Clinical Laboratory Services

Clinical Laboratory Services Division performs a wide range of routine and specialized medical laboratory investigations and delivers accurate reports by performing analysis, review and interpretation of results. The division is involved in the analysis of blood and other body fluids of both inpatients and outpatients using biochemical, haematological, immunological and electrophoretic automation technologies. The laboratory performs competencies in the clinical areas specified and delivers reports within a time period necessary for clinical relevancy. The division encompasses the disciplines of phlebotomy, clinical chemistry, clinical haematology, coagulation, urine analysis, electrophoresis and immunoassays. Many tests are reported with appreciable turnaround time of 60 minutes or less by implementing bidirectional interfacing of all major analyzers and these reports are readily accessible to the the clinicians for patient management. The division makes every effort to ensure consistency in quality round-the-clock services, rapid turnaround time, high standards for personnel, high-end instrumentation and technology, automation, conduct of continuing education programmes, short term training programmes, quality excellence programmes, research, and in computerized data management.

The services include specimen collection, processing, analysis and reporting of various tests for both out-patients and in-patients. The Laboratory provides 24x7 operational support by offering comprehensive clinical laboratory services in high volume chemistry, haematology and coagulation, serology for infectious diseases, therapeutic drug monitoring, blood gas analysis, automated serum and urine electrophoresis and immunofixation electrophoresis. Highly trained technologists perform the tests with state-of-the-art automated analyzers. Many cases are also referred to the division from government and private hospitals for special investigations. The following sections are part of the division:

The phlebotomy facility is arranged in Block B and Block E of the hospital. This section is handling an average 600 outpatients and collects acceptable specimens for laboratory evaluation according to best practice and applicable regulations and also maintains patient safety and specimen integrity during blood collection. Samples are collected in pre-labelled and barcoded ‘vacutainer’ tubes. This in turn improved the efficiency of the laboratory with an improvement in the average turnaround time.

The clinical chemistry laboratory analyses over 10,00,000 tests annually. The investigations that the laboratory carries out include blood (mostly on serum/plasma) and other body fluids (CSF, serous effusions, drains, etc.) for diagnostic and therapeutic purposes. A large array of investigations such as basic metabolic panel, comprehensive metabolic profile, hepatic function panel, renal function panel, lipid profile, electrolyte panel, blood gas panel, anaemia panel, myeloma panel including serum immunoglobulins and free kappa & lambda light chains, and many other parameters such as C- reactive protein, serum iron, total iron binding capacity (TIBC), ferritin, transferrin, folic acid, Gamma glutamyl transferase (GGT), glycated haemoglobin (HbA1c), glucose tolerance test (GTT) and glucose challenge test (GCT) are performed. Complete urine biochemical analysis including 24 hours urine protein and Bence-Jones protein are also performed in this division. Therapeutic drug monitoring of Methotrexate and Cyclosporin drug assays are being done for the measurement of therapeutic medication levels to optimize dosage. Pre-operative screening for HIV, hepatitis B virus and hepatitis C virus are also being done in this laboratory.

The Clinical Haematology section carries out about 7,00,000 tests annually. The laboratory performs routine haematology tests (complete blood count (CBC)), coagulation, and various body fluid testing and analysis. Total and differential counts of body fluids such as CSF, serous effusions, drains, etc. being carried out in this laboratory. Coagulation profile such as bleeding and clotting times (BT/CT), prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT) are being done to evaluate bleeding and clotting disorders and to monitor anticoagulation (anticlotting) therapies. Electrophoresis and Immunofixation electrophoresis (IFE) are done for the interpretation of monoclonal gammopathies by the demonstration of a monoclonal immunoglobulin molecule or free light chains in serum and urine.

The Clinical Laboratory’s Quality Management System is designed to sustain high quality by having internal quality control programs and external quality assurance schemes. The laboratory personnels demonstrate proficiency by discussing, interpreting and utilizing quality control methods to maintain laboratory accuracy and precision. The division is a participant for Haematology, Clinical Chemistry and Coagulation External Quality Assurance Services (EQAS) of Bio-Rad Laboratories, USA. Daily Internal quality control is also being carried out for Haematology, Clinical Chemistry and Coagulation parameters to monitor and evaluate the analytical process.

The division has been actively supported and collaborated in several basic and clinical research projects and also supported for doctoral thesis work. Continued improvements have been made in the laboratory information system and laboratory automation. Comprehensive and continuous training is provided to the staff giving them opportunities for continued professional growth. The Division has recently started a one year programme on ‘Advanced training in Clinical Laboratory Technology’, for graduate laboratory technicians. Short term training is also provided for undergraduate and postgraduate students of Biochemistry, Biotechnology and Medical Laboratory Technology.

Rajesh K R, Technical Officer(Lab)
Helen B, Technical Officer(Lab)