for
CERTIFICATE
in
Sanothimi, Bhaktapur
First Revision, 2010
(Revision initiative taken by NHPC in collaboration with WHO)
1. Program Description
This course is based on the academic requirements to enter into bachelor level health sciences as well
as able to provide diagnostic laboratory services as a middle level human health resource. After
completion of the course the graduate is expected to perform laboratory procedures as per assigned
by Nepal Health Professional council independently at different level health institutions in Nepal and
abroad. The program is three academic years' duration. The first year course focuses on basic science
and foundational subjects, the second year course focuses on basic laboratory subject theory/practical
simultaneously and the third year is given to the application of learned skills and knowledge within
the comprehensive practical settings, in hospitals and medical laboratory.
2. Program aims and objectives
The course aims to produce middle level medical laboratory technology personnel with sound
academic knowledge equipped with perfect technical skills who can face real life situation at the
level they are aimed at. The course enables students to:
Perform routine and special laboratory investigations on clinical and non-clinical samples
independently.
Interpret the results and explain underlying principles in each investigation.
Prepare reagents required for routine and special investigations.
Set up clinical laboratory in primary health centre and district level.
Practice quality control system in medical laboratory to deliver quality laboratory service.
Perform middle level laboratory management works, supervision of subordinates and preparation
of reports.
Assist in research works.
3. Target group
SLC and T SLC (Lab assistant) pass youths
4. Group size
30 students (Thirty) in a batch/yea (Man be increased to the maximum of 40 forty provided all NHPC
prescribed requirements are fulfilled)
5. Entry criteria
The entry criteria are:
SLC with 45% in aggregate with English, Science and Mathematics as compulsory subjects and
TSLC in Lab Technology with first division
Passed entrance examination administered by CTEVT
Applicant should submit the following documents at the time of application
SLC pass certificate
Character certificate
Citizenship certificate (for the name, parents name, age, date of birth and address verification
purpose only)
Physical fitness certificate (at the time of admission)
Student quota for different category of students as per the policy of CTEVT
6. Medium of instruction
The languages of instruction are:
English
Nepali
7. Course duration
The CMLS program extends to over three academic years. One academic year consists of 39
academic weeks and one academic week consists of 32 to 37 hours.
8. Pattern of attendance
Minimum of 80% attendance is required to appear in final examination.
9. Teacher and student ratio
The teacher student ratio is:
Overall all ratio of teacher and student must be 1:10 (at the institution level)
Teacher and student ratio for practical demonstration 1:10
Teacher and student ratio for bench work 1:5
75% of the teachers must be fulltime.
10. Program coordinator, teacher and demonstrator
The qualifications of the program coordinator, teacher and demonstration are as per minimum
requirements of NHPC.
11. Instructional media and materials
The following instructional media and materials are suggested for the effective instruction and
demonstration.
Printed Media Materials (Assignment sheets, Case studies, Handouts, Information sheets,
Individual training packets, Procedure sheets, Performance Check lists, Textbooks etc.)
Non-projected Media Materials (Display, Models, Flip chart, Poster, Writing board etc.)
Projected Media Materials (Opaque projections, Overhead transparencies, Slides etc.)
Audio-Visual Materials (Audiotapes, Films, Slide-tape programs, Videodiscs, Videotapes etc.)
Computer-Based Instructional Materials (Computer-based training, Interactive video etc.)
1. Professional practice / field visit provision
The details of professional practice and field visit are as follows:
Consists of 6 months duration at the end of the course.
Professional practice (Field practice) should be conducted in hospital Laboratories or research
centres recognised by Ministry of Health or concerned government authority.
Provision of at least one teacher in the institution where field visit is conducted- either from the
concerned institute or the hospital/centre itself.
2. Teaching learning methodology
The methods of teachings in the CHLS (Certificate in Health Laboratory Science) programme will be
a combination of several approaches. Such approaches can be Illustrated Lecture, Group Discussion,
Demonstration, Simulation, Guided practice, Practical experiences, Fieldwork, Laboratory,
Observation, Hospital visit, Term paper presentation, Case analysis, Tutoring, Role playing,
Heuristic and Other Independent learning.
Theory: Lecture, Discussion, Assignment, Group work
Practical: Demonstration, observation and Self practice,
3. Disciplinary and ethical requirements
Intoxication, insubordination or rudeness to peers will result in immediate suspension followed by
review by the disciplinary review committee of the school.
