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Hemoglobin S.

   There was this black American,
   Who generally felt unwell.
   He felt tired, weak and listless,
   And sometimes had dizzy spells.

   He felt shortness of breath on slight exertion,
   Usually accompanied by palpitations.
   In sports, games and physical activities,
   He had neither the ability nor the inclination.

   He once came down with a fever,
   Accompanied by a nagging cough.
   He was examined by Dr. Herrick,
   Who realized that this case was tough.

   The doctor was very meticulous,
   He did a thorough physical examination.
   In order to help him with the diagnosis
   He sent samples of blood for investigations.

   He found the heart distinctly abnormal;
   It was larger than it should have been.
   The heart sounds revealed a murmur;
   A yellow color in the sclera was seen.

   The lab report showed evidence of anemia;
   The hemoglobin was just eight grams percent.
   The serum showed a yellowish discoloration;
   Neither tubercle bacilli nor parasites were present.

   The doctor was however fascinated
   By the strange appearance of the RBC.
   The peripheral smear showed sickle-shaped cells,
   Instead of the biconcave ones we generally see.

   With the advances made in diagnostic procedures
   The molecular basis of this disease is now known.
   It arises due to a fault at the genetic level,
   The defect in the primary structure has been shown.

   The restriction endonuclease known as Mst II
   Cleaves the normal beta-globin gene into fragments two.
   If there is a T-for-A mutation, this site is not recognized;
   The lack of fragmentation provides the vital clue.

   The hydrophobic valine replaces glutamic acid,
   In the sixth position of the beta chain;
   The hemoglobin becomes abnormal,
   Its normal quaternary structure it cannot sustain.

   The globin chains acquire a sticky nature,
   Especially when oxygen tensions are low;
   They polymerize to form tactoids;
   The erythrocytes get bent almost like a bow.

   The prevalence of this disease in Africa,
   And amongst the black population was noted.
   And that this condition protected them against malaria,
   Caused by the dreaded plasmodium falciparum it was reported.

   It has now been proved that the malarial parasite
   Cannot grow inside the sickled erythrocyte.
   This is therefore the result of evolution,
   Nature trying to set the balance right.

DOI: 10.1373/clinchem.2014.232868

Author Contributions: All authors confirmed they have contributed to the intellectual content of this paper and have met the following3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval of the published article.

Authors' Disclosures or Potential Conflicts of Interest: No authors declared any potential conflicts of interest.

Usha Anand *

Anand Diagnostic Laboratory, Shivaji Nagar Bangalore, Ka, India.

* Address correspondence to this author at: Anand Diagnostic Laboratory, Anand Diagnostic Centre Blue Cross Chambers, Infantry Cross Road, Shivaji Nagar Bangalore, Ka, India 560001. Fax 80-25318550; e-mail

Received September 4,2014; accepted September 16,2014.

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Title Annotation:Unveiling the Right Side
Author:Anand, Usha
Publication:Clinical Chemistry
Article Type:Poem
Date:Apr 1, 2015
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