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Chemical pathology

1. SCOPE OF WORK
The Department of Chemical Pathology offers routine laboratory, research, and clinical services. The laboratory services involve the processing and running of samples for various biochemical investigations. Clinical services involve the care of patients with diverse metabolic conditions as out-patients. The scope of investigations and services offered by the Department of Chemical Pathology include:
CHEMICAL PATHOLOGY INVESTIGATIONS
Routine Investigations
1. PLASMA GLUCOSE: Fasting, Random, OGTT, HbA1c
2. Plasma ELECTROLYTES:
Sodium, Potassium, Bicarbonate, Chloride, Calcium, Magnesium, Phosphate
3. RENAL FUNCTION TESTS: Plasma urea &creatinine, uric acid, creatinine clearance
4. PLASMA LIPID PROFILE: Total Cholesterol, HDL-C, Triglyceride
5. LIVER FUNCTION TESTS:
Plasma Bilirubin (Total & Conjugated), Albumin &Total Protein
Serum Enzymes (ALT, AST, ALP, GGT)
6. Serum Hormone Analysis:
Thyroid Function Tests (TSH, T3, T4)
Reproductive Hormones (LH, FSH, Prolactin, Progesterone, Oestrogen, Testosterone)
Tumour markers (PSA)
7. CEREBROSPINAL FLUID (CSF) Analysis: CSF Glucose and CSF Protein
Specialized Investigations
1. Urine Toxicology Tests
2. Serum electrophoresis
3. Urine screening tests for Inborn Errors of Metabolism
4. Gallstone/Renal stone analysis
CLINICAL CHEMICAL PATHOLOGY
1. Metabolic Clinic
2. Clinical Consultations
3. Ward Rounds
1.3. Training of resident doctors, undergraduate medical students, industrial training (IT) students and interns.

STAFF STRENGTH & EXPERTISE
The Department currently consists of three Professional groups:
1. Medical Doctors: 7 Consultant Chemical Pathologists and 9 Resident Doctors (4 Senior Registrars and 5 Registrars)
2. Medical Laboratory Scientists (MLS): 7 Assistant Directors, 4 Chief MLS, 3 Assistant Chief MLS, 2 Principal MLS, 2 Senior MLS, 2 MLS 1, one Scientific Officer and one MLS-in-training.
3. Accounts and Administrative Staff: 5 Accountants, one Senior Executive Officer, and 2 Clerical Officers.

BRIEF HISTORY OF THE DEPARTMENT OF CHEMICAL PATHOLOGY, UPTH.

The Department of Chemical Pathology started as a unit of the Pathology Department when the University decided to use the General Hospital, Port Harcourt as its Teaching hospital. The movement from the temporary site at Emohua to the General Hospital was done on 31st August 1983. This single Pathology Department persisted both at the University and at the Teaching Hospital and was headed by Dr. O. Chinwa (a Morbid Anatomist) while Dr. Nsirim Nduka (a Medical Laboratory Scientist) was in charge of the Chemical Pathology Unit. Dr. Victor Wakwe became the Consultant-in-charge of the unit from December 1988. Dr. Nsirim Nduka and two other Medical Laboratory Scientists, Mr. A. I. Rukari and Mr. Karibi-Botoye, who started the unit and contributed a great deal to the success story of the Department, have now retired.
An accreditation visit by the Medical and Dental Council of Nigeria in 1990 led the University to split the single Pathology Department to the four departments of Chemical Pathology, Haematology & Blood Transfusion, Medical Microbiology, and Morbid Anatomy. The Director of Administration of the Hospital in a memorandum dated 1st April 1992 converted the existing units of the Pathology Department to full-fledged departments. Since the establishment of the Chemical Pathology Department in 1992 it has had the following Consultant Chemical Pathologists as heads:
1. Dr. V. C. Wakwe — 1992 – 1995
2. Dr. A. C. Ojule — 1995 – 1997
3. Dr. V. C. Wakwe — 1998 – 2000
4. Dr. (Mrs.) Adetoun A. Ejilemele — 2000 – 2006
5. Dr. Chituru G. Orluwene — 2006 – 2015
6. Dr. (Mrs.) Ehimen P.Odum — 2015 — date

The Department moved from the temporary General Hospital site to the present permanent site of the Hospital in 2005 and has since progressed from offering basic routine tests to performing specialized tests such as reproductive hormones, thyroid hormones, tumour markers, cardiac markers and bone markers, as well as other assays required for research purposes.

4. MODUS OPERANDI (PROTOCOL FOR PATIENTS & VISITORS TO THE HOSPITAL)
4.1 PROTOCOL FOR LABORATORY INVESTIGATIONS
Ordering for a test begins with filling out a laboratory request form by the doctor of the patient. These request forms must be correctly filled out to include – name, age, sex, hospital number, managing consultant, preliminary diagnosis, date of the request, investigations required, etc.
The patient/ relative brings the request form to the department where the tests/ procedures ordered will be costed. A teller is issued in quadruplicate (one copy each for the bank, the accounts unit, the patient and the department respectively) to the patient by the departmental accounts clerk to go and make payment at the nearest bank pay point and return with the remaining three stamped tellers to the accounts unit. The accounts unit retains one copy of the teller and sends the patient to the departmental reception section.
Payment must be made before any procedure can be carried out.
Patients covered by NHIS must present the NHIS cover paper before they can be attended to.
At the reception section, the patient presents the request form and the remaining two tellers. The staff at the reception collects one copy of the teller and returns the patients copy to him/her along with the appropriate specimen bottle for the required test(s).
Specimens in the laboratory are received in two ways:
Patients are directed to the departmental phlebotomy unit for specimen collection
Samples are collected in the wards/ clinics and transported to the laboratory
All samples should reach the laboratory within a one-hour maximum after collection. On no account should samples that have stayed overnight in the wards be sent for analysis as this yields wrong results due to denaturing of cells.
Samples should be collected in a manner to prevent clot formation or hemolysis during the process of collection as this can yield errors in analysis.
Note that samples improperly collected or with accompanying improperly filled forms may be rejected.
7. Samples should be submitted to the reception area of the department in the appropriate specimen bottles.
8. The patient/ relative returns to the department reception to collect the reports of the ordered tests at the expected turnaround time.
4.2 PROTOCOL FOR METABOLIC CLINIC
Patients must open a hospital folder in the records department before they can be seen or reviewed by doctors.
Patients come to the clinic on referrals from other clinics or the general outpatient department.
Clinic days are Mondays and patients are reviewed by the Consultant Chemical Pathologists and Resident Doctors.
Any patient requiring admission will be admitted into the medical ward.
Follow up appointments are given on an individual basis.

DR. (MRS.) E. P. ODUM
HOD, CHEMICAL PATHOLOGY

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