1.Results of the research study on influencing factors for mortality and morbidity rate of cardiovascular diseases
Tuul M ; Baasanjav N ; Purevsuren D
Mongolian Medical Sciences 2011;172(2):70-77
Background: According to statistics from National Center of Public Health Development of Mongolia morbidity rate of cardiovascular diseases was 501.84 cases per 10000 population in 2006, which demonstrates increase of 2 times compare to 1996 and 50% increase compare to 2000. Goal: To study bio-ecological factors influencing on mortality and morbidity rate of prevalent cardiovascular diseases among Mongolians.Materials and Methods: We have chosen arterial hypertension, acute myocardial infarction, and chronic rheumatoid fever according 10th classification of WHO. Indices of morbidity, mortality of diseases were calculated per 1000 population.Result: Average atmospheric temperature t0С (χф2=1494); atmospheric pressure (χф 2=36.07); precipitation (χф 2=704); and mineralization of rivers (χф 2=532) have statistically significant effect on morbidity rate of arterial hypertension among the population of Uvurkhangai, Gobi-Altai, Darkhan-Uul, Gobisumber aimags and UB city. Average atmospheric temperature t0С (χф 2=241); atmospheric pressure (χф2=88.62); precipitation (χф 2=62.18); and mineralization of rivers (χф2=86.28) have statistically significant effect on morbidity rate of chronic rheumatoid fever among the population of Arkhangai, Bayankhongor, Umnugobi, Gobisumber aimags.Conclusions:1. Geographical distribution of arterial hypertension is prevailed in Uvur-Khangai, Gobi-Altai, Darhan-Uul, Gobi-Sumber aimags and UB city, distribution of acute myocardial infarction is prevailed in Hovd, Hubsgul, Arkhangai, Selenge, Gobi-Sumberaimags and geographical distribution of chronic rheumatoid fever is prevailed in Bayankhongor, Arkhangai, Umnugobi, Gobisumber aimags. 2. Ecological factors have statistically significant (χF 2=23.1-161.1) influence on the distribution of morbidity and mortality of arterial hypertension, acute myocardial infarction and chronic rheumatoid fever. Influencing ecological factors in regions covered with this study, such as temperature, atmospheric pressure, wind speed and mineralization of water sources have weaker and reverse correlations each separately (r=-0.1-0.2) but in combination they have medium and reverse correlations (r =-0.45- 0.52).3. The result of the research study established that morbidity and mortality of cardiovascular diseases (arterial hypertension, acute myocardial infarction and chronic rheumatoid fever) distributed in 3 regions on the territory of Mongolia depending on ecological factors.
2. LATE RESULTS OF SURGICAL TREATMENT OF VALVULAR HEART DISEASE
Baasanjav N ; Bat-Undral D ; Bayaraa T
Journal of Surgery 2016;20(2):30-36
Introduction: The paper presents lateresults of surgical correction of the patientswith acquired heart disease.Materials and method: Two hundredfifty one patients had surgical defectcorrection from 2000 to 2016 years. Lateresults were observed in 134 patients. It wasrevealed that subgroup with aortic, mitral andmitral-aortic stenosis and in the subgroupwith aortic insufficiency, systolic functionof the left ventricular was significantlyincreased and heart cavities were positivelyremodeled.Results: Five-year survival rate in subgroupwith initial aortic stenosis and insufficiencywas 100% , in subgroup with initial mitralstenosis - 78.4%, with mitral insufficiency- 75.0%, with mitral-aortic stenosis - 94.1%and with mitral-aortic insufficiency - 49.1%.Conclusion: Risk factors of late mortalityof the patients with valve pathology andsystolic dysfunction of left ventricular aftersurgical correction are: IV NYHA, chronicheart failure, the heart-lung coefficientmore than 65%, high lung hypertension(systolic pressure in pulmonary artery morethan 60 mm.Hg), size of the left ventricularmore than 60 mm and index of end-diastolicvolume of left ventricular more than 110 ml/m2.
