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Laboratory Medicine & Pathology

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Pathology

Working through the hours to deliver the best laboratory service and pathology diagnostic tests performed by highly specialized consultants and scientists.

Our pathology laboratories provide all the required tests to assist the patient’s diagnosis from haematology and blood transfusion services, chemical pathology to microbiology and histopathology.

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They perform highly sophisticated tests in all specialties using different techniques, for the diagnosis, screening and monitoring of diseases. More than 6 million samples are processed per year. The laboratories are accredited by Accreditation Canada International and are ISO 15189 accredited since 2016.

Scope of Services

Haematology and blood transfusion services

The department provides a clinical and diagnostic haematology, transfusion, homeostasis and thrombosis service, processing around 700000 samples per year and more than one million tests.

It is considered as one of the education centers in Oman, it holds partnership with OMSB, SQU and other Institutions of health sciences which aim to provide educational support to the newly graduate Scientists and pathologists.

The department divided into six subsections:

  • Haematology main lab: fully automated and equipped with latest model of cell counters along with automated morphological system. The lab provides service of ESR, G6PD, Malaria and blood bone marrow.
  • Haemoglobinopthies: this lab investigates genetic blood disorders by high performance liquid chromatography technique and work with genetic center to perform any further genetic tests.
  • Flow cytometry: Leukaemia and lymphoma investigations are done using this technique for both adults and pediatrics along with other immunology investigation such as PNH, DHR, and platelet disorders.
  • Coagulation: provides complete cascade of investigations of platelet and coagulopathy disorders.
  • Stem cell unit: autologous stem cell transplant provided lymphoma and myeloma patients.
  • Transfusion services: serves Oncology center, national heart center, emergency department, renal unit, Obstetric and gynecology department and all type of surgeries done in Royal Hospital. It process more than 65000 samples and issues at least 30000 blood component per year. Blood transfusion services in Royal hospital perform all type of antibody investigations that includes different type of panels using capture and column technique. Auto and allo-adsorption studies help in finding suitable blood for patients with multiple antibodies, exchange transfusion and complicated blood groups. It provides services for Intrauterine transfusions for fetus. One of the outreach activities of the department is to arrange donation campaigns in the hospital for the staff and visitors.

Chemical Pathology

The department is on fully automated tracked system. it offers wide ranges of clinical biochemistry tests in different areas and processing around two million tests per year.

These include routine clinical chemistry service that deals with many organ function profiles such as renal function, liver function, cardiac markers, bone profile, lipid profile and various enzymes and metabolites as well as tests of glycaemic control in diabetic subjects. Other tests include hormones for assessment and function of endocrine glands such as those of the pituitary, thyroid, parathyroid, adrenal, gonads and pancreas. Facilities for different tumor markers are also available such as markers for breast, ovarian, testicular, colorectal, pancreatic, hepatic and prostate cancers. Specific protein service is also provided for patients with different involvement of protein functions including those of the immune and complement systems, as well as those for diagnosis of some haematological malignancy such as myeloma.

Therapeutic drug monitoring is another service that is offered for patients using specific drugs for which monitoring drug levels is of paramount importance in particular those undergoing organ transplantation. In addition, tests that are not available at the Royal Hospital are sent abroad. These tests include Onco-haematology, Genetics, Metabolic, Allergy testing, ….etc. We are also in partnership with local institutions performing some specialized tests such as SQUH, Public Health and Toxicology laboratory. Approximately 2000 samples are sent per year to other institutes and abroad.

Microbiology

This department is divided into two sections, namely Microbiology and Serology/Immunology section. The Microbiology lab does cultures and antibiotic sensitivity from various sites like Blood, Wounds, Sputum, Urine and Stools, as well as epidemiology of infectious diseases. In serology section the blood samples are tested for specific antigens and antibodies against various bacteria and viruses like Hepatitis, HIV, TORCH, Syphilis, Brucella, Rheumatoid Factor, EBV and COVID-19.

In Immunology tests done are Autoimmune tests like ANA, DNA, ANCA, ENA, ACCP and other Immunofluorescent tests. Specialized tests done in Microbiology are MRSA PCR, TB PCR, Identification of Candida auris using ChromAgar and automated identification of bacteria using the Maldi TOF. Specialized tests done in serology are ANA, AAB ACCP and EBV

The number of Samples processed during 2019 was 137,966 tests from Microbiology section and 39,380 tests for serology section.

The department is partnered with CPHL and SQUH laboratories. CPHL performs the Viral Loads for Hepatites, HIV and PCR for EBV, CMV and CSF, Dengue fever and Haemorrhagic fever. SQUH does the Immunodificiency antibody titre, Galactocmann test and Adenovirus.

New tests and technology introduced are COVID PCR, Maldi TOF, Alinity, Euroimmune immunofluorescence and ELISA automation.

The department does internal studies like validation of CIM test and Resist test of CRE samples against the GeneXpert. VRE typing of ICU COVID patients. Studies in collaboration with CPHL, like gene sequencing of ICU COVID patients, which is still ongoing. The department also trains OSMB doctors and trainee technicians from various institutions.

The department also works closely with the Infection Control team in screening the outbreaks in the hospital. It provides consultations to the clinicians on the investigation and antimicrobial management of infections and monitors the antibiotic usage in the hospital.

Histopathology

The laboratory is divided into two sections, namely Histopathology and Cytology. The Histopathology laboratory deals with tissue samples or biopsies per year. These tissues are processed in the laboratory and then reviewed by Specialist doctors, who make a diagnose. Many times, additional tests are done on the tissue sections to enable proper, clinically relevant diagnosis. These additional tests are done by two sections- Special Stains, Immuno-fluorescence and Immunohistochemistry.

In Cytology, samples of various fluids fine needle aspirations or cervical smears are screened for disease or malignancy. Very often, the cytology diagnosis is complemented with a biopsy later for diagnosis. The department has advanced technology and automation in areas such as immunohistochemistry and cytology (liquid-based cytology).

The department yearly covers up around 16700 histopathology and 8345 cytopathology samples. The department works as main center for second opinion cases across the country for cases such as lymphoma and for liver diseases. The main core testing at Histopathology is IHC (immune histo chemistry) where yearly 10,000- 15,000 different cancer markers are utilized in diagnosis and further more sent abroad to U.K for molecular testing. The department works with turnaround time policies matching with international standards and adopted from The Royal College of the pathologist.

The department has tie up’s with different sub specialties across the globe such as:

  • 1- DR. Fletccher –Brigham Hospital – USA
  • 2- Dr. Raja – C.S Mott and von Voigtlander women’s Hospital – USA
  • 3- DR . Eduardo Calonje – St. Thomas Hospital – U.K
  • 4- Prof. Glenn Mac Cluggage – The Royal Victoria Hospital
  • 5- Cerba laboratories – France

The department emphasis on health and safety of workers and environment equally and supporting that we were the first in diagnostic laboratories to initiate in the year 2018, recycling of hazardous chemicals and today in 2021 we are recycling 100% of our most hazardous and carcinogenic chemicals.

Our both departments Histopathology and Cytopathology since 2016-2021 have been matching the levels of our external quality schemes which are from UK-NEQAS where our techniques have been awarded as the best techniques and been published on UK-NEQAS website as reference.

The department had expended its services where we introduced renal, skin and muscle biopsies for immunohistochemistry and immune fluorescent studies. These service as well serves to all our medical faculties and hospitals.

The department is highly active in researches and publications where yearly the department publishes 7-11 articles in different pathology platforms and journals. These publications are results of dedicated and highly experienced pathology team members.

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