Enhancing cycle life and usable energy density of fast charging LiFePO4-graphite cell by regulating electrodes' lithium level.

Range anxiety is a primary concern among present-day electric vehicle (EV) owners, which could be curtailed by maximizing the driving range per charge or reducing the charging time of the lithium-ion battery (LIB) pack. Maximizing the driving range is a multifaceted task as charging-discharging the LIB up to 100% of its nominal capacity is limited by the cell chemistry (voltage window) and cell operating conditions. Our studies on commercial LiFePO4/graphite cells show that a cycle life of 4320 is achieved at 4C rate with 80% SOC-100% DOD combination (12 min charging time), which is the highest among the works reported with this cell chemistry. Complete utilization of electrodes' lithium during cycling resulted in the lowest cycle life of 956. This study demonstrates LIB charging-discharging protocol enabling longer driving range with quicker charging times. Besides, it might endow promising possibilities of future EV LIB packs with reduced size/weight and high safety.

Streptococcus dysgalactiae Subspecies dysgalactiae Infection Presenting With Septic Shock.

Streptococcus dysgalactiae has two main subspecies: Streptococcus dysgalactiae subspecies dysgalactiae (SDSD) and Streptococcus dysgalactiae subspecies equisimilis (SDSE). Although there are various case reports of SDSE causing clinical infection in humans, very few reports of SDSD causing human infections have been reported in the literature. As of date, there are only five case reports of infection with SDSD and all five patients survived the infection. We report a case of a 40-year-old male who presented with features of right upper limb cellulitis and went into septic shock. This report is unique as it presents the first report of SDSD causing fulminant sepsis in humans. Elevation of total fraction of creatinine kinase was also seen in our patient which could be due to myositis or rhabdomyolysis.

The First Case Series Report of Typhonium trilobatum Tuber Poisoning in Humans.

Typhonium is a genus belonging to the Araceae family, native to southern Asia and Australia. In folk medicine, Typhonium is used for its analgesic, anti-inflammatory, antidiarrheal, and wound-healing properties. We report a toxidrome of airway compromise due to Typhonium trilobatum tuber ingestion. We present an interesting case series of four patients who consumed raw tuber of T. trilobatum with suicidal thoughts. They exhibited a constellation of symptoms such as swelling of lips and tongue, drooling of saliva, and severe throat pain. One patient had significant upper airway edema and severe respiratory distress requiring emergency endotracheal intubation. Laboratory investigations were grossly normal in all four individuals, expect for mild asymptomatic hypokalemia in one and eosinophilia in another patient. We successfully managed all our patients with repeated adrenaline nebulization, antihistamines, and steroids. Typhonium is believed to be a beneficial herb. Toxicity of Typhonium is not reported much in the literature till date. An emergency department (ED) physician should be aware of this tuber toxicity as it presents with airway compromise, which resolves over hours. The symptoms are due to the local effects of calcium oxalate crystals in the tuber. Airway management is the priority and repeated adrenaline nebulization together with supportive care is advised. HOW TO CITE THIS ARTICLE: Anandhi D, Prakash Raju KNJ, Vivekanandan MP, Kumaresan V. The First Case Series Report of Typhonium trilobatum Tuber Poisoning in Humans. Indian J Crit Care Med 2020;24(7):581-584.

Profile of Pediatric Trauma among the Patients Attending Emergency Department in a Tertiary Care Hospital in South India.

BACKGROUND: Pediatric trauma is emerging as an epidemic worldwide; the epidemiology of pediatric trauma is different in different parts of the world. There are very few studies describing the pediatric trauma in developing countries. OBJECTIVES: The objectives of this study were to assess the type, mechanism, and extent of trauma among pediatric trauma patients and its association with clinical outcome. METHODOLOGY: This was a prospective observational study conducted in the department of emergency medicine and trauma at a tertiary care hospital in South India from September 2015 to March 2017. All children aged <12 years with a history of injuries irrespective of the cause for attending our trauma center were included in the study. OBSERVATIONS AND RESULTS: Of the 911 children enrolled, 63.9% sustained injuries at home. The leading modes of injury were fall at level ground (26.9%), road traffic accidents (RTAs) (25.5%), and fall from height (16.8%). Majority of RTA victims were two-wheeler pillion riders (40.5%) and pedestrians (31.9%). Nearly 49% of children had head and maxillofacial injuries. Polytrauma was found in 3.6% of children. Based on the Pediatric Trauma Score (PTS), 72.6% of children had mild trauma and 6.1% severe trauma. Totally, 18.9% of children required inpatient management, 7.5% surgical intervention, and 1.8% expired. CONCLUSIONS: Most of injuries in children occurred at home. This was followed by injuries on road. The leading cause of polytrauma was RTA. RTA victims were more likely to have severe injuries and poor outcome. They were more likely to require inpatient management compared to those who fell from height or fell at level ground. Glasgow Coma Scale and PTS may be used reliably to assess the severity of injuries sustained by children.

