The Royal Hospital

SENIOR STAFF
Dr. Waad-Allah Sharef Mula-Abed  MBChB,  MSc,  FRCPath, Sr. Consultant & Head of Section
Dr. Manal Khalifa Al Kindi  MD, DCH, MAACB, FRCPA, Sr. Consultant
Ms. Fatma Obaid Al Hatmi BSc, MSc, Chief Medical Laboratory Scientific Officer
Ms. Una Gibbons Huibers BSc, Technical Supervisor
Ms. Sawsan Salim Sultan Al Sinani BSc, MSc, Technical Supervisor  
Ms. Ghariba Mahir Mohammed AlKhusaiby BSc, MSc, Technical Supervisor
Ms. Fatma Said Bader Al Esrey DMLS, Ag Technical Supervisor  
Ms. Faiza Said Bader Al Esrey DMLS, Ag Technical Supervisor
Ms. Ghaliya Mohammed Naser Al Kasbi BSc, MSc, Technical Supervisor
In addition, there are 12 Senior MLSOs, and 10 MLSOs working in the department.

FACILITIES

One Automated Processing System (APS) (Abbott)
Three Architect c8000 (Abbott) General chemistry analyzers
Two Architect 2000 (Abbott) analyzer
One TDX ( Abbott ) analyzer
One Cobas e411 (Roche) analyzer  
C13 Urea Breath (GC.MS) analyzer
Easylite Lithium analyzer
Cebia Protein Immunochemistry system
Radiometer Blood Gas analyzers
Radioimmunoassay reader
ELISA reader
In addition, other specific equipment are used for semiautomatic and manual techniques.

 

NATURE OF WORK
This department offers clinical biochemistry tests in different areas. These include the core clinical chemistry service that deals with many organ function profiles such as renal function, liver function, cardiac markers, bone profile, lipid profile, various enzymes and metabolites as well as tests of glycaemic control in diabetic subjects. Other tests include hormones from endocrine glands such as the pituitary, thyroid, parathyroids, adrenals, gonads and pancreas. Facilities for different tumour markers are available such as markers for breast, ovarian, testicular, colorectal, pancreatic, hepatic and prostatic cancers. Specific proteins service is also provided for investigating suspected B.cell neoplasia including those pertaining to immune and complement disorders. Therapeutic drug monitoring is another service that is offered for patients on specific drugs, for which monitoring drug levels is of paramount importance especially for those undergoing organ transplantation, as well as anti-convulsants, antimicrobial drugs and cardio protective drugs. Various other miscellaneous tests are also measured in the laboratory. In total there are nearly 100 different tests available, about 700 specimens are handled daily and the current workload is nearly 1.3 millions tests per year.

The department is broadly divided into the following areas: specimen reception, automated chemistry, immunoassay (endocrine, tumor markers, vitamins, antibodies and therapeutic drug monitoring), protein chemistry (including RIA and ELISA assays), miscellaneous chemistry and referral section.

The specimen reception handles all the biological specimens received by the laboratory. Initial booking, separation and aliquoting are done at this level following which the samples are distributed to the relevant sections. This section also handles the sample preparation for referring biological specimens that are referred abroad for specific tests including metabolic screens and genetic testing.

The automated chemistry section deals with the analysis of general and core chemistry profiles such as renal, liver, bone, lipid as well as cardiac markers. Other tests such as enzymes, metabolites, glycaemic indicators, complements, immunoglobulins and fluid protein are also measured in this section. The major part of work load is fulfilled by this part of the laboratory which is operating 24 hour a day. Most of the tests are performed and released to the requestors within a turn-around-time of less than one hour.

The immunoassay and endocrine section deals with the analytical aspects of hormones as well as tumour markers, vitamins, antibodies and drug levels. Many of the tests available in this section include tests that are offered only at the Royal Hospital, and the section is offering such assays for other regional hospitals in the Sultanate of Oman. Updating the menu of tests in this section is always underway to achieve an up-to-date service for the newly required tests as per the international guidelines, an approach that is achieved following approval from the Directorate General of the hospital.

The protein section handles protein chemistry tests using electrophoresis and immunofixation techniques, particularly for investigating paraproteinaemia in B-cell neoplasm. Additional specific hormones, markers and specific antibodies are also analyzed in this section using RIA and ELISA technology.

The miscellaneous section deals with other tests using different biochemical techniques (eg. sweat chloride and conductivity, porphyrins, stone analysis, thin-layer chromatography, etc). Urea breath test is also performed using Urea Breath analyzer (which is a gas chromatography-mass spectrometry analyzer) for patients with upper gastrointestinal problems.

A senior MLSO is in charge of each section for organization and supervising the work in the area and validation of results. Once validated, the results are released to the clinical areas through the computer terminals in the wards. The computer system is programmed to withhold abnormal results which need the attention of the Chemical Pathologists who will release them to the requestors with commentary, if required.

All assay protocols are controlled with internal quality control samples. The department also participates in internationally well established external quality control schemes.

The department is operational 24 hours a day, 7 days a week. All test requesting and result processing is organized through a laboratory computer system, which is networked to the hospital-wide computer system for ward report.

PROFESSIONAL DEVELOPMENT AND EDUCATION
In line with the department's need to develop promising Omanis for senior posts, regular nomination of the MLSOs and technicians for further studies to obtain the MSc and BSc is followed in the department. The Department actively participates in the Health Sciences Laboratory Technician Training programme. The senior staff are regularly involved in curriculum development, review of trainees and as external examiners.  

Continuous professional development and medical education programmes are run by the department for training and assessing medical and science graduates. Residents of the Omani Medical Speciality Board (OMSB), graduates of Sultan Qaboos University and Institute of Medical Sciences are trained in the laboratory departments of the Royal Hospital. The laboratories have also been approved for training towards the Examinations of the Fellowship of the Royal College of Pathologists (FRCPath), UK. The Royal Hospital is an overseas centre for the Part 1 Examination of the FRCPTH qualification.

Internally, staff are continuously encouraged to participate in CME activities. This includes one lecture on the first Monday every month, as well as contribution in the grand round and combined meetings with the Paediatric Endocrinology Department on Wednesdays.

QUALITY ASSURANCE
All members of staff are involved in QA activities, as providing a quality service is everybody's responsibility and requires a team effort.  Besides internal Quality Assurance programs, the department participates in External Quality Assurance programs run by recognized external Institutions. Also, Chemical Pathology contributes to QA by participating in audit activities which involve reviewing Internal and External Quality Programmes and Standard Operational Procedures.