Pachyonychia congenita with unusual features

Pachyonychia congenita is a rare hereditary disorder characterized by gross thickening of all finger and toenails. We report an infant who had clinical features consistent with pachyonychia congenita type II, with unusual features of microcephaly, seizures, electroencephalogram abnormalities, failure to thrive, and heterochromia iridis.

3-Acetyl-4-hydroxyphenyl acrylate

In the title compound, C₁₂H₁₂O₄, the hydr­oxy O and the C and O atoms of the acetyl group are almost coplanar [maximum deviation = 0.0356 (1) Å] with the benzene ring. The dihedral angle between the benzene ring and the plane through the non-H atoms of the methacrylo­yloxy group is 86.1 (1)°. In the crystal structure, mol­ecules are linked by two C—H⋯O hydrogen bonds, forming dimers with graph-set descriptor R₂²(16). A strong intra­molecular O—H⋯O hydrogen bond is also observed.

Interesting clinical presentation of anterior knee pain causing diagnostic dilemma

A diverse variety of lesions may occasionally occur in the patella. In this case report, we are presenting an interesting case of anterior knee pain in middle aged gentleman. Initial investigations including Magnetic Resonance Imaging not showed any abnormality. Due to prolonged continued pain he had bone scan and MRI, which confirmed the diagnosis of Brodie's abscess. We are presenting this case of Brodie's abscess of the patella causing diagnostic dilemma because of its rarity.

Recurrent Kawasaki disease

We describe an infant who had recurrence of Kawasaki disease and responded to therapy with Intravenous Immune globulin (IVIG) and highlight the need for recognition of this vasculitis, which is being increasingly recognised in the Indian subcontinent.

Comparison of oxygen saturation levels by pulse oximetry in healthy children aged 1 month to 5 years residing at an altitude of 1500 metres and at sea level

OBJECTIVE

To compare oxygen saturation levels (SaO(2)) by pulse oximetry among healthy Indian children aged from 1 month to 5 years age residing at two different altitudes, Chennai and the Shervaroy hills.

DESIGN

Prospective observational study with a control group at sea level. SETTING 1: Chennai city which is at sea level (data published previously). SETTING 2: The Shervaroy hills (Yercaud, Salem district, Tamil Nadu) about 1500 metres above sea level (this study).

SUBJECTS

328 healthy children aged 1 month to 5 years living in the Shervaroy hills.

OUTCOME MEASURES

After assessment of anthropometry and heart and respiratory rates, oxygen saturation was recorded by pulse oximetry.

RESULTS

The mean SaO(2) values of children in the Shervaroy hills in the age groups 1 month to 3 years and 3-5 years were 97% and 98%, respectively. The mean -2 SD O(2) saturation values for the 1 month to 5 years age group was 93%. The overall mean and median values of oxygen saturation were 97% in the Shervaroy hills vs 99% for children in Chennai city (p<0.01). When compared with their counterparts in Chennai, the Shervaroy hills subjects had significantly lower mean weight and height and higher heart and respiratory rates (p<0.01).

CONCLUSION

The reference value for mean SaO(2) in healthy children aged 1 month to 5 years in the Shervaroy hills (1500 m) was 97%, with the (-2 SD) values having a mean of 93% which is significantly lower than those living in Chennai (sea level), 99% of whom had a -2 SD mean of 96.6%.

Qualitative and Textural Changes in Fresh Okra Pods (Hibiscus esculentus L.) under Modified Atmosphere Packaging in Perforated Film Packages

Improper post-harvest handling and storage under room temperature lead to high loss of moisture resulting in loss of strength and development of flaccidity in okra tissues, apart from the loss of its characteristic green color. In this study, different weights of freshly harvested okra pods (Hibiscus esculentus L.) were stored at 15°C and 75% relative humidity packaged under modified atmosphere (MAP) in 35 μm thick polypropylene film packages to assess the effect of different in-pack gaseous compositions of O2 and CO2 on the properties of okra. During storage, the normal freshness indicators of okra namely, the bright green color and ease of snapping at the tip served as the prominent qualitative and textural parameters, indicative of the acceptability of okra. Results indicated that an in-pack gaseous range for O2 (6.3-8.4%) and CO2 (10.7-11.8%) under MAP resulted in maintenance of green color and β-carotene in the pericarp, and ascorbic acid in the seeds as well as other qualitative parameters. Further, the texture analysis of okra at the pre-determined snapping point at the tip and also along the longitudinal portion showed that MAP stored okra were snapping easily at the tips and had a very slight increase in the other mechanical properties which were considered to be within acceptable limits.

