::: Hospital Services : Lab Services
CENTRAL DIAGNOSTIC LABORATORY
Our Quality Policy: Nothing comes before quality. We are acutely aware that our patients and physicians are depending upon us to produce accurate, complete and timely laboratory results. We meet this need because we never forget that each specimen represents a person awaiting a laboratory report that they can trust to help in making important healthcare decisions. Proficiency testing, quality control, document control and quality assurance exercised at the pre-analytical, analytical and post-analytical stages ensure that each specimen receives the best quality testing that laboratory medicine offers. Our commitment to quality is genuine and strong. Similarly, our commitment to compliance is based upon our belief that each person in our organisation will do the right thing every time, without compromise. We are pledged to this philosophy of ethical behaviour and know that while this encompasses adherence to all applicable regulations and standards, it goes beyond what the law requires. Our commitment to our patients requires no less.
 

  
 
GENERAL INFORMATION:
1] Request Forms:
The forms should have the following entries - Name, Age & Sex, Unit & Ward, IP/OP Number, Income – Non Paying / Paying Case, Convict/MLC/Non MLC, NGGO/ESI with Numbers, Clinical History, Provisional Diagnosis, Previous Test Results, Signature & Name of Unit Assistant Professor

2] Rights:
Lab tests are based on Mechanical & Subjective Observations. All constituent divisions of the CDL have independent Internal and External QC mechanisms. Feed back is welcome for better service. If results do not correlate with the clinical parameters of the patient, call the concerned lab and inform the issue and ask for a repeat test if required.

3] Collections:
EDTA Bottles [Red Necked] for CP/Hematology Blood Samples and Yellow Necked Bottles / Plain Bottles for Biochemistry Blood Samples are available at request .

4] Working:
The CDL works for 24hours on all days. OPD : On all days 7.30am to 12.30pm. Routine Indoor: All Days7.30am to 5.00pm. Emergency undertaken all 24hours. Samples and Requests to be marked ‘URGENT’

5] Enquiries shall be made to the respective divisional Medical Officers and Technical Supervisors.
BASIC TEST PARAMETERS
BIO-CHEMISTRY CLINICAL PATHOLOGY CLINICAL MICROBIOLOGY
Blood sugar
Blood Urea
Serum Creatinine
Serum Sodium
Serum Potassium
Serum Chloride
Serum Bicarbonate
Blood Gas
Serum Billirubin – Total
Serum Billirubin – Direct
Serum Billirubin – Indirect
Serum SGOT
Serum SGPT
Serum Alk Phosphatase
Serum LDH
Serum Total Protein
Serum Albumin
Serum Globulin
Serum Uric Acid
Serum Calcium
Serum Phosphorus
Serum Cholinesterase
Serum CPK_MB
Serum CPK
Serum Amylase
Serum Cholesterol
Serum TGL
Serum LDL
Serum VLDL
Serum HDL
Serum T3
Serum T4
Serum TSH
Serum FSH
Serum LH
Serum Prolactin
Serum Fibrinogen
Hb 1 AC
24 hours Urinary Protein
Urine Metabolic Screening
Urine Prot Creatine Ratio
 Benz Jones Protein











