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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