tag:blogger.com,1999:blog-53174995680316865582024-03-05T14:24:35.226-08:00Histopathology Lessons, Research And ResourcesHistopathology lessons, research and resources.Unknownnoreply@blogger.comBlogger27125tag:blogger.com,1999:blog-5317499568031686558.post-65454025031208723742018-01-05T05:29:00.000-08:002018-01-05T05:29:08.497-08:0011 Natural Dyes Used As Local Histological Stains<div class="MsoNormal">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBkbcOfRW4S4_bGL6dX7OKNn9O5Bk1nN8B7LZsuuUiFzYmWFTqgIaShGQ8Fx1po_5n1KU43bzn_NbNGexvmwD-DMzUSxWCFC1zXMA0dj7CK1zaQEPG3V14K-lqZ8OnSxsXIPsuY68_45ly/s1600/hibiscusA.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="412" data-original-width="505" height="261" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBkbcOfRW4S4_bGL6dX7OKNn9O5Bk1nN8B7LZsuuUiFzYmWFTqgIaShGQ8Fx1po_5n1KU43bzn_NbNGexvmwD-DMzUSxWCFC1zXMA0dj7CK1zaQEPG3V14K-lqZ8OnSxsXIPsuY68_45ly/s320/hibiscusA.jpg" width="320" /></a></div>
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The concern for safety, cost-cutting, eco-friendliness and
local availability is driving the quest to explore the abundant local plant
resources in developing countries. Researchers in these countries are now looking
inwards to make use of resources in their domain to solve their problems.
Recent works done in this regard are chronicled in this write up.</div>
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1. Punica
Granatum , (pomegranate): This was used for the staining of rat brain (Gharravi
et al., 2006).</div>
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2. Curcuma
longa: The crude ethanolic extract and column chromatographic fraction of this
local dye was used for the demonstration of collagen, muscle cells and red
blood cells (Awvioro, 2007). It was also used for staining of seminiferous
epithelium (Bassey et al., 2011).</div>
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3. Kola nut
(cola acuminata): This was used as eosin substitute to stain tissues (Shehu et
al., 2012).</div>
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4. Black
plum fruit (Syzygium cumini): This was used as histological stain for rat hepatic
tissue (Suabjakyong et al.,2011)</div>
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5. Extract
of butterfly pea flowers (Clitoria ternatea). This was used as histological
stain for blood cells (Suebkhumpet and Sotthibandhu, 2012).</div>
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6. Extract
of dry leaves of henna (Lawsonia intermis).
This was used as histological stain for angiospermic stem (Jan et al.
(2011).</div>
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7. Red beet
(Beta vulgaris) extract. This was used
as a histological stain for intestinal parasites (Al-Amura and co-researchers
(2012).</div>
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8. Black Mulberries. This was used as histological stain for
tissues (<span style="font-size: 12.0pt; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Tousson<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> and AL-Behbehani (2011).<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">9. Sorghum
bicolor. This was used as suitable
counterstain for haematoxylin in histological sections (Omoowo, 2014). Also
used for rat hippocampus cells demonstration
(Muhammed et al., 2016), liver and kidney (Benard et al., 2015) and brain
cells (Benard et al., 2015).<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">10. Baphia
nitida (Camwood). This was used as histological stain for dentine tissues
(Fasan, </span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">1977).<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">11. Hibiscus
sabdariffa. This has been used as
counter stain substitute to eosin ( Eman Hashim, 2006, Abdul-Afeez Ibnouf, 2014,
Raheem et al., 2015). It has also been
explored as nuclear stain to substitute for haematoxylin (Benard, 2008, Benard
et al., 2015, Benard et al., 2015, Benard et al., 2016, Muhammed et al., 2016,
Agbede et al., 2017, Benard et al., 2017 and Omorodion and Achukwu, 2017).<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">These promising efforts should be
followed up for the local laboratories to benefit from the translational
research this findings offer.<o:p></o:p></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijOCwe7jiAHbEx7855DE18IvsYmFDYtJZisKBSy0yaPH1k-o2_EafAVwK3E2AWGgLFoPEJDJ7FBo_vt0Xv0nS2IV5kryJai4wbCcWEZaZFj1Q8bOeouwjwskYMf1e0yRLXVvZ2k_gddnhq/s1600/hibiscusB.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="404" data-original-width="427" height="302" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijOCwe7jiAHbEx7855DE18IvsYmFDYtJZisKBSy0yaPH1k-o2_EafAVwK3E2AWGgLFoPEJDJ7FBo_vt0Xv0nS2IV5kryJai4wbCcWEZaZFj1Q8bOeouwjwskYMf1e0yRLXVvZ2k_gddnhq/s320/hibiscusB.jpg" width="320" /></a></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">References<o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">1. Abd-Alhafeez Ibnouf, Esam AbdulRaheem,
Mohamed Seed Ahmed, and Dalia Dahab (2014). Assessment of staining quality of
Roselle (Hibiscus Sabdariffa) on formalin-fixed paraffin-embedded renal tissue
sections. <i>Int J Cur Res Rev</i>; 6 (21): 26-28. <o:p></o:p></span></div>
<div class="Default" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">2. Agbede,
M.B., Benard, S.A., Afolabi, O.O., Okoye, J.O., Bankole, J.K., Fowotade, A.A., <o:p></o:p></span></div>
<div class="Default" style="line-height: 200%; margin-left: .5in;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Olutunde, O.A., Muhammed, O.A (2017): </span><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> The
Use of Hibiscus Sabdariffa Extract as Nuclear Stain for Skin Morphology and
Connective Tissue with Eosin Counterstain. <b> </b>Sokoto Journal Of Medical Laboratory
Science; 2(4):28-32<o:p></o:p></span></div>
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<span style="font-size: 12pt; line-height: 200%;">3. </span><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Al-Amura, M. F.A., Hassen, Z.A. and ALMhanawi,
B.H. (2012). Staining technique<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">for helminth parasites by use red beet (<i>Beta
Vulgaris L.</i>) extract. <i>Bas. J. Vet.</i><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<i><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Res. </span></i><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">11(1):
283-292.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">4. Avwioro, O.G., Onwuka, S.K., Moody,
J.O.,Agbedahunsi, J.M., Oduola, T., Ekpo, O.E. and Oladele, A.A. (2007).
Curcuma longa extract as a histological dye for collagen fibres and red blood
cells. <i>J.Anat</i>. 210: 600–603.<o:p></o:p></span></div>
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<span style="font-size: 12pt; line-height: 200%;">5. Bassey
R.B., Osinubi A.A., Oremosu A.A. (2012): Staining effect of Hibiscus sabdariffa
extract on sperm cell morphology of Sprague –Dawley rats. Journal of histotechonology 35(3): 110-113<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: .5in; text-align: justify; text-indent: -.5in; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">6. Benard S.A., Muhammed A.O., Fowotade
A.A., Afolabi O.O., and Olutunde O.A.(2017).
Iron Roselle: A Progressive Nuclear Stain For Connective Tissue Of Skin.
International Journal of Health Research and Innovation, vol.5. no.2, 25-31,
ISSN: 2051-5057 (print version). Scienpress Ltd.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin;">7. Benard S.A., Muhammed A.O., Fowotade
A.A., Afolabi O.O., Olutunde O.A. (2015): Sorghum </span><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> bicolor extract: A Suitable Counterstain In
Hibiscus Extract Nuclear Staining of Liver And Kidney: African Journal Of
Cellular Pathology 4: 13-16<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-left: .5in; text-indent: -.5in;">
<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin;">8. Benard S.A., Muhammed A.O., Fowotade
A.A., Afolabi O.O., Olutunde O.A. (2015): Hibiscus </span><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;"> Sabdariffa Etract As Haematoxylin Substitute
In The Histological Demonstration Of Brain Tissues: African Journal Of Cellular
Pathology: 5:32-35<o:p></o:p></span></div>
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<span style="font-size: 12pt; line-height: 200%;">9. Benard
Solomon. Iron-Roselle (2008): A Progressive Nuclear Stain Substitute For
Haematoxylin. <i>J. Histotechnologyy</i>. Vol. 31. 2, 31:57-59.<o:p></o:p></span></div>
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<span style="font-size: 12pt; line-height: 200%;">11. Egbujo EC, Adisa OJ, and Yahaya AB. A Study of the Staining
Effect of Roselle (Hibiscus Sabdariffa) on the Histologic Section of the
Testis. <i>Int. J. Morphol</i>. 2008; 26(4):927-930.<o:p></o:p></span></div>
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<span style="font-size: 12pt; line-height: 200%;">12. Eman A Hashim (2006). The use of watery extract of Kujarat
flowers Hibiscus Sabdariffa as a natural histological stain. <i>Iraqi J Med
Sci</i>. 5 (1): 29-33.<o:p></o:p></span></div>
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<span style="font-size: 12pt; line-height: 200%;">13. </span><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">Gharravi, A.M., Golarlipour, M.J., Ghorbani,
R.and Khazaei, M. (2006). Natural dye for staining astrocytes and neurons. <i>J.Neuro.
Sci. (Turkisk) </i>23(3): 215-218.<o:p></o:p></span></div>
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<span style="font-size: 12pt; line-height: 200%;">14. Ihuma JO, GH Asenge, JOK Abioye, and SK Dick (2012). Application of Methanolic extracts from
Hibiscus Sabdariffa Linn as a biological staining agent for some fungal
species. <i>International Journal of Plant, Animal and Environmental Sciences</i>.;
2 (2): 254-9<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-autospace: none; text-indent: -.5in;">
<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">15. Okolie, N.J.C. 2008. Staining of ova of intestinal
parasites with extracts of <i>Hibiscus Sabdariffa </i>and <i>Azadirachta</i> <i>Indica</i>.
<i>Inter. Sci. Res. J</i>. 1(2): 116-119.<o:p></o:p></span></div>
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<span style="font-size: 12pt; line-height: 200%;">16. Muhammed A.O., Olutunde O.A., Benard
S.A., Muhammad Ahmad AT and Omoowo BT (2016):Hibiscus-Shorgum: A New Morphological
Stain in Neuro-Histology:<i> International Journal of Health Research and
Innovation, vol.4. no.1, 31-38 ISSN: 2051-5057</i></span><span style="font-size: 12pt; line-height: 200%;"><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">17. Omorodion
N.T. and Achukwu P.U. (2017).
Investigation of Hibiscus Sabdariffa (Roselle) as Histological Stain and
in Assessment of Bar Bodies. <b>American
Journal of Biomedical Sciences</b>; 9(1), 15-19.<o:p></o:p></span></div>
<div class="Default" style="line-height: 200%; margin-left: .5in; text-indent: -.5in;">
<span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">18. Raheem M.A., Abd-Alhafeez O.I., Osman H.S., Hamza J.M
(2015). Using of <i>Hibiscus Sabdariffa </i>extract
as a natural histological stain of the Skin. American Journal of Research
Communication; 3(5), 211-216.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">19. Samanta, A. K., Agarwal, P. and Datta, S.(2007).
Dyeing of jute and cotton fabrics<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-autospace: none;">
<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">using jackfruit
wood extract: Part-I :Effects of mordanting and dyeing process variables on
colour yield and colour fastness properties. <i>Indian J</i> <i>Fibre &
Text Res</i>. 32(12): 466-476.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-autospace: none; text-indent: -.5in;">
<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">20. Suabjakyong, P., Romratanapun, S. and Thitipramote,
N. (2011). Extraction of natural histological dye from black plum fruit (<i>Syzygium
cumini</i>). <i>J.Microsc. Soc. Thailand</i>. 4(1): 13-15.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; mso-layout-grid-align: none; text-autospace: none; text-indent: -.5in;">
<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">21. Suebkhampet, A. and Sotthibandhu, P. (2012).
Effect of using aqueous crude extract from butterfly pea flowers (<i>Clitoria
ternatea </i>L.) as a dye on animal blood smear staining.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-autospace: none;">
<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">22. Tousson, E. and Al-Behbehani, B. (2011). Black Mulberries (<i>Morus nigra</i>) as a<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">natural dye for animal tissue staining. <i>Animal
Biol. </i>62(11): 49-56.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">23. Umar, A.A., Hena, S.A. and Wiam, I.M. (2012).
Kola nut (<i>Cola acuminata</i>) extract as a substitute to histological tissue
stain eosin. <i>Sci. J. Vet. Adv</i>. 1(2):33-37.<o:p></o:p></span></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-68854585054428552662016-06-03T03:31:00.001-07:002016-06-03T03:31:18.946-07:00Dr Kwabena Daquah: The Youthful Ghanian Histology Phenomenon!<div class="MsoNormal">
Met Dr. Kwabena Danquah at the International West African
Histology (IWAC) congress in Accra, Ghana between March 31<sup>st</sup> and
April 1<sup>st</sup>.</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjStBhPfckouhz_ZetlNmxNdQRu6XZn3sZdpnd2Jyc8xems1pm3MnntQlFVnYXOoSJ6qtAkqMRyQQHuEmp2wScDBNHXtrFTYC6B_JB_pzRJQr-RoFoa5v0vgG0C52ceIfPeHHMyn3g_4mVg/s1600/ABILITY.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjStBhPfckouhz_ZetlNmxNdQRu6XZn3sZdpnd2Jyc8xems1pm3MnntQlFVnYXOoSJ6qtAkqMRyQQHuEmp2wScDBNHXtrFTYC6B_JB_pzRJQr-RoFoa5v0vgG0C52ceIfPeHHMyn3g_4mVg/s320/ABILITY.jpg" width="180" /></a></div>
<div class="MsoNormal">
A first sight of his
stature is deceptive as he may be taken for a university under graduate. This young Medical Laboratory Scientist who
had his BSc Histopathology in Ghana also have an MSc degree and Ph.D both from
the PostMorth University, UK. He also had post doctoral experience in three
different Institutions. One at a Biotechnology company for 2 years, the second
from at……..for one year and the last one for 2 years at………….</div>
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This young MLS is a vibrant role model for other aspiring
young histoscientists in West Africa who desires to reach the zenith of their
profession especially in the emerging fields of molecular biology and
nanotechnology. It was for this reason the editor of this publication cornered
him for a lengthy interview with excerpts produced below for your delight:</div>
<div class="MsoNormal">
The Beginning</div>
<div class="MsoNormal">
Medical Laboratory started as a diploma programme in Ghanian
higher institution which later upgraded to a degree programme. Medical doctors were our lecturers in those
days. They made us feel inferior and told us there was no future for Medical
Laboratory Science.</div>
<div class="MsoNormal">
After my degree programme in Ghana, I had a schorlaship for
MSc at the University of Postmouth in the UK in 2004. It was during this period
that my eyes were opened to the wide field and importance of Medical Laboratory
Science in Medicine and beyond.</div>
<div class="MsoNormal">
My MSC was a modular programme and my choice of modules were
in Histopathology, cytochemistry, cytology, molecular biology etc hence my
specialization in histopathology. I had
exposure in electron microscopy and work on the use of virus to cure brain
cancer cells.</div>
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My PhD focused on molecular biology techniques in using
virus to cure cancer cells. After that I was opportune to do my post-doctoral
programme in three places at different periods.</div>
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<br /></div>
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Return To Ghana</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5MM3IK7SZ68u9-YHQFdrcXWuBJj7ck93ywX_qNdurBQzJA3xVdIEGNhUnbbZoPbYPy6pHtewiPsg5BUOL5RuRX4dFyABzb_ijQi7_C9x531PFxFF662WrEuPGRpmfckdlSveV-Ek3ssfj/s1600/IWAC6.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5MM3IK7SZ68u9-YHQFdrcXWuBJj7ck93ywX_qNdurBQzJA3xVdIEGNhUnbbZoPbYPy6pHtewiPsg5BUOL5RuRX4dFyABzb_ijQi7_C9x531PFxFF662WrEuPGRpmfckdlSveV-Ek3ssfj/s320/IWAC6.jpg" width="180" /></a></div>
<div class="MsoNormal">
I returned to Ghana in 2013. I have been lecturing and
mentoring students since. I also double
as a Director of a research Institute where collaborate with and help research
students in Pharmacology, Anatomy, molecular biology etc. The Institute also conducts workshops in
molecular techniques.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The Future</div>
<div class="MsoNormal">
I want to see a future where Medical Laboratory Science will
expand to research, production of reagents, and antibodies, Tissue culture,
nanotechnology, Therapeutic protein production etc. We have all it takes to
produce reagents and biologicals as it is very difficult to get reagents for
your research even if you have money in this part of the world.</div>
<div class="MsoNormal">
On Nigeria Delegates</div>
<br />
<div class="MsoNormal">
You Nigerians are very passionate and unique. My
interactions in the conference shows your level of exposure and expertise. I
give it to you that you are ahead in the practice of histology.</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-37964950205764993832016-02-19T02:47:00.002-08:002016-02-19T02:47:41.115-08:00Local Dye-Hibiscus Sabdariffa Good As Haematoxylin Substitute For Nuclear Staining In Brain Tissues<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuVD3AUCCbpeN2j4wp-idD7y1YpAmiZRp9v_52dee3zitetyuIkt8XbrfqA22zyGc_18DE7UeN8Ukn0ANQnSrkkyjaTQAx9wXIqTsCyWiyE2eWJNWo4hRS9OEs0XaWzGDfYZ7ey4xyN4yn/s1600/DSC09466.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuVD3AUCCbpeN2j4wp-idD7y1YpAmiZRp9v_52dee3zitetyuIkt8XbrfqA22zyGc_18DE7UeN8Ukn0ANQnSrkkyjaTQAx9wXIqTsCyWiyE2eWJNWo4hRS9OEs0XaWzGDfYZ7ey4xyN4yn/s320/DSC09466.JPG" width="320" /></a></div>
Another breakthrough was recorded by Nigerian Histology researchers recently in their quest to find local alternatives to expensive, harmful and environmentally hostile imported chemicals and reagents used in the histology laboratories across Sub-Saharan Africa.<br />
The title of the publication as reported by the African Journal Of Cellular Pathology is 'Hisbiscus Sabdariffa As Haematoxylin Substitute In Histological Demonstration Of Brain Tissues'.<br />
The work authored by Benard Solomon of the Histopathology Laboratory, Unilorin Teaching Hospital and other reputable researchers such as Muhammed A.O., of the Histopathology Department, usmanu danfodiyo University, Sokoto, Afolabi OO of the Department of Pathology, College of Health Sciences, University of Ilorin, Fowotade AA and Olutunde OA both of the Histopathology Laboratory, Unilorin Teaching Hospital, Kwara State, Nigeria examined the posibility of the dye extract substituting for heamatoxylin in nuclear staining of brain tissues. The outcome was revolutionary and impactful as it may be the ultimate solution to the high cost of importing foreign reagents for use in the histopathology laboratory as it concerns the widely used haematoxylin.<br />
<br />
While introducing the work, the authors submitted that <b>'Hibiscus sadariffa belong to the family</b><br />
<b>Malvaceae, which is commonly called roselle. Roselle is cultivated in India, Malaysia, Tropics,</b><br />
<b>subtropics and Central America (Roselle, 1987,Durance et al., 1999). The plant is widely</b><br />
<b>grown in Nigeria and other sub-Saharan African countries as a crop used for demarcation of farm</b><br />
<b>plots. The aqueous extract of the dry red calyx is often prepared as a drink for refreshment</b><br />
<b>locally called ‘zobo’. Other uses of the calyces include its being an edible vegetable among the</b><br />
<b>Yoruba ethnic group of South-West, Nigeria and a natural food colorant. (Aballa & Siddig 1993:</b><br />
<b>Adegunloye et al., 1996). Egyptians use to drink hibiscus extract and call it karkadae, while in</b><br />
<b>Iraq, it is called red tea. Studies in Iraq suggest using of hibiscus extract in food industry, using</b><br />
<b>it as a syrup and coloring agent (Alzubaidi,1977). Hibiscus was found as a natural source</b><br />
<b>of pectin, which solidify jelly and ice cream preparation (Ali, 2000). Hashim, (2006) revealed in his work that Hibiscus sabdariffa is called kujarat flower in Iran. Hibiscus calyces</b><br />
<b>contain per 100gm of edible portion, calcium (1.263mg), niacin (3.765mg), riboflavin</b><br />
<b>(0.277mg) and iron (8.98mg) (Durance et al.,1999,. Chemical analysis in Iraq, (Muller et al.,</b><br />
<b>1992) of kujarat reported their values of 100m of Ca and 9.55mg of Fe per mg of dry matter.</b><br />
<b>Three water-soluble ploysaccharids have been isolated from flower buds of Hibiscus sabdariffa</b><br />
<b>(HIB, 1.2.3)(Muller et al., 1992). Medical uses of these flowers are wide. Infusion of calyces</b><br />
<b>are regarded as diuretic, choleretic, febrifugal, hypotensive, decreasing the viscosity of blood</b><br />
<b>and stimulating intestinal peristalsis (Roselle,1987). Other medical study proposed its effect</b><br />
<b>in protection from induced cytotoxicity and genoetoxicity by different mechanisms (Tesng</b><br />
<b>et al., 1996). Other researchers proposed its use as a natural stain. They used extract to stain blood film, fungi and plant tissue (Al –Sarraj et al., 1997: Al-Sarraj, 1997). It was also used as a</b><br />
<b>natural histological cytoplasmic stain (Hashim, 2006, and Abd-Alhafeez Ibnouf et al., 2014).</b><br />
<b>Dried calyces of Hibiscus have dark red pigment. Chemical components of this pigment</b><br />
<b>were reported in previous studies (Hashim, 2006). It contains flavonoids gossypetine,</b><br />
<b>hibiscetine and sabdaretine. The major pigment reported as hibiscin that was identified as</b><br />
<b>daphniphylline. Small amount of delphinidine 3- monoglucosides, cyanidin 3-monoglucosides</b><br />
<b>(chrysanthenin) and delphinidine are also present (Roselle, 1987). The use of hibiscus</b><br />
<b>extract of dry Roselle calyx in the histological demonstrations of nuclear staining in lymph</b><br />
<b>node, appendix, testis and renal tissues has already been reported (Benard, 2008, Egbujo et</b><br />
<b>al., 2008, Abd-Alhafeez Ibnouf et al., 2014). However, the nuclear staining effect of the</b><br />
<b>extract on brain tissue has yet to be known hence the justification for this study.'</b><br />
<br />
Detailing the materials and methods used, the authors submitted that<b> 'Dry, red calyces of H. sabdariffa were obtained at a local market in Ilorin, the capital of Kwara State in the North-Central region of Nigeria. They were subsequently ground using a Binatone blender to a fairly powdery form. To 10g of the ground red calyces of H. sabdariffa in a conical flask, 200mls of distilled water was</b><br />
<b>added and brought to boil to give the brilliant red colored extract which was immediately</b><br />
<b>allowed to cool and filtered to give a clear H. sabdariffa extract. The staining formula was</b><br />
<b>compounded as follows:</b><br />
<b>H. sabdariffa extract 100ml</b><br />
<b>NaCl 5.0g</b><br />
<b>10% ferric chloride solution 1.2ml</b><br />
<b>Glacial acetic acid 3.0ml</b><br />
<b>Tissue Preparation and Staining</b><br />
<b>10% formol saline fixed, paraffin embedded</b><br />
<b>tissues from the cerebellum, cerebrum, and pons</b><br />
<b>were sectioned at 4μm and stained with H&E</b><br />
<b>and Hibiscus/Eosin techniques. They were</b><br />
<b>subsequently dehydrated, cleared and mounted</b><br />
<b>with DPX. Photomicrographs of the sections</b><br />
<b>were also taken.'</b><br />
<br />
Subsequently, they reported that the work resulted into the following <b>' The nucleus of the brain tissues was satisfactorily stained when compared with the standard haematoxylin and eosin control</b><br />
<b>sections. Nucleus stain dark-violet while red blood cells and cytoplasmic components stain light- pink.'</b><br />
<br />
In their discussion, the authors stated that <b>'For long, histopathology laboratory resource</b><br />
<b>managers in developing countries has depended on expensive imported reagents for use in their</b><br />
<b>laboratories most especially haematoxylin. The loss of foreign currency exchange has been</b><br />
<b>much more pronounced in the economies of these countries over the past few decades due to</b><br />
<b>economic downturn leading to increased high cost of these reagents. The aforementioned</b><br />
<b>scenario has made the search for local alternatives to haematoxylin as nuclear stain a</b><br />
<b>compelling necessity. Earlier on, the use of extract of hibiscus sabdariffa (Iron-Roselle,) has</b><br />
<b>shown promising outcomes for nuclear staining (Benard, 2008, Egbujo et al., 2008). Aqueous</b><br />
<b>extract of H. sabdariffa was also used to stain mice tissues as substitute to eosin as a</b><br />
<b>cytoplasmic stain ( Hashim, 2006). Abd-Alhafeez and his colleagues, (Abd-Alhafeez</b><br />
<b>Ibnouf et al., 2014) also reported the use of pure aqueous extract of H. sabdariffa for the staining</b><br />
<b>of cytoplasmic contents as eosin substitute on formalin fixed, paraffin embedded renal tissues.</b><br />
<b>However, to the author’s knowledge, this study represents the first initiative of using H.</b><br />
<b>sabdariffa aqueous extract solution as nuclear</b><br />
<b>stain for brain tissues. Results show satisfactory staining of brain tissues with the Hibiscus/Eosin</b><br />
<b>method. The nucleus is stained dark-violet while the cytoplasm is stained light- pink. Red</b><br />
<b>blood cells stain pink-red. The nuclear staining obtained from the staining of cerebellum,</b><br />
<b>cerebrum, and pons of the brain shows similar results comparable with standard haematoxylin</b><br />
<b>and eosin to the extent that an uninformed observer will think that it is H and E. (Fig I&II).</b><br />
<b>Figure Ia, Ib and Ic show H& E staining of cerebrum, cerebellum and pons respectively</b><br />
<b>with nucleus staining purple, cytoplasm staining pink and red blood cells, red. Figure IIa, IIb and</b><br />
<b>IIc show Hibiscus/Eosin staining of cerebrum, cerebellum and pons respectively with nucleus</b><br />
<b>staining dark-violet, cytoplasm staining pink and red blood cells, pink. However, the lightpink</b><br />
<b>staining of the cytoplasm in the Hibiscus/Eosin technique is in contrast with the</b><br />
<b>intense pink staining seen in the standard H&E. This could be due to the blockage of reactive</b><br />
<b>sites in the cytoplasm due to the presence of acetic acid in the Hibiscus solution. This is in</b><br />
<b>line with an earlier observation made by Egbujo et al., (2008). It is worth of note that the Hibiscus extract formular used for this work has been used satisfactorily by Benard (2008) for lymph node and appendix with optimum staining achieved in 5 minutes. This has further established Iron-Roselle (Hibiscus extract solution) as a progressive nuclear stain. In addition, the staining time in Iron-Roselle is shorter compared to haematoxylin hence could be a rapid stain for general demonstration of structure of the brain. The distinct nuclear clarity and preservation of the histomorphology</b><br />
<b>of the brain is particularly impressive. Unlike as done with the haematoxylin staining,</b><br />
<b>differentiation in 1% acid alcohol is not necessary in the Hibiscus extract stained</b><br />
<b>sections. The Hibiscus extract /eosin technique shows great promise as a new technique in</b><br />
<b>histology for the demonstration of nuclear components in brain tissues. H. sabdariffa is natural, locally available, cheap, easy to prepare, safe and resistant to fading. The wider application of the H. sabdariffa solution in the demonstration of general tissue structures in combination with other dyes would be of great interest to researchers especially in the histological diagnoses of diseases.'</b><br />
<br />
Conclusively, the researchers agreed that <b>'Hibiscus sabdariffa extract solution (ironroselle)</b><br />
<b>is suitable as haematoxylin substitute for the nuclear staining of brain tissues.'</b>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-5317499568031686558.post-88664383440990961512016-02-03T06:07:00.001-08:002016-02-03T06:07:56.542-08:00Study Unveils Hibiscus-Sorghum As New Neurological Staining Technique<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgZ2vGvjGPXliHG3k9UmYoyMNfH-DZcRU0oK9yEyGkFFFNKw6I8KzAxMB1qEYuNJaRJAuqBILxJM8ZTPe8PWbc0njFFuIkwQS_jQDY30wt4uPcJYXD6CrTIoHXxLe45gJczgb8bcPL6KuE/s1600/DSC09370.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgZ2vGvjGPXliHG3k9UmYoyMNfH-DZcRU0oK9yEyGkFFFNKw6I8KzAxMB1qEYuNJaRJAuqBILxJM8ZTPe8PWbc0njFFuIkwQS_jQDY30wt4uPcJYXD6CrTIoHXxLe45gJczgb8bcPL6KuE/s320/DSC09370.JPG" width="320" /></a></div>
Something great is coming out good for Africa as more of her young Medical Scientists explore local dyes for histopathological diagnoses of diseases. One of such is a recent study conducted by a group of researchers from the Faculty of Medical Laboratory Sciences, Uthmanu Danfodiyo University, Sokoto and the Histopathology unit, University of Ilorin Teaching hospital.<br />
The revolutionary study explored the possibility of combining Hibiscus extract nuclear staining with 10% Sorghum bicolor extract with the aim to replacing the general stain, H&E with the new staining technique in the demonstration of brain cells from the hypocampus.<br />
The recent findings was revealed in a publication released by the International Journal Of Health Research And Innovation, vol.4. no.1, 2016, 31-38.<br />
The work led by Muhammed Ola also include other co-authors such as Benard Solomon, Olutunde Oluwumi, Balikis Omoowo and Muhammad Ahmad Tangaza.<br />
The authors while reviewing earlier effort attested that 'Hematoxylin and Eosin (H&E) stains play a critical role in tissue-based diagnosis [1].The two, are the commonest stains being used in histopathology laboratories all over the globe which colour the nuclei a dark blue or purple, and the cytoplasm and connective tissue a shades of pink [2]. By colouring tissue structures (cytoplasm, nucleus, organelles, and extra-cellular components); these stains allow the sections to be viewed in details under the microscope, tissue morphology and/or any present abnormalities can then be easily detected [3]. Even when advanced staining methods are used, the H&E stain still forms a critical part of the diagnostic picture as it displays the underlying tissue morphology which allows correct interpretation to be made [4]. Most histological stains in current use are of synthetic origin; however, natural dyes are still promising to be cheaper potential sources [5]. Any development of new histological stain is justified if the new stain is cheaper, available, harmless, and easier in application [6]. Hibiscus sabdariffa belongs to the vascular flowering plants, known as Roselle or Red Sorrel in English and Karkade in Arabic [7]. It is a hardy herbaceous shrub belonging to the Family Malvaceae [8]. The plant has several uses; the outer thick red and fleshy cup-shaped leaves, for example, are commonly used in the production of several food products and are consumed worldwide as a cold beverage and as a hot (sour tea) drink [8]. Sorghum bicolor originated from North-Eastern tropical Africa (possibly Ethiopia) domesticated from as early as 5,000- 3,000BC to around 1000BC. From North-Eastern Africa sorghum was distributed all over Africa, through the Middle East to India. From India to China, from West Africa sorghum was taken to America through slave trade [9]. It is typically an annual, but some cultivars are perennial. It grows in clumps that may reach over 4 meters [9].Sorghum bicolor has a red dye present in the leaf sheath and sometimes in adjacent stem parts. In Africa, the dye is used for goat-skin leather (Nigeria) in local weaving design (Sudan) [10]. In some West African countries, the dye can be extracted from the plant to colour leathers, cloths, calabashes and as body pigment [11]. The hippocampus is anatomically one of the oldest regions of the brain. It is made up of interconnected layers of the dentate gyrus and cornuammonis. Each of the layers and/or subfields of the hippocampus have been shown to be involved in different hippocampal functions and tasks [12].<br />