 
Total Leucocyte Count 
Differential Leucocyte Count
Platelet Count
Hemoglobin
Hematocrit
MCV
MCH
MCHC
RDW
PDW
Manual PCV
Ivy Bleeding Time
Whole Blood Clotting Time
Prothrombin Time / INR
APTT
Clot Retraction Time
Urea Clot Lysis Time
Body fluids – Cell count
Peripheral Smear
Reticulocyte Count
Absolute Eosinophil Count
Sickling Test
Auto Hemolysis Test
Osmotic Fragility Test
Incubated Osmotic Fragility Test
NESTROFT
Marrow Aspiration Study
Marrow Iron Study
Body Fluids Analysis.
Urine pH
Urine Sp Gravity
Urine Sugar
Urine Albumin
Urine Acetone
Urine Bile salt
Urine Bile pigment
Urine Occult blood
Urine Urobilinogen
Urine Deposits
Fluid Desquamative Cytology
Vaginal / Cervical Cytology -Pap smear
FNAC
Guided FNAC
Semen Analysis
Stool Analysis
General Histopathology
Immunocytochemistry
Renal Biopsy
Renal Immunoflouresence
Muscle Biopsy
Cryostat Study
AFB Stain For M Tuberculosis
AFB Stain For M Leprae
Modified AF Stain for CryptoSporidia
Modified AF Stain for Cyclospora
KOH Mount
India Ink Prep for Cryptococcus
Dark Ground Microscopy
Phase Contrast Microscopy
Fluorescent Stain for M Tuberculosus
Fluorescent Stain for Toxoplasma
Fluorescent Stain for ANA
Bacterial Isolates – Conventional
Slide Agglutination with HTS
Streptococcal Grouping
Bacterial Isolates – Anaerobic
Fungal Isolates
Rapid Test - RPR
Rapid Test – ASO
Rapid Test – RA Factor
Rapid Test – CRP
Rapid Test – Dengue
Rapid Test – H1 N1
Rapid Test – HCV
Rapid Test – HbsAg
ACNA-C
ANCA-P
ANA Profile
Adenosine Deaminase
ELISA Test – Leptospirosis
ELISA Test – Dengue Ig M, IgG
ELISA Test – Dengue NS1
ELISA Test – Chickungunya
ELISA Test – HBV
ELISA Test – HCV
ELISA Test – HbS Ag
ELISA Test – HIV
Serology -  Widal
Serology -  Brucella
Serology -  Weil Felix Test
RT PCR – H1 N1, DEN, others
Theatre Sterilization
Flow Cytometry CD4 Count







 

OPERATIONS MANAGEMENT
 
I. CLINICAL BIOCHEMISTRY [7.00AM-7.00PM]
Blood Glucose
Random
Fasting
Post Prandial
Blood Glucose: Fasting Samples to be taken at 7.00am after over night fast. PP Samples to be taken 1 ½ hrs/2hrs after break fast.
Sr Lipid Profile: Fasting Samples to be taken at 7.00am after over night fast.
Minimum Volume 2ml Specify time of sampling. Samples should reach lab within 15mts. Turn around time 3hours
Blood Urea /BUN
Serum Creatinine
Serum Lipid Profile
Cholesterol
Triglycerides
LDL
HDL
VLDL
Cholesterol /HDL ratio
LDL/HDL ratio
Serum Electrolytes
Na,K, Cl, HCO3
ABG
Do no squeeze arm for sampling. Specify time of sampling. Minimum Volume 2ml Samples should reach lab within 30mts. Turn around time 3hours.
Serum Proteins
Total Protein
Albumen
Globulin
AG Ratio
Serum CPK -MB
Serum CPK -Muscle
Serum PSA
Serum Uric Acid
Serum Calcium
Serum Cholinesterase
Liver Function Test
SGOT
SGPT
ALP
LDH
Sr Bilirubin Total
Sr Bilirubin Direct
Sr Bilirubin Indirect
Glucose Tolerance Test
HBa1C
TUESDAYS ONLY: Patient has to be directly referred to the CDL. Turn around time 5hours
Body Fluid Analysis Specify time of sampling. Minimum Volume 2ml Samples should reach lab within 30mts. Turn around time 3hours
Stone Analysis Turn around time 7days
Urinary 24hour Protein Turn around time 6 Hours
Urinary Creatinine Turn around time 6 Hours
Urinary Screening for In Born Errors of Metabolism Turn around time 6 Hours
Thyroid Profile Test
T3
T4
TSH
Infertility Profile
FSH
LH
PRL
FRIDAYS ONLY: Fasting Samples to be taken at 7.00am after over night fast. Case selection for tests only after discussion with Medical Officer i/c Biochemistry.
EMERGENCY BIOCHEMISTRY [24X7]
Blood Glucose Minimum Volume 5ml Specify time of sampling. Samples should reach lab within 15mts. Turn around time 1hour
Blood Urea /BUN
Serum Creatinine
Ser Electrolytes
Na, K, Cl, HCO3
Ser Cholinesterase
Sr Bilirubin Total
Sr Bilirubin Direct
Sr Bilirubin Indirect
Body FluidAnalysis
Plasma CPK[MB]
II. CLINICAL MICROBIOLOGY [8.00AM-4.00PM]
 
