EVALUATION OF VARIOUS RISK FACTORS OF PERINATAL MORTALITY IN A TERTIARY HOSPITAL, AP

Background- It is important to know various maternal risk factors which lead to adverse perinatal outcome and enable us to form some strategies to reach our goals to reduce the perinatal deaths. Aims and Objectives of the study: is to evaluate the causes and risk factor for perinatal deaths in a tertiary institute and form strategies and protocols in our hospital to reduce perinatal deaths Prospective study Material and Methods- Study design: This study was conducted at OBGYN department, Siddhartha Medical College, Vijayawada done during the period of 1.01.2021 to 31.12.2021. All antenatal women admitted in labor room and antenatal wards were studied by means of a preformed proforma and viewed their outcome. In all cases of perinatal deaths risk factors were analysed in detail. - Results Total number of deliveries in the hospital were 9698. Out of which the perinatal deaths studied were 568 [5.85%]. Among these 252 [44%] were IUFD/ Still births and 316 [56%] were early neonatal deaths. In these cases of deaths 121 cases were Respiratory distress syndrome mostly due to prematurity, 82 birth asphyxia, 79 sepsis. The results were presented as percentages, rates and proportions. The results are compared with 5 studies and WHO standards. All studies had similar percentage except Philippine study 3 showed very low PNMR. [3][1,2,47] Analysis of perinatal deaths is important as it is an important index of Conclusion: antenatal care and quality of new born care in an institution

The Effect of Nuclear Overhauser Enhancement in Liver and Heart 31P NMR Spectra Localized by 2D Chemical Shift Technique

PURPOSE: To investigate the signal enhancement ratio by NOE effect on in vivo 31P MRS in human heart muscle and liver. we also evaluated the enhancement ratios of different phosphorus metabolites, which are important in 31P MRS for each organ. MATERIALS AND METHODS: Ten normal subjects (M: F = 8: 2, age range = 24-32 yrs) were included for in vivo 31P MRS measurements on a 1.5 T whole-body MRI/MRS system using 1H-31P dual tuned surface coil. Two-dimensional Chemical Shift Imaging (2D CSI) pulse sequence for 31P MRS was employed in all 31P MRS measurements. First, 31P MRS performed without NOE effect and then the same 2D CSI data acquisitions were repeated with NOE effect. After postprocessing the MRS raw data in the time domain, the signal enhancements in percent were estimated from the major metabolites. RESULTS: The calculated NOE enhancement for liver 31P MRS were: alpha-ATP (7%), beta- ATP (9%), gamma-ATP (17%), Pi (1%), PDE (19%), and PME (31%). Because there is no creatine kinase activity in liver, PCr signal is absent. For cardiac 31P MRS, whole body coil gave better scout images and thus better localization than surface coil. In 31P cardiac multi-voxel spectra, DPG signal increased from left to right according to the amount of blood included. The calculated enhancement for cardiac 31P MRS were: alpha -ATP (12%), beta-ATP (19%), gamma-ATP (30%), PCr (34%), Pi (20%), PDE (51%), and DPG (72%). CONCLUSION: Our results revealed that the NOE effect was more pronounced in heart muscle than in liver with different coupling to 1H spin system and thus different heteronuclear cross-relaxation.

Relationships of intracellular pH to oxygenated hemoglobin/myoglobin and to phosphate compounds in active muscle during forearm exercise / 体力科学

The purpose of this study is to find a key to clarifying the mechanism of lactic acid production during exercise. Five healthy men performed the grip and wrist flexion exercises at different occasions. Exercise intensities were increased by 5% MVC (maximum voluntary contraction force) per minute from 10% MVC. Intracellular pH, oxygenated hemoglobin/myoglobin (Oxy-Hb/Mb), inorganic phosphate (Pi), and phosphocreatin (PCr) in forearm flexor muscles were measured by <SUP>31</SUP>P-MRS and NIRS. The lowest Oxy-Hb/Mb concentrations during the grip and wrist flexion exercises were 40.7± 8.86% (average±SE) and 15.4 ± 2.26%, respectively. These results suggest that oxygen remain sufficient in the muscles at least during the grip exercise. Intracellular pH dropped as exercise intensity rose above 25% MVC for the grip and above 10% MVC for the wrist flexion exercise. These results support the idea that oxygen deficiency is not the only cause for lactic acid production during exercise. On the other hand, intracellular pH fell with either negative or positive relations to Pi/PCr ratio, Pi, and PCr in each exercise. These results support the suggestion that the main causes of lactic acid production during exercise are the changes in ADP, Pi, and PCr.

~31P-NMR STUDIES ON INTRACELLULAR pH AND ENERGY METABOLISM OF HEART, KIDNEY AND LIVER IN BURN SHOCK: AN ANIMAL EXPERIMENT / 第二军医大学学报

Cellular energy metabolism and intracellular pH of intact heart, kidney and liver of small animals were studied before and after burn with an effective technique of phosphorus-31 nuclear magnetic resonance (31P-NMR) spectroscopy. Advantages of this technique are that the measurement can be performed constantly without any complicated and destructive process, that it is possible to use this technique in clinical examination in the near future and that a lot of information can be obtained from only one spectrum.It was demonstrated that there were a short cellular energy source and a cellular acidosis in' heart, kidney and liver during burn shock. The high-energy phosphate compounds-lowered wavily but not straight, which could be divided into stress stage, compensation stage and decompensation stage. Intracellular pH decreased first in the heart, and then in the kidney and liver. In contrast to the results obtained by way of direct blood flow determination, the early and significant intracellular acidosis indicated the insufficiency of blood and oxygen supply in myocardium.

[31P] -Nuclear magnetic resonance spin lattice relaxation in lecithin reverse micelles.

[31P] -Nuclear magnetic resonance (NMR) spin lattice relaxation times (T1) have been measured for lecithin-nonpolar solvent-water as a function of added water for three solvents, namely, benzene, carbon tetrachloride and cyclohexane. In benzene and carbon tetrachloride systems, where spherical reverse micelles are formed, [31P]-NMR T1, values increase linearly with added water. However, in cyclohexane, the trends in the [31P]-T1 values indicate very different micellisation processes. Even at the lowest concentration of added water, the [31P]-T1 values in this solvent are substantially larger than the corresponding values in benzene and carbon tetrachloride, which is attributed to the intramolecular chlorinephosphate interaction being the weakest in cyclohexane. At a higher water content of six mols of water per mol of lecithin in cyclohexane solvent, the [31Ρ]-T1 values show a sharp decrease indicating a sudden change in the dynamics of the phosphate group, and this confirms the on set of 'reverse micelle-to-liquid crystalline' phase transition observed in this system by other spectroscopic and physical techniques.