The extraction and application of colouring matters from Hibiscus sabdariffaand<br />
Sorghum bicolor will be of great contribution to the exploitation of natural dyes and their applications, most especially in the field of neuropathology. This research wants to contribute to the use of natural dyesfrom H. sabdariffa and Sorghum bicolor as a substitute for haematoxylin and eosin in the staining of human and animal brain tissues in the field of histopathology.'<br />
Furthermore, the authors' submission on methodologies adopted stated that' Sorghum bicolor stalks and Hibiscus sabdariffa (Dry leaves) were purchased in a local market in Ilorin, and were identified by a Botanist in the Botany department of Obafemi Awolowo University, Ile-Ife, Nigeria. They were processed using the techniques of Omoowo and colleagues [13] and Benard [14] respectively. 10% Formalin fixed, paraffin wax processed brain tissues were sectioned at 3 microns. Slides of serial sections produced were tagged and stained as follows: A: Haematoxylin and Eosin (H&E), B: Hibiscus and Eosin (H-E), C: Haematoxylin and Sorghum (H&S), and D: Hibiscus and Sorghum (H-S).<br />
1. PREPARATION OF STAIN EXTRACTS<br />
1.1 HIBISCUS EXTRACT SOLUTION The dry calyces of Hibiscus sabdariffawere ground using a Binatone blender to a fairly powdery form. To 10g of the ground red calyces of H. sabdariffa in a conical flask, 200ml of distilled water was added and brought to boil to give the brilliant red coloured extract which was immediately allowed to cool and filtered to give a clear H. sabdariffa extract. The staining formula was compounded as follows: H. sabdariffa extract 100ml NaCl 5.0g 10% ferric chloride solution 1.2ml Glacial acetic acid 3.0ml 1.2 10% ALCOHOLIC EXTRACT OF SORGHUM S. bicolor stalk was ground into a powdery form with a Binatone blender. 10g of the ground powder was weighed using a sensitive balance (Ohaus) and dissolved in a conical flask containing 100ml of absolute alcohol. The solution was allowed to stay for 24 hr at room temperature (25±2ºC) after which it was filtered into a staining jar.<br />
2. STAINING PROCEDURES<br />
2.1 H&E<br />
34 Muhammed Abdurrasheed Ola et al.<br />
Section was dewaxed in xylene and hydrated through 100%, 90%, 70%, 50% alcohol to water<br />
It was stained in Harris haematoxylin for 15 minutes<br />
Rinsed in water<br />
Differentiated in 1% acid alcohol<br />
Blued in running tap water for 10 minutes<br />
Counter-stained in 1% alcoholic eosin for 1 minute<br />
Dehydrated in ascending grades of alcohol<br />
Cleared in xylene and<br />
Mounted with DPX<br />
2.2 H-E<br />
Sections were taken to water through 100%, 90%, 70%, 50% alcohol and water<br />
Stained in Hibiscus extract solution for 5 minutes<br />
Washed in running tap water for 2 minutes<br />
Counter-stained in 1% alcoholic Eosin for 1 minute<br />
Dehydrated in ascending grades of alcohol<br />
Cleared in xylene and<br />
Mounted with DPX<br />
2.3 H&S<br />
Section was dewaxed in xylene and hydrated through 100%, 90%, 70%, 50% alcohol to water<br />
It was stained in Harris haematoxylin for 15 minutes<br />
Rinsed in water<br />
Differentiated in 1% acid alcohol<br />
Blued in running tap water for 10 minutes<br />
Counter-stained in 10% alcoholic Sorghum for 3 minutes<br />
Dehydrated in ascending grades of alcohol<br />
Cleared in xylene and<br />
Mounted with DPX<br />
2.4 H-S<br />
Sections were taken to water through 100%, 90%, 70%, 50% alcohol and water<br />
Hibiscus-Shorgum: A New Morphological Stain... 35<br />
Stained in Hibiscus extract solution for 5 minutes<br />
Washed in running tap water for 2 minutes<br />
Counter-stained in 10% alcoholic Sorghum for 3 minutes<br />
Dehydrated in ascending grades of alcohol<br />
Cleared in xylene and<br />
Mounted with DPX<br />
<br />
Findings from the work showed that 'The histomorphological features of the Hippocampal layers, the neurones as well as the glial cells were distinctly preserved across all the groups. The H-E stained<br />
section (group D), had the closest resemblance to the H&E (The positive control<br />
group).<br />
In their analysis of the work done, the authors comparatively stated that 'Before now, interest of the scientists in histopathology has not been directed towards finding alternatives to the age long Haematoxylin and Eosin stains; despite its cost and scarce availability. The few available literatures on the topic seem very recent. The nuclear staining capability of Hibiscus sabdariffa has been established by Benard [14]. He prepared a stain composed of H. sabdariffa extract, ferric chloride, sodium chloride, and glacial acetic acid. This solution was used to stain paraffin sections of formaldehyde-fixed tissues along with parallel Haematoxylin and Eosin (H&E) staining for control. Results showed that staining of nuclei with the extract solution was comparable with those sections stained with H&E. He then suggested that the extract solution could be a progressive nuclear stain substitute for hemalum in H&E procedure. Likewise, Omoowo et al [13] established the counter-staining potentials of stalk extracts of S. bicolor, and specifically recommended the absolute ethanolic extract of 10% S. bicolor which has the closest morphologic resemblance, as a substitute for eosin in diagnostic histopathology staining. This study had tested the applicability of the established techniques of Benard [14] and Omoowo et al [13] on the brain tissue. Hippocampus was specifically selected due to its dense population of neurons, glial cells and distinct interconnected layers of the dentate gyrus and cornuammonis [12]. Sections from Hibiscus-Sorghum (group D) showed the neural cells nuclei with brilliant blue-black colouration, and the cytoplasm stained pinkish brown. This was the same reports from the previous authors [14][13] though; none of these authors had earlier worked on brain tissue.<br />
Eman et al[15] reported that the purified acidic part of Hibiscus sabdariffa could be used instead of eosin because this part has similar physical and chemical characteristics to the eosin stain. Likewise, Egbujo et al [16] prepared Roselle (Hibiscus sabdariffa) aqueous extracts with various modifications, and used it for the differential staining of rabbit testicular tissue sections. He reported various levels of differentiation of nuclear and cytoplasmic structures as well as other structures of this organ with 1% eosin as a counter stain. The best staining result was reportedly obtained when iron alum was used to mordant the extract and when the extract mordanted with potassium alum was acidified using acetic acid. Methanolicextract of H. sabdariffa has been used as a staining agent for some fungi and therefore hope to reduce the problems associated with over-dependence on toxic, expensive and scarcely available exotic stains [17]. Ibnouf and colleagues had also in two different publications, confirmed the staining ability of aqueous extract of H. sabdariffa, and suggested that it may be good as a replacement for eosin; though with the shortcoming of too long staining period [18][19]. The good results recorded from the exchange and substitution of one stain for the other (as demonstrated in group B and C) testified to the flexibility of the new H-S technique, and equally attested to the iso-electrical compatibility of the four stains [20]. H. sabdariffa, according to Egbujo et al [16] and Benard [14] can be substituted for haematoxylin in H&E procedure. However, Ihuma [17], Ejugbo et al [16], Eman et al[15] and Ibnouf et al [18] reported its counter-staining characteristics, and recommended its replacement for eosin. Because of these variance reports, new research is underway to investigate the possibility of using only the extracts of this plant as both nuclear and cytoplasmic stains at different manipulation. Conclusively, this new staining technique (H-S) could be a substitute to H&E staining technique in neurological studies because the neural components were clearly demonstrated. It could therefore be a useful tool in diagnostic neuropathology.'<br />
<br />
The well referenced publication included the following papers as<br />
REFERENCES<br />
J. A Kiernan, Histological and Histochemical Methods: Theory and Practice. 4th ed, Bloxham, UK: Scion, 2008.<br />
[2] Cellpath, Staining theory. 2006,67-72<br />
[3] S. Iyiola and O. G Avwioro,“Alum haematoxylin stain for the demonstration of nuclear and extra nuclear substances”. Journal of Pharmacy and Clinical Sciences, 1, (2011),20-23.<br />
[4] O. GAvwioro,“Histochemical Uses of Haematoxylin - A Review”. Journal of Pharmacy and Clinical Sciences,1, (2011), 24-34.<br />
[5] H. I Mattuk, Studies on the utilization of natural colorants extracted from some plant sources. Egypt J. Appl.Sci., 13, (1998), 286-303.<br />
[6] D. P Penney, J. M Powers,M. Frank and C.Churukian, Analysis and testing of Biological Stains–the Biological Stain Commission Procedures. Biotechnic& Histochemistry, 77, (2002), 237-275.<br />
[7] B. H Ali, N. Al-Wabel and G. Blunden, Phytochemical, pharmacological and toxicological aspects of a Hibiscus Sabdariffa; a review. Phytotherapy Research, 19(5), (2005), 369- 375.<br />
[8] Y. Qi, K. L Chin, F. Malekian, M. Berhame, and J. Gager, Biological characteristics, nutritional and medicinal value of Roselle Hibiscus Sabdariffa. Circular-Urban Forestry Natural Resources and Environment,604, (2005), 1-2.<br />
[9] A. Umar, Effect of Raw and Modified Sorghum Cellulose Fibre on the Mechanical Properties of Natural Rubber Composite. MSc. Dissertation, Dept. of Pure and Industrial Chemistry, BayeroUniversity Kano, 2009.<br />
[10] T. V Balole and G. M Legwaila, Sorghum bicolor (L.)Moench (Internet) record from protabase. Jansen. P.C.M and Cardon D. (Editors) 2008.<br />
<div>
<div>
L. S Cobleyand W. M Steele, An introduction to the botany of tropical crops. 2nd ed, 1976, 43-45.</div>
<div>
[12] S. Leutgeb,J. K Leutgeb,A. Treves, M.B Moser andE.I Moser, Distinct ensemble codes in hippocampal areas CA3 and CA1. Science, 305, (2004), 1295-1298</div>
<div>
[13] B. T Omoowo, J. K Bankole, A. O Muhammed, S. A Benard and O. O Afolabi, Histomorphological assessment of the extract of the stalk of Sorghum bicolor as counter stain. African Journal of Cellular Pathology,2, (2014), 69-74.</div>
<div>
[14] S. A Benard, Iron-Roselle: A Progressive nuclear stain substitute for hematoxylin. The Journal of Histotechnology, 31(2), (2008), 57-59.</div>
<div>
[15] A. H Eman, The use of watery extract of Kujarat flowers Hibiscus Sabdariffaas a natural histological stain. Iraqi Journal of Med Sci,5(1), (2006), 29-33.</div>
<div>
[16] E. C Egbujo, O. J Adisa and A. B Yahaya, A Study of the Staining Effect of Roselle (Hibiscus Sabdariffa) on the Histologic Section of the Testis. International Journal of Morphology,26(4), (2008), 927-930.</div>
<div>
[17] J. O Ihuma, G. H Asenge, J. O. K Abioye, and S. K Dick, Application of Methanolicextracts from Hibiscus Sabdariffa Linn as a biological staining agent for some fungal species. International Journal of Plant, Animal and Environmental Sciences, 2(2), (2012), 254-259.</div>
<div>
[18] A. Ibnouf, E. AbdulRaheem, M. SeedAhmed and D. Dahab, Assessment of Staining Quality of Roselle (Hibiscus sabdariffa) on Formalin Fixed Paraffin-Embedded Renal Tissue Sections. IJCRR, 6(21), (2014), 26-28.</div>
<div>
[19] A. Ibnouf, K. Adam, E. AbdulRaheem and A. Ageep, Staining of Histological Sections from the Small Intestine using Hibiscus sabdariffa. Journal of Biomedical and Pharmaceutical Research,3(5), (2014), 01-03.</div>
<div>
[20] S. ABenard, A. OMuhammed, A. A Fowotade, O.O Afolabi andO.A Olutunde,Sorghum bicolor Extract: A Suitable Counter Stain in Hibiscus Extract Nuclear Staining of Liver and Kidney.African Journal of Cellular Pathology,4, (2015),13-16.</div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-69123851712051992792016-01-12T01:50:00.001-08:002016-01-12T01:50:57.583-08:00Histopathology Lessons, Research And Resources: Progress In The Development Of Diagnostic Histopat...<a href="http://histopathologyresearchresources.blogspot.com/2009/07/progress-in-development-of-diagnostic.html?spref=bl">Histopathology Lessons, Research And Resources: Progress In The Development Of Diagnostic Histopat...</a>: Dyes were the foundation for diagnostic histopathological staining. Most of the early methods for histopathological analysis of tissue sec...Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-63713555160378293532015-11-19T04:30:00.000-08:002015-11-19T04:30:12.932-08:00Understanding Quality Management System In Histopathology Laboratory: By Benard Solomon University Of Ilorin Teaching Hospital, Ilorin<div class="MsoNormal">
<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: large;">Summary</span><span style="font-size: 12pt;"><o:p></o:p></span></span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Histopathology
is the branch of medical science which focuses on the microscopic diagnosis of
tissues in diseased states. It also comes handy on assessment of the efficacy,
safety and effectiveness of new drugs such as tamoxifen/herceptin at the
molecular level, medical devices and biologicasl (such as cervical cancer
vaccine) prior to approval for public use.
Towards this end, quality data must be generated from the histopathology
laboratory. In many developing
countries, doubts often arise on the quality of the data generated from
laboratory facilities. One of the
adduced reasons for this poor showing is lack of quality management system,
lack of understanding of the concept, implementation and monitoring of
Laboratory Quality Management System (QMS).<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">A thorough
understanding of the essentials of quality management system is therefore a
necessity by all stakeholders working in the histopathology laboratory
especially the histology scientist so as to foster the generation of reliable,
valid, complete, timely, precise, accurate, fault-proof (integrity), and
confidential data. This will ultimately
yield enviable outcomes such as reduction in incidences of high disease burdens
especially those of malignant origins.
This article is aimed at explaining the various essential components of
the laboratory quality management system as it applies to histopathology
laboratory setting with a view to empowering medical laboratory professionals
in that field to generating quality histopathology laboratory data through the
implementation of the quality management system.<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></div>
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<span style="line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><b><span style="font-size: large;">Introduction</span></b><span style="font-size: 12pt;"><o:p></o:p></span></span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">The prime
place of the histopathology laboratory just like others is to produce valid,
accurate, complete, reliable, timely, fault-proof and confidential data which
meets desired purpose. The production of
high quality histopathology slides must be viewed in the context of
cost-effectiveness, cost-benefit and cost-utility due to the reality of scarce
resources available in a low resource setting.
The necessity of top quality histopathology laboratory services cannot
be overemphasized as it provides the evidence-based foundation for medical
diagnosis, treatment and monitoring. Histopathology laboratory data is very
vital in the provision of epidemiological evidence at local, national and
international levels and boost effort towards prevention of future outbreaks of
epidemics through autopsy.<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Inclusively,
histopathology laboratory data provides strong support for training and
research and it is the basic demand by accreditation bodies for regulatory
purposes.<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">National and
international health bodies responsible for determination of standards have
recently generated keen awareness to stir up the implementation of quality
systems to improve laboratory services.
The ISO 15189 especially is well suited for the histopathology
laboratory and aims at customers’ satisfaction.<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Quality
management system in the histopathology laboratory will promote human capital
development, job satisfaction, detect and eliminate errors in laboratory processes
and procedures, foster high ethical practice and ultimately contribute to
building a strong health system. With
quality management system, laboratory policy formulation and implementation
becomes a sine qua non.<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">What is
Quality Management System (QMS)?<o:p></o:p></span></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12.0pt; line-height: 200%;">According to the ISO, quality management system (QMS) is
defined as ‘</span><span style="color: #333333; font-size: 12pt; line-height: 200%;">coordinated activities (management system) to
direct and control an organization with regards to quality’. <o:p></o:p></span></span></div>
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<span style="color: #333333; font-size: 12pt; line-height: 200%;"><span style="font-family: Arial, Helvetica, sans-serif;">A
system is built around the path of work flow through policy formulation,
processes, procedures, control, assessment and improvement which will enable
the laboratory organization to achieve its desired quality goals.<o:p></o:p></span></span></div>
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<span style="color: #333333; font-size: 12pt; line-height: 200%;"><span style="font-family: Arial, Helvetica, sans-serif;">Routine
operation of quality management system ensure that work is properly documented
which results in the generation of reliable data, improvement of services and
high degree of customer’s satisfaction. <o:p></o:p></span></span></div>
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<span style="color: #333333; font-size: 12pt; line-height: 200%;"><span style="font-family: Arial, Helvetica, sans-serif;">When
quality management system is fully implemented, the laboratory is positioned
for high level accreditation status and helps the laboratory to generate valid,
complete, timely, confidential and high integrity data. Staff motivation, job satisfaction,
continuous professional development, improved leadership and management skills
coupled with high credibility rating constitute other benefits of quality
management system.<o:p></o:p></span></span></div>
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<span style="color: #333333; font-size: 12pt; line-height: 200%;"><span style="font-family: Arial, Helvetica, sans-serif;">Definition
of Terms<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Quality Policy: A written
commitment on the laboratory organizations’ processes, structures, procedures
and protocols and other coordinated activities geared towards quality results
and customers’ satisfactions<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Personnel Policy: A
written policy on recruitment, orientation, task assignment and development of
staff<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Equipment Policy: A
written commitment on how equipment will be purchased, used and maintained<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Supply/Inventory Policy:
A written commitment on how laboratory reagents and consumables will be
ordered, received, used and preserved<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Process Control Policy: A
written statement on specimen handling, quality control and laboratory
protocols.<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Assessment Policy: A
written statement on how to audit and assess coordinated activities in the
laboratory to aid good laboratory practice<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Information management
Policy: A written declaration on how
data will be managed in the laboratory<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Documents/Records Policy:
A Written commitment on documents used in the laboratory and how to use them<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Process improvement
Policy: A written statement on procedures established to improve laboratory
activities<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Customers’ service Policy:
A declaration of how customers will be served to meet their demands<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Safety/Facility Policy: A
written commitment on safety measures to be carried out by the laboratory and
professionals working therein.<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Quality Control: This is
the operational procedures and protocols put in place to ensure that data
generated in the laboratory are accurate, reliable, valid, complete, precise,
specific and confidential.<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Quality Assessment: This
is the structure put in place to monitor and evaluate compliance with
established protocols in the system to ensure results are reliable and also to
promote process improvement.<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Procedure: A specified
way of performing a laboratory task or activity. It is documented in form or
Standard Operating Procedures (SOP).<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="color: #333333; font-size: 12pt; line-height: 200%;">Processes: Following a
documented procedure to generate expected results.<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="color: #333333; line-height: 200%;"><span style="font-family: Arial, Helvetica, sans-serif;"><b><span style="font-size: large;">Essentials
of Quality Management System</span></b><span style="font-size: 12pt;"><o:p></o:p></span></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-family: Arial, Helvetica, sans-serif;"><b><span style="color: #333333; font-size: 12pt; line-height: 200%;">Organization</span></b><span style="color: #333333; font-size: 12pt; line-height: 200%;">: Quality management
system cannot be implemented without the support of management. The laboratory
management must draw up a quality policy to describe in detail the mission,
vision, organogram and responsibilities stating clearly what is to be done, who
to do it and how it will be done. The
organization will also allocate resources and provide motivation to carry out
step wise implementation of the quality management system.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;"><br /></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv8VXdoN4qn_VT9rYHP2IRNLnqakJ9SqBh-mhPgilBjILsqoK8FPNDJIGDpW7QXp87mpMY6lkh_E3ae7qGGkm1N9OuEbyb1M-ddQp_UCvVlmqMoZObMv-vHxrwCC_Ilelj1pLuBMK5n00q/s1600/CUTUP2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv8VXdoN4qn_VT9rYHP2IRNLnqakJ9SqBh-mhPgilBjILsqoK8FPNDJIGDpW7QXp87mpMY6lkh_E3ae7qGGkm1N9OuEbyb1M-ddQp_UCvVlmqMoZObMv-vHxrwCC_Ilelj1pLuBMK5n00q/s320/CUTUP2.jpg" width="320" /></a><span style="font-family: Arial, Helvetica, sans-serif;"><b><span style="color: #333333; font-size: 12pt; line-height: 200%;">Personnel</span></b></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #333333; font-size: 12pt; line-height: 200%;">The right mix of
qualified, competent and licensed laboratory professionals must be recruited,
given orientation, given task and job specification with a view to achieving
quality management system objectives.
Personnel must be motivated and given the right condition of work to
give maximum performance. Opportunities
for training and continuous professional development must be provided on
regular basis for high degree human resource management. The threat of quackery confronting
laboratories in developing countries should be totally mitigated. Human resources
in the laboratory should have the right qualification, given the right job, in
the right condition, at the right time and the right place.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-family: Arial, Helvetica, sans-serif;"><b><span style="color: #333333; font-size: 12pt; line-height: 200%;">Equipment</span></b><span style="color: #333333; font-size: 12pt; line-height: 200%;">: The right equipment
with right specification must be acquired, installed and maintained to promote
excellent performance at all times. New
equipment must be calibrated before use.
A maintainance log must be made available to document processes of
scheduled maintainance and whenever fault is developed, appropriate authorities
should be contacted for repairs. The
best professional with wrong equipment will still generate unreliable results.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-family: Arial, Helvetica, sans-serif;"><b><span style="color: #333333; font-size: 12pt; line-height: 200%;">Process Control</span></b><span style="color: #333333; font-size: 12pt; line-height: 200%;">: A laboratory handbook should be made
available to detail how specimens will be received and handled in the
laboratory. The content of the handbook
</span></span></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: Arial, Helvetica, sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgS3NNJrISNeF3FqzTDfBm0Zlbi_dsbrL9FsuvM9fuzXlqX1u5N4apARgAZ0T0ndnyZ_qG6VjbqcVlHl0H1TbP66CtzZS1tmWR1QjjTlRO-okdpqf7Y0vvYwxqFPrha9ljtnADx5xmKa1bq/s1600/inventory.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgS3NNJrISNeF3FqzTDfBm0Zlbi_dsbrL9FsuvM9fuzXlqX1u5N4apARgAZ0T0ndnyZ_qG6VjbqcVlHl0H1TbP66CtzZS1tmWR1QjjTlRO-okdpqf7Y0vvYwxqFPrha9ljtnADx5xmKa1bq/s1600/inventory.jpg" /></a></span></div>
<span style="font-family: Arial, Helvetica, sans-serif;">should be at the beck and call of all persons involved in the processing of
specimens in the laboratory. A Standard
Operational Procedure (SOP) manual should also be available describing
protocols for every test, procedure and technique to be performed. This should cover the pre-analytical,
analytical and post-analytical phases of laboratory analysis. SOPs should be pasted on conspicuous places
on the wall in the laboratory.<o:p></o:p></span><br />
<div class="MsoNormal" style="line-height: 200%;">
<span style="color: #333333; font-size: 12pt; line-height: 200%;"><span style="font-family: Arial, Helvetica, sans-serif;">Control
blocks should be sourced for in –house or procured and included in each
technique performed in the laboratory e.g. appendix/uterus for H&E,
positive fungal block for GMS etc. <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="color: #333333; font-size: 12pt; line-height: 200%;"><span style="font-family: Arial, Helvetica, sans-serif;">When
necessary, job aids should be given to professionals on the bench to carry out
simple tasks.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;"><b><span style="font-size: 14.0pt; line-height: 115%;">Inventory Control</span></b></span></div>
<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12.0pt; line-height: 115%;">The right reagent and consumables
for use in the laboratory must be selected, quantified, </span></span></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: Arial, Helvetica, sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6FSlvqMROhbLwjXS247M_2ZIBXWfqlMLbukHN9QAdyd3Xcayutu0kUDf-bEq7Utyy_0rpZxdDbf_58L9y2AzzJe06qSCNVKyOOcUvHaVCZ3ZK13LU8zz7L3m4I3CYadekiq9g7J8crx_2/s1600/LABORATORYHANDBOOK.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6FSlvqMROhbLwjXS247M_2ZIBXWfqlMLbukHN9QAdyd3Xcayutu0kUDf-bEq7Utyy_0rpZxdDbf_58L9y2AzzJe06qSCNVKyOOcUvHaVCZ3ZK13LU8zz7L3m4I3CYadekiq9g7J8crx_2/s320/LABORATORYHANDBOOK.jpg" width="258" /></a></span></div>
<span style="font-family: Arial, Helvetica, sans-serif;">procured, stored in the
right condition and distributed for use on the bench with a view to serving
customers in the best way possible. The
maximum-minimum stock level inventory control system must be implemented to
ensure uninterrupted service. Regular assessment of stock status is recommended
to determine the <a href="file:///C:/Users/SOLOMON/Desktop/QMSBooks/StockOnHand.txt"><span style="color: black; font-size: 12.0pt; line-height: 115%; mso-themecolor: text1; text-decoration: none; text-underline: none;">stock on hand</span></a><span style="font-size: 12pt; line-height: 115%;">, </span><a href="file:///C:/Users/SOLOMON/Desktop/QMSBooks/AverageMonthlyStock.txt"><span style="color: black; font-size: 12.0pt; line-height: 115%; mso-themecolor: text1; text-decoration: none; text-underline: none;">average
Monthly consumption</span></a><span style="font-size: 12pt; line-height: 115%;"> and </span><a href="file:///C:/Users/SOLOMON/Desktop/QMSBooks/MonthsOfStock.txt"><span style="color: black; font-size: 12.0pt; line-height: 115%; mso-themecolor: text1; text-decoration: none; text-underline: none;">Months of stock</span></a><span style="font-size: 12pt; line-height: 115%;">.<o:p></o:p></span></span><br />
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Rate of
consumption of consumables should be tracked either manually using registers or
electronically using a simple MS file or Excel worksheet.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Reagents
must be stored appropriately in the refrigerator at 4<sup>0</sup>C or at room
temperature as recommended by manufacturers. The factor of expiry date must be
considered when ordering for reagents and consumables.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></b></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Documents And Records<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Documents
include written policies and procedures upon which the organizational quality
</span></span></div>
<div class="separator" style="clear: both; text-align: center;">
</div>
<span style="font-family: Arial, Helvetica, sans-serif;">management system revolves. Records are
data of patients and other activities in the laboratory which cannot be
changed. The histopathology laboratory
must have the quality manual, laboratory handbook, SOP manual, safety manual
and the policy document. Documents can be reviewed to meet with the dynamic
nature of scientific developments.<o:p></o:p></span><br />
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Each
laboratory must determine the kind of registers to use in order to capture all
the activities surrounding specimen handling and processing. All processes from
reception to release of results must be well accounted for in the record books.
Suggested registers include:<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">Histology
Day Book<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">Cut
Up Register<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">Decalcification
Register<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">Processing
Register<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">Sectioning
Register<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">H&E
Slides Register<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">Special
Stains Register<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">Blocks
Archive Register<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt; line-height: 115%;">·<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 115%;">Slides
Archive Register etc.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">In a digital
environment, a Microsoft Access program can be used to document the aforementioned
records.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Information Management:<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Managing
information in the histopathology laboratory could be manual or electronic.