3.Epidemiology of neurohereditary diseases in the population of some provinces (aimags) existence in south and central part of Mongolia
Baasanjav D ; Erdenechimeg YA ; Chimeglkham B ; Sarantsetseg T ; Oyungerel B ; Bolormaa D
Mongolian Medical Sciences 2014;168(2):12-17
BACKGROUND:Our previous study has shown that the prevalence and structure of the neurohereditary diseaseswere different by provinces and some form of these diseases as “indigenous” in some isolatedpopulation. There are some scientific results of our researches–genetics about consanguineous,which is more potential factor of community is some area of Mongolia. All these circumstance isgiving to carry out this study.MATERIALS AND METHODS:We used descriptive epidemiological method for revealing hereditary neurological diseases in thepopulation of 6 provinces (aimags) of Mongolia: Dornogobi (Easth-gobi), Sukhbaatar, Gobisumber,Central aimag, Bulgan, and Darkhan-Uul. Total population of these provinces is 363072. Thenumber of population in 6 provinces was fluctuated in the range from 15.000 (Govisumber) to 88.875(Darkhan-Uul). Prevalence was accounted for 100.000 populations.RESULTS:The prevalence of neurohereditary diseases makes up 17.08 cases per 100.000 populations amongthese 6 provinces. 79% of these are hereditary neuromuscular diseases i.e 49 patients from 29families. Myotonic dystrophia and genetic neuropathies Charcot-Marie-Tooth have comparativehigh prevalence over test forms of disease.The high rate neurohereditary diseases was established in the population of Bulgan (35.80•10-5),Sukhbaatar (31.17•10-5), and Dornogobi (21.33•10-5) provinces. Their prevalence’s prevailed in the7-10 times over rates Darkhan-Uul, 3-5 times over rates of Gobisumber aimags.No neuromuscular forms of neurohereditary diseases i.e spastic paraplegia (11.3%) andspinocerebeller ataxia (9.68%) accounts for 21% among all forms of neurohereditary diseases.The prevalence of neuromuscular diseases in the population of these six provinces is two times highthen the average rate of the population of Russia (1980 years). First reason is may be associatedwith high predisposition of based on consanguineous through reproductive way in some of theseprovinces of Mongolia.
4.Epidemiology of neurohereditary diseases in the population of some provinces (aimags) existence in south and central part of Mongolia
Baasanjav D ; Erdenechimeg YA ; Chimeglkham B ; Sarantsetseg T ; Oyungerel B ; Bolormaa D
Mongolian Medical Sciences 2013;166(4):15-20
Background: Our previous study has shown that the prevalence and structure of the neurohereditary diseases were different by provinces and some form of these diseases as “indigenous” in some isolated population. There are some scientific results of our researches–genetics about consanguineous, which is more potential factor of community is some area of Mongolia. All these circumstance is giving to carry out this study.Materials and Methods: We used descriptive epidemiological method for revealing hereditary neurological diseases in the population of 6 provinces (aimags) of Mongolia: Dornogobi (Easthgobi), Sukhbaatar, Gobisumber, Central aimag, Bulgan, and Darkhan-Uul. Total population of these provinces is 363072. The number of population in 6 provinces was fluctuated in the range from 15.000 (Govisumber) to 88.875 (Darkhan-Uul). Prevalence was accounted for 100.000 populations.Results: The prevalence of neurohereditary diseases makes up 17.08 cases per 100.000 populations among these 6 provinces. 79% of these are hereditary neuromuscular diseases i.e. 49 patients from 29 families. Miltonic dystrophia and genetic neuropathies Charcot-Marie-Tooth have comparative high prevalence over test forms of disease.The high rate neurohereditary diseases was established in the population of Bulgan (35.80•10-5), Sukhbaatar (31.17•10-5), and Dornogobi (21.33•10-5) provinces. Their prevalence’s prevailed in the 7-10 times over rates Darkhan-Uul, 3-5 times over rates of Gobisumber aimags. No neuromuscular forms of neurohereditary diseases i.e spastic paraplegia (11.3%) and spinocerebeller ataxia (9.68%) accounts for 21% among all forms of neurohereditary diseases. The prevalence of neuromuscular diseases in the population of these six provinces is two times high then the average rate of the population of Russia (1980 years). First reason is may be associated with high predisposition of based on consanguineous through reproductive way in some of these provinces of Mongolia.