Dishonesty in academic or practice activities will result in immediate suspension followed by
administrative review, with possible expulsion.
Illicit drug use, bearing arms on campus, threats or assaults to peers, faculty or staff will result in
immediate suspension, followed by administrative review with possible expulsion.
15. Methods of evaluation
Internal assessment
o There shall be a transparent evaluation system for each subject both in theory and practical
o Internal assessment every 4 months with feedback to the students
c
o
o
o
Subject
English
Nepali
Social Studies
Anatomy &
Physiology
Physics
Chemistry
Zoology
Botany
Mathematics,
BioStatistics &
Computer
Application
Total
Weekly
Hours
Distribution of Marks
Practical
Time
Final
Internal Final
(Hrs)
80
3
80
3
40
3
64
3
8
12
Theory
Internal
3
3
3
3
3
3
3
5
20
20
10
16
3
3
3
3
3
1
2
2
1
2
4
5
5
4
5
16
16
16
16
16
64
64
64
64
64
27
10
37
146
584
3
3
3
3
3
8
8
8
8
8
12
12
12
12
12
48
72
Time
(Hrs)
3
3
3
3
3
3
Total
Marks
100
100
50
100
100
100
100
100
100
850
Second year
Mode
S.No.
1.
2.
3.
4.
5.
6.
Subject
Microbiology,
Immunology
Haematology
and Blood
Banking
Clinical
Biochemistry
Medical
Parasitology
Basic Pathology
& First Aid
Basic Public
Health
Total
Weekly
Hours
Distribution of Marks
Practical
Time
Final
Internal Final
(Hrs)
80
3
40
60
Theory
Internal
Time
(Hrs)
3
Total
Marks
20
20
80
40
60
200
20
80
40
60
200
32
50
16
64
12
100
16
64
12
100
22
14
36
124
496
152
228
200
850
Third year
Mode
S.No.
1
2
3
Subject
Histotechnology &
Cytology
Instrumentation
and Automation
Field Practice in
Hospital Labs &
Community (Last
SIX months)
Total
Weekly
Hours
Distribution of Marks
Practical
Time
Final (Hrs
Internal
Final
)
Theory
Internal
10
16
32
40
Time
(Hrs)
1.5
20
30
1.5
3
2
16
200
200
1.5
32
400
400
32
Total
Marks
100
50
500
50*
800
*Details on the distribution of marks for field practice evaluation are mentioned in the Field Practice section of the curriculum.
Second Year
1. Microbiology and Immunology
2. Haematology and Blood Banking
3. Clinical Biochemistry
4. Medical Parasitology
5. Basic Pathology & First Aids
6. Basic Public Health
Klebsiella spp.
Pseudomonas spp.
Proteus spp
Clostridia spp
Treponema pallidum
Salmonella typhi, S. paratyphi -A , B
Shigella spp.
Vibrio spp.
Immunology
(27 Hours)
Describe immunity, antigen/ hapten, antibody.
Explain the innate and acquired defence mechanism.
Describe classification of antigen antibody reactions (agglutination, precipitation, CFT, ELISA,
RIA and IFA) including hypersensitivity reactions.
Describe vaccine. List out the common vaccine against vaccine preventable diseases in Nepal.
PRACTICAL
Unit 1 Bacteriology
(40 Hours)
1.
Use microscope and carry out its maintenance.
2.
Clean, decontaminate and sterilize glassware by using autoclave, hot air oven, direct flaming and
chemical disinfectants.
3.
Prepare Gram's stain, Albert's stain and Ziehl Neelson stain.
4.
Prepare various culture media (nutrient broth, nutrient agar, blood agar, chocolate agar,
McConkey agar, thioglycolate broth, buffer glycerol saline).
5.
Prepare basic biochemical media (peptone water, glucose phosphate broth, citrate, TSI and SIM
medium and urea agar).
6.
Prove universal presence of microbes by settle plate method.
7.
Process various clinical samples received in bacteriology lab.
8.
Perform antimicrobial susceptibility testing of isolated organism in pure form (disc diffusion
method).
9.
Perform catalase, coagulase, oxidase, motility and biochemical tests.
10.
Dispose various contaminated materials.
Unit 2
1.
2.
3.
4.
Mycology
(12 Hours)
Prepare KOH solution and SDA medium.