Manual handling of information is susceptible to inherent errors of
transcription and other damaging factors. Most developing countries’
laboratories still adopt this method as a result of scarce resources.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">However,
electronic information management provides a convenient, coordinated and
error-minimized platform for managing information being generated in the
laboratory. Laboratory Information System (LIS) should be incorporated as a
long term objectives of laboratories in developing countries. Grants and assistance from global agencies
can bring necessary succor in this direction.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.4pt; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="YO" style="color: #333333; font-size: 11.5pt;">A laboratory information system stores information
in a relational database, such as Oracle, DB2 or MS SQL. </span><span lang="YO" style="color: #333333; font-size: 11.5pt;"> </span><span lang="YO" style="color: #333333; font-size: 11.5pt;">A link is established between samples, storage
conditions, test dates, analyst certification, instrument calibration and
testing parameters. It is aimed at supporting automation in the laboratory,
reducing turn around time, improving service quality, and reducing errors.</span><span style="color: #333333; font-size: 11.5pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Occurrence Management<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Unusual
incidences do occur daily in the histopathology laboratory. It could originate from methods, techniques,
safety issues, equipments, specimen handling (fixation) and other similar
sources. A recent survey in a tertiary institution’s
histopathology laboratory indicates that power failure and equipment breakdown
constitutes the two leading causes of unusual incidences which interrupts
services. <o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Each
laboratory must have a way of documenting these occurrences for the purpose of
reference and system integrity. It will also form the basis of reporting to
higher authorities on reasons why results/work is delayed.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Audit/Assessment<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Self
auditing creates a strong foundation for process improvement which rubs
positively on the quality of service and results. Data obtained from such documentation avail
practitioners’ information on adherence to established guidelines, processes
and procedures. It reveals areas of
strength and weaknesses, identifies skill gaps and prepares the organization
for external auditing and assessment cum accreditation.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Each
laboratory must have an audit checklist to monitor and evaluate all activities
in the histopathology laboratory.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Process Improvement<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">New
discoveries, techniques and methods can provide valid reasons for improving
processes and procedures in the laboratory to enhance compliance with the lean
concept which demands the use of cheap but efficient resources in the delivery
of quality and timely results.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Feedback
obtained from the audit process also provides useful information for process
improvement. For example if a skill gap
is identified and the staff trained to acquire the skill, right application of
the skill is bound to improve the process.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">When errors
are detected, they should be corrected and ultimately eliminated. This will
instill confidence and promote the generation of quality results.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Customers’ Service<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Histopathology
laboratories exist in the first instance because her services are being
demanded by clients who may be individuals or corporate entities. The mantra
‘customer is king’ must be imbibed by the laboratory organization to ensure a
paradigm shift in thinking and service delivery.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Customers must
be made comfortable in the laboratory service environment throughout their
stay. A superb system of result delivery
should also be instituted which must be convenient and fast. Electronic means of delivery of results and
social media exploration could ensure return patronage by impressed clients. A
satisfied client is guaranteed to be retained.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">It will not
be out of place for histopathology laboratories to have a customers’
relationship unit. The use of customers’
complaint form is recommended to harvest what the client detests in the
laboratory as well as getting a feedback on services and what the customer
really want. <o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Facilities and Safety<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">The
laboratory environment must be safe for practitioners, clients and the
public. Guaranteed safety starts from a
well designed and customized laboratory which meets both national and
international requirements for level 2 biosafety.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Each worker
must be made to observe basic precautionary measures in the laboratory and fire
extinguishers placed at strategic places in the laboratory. A first aid box is required for treatment of
simple injuries and all laboratory staff must be immunized against common diseases
like hepatitis. . <o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.4pt; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="YO" style="color: #333333; font-size: 11.5pt;">The laboratory must be designed to have
enough space to accommodate all machines and tools, working benches, shel</span><span style="color: #333333; font-size: 11.5pt;">f</span><span lang="YO" style="color: #333333; font-size: 11.5pt;"> for chemicals, retained slides and block
storage. It must also support efficient and smooth workflow. It should have enough
sink and the room should be well air conditioned.</span><span style="color: #333333; font-size: 11.5pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.4pt; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="YO" style="color: #333333; font-size: 11.5pt;">There should be enough space to also
accommodate specialized tests e.g. cytology, immunohistochemistry,
histochemistry, archive room, tissue bank etc.</span><span style="color: #333333; font-size: 11.5pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.4pt; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="YO" style="color: #333333; font-size: 11.5pt;">The room must be well ventilated with
electrical wiring to standard laboratory specification.</span><span style="color: #333333; font-size: 11.5pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; line-height: 16.4pt; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify; text-justify: inter-ideograph;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="YO" style="color: #333333; font-size: 11.5pt;">Where there is challenge on power supply,
alternative sources of emergency power supply must be made available for
constant power </span><span style="color: #333333; font-size: 11.5pt;">generation</span><span lang="YO" style="color: #333333; font-size: 11.5pt;">.</span><span style="color: #333333; font-size: 11.5pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span style="font-size: 12.0pt; line-height: 115%;"><span style="font-family: Arial, Helvetica, sans-serif;">Conclusion<o:p></o:p></span></span></b></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt;"><span style="font-family: Arial, Helvetica, sans-serif;">Documentation
is the soul of good laboratory practice!
Any work done in the laboratory without documentation is good as not
done at all. Therefore, in order to
achieve high quality histopathology results in a consistent and satisfactory
manner that meets the expectations of clients, quality auditors and regulatory
agencies, the implementation of quality management system is a necessity.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt;"><span style="font-family: Arial, Helvetica, sans-serif;">The
top management of every histopathology laboratory organization should
demonstrate keen commitment in adopting this principle to accomplish desired
end.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt;"><span style="font-family: Arial, Helvetica, sans-serif;">Staff
training and motivation coupled with a conducive work environment is equally
essential in achieving quality goals.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt;"><span style="font-family: Arial, Helvetica, sans-serif;">It
is mandatory that all activities in the histopathology laboratory be documented
along work flow as a basic requirement for implementing quality management
system.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt;"><span style="font-family: Arial, Helvetica, sans-serif;">National
and global regulatory agencies should sustain the current level of awareness
generation, training and support to developing countries in the effort towards
stepwise implementation of quality management system with a view to generating
accurate, reliable, complete, valid, timely and confidential laboratory data
especially in the histopathology laboratory which will improve services,
support the development of new drugs, efficient treatments and better medical
diagnostic governance.<o:p></o:p></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span></div>
<div class="MsoNormal">
<span style="font-size: 12.0pt;"><span style="font-family: Arial, Helvetica, sans-serif;">References<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpFirst" style="text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt;">·<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt;">Benard Solomon
and Olutunde O.A.: Histopathology Laboratory Practical training guide for
Medical Laboratory Students and Interns<o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 12pt;">·<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><a href="http://histopathologyresearchresources.blogspot.com/2012/07/quality-control-in-histopathology.html"><span style="font-size: 12.0pt;">http://histopathologyresearchresources.blogspot.com/2012/07/quality-control-in-histopathology.html</span></a><span style="font-size: 12.0pt;"><o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;">·<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]-->https://globalhealthlaboratories.tghn.org/articles/improving-clinical-research-data-understanding-and-implementation-laboratory-quality-management-system-lqms/</span></div>
<div class="MsoListParagraphCxSpLast">
<br /></div>
<div class="MsoNormal">
<br /></div>
<br />
<div class="MsoNormal">
<br /></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-26354035793127166052015-10-13T02:23:00.000-07:002015-10-13T02:23:23.122-07:00QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY-8<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">FACILITIES AND SAFETY<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Just as the quality of results produced by the histopathology
laboratory is important, so is the safety of the staff, clients and the public. According to the WHO safety protocol, all
diagnostic laboratories should be designed and organized for bio-safety level 2
or above.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Safety is important to build reputation, gain/retain
customers, staff retention, low cost and low litigation.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Overall safety in the laboratory is the responsibility of the
medical laboratory manager.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Quality management of facilities and safety should take care
of security, containment, safety and ergonomics.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Good safety practices start with availability of a safety
manual. This will take care of the
policies and procedures to prevent harm to workers, visitors and the community.
The manual also must highlight standard laboratory safety practices, general
safety equipment available and how to manage wastes.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The design of the histopathology laboratory must take into
cognizance the fact that patients and patients’ samples shouldn’t have common
pathways. Proper ventilation must be
ensured and surfaces and benches should be such that could be cleaned and
disinfected.<o:p></o:p></span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-63799247608599777812015-09-21T05:51:00.003-07:002015-09-21T05:51:42.547-07:00INTRODUCTION TO QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY-7<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in; text-justify: inter-ideograph;">
CUSTOMER SERVICE: MAKING YOUR CUSTOMERS HAPPY!</div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Histopathology laboratory services are centered on the patient. Therefore, the satisfaction of the patient
should be of paramount importance to the Medical Laboratory Scientist and other
members of staff.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Quality Control and Quality Management System will fail if it excludes
customer’s satisfaction. In public
medical laboratories, the Servicom unit should be established and saddled with the responsibility of ensuring
customer’s satisfaction on histopathology laboratory services.
<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Private medical laboratories should have a customer care desk to ensure
that customers are well satisfied at all times.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">All members of staff must be committed to this objective. Adequate planning is also important to gather
necessary information from customers who benefit from services so
rendered. Knowledgeable members of the
laboratory or those specifically trained to meet this objective should be
assigned with the responsibility of monitoring customer’s satisfaction.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Calculators,
computers and Internet are requisite tools for the manpower saddled with this
responsibility.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;"><b>Patient’s
Requirements<o:p></o:p></b></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Clients
should be provided with:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Right
and timely information<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Good
collection facilities<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Trained
and available personnel<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Good
maintenance of laboratory records<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;"><b>How To
Monitor Customer’s Satisfaction<o:p></o:p></b></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">This could be
achieved using:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Complaint
monitoring<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Quality
indicators<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Internal
audit<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Management
review<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Satisfaction
survey<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Interviews
and focus groups.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">A patient’s
complain register should be made available to properly monitor issues that may
arise from this end. The register should
capture:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Nature
of complaints<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Time<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Patient
refusal<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Lost
or delayed results<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">These will
serve as indicators for determining customer’s needs and gathering information
on level of customer’s satisfaction.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;"><br /></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
NEXT: FACILITIES AND SAFETY</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-59032194262500624762015-09-07T00:26:00.002-07:002015-09-07T00:26:29.615-07:00Quality Management System In Histopathology Laboratory- Part 6<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">INFORMATION
MANAGEMENT<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">This is
broadly divided into paper-management and computer –based information
management. Information management
system captures all the processes needed for data management. This includes all in-coming and out-going
patient information.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Elements of
Information Management<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Patient
identifiers<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Sample
identifiers<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Security
of data<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Reporting
system<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Common
Information Management Problems<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Insufficient
patient data<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Poor
archiving<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Incompatibility
between computerized system and other electronic system causing data
transmission problem<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Incomplete
data entry<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Computer
based Laboratory Information System<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">A
computerized system for laboratory data is often called a Laboratory
Information Management System (LIMS or LIS). Each laboratory will have to decide on how this solution could be deployed for maximum benefit. A lot of resources is always needed to embark on such a capital intensive effort as this. Management support is critical to its attainment.</span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;"> Microsoft Access is also a simple software package for running a computerized
system for laboratory data. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">NEXT...CUSTOMER SERVICE</span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-56922835625436097162015-08-31T01:33:00.001-07:002015-08-31T02:39:09.222-07:00INTRODUCTION TO QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY-5<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Process
Improvement<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj72Ay-dIx4yk-AzKrKAf4YmPGrUD6Iukb5VIZZgZsqY49GIumTQz2BM_GoYlIebyQG2h_gdFZQxoImLrvuZ7ri-ufjfNqN5-1Wdi4QHFLR5uNaMmIjhoujLVj2fv3Dhl3bbEkWQsEdhmNS/s1600/Processimprovement.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="233" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj72Ay-dIx4yk-AzKrKAf4YmPGrUD6Iukb5VIZZgZsqY49GIumTQz2BM_GoYlIebyQG2h_gdFZQxoImLrvuZ7ri-ufjfNqN5-1Wdi4QHFLR5uNaMmIjhoujLVj2fv3Dhl3bbEkWQsEdhmNS/s320/Processimprovement.jpg" width="320" /></a></div>
<span style="font-size: 12.0pt; line-height: 200%;">The goal of
the laboratory is to continually improve on its processes for consistent,
quality results. Process improvement is
the way to achieve this goal. In line
with ISO 15189 standard requirements, continual improvement can be achieved through:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Identifying
system weakness and error<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Developing
plans to implement improvement<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Implementing
the plan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Reviewing
the effectiveness of the plan<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Adjusting
plans in line with audit results.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Tools For
Process Improvement<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Internal
audit<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">External
audit<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">External
assessment<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Management
review<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Examples of
Quality Indicators<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Proficiency
testing<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Quality
control<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Personnel
competencies<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Turnaround
time<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Patient
identification<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Patient’s
identification<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Report
accuracy<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Tools For
Implementing Process Improvement<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Commitment
from all members staff<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Careful
planning<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Organizational
structure that supports improvement<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Top
management involvement<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Participation
of MLS on bench/ task performers<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Planning
Tools For Process Improvement<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Identify
the root causes of error<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Categorize
the errors<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Perform
cost-benefit analysis<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -.25in; text-justify: inter-ideograph;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Consider
the cost of inaction<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Summary<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">Process
improvement is a cardinal requirement for a Quality Management System which
requires commitment, planning, structure, leadership, participation and
engagement.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-justify: inter-ideograph;">
<span style="font-size: 12.0pt; line-height: 200%;">NEXT:Information management</span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-77732253155446088472015-08-24T00:27:00.000-07:002015-08-24T00:27:59.735-07:00INTRODUCTION TO QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY- PART 4<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">DOCUMENTS AND RECORDS<o:p></o:p></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-kBkFZOLoY-wOYmmTl9OwdpyUQ15TRyuGu1ckbcnIar85TsHu46v4wAsHc7mmBcEpCq9E-64qV1MrB7zCNdDe9zn0MwmZOA0655mP8uoiawax6I5AghUpcnMm4sqpwggWDLHoOIASYbbY/s1600/documentsandrecords.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="144" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-kBkFZOLoY-wOYmmTl9OwdpyUQ15TRyuGu1ckbcnIar85TsHu46v4wAsHc7mmBcEpCq9E-64qV1MrB7zCNdDe9zn0MwmZOA0655mP8uoiawax6I5AghUpcnMm4sqpwggWDLHoOIASYbbY/s320/documentsandrecords.jpg" width="320" /></a></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Documents and records lay the foundation for information
obtained in the laboratory therefore, information management and
documents/records interwoven. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Documents are written policies, processes and procedures
which lay the foundation for all activities in the histopathology
laboratory. They include:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">1.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Histopathology
Laboratory Handbook<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">2.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">SOP
manual<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">3.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Safety
manual<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">4.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Histopathology
Laboratory policy manual<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">5.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Histopathology
laboratory quality management system guidelines etc <o:p></o:p></span><span style="font-size: 12pt; line-height: 200%;">Documents could be updated/reviewed hence are subject to
changes.</span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Records on the other hand are data generated in the
laboratory in the course of performing histopathology laboratory activities. Such records include:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">1*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Histology
day register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">2*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Cut
–up register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">3*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Decal
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">4*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Post
mortem register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">5*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Processing
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">6*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Sectioning
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">7*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Special
stain register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">8*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">H&E
register/Dispatch register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">9*<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Immuno
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">1*.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Histology request form<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">11.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Special stain request form<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin;">12.<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Immuno request form etc<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Records are not subject to changes and are therefore
permanent. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Documents and records must be accessible to users at all
times for consistent results and assessment<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">OCURRENCE MANAGEMENT<o:p></o:p></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9TJkYStn6XBjM9ySXmOhwjJNMnqidyOLxOLsczgDaZvTAPTZLmCalbhv6Z7a0GcYGH4GW-cNCszxDuc1oJhZWKIuYQojRl0-Wfh37_MLJlOdsbK6VDV0L4TF9m1js2JJ6fKEiCl0HnJdV/s1600/OCCURENCE.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="268" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9TJkYStn6XBjM9ySXmOhwjJNMnqidyOLxOLsczgDaZvTAPTZLmCalbhv6Z7a0GcYGH4GW-cNCszxDuc1oJhZWKIuYQojRl0-Wfh37_MLJlOdsbK6VDV0L4TF9m1js2JJ6fKEiCl0HnJdV/s320/OCCURENCE.jpg" width="320" /></a></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">According to the WHO QMS guidelines, occurrence is ‘any event
that has a negative impact on an organization, including its personnel,
products of the organization, equipments or the environment in which it
operates.<o:p></o:p></span></div>
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">The
occurrence management system detect errors, correct the errors and also put
measures in place to prevent future occurrence.</span><span style="font-size: 12pt; line-height: 200%;">Errors are more likely and preponderant in the pre-analytic
(41%) and post-analytic (55%) than in the analytic phase (4%) (CDC report).</span>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Pre-examination errors include wrong/inadequate sample
collection, unfixed/improperly fixed specimen, mislabeling/wrong/insufficient
patient’s detail, improper storage or specimens and reagents. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Analytical errors include, non usage of SOP, non usage of
control blocks, mislabeling of blocks, sample mix-up, reagent mix-up, and expired
reagents.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Post examination errors include, transcription error,
illegible handwriting, wrong dispatch/loss of report and non availability of
report.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Problems arise in the histopathology laboratory from time to
time. These errors should be
investigated, corrected and prevented.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;"><br /></span></div>
<div class="MsoNormal" style="line-height: 200%;">
NEXT: PROCESS IMPROVEMENT...</div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<br /></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 200%;"><br /></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-size: 12.0pt; line-height: 200%;"><br /></span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-80519955362328009192015-08-17T02:43:00.000-07:002015-08-17T02:43:58.431-07:00INTRODUCTION TO QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY-3<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">PURCHASING AND INVENTORY<o:p></o:p></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkuIh9NchBLkKvcj8Msp1GUyM26bmLQ6ij4-rRZ5t1QsdEl7Ki8TQLeTCFeZPZe_gMRfB2DS3kxPHJio7wX-RlNyIzr4Qbxim0KFCALDyCdaRVZ97fEuu0aGg3M4GQBEozfoAil65MLDD3/s1600/Inventory2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkuIh9NchBLkKvcj8Msp1GUyM26bmLQ6ij4-rRZ5t1QsdEl7Ki8TQLeTCFeZPZe_gMRfB2DS3kxPHJio7wX-RlNyIzr4Qbxim0KFCALDyCdaRVZ97fEuu0aGg3M4GQBEozfoAil65MLDD3/s1600/Inventory2.jpg" /></a></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">This is essential for efficient, cost-effective laboratory
operations and uninterrupted availability of reagents, consumables, supplies
and services. It also ensures prevention
of wastages, guarantees proper storage and continuous viability of reagents.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Benefits include availability of reagents as and when due,
getting high quality reagents at appropriate cost and validity of reagents at
all time.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-justify: inter-ideograph;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-bidi;">The inventory
management system is triggered by requests for what the laboratory need after
careful analysis. Quotations are received
from suppliers who deliver into a central store where inspection is made before
it is accepted by the laboratory and stored in the appropriate location and
under standard conditions of storage.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-justify: inter-ideograph;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-bidi;">Tools like logbooks
and registers are essential for proper inventory. Provision has been made in the Medical
Laboratory Policy for a centralized national procurement system with a central
store area that distributes directly to the laboratories.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%; margin-bottom: .0001pt; margin-bottom: 0in; mso-layout-grid-align: none; text-align: justify; text-autospace: none; text-justify: inter-ideograph;">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-bidi;">Purchasing and
inventory is very challenging in the histopathology laboratory. Identified ones include, balancing
availability of reagents/consumables with their expiry dates, monitoring of
expiry dates and overstocking. There
must be an established policy and procedure for inventory management. Inclusively, responsibility for
implementation must be well assigned to appropriate personnel.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;"> </span><span style="font-size: 12pt; line-height: 200%;">PROCESS CONTROL</span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Process control in the histopathology laboratory starts from
proper sample collection and fixation. The different sampling techniques in
histology has been comprehensively discussed (<a href="http://histopathologyresearchresources.blogspot.com/2010/07/issues-on-diagnostic-value-of.html">Sampling Techniqes inHistopathology).</a><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Process control therefore covers the pre-analytic, analytic
and post-analytic phase in specimen handling.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">There should be a histopathology laboratory handbook that
details how to collect, receive and handle histopathology biopsies and the
information made available to stakeholders. The handbook is a powerful tool to
quickly acquaint a new entrant/recruit with the ‘what to do’ and ‘how to do’ in
the histopathology laboratory.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Process control also captures the use and proper storage of
reagents and other consumables.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">An efficient quality control management system must be well
established to ensure reliable results at all times. All methods and techniques
should be controlled. Positive blocks
should be sourced and kept for the use of histo-scientists on the bench. For
example, blocks of uterus, fibroadenoma and appendix should be sourced as
H&E control.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">A policy on sample handling should be in place to drive
process control so as to allow for proper tracking samples received in the
laboratory. This policy should also
highlight how samples will be disposed.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">INFORMATION MANAGEMENT<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Information management is the circulatory system of the
quality management system. It links all
the processes, procedures, policies, and other activities in the
laboratory. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Information management could either be in digital form or
paper form. Most histopathology
laboratories in the developing Countries still depend on paper communication
and information management.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Information management reveals the tracking system in the
laboratory for all samples received and how they were handled till the final
product was released and report generated.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The backbone of the information management system in the
histopathology laboratory include:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Request
form<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Histology
day book<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Data
sheets<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Decal
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Processing
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">H&E
Slides register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Special
stains register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Immuno
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Post
mortem (PM) register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Audit
checklist<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Log
books<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Inventory
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Dispatch
register<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Slides
screening register etc<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">For an effective information management system, the
importance of planning and staff training cannot be overemphasized. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">NEXT: Documents and Records.............</span></div>
Unknownnoreply@blogger.com2tag:blogger.com,1999:blog-5317499568031686558.post-10433174696208482102015-08-10T00:47:00.003-07:002015-08-10T02:38:48.910-07:00Introduction To Quality Management System In Histopathology Laboratory-2<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">All activities in the Histopathology Laboratory like any
other Medical Laboratory is geared towards the generation of high quality
laboratory results which must be reliable and timely. The quality of slides released by the
Histopathology laboratory must meet top quality standard and expectations of
clients which include Physicians, Pathologists, Patients and the Public.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The operations in the Histopathology Laboratory therefore
must be well organized, controlled and in a well laid out process and
procedure.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The quality management system model is the appropriate tool
to actualize the crave and necessity for quality results.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">12 ESSENTIAL QUALITY MANAGEMENT SYSTEM TOOLS<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">There are twelve essential tools in a quality management
system model according to the ISO 15189 and CLSI specification. These tools ensure that all activities,
processes, procedures are well coordinated to drive policies, detect errors and
guarantee safety of personnel.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%;"><b>ORGANISATION</b><o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%;">A practical way to have a well organized histopathology
laboratory is to have a quality manager to establish and implement quality
management system policies and requirements.
