mandatory as per the quidelines of Drugs c controller (who are the licensing authority for the blood banks).
86. Laboratory technicians –possessing a degree or diploma in Medical laboratory technology (from a university / institution recognized by central government or state government) and with atleast 6 months formal training in various blood bank techniques is a mandatory requirement. The also can perform a role of a phlebotomist.
87. Registered nurse
88.  Technical supervisor
89. Public relation / information personal
90.  Lab assistants
91. Cleaner
92. Secretary / Clerk cum typist              
93. Record keeper.  

Accessories 

94. Blankets, emesis basins, hemostats, sponge forceps, gauge, dressing tray, solution jars, waste disposal containers, soaps, detergents, paper napkins, towels, incinerator and standby generator.      

CLINICAL BIOCHEMISTRY

Instrumentation

1. Hot air oven
2. Hot plate
3. Water bath
4. Incubator
5. Digital photometer (colorimeter)
6. Digital Balance
7. Droppers / Dropping bottle plastic
8. Photoflamieter
9. Pipette bulb
10. Pipette with pipette stain
11. Plastic beaker
12. Plastic centrifuge tube
13. pH meter
14. Glucometer
15. Electrophoresis unit powder pack 
16. Micropipette (10 μl, 50 μl, 100 μl, 500 μl, 1000 μl) with stain
17. Micro tips (Large, small size)
18. Glass Rods (Stirrer , Magnetic stirrer)
19. Glass beaker or Plastic beaker (100 ml, 250 ml, 500 ml, 1000 ml)
20. Conical flask (100 ml, 250 ml, 500 ml, 1000 ml)
21. Measuring cylinder (100 ml, 500 ml, 1000 ml)
22. Volumetric flask (100 ml, 500 ml, 1000 ml)  
23. Funnel
24. Filter paper
25. Tissue paper roll
26. Test tube holder
27. Test tubes of various sizes (large, small size)
28. Test tubes racks various sizes
29. Test tube brush
30. Timer electronic (Min / Sec)
31. Vortex mixer
32. Insulin Needle syringe

Autoanalyzer area:

Now a day most of the laboratories have analyzers for routine biochemistry investigation purposes. These may vary from semi to fully automated analyzers. Modern analyzers are structure to perform glucose including profile like lipid, Cardic, renal, thyroid and pancreatic. It is advisable to have sophisticated instruments for the purpose of hormones analysis. Along with Flouropolarisation, Radioimmunoassay (RIA) chemiluminescence assay ELISA is one of the methods following now a day to estimated hormones including autoimmune antibodies.                  

33. Erba Chem

29. ERBA Smart Lab Automated (Fully automated instrument for Biochemistry)   

34. ERBA Chem-5 (Semi-automated instrument for Biochemistry)    
35. ERBA Chem-5 Plus V2
36. Photometer 5010
37. Stat 21 (Semi automated analyzers)
38. Hitachi 911 and 912
39. RA 2000 (Fully automated analyzers)

35. ADVIA Centaur Immunoassay System (Fully automated instrument for thyroid Panel)

40. DAD Behring Dimension (AR & RXL)  (Fully automated instrument for Biochemistry) 
41. 9180 Electrolyte instrument for Biochemistry
42. Rapid Chem-744 Bayer  Electrolyte instrument for Biochemistry
43. Dia Stat (Bio Rad) automated instrument for Biochemistry (GHB)
44. AVL Compact-3 (Automated instrument for Blood Gas Analysis)
45. Axsym and Elecsys  (Fully automated analyzers for Tumour markers)

● The choice depends upon the workload and affordability. They are available
 on rental basis also from those companies. 

Reagents / Solution:

Reagents should be purchased from good companies, which really provide the quality of kits or reagents to meet the accuracy. A constant check is maintained on expiration dates. Chemicals and reagents after the expiration dates should be disposed of without delay to prevent impending hazards. Storage specifications mentioned for the chemicals by the manufacture and the expiration of dates is strictly followed.