5.Prevalence rate of multiple sclerosis in adult population of Ulaanbaatar city
Shuren D ; Tsagaankhuu G ; Baasanjav D
Mongolian Medical Sciences 2012;160(2):21-25
Introduction: There are still MS has been diagnosed in Mongolia during last 40 years, there is a lack of information regarding to geographical distribution and ethnic differences in origins of MS. That is why our main purpose is to do study the prevalence rate of MS in populations of UB city. Goal: To determine the prevalence rate of MS in adult populations of Ulaanbaatar (UB) City.Materials and Methods: To study the morbidity of MS in Mongolia using statistical data; to determine the prevalence rate of MS using hospital-based design and following the “door-to-door” methods. Results: MS morbidity analysis of five-year statistical data (2003-2007) showed an average of 178 per 100000; morbidity level in both rural and urban settings was 7.0 per 100000; among them 43% were patients in the 30-40-year-old age group. According to our study the prevalence rate of MS in UB City for a adult population of 100,000 above the age of 16 was 10.3; Rate of prevalence in females is 4 times more than in males (15.8 vs 4.2); the highest prevalence rate in females was in the 40-49 year-old age group (31.3); in males was in the 50-59 year-old age group (14.9). It is shown by disease dominating middle-aged women and older men relatively (p<0.05). In our clinical study of 67 MS patients, the mean age was 41.79±8.76. The age at onset ranged from 18-50 years (31.5± 9.2-for females; 37.3± 9.7-for males). Conclusion: The average morbidity rate of MS in Mongolia by statistical analysis from 2003-2007 data was 7.0 per 100,000 people; with a female-to-male ratio of 2:1. The prevalence rate of MS in adult populations of Ulaanbaatar for 100,000 people was 10.3; with a “chi”-square for females that was 4 times higher compared to males.
6.First Successful Endovascular Repair of Descending Thoracic Aortic Aneurysm In Mongolia
Lkhagvasuren Z ; Marcus HOWEL ; Tsegeenjav D ; Baasanjav N ; Burmaajav B
Mongolian Medical Sciences 2010;151(1):4-7
Endovascular repair of descending thoracic aortic aneurysm is an attractive approach. Candidates for endovascular repair should have an inner aortic diameter of 23-37 mm adjacent to the aneurysm without signifi cant thrombus or calcifi cation in these so called landing zones. They should have at least 2 cm of normal aorta both proximal and distal to the aneurysm to ensure adequate fi xationof the divece. Endografting of the descending thoracic aorta requires preoperative measurements of the diameter of the proximal and distal necks of the aneurysm, tratment length, and proximal and distal angulation. This information can be obtained from CT-ic angiography using three dimensional reconstruction.