The manager must be supported by the Management of the organization and
other senior laboratory officials e.g. Laboratory Manager/CEO.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The quality manager will be saddled with the </span>responsibility
to implement, allocate resources, develop and distribute a quality manual,
begin implementation, and monitor compliance with the quality policy and the
quality management system requirements.<span style="font-size: 12.0pt; line-height: 200%;"><o:p></o:p></span></div>
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<b><span style="font-size: 12.0pt; line-height: 200%;"> </span><span style="font-size: 12pt; line-height: 200%;">PERSONNEL</span></b></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5y15onWTT1TbjuPBlxonoNm5bfl5YCB0MdETy7qjNpIfm87Oo0BM5UPiFN1IgyAfUPiFDwcMw2PBEmN9sSigAIviBMNpklVLE60j-OFtaCS8T4CEBjONwzqFKY6L5dtNiALmbZs2Nkuw-/s1600/CUTUP.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5y15onWTT1TbjuPBlxonoNm5bfl5YCB0MdETy7qjNpIfm87Oo0BM5UPiFN1IgyAfUPiFDwcMw2PBEmN9sSigAIviBMNpklVLE60j-OFtaCS8T4CEBjONwzqFKY6L5dtNiALmbZs2Nkuw-/s320/CUTUP.jpg" width="320" /></a></div>
<span style="font-size: 12.0pt; line-height: 200%;">Personnel constitute the most important resource in the
histopathology laboratory. The laboratory manager must ensure that qualified,
competent, licensed staffs across all cadres are recruited to work in the
histopathology laboratory.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Core staff compliment in the histopathology laboratory should
be Medical Laboratory Scientists, Medical Laboratory Technicians and Medical
Laboratory Assistants. Support staff
such as messengers, cleaners and secretarial staff should also be considered.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">For core staff, job description must be well laid out in the
scheme of service (SOS) highlighting all cadres of staff. International
organizations and non- governmental organizations (NGOs) give job specifications
whenever job vacancies are declared through advertisement.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The Director is the overall quality manager. However, he should assign the duty of quality control to another senior
officer. Very important areas of interest regarding personnel issues include:<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;"><b>Importance of Motivation</b><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">People respond to motivation in different ways. Staff should be given recognition for
performance, bonuses, and training opportunities/sponsorship.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;"><b>Orientation</b><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">A new staff should be introduced to the new work environment
and the job tasks, duties and schedule in the new place of work. This is vital
to adequately cover laboratory structure, policies, procedures, processes,
practice and other sundry issues. A well orientated staff is an asset to the
histopathology laboratory.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Job description with an overview on standard operating
procedures (SOP) should also be part of the brief for the employee.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;"><b>Competency Assessment</b><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Personnel assessment is the key to identifying problems with
staff performance and provides opportunities to correct the identified skill
gaps so as not to negatively affect services.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 200%;"> </span><b style="font-size: 12pt; line-height: 200%;">EQUIPMENT</b></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixcBe_Gor0_X-4b1Q7RcarcapoR43NhF86vEwug_P_iDEVLIhKWMaGfcyti7nCyJ4ii2a1IBF5WNnQSAz5Oprsohx231lKOlkR8nzOSLNHqDVueYGKzFu7GNADIvdLD1Qfb2LXjrl4g_wS/s1600/LABROOM.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixcBe_Gor0_X-4b1Q7RcarcapoR43NhF86vEwug_P_iDEVLIhKWMaGfcyti7nCyJ4ii2a1IBF5WNnQSAz5Oprsohx231lKOlkR8nzOSLNHqDVueYGKzFu7GNADIvdLD1Qfb2LXjrl4g_wS/s320/LABROOM.jpg" style="cursor: move;" width="320" /></a></div>
<span style="line-height: 32px;">Equipment</span><span style="font-size: 12pt; line-height: 200%;"> used in the histopathology laboratory must be well
specified, appropriate for use and well managed. When </span><span style="line-height: 32px;">equipment</span><span style="font-size: 12pt; line-height: 200%;"> are professionally chosen, it
attracts the following benefits:<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">High
level of performance<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Improves
the confidence of staff<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Lowers
repair cost<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Prolongs
the life span of the equipment<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Forestalls
interruption of services due to repairs<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Increases
the level of safety for workers and<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Leads
to greater customer satisfaction.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="line-height: 32px;">Equipment</span><span style="font-size: 12pt; line-height: 200%;"> used in the histopathology laboratory must be
planned for. Due process must be
followed in their selection and purchase depending on organizational
guidelines. After purchase, it should be
inspected, validated and calibrated for use in the laboratory.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="line-height: 32px;">Equipment</span><span style="font-size: 12pt; line-height: 200%;"> merchants have agents who install and maintain
them. The manuals must be made available
for troubleshooting and good maintenance.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: 12pt; line-height: 200%;">Users of the </span><span style="line-height: 32px;">equipment</span><span style="font-size: 12pt; line-height: 200%;"> should be trained and responsibility
of their operation should be assigned to a competent staff. There should be a written plan for calibration,
performance verification and proper operation of the </span><span style="line-height: 32px;">equipment</span><span style="font-size: 12pt; line-height: 200%;">. In the same vein, there is need to establish
a daily, weekly and monthly maintenance schedule of the </span><span style="line-height: 32px;">equipment</span><span style="font-size: 12pt; line-height: 200%;">.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">It is essential that equipment inventory be made and maintenance
logbook designed to capture records of equipment faults, repairs and corrective action
taken. Tools for equipment management
such as charts, checklists, graphs and service reports should be generously
applied.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;"><br /></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">NEXT:PURCHASING AND INVENTORY..</span></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-341263458177023712015-08-04T23:57:00.002-07:002015-08-05T00:32:25.256-07:00INTRODUCTION TO QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY-1 By Benard Solomon<div class="MsoNormal" style="line-height: 200%;">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgPoO-zTi_r_SdHbFvgQrh34ehoJPgeW-L-IGcpb6UuRUCOghxBCQ2TkS5l8CeTTAaeTsraqhfWWPhX9Z_nCj3b4_xMnWWygtCJN-23R-dqLN1kGhirv5OMRlZyvvdCs0A0IgldxXkvt3Ad/s1600/DSC02673.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgPoO-zTi_r_SdHbFvgQrh34ehoJPgeW-L-IGcpb6UuRUCOghxBCQ2TkS5l8CeTTAaeTsraqhfWWPhX9Z_nCj3b4_xMnWWygtCJN-23R-dqLN1kGhirv5OMRlZyvvdCs0A0IgldxXkvt3Ad/s320/DSC02673.JPG" width="320" /></a></div>
<span style="font-size: 12.0pt; line-height: 200%;">QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">PREAMBLE<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">High quality Histopathology Laboratory results are becoming
increasingly important as physicians, Pathologists and patients (clients) raise
the level of their expectations on the competence of the Histo-Scientist to
enhance:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; line-height: 200%;"><span style="font-size: large;">·</span><span style="font-family: 'Times New Roman'; font-stretch: normal; line-height: normal;"><span style="font-size: large;"> </span>(1)<span style="font-size: large;"> </span></span></span><!--[endif]--><span style="line-height: 200%;">Diagnosis<span style="font-size: large;"> </span></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxpT5j7DV9BK_P_ClUv6dMSKiIdm4NAyytKsfuH80lxRFsZIfafRBeqgArvvrqENcN_6Gm1kq7RUegsQ_PKrc7AHedexQyXR26fuA5BZ6UTJ9ZB8Et76ZaJttakQrIEB5TTcAHaMFh7aMw/s1600/DECALBENCH.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxpT5j7DV9BK_P_ClUv6dMSKiIdm4NAyytKsfuH80lxRFsZIfafRBeqgArvvrqENcN_6Gm1kq7RUegsQ_PKrc7AHedexQyXR26fuA5BZ6UTJ9ZB8Et76ZaJttakQrIEB5TTcAHaMFh7aMw/s320/DECALBENCH.jpg" width="320" /></a></div>
<span style="font-size: 12pt;"><o:p></o:p></span><br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> (2) </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Appropriate
treatment/Management decisions<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> (3) </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Disease
Prevention and<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> (4) </span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Governance
(Planning and budgeting)<o:p></o:p></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLj_T7ntTZfHztEfETRdfU1bFA_khWPoyOx4eDvDnmtHtYefnNZlLfd9WVRou-KPbT1GVE6-U78aJFOIsUl92hCkMbULaSMQQBTmLYavVuSPYBXO3R5VR6DKRzlPftkjM6P0vJ89GWf2Nu/s1600/CHRONICAPPENDICITIS.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLj_T7ntTZfHztEfETRdfU1bFA_khWPoyOx4eDvDnmtHtYefnNZlLfd9WVRou-KPbT1GVE6-U78aJFOIsUl92hCkMbULaSMQQBTmLYavVuSPYBXO3R5VR6DKRzlPftkjM6P0vJ89GWf2Nu/s320/CHRONICAPPENDICITIS.JPG" width="320" /></a></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">All procedures and processes established to effect quality
outcome must therefore be able to detect errors in order to mitigate poor
results.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The need for accurate, reliable and timely medical laboratory
results is explained in the ISO 15189:2012 and ISO 9001:2000 which must be
implemented by medical laboratories with intention to be relevant and
competitive in this modern age.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;"> </span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The concept of quality management system recently gaining
ground is often generalized with no allusion to how it applies to the
histopathology laboratory.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">It is our utmost pleasure therefore to address how quality
management system could be applied in the histopathology laboratory.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Aim<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">To explain the concept of quality management system as it
applies to the histopathology laboratory<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Objectives<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">To
define simple related terms<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">To
reveal the 12 QMS model<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">To
give practical illustration on how to apply the 12 essentials of QMS in
histopathology laboratory setting.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="line-height: 200%;"><b><span style="font-size: large;">Definitions</span></b><span style="font-size: 12pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="line-height: 200%;"><span style="font-size: x-large;">Quality Management System </span><span style="font-size: 12pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">According to the ISO, quality management system (QMS) is
defined as ‘</span><span style="color: #333333; font-family: "Helvetica","sans-serif"; font-size: 11.5pt; line-height: 200%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">coordinated activities (management system) to
direct and control an organization with regards to quality’. </span><span style="font-size: 12.0pt; line-height: 200%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="line-height: 200%;"><span style="font-size: x-large;">Histopathology</span><span style="font-size: 12pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Histo means tissues; pathology means study of diseases. Histopathology therefore is the study of
diseases in tissues.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Laboratory<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">According to AMLSN-MLSCN e-learning course on quality
management system, Laboratory is <b><i>‘</i></b></span><b><i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-fareast-font-family: "Times New Roman";">a building or part of a building, or other place equipped to
conduct scientific experiments.</span></i></b><b><i><span style="font-size: 12.0pt; line-height: 200%;"><o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="line-height: 200%;"><b><span style="font-size: large;">Medical Laboratory</span></b><span style="font-size: 12pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Medical laboratory is a building or part of a building or
other place equipped to conduct scientific analysis on human and animal
tissues, body fluid, excretions, production of biological, for the purpose of
diagnosis, treatment and research.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Histopathology Laboratory<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">This is a building or part of a building where scientific
analysis is done on human and animal tissues for the purpose of diagnosis,
treatment and research.<o:p></o:p></span><br />
<span style="font-size: 12.0pt; line-height: 200%;"><br /></span></div>
Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-5317499568031686558.post-63175827151762194922015-05-20T03:43:00.001-07:002015-05-20T03:43:54.772-07:00Quality Management System In Histopathology Laboratory: -An Introduction By Benard Solomon<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">QUALITY MANAGEMENT SYSTEM IN HISTOPATHOLOGY LABORATORY<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">PREAMBLE<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">High quality Histopathology Laboratory results are becoming
increasingly important as physicians, Pathologists and patients (clients) raise
the level of their expectations on the competence of the Histo-Scientist to
enhance:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Diagnosis<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Appropriate
treatment/Management decisions<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Disease
Prevention and<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">Governance
(Planning and budgeting)<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">All procedures and processes established to effect quality
outcome must therefore be able to detect errors in order to mitigate poor
results.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The need for accurate, reliable and timely medical laboratory
results is explained in the ISO 15189:2012 and ISO 9001:2000 which must be
implemented by medical laboratories with intention to be relevant and
competitive in this modern age.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">The concept of quality management system recently gaining
ground is often generalized with no allusion to how it applies to the
histopathology laboratory.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">It is our utmost pleasure therefore to address how quality
management system could be applied in the histopathology laboratory.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Aim<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">To explain the concept of quality management system as it
applies to the histopathology laboratory<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Objectives<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">To
define simple related terms<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">To
reveal the 12 QMS model<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: Symbol; font-size: 12.0pt; line-height: 200%; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 200%;">To
give practical illustration on how to apply the 12 essentials of QMS in
histopathology laboratory setting.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Definitions<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Quality Management System <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">According to the ISO, quality management system (QMS) is
defined as ‘</span><span style="color: #333333; font-family: "Helvetica","sans-serif"; font-size: 11.5pt; line-height: 200%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">coordinated activities (management system) to
direct and control an organization with regards to quality’. </span><span style="font-size: 12.0pt; line-height: 200%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Histopathology<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Histo means tissues; pathology means study of diseases. Histopathology therefore is the study of
diseases in tissues.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Laboratory<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">According to AMLSN-MLSCN e-learning course on quality
management system, Laboratory is <b><i>‘</i></b></span><b><i><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%; mso-fareast-font-family: "Times New Roman";">a building or part of a building, or other place equipped to
conduct scientific experiments.</span></i></b><b><i><span style="font-size: 12.0pt; line-height: 200%;"><o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="line-height: 200%;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Medical Laboratory<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Medical laboratory is a building or part of a building or
other place equipped to conduct scientific analysis on human and animal
tissues, body fluid, excretions, production of biological, for the purpose of
diagnosis, treatment and research.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Histopathology Laboratory<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">This is a building or part of a building where scientific
analysis is done on human and animal tissues for the purpose of diagnosis,
treatment and research.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;"><br /></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span style="font-size: 12.0pt; line-height: 200%;">Next...........Quality Management System Model</span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-14036372207656268702015-03-21T12:35:00.000-07:002015-03-21T12:40:10.795-07:00Local Natural Dyes As Histological Stain: The Sub-Saharan African Perspective By Benard SolomonHistologists in developing countries especially the Sub-Saharan African region over the years had depended on resources produced from foreign countries in the developed world. The reasons for this is not far fetched-Medical Science was imported from the developed nations therefore the student must<br />
follow the teachings of his master and also use the resources recommended in the process.<br />
This has resulted in abysmal dependence on imported reagents using very scarce foreign reserves which impacts negatively on the economies of developing nations especially Sub-Saharan African countries.<br />
<br />
But the economies of these countries has nosedived in the past decades leading to skyrocketing cost of these imported histology laboratory reagents.<br />
Most of these imported dyes are synthetic in nature which has been found to be detrimental to human health in one way or the other.<br />
<br />
In order to frontally address the developmental needs of their countries, histology researchers and scientists must now look inwards for local alternatives to the foreign imported reagents so as to conserve foreign reserves, create employment opportunities, industrial growth and shoring up the compedium of natural dyes that could be applied in the histological demonstration of tissue components.<br />
<br />
Theses natural dyes are safe, cheap, eco-friendly, and biodegradable.<br />
<br />
This paper focuses on the use of natural dyes from plant extract, different methods of extraction and recent discoveries in the applications of these dyes in histological demonstration of tissues.<br />
<br />
<br />
<h2>
Extraction Methods</h2>
<br />
Various parts of plants such as roots, stems, leaves, flowers, fruits and seeds are used for dye extraction. Some plants may have more than one color depending on which part of the plant one uses. The color yield and shade of the color a plant produces vary according to time of the year the plant is picked, how it is grown, soil conditions, etc. Before extraction, the parts of the plants are collected and generally shade- dried in air or sun -dried. Then the grinding is carried out to break down the material into very small pieces or powder using the manual or electric grinding machines. Optimum conditions of extraction are determined by varying extraction parameters such as type of solvents, time of extraction, ratio between plant material and solvent, temperature and pH which depend on the properties of particular dye components (Prabhu and Bhute, 2012).<br />
<br />
<br />
After extraction, the extracts are generally filtered through various filters such as cheesecloth, cotton wool or paper filter. The filtrates may be freshly used (normally aqueous extract) or<br />
further evaporated of solvent, washing and drying to get purified dye. There are mainly four methods used in extraction of natural dyes (Samanta and Konar, 2011).<br />
<br />
Methods of extraction of natural dyes include:<br />
<br />
1. <span class="Apple-tab-span" style="white-space: pre;"> </span>Aqueous extraction<br />
<br />
2.<span class="Apple-tab-span" style="white-space: pre;"> </span>Extraction by non-aqueous and other solvent assisted <span class="Apple-tab-span" style="white-space: pre;"> </span>system<span class="Apple-tab-span" style="white-space: pre;"> </span><br />
3.<span class="Apple-tab-span" style="white-space: pre;"> </span>Extraction by acid or alkaline assisted system<br />
<br />
4.<span class="Apple-tab-span" style="white-space: pre;"> </span>Extraction by other methods e.g. ultrasound assisted <span class="Apple-tab-span" style="white-space: pre;"> </span>and enzyme assisted extraction<br />
<br />
Natural dyes often need mordants to enhance their staining capabilities. These mordants could chemical or natural in nature.<br />
<br />
<h2>
Histological Uses of Natural Dyes: Recent Developments</h2>
The following locally available dyes has been used of recent in the histological demonstration of tissue components:<br />
<br />
<h2>
Hibiscus sabdariffa</h2>
20% aqeuous extract of H. sabdariffa was used by Eman Hashim (2006) to stain tissues in albino mice as eosin substitute in the Haematoxylin and Eosin technique.<br />
<br />
5% H. sabdariffa aqeous solution mordanted with ferric chloride was used as haematoxylin substitute in the H&e technique by Benard (2008) on formalin fixed, paraffin embedded appendix and lymph node tissues.<br />
<br />
Egbujo et. al., (2008) prepared aqueous extract of H. sabdariffa with alum and iron mordants to stain testicular biopsies. Iron-mordanted H. sabdariffa solution gave best results.<br />
<br />
Ibnouf et.al assessed the staining quality of H. sabdariffa on formalin fixed, paraffin embedded renal tissue and found out that 5% aqueous extract of the dye gave best results.<br />
<br />
<h2>
Curcuma Longa</h2>
Yellow staining of collagen was demonstrated by Avwioro et. al (2006) by using extract of Curcuma longa. Ethanolic extract of Curcuma longa was used as counter stain for haemtoxylin stained sections of testes by Bassey et. al (2011).<br />
<br />
<h2>
Sorghum bicolor</h2>
Shades of pinkish-yellow staining of collagen was demonstrated by Avwioro et. al.,(2007) by using Sorghum bicolor leaf extract.<br />
<br />
The histomorphology of selected histological tissues were assessed using alcoholic extract of Sorghum bicolor by Omoowo et. al., (2014).<br />
<br />
Kola nut<br />
Extract of kola nut was used as eosin substitute in rat tissues by Shehua et. al., (2012).<br />
<br />
With progress made so far, hope arises in the horizon for developing countries that resources locally available to them can be useful in the histological demonstration of tissues which could lead to conservation of foreign reserves and progressive development of their economies. However, the issue of standardization, climatic variations, and cultivation methods need to be evaluated.<br />
<br />
<h2>
REFERENCES</h2>
Avwioro, O.G., Onwuka, S.K., Moody, J.O., Agbedahunsi, J.M., Oduola, T., Ekpo, O.E. and Oladele, A.A. 2007. Curcuma longa extract as a histological dye for collagen fibres and red blood cells. J. Anat. 210: 600–603.<br />
<br />
Avwioro, OG, Aloamaka, CP, Oduola, T and Komolafe, AO (2006). Collagen and muscle stains obtained from Sorghum bicolor. Sc. J. Clin. Lab. Invest. 66: 161-168.<br />
<br />
Benard SA, (2008): Iron-Roselle: A Progressive nuclear Stain Substitute For Hematoxylin; The Journal of Histotechnology/Vol.31.No.2 :57-59/june.<br />
<br />
<br />
Egbujo E. C., Adisa O. J. and Yahaya, A. B 2008. A study of the staining effect of Roselle (Hibiscus sabdariffa) on the histologic section of the testis. Int. J. Morphol. 26(4): 927-930.<br />
<br />
<br />
Hashim, E.A. 2006. The use of watery extract of kujarat flowers Hibiscus Sabdariffa as a natural histological stain. Iraqi J. Med. Sci. 5(1): 29-33.<br />
<br />
<br />
Omoowo BT, Bankole JK, Muhammed AO, Benard SA, Afolabi OO (2014). Histomorphological assessment of the extract of the stalk of Sorghum bicolor as counter stain. African Journal of Cellular Pathology 2:69-74<br />
<br />
<br />
Prabhu, K. H. and Bhute, A.S. 2012. Plant based natural dyes and mordnats: A review. J. Nat. Prod. Plant Resour. 2(6):<br />
649-664.<br />
<br />
Samanta, A.K. and Konar, A. (cited 7 November 2013) 2011. Dyeing of textiles with natural dyes. Available<br />
from: http://www.intechopen.com/ books/natural-dyes<br />
<br />
Shehua, S.A., Sonfada, M.L., Danmaigoro, A., Umar, A.A., Hena, S.A. and Wiam, I.M. 2012. Kola nut (Cola acuminata)<br />
extract as a substitute to histological tissue stain eosin. Sci. J. Vet. Adv. 1(2): 33-37.<br />
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<br />Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-5317499568031686558.post-72890594222008766762015-02-05T03:28:00.002-08:002015-02-13T00:52:08.545-08:00Hibiscus Extract In The Histological Demonstration of Tissues: So Far, So Good By Benard Solomon<div class="MsoNormal">
How time flies! Over the years, I have been priviledged to
witness how ideas in the realm of thoughts can crystallize into tangible
research design and discoveries with a lesson in the danger of neglecting ideas
flashed in ones subconscious mind even when things seem difficult or
impossible. Truly, whatsoever a man’s mind could conceive, he can achieve!</div>
<div class="MsoNormal">
Dateline was my adventure into the wild, world of the
internet which has been well documented in my book-<a href="http://simplestepstobiomedicalintenet.blogspot.com/">Simple Steps To BiomedicalInternet. </a> One of the results of my curiosity
was my membership of the histonet, a listserve for histotechnologists and
histoscientists based in the United States of America.</div>
<div class="MsoNormal">
That singular opportunity gave me the leverage of raising a
query on the use of Hibiscus sabdariffa extract in histological demonstration
of tissues.</div>
<div class="MsoNormal">
The reply to my query by two highly distinguished experts in
that forum, John Kiernan of the Department of Anatomy and cell Biology,
University of Western Ontario, London, Canada and Geof McAuliffe gave me the
inspiration needed to forge ahead in the exploration of the fresh ideas and
raging storm in my mind having realized from their response that I had before
me a reality of pioneering a new research effort hence the saying ‘You Are On
Your Own’ aptly applied to me.</div>
<div class="MsoNormal">
The first breakthrough in that effort of persistence remains
the publication in the Journal of Histotechnology based in the United States of
America titled ‘Iron-Roselle’: A Progressive Nuclear Stain Substitute For Hematoxylin (2008). The publication marked the end of six
consecutive years of great and persistent effort (between 2002 &2006) in unraveling
the secret staining components, coloring pigment and workable staining method
that will be reproducible anywhere in the world.</div>
<div class="MsoNormal">
The scientific community was woken to the reality of using a
naturally available local dye widely distributed globally that could be a
substitute to haematoxylin in the nuclear demonstration of tissues.</div>
<div class="MsoNormal">
Since science in interconnected, one thing must lead to
another. The work of Al Tikriti SA and
Walker F (1978) on Anthocyanin-BB gave me much insight into the usefulness of
Anthocyanins. It’s presence in Black
Berry became the highlight of their discovery.
Later, I discovered too that there is a common substance Black Berry and
Hibiscus shared! It is ANTHOCYANIN. Eureka!</div>
<div class="MsoNormal">
With that, it became easier to comprehend the possibility of
using Hibiscus sabdariffa to stain histological sections the same way it was
done for Black Berry. That’s now
history.</div>
<div class="MsoNormal">
Unknowingly to me at that time, Egbujo and colleagues,
Egbujo et al., (2008) has been making similar effort with slight
differences. No wonder their findings
came months after my own publication. The
possible use of H. sabdariffa in histological demonstration of tissues was
therefore confirmed and taken out of the realm of speculation! Can anyone beat
medical science to that?</div>
<div class="MsoNormal">
It is not that other researchers
haven’t made any effort in this light but the objectives were different. Earlier effort only explored the use of H.
sabdariffa as substitute to eosin and not to haematoxylin. The works of
Al-Sarraj et al., (1997) readily comes to mind in this instance.</div>
<div class="MsoNormal">
Recently, more interest has been generated in the scientific
community to discover the wider application of the use of H. sabdariffa in the
histological demonstration of tissues. It
is in this wise that the effort of E.A. Hashim (2006) and Ibnouf et al., (2014)
becomes center of attraction.</div>
<div class="MsoNormal">
Conclusively, it has been for me moments of painstaking
effort and satisfaction. In the realm of
Hibiscus sabdariffa research as it relates to histological demonstration of
tissue components, it is for me, So Far, So Good!</div>
<div class="MsoNormal">
<b>REFERENCES<o:p></o:p></b></div>
<div class="MsoNormal">
Al-Tikriti SA, Walker F,: Anthocyanin BB: A nuclear stain
substitute for haematoxylin. J. Clin.
Pathol. 31:194-196, 1978</div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-size: 11.5pt; mso-bidi-font-weight: bold;">Abd-Alhafeez Ibnouf</span><span class="A5"><span style="font-size: 7.0pt;">1</span></span><span style="font-size: 11.5pt; mso-bidi-font-weight: bold;">, Esam AbdulRaheem</span><span class="A5"><span style="font-size: 7.0pt;">2</span></span><span style="font-size: 11.5pt; mso-bidi-font-weight: bold;">, Mohamed SeedAhmed</span><span class="A5"><span style="font-size: 7.0pt;">1</span></span><span style="font-size: 11.5pt; mso-bidi-font-weight: bold;">, Dalia Dahab</span><span class="A5"><span style="font-size: 7.0pt;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="Default">
<span class="A5"><span style="font-size: 7.0pt;">:</span></span><span class="A10"><span style="font-size: 8.0pt;"> Assessment of staining quality of Roselle (<i>hibiscus sabdariffa</i>) on
formalin-fixed paraffin-embedded renal tissue sections; </span></span><span style="font-family: "Myriad Pro","sans-serif"; mso-bidi-font-family: "Myriad Pro";"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Myriad Pro","sans-serif"; font-size: 12.0pt;"> </span><span style="font-family: 'Myriad Pro', sans-serif; font-size: 9pt;">Int J Cur Res Rev | Vol 6 • Issue 21 • No vember 2014
pg 26-28</span><span style="font-size: 9pt;"><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
Benard Solomon. Iron-Roselle: A Progressive Nuclear
Stain <span style="font-size: 9pt;">Substitute For Haematoxylin. <i>J. Histotechnologyy</i>. 2008;
31:57.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
Eman A Hashim. The use of watery extract of Kujarat
flow<span style="font-size: 9pt;">ers Hibiscus Sabdariffa as a natural histological stain. <i>Iraqi
J Med Sci</i>. 2006; 5 (1): 29-33.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
Egbujo EC, Adisa OJ, and Yahaya AB. A Study of the <span style="font-size: 9pt;">Staining
Effect of Roselle (Hibiscus Sabdariffa) on the Histologic Section of the
