In the biochemistry lab, in addition to the basic biochemical assays we perform serum alpha-1 antitrypsin, haptoglobin, d-Dimer, magnesium, LDH, iron & TIBC, transferrin, cholinesterase and ceruloplasmin assays by immune-turbidimetric methods in Beckman Coulter AU480 analyzer. We perform several tests important in management and prevention of NCD such as HbA1c, urine microalbumin/creatinine ratio and lipid profiles. HbA1c is tested using Biorad D10 HPLC system. Lithium assay is done using ion selective electrodes (ISE). Serum copper assay is also available in the Randox Imola system. Quality control is maintained using quality control material at two levels.
Serum and urine protein electrophoresis and immunofixation by agarose gel electrophoresis by Sebia analyser are currently being performed at MRI.
In the immunoassay laboratory number of hormones including iPTH, insulin, c-peptide, progesterone, estradiols, testosterone, cortisol, beta HCG and DHEAS are performed. We also perform tumour markers such as CA125, CA19-9, PSA, alpha-fetoprotein. Nutritional markers including 25 OH cholecalciferol, ferritin, vitamin B12 and folate levels are also done. Rare tests such as anti-TPO antibodies, anti-thyroglobulin antibodies were added too. With collaboration of pharmacology department we do perform blood cyclosporine and tacrolimus assay for renal transplant recipients. These are assayed using a chemi-luminescence micro-particle immunoassay system in two highly sophisticated Abbot Architecti1000 analyzers. We measure 17-OH progesterone and GH using Human Elysis Duo Fully automated ELISA system. Urine total metanephrine assay was established recently in collaboration with pharmacology department. We are about to start few imporatant tests such including ACTH, Renin /Aldosterone, thyroglobulin and IGF1 in newly acquired Diasorin Liaison system. Accuracy of all the measurements are monitored closely with daily assayed quality control levels to cover the range of low normal and high levels.
The Neonatal Screening Programme for Congenital Hypothyroidism
All the newborns born in Western, Northern, North Central and North Western provinces are screened for congenital hypothyroidism by us. Heel prick blood sample is taken to a Guthrie card within 24 hours and posted/sent to MRI. It is analyzed using a fluoresence immunoassay system (AutoDELFIA fully automated immunoassay system from Perkin Elmer) and all the positive cases are informed to the relevant MOH over the phone and a referral letter to a Paediatrician is posted. Each month about 11,000 babies are screened. In collaboration with Family Health Bureau we participate in training of staff in pre-analytical handling of samples.
National External Quality Assurance Scheme
We conduct NEQAS in routine chemistry for 100 participant laboratories in the government institutions for 13 tests on a monthly basis. Recently we started external quality assurance service for immunoassays for 20 participant laboratories in government hospitals in collaboration with service provider who is accredited.
We acquired Inductively Coupled Plasma- Mass Spectrometry system which can analyze blood, other body fluids and non-clinical material (water, food items) for heavy metals and trace metals. The equipment will be used to provide services as well as in research.
We have started research on lipids and apolipoproteins. We are about to start few more projects on sdLDL, lead levels and anaemia in pregnant mothers.
Post graduate training in Medicine
Post graduate Institute of Medicine allocates two chemical pathology trainees annually to MRI for a period of 4 and ½ years. In addition all trainees in chemical pathology spend 5 months of their training in the Biochemistry Department of MRI. Additionally trainees in STD, medical administration, clinical nutrition, transfusion medicine are trained in the biochemistry department.
MLT students from all three medical schools and KDA have training periods in the biochemistry department.