Note: - All the reagents and supplies used in the laboratory should be stored at proper temperature in a safe and hygienic place and in accordance with the instruction provided by the manufacture.        

46. Sulfuric acid (H₂ SO₄)
47. Deionized water    
48. Alpha Amylase
49. Glucose                                   (Method – GOD / POD, Storage  2 – 8 ⁰C)  
50. G-6-PDH                                (Method –Kinetic, Storage  2 – 8 ⁰C)  
51. Cholesterol                              (Method – CHOD / PAP, Storage  2 – 8 ⁰C)  
52. Creatinine                                (Method – Alkaline Picrate, Jaffe’s, Storage  RT) 
53. Chloride                                  (Method – Thiocyanate, Storage  RT) 
54. Triglycerides                           (Method – GPO / PAP, Storage  2 – 8 ⁰C)  
55. Urea                             (Method – Diacetyl Monoxime (DAM),  Storage  RT) 
56. Uric Acid                                (Method – Uricase /  PAP, Storage  2 – 8 ⁰C)  
57. CKMB                        (Method – Immunoinhibition / Mod. IFCC, Storage  2 – 8 ⁰C)  
58. CK NAC
59. Bilirubin                                  (Method – Mod. Jendrassik & Grof’s, Storage RT) 
60. Alkaline Phosphates                (Method – Kind & Kings, Storage  2 – 8 ⁰C) 
61. Calcium                                   (Method – OCPC, Arsenazo, Storage  2 – 8 ⁰C) 
62. SGOT                                      (Method – Reitman & Frankel’s, Storage  2 – 8 ⁰C) 
63. SGPT                                      (Method – Reitman & Frankel’s, Storage  2 – 8 ⁰C) 
64. Sodium / Potassium                (Method – Colorimetric, Storage  RT) 
65. Magnesium
66. Total Protein                           (Method – Biuret, Storage  RT) 
67. Micro Protein                           (Method – Biuret, Storage  RT) 
68. Hemoglobin
69. Amylase                                   (Method – Direct Substrate, Storage  RT) 
70. Acid Phosphates                      (Method – Pyrogallol Red, Storage  2 – 8 ⁰C) 
71. Total Lipid                             
72. Phosphorus    (Method – Mod. Gomori’s, Molybdate U.V, Storage RT) 
73. LDH                                        (Method – Mod.IFCC, Storage  2 – 8 ⁰C)  
74. LDL
75. HDL                                        (Method – PEG Ppt. Set, Storage  2 – 8 ⁰C)  
76. GGT                                        (Method – Carboxy Substrate, Storage  2 – 8 ⁰C)  
77. Albumin                                   (Method – BCG, Storage  RT) 
78. Iron
79. TIBC
80. Lipase
81. Glycosylated Hb (Method – Ion Exchange/Resin Separation, Storage  2 – 8 ⁰C) 
82. Hemocor – D                           (Method – CMG (Ready to Use), Storage  RT) 
83. Hemocor – C                            (Method – CMG X25, Storage  RT) 
84. Hemocor – Std.                       (Method – CMG Std., Storage  2 – 8 ⁰C) 
85. Hemospot (Occult Blood Test)          (Method – Two Field Guaiac Resin,Storage 2-8 ⁰C) 
86. Control Sera Abnormal
87. Control Sera Normal
88. LP(a)
89. APO A1
90. APO B
91. CK NAC                                   (Method – Mod. IFCC, Storage  2 – 8 ⁰C)   
92. Acetic acid glacial (CH₃COOH)
93. Ammonia Solution  - 500 ml
94. Ammonium Hydroxide – 500 gm 
95. Agarose gel – 125 gm
96. Bovine Serum Albumin
97. Bromophenol Blue – 5 gm  
98. Benedict's Reagent – 500 ml
99. Benzene for Synthetic – 500 ml 