Testis. <i>Int. J. Morphol</i>. 2008; 26(4):927-930.</span></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-47829464825130923112014-08-19T03:25:00.000-07:002014-08-19T03:25:14.220-07:00Haemtoxylin Stain: A Review By AwvioroJPCS Vol(1) ● April-June 2011 www.arpapress.com/Volumes/JPCS/Vol1/JPCS_1_05.pdf<br />24<br />HISTOCHEMICAL USES OF HAEMATOXYLIN - A REVIEW<br />Godwin Avwioro Faculty of Basic Medical Science, Delta State University, Abraka, Nigeria<br />Email: avwiorog@yahoo.com, Tel: 2348037149777 ABSTRACT The natural dye, haematoxylin obtained from the logwood, haematoxylon campechianum is the most important and most used dye in histology, histochemistry, histopathology and in cytology. It is especially used in histopathology and cytology for the diagnosis of malignant and non malignant lesions. It can be used as a primary stain and as a counter stain where it will differentiate acidophilic materials from basophilic materials and stain non cellular substances such as fibrin, crystals and pigments in various shades depending on the nature of the mordant used and the second stain. Haematoxylin has been used extensively in the demonstration of certain parasites, lipids, carbohydrates, nucleic acids, metals, connective tissue fibers and in immunohistochemistry. Haematoxylin has also been used in the demonstration of several intracellular substances such as mitochondria, chromosomes, chromatin, nucleoli, centrioles, nuclear membrane, ground cytoplasm, cross striations of muscle fibres and chromatin granules in several staining techniques. Haematoxylin is therefore an indispensable dye in histochemistry and histopathology. Key words: Haematoxylin, histochemistry, staining, mordant<br />1. INTRODUCTION<br />Haematoxylin is the most important and most used dye in the histopathology and histochemistry laboratories [1]. It is especially used in Erhlich's haematoxylin and eosin technique for the demonstration of general tissue structures where it stains tissue in shades of blue, pink and red enabling recognition of malignant and non malignant cells as well as several intracellular and extracellular substances necessary for diagnosis of disease conditions in tissues and cells [1]. The colour of the dye can be altered by mixing it with other agents such as iron alum (black), potash alum (blue) and salts of tin (red) [2]. Haematoxylin which has been used extensively as a nuclear counter stain and for the staining of specific intracellular and extracellular substances has also been used in the textile industries, although to a lesser extent. Haematoxylin is obtained from the logwood, haematoxylon campechianum [3]. The crude product is obtained from the milled heartwood by hot water or steam, purified by ether extraction, dried and recrystallized from water [4,5,6]. Alternatively, the aqueous extract is precipitated from solution with urea7. Haematoxylin has also been prepared synthetically [8], but it is not widely available. Haematoxylin has no staining properties, unless it is oxidized in a process called ripening to yield haematein, which is then combined with certain chemicals called mordants [1]. The process of oxidizing haematoxylin to haematein [5,9] (Fig.1), which is the active staining ingredient can be achieved naturally and artificially. In the natural process, prepared haematoxylin solution is exposed to air and sunlight for 6 to 8 weeks before it is used [10]. The advantage of the natural process of oxidation is that the solution lasts longer because oxidation is slow and gradual. In the artificial process of oxidation, oxidising agents such as sodium iodate, hydrogen peroxide, mercuric oxide and potassium permanganate are added to the solution of haematoxylin. These effect instant oxidation of haematoxylin to haematein and the solution may be used immediately, although with a shorter life span because dye solution is quickly over oxidized. Haematoxylin cannot stain a tissue unless a mordant is incorporated into the dye [11,12]. Mordants are metallic salts, which act as a bridge between the stain and tissue enabling staining to take place [1]. The colour of the staining reaction depends on the constituents of the staining solution and the type of mordant used. Some staining solutions, which contain aluminium alum and potassium alum as the mordant, give a blue nuclear staining while those which contain iron give a black staining reaction. Other metallic salts which have been combined with haematoxylin in special staining techniques are chrome alum for the staining of lipoproteins [13], myelin, phospholipids and cytoplasmic granules in B cells of the anterior pituitary and pancreatic islet [14], molybdenum for the staining of collagen15,16 and neural tissue[17]. Copper haematoxylin has been used to stain fatty acids [13], myelin sheaths and mitochondria [18]. Lead-haematoxylin solution has been used for the staining of axis cylinders, although staining may be up to 6 weeks.<br />2. USES OF HAEMATOXYLIN<br />Carbohydrates Connective tissue mucin can be stained with Mayer's mucihaematein while an alum haematoxylin may be used to quench nuclear fluorescence, which would give a false positive result if not quenched when staining amyloid with thioflavine T fluorescence stain [17]. Haematoxylin has also been used as a nuclear stain in some<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />25<br />techniques when demonstrating carbohydrates. These techniques include Best’s carmine for glycogen [18], Periodic acid Schiff for neutral mucopolysaccharide [21], Mucicarmine for mucin [22] and Congo red for amyloid [23].<br />Lipids Baker's acid haematein method is used for the demonstration of phospholipids [24], while the alum haematoxylins are used as nuclear counter stains when Oil red O is used for the staining of lipids [25].<br />Connective tissue fibers Verhoeff's haematoxylin [26] has been used for the staining of elastic fibers black. Weigert's haematoxylin [27] and Celestine blue haemalum sequence are used as nuclear stains when demonstrating connective tissue fibers particularly when subsequent staining reagents are acidic, such as van Gieson stain [28] which will remove alum haematoxylin from tissue.<br />Nervous tissue The Weigert-Pal [29] and Loyez [30] haematoxylin methods are used for staining myelin. The phosphotungstic acid haematoxylin [31] which is used for the staining of astrocytes, myoglia and fibroglia contains haematoxylin as the active constituent.<br />Microfilaria and Amoeba The differential diagnosis of microfilaria based on nuclear arrangement is enhanced when their nuclei are stained with hot haemalum. Amoeba in sections are also well demonstrated with haemalum [32].<br />Intracellular substances The Gomori's chrome alum haematoxylin phloxine has been used for the staining of alpha and beta cells of the pancreas [33]. The pituitary alpha and beta cells are well demonstrated with the trichrome stains, majority of which contain haematoxylin as the nuclear stain34. Heidenhain's iron haematoxylin is an excellent cytological stain, which stains chromosomes, chromatin, nucleoli, mitochondria, centriole and cross striations of muscle fibers in shades of black and grey [35].<br />Cytology Haematoxylin has been found extremely useful in cytology where it is used for differentiating malignant cells from non-malignant cells. Cytohormonal, sex chromatin body and nutritional influences on epithelial cells studied in the Papanicolaou technique [36] depend essentially on the staining character of haematoxylin [37].<br />Fibrin Celestine blue haemalum is used as a nuclear stain in Martius Scarlet Blue [34], and the Fuchsin-Millers method for fibrin.<br />Metals Aqueous solutions of haematoxylin have been used for the identification of lead, copper and iron (haemosiderin) deposits in tissues [38].<br />Photomicrography Being able to stain many cytoplasmic and nuclear structures in shades of black and grey, the Heidenhain's haematoxylin [35] is particularly an excellent stain for photomicrography.<br />Immunohistochemistry Some immunohistochemical techniques for the demonstration of tissue antigens have been counter stained with haematoxylin in order to give a good contrast between the object demonstrated and the surrounding tissue [39,40].<br />3. BLUEING<br />Most haematoxylin solutions, which stain regressively, require differentiation [41], i.e. treatment with an acid reagent to remove excess stain from tissue section. The tissue section is subsequently treated with an alkaline solution or vapour to neutralise the acid and restore a blue colour to the tissue [42]. This process is called blueing and it can be achieved by treating tissue section with one of the following alkaline vapours or solutions.<br />1. Ammonia vapour for a few seconds<br />2. 5% ammonium hydroxide for 2 minutes<br />3. Running tap water for 10 minutes<br />4. 2% potassium hydroxide for 2 minutes<br />5. Scott's [43] tap water substitute (TWS) for 2 minutes.<br />TWS is prepared by dissolving 3.5g sodium bicarbonate and 20g magnesium sulphate in 1 litre of distilled water. A grain of thymol is added to serve as a preservative. It must be emphasized that the higher the pH of a blueing solution, the faster the speed at which blueing takes place but with a risk of tendency of sections to fall off slides.<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />26<br />4. ALUM HAEMATOXYLIN<br />Alum haematoxylin solutions contain potassium alum or ammonium alum as the mordant. They include Ehrlich's [43], Mayer's [31], Cole's [44], Harris [36], Delafield's [45], Iyiola and Avwioro’s [55] and Carazzi's [54] haematoxylin. Alum haematoxylins are used when the counter stain does not contain an acid. Acidic counter stains such as van Gieson [27] rapidly remove alum haematoxylin from sections; therefore, they are not used on tissues, which have been stained with an alum haematoxylin.<br />Ehrlich's haematoxylin Ehrlich's haematoxylin [44] is a regressive stain requiring differentiation with 1% acid alcohol. It has a staining time of 5-30 minutes depending on the extent of oxidation of haematoxylin and previous treatment of tissue such as fixation. When counterstained with eosin, Ehrlich's haematoxylin is used for the demonstration of general tissue structures where they stain various tissue structures in shades of blue, pink and red. It also stains mucopolysaccharides and cement lines of bone [47]. The glycerine content helps to stabilize the stain and prevent over oxidation. It also slows down the rate of evaporation. The acetic acid in Ehrlich's haematoxylin reduces the pH and sharpens nuclear staining.<br />Harris haematoxylin Harris haematoxylin [37] is a powerful nuclear stain, which may be used regressively and progressively. In view of its improved selectivity of nuclear staining, it is generally used in exfoliative cytology for the demonstration of malignant and non malignant cells1. Staining time is 2-5 minutes. Harris haematoxylin contains mercuric oxide, which oxidizes haematoxylin to haematein (Fig.1) making it possible for the solution to be used almost immediately.<br />Mayer's haemalum Mayer's haemalum [32] is a more powerful stain than Ehrlich's haematoxylin and a precise nuclear stain which is used progressively, although, it may be used regressively with a staining time of 5-10 minutes. Mayer's haemalum [32], unlike Ehrlich's haematoxylin [42] does not stain mucopolysaccharides. Therefore, it is used as a nuclear counter stain for the demonstration of glycogen [48], amyloid [23] and Mucicarmine [22]. Nuclei of microfilaria and amoebae in sections and smears are well demonstrated with this stain. Mayer's haemalum [22] is also used in the Celestine blue-haemalum nuclear stain. Mayer's haemalum contains sodium iodate, which oxidizes haematoxylin to haematein; therefore, the stain may be used immediately after preparation. Chloral hydrate in Mayer's haematoxylin acts as a preservative while the citric acid sharpens nuclear staining. Potassium alum or ammonium alum is the mordant in Mayer’s haematoxylin [1].<br />Cole's haematoxylin Cole's haematoxylin [45] can be as a progressive stain and it can also be used regressively as a routine stain similar to Ehrlich's haematoxylin with a staining time of about 10 minutes. Cole's haematoxylin [45] may be used in place of Mayer's haemalum [22] in the Celestine blue haemalum nuclear stain. It contains iodine, which oxidizes haematoxylin to haematein making it possible for the solution to be used immediately [1].<br />5. IRON HAEMATOXYLIN<br />The mordant in these solutions are ferric chloride or ferric ammonium sulphate [49]. These ferric compounds in addition to being mordants [1] also oxidize haematoxylin to haematein (Fig.1) causing over oxidation of prepared and stored haematoxylin. For the latter reason, iron haematoxylin solutions are prepared just before use, but simple alcoholic and aqueous solutions of haematoxylin must be prepared and kept for 4-6 weeks as stock solutions to enable ripening or oxidation before use. The solutions of haematoxylin and the iron alum are either mixed immediately before use as in Weigert's [27] and Verhoeff's [26] haematoxylins or tissue sections are mordanted in the iron alum before application of the haematoxylin solution as in Heidenhain's haematoxylin [35]. Iron haematoxylins are used when an acidic counter stain such as van Gieson [28] is to be applied to a section because iron haematoxylins are not quickly decolourised by acidic stains.<br />Heidenhain's iron haematoxylin Heidenhain's iron haematoxylin [50] is a regressive cytological stain which stains tissue jet black, and by careful selective differentiation, many tissue and cell components can be revealed in shades of black and grey. This makes it useful for photomicrography. In the technique, iron alum is also used as a differentiating agent and as an oxidising agent, which oxidises haematoxylin to haematein (Fig.1), the active staining component. Being a cytological stain, tissue sections must be very thin to enable easy demonstration of cell constituents. Staining time is 30-45 minutes at 560C. Heidenhain's iron haematoxylin will demonstrate mitochondria, chromatin, chromosomes, nucleoli, centrioles, nuclear membrane, cross-striations of muscle fibers and myelin [1]. Red blood cells are stained black. Heidenhain's iron haematoxylin [50] is usually not counterstained but it may be counterstained with a connective tissue stain such as van Gieson [28].<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />27<br />Weigert's iron haematoxylin Weigert's iron haematoxylin [27] is used for the staining of cell nuclei when subsequent staining reagents contain acid such as in van Gieson [28] stain which will decolourise nuclear staining if stained previously with a solution of haematoxylin which contains potassium alum or ammonium alum as the mordant. The Weigert's haematoxylin, which is 1% alcoholic haematoxylin, is stored separately from the mordant, which is acidified ferric chloride. Equal volumes are mixed immediately before use. The resulting colour should be purplish black with a staining time of 20-30 minutes. Weigert's iron haematoxylin is used for the staining of cell nuclei when demonstrating collagen and muscle with the van Gieson stain and the trichrome connective tissue stains [51].<br />Verhoeff's iron haematoxylin Verhoeff's iron haematoxylin [26] is an elastic tissue stain. The constituents, 5% alcoholic haematoxylin, 10% ferric chloride and strong iodine are prepared separately and mixed immediately before use. This is because prepared Verhoeff's haematoxylin does not keep because of its rapid over oxidation. The ferric chloride is acting as a mordant [1] and it is also used as a differentiator [40]. Staining time is 25-60 minutes.<br />Celestine blue-haemalum Celestine blue [52] is an oxazine dye that is used as a nuclear stain in place of iron haematoxylins. Celestine blue haemalum sequence utilises two mordants incorporated into two different stains. Celestine blue is combined with the mordant ferric ammonium alum (iron alum) and used in sequence with Mayer's haematoxylin [32] (Mayer's haematoxylin contains ammonium alum or potassium alum as the mordant) to give a very precise and powerful nuclear stain, which resists decolourisation when subsequently treated with acid stains. Cole's haematoxylin [45] can be used in place of Mayer's haematoxylin [32]. A disadvantage of Celestine blue is that it stains cellulose nitrate very strongly and it is very difficult to remove. Therefore, it is not suitable for cellulose nitrate embedded materials.<br />6. PHOSPHOTUNGSTIC ACID HAEMATOXYLIN (PTAH)31<br />In many laboratories, PTAH [31] has now become a routine stain for nervous tissue owing to its ability to stain astrocytes, fibroglia, myoglia, muscle striations, collagen, reticulin, fibrin, etc in shades of blue and red [1]. PTAH is a progressive stain with a staining time of 1-16 hours at room temperature or 1-2 hours at 600C. Tissue sections may be treated with Mallory bleach to suppress staining of myelin. The bleaching process involves treating sections with potassium permanganate and oxalic acid. The dehydrating alcohols rapidly remove the red staining from the sections; therefore, dehydration in alcohol should be very rapid.<br />7. CONSTITUENTS OF THE HAEMATOXYLIN STAINS<br />EHRLICH'S ALUM HAEMATOXYLIN [44]<br />Staining time 10-15 minutes<br />Constituents<br />Haematoxylin<br />6g<br />Absolute alcohol<br />300ml<br />Distilled water<br />300ml<br />Glycerol<br />300ml<br />Glacial acetic acid<br />30ml<br />Add excess potassium or ammonium alum until solution is saturated. Dissolve haematoxylin in the alcohol and add other reagents in the order given. The alum should be added until solution is saturated. The prepared solution should be covered with a loose cotton wool or gauze and exposed to light for 4 to 6 weeks to enable it oxidise or ripen. Solution lasts more than a year.<br />HARRIS ALUM HAEMATOXYLIN [37]<br />Staining time 5 minutes<br />Constituents<br />Haematoxylin<br />2.5g<br />Absolute alcohol<br />50ml<br />Ammonium or potassium alum<br />50g<br />Distilled water<br />500ml<br />Mercuric oxide<br />1.5g<br />Glacial acetic acid<br />20ml<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />28<br />Dissolve the haematoxylin in absolute alcohol, and the alum in distilled water. Where necessary, heat may be applied. Then, mix the two solutions. Boil solution in a large flask, add mercuric chloride and mix. Cool immediately in cold water and add glacial acetic acid.<br />The stain can be used immediately. It lasts for about three months.<br />MAYER'S HAEMALUM [32]<br />Staining time as a progressive stain is 5-10 minutes, while as a regressive stain is 40-60 minutes.<br />Constituents<br />Haematoxylin<br />1g<br />Distilled water<br />1000ml<br />Potassium alum or Ammonium alum<br />50g<br />Sodium iodate<br />0.2g<br />Citric acid<br />1g<br />Chloral hydrate<br />50g<br />Reagents are added in the order given making sure that each addition dissolves before the next is added. Heat may be applied where necessary. The stain may be used immediately and lasts 3-4 months.<br />COLE'S HAEMATOXYLIN [45]<br />Staining time 5 minutes<br />Constituents<br />Haematoxylin<br />1.5g<br />1% iodine in 95% alcohol<br />50ml<br />Saturated aqueous ammonium or potassium alum<br />700ml<br />Distilled water<br />250ml<br />Heat distilled water until it boils and dissolve haematoxylin in it. Then add iodine and alum. Cool and filter.<br />Stain lasts about 3 months.<br />GILL'S HAEMATOXYLIN [53]<br />Constituents<br />Distilled water<br />730ml<br />Ethylene glycol<br />250ml<br />Haematoxylin<br />2g<br />Sodium iodate<br />0.2g<br />Aluminium sulphate<br />17.6g<br />Glacial acetic acid<br />20ml<br />Combine the reagents in the order given and mix for 1 hour at room temperature. The stain can be used immediately.<br />CARAZZI'S HAEMATOXYLIN [54]<br />Constituents<br />Haematoxylin<br />0.5g<br />Potassium iodate<br />0.01g<br />Potassium alum<br />25g<br />Glycerol<br />100ml<br />Distilled water<br />400ml<br />Add the haematoxylin to the glycerol. Dissolve the potassium iodate in about 25ml of the water and prepare the alum using the remainder. Mix the haematoxylin and alum solutions and then carefully add the potassium iodate.<br />IYIOLA AND AVWIORO’S ALUM HAEMATOXYLIN [55]<br />Heamatoxylin<br />1g<br />Citric acid<br />1g<br />Ammonium alum<br />50g<br />Glycerine<br />50ml<br />Distilled water<br />1000ml<br />Sodium iodate<br />0.15g<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />29<br />The reagents are added to about 500ml of distilled water, mixed and made up to 1000ml with distilled water. The mixture is boiled, removed from flame and sodium iodate added immediately and mixed gently. The mixture which will turn deep red should be cooled rapidly in running water.<br />HEAMATOXYLIN AND EOSIN FOR GENERAL TISSUE STRUCTURE [1]<br />Solutions required (Erhlich's haematoxylin, 1% HCl in 70% alcohol, 1% eosin)<br />METHOD<br />1. Dewax and hydrate<br />1. Stain in Erhlich's haematoxylin 15 minutes<br />2. Rinse in water<br />3. Differentiate in 1% HCl in 70% alcohol 1 minute<br />4. Rinse in water<br />5. Blue in tap water 10 minutes<br />6. or in Scott's tap water substitute 2 minutes<br />7. Counter stain with 1% eosin 1 minute<br />8. Rinse in water<br />9. Dehydrate, clear and mount<br />Results<br />Nuclei<br />Blue to blue-black<br />karyosomes<br />Dark blue<br />Cytoplasm<br />Pink<br />Collagen and osteoid tissue<br />Light pink<br />Cartilage, cement lines of bone, calcified bone<br />Shades of blue<br />Red blood cells, eosinophil granules, Paneth cell granules, keratin<br />Red<br />RAPID HAEMATOXYLIN AND EOSIN METHOD FOR GENERAL TISSUE STRUCTURE [1]<br />Solutions required (Mayer's or Harris haematoxylin, 1% HCl in 70% alcohol, Scott's tap water substitute or ammonia vapour, 1% alcoholic eosin)<br />METHOD<br />1. Dewax and hydrate<br />2. Stain in Harris or Mayer's haematoxylin - 2 to 5 minutes<br />3. Rinse in water<br />4. Differentiate in 1% HCl in 70% alcohol - 1 minute<br />5. Rinse in water<br />6. Blue in ammonia vapour for 5 to 10 seconds<br />or in Scott's tap water substitute - 2 minutes<br />7. Counter stain with 1% eosin - 1 minute<br />8. Transfer to 70% alcohol eosin - 1 minute<br />9. Complete dehydration in absolute alcohol, clear and mount<br />Results<br />Nuclei<br />Blue<br />Cytoplasm<br />Pink<br />Red blood cells, eosinophil granules, Paneth cell granules, other eosinophlic substances<br />Red<br />HEIDENHAIN'S IRON HAEMATOXYLIN [35]<br />Staining time 30-45 minutes at 600C or 12-24 hours at room temperature.<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />30<br />Constituents<br />5% Iron alum (mordant and differentiator)<br />Ferric ammonium sulphate<br />5g<br />Distilled water<br />100ml<br />0.5% haematoxylin in 10% alcohol<br />Haematoxylin<br />0.5g<br />Absolute alcohol<br />10ml<br />Distilled water<br />90ml<br />Dissolve haematoxylin in alcohol before adding water.<br />The solution should be allowed to ripe for 4-6 weeks before use.<br />OR<br />5% ripened alcoholic haematoxylin<br />10ml<br />Distilled water<br />90ml<br />This solution can be used immediately.<br />METHOD<br />1. Dewax and take sections to 90% alcohol through absolute alcohol<br />2. Mordant in 5% iron alum solution -30-45 minutes at 600C or 12-24 hours at room temperature<br />3. Rinse very briefly in water<br />4. Stain in 0.5% haematoxylin - for the same time and temperature as in 5% alum<br />5. Rinse briefly in water<br />6. Differentiate in 2-5% iron alum. (2% iron alum is easier to control)<br />OR<br />Saturated alcoholic picric acid diluted 2 in 3 (6%) is slower, easier to control and differentiates muscle striations better.<br />7. Wash in running water to remove iron alum - 5 minutes<br />8. Dehydrate, clear and mount.<br />Results<br />Mitochondria, chromosomes, chromatin, nucleoli, centrioles, nuclear membrane, ground cytoplasm, cross striations of muscle fibres<br />Shades of grey and black depending on degree of differentiation<br />WEIGERT'S IRON HAEMATOXYLIN [27]<br />Staining time 20-30 minutes<br />Constituents: Solutions A and B<br />Solution A<br />1% alcoholic haematoxylin (not less than 5 days old to enable ripening)<br />Solution B<br />30% aqueous ferric chloride<br />4ml<br />Distilled water<br />100ml<br />Hydrochloric acid<br />7ml<br />Mix equal volumes of solutions A and B just before use.<br />The mixed solution lasts about 24 hours depending on the age of the haematoxylin.<br />1% acid alcohol<br />Absolute alcohol<br />70ml<br />Distilled water<br />29ml<br />Hydrochloric acid<br />1ml<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />31<br />METHOD<br />1. Dewax and hydrate<br />2. Stain in equal volumes of solutions A and B -20 minutes<br />3. Rinse in water<br />4. Differentiate in 1% acid alcohol.<br />5. Wash and blue in running tap water -10 minutes<br />6. Counter stain according to substances to be demonstrated.<br />7. Dehydrate, clear and mount<br />Results<br />Nuclei<br />Brown to black<br />Other structures<br />According to counter stain<br />VERHOEFF'S HAEMATOXYLIN [26]<br />Constituents<br />Stock Solutions<br />5% alcoholic haematoxylin<br />10ml<br />10% ferric chloride<br />4ml<br />Strong iodine<br />4ml<br />Strong iodine is prepared by dissolving 4g potassium iodide in 100ml distilled water. 2g iodine is then added to the solution.<br />The solutions are prepared and kept separately as stock. They are mixed in the order and volumes given above immediately before use.<br />Prepared solution does not last more than a few hours and at most one day depending on the age of the haematoxylin solution.<br />METHOD<br />1. Dewax and hydrate.<br />2. Stain in freshly prepared haematoxylin solution until section is uniformly black -15-60 min<br />3. Rinse in water<br />4. Differentiate in 2% ferric chloride until elastic fibres remain black -1-2 min<br />5. Wash in tap water -5-10 min<br />6. Wash off iodine staining of background with 95% alcohol -5 min<br />7. OR in 2.5% sodium thiosulphate -1-2 min<br />8. Counter stain with 1% eosin -1 min<br />OR van Gieson -2 min<br />9. Dehydrate, clear and mount.<br />Results<br />Elastic fibres<br />Black<br />Nuclei<br />Brown<br />Cytoplasm and other connective tissue<br />According to counter stain<br />If counter stained with van Gieson<br />Collagen<br />Red<br />Muscle fibres, red blood cells<br />Yellow<br />Elastic fibres<br />Black<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />32<br />CELESTINE BLUE-HAEMALUM [52]<br />Celestine blue solution<br />Constituents<br />Celestine blue B<br />0.5g<br />Ferric ammonium sulphate (iron alum)<br />5g<br />Glycerine<br />14ml<br />Distilled water<br />100ml<br />Dissolve ferric ammonium sulphate in the water, add Celestine blue and boil for 3 to 5 minutes. Cool, filter and add glycerine. The stain lasts for about 6-8 months.<br />METHOD<br />1. Dewax and hydrate<br />2. Stain in Celestine blue solution -5 minutes<br />3. Rinse in water<br />4. Stain in Cole's or Mayer's haematoxylin - 5 minutes<br />5. Wash in running tap water<br />6. Differentiate and stain other structures by the desired technique.<br />MALLORY'S PHOSPHOTUNGSTIC ACID HAEMATOXYLIN (PTAH) [31]<br />Staining time 3-24 hours<br />Constituents<br />Haematein<br />1g<br />Phosphotungstic acid<br />20g<br />Distilled water<br />1000ml<br />The haematoxylin and phosphotungstic acid dissolved separately in distilled water applying heat if necessary and mix the two solutions. Then make it up to 1000ml with distilled water. Stain is ready for use after 24 hours.<br />If haematoxylin is used in place of haematein, then the stain should be oxidized with 0.177g potassium permanganate and used after 24 hours. Alternatively, stain may be exposed to light and warmth for 5 to 6 weeks to allow for natural oxidation before use.<br />METHOD<br />1. Dewax and hydrate<br />2. Oxidise in 0.25% potassium permanganate - 5 minutes.<br />3. Rinse in distilled water.<br />4. Bleach in 5% oxalic acid - 5 minutes.<br />5. Wash well in tap water.<br />6. Stain in PTAH solution at room temperature - 3-24 hours.<br />7. Dehydrate very rapidly through 95% alcohol and absolute alcohol because alcohol removes the red staining rapidly.<br />8. Clear in xylene and mount.<br />Results<br />Nuclei, centrioles, fibrin, cross striations of muscle fibres, red blood cells, fibroglia fibres, myoglia, astrocytes<br />Shades of blue<br />Collagen, reticulin fibres, ground fibres, ground substance of bone, cartilage<br />Yellow to brick red<br />8. CONCLUSION<br />Haematoxylin is the most important and most used dye in the medical laboratory being able to differentiate malignant cells from non malignant cells makes it an excellent tool in the diagnosis of diseases affecting tissues. Its ability to stain several intracellular and extracellular substances in shades of blue to black also makes very useful in histochemistry and histology.<br />JPCS Vol(1) ● April-June 2011 Avwioro & al. ● Histochemical Uses of Haematoxylin<br />33<br />9. REFERENCES<br />[1]. Avwioro OG. Histochemistry and tissue pathology, principles and techniques. Claverianum press, Nigeria. 2010<br />[2]. Lillie RD, Fullmer HM. Histopathologic technic and practical histochernistry. New York: McGraw-Hill. 1976<br />[3]. Willis JC. A dictionary of the flowering plants and ferns. Cambridge: Cambridge University Press. 1951.<br />[4]. Corm HJ. The haematoxylin problem. Stain Technol. 1927; 2;1-3.<br />[5]. Duff DH. Logwood colouring matters. Dyer 1950; 103;271-3.<br />[6]. Lalor GC, Martin SL. Studies on haematoxylin and haematein. The colouring principles of logwood. I-Absorption spectra of pure compounds in various solvents and a spectrophotometric method of analysis for haematoxylin and haematein. 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Iyiola S, Avwioro OG. Alum haematoxylin stain for the demonstration of nuclear and extra nuclear substances. Journal of Pharmacy and Clinical Sciences 2011; 1Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-64053978596543018792012-07-24T06:32:00.001-07:002012-07-24T06:32:05.499-07:00Quality Control In Histopathology Laboratory: By Benard Solomon<!--[if !mso]>
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<br />
<div class="MsoNormal">
<span lang="YO">Basic minimum standards acceptable for good
laboratory practice is a sine qua non for the delivery of quality products,
efficient services and cost efficiency.<span style="mso-spacerun: yes;">
</span>These are the core concerns of Quality Control in the Histopathology
Laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">According to the encyclopedia Britannica ‘A
standard is that which has been selected as a model to which objects or actions
may be compared’. It is a document that sets out a detailed description of
requirements, dimensions, materials and /or procedures designed to ensure that
a product or service meets its purpose and consistently performs to its
intended use.<span style="mso-spacerun: yes;"> </span>It aims at achieving
Consistency and Reproducibility.</span></div>
<div class="MsoNormal">
<span lang="YO">The American Heritage English dictionary also
defines quality as ‘an attribute of an individual or object’ seen as superiority
of kind or as a level of excellence.</span></div>
<div class="MsoNormal">
<span lang="YO">According to Wikipedia, quality ‘is the
conformance to specifications’.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18pt; line-height: 115%;">Divergent Views On Quality</span></div>
<div class="MsoNormal">
<span lang="YO">Quality means different things to different
professionals working in the histopathology laboratory, the patient and the
requesting physician.</span></div>
<div class="MsoNormal">
<span lang="YO">To the Medical Laboratory Scientist, quality
means the production of high quality sections or slides. Probing questions
considered include <span style="mso-spacerun: yes;"> </span>‘is it well
stained?’, ‘is it well differentiated?’ ‘Is it air bubble free; is it artifact
free; are the required tissue elements specifically demonstrated? </span></div>
<div class="MsoNormal">
<span style="mso-ansi-language: EN-US; mso-no-proof: yes;">
</span></div>
<div class="MsoNormal">
<span lang="YO"><br /></span></div>
<div class="MsoNormal">
<span style="mso-ansi-language: EN-US; mso-no-proof: yes;">
</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO">To the pathologist, quality<span style="mso-spacerun: yes;"> </span>means accurate, timely and complete reports.
To the requesting physician , quality means timely reports useful in the management
of patients. To the patient, quality means getting timely medical treatment at
the shortest possible time.</span></div>
<div class="MsoNormal">
<span lang="YO">Therefore for the histopathology laboratory,
quality control must be seen as the policies, practices and procedures
enshrined for the production of high quality sections with accurate, timely and
complete reports in a cost effective manner at all times.</span></div>
<div class="MsoNormal">
<span lang="YO">Objectives Of Quality Control In
Histopathology Laboratory</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To ensure quality services that
guarantees patient’s satisfaction</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To produce high quality sections
within and between laboratories</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To generate accurate, timely and
complete reports</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To reduce turn around time</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To promote ethics and
professionalism</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To enhance improved performance</span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To enchance continuous training
and professional development</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Overview Of Quality Control</span></div>
<div class="MsoNormal">
<span lang="YO">Quality Control in histopathology laboratory
shall be considered in the following order:</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Pre-analytical requirements</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Analytical requirements</span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Post-analytical requirments.</span></div>
<div class="MsoNormal">
<span lang="YO">Pre-Analytical Requirements</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Laboratory Design</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Personnel</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Equipments</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Sampling</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Request Form</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Fixation</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Transportation</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Registration</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Laboratory Number</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Reagents</span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">ICT</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18pt; line-height: 115%;">Laboratory Design</span></div>
<div class="MsoNormal">
<span lang="YO">The laboratory must be designed to have enough
space to accommodate all machines and tools, working benches, shelve for
chemicals, retained slides and block storage. It must also support efficient
and smooth workflow. It should have enough sink and the room should be well air
conditioned.</span></div>
<div class="MsoNormal">
<span lang="YO">There should be enough space to also
accommodate specialized tests e.g. cytology, immunohistochemistry,
histochemistry, archive room, tissue bank etc.</span></div>
<div class="MsoNormal">
<span lang="YO">The room must be well ventilated with
electrical wiring to standard laboratory specification.</span></div>
<div class="MsoNormal">
<span lang="YO">Where there is challenge on power supply,
alternative sources of emergency power supply must be made available for
constant power supply.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18pt; line-height: 115%;">Personnel</span></div>
<div class="MsoNormal">
<span lang="YO">Quality control cannot have a strong
foundation without well trained, certified and competent medical laboratory
professionals. Apart from being qualified and licensed, the personnel to handle
medical laboratory diagnostic activities must continually enroll for continuous
professional development courses to keep himself abreast of recent developments
in his chosen field.</span></div>
<div class="MsoNormal">
<span lang="YO">Professionals trained to partake in medical
laboratory testing include, medical laboratory scientists, technicians and
their subordinate staff.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18pt; line-height: 115%;">Equipments</span></div>
<div class="MsoNormal">
<span lang="YO">No matter how competent and proficient a
medical histoscientist may be, high quality sections cannot be guaranteed if
obsolete, unserviceable and non-functional equipments are at his disposal. This
precarious condition is still the lot of some third world countries’
histopathology laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">Standard and modern microtomes, wax
dispensers, staining machines, embedding work stations, cryostat, hot plate,
oven, floating bath etc are vital for standard performance in the
histopathology laboratory.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18pt; line-height: 115%;">Sampling</span></div>
<div class="MsoNormal">
<span lang="YO">Sampling error is responsible for cases of
insufficient and non-representative reports.<span style="mso-spacerun: yes;">
</span>This unnecessarily prolong treatment time and increase the cost of
medicare at the expense of the patient and the expectant relatives.</span></div>
<div class="MsoNormal">
<span lang="YO">Biopsies should be professionally taken with
no error ( sufficient and at appropriate site) so that histopathological
investigations could be satisfactorily completed with accurate reports.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18pt; line-height: 115%;">Request Form</span></div>
<div class="MsoNormal">
<span lang="YO">Request form must be well customised to
capture patient identity, requesting practitioner, test required, requesting
facility/hospital, hospital number, clinical details, provisional diagnosis,
information on drugs administered, date received, type of<span style="mso-spacerun: yes;"> </span>fixative, time of surgery and time of
fixation to mention a few.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18pt; line-height: 115%;">Fixation</span></div>
<div class="MsoNormal">
<span lang="YO">Fixation being the basis of histotechnological
techniques must be perfectly done. Most laboratories still use 10% formol
saline globally.<span style="mso-spacerun: yes;"> </span>For laboratories
running immuno-services, 10% Neutral Buffered Formalin is recommended. Fixation
should be done immediately after surgery and at worst, one hour post-surgery to
arrest autolysis and putrefaction.</span></div>
<div class="MsoNormal">
<span lang="YO">The volume of fixative should be 10-20 times
the volume of the specimen i.e.<span style="mso-spacerun: yes;"> </span>ration
of specimen to fixative should be ratio 1:10.</span></div>
<div class="MsoNormal">
<span lang="YO">Large specimens like breast should be sliced
open for the fixative to permeate it to avoid Ischaemic necrosis.<span style="mso-spacerun: yes;"> </span>In the same vein, lungs should be infused
with formalin and <span style="mso-spacerun: yes;"> </span>covered with cotton
wool soaked in formalin.<span style="mso-spacerun: yes;"> </span>The same
treatment goes for the gastro-intestinal tract(intestine).</span></div>
<div class="MsoNormal">
<span lang="YO">Bouin’s fluid is recommended for testicular
biopsies. Immunohistochemistry specimens should be fixed for between 6 and 72
hours.</span></div>
<div class="MsoNormal">
<span lang="YO">Fixed specimens should be transported in
sealed, well labelled, sizeable plastic containers.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Registration</span></div>
<div class="MsoNormal">
<span lang="YO">Samples received must be confirmed to have
been properly fixed before acceptance in the laboratory. Once that is done, the
patient’s information provided on the request form should be entered into the
day register.</span></div>
<div class="MsoNormal">
<span lang="YO">Laboratory identification number must be
immediately assigned to registered samples which must be well labelled before
being transferred to the grossing room.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18pt; line-height: 115%;">Reagents</span></div>
<div class="MsoNormal">
<span lang="YO">Reagents must be original and stored in the
right storage conditions at all times.<span style="mso-spacerun: yes;">
</span>They must be taken in adequate measurement, in the right container, well
compounded, filtered if necessary and dated.</span></div>
<div class="MsoNormal">
<span lang="YO">Deliquescent and hygroscopic chemicals should
be stored in air-tight containers.<span style="mso-spacerun: yes;">
</span>Hydrogen peroxide should be stored in brown glass.</span></div>
<div class="MsoNormal">
<span lang="YO">Schiff’s reagent should be stored in brown
bottle and preserved in a refrigerator.<span style="mso-spacerun: yes;"> </span>Silver
nitrate solution should be stored in a dark glass stoppered bottle and kept in
a dark cupboard.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Information Communication Technology (ICT)</span></div>
<div class="MsoNormal">
<span lang="YO">ICT infrastructures minimises error and
greatly improves performance while at the same time reducing turn around time
of histopathology services and<span style="mso-spacerun: yes;"> </span>reports.