                          DIVISIONS                    INVESTIGATIONS
BACTERIOLOGY DIRECT MICROSCOPY
GRAM STAIN
ACID FAST STAIN
FLUORESCENT STAINS
CULTURE AND SENSITIVITY
CLINICAL SEROLOGY Widal
RPR
ASO Titer
RA Factor
HBS Ag
ANCA-C, ANCA-P
APLA
ACLA
ADA
ANA Profile
Complement C3
CLINICAL VIROLOGY HIV
HBV
HCV
Japanese B
Dengue - NSI, IgM,IgG
Chikungunya
Swine Flu
MYCOLOGY KOH MOUNT
LACTOPHENOL COTTON BLUE MOUNT
FUNGAL CULTURE
PARASITOLOGY STOOL EXAMINATION
WET SALINE & IODINE MOUNT
MODIFIED ACID FAST STAIN
BLOOD SMEAR EXAMINATION FOR MP/MF
THEATRE STERILISATION AEROBIC CULTURE
ANAEROBIC CULTURE FOR TETANUS
 
Specimen Instructions
URINE
Mid stream urine
Indwelling
catheter urine
Send in sterile screw cap container to the lab within 2 hours or refrigerated at 4°C and delivered within 24 hours.
DO NOT collect urine from bedpans, urinals, or catheter bags
SPUTUM
Induced sputum
Suction tip
Bronchoalveolar
lavage
Bronchial wash
If TB is suspected, use precautions to prevent spreading of infection.
Deep cough from the chest should be collected.
Collect sputum in a dry  wide mouthed sterile container
Transport to the laboratory as soon as possible
Refrigerate at 4°C if there is delay in delivery.
Send three consecutive samples
PUS
Superficial
Wounds
Abscess
Pustule
Ulcer
Deep wound
 Aspirated pus is ideal. swabs – only an alternative
Send it in a dry sterile container within 2 hours.
Avoid contamination with surrounding normal flora on skin etc.
SWABS
Throat, Urethra
Vaginal, Aural
Nasal swab
Send in a dry sterile container  at the earliest
CONJUCTIVAL SWAB Use swab premoistened with sterile saline and send at the earliest
CORNEAL SCRAPINGS Collect and Bedside inoculation of material in to Blood agar, Chocolate agar, SDA, Thioglycollate broth. Send immediately.
BODY FLUIDS
pleural fluid
pericardial fluid
peritoneal fluid
synovial fluid
amniotic fluid
vitreous fluid
Collect in a dry sterile container and send to the lab without delay.
CSF Collect in a dry sterile container and send to the lab without delay. CSF is never to be refrigerated
STOOL Send it in a clean leak proof container with  Cary-Blair/VRM.
Transport to lab as soon as possible
Send stool rather than rectal swabs
 BLOOD Wash the area with soap &water and then with 70%alcohol
Do not palpate again
Wear gloves while collecting - Drawn blood and immediately place in blood culture bottles and send within 24 hours.
Incubate at 37c
DONT REFRIGERATE
TISSUE BIOPSIES Collect in a dry sterile container and send to the lab without delay
It is not necessary to add sterile water to biopsies unless they are very small and in danger of drying out.
Microbiology specimens should never be put in formalin.
SKIN SCRAPINGS &
SLIT SKIN SMEAR
Scrape the skin  from active  edge of lesion in a dry sterile petri dish/black paper
NAIL SCRAPINGS
HAIR CLIPINGS
Send clipings of affected area
Pluck hairs with intact shaft
Cut hairs are not satisfactory
 