100. Brilliant Cresyl Blue – 125 ml

101. Biuret reagent – 125 ml

102. Barfoed’s reagent – 125 ml

103. Cronce Brile Blue – 5 gm

104. Caustic Soda  

105. Copper Sulphate Pentahydrate – 500 gm

106. Chloroform (CHCl₃) – 2.5 L

107. Chromium Oxide Purified – 500 gm

108. Cupric acetate – 500 gm   

109. D (-) Fructose – 100 gm

110. Dextrin white prate – 500 gm

111. Diphenylamine – 100 gm  

112. DL – Tryptophan – 125 gm

113. D – Galactose – 25 gm

114. D – Xylose Puuries – 25 gm

115. Diethyl Ether – 500 ml

116. Diethyl

117. Ethanol absolute – 500 ml  (Ethyl Alcohol)

118. Folin & Ciocalteu’s – 125 ml

119. Folic reagent

120. Ferric Chloride – 500 gm

121. Fructose – 250 gm

122. Galactose

123. Glucose Standard Solution 1 %  - 125 ml

124. Glucose Powder – 100 gm

125. Glycogen – 5 gm

126. Glycine – 500 gm

127. Glyoxylic Acid – 500 gm  

128. HCL – 500 ml

129. Iodine Solution – 500 ml

130. Lactose   

131. L – Cysteine – 125 gm

132. L – Tyrosine – 25 gm

133. L – Methionine for Biochemistry

134. Maltose

135. Methionine

136. Millon’s reagent

137. Mercuric Sulphate - 125 ml  

138. H₂SO₄ Concentrated -500 ml

139. HNO₃ Concentrated – 500 ml

140. Ninhydrin – 100 gm

141. Nitric Acid – 100 gm

142. Na Nitronodes – 100 gm 

143. α – Naphthol – 100 gm

144. Orcinol -25 gm

145. Oleic Acid – 500 ml

146. Ortho – Toluidine Kit

147. Pentose Sugar

148. Potassium Iodine

149. Petroleum Ether

150. Phenylalanine

151. Resorcinol – 500 ml

152. Rancid Oil  

153. Solution for Leishman stain (Methanol) -2.5 L

154. Starch Soluble – 500 gm

155. Starch Soluble Extra Pure – 500 gm

156. Spreed Lamp   

157. Silica gel – 500 gm

158. Sodium Carbonate Monohydrate – 500 gm

159. Sucrose – 500 gm

160. Sodium Molybdate Pure – 500 gm

161. Sodium Hydroxide Pellets Purified – 500 gm

162. Sodium & Potassium Tartrate – 500 gm

163. Sodium Bisulphate – 500 gm

164. Sodium Nitrite Purified – 500 gm      

165. Tris Buffer – 100 gm

166. Trichloroacetic Acid (TCA) – 100 gm

167. Trichloroacetic Acid 10 % - 125 ml

168. Tyrosine

Washing room  

169. Autoclave with temperature and pressure indicator, hotair oven,

170. Distillation plant

171. Ultrasonic cleaner

172. Detergent and other agents for cleaning laboratory glass ware.

Office 

173. Telephones and telex

174. Filing cabinets

175. Computer with printer (typewriting)

176. Stationary items 

Accessories 

177. Gauze, solution jars, waste disposal containers, soaps, detergents, paper napkins,   towels, incinerator, and first aid kits and stand by generator.

Work force/staffing

The following staff positions are required. 

178. Medical officer - a medical officer with a M.D. degree in pathology (from a recognized University) and having suitable experience.

179. Laboratory technicians –possessing recognized diploma or degree in Medical laboratory technology.   

180. Scientific assistant.

181. Lab assistants.

182. Lab attendor.

183. Secretary / Clerk cum typist.

CLINICAL MICROBIOLOGY

Instrumentation

Instruments commonly found in the microbiology lab included.