Electronic data entry, data capture, multimedia adaptation, electronic data
storage and retrieval are means through which this is achieved.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Analytic Requirements</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Grossing</span></div>
<div class="MsoNormal">
<span lang="YO">The grossing room should be well ventilated
with an air extractor. Other tools such as weighing balance, knives of
different sizes, scissors, needle probles, thread, blade, ruler, board, sieve
etc should be made available.</span></div>
<div class="MsoNormal">
<span lang="YO">Brief description of the sample should be
taken with reference to the size, shape, colour, nature and texture of the
specimen.</span></div>
<div class="MsoNormal">
<span lang="YO">All hard tissues should be sent for
decalcification.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;"> Processing</span></div>
<div class="MsoNormal">
<span lang="YO">Processing of tissues should be fully
automated.<span style="mso-spacerun: yes;"> </span>Right choice of reagents and
processing schedule should be adopted. Periodic change of processing fluid is
highly recommended depending on the workload of the laboratory.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Standard Operating Procedures</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO">All methods and processes should be run with
standard operating procedures following widely acceptable international
standard such as name of author, title, principle, purpose, procedure, warning,
harzards, precuations, date, supervisor, date to be reviewed and references.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Controls</span></div>
<div class="MsoNormal">
<span lang="YO">Reagent control, positive controls and
negative control for all the techniques.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Equipments</span></div>
<div class="MsoNormal">
<span lang="YO">Equipments should be kept warm through main
power source for optimum performance. The paraffin waz oven should operated at
required temperatures.<span style="mso-spacerun: yes;"> </span>Air conditioner
should be switched on to maintain optimum performance and regulate excess heat
generated by the machines.<span style="mso-spacerun: yes;">
</span>Refridgerators and freezers to be kept on to preserve reagents and
arrest and arrest thawing and re-freezing. Finally, there should be periodic
cleaning and lubrication of equipments.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Screening Of Slides</span></div>
<div class="MsoNormal">
<span lang="YO">Slides must be adequately screened
macroscopically and microscopically to ensure high quality before sent for
reporting.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Documentation</span></div>
<div class="MsoNormal">
<span lang="YO">Laboratories must ensure documentation of all
processes and procedures for effective service delivery.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16pt; line-height: 115%;">Post-Analytic Requirements</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Reporting</span></div>
<div class="MsoNormal">
<span lang="YO">Most laboratories especially in the third
world countries still depend on microscopic reporting but multimedia imaging
reporting is fast gaining ground in the developed world.</span></div>
<div class="MsoNormal">
<span lang="YO">Speech recognition software has also replaced
manual typing to eliminate errors and unncessary delay.</span></div>
<div class="MsoNormal">
<span lang="YO">Adoption of standard criteria and reporting
guidelines to reduce diagnostic fallibility such as oversight and
misinterpretation is highly recommended.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Interpretation</span></div>
<div class="MsoNormal">
<span lang="YO">Is the tissue malignant? Is it normal? If
malignant what is the nature and origin of the tumour?<span style="mso-spacerun: yes;"> </span>How can it be graded and what grade does is
fall?<span style="mso-spacerun: yes;"> </span>In order to have well acceptable
reports, molecular grading (Immunohistochemistry) is highly recommended.<span style="mso-spacerun: yes;"> </span>Centers without immuno diagnostic facillities
should link up with established centers for this service.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Typing Of Reports</span></div>
<div class="MsoNormal">
<span lang="YO">Where manual typing is still in practice, it
must be done by well trained, qualified and highly proficient typist who are
well grounded in medico-pathology terminologies. In more advanced setting,
speech recognition software is the best.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Communication</span></div>
<div class="MsoNormal">
<span lang="YO">Communication on reports through
clinico-pathology meetings with surgeons and physicians is highly recommended.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal">
<span lang="YO">Peer review auditing using related samples
would also be of immense importance.<span style="mso-spacerun: yes;"> </span>As
a complement, specialist referal of difficult cases is of vital neccesity.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Auditing</span></div>
<div class="MsoNormal">
<span lang="YO">A laboratory audit is the process of comparing
observations of actual conditions with requirements.<span style="mso-spacerun: yes;"> </span>Auditing processes, procedures, workflow
output and turn around time should be done periodically to determine
conformance with established policies, procedures and processes.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Dispatch of Reports</span></div>
<div class="MsoNormal">
<span lang="YO">Rapid dispatch of reports to requesting<span style="mso-spacerun: yes;"> </span>clinicians is highly recommended and
duplicates should be kept in the laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">Electronic dispatch of reports will be of
great benefit where information technology infrastructures are installed.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Block Archive</span></div>
<div class="MsoNormal">
<span lang="YO">A well ventilated, fully air conditioned archive
room should be set aside for blocks of tissues handled in the histopathology
laboratory.<span style="mso-spacerun: yes;"> </span>A systematic method of
indenting and filing should also be put in place for easy retrieval of the
blocks in the future.</span></div>
<div class="MsoNormal">
<span lang="YO">Filing cabinets musth be made of steel and not
wood.<span style="mso-spacerun: yes;"> </span>This is necessary to insulate the
blocks from destructive fire incidents that may occur.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Tissue Bank</span></div>
<div class="MsoNormal">
<span lang="YO">Special cases and positive blocks should be
kept in a fully air conditioned, well refrigerated apartment. This will promote
research and educational advancement.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Seminars And Continuous Professional Development</span></div>
<div class="MsoNormal">
<span lang="YO">This should be seen as a complementary and
important aspect of quality control in the histopathology laboratory.<span style="mso-spacerun: yes;"> </span>Quality control efforts will succeed where
the personnel are well exposed and abreast of current trends.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Inventory</span></div>
<div class="MsoNormal">
<span lang="YO">Before any testing is done in any laboratory
or before new process can beging, the laboratory needs to identify and purchase
all related materials and reagents.<span style="mso-spacerun: yes;">
</span>Inventory of laboratory consumables, reagents and equipments.<span style="mso-spacerun: yes;"> </span>Suppliers should have identification seals
for items supplied.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Critical Value Reporting</span></div>
<div class="MsoNormal">
<span lang="YO">Critical value reporting captures and analyses
non-conforming events contrary to established policies, procedures and
practices ain the laboratory.<span style="mso-spacerun: yes;"> </span>It is a
means of identifying occurrences, remedial action taken, investigation and
documentation done,<span style="mso-spacerun: yes;"> </span>action plan,
classification of the occurrence , analysis and presentation, management review
and follow up.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14pt; line-height: 115%;">Quality Assurance Program</span></div>
<div class="MsoNormal">
<span lang="YO">Quality assurance measures current
performance, compares it with established goals and good laboratory practice
and is eventually aimed at improving services.</span></div>
<div class="MsoNormal">
<span lang="YO">A standard histopathology laboratory must have
both internal and external quality assurance policies.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="YO" style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Laboratory
Information System</span></b></div>
<div class="MsoNormal">
<span lang="YO">A laboratory information system stores
information in a relational database, such as Oracle, DB2 or MS SQL.<span style="mso-spacerun: yes;"> </span>A link is established between samples,
storage conditions, test dates, analyst certification, instrument calibration
and testing parameters. It is aimed at supporting automation in the laboratory,
reducing turn around time, improving service quality, and reducing errors.</span></div>
<div class="MsoNormal">
<span lang="YO">In conclusion, quality control is essential
for effective performance of the laboratory.<span style="mso-spacerun: yes;">
</span>However, it is instructive to note that it can only thrive in a
conducive setting.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><span lang="YO">References</span></b></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Philip Bryant: Issues about tissue, Part 3: Sampling Outside the
Laboratory, The Journal of histotechnology Vol. 29, No. 2, 81-87,2006</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Institute of Applied Sciences, Analytical Laboratory Standard Operating
Procedures.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Requirements for Pathology Laboratories (2007 edition): Autralian
National Pathology Accreditation Advisory Council</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Guidelines for the Implementation of a National QA Programme in
Histopathology: Faculty of Pathology, Royal College of Physicians of Ireland</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Lucia M. Berte, MA, :Laboratory Quality Management: A Roadmap: Clin Lab
Med 27 (2007) 771-790</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">BURNETT, L 2002: Applications of quality management in pathology
laboratories; DBA thesis, Southern Cross Univeristy, Lismore, NSW.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">R. R. Nakhleh, What is quality in surgical pathology? J Clin Pathol
July, 2006; 59(7): 669-672</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">F.J. Baker, R.E. Silverton:Introduction to Medical Laboratory
Technology, Sixth Edition, Butterworths.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">John D. Bancroft, Marilyn Gamble,Theory And Practice of Histological
Techniques: Fifth edition, Churchill Livingstone</span></div>
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Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-5317499568031686558.post-56867220589048949522012-07-24T06:27:00.006-07:002012-07-24T06:27:29.812-07:00Quality Control In Histopathology Laboratory By Benard Solomon<!--[if gte mso 9]><xml>
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<span lang="YO">Basic minimum standards acceptable for good
laboratory practice is a sine qua non for the delivery of quality products,
efficient services and cost efficiency.<span style="mso-spacerun: yes;">
</span>These are the core concerns of Quality Control in the Histopathology
Laboratory.</span></div>
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<span lang="YO">According to the encyclopedia Britannica ‘A
standard is that which has been selected as a model to which objects or actions
may be compared’. It is a document that sets out a detailed description of
requirements, dimensions, materials and /or procedures designed to ensure that
a product or service meets its purpose and consistently performs to its
intended use.<span style="mso-spacerun: yes;"> </span>It aims at achieving
Consistency and Reproducibility.</span></div>
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<span lang="YO">The American Heritage english dictionary also
defines quality as ‘an attibute of an individual or object’ seen as superiority
of kind or as a level of excellence.</span></div>
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<span lang="YO">According to Wikipedia, quality ‘is the
conformance to specifications’.</span></div>
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<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Divergent Views On Quality</span></div>
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<span lang="YO">Quality means different things to different
professionals working in the histopathology laboratory, the patient and the
requesting physician.</span></div>
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<span lang="YO">To the Medical Laboratory Scientist, quality
means the production of high quality sections or slides. Probing questions
considered include <span style="mso-spacerun: yes;"> </span>‘is it well
stained?’, ‘is it well differentiated?’ ‘Is it air bubble free; is it artifact
free; are the required tissue elements specifically demonstrated? </span></div>
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<div class="MsoNormal">
<span lang="YO" style="font-size: 24.0pt; line-height: 115%;">Quality
Control In Histopathology Laboratory</span></div>
<div class="MsoNormal">
<span lang="YO">Basic minimum standards acceptable for good
laboratory practice is a sine qua non for the delivery of quality products,
efficient services and cost efficiency.<span style="mso-spacerun: yes;">
</span>These are the core concerns of Quality Control in the Histopathology
Laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">According to the encyclopedia Britannica ‘A
standard is that which has been selected as a model to which objects or actions
may be compared’. It is a document that sets out a detailed description of
requirements, dimensions, materials and /or procedures designed to ensure that
a product or service meets its purpose and consistently performs to its
intended use.<span style="mso-spacerun: yes;"> </span>It aims at achieving
Consistency and Reproducibility.</span></div>
<div class="MsoNormal">
<span lang="YO">The American Heritage english dictionary also
defines quality as ‘an attribute of an individual or object’ seen as superiority
of kind or as a level of excellence.</span></div>
<div class="MsoNormal">
<span lang="YO">According to Wikipedia, quality ‘is the
conformance to specifications’.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Divergent Views On Quality</span></div>
<div class="MsoNormal">
<span lang="YO">Quality means different things to different
professionals working in the histopathology laboratory, the patient and the
requesting physician.</span></div>
<div class="MsoNormal">
<span lang="YO">To the Medical Laboratory Scientist, quality
means the production of high quality sections or slides. Probing questions
considered include <span style="mso-spacerun: yes;"> </span>‘is it well
stained?’, ‘is it well differentiated?’ ‘Is it air bubble free; is it artifact
free; are the required tissue elements specifically demonstrated? </span></div>
<div class="MsoNormal">
<span style="mso-ansi-language: EN-US; mso-no-proof: yes;">
</span></div>
<br /><div class="MsoNormal">
<span lang="YO">To the pathologist, quality<span style="mso-spacerun: yes;"> </span>means accurate, timely and complete reports.
To the requesting physician , quality means timely reports useful in the management
of patients. To the patient, quality means getting timely medical treatment at
the shortest possible time.</span></div>
<div class="MsoNormal">
<span lang="YO">Therefore for the histopathology laboratory,
quality control must be seen as the policies, practices and procedures
enshrined for the production of high quality sections with accurate, timely and
complete reports in a cost effective manner at all times.</span></div>
<div class="MsoNormal">
<span lang="YO">Objectives Of Quality Control In
Histopathology Laboratory</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To ensure quality services that
guarantees patient’s satisfaction</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To produce high quality sections
within and between laboratories</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To generate accurate, timely and
complete reports</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To reduce turn around time</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To promote ethics and
professionalism</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To enhance improved performance</span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To enchance continuous training
and professional development</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Overview Of Quality Control</span></div>
<div class="MsoNormal">
<span lang="YO">Quality Control in histopathology laboratory
shall be considered in the following order:</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Pre-analytical requirements</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Analytical requirements</span></div>
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<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Post-analytical requirments.</span></div>
<div class="MsoNormal">
<span lang="YO">Pre-Analytical Requirements</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Laboratory Design</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Personnel</span></div>
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<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Equipments</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Sampling</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Request Form</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Fixation</span></div>
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<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Transportation</span></div>
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<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Registration</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Laboratory Number</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Reagents</span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">ICT</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Laboratory Design</span></div>
<div class="MsoNormal">
<span lang="YO">The laboratory must be designed to have enough
space to accommodate all machines and tools, working benches, shelve for
chemicals, retained slides and block storage. It must also support efficient
and smooth workflow. It should have enough sink and the room should be well air
conditioned.</span></div>
<div class="MsoNormal">
<span lang="YO">There should be enough space to also
accommodate specialized tests e.g. cytology, immunohistochemistry,
histochemistry, archive room, tissue bank etc.</span></div>
<div class="MsoNormal">
<span lang="YO">The room must be well ventilated with
electrical wiring to standard laboratory specification.</span></div>
<div class="MsoNormal">
<span lang="YO">Where there is challenge on power supply,
alternative sources of emergency power supply must be made available for
constant power supply.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Personnel</span></div>
<div class="MsoNormal">
<span lang="YO">Quality control cannot have a strong
foundation without well trained, certified and competent medical laboratory
professionals. Apart from being qualified and licensed, the personnel to handle
medical laboratory diagnostic activities must continually enroll for continuous
professional development courses to keep himself abreast of recent developments
in his chosen field.</span></div>
<div class="MsoNormal">
<span lang="YO">Professionals trained to partake in medical
laboratory testing include, medical laboratory scientists, technicians and
their subordinate staff.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Equipments</span></div>
<div class="MsoNormal">
<span lang="YO">No matter how competent and proficient a
medical histoscientist may be, high quality sections cannot be guaranteed if
obsolete, unserviceable and non-functional equipments are at his disposal. This
precarious condition is still the lot of some third world countries’
histopathology laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">Standard and modern microtomes, wax
dispensers, staining machines, embedding work stations, cryostat, hot plate,
oven, floating bath etc are vital for standard performance in the
histopathology laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Sampling</span></div>
<div class="MsoNormal">
<span lang="YO">Sampling error is responsible for cases of
insufficient and non-representative reports.<span style="mso-spacerun: yes;">
</span>This unnecessarily prolong treatment time and increase the cost of
medicare at the expense of the patient and the expectant relatives.</span></div>
<div class="MsoNormal">
<span lang="YO">Biopsies should be professionally taken with
no error ( sufficient and at appropriate site) so that histopathological
investigations could be satisfactorily completed with accurate reports.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Request Form</span></div>
<div class="MsoNormal">
<span lang="YO">Request form must be well customised to
capture patient identity, requesting practitioner, test required, requesting
facility/hospital, hospital number, clinical details, provisional diagnosis,
information on drugs administered, date received, type of<span style="mso-spacerun: yes;"> </span>fixative, time of surgery and time of
fixation to mention a few.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Fixation</span></div>
<div class="MsoNormal">
<span lang="YO">Fixation being the basis of histotechnological
techniques must be perfectly done. Most laboratories still use 10% formol
saline globally.<span style="mso-spacerun: yes;"> </span>For laboratories
running immuno-services, 10% Neutral Buffered Formalin is recommended. Fixation
should be done immediately after surgery and at worst, one hour post-surgery to
arrest autolysis and putrefaction.</span></div>
<div class="MsoNormal">
<span lang="YO">The volume of fixative should be 10-20 times
the volume of the specimen i.e.<span style="mso-spacerun: yes;"> </span>ration
of specimen to fixative should be ratio 1:10.</span></div>
<div class="MsoNormal">
<span lang="YO">Large specimens like breast should be sliced
open for the fixative to permeate it to avoid Ischaemic necrosis.<span style="mso-spacerun: yes;"> </span>In the same vein, lungs should be infused
with formalin and <span style="mso-spacerun: yes;"> </span>covered with cotton
wool soaked in formalin.<span style="mso-spacerun: yes;"> </span>The same
treatment goes for the gastro-intestinal tract(intestine).</span></div>
<div class="MsoNormal">
<span lang="YO">Bouin’s fluid is recommended for testicular
biopsies. Immunohistochemistry specimens should be fixed for between 6 and 72
hours.</span></div>
<div class="MsoNormal">
<span lang="YO">Fixed specimens should be transported in
sealed, well labelled, sizeable plastic containers.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Registration</span></div>
<div class="MsoNormal">
<span lang="YO">Samples received must be confirmed to have
been properly fixed before acceptance in the laboratory. Once that is done, the
patient’s information provided on the request form should be entered into the
day register.</span></div>
<div class="MsoNormal">
<span lang="YO">Laboratory identification number must be
immediately assigned to registered samples which must be well labelled before
being transfered to the grossing room.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Reagents</span></div>
<div class="MsoNormal">
<span lang="YO">Reagents must be original and stored in the
right storage conditions at all times.<span style="mso-spacerun: yes;">
</span>They must be taken in adequate measurement, in the right container, well
compounded, filtered if necessary and dated.</span></div>
<div class="MsoNormal">
<span lang="YO">Deliquescent and hygroscopic chemicals should
be stored in air-tight containers.<span style="mso-spacerun: yes;">
</span>Hydrogen peroxide should be stored in brown glass.</span></div>
<div class="MsoNormal">
<span lang="YO">Schiff’s reagent should be stored in brown
bottle and preserved in a refrigerator.<span style="mso-spacerun: yes;"> </span>Silver
nitrate solution should be stored in a dark glass stoppered bottle and kept in
a dark cupboard.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Information Communication Technology (ICT)</span></div>
<div class="MsoNormal">
<span lang="YO">ICT infrastructures minimises error and
greatly improves performance while at the same time reducing turn around time
of histopathology services and<span style="mso-spacerun: yes;"> </span>reports.
Electronic data entry, data capture, multimedia adaptation, electronic data
storage and retrieval are means through which this is achieved.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Analytic Requirements</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Grossing</span></div>
<div class="MsoNormal">
<span lang="YO">The grossing room should be well ventilated
with an air extractor. Other tools such as weighing balance, knives of
different sizes, scissors, needle probles, thread, blade, ruler, board, sieve
etc should be made available.</span></div>
<div class="MsoNormal">
<span lang="YO">Brief description of the sample should be
taken with reference to the size, shape, colour, nature and texture of the
specimen.</span></div>
<div class="MsoNormal">
<span lang="YO">All hard tissues should be sent for
decalcification.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Processing</span></div>
<div class="MsoNormal">
<span lang="YO">Processing of tissues should be fully
automated.<span style="mso-spacerun: yes;"> </span>Right choice of reagents and
processing schedule should be adopted. Periodic change of processing fluid is
highly recommended depending on the workload of the laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Standard Operating Procedures</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO">All methods and processes should be run with
standard operating procedures following widely acceptable international
standard such as name of author, title, principle, purpose, procedure, warning,
harzards, precuations, date, supervisor, date to be reviewed and references.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Controls</span></div>
<div class="MsoNormal">
<span lang="YO">Reagent control, positive controls and
negative control for all the techniques.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Equipments</span></div>
<div class="MsoNormal">
<span lang="YO">Equipments should be kept warm through main
power source for optimum performance. The paraffin waz oven should operated at
required temperatures.<span style="mso-spacerun: yes;"> </span>Air conditioner
should be switched on to maintain optimum performance and regulate excess heat
generated by the machines.<span style="mso-spacerun: yes;">
</span>Refridgerators and freezers to be kept on to preserve reagents and
arrest and arrest thawing and re-freezing. Finally, there should be periodic
cleaning and lubrication of equipments.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Screening Of Slides</span></div>
<div class="MsoNormal">
<span lang="YO">Slides must be adequately screened
macroscopically and microscopically to ensure high quality before sent for
reporting.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Documentation</span></div>
<div class="MsoNormal">
<span lang="YO">Laboratories must ensure documentation of all
processes and procedures for effective service delivery.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Post-Analytic Requirements</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Reporting</span></div>
<div class="MsoNormal">
<span lang="YO">Most laboratories especially in the third
world countries still depend on microscopic reporting but multimedia imaging
reporting is fast gaining ground in the developed world.</span></div>
<div class="MsoNormal">
<span lang="YO">Speech recognition software has also replaced
manual typing to eliminate errors and unncessary delay.</span></div>
<div class="MsoNormal">
<span lang="YO">Adoption of standard criteria and reporting
guidelines to reduce diagnostic fallibility such as oversight and
misinterpretation is highly recommended.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Interpretation</span></div>
<div class="MsoNormal">
<span lang="YO">Is the tissue malignant? Is it normal? If
malignant what is the nature and origin of the tumour?<span style="mso-spacerun: yes;"> </span>How can it be graded and what grade does is
fall?<span style="mso-spacerun: yes;"> </span>In order to have well acceptable
reports, molecular grading (Immunohistochemistry) is highly recommended.<span style="mso-spacerun: yes;"> </span>Centers without immuno diagnostic facillities
should link up with established centers for this service.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Typing Of Reports</span></div>
<div class="MsoNormal">
<span lang="YO">Where manual typing is still in practice, it
must be done by well trained, qualified and highly proficient typist who are
well grounded in medico-pathology terminologies. In more advanced setting,
speech recognition software is the best.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Communication</span></div>
<div class="MsoNormal">
<span lang="YO">Communication on reports through
clinico-pathology meetings with surgeons and physicians is highly recommended.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal">
<span lang="YO">Peer review auditing using related samples
would also be of immense importance.<span style="mso-spacerun: yes;"> </span>As
a complement, specialist referal of difficult cases is of vital neccesity.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Auditing</span></div>
<div class="MsoNormal">
<span lang="YO">A laboratory audit is the process of comparing
observations of actual conditions with requirements.<span style="mso-spacerun: yes;"> </span>Auditing processes, procedures, workflow
output and turn around time should be done periodically to determine
conformance with established policies, procedures and processes.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Dispatch of Reports</span></div>
<div class="MsoNormal">
<span lang="YO">Rapid dispatch of reports to requesting<span style="mso-spacerun: yes;"> </span>clinicians is highly recommended and
duplicates should be kept in the laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">Electronic dispatch of reports will be of
great benefit where information technology infrastructures are installed.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Block Archive</span></div>
<div class="MsoNormal">
<span lang="YO">A well ventilated, fully air conditioned archive
room should be set aside for blocks of tissues handled in the histopathology
laboratory.<span style="mso-spacerun: yes;"> </span>A systematic method of
indenting and filing should also be put in place for easy retrieval of the
blocks in the future.</span></div>
<div class="MsoNormal">
<span lang="YO">Filing cabinets musth be made of steel and not
wood.<span style="mso-spacerun: yes;"> </span>This is necessary to insulate the
blocks from destructive fire incidents that may occur.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Tissue Bank</span></div>
<div class="MsoNormal">
<span lang="YO">Special cases and positive blocks should be
kept in a fully air conditioned, well refrigerated apartment. This will promote
research and educational advancement.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Seminars And Continuous Professional Development</span></div>
<div class="MsoNormal">
<span lang="YO">This should be seen as a complementary and
important aspect of quality control in the histopathology laboratory.<span style="mso-spacerun: yes;"> </span>Quality control efforts will succeed where
the personnel are well exposed and abreast of current trends.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Inventory</span></div>
<div class="MsoNormal">
<span lang="YO">Before any testing is done in any laboratory
or before new process can begin, the laboratory needs to identify and purchase
all related materials and reagents.<span style="mso-spacerun: yes;">
</span>Inventory of laboratory consumables, reagents and equipments.<span style="mso-spacerun: yes;"> </span>Suppliers should have identification seals
for items supplied.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Critical Value Reporting</span></div>
<div class="MsoNormal">
<span lang="YO">Critical value reporting captures and analyses
non-conforming events contrary to established policies, procedures and
practices ain the laboratory.<span style="mso-spacerun: yes;"> </span>It is a
means of identifying occurrences, remedial action taken, investigation and
documentation done,<span style="mso-spacerun: yes;"> </span>action plan,
classification of the occurrence , analysis and presentation, management review
and follow up.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Quality Assurance Program</span></div>
<div class="MsoNormal">
<span lang="YO">Quality assurance measures current
performance, compares it with established goals and good laboratory practice
and is eventually aimed at improving services.</span></div>
<div class="MsoNormal">
<span lang="YO">A standard histopathology laboratory must have
both internal and external quality assurance policies.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="YO" style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Laboratory
Information System</span></b></div>
<div class="MsoNormal">
<span lang="YO">A laboratory information system stores
information in a relational database, such as Oracle, DB2 or MS SQL.<span style="mso-spacerun: yes;"> </span>A link is established between samples,
storage conditions, test dates, analyst certification, instrument calibration
and testing parameters. It is aimed at supporting automation in the laboratory,
reducing turn around time, improving service quality, and reducing errors.</span></div>
<div class="MsoNormal">
<span lang="YO">In conclusion, quality control is essential
for effective performance of the laboratory.<span style="mso-spacerun: yes;">
</span>However, it is instructive to note that it can only thrive in a
conducive setting.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO">References</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Philip Bryant: Issues about tissue, Part 3: Sampling Outside the
Laboratory, The Journal of histotechnology Vol. 29, No. 2, 81-87,2006</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Institute of Applied Sciences, Analytical Laboratory Standard Operating
Procedures.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Requirements for Pathology Laboratories (2007 edition): Autralian
National Pathology Accreditation Advisory Council</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Guidelines for the Implementation of a National QA Programme in
Histopathology: Faculty of Pathology, Royal College of Physicians of Ireland</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Lucia M. Berte, MA, :Laboratory Quality Management: A Roadmap: Clin Lab
Med 27 (2007) 771-790</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">BURNETT, L 2002: Applications of quality management in pathology
laboratories; DBA thesis, Southern Cross Univeristy, Lismore, NSW.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">R. R. Nakhleh, What is quality in surgical pathology? J Clin Pathol
July, 2006; 59(7): 669-672</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">F.J. Baker, R.E. Silverton:Introduction to Medical Laboratory
Technology, Sixth Edition, Butterworths.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">John D. Bancroft, Marilyn Gamble,Theory And Practice of Histological
Techniques: Fifth edition, Churchill Livingstone</span></div>
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<br /></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-78554796318566914072012-07-24T06:27:00.003-07:002012-07-24T06:27:15.828-07:00Quality Control In Histopathology Laboratory By Benard Solomon<!--[if gte mso 9]><xml>
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<span lang="YO">Basic minimum standards acceptable for good
laboratory practice is a sine qua non for the delivery of quality products,
efficient services and cost efficiency.<span style="mso-spacerun: yes;">
</span>These are the core concerns of Quality Control in the Histopathology
Laboratory.</span></div>
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<span lang="YO">According to the encyclopedia Britannica ‘A
standard is that which has been selected as a model to which objects or actions
may be compared’. It is a document that sets out a detailed description of
requirements, dimensions, materials and /or procedures designed to ensure that
a product or service meets its purpose and consistently performs to its
intended use.<span style="mso-spacerun: yes;"> </span>It aims at achieving
Consistency and Reproducibility.</span></div>
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<span lang="YO">The American Heritage english dictionary also
defines quality as ‘an attibute of an individual or object’ seen as superiority
of kind or as a level of excellence.</span></div>
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<span lang="YO">According to Wikipedia, quality ‘is the
conformance to specifications’.</span></div>
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<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Divergent Views On Quality</span></div>
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<span lang="YO">Quality means different things to different
professionals working in the histopathology laboratory, the patient and the
requesting physician.</span></div>
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<span lang="YO">To the Medical Laboratory Scientist, quality
means the production of high quality sections or slides. Probing questions
considered include <span style="mso-spacerun: yes;"> </span>‘is it well
stained?’, ‘is it well differentiated?’ ‘Is it air bubble free; is it artifact
free; are the required tissue elements specifically demonstrated? </span></div>
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<div class="MsoNormal">
<span lang="YO" style="font-size: 24.0pt; line-height: 115%;">Quality
Control In Histopathology Laboratory</span></div>
<div class="MsoNormal">
<span lang="YO">Basic minimum standards acceptable for good
laboratory practice is a sine qua non for the delivery of quality products,
efficient services and cost efficiency.<span style="mso-spacerun: yes;">
</span>These are the core concerns of Quality Control in the Histopathology
Laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">According to the encyclopedia Britannica ‘A
standard is that which has been selected as a model to which objects or actions
may be compared’. It is a document that sets out a detailed description of
requirements, dimensions, materials and /or procedures designed to ensure that
a product or service meets its purpose and consistently performs to its
intended use.<span style="mso-spacerun: yes;"> </span>It aims at achieving
Consistency and Reproducibility.</span></div>
<div class="MsoNormal">
<span lang="YO">The American Heritage english dictionary also
defines quality as ‘an attribute of an individual or object’ seen as superiority
of kind or as a level of excellence.</span></div>
<div class="MsoNormal">
<span lang="YO">According to Wikipedia, quality ‘is the
conformance to specifications’.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Divergent Views On Quality</span></div>
<div class="MsoNormal">
<span lang="YO">Quality means different things to different
professionals working in the histopathology laboratory, the patient and the
requesting physician.</span></div>
<div class="MsoNormal">
<span lang="YO">To the Medical Laboratory Scientist, quality
means the production of high quality sections or slides. Probing questions
considered include <span style="mso-spacerun: yes;"> </span>‘is it well
stained?’, ‘is it well differentiated?’ ‘Is it air bubble free; is it artifact
free; are the required tissue elements specifically demonstrated? </span></div>
<div class="MsoNormal">
<span style="mso-ansi-language: EN-US; mso-no-proof: yes;">
</span></div>
<br /><div class="MsoNormal">
<span lang="YO">To the pathologist, quality<span style="mso-spacerun: yes;"> </span>means accurate, timely and complete reports.