Cardiac arrhythmias, electrolyte abnormalities and serum cardiac glycoside concentrations in yellow oleander (Cascabela thevetia) poisoning - a prospective study.

BACKGROUND: Consumption of yellow oleander (Cascabela thevetia) is a popular method of intentional self-harm in South India. OBJECTIVES: The objectives of this study were to identify the cardiac arrhythmias and electrolyte abnormalities in yellow oleander poisoning and to identify the association between electrolyte abnormalities, cardiac glycoside concentrations at admission and the severity of cardiotoxicity. This study was also designed to identify clinical and biochemical parameters at presentation which predict serious arrhythmias and determinants of mortality. MATERIALS AND METHODS: This was a prospective study among 192 patients who attended our Emergency department after consuming yellow oleander seeds. Patients were monitored with serial ECGs. Serious cardiac arrhythmias included sinus bradycardia <40/min, sinus arrest/exit block, second or third degree AV block, atrial tachyarrhythmias and ventricular tachyarrhythmias. Serum sodium, potassium, magnesium, total calcium and cardiac glycoside concentrations were measured at presentation for all 192 patients. Serial estimation of cardiac glycoside concentration was done in 43 patients who presented within 24 hours of consuming at least five seeds. RESULTS: At presentation, 46 patients had serious arrhythmias and on follow-up, 11 developed new-onset serious arrhythmia. Sinus bradycardia (27%) was the most common arrhythmia followed by second-degree AV block (17%); multiple arrhythmias were observed in 18%. Digoxin effect in ECG correlated significantly with hyperkalemia. Mortality rate was 5%. Serum sodium, total calcium and magnesium levels did not correlate with cardiotoxicity. Cardiac glycoside concentration was of relatively modest clinical utility to discriminate patients with serious dysrhythmias (AUC: 0.719, 95% CI: 0.63-0.81). Prolonged PR interval and digoxin effect in ECG were significantly associated with an increased likelihood of serious dysrhythmias. Increase in 0.4 number of seed intake increased the odds of mortality by 1.5 times when all other independent variables were kept constant. CONCLUSION: Cardiac glycoside concentration at the time of presentation predicted the development of new-onset serious arrhythmias. Although serum potassium correlated significantly with cardiac glycoside concentration at admission and overall serious dysrhythmias, it did not predict the development of new-onset serious arrhythmia. On the whole, serious dysrhythmias were significantly associated with higher number of seeds ingested, hypotension at admission, PR interval prolongation, presence of digoxin effect in ECG, hyperkalemia and higher cardiac glycoside concentration. The independent determinants of mortality were larger number of seeds ingested and hypotension at admission. Cardiac glycoside concentration and hyperkalemia failed to be independent markers of serious dysrhythmias as well as mortality.

Wild tuber poisoning: Arum maculatum - A rare case report.

Arum maculatum, commonly known as wild Arum, is a woodland plant species of the Araceae family. All parts of this plant are considered toxic. We report a case of a young man who allegedly consumed poisonous wild tuber with suicidal intention. He presented to our emergency department 3 h later with features of angioedema. He was managed successfully with adrenaline and hydrocortisone. He was discharged after 4 days of observation. Later, the wild tuber plant was identified to be A. maculatum. We recommend that all patients who present with unknown substance poisoning should be managed according to the principles of intensive care, irrespective of the diagnosis.

Pediatric Trauma - An Emerging Epidemic.