Perform skin/nail,/hair-scraping , KOH preparation and inoculation in SDA.
Perform India ink preparation and identify crytococcus neoformans in CSF.
Perform germ tube test.
Unit 3 Virology
(12 Hours)
1.
Clean and sterilize glassware used in virology laboratory.
2.
Perform Giemsa staining for viral inclusion bodies.
3
3.
4.
5.
Unit 4 Immunology
(14 Hours)
1.
Perform intradermal skin test (Mantoux Test).
2.
Perform VDRL, ASO titre, RA factor, CRP, Widal and Brucella agglutination Test
Textbooks
1. District laboratory Manual for developing Countries (Volume I and II) - Monica Cheesberg
2. Parasitology (Helminthology & Pratozoology) in relation to Clinical Medicine
(Latest
edition)
- K.D. Chatterjee MD
3. Practical Medical Microbiology
- Mackie and McCortney
4. Text Book of Microbiology
-R.Anantnarayan &C.K.J.Panikar
Reference Books
1 Diagnostic Medical Microbiology
2 Medical Microbiology Volume I & II
3 Review of Medical Microbiology
4 Lynch's Medical Laboratory Technology
5 Quality Control in Clinical Laboratory
6 Guide to Medical Laboratory Instruments
7 Clinical Microbiology
8.
9.
PRACTICAL
Unit 1 Haematology and Immunohaematology (78 Hours)
1.
Handle and care of various haematological equipments; (instrument), apparatus and glassware
(new and old) and its.
2.
Handle microscope and clean various glassware (new and old), laboratory room, floor, working
bench, table, sterilization of various instrument, glassware, syringes and needles
3.
Collect blood sample for various haematological test:
a. Skin method; Capillary puncture; (fingertip, ear lobe, toe and heel)
b. Vein puncture as many times as possible.
4.
Prepare various anticoagulant tubes and vials.
a. EDTA
b. Oxalate
c. Citrate
d. Heparin
5.
Prepare chemicals, reagents and solution, and stain
a. Preparation of stains- Wright's stain, Giemsa stain, Leishmania stain
b. Cytochemical and bone marrow stain.
c. Preparation of diluting fluid (Turks fluid) for WBC, RBC.
d. Preparation of diluting fluid for platelet count
e. Supra-vital stain.
6.
Prepare smear stain by various method
a. Thin blood smears
b. Thick blood smear and dehaemoglobinization
c. Staining by Wright stain Giemsa stain, Leishman stain
7.
Identify normal and abnormal erythrocyte, platelet and leucocytes: (neutrophils, lymphocytes,
monocytes, eosiniphils and basophils) and comment them.
8.
Perform differential leucocytes on a blood smear.
9.
Prepare blood-diluting fluids.
10.
Count total cells
a. Total WBC count
b. Total RBC count
c. Total platelet count
11.
Estimate haemoglobin by various method
a. Shalis method
b. Cyanmethaemoglobin method
c. Microcell couner
12.
Perform ESR test:
a. Wintrobe method
b. Westergren method
13.
Prepare Supravital stain and perform reticulocyte count.
14.
Perform bleeding time and whole blood coagulation time by various method.
15.
Perform prothrombin time test
16.
Prepare bone marrow smears, staining and microscopic examination.
17.
Find out blood indices values.
18.
Identify the parasites.
a) Malaria
b) Microfilaria
19.
Perform aldehyde test.
20.
Perform complete blood counts (Hb, WBC, RBC, Platelet, DLC, ESR)
21.
Perform haematocrit (PCV) estimation:
a. Wintrobe
b. Microhaematocrit method.
22.
Perform blood grouping and Rh typing
23.
Perform cross matching.
7
24.
25.
26.
27.
28.
Recommended books
1.
Practical haematology
2.
Practical Heamatology
8
Manual for Medical Laboratory Technology, Volume I & II
9
A hand book of Medical Laboratory Technology
10
Medical laboratory Manual for Tropical Volume I
11
Medical Laboratory Technology , Volume I, II, III
12
Manual of basic techniques for a health laboratory
13
Text Book of Medical Laboratory Technology
14
Organisation of a Blood Transfusion service
15
Viva in voce in Pathology, Bacteriology and Haematology
16
Laboratory Practical Haematology
J V Dacie
-Wintrobe
- Monica Cheeselburgh
- Christian Medical College, Vellore
- British Government
- Kanai L Mukherjee
- WHO Academic Publishers Calcutta
- M. Nakanishi et.al.
