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Gladys Chia
Chew Yu Mei
Yvonne Teo
Cornelyus Ng
Lau Leslie

19 July 2008

9:10:00 PM

Haematology, Clinical Chemisty and Immunology, Microbiology and histopathology are the few departments that the hospital that I am attached to offer, unlike some other lab that you may be attached to which will have and for the first 1 month, me and my SIP mates will be on a rotational basis where we get to try each different department every week.

So for the first week, I was attached to Haemtology where I get to practice what Mr Poh have taught us in school- PBF, ESR, WBC Differential, PT/APTT etc. It is really applying what you learn but this time round is with PATIENT'S BLOOD. And, the urgent samples are never ending, therefore, I've mastered doing 3 PBR Slides within 1 minute. SERIOUSLY.

In haematology, some of you might think that it is weird but in my lab, URINE ANALYSIS (Urine microscopy examination, dipstick analysis, urine culture - anything that has gotta to do with urine) is under haematology instead of Clinical Chemistry (Do you remember using my urine sample during Dr Khin's Lab for Urinalysis?) So for the whole of first week, besides doing blood related testings, I was doing urinalysis too.

Thus, I am going to describe one of the test that I have been doing during my stay in Haematology - Urine Drug Test. The patient's urine is usually sent in two bottle and labelled with a sticker to indicate that they are used for drug testings. So, as you know, drug testing is to test for drug in the urine that is excreted by the body system and found positive in the urine if the patient took the drug.

There are basically two types drug that my lab does, one common test will be the COT (One step cotinine test device) and another one which is more rare will be the TOX (7 drug screen test).

COT (Cotinine Test)
Introduction
Cotinine is the first-stage metabolite of nicotine which can be found in every person who is a member of tobacco-smoking society or those who may be a passive smoker (2nd hand smoker). Nicotine is excreted in urine rapidly via the kidney 2 to 3 days after Nicotine use as unchanged drug with 10% as cotinine and 35% as hydroxycontinine. Therefore, Continine is easy to be detected in the urine using the COT test kits, which make use of a monoclonal antibody to selectively detect elevated levels of Continine in urine. It yields a positive result when the Continine in urine exceeds 200ng/ml.

Principle
Immunoassay based on the principle of competitive binding. Drugs which may be present in the urine specimen compete against the drug conjugate for binding sites on the antibody. During the test, a urine specimen migrates upward by capillary action. If the Cotinine level in the urine specimen is below 200ng/ml, it will not saturate at the binding sites of antibody coated particles in the test device. The antibody coated particles will then be captured by immobilized Cotinine conjugate and a visible coloured line will show up in the test line region - this is a negative results. If it is positive, the line will not show up because it will saturate all the binding sites of anti-Cotinine antibodies.

Taken from: http://www.uatests.com/img/1panel40box.jpg
Directions
1. Label the test kit with the patient's lab request number to allow tracking or verifying of results in future.
2. Place 3 drops of patient's urine sample into the specimen well (S) of the test device using the given dropper in the package that is alread callibrated to be 100ul.
3. Wait for the coloured line to appear. The results should be read at 5 minutes.

Results and Interpretations

Read as per the illustration above.

After reading the results, I will verify and upload the results on the LIS for approval (:

Hopefully, what I describe here would be useful and interesting for you. Please feel free to post your comments, I'll reply them ASAP (:

LESLIE

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