We enrolled 911 children aged <12 years presenting to the trauma center of a tertiary-care hospital (over a period of 18 months) with history of injuries. Majority (582; 63.9%) of children had sustained injuries at home; 56 (6.1%) had severe injuries based on Pediatric Trauma Score. Of road traffic accidents victims (n=232), majority (40.5%) were two-wheeler pillion riders or pedestrians (31.9%). More Indian data are required and efforts are needed to prioritize injury prevention efforts in children.

Acute myocardial infarction in yellow oleander poisoning.

Self-harm by consuming yellow oleander seeds has become more frequent in South Asian countries, especially Sri Lanka and in southern parts of India. Yellow oleander poisoning usually presents with gastrointestinal, cardiovascular, and neurological manifestations as well as electrolyte abnormalities. Cardiac effects can manifest as nearly any type of dysrhythmia and sudden death with very few premonitory signs. To our knowledge yellow oleander poisoning related acute myocardial infarction has not yet been reported. We report a 37-year-old man with yellow oleander poisoning who had normal sinus rhythm at presentation but within few hours developed acute ST-segment myocardial infarction.

A facile synthesis of a carbon-encapsulated Fe3O4 nanocomposite and its performance as anode in lithium-ion batteries.

A carbon-encapsulated Fe3O4 nanocomposite was prepared by a simple one-step pyrolysis of iron pentacarbonyl without using any templates, solvents or surfactants. The structure and morphology of the nanocomposite was investigated by X-ray diffraction, scanning electron microscopy, transmission electron microscopy, Brunauer-Emmett-Teller analysis and Raman spectroscopy. Fe3O4 nanoparticles are dispersed intimately in a carbon framework. The nanocomposite exhibits well constructed core-shell and nanotube structures, with Fe3O4 cores and graphitic shells/tubes. The as-synthesized material could be used directly as anode in a lithium-ion cell and demonstrated a stable capacity, and good cyclic and rate performances.

Evaluation of the adverse reactions of antiretroviral drug regimens in a tertiary care hospital.

OBJECTIVES: Antiretroviral toxicity is an increasingly important issue in the management of HIV-infected patients. The objective of our study was to evaluate the toxicity profile of currently used antiretroviral regimens and to compare these toxicities among males and females. MATERIALS AND METHODS: A retrospective analysis with a one year follow-up was done at a tertiary care hospital by reviewing the record. Patients who were >18 years of age attending the hospital and were initiated an antiretroviral drug regimen were included in the analysis. Data regarding demographic details, medical history, details of human immunodeficiency virus (HIV) infection including most recent CD4 count, details of antiretroviral therapy (ART) collected from patient's records. Adverse drug reactions were recorded by reviewing patient records. RESULT: A total of 99 patients were included in study. Among them, 71 (71.7%) were males and 28(28.3%) were females. Common adverse effects observed included anemia (58.6%), pruritus(23.2%), skin rash(18.2%), hypertriglyceridemia(15.2%), and hepatitis (60.6%), peripheral neuropathy (14.1%). Prevalence of skin rash was more in females than males, the difference being statistically significant. Pruritus was also commonly seen in females than males though the difference observed in our study is statistically insignificant. Hypertriglyceridemia was more in males compared to females, the difference is statistically significant. CONCLUSION: The most common adverse effects associated with currently used ART regimens are anemia, hepatic toxicity, itching, skin rash, elevated triglycerides, and peripheral neuropathy. Gender differences were seen mainly with skin rash, which was significantly more in females.

Synthesis, redox, and magnetic properties of a neutral, mixed-valent heptanuclear manganese wheel with S = 27/2 high-spin ground state.