- W.N. Gibbs & AFH. Britton
- Dr. K.N. Schev
-K. Parajuli
4.
5.
6.
7.
8.
PRACTICAL
Biochemistry
(78 Hours)
1.
Prepare solutions of different concentrations (Normal, Molar and Percentage).
2.
Perform titration of acid & bases.
3.
Estimate organic constitutions of blood, urine & CSF including sugar, urea, creatinine, billirubin,
albumin, total proteins, uric acid, Cholestorel,Triglecesides, HDL,LDL
4.
Estimate enzymes: amylase, GPT, GOT, acid & alkaline phosphatases.
5.
Estimate inorganic constituents of serum, urine & other body fluids: sodium, potassium, calcium,
phosphorus and chloride.
6.
Prepare the calibration of standard graph for various tests.
Textbooks
1.
Biochemistry
2.
Fundamental Biochemistry
3.
Varley's Practical Clinical Biochemistry
- U. Satyanarayan
- A.C. Deb
- Goweklook
Reference books
1.
Quality Control in Clinical Laboratory
- David Tonks
2.
An Introduction to Medical Laboratory Technology
- F J Baker, R E Silverton
3.
An Introduction to Medical Technology
- F J Baker
4.
A biologists guide to principals and techniques of practical biochemistry - Bryn & Keith
5.
Harpers Biochemistry
-Harper
6.
A Text book of Clinical Chemistry
- Teitz
1.
2.
3.
4.
Fasciola hepatica,
Faciolopsis buski
Paragonimus westermani
Schistosoma haematobium, S. mansoni, and S. japanicum
11
Recommended Books
1.
Medical Parasitology
- K.D. Chatterjee MD
2.
Medical Parasitology
- N.C. Dey and T. K. Dey
3.
Illustrated Medical Microbiology
- Satish Gupte
4.
Medical Bacteriology Medical Mycology and AIDS
- Prof. N C Dey & T K Dey
5.
Viva voce in Pathology, Bacteriology and Haematology - Dr. K.N. Schadev
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- lzj s'df/ /fO{
Introduction
Types and its causes
Common terminology used in cell injury
Clinical diagnosis and laboratory interpretation
Screening laboratory investigation.
Unit 3
1.
2.
3.
Unit 4 Neoplasia
1.
2.
3.
4.
5.
6.
7.
8.
Introduction
Benign and malignant tumours
Terminology used in Malignant clinical interpretation
(carcinoma, sarcoma, lymphoma, dysgerminoma, etc)
Laboratory investigation and interpretation
Application of Immunological investigations
Essential Histo and cytochemical investigations
Introduction of tumour marker.
9.
10.
11.
12.
13.
14.
(10 Hours)
14
Unit 2
a)
b)
c)
d)
e)
f)
g)
Basic Epidemiology
(10 Hours)
Introduction
Epidemiologic triad
Epidemiologic measurements
Epidemiologic measurements
Disease transmission, prevention and control
Immunization
Screening
Unit 3
a)
b)
c)
d)
e)
f)
Unit 4
a)
b)
c)
d)
Unit 5
a)
b)
c)
d)
e)
Unit 6
a)
b)
c)
d)
e)
f)
Unit 7
1.
2.
3.
4.
5.
6.
7.
Unit 8
1.
2.
3.
4.
5.
6.
7.
8.
15
(8 Hours)
(5 Hours)
(5 Hours)
Unit 10
a)
b)
c)
Health Research
(2Hrs)
Introduction
Types of research
Methods of research
PRACTICAL
Basic Hygiene and Sanitation (15 Hours)
a) Analyse the existing drinking water source, waste disposal system, food preparation, preservation
technique and measures to control rodent and insects.
b) Identify the needs of the community regarding personal hygiene and environmental sanitation.
c) Educate the community for safe hygienic practices and maintenance of sanitary latrine.
d) Cooperate with other team members in sanitary activities in the community.
Health education needs, methods and media (15 Hours)
d) Conduct educational diagnosis survey to identify the health education need of a selected
community.
e) Prepare a modular health education plan for deliberation of health education in selected
community or health post.
f) Use following health education method effectively
Communication exercise, Group discussion, Role play, Counselling, Lecture, Demonstration
and Exhibition
g) Collect health education materials from different organisation.
h) Prepare simple media for health education like
Poster, Flannel graph, Models, Charts and graphs, Puppets and Pamphlets
Health care system (5 Hours)
a) Observation of health care delivery system in Nepal at different level health institutions.