7.The prevalence of hereditary spastic paraplegia in population of Mongolia
Baasanjav D ; Erdenechimeg Y ; Oyungerel B ; Sarantsetseg T ; Khandsuren B ; Chimeglham B
Mongolian Medical Sciences 2011;168(1):27-30
Background. The prevalence of hereditary spastic paraplegia or Shtrumpel disease is very various in studied countries of the world. It fluctuated between 0.43 (Bulgaria) and 72.4 (South African Republic) per 100’000 population.Method. In this study which is a part of a general epidemiological study of some hereditary neurological diseases in Mongolia since 1997, authors established the prevalence of myotonic dystrophy among 1.7 million population from 14 aimags and the capital city Ulaanbaatar during the period from 1997 to 2010.Goal. The study aimed to establish the prevalence of hereditary spastic paraplegia (HSP) in Mongolia.Material and Method. This study is part of a general study of the epidemiology of hereditary neurological diseases in population of 14 aimags (provinces) and the capital city Ulaanbaatar (the total population covered by the study was 1’738’000) which is being carried out since 1997. The sizes of population in aimags and the city ranged from 47,800 (Southgobi) to 605,292 (Ulaanbaatar). This study report extrapolates the prevalence nationwide. Diagnosis was established by mainly clinical characteristicsResult. Study revealed 47 patients from 15 families. The prevalence of HSP by aimags was established from 0 to 13.48 per 100’000 population (Uvs aimag). The average nationwide prevalence (1’700’000 above) was established at 2.70/100’000. There are revealed 9 cases (19.1%) in ages of 0 and 14, 6 cases (12.8%) in ages of 14-19, 27 cases (57.5%) in ages of 20- 49 and 5 cases (10.6%) in age above 50.Conclusion1. By prevalence of HSP Mongolia belongs to countries with average prevalence. But the prevalence rates differ by aimags. Patients with HSP in Ulaanbaatar (11 cases) were covered by molecule-genetic analysis by types of the disease, revealing occurrences of II and IV subtypes. 2. Of all patients, 90% are below 50 years of age pointing to the early morbidity with this disease in the context of their early mortality. The situation reveals the need of further moleculegenetic and clinical studies of the types of this disease and of improvement of clinical and genetic counseling of HSP patients.
8.Structure and prevalence of hereditary neurological diseases in population of some provinces (aimags) of Mongolia
Baasanjav D ; Erdenechimeg YA ; Oyungerel B ; Sarantsetseg T ; Chimeglkham B ; Khandsuren B
Mongolian Medical Sciences 2010;152(2):24-30
BACKGROUND: The study of epidemiology of hereditary neurological diseases in Mongolia began a few years ago. Itcovered a few aimags (provinces) (D.Baasanjav, 2000-2005). Previous studies have shown, that hereditary neurologicaldiseases are not rare in Mongolia and structure and prevalence of these diseases vary by aimags. Mo n g o l i ahas 21 aimags (administrative provinces), each with a population from 45000 till 110440. In some “isolated” populationsspecific neurological hereditary diseases can be marked as “indigenous”. So the epidemiological study of hereditaryneurological diseases in Mongolia is one of the urgent medical shortcoming in Mongolia.MATERIAL AND METHOD: We used descriptive epidemiological method for revealing hereditary neurological diseases infamilies in population of 8 provinces (aimags) of Mongolia, Bayan-Ulgii, Bayankhongor, Govi-Altai, Zavkhan, Dundgobi,Khentii, Orkhon, Uvurkhangai, total of 627,000 population. The population of these aimags fluctuated in the range from47959 (Dundgobi) to 110440 (Uvurkhangai). Diseases were diagnosed by neurologists using clinical and genealogicalmethods.RESULTS: The study revealed 77 patients in 40 families in the studied population with variety of neurological hereditarydiseases. The overall prevalence of hereditary neurological diseases for 100,000 population is 12,26. The prevalencevaries by aimags from 2,08 (Dundgobi) to 32,50 (Gobi-Altai) per 100.000 population. The prevalence and their rangeby nosological structure per 100000 population in aimags are: myotonic dystrophy 5.41 widely varying by aimags: from4.66 in Bayankhongor to 27.09 in Gobi-Altai; Charcot-Marie-Tooth syndrome 1.59 and ranging from 2.08 in Dundgobito 4.66 in Bayankhongor; Duchenne muscular dystrophy -0.79 and ranging from 0.90 in Uvurkhangai to 3.19 in Bayan-Ulgii; the limb girdle muscular dystrophy -0.95 and ranging from 1.81 in Uvurkhangai to 4.66 in Bayan-Ulgii; Strumpellfamilial spastic paraplegia -0.95 for total pop and ranging from 2.71 in Uvurkhangai to 5.41 in Bayankhongor; familialparoxysmal myoplegia -0.79 for total pop. and range from 2.22 in Orkhon to 5.41 in Gobi-Altai; spinocerebellar ataxia -0.47 for total pop. (3.91-in Zavkhan); bulbo-spinal amyotrophy -0.32(only in Bayankhongor); spinal amyotrophy of adults-0.16(only in Uvurkhangai); arthrogryposis with myodystrophy -0.63 (only in Khentii); kyphoscoliosis with myodistrophyand nanism -0.16 (1.06 in Bayan-Ulgii)A comparatively high prevalence of all neurological hereditary diseases per 100.000 pop. was established in Gobi-Altai(32.50), Orkhon-26.56, Bayankhongor-15.16, Bayan-Ulgii -11.70 rates; the low prevalence - in Dundgobi-2.08 and-Zavkhan-3.91.The hereditary neuromuscular diseases among all hereditary neurological diseases taken up 71.9% i.e 55 patients from29 families. The myotonic dystrophy is tops the list of neuromuscular diseases (61.8%)CONCLUSION: Hereditary neurological diseases have a relatively high prevalence among the population of Mongolia,specially the neuromuscular diseases; so the control of these diseases in the country is one of the special priorityproblem of the national health care.