Reaction of lithium tetrachloromanganate(II) with N-n-butyldiethanolamine H2L3 (3) in the presence of LiH leads to the formation of wheel-shaped, mixed-valent heptanuclear, neutral complex {MnII subset[MnII2MnIII4Cl6(L3)6]} (4). The manganese wheel crystallizes in the triclinic space group P as 4.2CHCl3 or 4.3THF when either diethyl ether or n-pentane was allowed to diffuse into solutions of 4 in chloroform or tetrahydrofuran. The oxidation states of each manganese ion in 4.2CHCl3 or 4.3THF were assigned on the basis of detailed symmetry, bond length, and charge considerations, as well as by the Jahn-Teller axial elongation observed for the manganese(III) ions, and were further supported by cyclic voltammetry. The analysis of the SQUID magnetic susceptibility data for complex 4.2CHCl3 showed that the intramolecular magnetic coupling of the manganese(II,III) ions is dominated by ferromagnetic exchange interactions. This results in an S = 27/2 ground-state multiplet at low magnetic field. At fields higher than 0.68 T, the energetically lowest state is given by the mS = 31/2 component of the S = 31/2 multiplet due to the Zeeman effect. The ligand-field-splitting parameters were determined by anisotropy SQUID measurements on single crystalline samples along the crystallographic x, y, and z axes (D = -0.055 K, E = 6.6 mK) and by high-frequency electron spin resonance measurements on a polycrystalline powder of 4.2CHCl3 (D = -0.068 K, E = 9.7 mK). The resulting barrier height for magnetization reversal amounts to U approximately 10 K. Finally, 2DEG Hall magnetization measurements revealed that 4.2CHCl3 shows single-molecule magnet behavior up to the blocking temperature of about 0.6 K with closely spaced steps in the hysteresis because of the quantum tunneling of the magnetization.

Hydrazine nitrosation of a metal-bound nitric oxide: structural evidence for the formation of an ammine complex.

Hydrazine nitrosation of [Ru(NO)(py(si)S4)]Br.THF (1) (py(si)S4(2-) = 2,6-bis(3-triphenylsilyl-2-sulfanylphenylthiomethyl)pyridine2-) in methanol/DMF led to the formation of mononuclear ammine complex [Ru(NH3)(py(si)S4)] (2) and N2O, whereas the reaction performed in THF/CH2Cl2/toluene afforded thioether-bridged dinuclear ammine complex [(NH3)Ru(mu-py(si)S4)Ru(py(si)S4)] (3). Compound 2 dimerizes in solution at room temperature to form 3 and is regenerated upon treatment of 3 with NH3. A plausible mechanism for the hydrazine nitrosation of 1 has been proposed. The reaction of 1 with NH3 or N3- does not lead to a nucleophilic attack at the NO+ ligand but to a deprotonation that yields neutral nitrosyl complex [Ru(NO){py(si)S4(H+)}] (4), which is supported by density functional theory calculations.

A non-heme dinuclear iron(II) complex containing a single, unsupported hydroxo bridge.

Complexation of the tetrapodal pentadentate NN4 ligand 2,6-C5H3N[CMe(CH2NH2)2]2 (I) with iron(II) perchlorate hydrate in methanol, in the presence of N-methylimidazole, produces a diferrous complex with a single, unsupported mu-OH ligand between two {(I)FeII} coordination modules.

Synthesis and characterization of metal-centered, six-membered, mixed-valent, heterometallic wheels of iron, manganese, and indium.

Heptanuclear metal-centered, six-membered, mixed-valent, heterometallic wheels 1-3 of iron, manganese, and indium were prepared in a one-pot reaction from N-benzyldiethanolamine (H2L(1)), cesium carbonate, [PPh4]2[MnCl4], and FeCl3 or InCl3. All three complexes were characterized by the combination of elemental analysis, FAB mass spectroscopy, X-ray diffraction and cyclic voltammetry and in the case of 1 additionally by Mössbauer spectroscopy. In 1, four Mn(II) ions in the periphery are arranged in pairs alternating with one Fe(III) ion each, with an Fe(III) ion located in the center. In 2, three Mn(II) ions alternate with three In(III) ions, whereas in 3, four In(III) ions are arranged in pairs and alternate with one Mn(II) ion each. In 2 and 3 an Mn(II) ion is encapsulated in the center.

Visible light induced reversible extrusion of nitric oxide from a ruthenium(II) nitrosyl complex: a facile delivery of nitric oxide.

The new ruthenium compound [Ru(NO)(pysiS4)]Br (3) (pysiS4 = 2,6-bis(3-triphenylsilyl-2-sulfanylphenylthiomethyl)pyridine), containing sterically bulky SiPh3 groups ortho to the thiolate donors, has been synthesized. In solution, 3 releases NO efficiently on exposure to visible light (lambda >/= 455 nm) at room temperature to afford [Ru(Br)(pysiS4)] (4). Treatment of 4 with NO yielded exclusively 3 without any metal-bound side reaction.

Protonation and H/D exchange reactions promoted by a sulfur-rich osmium hydride complex: identification of a labile dihydrogen complex.