Textbooks
1.
- K Park
Reference books:
1. Basic Principles of Management - Shrestha, B.M.. Akshyulak Publication, Nepal. 2039B.S.
2. Inventory Control and Basic Logistics Procedure Manual on Store Management for PHC/HP and
SHP Personnel. HMG/JSI. 2054B.S.
3. Textbook of Preventive and Social Medicine - Park, K. B. Bhanot, Jabalpur, India. 2000.
4. Health Logistics Procedure Manual. - NHTC/LMD/USAID JSI, Nepal 2057.
5. Health Statistics and EPI Cold Chain Management Procedure Manual. -NHTC/LMD/USAID JSI,
Nepal 2057.
16
6.
7.
8.
9.
10.
17
Third Year
1.
2.
3.
18
6.
7.
8.
9.
10.
11.
12.
13.
14.
Prepare reagents & stains used for Hematoxylin & Eosin stain, PAS stain, Alcian Blue stain and
Ziehl-Neelsen stain.
Prepare reagents & stains used for Giemsa and Papanicolaou stains.
Stain sections by H/E stain, PAS stain, Alcian Blue stain and Ziehl-Neelsen stain.
Prepare cytological fixatives and fixation of cells.
Prepare cytological smears and stain with pap method.
Stain FNAC smears by Giemsa and Papanicolaou methods.
Mount stained smears/section.
Perform semen analysis.
Perform Aceto-Orcein staining for Barr body.
Recommended Books
1. Theory and Practice of Histological Techniques. 5th Edition. - John D. Bancroft, Alans Stevens
and David R. Turner
2. Diagnostic Cytology and its histologic bases- L.G. Koss, Fourth Edition.
3. Gradwohls clinical Laboratory methods and diagnosis. Edited by Alex C. Sonnenwirth and
Leonard Jenett.
4. Quarterly, annual and special Publications of the International Union for Health Education and
Health Promotion and Victoria Health Foundation
5. Cytology Technical Manual- Cytology Research Center ICMR (India)
6. The "Pap Smear" M.E. Boon
7. Practical Cytology Ron Bowdich
8. Comprehensive Cytopathology Marluce Bibbo, Second Edition.
20
Program: CMLT
Instrumentation and Automation
Hour
per
week:
Total hours:
Full marks: 50
Subject:
Course Description
This course is designed to provide basic knowledge and skills on instrumentation and automation in
clinical pathology laboratory. This course is designed to develop basic but comprehensive knowledge of
commonly used instruments in laboratory, their uses, principles, procedures, maintenance and
precautions during analysis of various tests.
Course Objectives
After the completion of this course, the students will be able to:
1. Explain the need of instrumentation and automation for the diagnosis of different diseases.
2. Classify the medically important instruments for the diagnosis of specific diseases.
3. Describe the care, handling and maintenance of instruments.
4. Define the load of samples and need for automation.
Course content
THEORY
Unit 1
21
Duration
1.
1 months
2.
1.5 months
3.
Biochemistry lab
1 months
4.
Microbiology lab
1.5 months
5.
Parasitology
1 months
Paper
I
II
Students should be present in the departments at least 90% of the allotted days to be eligible to sit in the
final examination. Students will have to perform all tests under the supervision of departmental staffs and
may be allowed to perform tests independently if the supervisor finds them perfect.
Students should keep their practical record (logbook) signed periodically by their supervisor/instructor at
the end of the posting in each subject.
Evaluation Scheme
Under this scheme students will have to perform a prescribed number of tests in each department. At the
end of the term the teacher or supervisor closely evaluates their performance for accuracy and precision
according to the evaluation sheet proposed. At the end of the course there will be a final practical and
oral examination.
Distribution of marks for evaluation
No
Evaluator/Paper
Distribution of marks
Internal
Final
Time
Total Marks
200
100
100
200
100
100
200
200
3 hrs
3 hrs
400
22
Important note: Each student must pass in each of the section of the evaluation as presented above
with a minimum of 60% marks. This means they must secure 120 each in section 1 and 2 and 240 marks
in section 3.
23
24