1. Bacterial detection devices (eg.: blood cultures).
2. Bacterial identification and susceptibility testing devices.
3. Bloating paper
4. Gas-liquid chromatographs.
5. Microscopes (light, fluroscent, phase, dark-field).
6. Centrifuges.
7. Culture loop (Platinum loop holder)
8. Autoclaves.
9. Dry heat oven. (Hot air oven)
10. Digital Weighing Balance 
11. Incubators.
12. Water baths.
13. Vortex mixers.
14. Anaerobe Chamber.
15. Refrigerators / Freezers.
16. Ultra-low freezers.
17. Biological Safety Cabin.
18. Fume hood.
19. Forceps of various size 
20. Scissors of various size
21. Sperm quality analyzer
22. ELISA reader  with printer
23. Tape writer
24. Surgical blade
25. Thermal Cyclers.
26. Spread lamp
27. Stool culture bottle
28. Culture plate or Petridish disposable
29. Urine culture bottle
30. Stapler
31. Waite paper
32. Reporting paper, schal, silo tape (micro pore)  
33. Carbon copy,  File register,  Involve,  fabicole, witner (eraser), Rate list
34. Hb panicle & pen, copy, digital calculator   
35. Lab mohair, shop with shop stain
36. Towel, Mach box, chair
37. Small bucket (dust been), Plastic plot hen,  Jug       
38. Punching machine
39. Bio Rad USA (Semi- automated instrument) for ELISA Reader
40. Bactec-9050   For Rapid Blood Culture etc.

Reagent 

41. Acetone
42. Albert’s stain
43. Acid fast stain kit
44. Bacitracin (10 IU)
45. Carbol fuschin
46. Crystal violet
47. Ehrlich reagent
48. Gram stain
49. Grams iodine
50. Hydrogen peroxide (for catalase test)
51. Lacto phenol cotton blue      
52. Methylene blue solution
53. Novobiocin (5 µgm)
54. Safranine solution 

Culture media 

55. Nutrient agar
56. Nutrient broth
57. Mackonkey agar
58. Mackonkey broth
59. Mueller Hinton agar
60. Brain heart infusion
61. Brain heart agar
62. Blood agar base
63. pH paper
64. Peptone water
65. Sheep blood Agar
66. Sabroudes agar
67. SDA with SD broth 
68. Simmon’s citrate agar
69. Sealant broth
70. Triple sugur iron agar (TSI)
71. Culture sensitivity discs
72. Urea’s agar
73. XLD
74. Thioglycolate medium

Antibiotics 

75. Amoxycillin
76. Ampicillin
77. Azithromycin
78. Cephepine
79. Cefoperazone
80. Cefpirome
81. Ceftazidine
82. Ceforoxime
83. Cefotaxime
84. Ciprofloxacin
85. Cotrimaxazole
86. Erythromycin
87. Gentamicin
88. Imipenam
89. Nalidixicaid
90. Netilmicin
91. Nitrofurantion
92. Peecilin G
93. Pepracillin
94. Tetracycline
95. Ticacillin / Clavulanic acid
96. Vancomycin
97. Teicoplanin.  Etc.