The sulfur-rich osmium nitrosyl complexes Bu(4)N[Os(NO)((bu)S(2))(2)] (1) [(bu)S(2)(2-) = 3,5-tert-butyl-1,2-benzenedithiolate(2-)] and [Os(NO)(py(bu)S(4))]Br ()[py(bu)S(4)(2-) = 2,6-bis(2-sulfanyl-3,5-di-tert-butylphenylthio)dimethylpyridine(2-)] have been synthesized. The molecular structure of 1 exhibits a square-pyramidal geometry with the NO group at the apical position. A pseudo-octahedral geometry with two thiolate and two thioether donors in trans configuration is found for 2. Compound 2 shows two quasi-reversible one-electron redox waves at E(1/2) = 0.51 and -0.46 V vs. NHE for the redox couples [Os(NO)(py(bu)S(4))](+1/0) and [Os(NO)(py(bu)S(4))](0/-1), respectively. 2 reacts with NaAlH(4) to produce Na[Os(H)(py(bu)S(4))] (3), which exhibits a typical hydride resonance in the (1)H NMR spectrum at delta =-15.03 ppm. Protonation of 3 with HBF(4)/CD(3)OD at 20 degrees C rapidly releases H(2)/HD to afford the dinuclear complex [Os(py(bu)S(4))](2) (4). Low temperature (1)H and (2)H NMR spectra of in [D(8)]THF with CH(3)OH or CD(3)OD at -80 degree C allow the observation of the formation of [Os(H(2)/HD)(py(bu)S(4))]. A 1 : 1 : 1 triplet at delta = -7.84 ppm [J(HD) = 31.2 Hz] and a relaxation time of T(1)(min) = 6 ms (-65 degrees C, 270 MHz) firmly establish the presence of eta(2)-H(2)/HD ligand. At room temperature, 3 interacts with D(2) (1 atm) and undergoes heterolytic D(2) cleavage followed by H/D exchange to form Na[Os(D)(py(bu)S(4))] (3a). A plausible cyclic mechanism has been proposed.

Iron carbonyl, nitrosyl, and nitro complexes of a tetrapodal pentadentate amine ligand: synthesis, electronic structure, and nitrite reductase-like reactivity.

The tetrapodal pentaamine 2,6-C5H3N[CMe(CH2NH2)2]2 (pyN4, 1) forms a series of octahedral iron(II) complexes of general formula [Fe(L)(1)]Xn with a variety of small-molecule ligands L at the sixth coordination site (L = X = Br, n = 1 (2); L = CO, X = Br, n = 2 (3); L = NO, X = Br, n = 2 (4); L = NO+, X = Br, n = 3 (5); L = NO2-, X = Br, n = 1 (6)). The bromo complex, which is remarkably stable towards hydrolysis and oxidation, serves as the precursor for all other complexes, which may be obtained by ligand exchange, employing CO, NO, NOBF4, and NaNO2, respectively. All complexes have been fully characterised, including solid-state structures in most cases. Attempts to obtain single crystals of 6 produced the dinuclear complex [Fe2[mu 2-(eta 1-N: eta 1-O)-NO2](1)2]Br2PF6 (7), whose bridging NO2- unit, which is unsupported by bracketing ligands, is without precedent in the coordination chemistry of iron. Compound 2 has a high-spin electronic configuration with four unpaired electrons (S = 2), while the carbonyl complex 3 is low-spin (S = 0), as are complexes 5, 6 and 7 (S = 0 in all cases); the 19 valence electron nitrosyl complex 4 has S = 1/2. Complex 4 and its oxidation product, 5 ([Fe(NO)]7 and [Fe(NO)]6 in the Feltham-Enemark notation) may be interconverted by a one-electron redox process. Both complexes are also accessible from the mononuclear nitro complex 6: Treatment with acid produces the 18 valence electron NO+ complex 5, whereas hydrolysis in the absence of added protons (in methanolic solution) gives the 19 valence electron NO. complex 4, with formal reduction of the NO2- ligand. This reactivity mimicks the function of certain heme-dependent nitrite reductases. Density functional calculations for complexes 3, 4 and 5 provide a description of the electronic structures and are compatible with the formulation of iron(II) in all cases; this is derived from the careful analysis of the combined IR, ESR and Mössbauer spectroscopic data, as well as structural parameters.