To the requesting physician , quality means timely reports useful in the management
of patients. To the patient, quality means getting timely medical treatment at
the shortest possible time.</span></div>
<div class="MsoNormal">
<span lang="YO">Therefore for the histopathology laboratory,
quality control must be seen as the policies, practices and procedures
enshrined for the production of high quality sections with accurate, timely and
complete reports in a cost effective manner at all times.</span></div>
<div class="MsoNormal">
<span lang="YO">Objectives Of Quality Control In
Histopathology Laboratory</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To ensure quality services that
guarantees patient’s satisfaction</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To produce high quality sections
within and between laboratories</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To generate accurate, timely and
complete reports</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To reduce turn around time</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To promote ethics and
professionalism</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To enhance improved performance</span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">To enchance continuous training
and professional development</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Overview Of Quality Control</span></div>
<div class="MsoNormal">
<span lang="YO">Quality Control in histopathology laboratory
shall be considered in the following order:</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Pre-analytical requirements</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Analytical requirements</span></div>
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<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Post-analytical requirments.</span></div>
<div class="MsoNormal">
<span lang="YO">Pre-Analytical Requirements</span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Laboratory Design</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Personnel</span></div>
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<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Equipments</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Sampling</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Request Form</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Fixation</span></div>
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<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Transportation</span></div>
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<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Registration</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Laboratory Number</span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">Reagents</span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo1; text-indent: -.25in;">
<span lang="YO" style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span lang="YO">ICT</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Laboratory Design</span></div>
<div class="MsoNormal">
<span lang="YO">The laboratory must be designed to have enough
space to accommodate all machines and tools, working benches, shelve for
chemicals, retained slides and block storage. It must also support efficient
and smooth workflow. It should have enough sink and the room should be well air
conditioned.</span></div>
<div class="MsoNormal">
<span lang="YO">There should be enough space to also
accommodate specialized tests e.g. cytology, immunohistochemistry,
histochemistry, archive room, tissue bank etc.</span></div>
<div class="MsoNormal">
<span lang="YO">The room must be well ventilated with
electrical wiring to standard laboratory specification.</span></div>
<div class="MsoNormal">
<span lang="YO">Where there is challenge on power supply,
alternative sources of emergency power supply must be made available for
constant power supply.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Personnel</span></div>
<div class="MsoNormal">
<span lang="YO">Quality control cannot have a strong
foundation without well trained, certified and competent medical laboratory
professionals. Apart from being qualified and licensed, the personnel to handle
medical laboratory diagnostic activities must continually enroll for continuous
professional development courses to keep himself abreast of recent developments
in his chosen field.</span></div>
<div class="MsoNormal">
<span lang="YO">Professionals trained to partake in medical
laboratory testing include, medical laboratory scientists, technicians and
their subordinate staff.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Equipments</span></div>
<div class="MsoNormal">
<span lang="YO">No matter how competent and proficient a
medical histoscientist may be, high quality sections cannot be guaranteed if
obsolete, unserviceable and non-functional equipments are at his disposal. This
precarious condition is still the lot of some third world countries’
histopathology laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">Standard and modern microtomes, wax
dispensers, staining machines, embedding work stations, cryostat, hot plate,
oven, floating bath etc are vital for standard performance in the
histopathology laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Sampling</span></div>
<div class="MsoNormal">
<span lang="YO">Sampling error is responsible for cases of
insufficient and non-representative reports.<span style="mso-spacerun: yes;">
</span>This unnecessarily prolong treatment time and increase the cost of
medicare at the expense of the patient and the expectant relatives.</span></div>
<div class="MsoNormal">
<span lang="YO">Biopsies should be professionally taken with
no error ( sufficient and at appropriate site) so that histopathological
investigations could be satisfactorily completed with accurate reports.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Request Form</span></div>
<div class="MsoNormal">
<span lang="YO">Request form must be well customised to
capture patient identity, requesting practitioner, test required, requesting
facility/hospital, hospital number, clinical details, provisional diagnosis,
information on drugs administered, date received, type of<span style="mso-spacerun: yes;"> </span>fixative, time of surgery and time of
fixation to mention a few.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Fixation</span></div>
<div class="MsoNormal">
<span lang="YO">Fixation being the basis of histotechnological
techniques must be perfectly done. Most laboratories still use 10% formol
saline globally.<span style="mso-spacerun: yes;"> </span>For laboratories
running immuno-services, 10% Neutral Buffered Formalin is recommended. Fixation
should be done immediately after surgery and at worst, one hour post-surgery to
arrest autolysis and putrefaction.</span></div>
<div class="MsoNormal">
<span lang="YO">The volume of fixative should be 10-20 times
the volume of the specimen i.e.<span style="mso-spacerun: yes;"> </span>ration
of specimen to fixative should be ratio 1:10.</span></div>
<div class="MsoNormal">
<span lang="YO">Large specimens like breast should be sliced
open for the fixative to permeate it to avoid Ischaemic necrosis.<span style="mso-spacerun: yes;"> </span>In the same vein, lungs should be infused
with formalin and <span style="mso-spacerun: yes;"> </span>covered with cotton
wool soaked in formalin.<span style="mso-spacerun: yes;"> </span>The same
treatment goes for the gastro-intestinal tract(intestine).</span></div>
<div class="MsoNormal">
<span lang="YO">Bouin’s fluid is recommended for testicular
biopsies. Immunohistochemistry specimens should be fixed for between 6 and 72
hours.</span></div>
<div class="MsoNormal">
<span lang="YO">Fixed specimens should be transported in
sealed, well labelled, sizeable plastic containers.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Registration</span></div>
<div class="MsoNormal">
<span lang="YO">Samples received must be confirmed to have
been properly fixed before acceptance in the laboratory. Once that is done, the
patient’s information provided on the request form should be entered into the
day register.</span></div>
<div class="MsoNormal">
<span lang="YO">Laboratory identification number must be
immediately assigned to registered samples which must be well labelled before
being transfered to the grossing room.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Reagents</span></div>
<div class="MsoNormal">
<span lang="YO">Reagents must be original and stored in the
right storage conditions at all times.<span style="mso-spacerun: yes;">
</span>They must be taken in adequate measurement, in the right container, well
compounded, filtered if necessary and dated.</span></div>
<div class="MsoNormal">
<span lang="YO">Deliquescent and hygroscopic chemicals should
be stored in air-tight containers.<span style="mso-spacerun: yes;">
</span>Hydrogen peroxide should be stored in brown glass.</span></div>
<div class="MsoNormal">
<span lang="YO">Schiff’s reagent should be stored in brown
bottle and preserved in a refrigerator.<span style="mso-spacerun: yes;"> </span>Silver
nitrate solution should be stored in a dark glass stoppered bottle and kept in
a dark cupboard.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Information Communication Technology (ICT)</span></div>
<div class="MsoNormal">
<span lang="YO">ICT infrastructures minimises error and
greatly improves performance while at the same time reducing turn around time
of histopathology services and<span style="mso-spacerun: yes;"> </span>reports.
Electronic data entry, data capture, multimedia adaptation, electronic data
storage and retrieval are means through which this is achieved.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Analytic Requirements</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 18.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Grossing</span></div>
<div class="MsoNormal">
<span lang="YO">The grossing room should be well ventilated
with an air extractor. Other tools such as weighing balance, knives of
different sizes, scissors, needle probles, thread, blade, ruler, board, sieve
etc should be made available.</span></div>
<div class="MsoNormal">
<span lang="YO">Brief description of the sample should be
taken with reference to the size, shape, colour, nature and texture of the
specimen.</span></div>
<div class="MsoNormal">
<span lang="YO">All hard tissues should be sent for
decalcification.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Processing</span></div>
<div class="MsoNormal">
<span lang="YO">Processing of tissues should be fully
automated.<span style="mso-spacerun: yes;"> </span>Right choice of reagents and
processing schedule should be adopted. Periodic change of processing fluid is
highly recommended depending on the workload of the laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Standard Operating Procedures</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO">All methods and processes should be run with
standard operating procedures following widely acceptable international
standard such as name of author, title, principle, purpose, procedure, warning,
harzards, precuations, date, supervisor, date to be reviewed and references.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Controls</span></div>
<div class="MsoNormal">
<span lang="YO">Reagent control, positive controls and
negative control for all the techniques.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Equipments</span></div>
<div class="MsoNormal">
<span lang="YO">Equipments should be kept warm through main
power source for optimum performance. The paraffin waz oven should operated at
required temperatures.<span style="mso-spacerun: yes;"> </span>Air conditioner
should be switched on to maintain optimum performance and regulate excess heat
generated by the machines.<span style="mso-spacerun: yes;">
</span>Refridgerators and freezers to be kept on to preserve reagents and
arrest and arrest thawing and re-freezing. Finally, there should be periodic
cleaning and lubrication of equipments.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Screening Of Slides</span></div>
<div class="MsoNormal">
<span lang="YO">Slides must be adequately screened
macroscopically and microscopically to ensure high quality before sent for
reporting.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Documentation</span></div>
<div class="MsoNormal">
<span lang="YO">Laboratories must ensure documentation of all
processes and procedures for effective service delivery.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Post-Analytic Requirements</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Reporting</span></div>
<div class="MsoNormal">
<span lang="YO">Most laboratories especially in the third
world countries still depend on microscopic reporting but multimedia imaging
reporting is fast gaining ground in the developed world.</span></div>
<div class="MsoNormal">
<span lang="YO">Speech recognition software has also replaced
manual typing to eliminate errors and unncessary delay.</span></div>
<div class="MsoNormal">
<span lang="YO">Adoption of standard criteria and reporting
guidelines to reduce diagnostic fallibility such as oversight and
misinterpretation is highly recommended.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Interpretation</span></div>
<div class="MsoNormal">
<span lang="YO">Is the tissue malignant? Is it normal? If
malignant what is the nature and origin of the tumour?<span style="mso-spacerun: yes;"> </span>How can it be graded and what grade does is
fall?<span style="mso-spacerun: yes;"> </span>In order to have well acceptable
reports, molecular grading (Immunohistochemistry) is highly recommended.<span style="mso-spacerun: yes;"> </span>Centers without immuno diagnostic facillities
should link up with established centers for this service.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Typing Of Reports</span></div>
<div class="MsoNormal">
<span lang="YO">Where manual typing is still in practice, it
must be done by well trained, qualified and highly proficient typist who are
well grounded in medico-pathology terminologies. In more advanced setting,
speech recognition software is the best.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Communication</span></div>
<div class="MsoNormal">
<span lang="YO">Communication on reports through
clinico-pathology meetings with surgeons and physicians is highly recommended.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal">
<span lang="YO">Peer review auditing using related samples
would also be of immense importance.<span style="mso-spacerun: yes;"> </span>As
a complement, specialist referal of difficult cases is of vital neccesity.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Auditing</span></div>
<div class="MsoNormal">
<span lang="YO">A laboratory audit is the process of comparing
observations of actual conditions with requirements.<span style="mso-spacerun: yes;"> </span>Auditing processes, procedures, workflow
output and turn around time should be done periodically to determine
conformance with established policies, procedures and processes.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Dispatch of Reports</span></div>
<div class="MsoNormal">
<span lang="YO">Rapid dispatch of reports to requesting<span style="mso-spacerun: yes;"> </span>clinicians is highly recommended and
duplicates should be kept in the laboratory.</span></div>
<div class="MsoNormal">
<span lang="YO">Electronic dispatch of reports will be of
great benefit where information technology infrastructures are installed.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Block Archive</span></div>
<div class="MsoNormal">
<span lang="YO">A well ventilated, fully air conditioned archive
room should be set aside for blocks of tissues handled in the histopathology
laboratory.<span style="mso-spacerun: yes;"> </span>A systematic method of
indenting and filing should also be put in place for easy retrieval of the
blocks in the future.</span></div>
<div class="MsoNormal">
<span lang="YO">Filing cabinets musth be made of steel and not
wood.<span style="mso-spacerun: yes;"> </span>This is necessary to insulate the
blocks from destructive fire incidents that may occur.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Tissue Bank</span></div>
<div class="MsoNormal">
<span lang="YO">Special cases and positive blocks should be
kept in a fully air conditioned, well refrigerated apartment. This will promote
research and educational advancement.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Seminars And Continuous Professional Development</span></div>
<div class="MsoNormal">
<span lang="YO">This should be seen as a complementary and
important aspect of quality control in the histopathology laboratory.<span style="mso-spacerun: yes;"> </span>Quality control efforts will succeed where
the personnel are well exposed and abreast of current trends.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Inventory</span></div>
<div class="MsoNormal">
<span lang="YO">Before any testing is done in any laboratory
or before new process can begin, the laboratory needs to identify and purchase
all related materials and reagents.<span style="mso-spacerun: yes;">
</span>Inventory of laboratory consumables, reagents and equipments.<span style="mso-spacerun: yes;"> </span>Suppliers should have identification seals
for items supplied.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Critical Value Reporting</span></div>
<div class="MsoNormal">
<span lang="YO">Critical value reporting captures and analyses
non-conforming events contrary to established policies, procedures and
practices ain the laboratory.<span style="mso-spacerun: yes;"> </span>It is a
means of identifying occurrences, remedial action taken, investigation and
documentation done,<span style="mso-spacerun: yes;"> </span>action plan,
classification of the occurrence , analysis and presentation, management review
and follow up.</span></div>
<div class="MsoNormal">
<span lang="YO" style="font-size: 14.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Quality Assurance Program</span></div>
<div class="MsoNormal">
<span lang="YO">Quality assurance measures current
performance, compares it with established goals and good laboratory practice
and is eventually aimed at improving services.</span></div>
<div class="MsoNormal">
<span lang="YO">A standard histopathology laboratory must have
both internal and external quality assurance policies.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="YO" style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Laboratory
Information System</span></b></div>
<div class="MsoNormal">
<span lang="YO">A laboratory information system stores
information in a relational database, such as Oracle, DB2 or MS SQL.<span style="mso-spacerun: yes;"> </span>A link is established between samples,
storage conditions, test dates, analyst certification, instrument calibration
and testing parameters. It is aimed at supporting automation in the laboratory,
reducing turn around time, improving service quality, and reducing errors.</span></div>
<div class="MsoNormal">
<span lang="YO">In conclusion, quality control is essential
for effective performance of the laboratory.<span style="mso-spacerun: yes;">
</span>However, it is instructive to note that it can only thrive in a
conducive setting.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="YO">References</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Philip Bryant: Issues about tissue, Part 3: Sampling Outside the
Laboratory, The Journal of histotechnology Vol. 29, No. 2, 81-87,2006</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Institute of Applied Sciences, Analytical Laboratory Standard Operating
Procedures.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Requirements for Pathology Laboratories (2007 edition): Autralian
National Pathology Accreditation Advisory Council</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Guidelines for the Implementation of a National QA Programme in
Histopathology: Faculty of Pathology, Royal College of Physicians of Ireland</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">Lucia M. Berte, MA, :Laboratory Quality Management: A Roadmap: Clin Lab
Med 27 (2007) 771-790</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">BURNETT, L 2002: Applications of quality management in pathology
laboratories; DBA thesis, Southern Cross Univeristy, Lismore, NSW.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">R. R. Nakhleh, What is quality in surgical pathology? J Clin Pathol
July, 2006; 59(7): 669-672</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">F.J. Baker, R.E. Silverton:Introduction to Medical Laboratory
Technology, Sixth Edition, Butterworths.</span></div>
<div class="MsoNormal" style="margin-left: .5in; mso-list: l0 level1 lfo2; tab-stops: list .5in; text-indent: -.25in;">
<span lang="YO" style="font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">•<span style="font: 7.0pt "Times New Roman";"> </span></span></span><span lang="YO">John D. Bancroft, Marilyn Gamble,Theory And Practice of Histological
Techniques: Fifth edition, Churchill Livingstone</span></div>
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<br /></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-32519476876689257352011-12-05T00:17:00.000-08:002011-12-05T00:17:00.223-08:00Hibiscus Sabdariffa Extract-A Progressive Nuclear Stain Substitute For HaematoxilinA recent disovery in an article published by the Journal of Histotechnology has shown that extract of Hibiscus flower can be used as a progressive stain in histopathology diagnosis and to demontrate tissues in histology.<br />Summary of the paper authored by Benard Solomon of the Pathology Department University Of Ilorin Teaching Hospital, Kwara State, Nigeria is as follows:<br /><br /><span style="font-size:180%;">Title Of Paper:</span>-<strong><span style="font-size:130%;">Iron-Roselle: A Progressive Nuclear Stain Substitute For Haematoxylin.</span></strong><br /><br /><strong>Abstract</strong><br />Roselle, the dried calyces of Hibiscus sabdariffa L., is a food colorant used in many tropical Countries. A simple hot-water extract of rosell, with added ferric chloride(FeCl3.6H20) and acetic acid, provides a progressive blue stain for cell nuclie comparable to that ssen with hemalum.<br />Dry, red calyces of H. sabdariffa were ground with a binatone blender. To 10g of the ground red calyces of H.sabdariffa in a conical flask, 200ml of distilled water was added and brought to boil to create the brilliant red-colored extract. It was immediately allowed to cool and filtered with a Whatman filter paper to give a clear H.sabdariffa extract.<br />The extract staining solution was compounded as follows:<br />100ml of clear H.sabdariffa extract, 5.0g of sodium chloride, 1.2ml of 10% ferric chloride solution, and 3.0ml glacial acetic acid. The solution was used to stain paraffin sections of formaldehyde-fixed tissues at 4 microns along with parallel hematoxylin and eosin (H&E) stainins for a control.<br />Results showed that staining of nuclei with the extract solution was comparable with those sections stained with H&E. It is therefore suggested that the extract solution could be a progressive nuclear stain substitue for hemalum in H&E procedures due to its domestic availability, ease of preparation and use, resistance to fading and above all its good nuclear staining properties.(The J. Histotechnologyy 31:57,2008)<br /><br />Source-The Journal of Histotechnology/Vol. 31, No.2/June 2008.Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-5317499568031686558.post-5635690811306914072011-04-08T02:16:00.000-07:002013-06-14T03:24:06.640-07:00A Case For Breast Tumour Banks To Complement Breast Cancer Research In Africa: By Benard Solomon, Pathology Dept. Unilorin Teaching Hospital, NigeriaBreast cancer is a global health challenge both to women and men. However, women are the major population at risk.<br />
In advance Countries, concerted effort have been made to reduce mortality rate and breast cancer risk among women. Besides establishing<br />
research Institutes, the availability of Breast Tumour Banks(BTB) has significantly improved the diagnosis and management of breast cancer.<br />
<br />
A recent search in google, the world's most popular search engine reveals that Breast Tumour Banks(BTB) are available in most European Countries,<br />
North America, Canada, U.S.A., Asia, Australia and the Middle East. There is none in Africa!<br />
<br />
This poses a great health challenge to African population especially women.<br />
<br />
It is estimated that 153,100 new cases of cancer occur in Canada every year. 1, 354 die weekly. In Australia, it is also estimated that 15,409 women are expeccted<br />
to be diagnosed with Breast cancer.<br />
In India, an estimated 80,000 new cases are diagnosed annually.<br />
<br />
Africa has the following incidences:<br />
* 3, 785 cases occur in South Africa annually<br />
<br />
* 10,000 cases in Nigeria annually<br />
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* 20.4 per 100,000 in Harare and 16.4 per 100,000 in Kampala<br />
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* Gambia has 3.4 per 100,000 while Egypt has 10,556 annually.<br />
<br />
Although breast cancer incidence is lower in Africa, there is a consensus among experts that there will be increase in the coming years.<br />
Pre-emptive and concerted effort in the area of cancer research becomes imperative. Establishment of BTB is a sine qua non in this direction.<br />
<br />
What is a Breast Tumour Bank? A breast tumour bank is a kind of bio-repository. A bio-repository is a facility that collects, catalogs and stores samples of biological<br />
materials for laboratory research. Since breast tumour bank is a human sample, it is important that medical information be stored along with a written consent to use the samples<br />
for laboratory studies.<br />
<br />
Facilities for BTB as modeled by the Texas Tumour Bank include:<br />
<br />
Tissue Collection: This is a special software called TissueStation, an informatics system developed and<br />
maintained by the Clinical Research Information Systems. This is used for storage of tissue collection data using an Oracle database accessible over the web via an Oracle Forms Client.<br />
Data security is enhanced by the use of firewall and automated routine back-up with user authorisation.<br />
<br />
Any BTB to be deployed should have the ability to communicate with internal clinical data repository systems especially the pathology laboratory information systems and clinical protocol-based tissue request system.<br />
<br />
There should be a freezer security system to continuously monitor temperature with individual cryoprobes that record ambient temperatures in each freezer.<br />
The cryoprobes should be linked to a centralized computer system in the institutional security office and manned twenty four hours a day. An alarm system that notifies monitoring services must also be installed.<br />
<br />
Talking about breast tumour banks data in the world, a recent bio-banks data released by the global directory shows that Europe has 79 banks, 15 in North America, more than 156 in America, 24 in Asia, 11 in Australia, 4 in Middle Ease<br />
with Israel and Iran having 3 and 1 respectively.<br />
<br />
A closer look at the directory shows that across Europe there are Breast Tumour Banks in Vienna, Brussels, Bern, Granada, Madrid, Lyon, Marseille, Toulouse, Genoa, Birmingham, Cambridge, Cardiff, Liverpool, London and Southampton.<br />
Cities with BTB in North America are Toronto, Vancouver and Winnipeg. A google search also shows that there is breast tumour banks in Manitoba.<br />
<br />
In the U.S.A., BTB exist is Tucson, Atlanat, Augusta, Worcester, Frederick, Ann Arbor, Rochester, Durham, Philadelphia, Houston, Bainbridge Island, San Antonio and Galveston.<br />
Across Asia, BTB are found in China, India, Japan, Korea, Malasia, Singapore and Thailand.<br />
<br />
Furthermore, it is worth mentioning that BTB in Australia exists in Auchenflower and Westmead.<br />
<br />
In the Middle East, Breast Tumour Banks have been established in Iran and Israel.<br />
<br />
Although BTB could exist in other cities yet to be included in the global directory as compilation is still on-going, it is imperative to note that those Continents and Countries have instituted pragmatic efforts at promoting breast cancer research.<br />
<br />
The African situation is pathetic! From South Africa to Zimbabwe, Egypt, Tunisia, Ghana and Nigeria, no single BTB has been established.<br />
It is therefore not surprising that recent breakthrough in breast cancer research such as the success stories that led to the discoveries of Tamozifen and Herceptin came from Countries with Brest Tumour Banks especially America which has the largest number<br />
of Breast Tumour Banks.<br />
<br />
Incidence of breast cancer is lower among African Countries when compared with their counterparts in other Continents but that cannot be taken as an excuse because breast cancer is on the increase. One of the reasons for this is the adoption of Western lifestyle by African<br />
middle class. The future generation are therefore at higher risk. Taking pre-emptive measures by establishing Breast Tumour Banks for the promotion of research with the objective of finding home-grown remedies that are scientifically tested becomes sensible and a duty African<br />
Governments and Non-Governmental Organizations must attend to for an urgent intervention strategy.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-23719859413478590292010-12-14T04:42:00.000-08:002015-08-13T05:12:52.034-07:00Review Of Multimedia Devices In Use In Histopathology Practice And Education-Effective Tool For Continuous Professional Development- By Benard Solomon<div class="MsoNormal">
Introduction</div>
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Since the modern transformation in Information Communication Technology, the science of histology and histopathology has not been spared the extensive influence of the power of technology. It is now possible for students to be taught not only through visual-aids but through the Internet.</div>
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Computer devices that make this possible are called multimedia. This paper will review these devices and how they have improved the science, education and practice of histopathology as a medical science.</div>
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<strong>Definitions</strong></div>
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The Webster dictionary defines histology as ‘ the branch of biology concerned with the microscopic study of the structure of tissues.</div>
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In the same vein, the medical dictionary defines histology as ‘The study of the form of structures seen under the microscope. Also called microscopic anatomy, as opposed to gross anatomy which involves structures that can be observed with the naked eye.'</div>
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Histopathology in the other sense is defined as ‘the science concerned with the study of microscopic changes in diseased tissues.’ </div>
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For the purpose of this paper, histology could be defined as the microscopical study of normal tissues while histopathology is the microscopical study of diseased tissues.</div>
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Multimedia</div>
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These are applications that integrate text, pictures, motion pictures, animated graphics and sound. They are used with the computer system. In this way, the computer is not only seen as a working or educational tool but an entertainment medium. Multimedia applications relate directly to :</div>
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CPU, CD ROM/DVD drive, Sound Card, Graphic Card Display Monitor and Editors.</div>
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Multimedia applications as it relates to the study and practice of histopathology shall be discussed as follows:</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt;"> </span></span></span>Animations: These are moving diagrams or cartoons that move in sequence of images displayed one after the other. DiGiacinto D and Fisk G has written extensively on the effectiveness of learning when verbal instruction is combined with visual demonstrations.<span style="mso-spacerun: yes;"> </span>This becomes especially useful when dealing with a complex informaiton. O’Day D.H. also demonstrated how to provide simulated experiences to assist learners in comprehending detailed processes using powerpoint and Camtasia.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt;"> </span></span></span>Audience Response System: This is a software package that work intuitively with PowerPoint to create interactive presentations that engage participants, assess learning and promote discussion. This system particularly promote real-time learning whereby lecturers can gauge the level of student comprehension. The Mayo Clinic has been exceptional in the use of this technology for its histopathology training program.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt;"> </span></span></span>Web-Based Course Management System: This education system allow educational institutions to deliver online curriculum via the Intranet. Students are able to access lectures with voice-over audio recording wherever they may be and at anytime they wish once there is Internet connection. This system thus make it possible for student to consolidate knowledge gained during class instructions. It is also interesting to understand that this system allow teachers to provide online examinations which can be graded by the system and returned to students for immediate feedback. The Open, long distance learning system benefits a lot from the technology. Above all, this system also allow for knowledge acquisition by students or practitioners with different learning styles through the incorporation of pictures, text, animations and videos.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt;"> </span></span></span>Camtasia Studio/Camstudio: This is an audio, voice-over recording software which could be used in synchrony with PowerPoint presentations. Lectures can be recorded and uploaded to the web-based course management system. Students can then access the lectures at their convenience and as often as they need. A powerful open source alternative to Camtasia is Camstudio which is simple to use and easy to download.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt;"> </span></span></span>Adobe Contribute CS3:<span style="mso-spacerun: yes;"> </span>This web publishing tool is mainly used to create and edit web content. Weekly calendars are published and information are posted for student’s update.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt;"> </span></span></span>Teleconference:<span style="mso-spacerun: yes;"> </span>This technology makes it possible for remote presentations to be made mostly by well established global organisations like the National Society for Histotechnology (NSH) or the American Society for Clinical Pathology (ASCP). It provides current trends from experts in the field of pathology in real-time.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt;"> </span></span></span>Videos: Videos enhance learning through active demonstration of histopathology techniques. It could be used to assist students in understand basic concepts of the science of histopathology e.g. microscopy, types of biopsies and histopathology techniques.</div>