SEROLOGY

Instrumentation

1.      Mechanical shaker for serological (Rotatory Shaker) 

2.      Refrigerators / Freezers.

3.      Micropipette (10 μl, 50 μl, 100 μl, 500 μl, 1000 μl) with stain

4.      Micro tips (Large, small size)

5.      Timer electronic (Min / Sec)

Reagent

6.      ASO

7.      CRP

8.      RA Factor

9.      RPR

10.  RH Factor

11.  VDRL

12.  Widal

13.  Sle

14.  Blood Grouping

15.  Toxo Plasma

16.  TPHA

17.  PPD 5TU

18.  PPD 10TU

Rapid tests

19.  HCG

20.  HBsAg      (Hepa card)

21.  HIV 1&2   (Method - Tridot)

22.  HCV         (Method - Tridot)

23.  Malaria Test Kit (Optimal ) Antigen

24.  Troponine. T

25.  Dengue

ELISA KITS

Thyroid Panel ELISA

1.      T3

2.      T4

3.      TSH

4.      FREF T3

5.      FREE T4

6.      Ultra Sensitive TSH

Fertility Panel ELISA

7.      Prolactin

8.      LH

9.      FSH

10.  Testosterone

11.  Progesterone

12.  Estradiol

13.  Cortisol

ToRCH Panel ELISA

14.  Toxoplasma IgG

15.  Toxoplasma IgM

16.  Cytomegalovirus IgG

17.  Cytomegalovirus IgM

18.  Rubella IgG

19.  Rubella IgM

20.  Herpes Simplex Virus 1 IgG

21.  Herpes Simplex Virus 1 IgM

22.  Herpes Simplex Virus 2 IgG

23.  Herpes Simplex Virus 2 IgM

Tumor Markers

24.  Human Chorionic Gonadotropin (B-HCG)

25.  Prostat Specific Antigen (PSA)

26.  Alpha Feto Protein

27.  Carcino Embryonic Antigen (CEA)

28.  Ferritin

Other ELISA

29.  Human Growth Hormone (GH)

30.  Digoxin

31.  Anti-H Pylori IgG

32.  Anti-H Pylori IgM

33.  Anti-H Pylori IgA

Auto immune ELISA Kits

34.  EIA Ana Screen

35.  IFA Ana Hep-2

36.  EIA Ana 06 Profiles3

37.  EIA Anti -DS- DNA

38.  IFA Anti DNA

39.  Anti- Cardiolipin IgG / IgM

40.  Anti- Cardiolipin IgA

41.  Anti- Cardiolipin IgG / IgM / IgA

42.  Anti Insulin

43.  Anti B2- Macroglobulin

 

CLINICAL PATHOLOGY

Urine and stool section:

1. Plastic disposals containers – for urine collection
2. Reagent strips
3. Test tube holder
4. pH meter / litmus paper
5. Urinometer

Reagents used for various tests – not routinely used.

6. Gram’s iodine
7. Zinc sulphate
8. 0.85 % saline
9. Barium chloride
10. Benedict reagent
11. Brilliant cresyl blue 
12. Logol’s iodine
13. Occult blood powder
14. Sulfur powder
15. Fouchets reagent
16. Seman diluting fluid
17. Sulphosalicylic
18. Litmus paper blue
19. Litmus paper red
20. pH paper
21. Uristic
22. Gloves
23. Mask (Paper, Cloth – mask)
24. Uriscan Analyzer or,
25. Automated Urine analyzer: The reagent strip is dipped into the urine sample and then is fed into the reader, which gives the value of the various contents in the urine sample.

Washing room:  

26. Autoclave with temperature and pressure indicator, hotair oven
27. Distillation plant
28. Ultrasonic cleaner
29. Detergent and other agents for cleaning laboratory glass ware.

Office:     

30. Telephones and telex
31. Filing cabinets
32. Computer with printer (typewriter)
33. Stationary items

Accessories: 

34. Gauze, solution jars, waste disposal containers, soaps, detergents, paper napkins, towels, incinerator, and first aid kits and stand by generator.

Work force / staffing:

The following positions are required

35. Medical officer – a medical officer with a M.D. degree in pathology (from a recognized University) and having suitable experience.
36. Laboratory technicians –possessing a degree or diploma in Medical laboratory technology (from a university / institution recognized by central government or state government).
37. Technical supervisor
38. Lab assistants
39. Secretary / Clerk cum typist.    

