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18 Med. Sci. & L. 1 (1978)

handle is hein.journals/mdsclw18 and id is 1 raw text is: Printed in Great Britain Editorial 1 Editorial The guest editorial in this issue has been contributed by Professor G. C. Jenkins PhD, MB, FRCPath. (haenatologist). During the last two decades increasing nUtribers of immigrants have reached the United Kingdom from the Commonwealth Countries. This turn of events has inevitably resulted in the importation of a number of haernatological conditions both inherited and acquired, each of which may have medico- legal consequences or significance. The unwary practitioner may not be prepared for the sudden jet-transfer of a Patient from a tropical climate with cerebral thalaria. His only knowledge of' such an acute illness may have been acquired from the now dusty recesses of a long-forgotten text-book. Nevertheless, the loss of such a patient under his care could result, among Other things, in a charge of' legal negli- geIce, and on just such a charge a family practitioner was recently found guilty. Only by regular review and re-education can such an outcome be avoided. The field of blood identification has been extended and become more wide ranging With the help of a whole range of inherited features found in different parts of the red cells produced by people from overseas. The obvious advantages of these additional identi- fying markers are realized in disputed Paternity cases and in the investigation of blod stains. The frequency of red cell blood group antigens vary in different races in man. Techniques of' typing blood stains have now become very sophisticated and, though delicate, a high degree of' accuracy and reliability has been achieved. Abnormal haernoglobins fall basically into two main groups. These are structural abnormality of the polypeptide chains constituting the globin, or quantitative deletion of polypeptide chains which pro- duces thalassaemia. Common examples of the qualitative abnormality are sickle haemo- globin in the Central African and New World Negro, haemoglobin C in the West African and New World Negro, haemoglobin D from North-West India and haemnoglobin E from South East Asia. They are inherited as mendelian co-dominant characters and the presence in a baby of an abnormal haemo- globin component, the mother of whom is normal, must indicate that the true father is a carrier of the gene. It follows also that careful analysis of blood stains at the scene of crimes of violence may be helpful in identifying the assailant or distinguishing the blood of the victim. Red cell enzyme deficiencies occur particu- larly in Mediterranean races and Negro populations. They tend to be more vulnerable to the adverse effects of certain drugs with possible medicolegal consequences. However, of more importance is that a whole range of known enzymes can now be detected in the identification of blood stains and typed according to their differential mobility on electrophoresis. Some genetically determined abnormalities may well affect the outcome of' surgical or traumatic challenge. This applies particu- larly to haemoglobin S disease either in the homozygous state or when it is linked with haemoglobin C (SC disease) or thalassaenia (sickle thalassaemia). Any situation of markedly reduced oxygen tension may precipitate a sickle crisis in such conditions.

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