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From the above multimedia applications in use, it is evidently clear that the following are achieved:</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt;"> </span></span></span>Enhancement of educational presentations and learning through in-depth, detail both visual and verbal thus enhancing continuing education.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt;"> </span></span></span>Creation of PowerPoint presentations that contain questions to evaluate the progress, performance and knowledge of students.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt;"> </span></span></span>Enhancement of formalized learning through structured online courseware that can be modified to fit the needs of learners.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt;"> </span></span></span><span style="mso-spacerun: yes;"> </span>Liberty to view presentations at learner’s convenience which has contributed to continuing professional development in great measure.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt;"> </span></span></span>Leverage for education team to create web pages that contain calendars, newsletters and education venues and web forms to request for credit and teleconference materials.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt;"> </span></span></span>Provision of latest information pertinent to areas of specialization and education which has enhanced general understanding of topical issues.</div>
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Websites For Incorporated Multimedia Education</div>
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The following websites are a great resource for multimedia use in histopathology:</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt;"> </span></span></span><a href="http://www.expressionpathology.com/">http://www.expressionpathology.com</a></div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt;"> </span></span></span><a href="http://www.visualhistology.com/">http://www.visualhistology.com</a></div>
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References</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt;"> </span></span></span>icrocomputing and www, National Open Uninversity pg. 91</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt;"> </span></span></span>O’Day DH: How to make pedagogically meaningful animations for teaching and research using PowerPoint and Camtasia. Proceedings of the IPSI-2006, International Conference on Advances in the Internet, Processing, Systems, and Interdisciplinary Research, Chapter IV; February 6; Marbella, Spain. 2000b</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt;"> </span></span></span>DiGiacinto D: Using multimedia effectively in the teaching-learning process. J Allied Health 36:176-179, 2007.</div>
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<span style="font-family: Calibri; mso-bidi-mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt;"> </span></span></span>Fisk G: Using animation in forensic pathology and science education. LabMedicine 39:587-592, 2008.</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5317499568031686558.post-77473162160000325552010-07-02T06:41:00.000-07:002010-12-14T04:59:54.549-08:00Issues On Diagnostic Value Of Histopathology-By Benard SolomonHistopathology is a stimulating and demanding science with a distinguishing advantage of remaining one of the principal diagnostic tools whose valuable contribution for predicting biological behaviour of diseases and controlling patient management is phenomenal.<br /><br />It is a medical science with a distinct history, evolution, techniques, sampling methods, processing, interpretation and diagnostic fallibility. The clinician samples tissues and send it to the laboratory for histopathological processing in a standard concentration of fixative. Through biopsy interpretation and assessment of surgical resections and autopsies, the Histopathologists is able to differentiate between normal and abnormal tissues.<br /><br />The professional input of the medical histologist (histotechnologist/scientist) is necessary to make the tissue visible for microscopic studies.<br /><br />The Clinician and Histopathologists must adopt the following critical thinking process to make a diagnosis:<br /><br />(1) Knowledge: to have a sound working knowledge of symptoms and diseases<br />(2) Comprehension: to understand the tissue and organ systems that may be involved both in normal and diseased conditions<br />(3) Application: to be able to identify and name pathological processes that may occur<br />(4) Analysis: to have the ability to discriminate one pathological process from another<br />(5) Synthesis: to decide the most likely causes from epidemiological data<br />(6) Evaluation: to decide on likely diagnosis.<br /><br />How did histopathology evolve as a medical science and diagnostic tool? How and where are samples collected? What are the important substances demonstrated in the histopathology laboratory? What is the role of autopsy in histopathology diagnoses? How are diseases diagnosed and interpreted? What are the issues involved in the diagnostic fallibility of histopathology? These are the focus of this paper which shall be elucidated under the following subheadings:<br /><br />• History of histopathology<br />• Histopathology Sampling methods<br />• Important Substances and Structures Demonstrated<br />• The Role Of Autopsy<br />• Diagnosis of Diseases<br />• Biopsy Interpretation<br />• Diagnostic fallibility<br /><br /><br />History Of Histopathology<br />Several discoveries led to the emergence of histopathology as a medical specialty. It evolved from combined advancement in anatomy, physiology and pathology. Johannes Muller (1801-1858) takes the credit for the birth of histopathology. He was the first to use the microscope to reveal the nature and structural characteristics of cancer in 1838.<br /><br />As scientists recorded a breakthrough in the use of microscopes to study tissue elements, efforts began to be made to improve on the quality of materials studied. Several chemical agents were used to preserve tissues until formalin became a universally acceptable fixative. It was discovered by Blum in 1893.<br /><br />Initially, freehand sections were prepared using razors. Later, instruments were designed to hold specimens so that thinner slices could be cut. The use of the microtome for animal tissues occurred in 1848. The Cambridge rocker (1885) became widely used in pathology laboratories for its ability to section serial sections. Unfortunately however, it could not section tough tissues and large blocks. The introduction of the sledge microtome helped to overcome this limitation. The rotary microtome soon came to fore for sectioning tissue blocks. Motorized microtomes are now available in modern laboratories to reduce carpal tunnel syndrome caused by repetitive motion.<br /><br />The paraffin wax method was developed slowly over a period of time by several researchers to solve the problem involved in cutting thin sections. Fixed, dehydrated and cleared tissues were infiltrated with molten paraffin wax which provide firm support for tissues and make sectioning easier.<br /><br />With time, there arose justified need for dyes to make differential colouring of tissues possible for microscopic studies. Early researchers used naturally occurring dyes such as madder, indigo and carmine. Leeuwenhoek had used saffron from crocus to study muscle but hematoxylin was first successfully used by Wilhelm von Waldeyer in 1863. The hematoxylin and eosin method was introduced in 1875 by Wissowzky. The periodic acid Schiff method was developed by McManus in 1946. Silver nitrate preparations were used in histopathology and dated back to the mid 1880’s.<br /><br />By 1960, automatic stainers started appearing in histopathology laboratories. Productivity was enhanced and time saved.<br /><br />Welch was the first to use a frozen section to diagnose breast cancer during surgery in 1891. Before then, Francois Raspail (1794-1878) was regarded as the ‘Founder of Histochemistry’. The tissue is frozen and the fluid in it freezes and then provides support for the cutting of sections.<br />As things progressed, tissue processors were introduced to shorten the time required for histopathological processing of tissues. The first automated tissue processor was made in Germany in 1909.<br /><br />The field of enzyme histochemistry was created in 1939 when Gomori and Takmatsu developed methods for demonstrating the enzyme alkaline phosphatase in frozen sections. This is widely applied in the diagnosis of muscle biopsies in neuromuscular disorders, some enzyme deficiency disorders and bone marrow biopsies.<br />Immunohistochemisty methods were introduced into histopathology laboratories when Taylor and Burns developed a working method for IHC suitable for formalin-fixed paraffin-embedded tissues in 1974. Prior to the time, researchers had used 3,-3 diaminobenzindine (DAB) to create a stable colored compound at the site of the protein in the tissue. The peroxidase antiperoxidase method, which inserts a secondary antibody, that attaches to the primary antibody and a peroxidase antiperoxidase complex was developed by Sternberger et al. This occurred in 1970. Today, IHC methods have revolutionized cancer diagnosis in the histopathology laboratory.<br /><br />Laboratory Information Systems started arriving in clinical laboratories in the mid-1970’s but workable packages for surgical pathology became available later.<br /><br />Histopathology Sampling Methods<br /><br />For an accurate histological diagnosis, a representative sample from the area of investigation is a must. The methods and techniques applied for collecting these samples are categorized into surgical and imaging and are performed outside the laboratory. Sound knowledge about them is a necessity because they are an integral part of the diagnostic process.<br />Tissue samples from a living body is called biopsy while samples from a dead body is called autopsy.<br />Biopsies are invasive techniques which carry element of risks. These risks include:<br />(1) Infection or bleeding from biopsy site<br />(2) Contamination from biopsy instrument<br />(3) Perforation of tissues or organs<br />(4) Dissemination of tumours<br />(5) Local paralysis<br />(6) Pneumothorax and sepsis<br />(7) For brain biopsies, it is stroke, seizure or death<br /><br />For any biopsy to be carried out therefore, there must be a genuine clinical indication. Tissue biopsy sampling methods are highlighted as follows:<br /><br />Advanced Breast Biopsy Instrumentation (ABBI)<br />This is also known as large-core breast biopsy-a surgical technique that involves removing breast lesions under image guidance. The patient is made to lie face down on a prone biopsy table and a stereotactic mammography imaging with computers is used to pinpoint the exact location of a breast mass based on X-rays taken from two different angles. Up to 20mm of breast tissue may be taken and the procedure allows for the removal of the entire lesion in one nonfragmented piece while minimizing the amount of healthy tissue taken.<br /><br />Aspiration Biopsy Cytology (ABC)<br />This procedure plays an important role in the preoperative diagnosis of soft-tissue tumours. The process involves the extraction of cells from tissue mass found in areas such as breast, liver, thyroid and lymph node. This method uses a thin, hollow needle and syringe to aspirate cells from masses that could be palpated through the skin. For deep lesions, X-ray or ultrasound guidance is necessary.<br /><br /><br />Brush Biopsy Cytology<br />This method is used for sampling ureter, mouth, bronchus, biliary tract and esophagus for the purpose of detecting cancer cells. For sampling the ureter, a cystoscope, guide wire, uteroscope, nylon or steel brush and biopsy forceps are employed.<br /><br />Computed Tomography(CT)<br />This is also known as computed axial tomography (CAT scanning). It combines the use of a computer and X-rays. It is particularly useful for the diagnosis of lung disease, locating and imaging tumours and for facilitating needle biopsies.<br /><br />Cone Biopsy<br />This technique is used to diagnose cervical cancer in patients that have had abnormal cervical smears or biopsies. It is an extensive form of cervical biopsy in which a cone-shaped sample of tissue is removed from the inner surface of the cervix.<br /><br />Core Biopsy<br />This sampling method uses a large-bore needle to aspirate cellular materials through insertion from organs such as kidney, liver, breast and prostate. The procedure is performed in much the same way as fine needle aspirations but often require local anesthetic.<br /><br />Crosby Capsule Biopsy<br />This technique is used for obtaining small bowel biopsies for the investigation of malabsorption states such as gluten enteropathy. The patient is made to swallow a capsule attached to a thin tube. X-ray is taken to observe when the capsule is at the exact site. Negative pressure is then created in the tube and a small portion of the bowel mucosa is sucked into the capsule. A small cutting device in the capsule is activated and a biopsy of the mucosa taken.<br /><br />Curettings<br />This technique involve scrapping of tissues from cavities or growths using a curette, a scoop or spoon- shaped surgical instrument. It is a popular method for uterine samples.<br /><br />Endoscopic Biopsy<br />Endoscopy is the examination and inspection of the interior of body organs, joints, or cavities through an endoscope and may be taken through a natural body orifice or a small surgical incision. The endoscope is a device that uses fiberoptica and powerful lens systems to provide lighting and visualization of the interior of tissues. Therefore, endoscopy is a general term that refers to biopsies taken using endoscopes. It include the following:<br />1. Gastroscopy-Endoscopic biopsies taken from the stomach<br />2. Colonoscopy or Sigmoidoscopy-Endoscopic biopsies taken from the Colon<br />3. Cystoscopy-Endoscopic biopsies taken from the bladder<br />4. Bronchoscopy-Endoscopic biopsies taken from the lungs<br />5. Arthroscopy-Endoscopic biopsies taken from the joints<br />6. Colposcopy-Endoscopic biopsies taken from the cervix<br />7. Laparoscopy-Endoscopic biopsies taken from the abdominal cavities.<br /><br />Endoscopic Retrograde Cholangiopancreatography(ERCP)<br />This is an X-ray examination of the pancreatic and bile ducts and is used in the diagnostic assessment of patients with suspected pancreaticobiliary disease.<br /><br />Excision Biopsy<br />This is a surgical procedure performed on a lesion that is small enough to be removed easily. General or local anesthesia is used. Marking of excision biopsy margins with sutures or metal clips by the surgeon is necessary to aid future biopsy in case of incomplete incision.<br /><br />Fine Needle Aspiration Cytology (FNAC)<br />This procedure involves the insertion of a needle into the mass and negative pressure created in the syringe. Cellular material is drawn as a result of the negative pressure. The needle is moved back and forth to aspirate enough material for diagnosis. This procedure prevents the patient from having an open surgical biopsy. It does not require anesthetic and discomfort is usually minimal. Bleeding is the most common complication. Infection is rare.<br /><br />Incisional Biopsy<br />This technique samples a large, sometimes inaccessible mass that cannot be removed easily. The surgeon cuts into the mass and removes a sample that is then used to establish a definitive diagnosis before the continuation of major surgery.<br /><br />Imprints<br />Otherwise known as touch preparations. Smears are prepared by pressing the cut surface of freshly dissected samples e.g. lymph node onto the surface of a microscope slide. The result is a thin layer of cells that may be stained and examined microscopically.<br /><br />Liquid Based Cytology<br />This is an automated alternative to the conventional Pap smear. A sample fromm the cervix is collected using a plastic brush device that is detached after specimen collection and placed into a vial of transport medium.<br />In the laboratory, the transport media vials are vortex mixed and the cell suspension passed through a density gradient centrifugation process to remove mucus and blood cells. The cell pellet is then re-suspended and a thin-layer sample transferred to a microscope slide that can be stained and examined microscopically.<br /><br />Loop Electrosurgical Excision Procedure (LEEP)<br />This procedure is used to treat cervical dysplasia, a pre-cancerous change of the cervical epithelium that can be identified on cervical smear examination. The method uses a thin wire loop electrode attached to an electrosurgical generator that transmits a painless electrical current to the loop. As the loop comes in contact with the cervix, the tissue is rapidly heated, causing the cells to separate. The loop quickly cuts a margin around the affected cervical tissue and removes sufficient tissue for definitive treatment and pathologic evaluation. The LEEP specimen is larger that a colposcopic sample and similar in size to a cone biopsy.<br /><br />Punch Biopsy<br />A small, sharp, hollow tube called punch is placed over a lesion after a local anesthetic. The tool is then pushed down and slowly rotated to cut out a circular piece of skin. When the punch is removed, the circular skin sample if lifted up with a forceps or a needle and the skin is cut away. The technique is used for skin generally. However, it is also used for cervix after an abnormal cervical smear.<br /><br />Shave Biopsy<br />Used for obtaining skin samples that affect only the top layers of the skin i.e. dermis and epidermis with a razor blade or scalpel. A deep shave may be necessary to evaluate pigmented moles or other skin tumours.<br /><br />Smears<br />Most applicable to Pap smear. The surface of the cervix is scraped with a spatula-shaped instrument t obtain the sample of cells. The cells obtained are carefully smeared onto a glass slide, stained and examined microscopically for any abnormality.<br /><br />Stereotactic Biopsy<br />This is a specialized radiological technique used to evaluate masses that are either too small to be palpated directly through the skin or are located in an inaccessible part of the body such as the brain. The most common use of this technique is a stereotactic breast biopsy where a special computer is used to guide a needle to an abnormality seen on mammography.<br /><br />Trephine Biopsy<br />Trephine biopsies of the bone marrow are usually performed on the posterior iliac crest and should be carried out when clinically indicated. The trephine needle removes a sample of bone marrow of at least 1.6cm that is used to prepare biopsies, smears, or films for the diagnosis, staging and progress of disorders involving the blood cells such as myelomas, lymphomas and leukemias.<br /><br /><br />Important Substances And Structures Demonstrated By Histopathology Staining Methods.<br />A brief highlight of substances and structures demonstrated to aid histopathology diagnosis is vital to elucidate the pivotal role this clinical specialty play in medical diagnosis. Staining techniques applied for the substances shall also be mentioned without delving into the details. The disease conditions where they are useful will also be mentioned.<br />The following substances and structures are worth of attention for this work:<br /><br />(1) Carbohydrates<br />(2) Mucins<br />(3) Pigments<br />(4) Lipids<br />(5) Elastic Fibers<br />(6) Collagen Fibers<br />(7) Reticulin Fibers<br />(8) Amyloid Fibrils<br />(9) Endocrine Glands<br />(10) Myelin<br />(11) Microorganisms<br />(12) RNA and DNA<br /><br />Carbohydrates<br />These are a large group of substances which exist in normal and pathological tissues. They were previously classified based on their structures, site in the body and staining reactions. Recently however, Kiernan classified them broadly as polysaccharides, proteoglycans and glycoproteins.<br />The Periodic Acid Schiff method is the most popular stain for carbohydrates. It was developed by McManus in 1946 and mostly used to demonstrate the presence of glycogen in tissue sections. Glycogen is normally found in the liver, endocervix and fresh muscle but pathologically present in adenocarcinomas, mesotheliomas, seminomas and in clear cell carcinomas.<br /><br />Mucins<br />These could be acid mucins, neutral mucins or sialomucins depending on their chemical compositions. Generally, they have the ability to absorb ferric iron from colloidal iron solutions.<br />Mucins in goblet cells of the G.I.T. is demonstrated by the Best Carmine method. The Hales’ colloidal iron method demonstrates acid mucins (blue), the high iron diamine method identifies sulfated mucins (brown-black). The alcian blue method devised by Steedman in 1950 remains the most versatile method for acid mucins.<br />Demonstration of mucins are significant in the diagnosis of primary tumours of the lower G.I.T. and some metastases from adenocarcinomas of the lower G.I.T.<br /><br />Pigments<br />Many pigments could be found in the human body under normal and pathological conditions. Pigments develop from fixation process, disease process, some are naturally occurring while others are introduced from outside the body otherwise known as exogenous pigments.<br />Pigments created by the body’s metabolism are of most interest to pathologists. They include hemosiderin, melanin, chromaffin substance, lipochrome, lipofuscin, hemoglobin and Dubin-Johnson pigment. However, iron pigments and melanin pigments are the most commonly demonstrated pigments in routine histopathological diagnosis.<br />Perl’s Prussian blue method is used to demonstrate iron pigment and aid in the diagnosis of bone marrow disorders and hemosiderosis of the liver.<br />Melanin is naturally occurring in the skin and the substantia nigra in the midbrain but pathologically present in melanin –producing neoplasms such as neveu or melanoma. Methods for the demonstration of melanin include Masson Fontana (black) and the Diazo method.<br /><br />Lipids<br />Lipids could be classified as simple lipids, compound lipids and derived lipids. A wide range of stains for lipids (fat) are possible on histological sections. Fat exists normally in some organs of the body and in the skin but indicative of pathological process when found inside the liver, or as a lipoma or liposarcoma.<br />Common fat stains include osmium tetroxide, Sudan III, Sudan IV, Oil red O, Sudan Black. Less commonly used stains are Bakers acid hematein, Luxol fast blue and Nile blue sulphate methods. Fat stains are useful in the diagnosis of neuronal and other storage disorders.<br /><br />Elastic Fibers<br />Elastic tissue is present in the skin, ligaments and the elastic laminae of blood vessels. It is also very abundant in the lung and the wall of the aorta.<br />The Verhoeff elastic method combined with Van Gieson is the most popular elastic fibers stain used in histopathology laboratories. Orcein is reputed to be the stain of choice for delicate elastic fibers in skin and favoured by dermatopathologists. The Gomori aldehyde fuschsine method introduced in 1950 is a progressive method for elastic fibers. <br /><br />Collagen Fibers<br />Collagen forms a coarse extracellular framework or scaffolding; its fibers are the coarse connective tissue fibers. They are doubly refractile and stain red with van Gieson’s stain. It is well demonstrated by the trichrome methods and in polarized light, collagen is brilliantly bi-refringent. In present times, Masson’s trichrome introduced in 1929 is the most popular connective tissue stain. Nuclei is stained blue-black, cytoplasm red, and connective tissue green or blue depending on counter stain chose.<br /><br />Reticulin Fibers<br />Reticulin is the name given to the chemical entity or substance of which reticular fibers are composed; it is a protein to which fatty acids and polysaccharides are bound. <br />Reticulin fibers are demonstrated by silver impregnation, the gold method and the periodic acid Schiff technique.<br />Certain neoplasms produce abundant reticulin which assumes characteristic patterns. These are neoplasms derived from mesodermal elements e.g. rhabdomyosarcomas, hemangiosarcomas and also fibroblastic tumors.<br />In the liver, reticulin stains are often helpful in early cirrhosis. They are indispensable in the diagnosis of early fibrosis of the marrow and are helpful in differentiating certain kidney lesions.<br /><br /><br />Amyloid Fibrils<br />Amyloid fibers are seen in amyloidosis- a group of diseases resulting in the deposition of insoluble protein in the interstitial spaces of blood vessels and various organs. There are at least five types. Secondary amyloid is usually created in response to chronic inflammatory processes including pulmonary infection, tuberculosis and rheumatoid arthritis as well as some neoplasms.<br />A popular amyloid stain is Congo red. The carbohydrate component can be demonstrated by the PAS method and iodine. Pretreatment with potassium permanganate will reduce secondary amyloid staining. Amyloid is metachromatic and bi-refringent in polarized light.<br /><br /><br /> Myelin<br />Myelin are demonstrated for the study of axonal diseases especially when they become degenerated. Myelin is the material that forms the extended surface membrane of Schwann cells in the peripheral nervous system and of oligodendrocytes in the central nervous system. It forms a multiplayer sheath around the axons of neurons and provides electrical insulation.<br />Staining methods for its demonstration include Weigert Pal, Kultschitsky and Loyez. The PTAH method will also demonstrate myelin. Modern methods of demonstration are the Luxol fast blue and eriochrome cyanine R (Solochrome cyanin). <br /><br />Microorganisms<br />Demonstration of acid-fast , gram positive and negative organisms is very popular in histopathology laboratories. The demonstration of Mycobacterium tuberculosis is of keen interest to pathologists especially in areas where tuberculosis is endemic.<br />Robert Koch in1882 was the first to develop a workable method for the demonstration of this organism. Others such as Ehrlich, Franz Ziehl, Rindfleisch and Neelson improved upon the method of staining the organism. The Ziehl Neelsen stain commonly used today is applicable to paraffin sections.<br />Poor staining results for some acid-fast organisms which contain reduced amount of lipid in their coats. To improve on this, methods that uses oil to remove paraffin wax from sections was devised. The most prominent among them is the Fite Faraco method for Mycobacterium leprae. In advanced laboratories, fluorescent method using auramine-rhodamine is favored for the visualization of sparse acid-fast bacilli.<br />The Gram stain devised by Christian Gram is the widely used method for differentiating gram-positive and negative organisms. This method and its variations is still widely applicable to paraffin sections. Modifications of the Gram method are the Gram-Twort method, (1924), the Brown and Brenn method (1931) and the Brown and Hopps method (1973).<br /><br />RNA and DNA<br />The demonstration of RNA and DNA is vital in studying the cell population of tumours. The Feulgen method for nucleic acids was developed in 1942 and popular in histopathology laboratories. Nucleic acids are hydrolyzed by hydrochloric acid to create aldehydes which are demonstrated by Schiff’s reagent.<br />The Unna-Pappenheim method developed earlier stains DNA with methyl green and RNA with pyronine Y. Fixation is Carnoy fluid give best results.<br /><br />The Role Of Autopsy<br />Certain occurrences reinforce the role of autopsy is histopathological diagnoses. Among such factors are:<br />(1) Many disorders are unrecognizable before death<br />(2) Errors occur in biopsy sampling<br />(3) Discordance between primary clinical diagnosis and that obtained from autopsy has been found to be high especially in malignant tumors.<br /><br />Comparing histological diagnoses with those obtained from autopsies often improve diagnostic methods and help rectify errors from biopsy sampling.<br />However, it should be noted that confidence in modern methods of diagnosis such as radiological imaging techniques, computerization, plastination and other audiovisual teaching methods has heralded a worldwide decline in autopsies requests.<br /><br />Diseases, Diagnoses And Biopsy Interpretation<br />Diseases are broadly classified into malignant and nonmalignant groupings. Each has its agents and causes. Genetic agents causes chromosomal abnormalities which results in diseases such as Down’s syndrome, achondroplasia and cystic fibrosis.<br />Diseases such as osteomalacia, burns, liver disease, tuberculosis, influenza, schistosomiasis, hay fever, thyroiditis, schizophrenia are acquired and caused by vit. D deficiency, physical agents, drugs, bacteria, viruses, parasites, autoimmunity, psychogenic factors respectively. They are all nonmalignant diseases.<br />Malignant diseases could be caused by chemical agents, environmental agents and oncogenic agents. Skin cancer could result from arsenic exposure, mesothelioma could result from asbestos exposure. Other diseases such as leukemia, mouth and throat cancer and cancer of the scrotum could result from exposure to azo dyes, benzene, betel nut and soot respectively.<br />Environmental factors such as dioxin, radiation, smoking and sunlight could cause lymphoma, thyroid cancer, lung cancer and skin cancer respectively.<br />Human paillomavirus, Epstein-Bar virus and hepatitis B virus are oncogenic agents that could lead to the following malignant diseases-cervical cancer, Burkitt’s lymphoma and liver cancer respectively.<br />Diagnosis involves recognizing a particular disease and giving it a name. Diseases are easily recognized from disorders in the structure and malfunction of tissues. The patient’s sample is compared with what is known as normal. Normality is a bell-shaped curve of normal distribution rather than a discrete, single locus.<br />In making tentative diagnoses, macroscopic appearances are supported by microscopic examination. Benign conditions such as lipomas, fibroid uteri, and dermoid cysts can be readily recognized by macroscopic appearances. So also could carcinomas of the breast, bowel and ovary be readily identified.<br />In microscopic examination, the pathological process is assigned a name e.g. papilloam, carcinoma and tissue type e.g. squamous and glandular.<br />In tumor pathology, the degree of differentiation (grading) and depth of invasion (staging) are major prognostic factors.<br />Grading is usually classified as low grade or high grade. For staging, the TNM system is one of those currently in use. T is the extent of the primary tumor, N indicates the absence or presence and extent of regional lymph node metastases, and M indicates the absence or presence of distant metastases.<br /><br /><br /><br />Diagnostic Fallibility<br />While the importance of histopathology in the diagnoses of diseases is not in doubt, it is however honorable to admit that errors do occur. The expression of error is aptly described as diagnostic fallibility. These inaccuracies critically affect patient care and are categorized as oversights or misinterpretations.<br />Risk management strategies must be adopted to minimize or completely eradicate these errors which can give rise to damage liability and litigation. Recommended strategies include:<br />(1) Holding of regular audits<br />(2) Improving standards through clinico-pathology meetings<br />(3) Peer review audits using selected samples<br />(4) Specialist referral of difficult cases and<br />(5) Adoption of standard criteria and reporting guidelines.<br /><br />Conclusion<br />In an attempt to bring the value of histopathology as a diagnostic tool to the front burner, this paper has briefly exposed the evolution of histopathology cum histotechnique. A better understanding of the history of histopathology and transformation over the past 50 years and beyond has thus been given.<br />Closely following is the role played by different professionals like medical histologists (Histotechnologists/scientists) to make diagnostic possible at microscopic level.<br />In order to have a broad understanding and appreciation of the various ways of obtaining biopsy samples in the theatre, sampling methods which primarily determines the quality of diagnosis to be given has been elucidated. A full knowledge of the nature of specimens and where they were taken has thus been fully established.<br />To make this subject clearer, different materials demonstrable in the histopathology laboratory have been discussed with brief mention of the techniques and the results expected. Also mentioned were means of interpreting microscopic slides.<br />Histopathology like any other medical science has its limitations. This has been highlighted as diagnostic fallibility.<br />Histopathology has thus been showcased as a valuable diagnostic tool in establishing the reasons, types and degree of diseases for both the living and the dead.<br /><br /><br />Bibliography<br /><br />Michael Titford: A Short History Of Histopathology Technique, Journal of Histotechnology, Vol. 29, No. 2, June 2006. pp 99-110<br /><br />Bracegirdle B: A History of Microtechnique (ed 2). Lincolnwood, IL, Science Heritage Ltd. 1986<br /><br />Johannes Muller (1801-1858) Anatomist, physiologist, pathologist (Editorial). JAMA 214:2049-2051, 1970.<br /><br />Cook H: Evolution of histology. Biomedical Scientist. 9:825-827m 2000<br /><br />Von Waldeyer W:Untersuchungen über den Ursprung und den Verlauf des axsencylinders bei Wirbellosen und Wirbelthieren sowie über dessen Endverhalten in der quergensteiften Muskelfaser. Henle Pfeifer’s Rat Med. 20:193-256, 1863.<br /><br />Pearse AGE: Histochemistry Theoretical and Applied. 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J Am Acad Dermatol 46:690-694, 2002<br /><br />Imprints<br />Ferreiro JA, Myers, JL, Bostwick DG: Accuracy of frozen section diagnosis in surgical pathology: review of a 1-year experience with 24,880 cases at Mayo Clinic Rochester: Mayo Clin Proc 70:1137-1141, 1995.<br /><br /><br />Liquid Based Cytology<br />Bergeron C, Bishop J, Lemarie A, Cas F, Ayivi J, Huynh B, et al: Accuracy of thin-layer cytology in patients undergoing cervical cone biopsy. Acta Cytol 45:519-524, 2001<br /><br />Loop Electrosurgical Excision Procedure<br />Livasy CA, Maygarden SJ, Rajaratnam CT, Novotny DB: Predictors of recurrent dysplasia after a cervical loop electrocautery excision procedure for CIN-3: s study of margin, endocervical gland and quadrant involvement. Mod Pathol 12:233-238, 1999<br /><br />Punch Biopsy<br />Todd P, Garioch JJ, Humphreys S, Seywright M, Thomson J, du Vivier AWP: Evaluation of the 2mm punch biopsy in dermatological diagnosis. Clin Exp Dermatol 21:11-13, 2996<br /><br />Shave Biopsy<br />Gambichler T, Senger E, Rapp S, Alamouti D, Altmeyer P, Hoffman K: Deep shave excision of macular melanocytic nevi with the razor blade biopsy technique. Dermatol Surg 26:662-666, 2000<br /><br />Smears<br />Underwood JCE: Macroscopy, microscopy and sampling. In introduction to Biopsy Interpretation and Surgical Pathology.<br /><br />Stereotactic Biopsy<br />Sickles EA: Breast imaging: from 1965 to the present. Radiology 215:1-16, 2000<br /><br />Trephine Biopsy<br />Bain BJ: Bone marrow trephine biopsy. J Clin Pathol 54:737-741, 2001<br /><br />Mucins<br />Cook HC: Carbohydrates, in Bancroft JD, Stevens A(ed). Bloxham, UK, Scion Publishing, 2008, pp 286, 276-281<br /><br />Pigments<br />Wilson POG, Chalk BT: The neuroendocrine system, in Bancroft JD, Stevens A(ed). 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In: The Biology of Disease. 2nd ed. Blackwell Science, Oxford, 2001.<br /><br />Sobin LH, Wittekind C(eds): TNM Classification of Malignant Tumours. 6th ed. Wiley-Liss, New Yourk, 2002.<br /><br />Diagnostic Fallibility<br />Underwood JCE: Diagnosit histopathology. In: Introduction to Biopsy Interpretation and Surgical Pathology. 2nd Ed. Springer-Verlag, London. 1987, pp 1-16<br /><br />Ramsay AD; Errors in histopathology reporting: detection and avoidance. Histopathology 34:481-490, 1999.<br /><br />Nordrum I,Johansen M, Amin A, Isaksen V, Ludvigsen Ja; diagnostic accuracy of second-opinion diagnoses based on still images. Hum Pathol 35:129-135, 2004.Unknownnoreply@blogger.com0