HISTOPATHOLOGY

Instruments required (start up requirements)

1. Scissors of various sizes
2. Forceps of various sizes
3. Metal 12-inch ruler
4. Scalpel handles. -6
5. Surgical blades 3 gross
6. Metal probe
7. Bone cutter
8. Brain knife
9. Cover slip
10. Microscope compound
11. Automatic tissue processor   
12. Enamel basins, jugs and trays
13. Balance with weights or digital weighing machine
14. Cassettes, including micro cassettes and Tissue baskets.
15. Surgical gloves- 1000 pairs
16. Filter paper – 100 sheets
17. Furniture: Chairs, revolving stools, table
18. Disinfectant and liquid soap. 50 liter

Tissue processing for manual:           

19. Beakers
20. Alcohol meter
21. Glass funnels
22. Graduated measuring cylinders (50 ml, and 1000 ml capacity)
23. Graduated pipettes
24. Coplin jars
25. Tissue container
26. Narrow mouth reagent bottles (100 ml capacity)
27. Narrow mouth reagent bottles (1000 ml capacity)
28. Mechanical balance, or
29. Electronic balance

Requirements:  

30. Tissue processor
31. Tissue cassettes
32. Tissue flotation water bath
33. Paraffin wax bath
34. Wax bath
35. Incubator
36. Hot air oven
37. Hot plate
38. Honing stone
39. Slid warmer
40. Strop
41. Automatic knife sharpener
42. Belgium yellow (Hone)
43. Bone decalcifier
44. Microtome knives-4
45. Tissue baskets, castes, microcassettes, processing sets – 3 sets
46. Metal or brass L blocks – 1 dozen pairs
47. Leather strop
48. L - Pieces
49. Chuck
50. Diamond Pencil
51. Enemal jug
52. Enemal tray different size
53. Vertical Coplin jar
54. Volumetric flask (1000 ml, 500 ml, 100 ml).
55. Reagent bottle (1000 ml, 500 ml, and 100 ml).
56. Rotary microtome
57. Glass Plate (Hone)
58. Grossing Knife
59. Grind stone for sharpening of ordinary knives
60. Glass slides – 250 packets of ½ gross, (Specifications: Micro slides with polished edges, and lint free packing – Size 75 mm long x 25 mm wide, Thickness 1 mm) 

List of reagents: (start up requirements)

61. Absolute alcohol, Rectified spirit or isopropyl alcohol           200 liters
62. Xylene                                                 20 liters
63. Ethanol                                                30 liter
64. Either                                                     
65. Eosin                                                   50 gm
66. Formalin (40 % Formaldehyde solution)
67. Formic Acid
68. Hematoxylin                                       75 gm
69. Hematoxylin power (stain H&E)       75 gm
70. Tincture iodine                                    500 ml
71. Hydrochloric acid                               500 ml
72. Potassium dichromate                         1 kg
73. Picric Acid                                          200 ml
74. Parraffinoil 
75. Potassium Alanine (stain H&E)
76. Formaldehyde                                     30 x 5 liters
77. DPX                                                    3 x 250 ml
78. Dettol                                                  75 liter
79. Potassium aluminum sulfate               3 x 500 gm
80. Mercuric oxide                                    100 gm
81. Mercuric chloride (stain H&E)
82. Sulphuric Acid                                    1 liter
83. Acetic acid (glacial)                            500 ml
84. Acetone                                               400 ml
85. Ammonia solution                               200 ml 
86. Active charcoal
87. Paraffin Wax                                       100 x 500 gm
88. Lithium carbonate                               500 gm
89. Liquor ammonia                                  1 bottle

Other items:

90. Filter paper sheets                               100
91. Surgical gauze                                     3 packets
92. Absorbent cotton                                3 packets
93. Plastic buckets, mugs                          4 each
94. Pipette stain                                         01
95. Pipette with brushes                           10
96. Bottle washing brushes                       10
97. Glass marking pencils                         20
98. Lead pencils                                        12
99. Slide labels (stickers)                          12000 nos.

100. Slid warming table

101. Surgical gloves                                  1000 pairs

102. Slide filling cabinet

103. Biopsy requisition forms                   3500 forms

104. Biopsy report forms                          7000 forms

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