Systemic capillary leak syndrome resulting in compartment syndrome and the requirement for a surgical airway

We report on a case of systemic capillary leak syndrome associated with a monoclonal band on plasma electrophoresis. In our patient hospital admission was precipitated by ischaemic pain in the left lower limb, associated with polycythaemia, renal failure and hypovolaemic shock. Fluid resuscitation, venesection and renal replacement therapy were instituted but a compartment syndrome developed necessitating surgery. Failure of tracheal intubation resulted in the requirement for a surgical airway. Despite surgical and resuscitative efforts the outcome was fatal from hypovolaemia and hyperkalaemia. We aim to highlight the difficulties in managing this condition and to remind healthcare workers to include it in the differential diagnoses for patients presenting with polycythaemia; in particular polycythaemic patients with a monoclonal band on plasma electrophoresis.

Aqueous solution of [bmim][PF6]: ion and solvent effects on structure and dynamics

A dilute aqueous solution of the salt 1-n-butyl,3-methylimidazolium hexafluorophosphate ([bmim][PF(6)]) has been studied using molecular dynamics simulations to investigate the effect of ions on water and vice versa. The anion is found to diffuse faster than the cation in the solution, in contrast to observations in the pure ionic liquid. Distributions of pair energies have been employed to identify ion association, and around 13% of the ions were found to exist as pairs. The mean potential energy of water molecules present in the coordination shell of an anion is less than that of water molecules coordinated to a cation. The former kind also exhibit two distinct orientational preferences with respect to the anion. The larger diffusion coefficient of the anion is related to the faster dynamics of water molecules in its hydration layer, as evidenced from the relaxation of their residence time correlation function.

Intermolecular correlations in an ionic liquid under shear

The behavior of a model room temperature ionic liquid under shear is explored using non-equilibrium molecular dynamics simulations. The external field reduces intermolecular structure in the liquid. However, orientational ordering of the molecules in the form of a nematic phase is observed under shear.

2,3,4,9-Tetra-hydro-1H-carbazole

In the title compound, C(12)H(13)N, two methyl-ene C atoms of the cyclo-hexene ring are disordered over two sites with occupancies of 0.591 (10) and 0.409 (10); both disorder components adopt half-chair conformations. The crystal structure is stabilized by inter-molecular N-H⋯π and C-H⋯π inter-actions.

3-Acetyl-4-hydroxyphenyl acrylate. Corrigendum

Corrigendum to Acta Cryst. (2007), E63, o4725.

The chemical name in the title of the paper by Chakkara­varthi, Anthonysamy, Balasubramanian & Manivannan [Acta Cryst. (2007), E63, o4725] is corrected.

Tuberculous gluteal abscess in infancy

Primary tuberculous gluteal abscess without bone involvement has not been reported in infancy. We report 3 infants with isolated tuberculous gluteal abscess who presented with gluteal swelling of 2 weeks, 1 month and 6 months duration, respectively. Tuberculin test was positive in all cases. Pus cultures from the gluteal abscess grew Mycobacterium tuberculosis in all 3 infants.

Tuberculosis associated hemophagocytic syndrome in infancy

An infant presented with prolonged fever, generalized lymphadenopathy, splenohepatomegaly, anemia and seborrheic dermatitis. Investigations including bone marrow findings confirmed the diagnosis of hemo-phagocytic syndrome (HPS) and the infant succumbed. Liver biopsy features of epithelioid granuloma and positive AFB culture of gastric aspirate confirmed the diagnosis of tuberculosis (TB). This rare association of HPS and tuberculosis in infancy is reported.

Synthesis and NMR spectral studies of some 2,6-diarylpiperidin-4-one O-benzyloximes

Variously substituted 2,6-diarylpiperidin-4-one O-benzyloximes were synthesized by the direct condensation of the corresponding 2,6-diarylpiperidin-4-ones with O-benzylhydroxylamine hydrochloride. All the synthesized compounds are characterized by IR, Mass and NMR spectral studies. NMR spectral assignments are made unambiguously by their one-dimensional (1H NMR and 13C NMR) and two-dimensional (1H-1H COSY, NOESY, HSQC and HMBC) NMR spectra. All the synthesized compounds are resulted as single isomer, i.e., exclusively E isomer (9-14). The conformational preference of 2,6-diarylpiperidin-4-one oxime ethers with and without alkyl substituents at C-3 and C-5 has also been discussed using the spectral studies. The observed chemical shifts and coupling constants suggest that compounds 8-13 adopt normal chair conformation with equatorial orientation of all the substituents while compound 14 contributes significant boat conformation along with the predominant chair conformation in solution. The effect of oximination on ring carbons, their associated protons, alkyl substituents and ipso carbons are studied. Every proton in the piperidone ring of the oxime ether is observed as distinct signal due to oximination. The order of chemical shift magnitude in compound 8 is H-2a>H-6a>H-5e>H-3e>H-3a>H-5a. For 9-12, the order is H-6a>H-5e>H-2a>H-3a>H-5a, for 13, H-6a>H-2a>H-5e>H-3a>H-5a and for 14, the order is H-2a>H-6a>H-5e>H-3a>H-5a while the 13C chemical shift magnitude for 8-14 due to oximination is C-2>C-6>C-3>C-5.