EMERGENCY CLINICAL PATHOLOGY LABORATORY[24X7]
Blood Hemoglobin Turn Around time 1hour
Urine Acetone Turn around time 15mts
Fluid Cell Count Inform the lab prior to taking sample. And should reach the lab within 10 mts Turn around time 1hour
Occult Blood Turn around time 1hour. Inform the lab prior to taking sample
CLINICAL PATHOLOGY  LABORATORY[7.00AM-7.00PM]
1] BLOOD Send Samples in EDTA Bottle [Red Neck]
TC,
DC,
Hemoglobin
ESR
Send Samples in EDTA Bottle [Red Neck]. Shake the bottle before sending sample to lab [to reach lab within 1 hour]. Turn around time 4hours. Minimum volume 2ml
Platelet Count Do not squeeze the limb to take blood. Send Samples in EDTA Bottle [Red Neck]. Shake the bottle before sending sample to lab [to reach lab within 1 hour]. Turn around time 4hours. Minimum volume 1ml
Smear forMP/MF  
Retic Count  
2] URINE
Albumen
Sugar
Deposits
Blood
Acetone
Bile Salts
B Pigments
Send in plain labelled capped bottle. No additives. Minimum volume 3ml
3] BODY FLUIDS Cell Count Send in plain labelled capped bottle. 1 drop of Formalin / 10cc. Turn around time 4hours. Inform the lab prior Sample should reach lab in 10 mts. Minimum volume 1ml
4] MOTION
Ova
Cyst
Blood
Red Sugar
Send in plain labelled capped bottle. Turn around time 4hours. Inform the lab prior to sending sample. Should reach the lab in 30mts.
5] SEMEN ANALYSIS Send in plain labelled capped wide mouth bottle. Turn around time 6hours. Inform the lab prior to sending sample. And should reach the lab within 5mts. Minimum volume 2ml
HEMATOLOGY[7.00AM-1.00PM]
Hemogram Take Blood in EDTA Bottle [Red Neck]. Shake the bottle before sending sample to lab [to reach lab within 1 hour]. Turn around time 4hours. Minimum volume 3ml. Do not squeeze the limb to take blood. The requisition should have clinical  history & lab test results.
Peripheral Smear Study Take Blood in EDTA Bottle [Red Neck]. Shake the bottle before sending sample to lab [to reach lab within 1 hour]. Turn around time 4hours. Minimum volume 1ml. Do not squeeze the limb to take blood. The requisition should have clinical  history & lab test results.
Bone Marrow Study The Medical Officer i/c of CP/Hematology should be informed prior to taking sample. Requisition should have clinical  history, Peripheral Smear study & Hemogram results. Sample to lab to reach lab within 1 hour. Turn around time 24hours. Minimum 6 slides. Peripheral Smear to accompany BMA slides.
Hemolysis Profile
1] Coombs Test
2] Os Fragility T
3] Sickle Test
4] Heinz Body T
5] AutoHemolysis
6] NESTROFT
7] Incubated OFT
The Medical Officer i/c of CP/Hematology should be informed prior to taking sample. Requisition should have clinical  history, Peripheral Smear study & Hemogram results. Sample to lab to reach lab within 1 hour. Turn around time 24hours. Minimum volume 3ml. Peripheral Smear to accompany sample.
Hemostasis Test
1] Bleeding Time
2] Clotting Time
3] PT – INR
4] APTT
5] Fibrinogen
6] Clot Lysis Time
7] Platelet Count
The Medical Officer i/c of CP/Hematology should be informed prior to taking sample. Requisition should have clinical  history, Peripheral Smear study & Hemogram results. Sample to be taken in tube issued in lab by technician. Sample to reach lab within 10mts. Turn around time 4hours. Minimum volume 3ml. Peripheral Smear to accompany sample.
CYTOPATHOLOGY[8.00AM-1.00PM]
FNAC
[Fine Needle Aspiration Cytology]
Requisition should have clinical  history, Lab results. Turn around time 24hours.
Guided FNAC Medical Officer i/c Cytology to be requested. Requisition should have clinical  history, Lab results. Turn around time 24hours.
CERVICAL/VAGINAL SMEAR STUDY Requisition should have clinical  history, Lab results. Turn around time 24hours.
BUCCAL SMEAR STUDY Requisition should have clinical  history, Lab results. Turn around time 24hours.
HISTOPATHOLOGY[10.00AM-4.00PM] [COLLEGE]
Requisition should have DETAILED clinical  history & ALL relevant Lab results. The Samples should be sent in 10% Formalin – filled to 10 times the volume of the biopsy. Turn around time 5days.

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