9.Prevalence and clinical characteristic of multiple sclerosis in rural population of Mongolia
Baasanjav D ; Erdenechimeg YA ; Oyungerel B ; Sarantsetseg T ; Chimeglkham B ; Khandsuren B
Mongolian Medical Sciences 2010;152(2):31-36
BACKGROUND: Multiple sclerosis is spreading in population of Mongolia last 30 years. But there are rare of the date ofprevalence of this disease in Mongolia. So we have studied the prevalence of this disease in population of 8 provinces(aimags) of Mongolia in 2008 year.GOAL: To reveal and establish prevalence and clinical characteristic of multiple sclerosis (MS) in population of 8 aimags(provinces) of Mongolia.METHOD: Revealing of patients with multiple sclerosis in population was made by neurologists, which are possessedof clinical method for revealing or confirm the diagnosis and were taken in register the patients only with confirmeddiagnosis. This study was conducted in following 8 aimags of Mongolia: Bayan-Ulgii, Bayankhongor, Gobi-Altai,Dundgobi, Uvurkhangai, Zavkhan, Khentii, and Orkhon; total population of these aimags is 627762 (m-306482, f-321279). The prevalence of this disease was calculated for 100.000 populations.RESULTS: There have been revealed total 35 patients in 8 aimags. The prevalence for 100.000 population is 5,57 (m-2,61; f-8,40) and has been fluctuated in provinces in range from 1,81 (Uvurkhangai aimag) till 13,28 (Khentii aimag) for100 000 population.The rest 6 provinces (aimags) have prevalence in range from 4,17 (Dundgobi) till 6,38 (Bayan-Ulgii).All patients were distributed by clinical characteristic in next main forms:Cerebro-spinal form in 22 patients (62,8%) among them optico-myelitis in 9 cases (40,9%); Spinal form in 6 patients(17,1%); Cerebral form in 4 cases (11,4%); only optical form in 3 cases (8,6%).Pure spinal, cerebral and optic forms are diagnosed in patients, which have duration of disease no more 6-7 years.By the courses of disease all patients distributed in courses the beginning with acute attack incomplete recovery(remissions) revealed in 18 patients (51,4%), more rapid but steadily progressive course in 5 cases (14,3%), acutesevere attacks course in 5 patients (14,3%).CONCLUSION:1. Multiple sclerosis is spreading in population of Mongolia in last 30 years after 1980.2. The prevalence of this disease in population of 8 provinces (aimags) of Mongolia in 2008 year is 5,57 cases (inmen-2,61; in women-8,40) for 100.000 population. The rates of prevalence of the disease by aimags are oscillated inrates from 1,81(Uvurkhangai) till 13,28 (Khentii) for 100.000 population.3. The women suffered more in 3 time than in man and optic form revealed in 34,2 % cases (in 12 patients). Theage of beginning of the disease was fluctuated in age from 16-19 years old till 60 above years old.4. By level of prevalence of this disease Mongolia now is belonging to countries of the world, which have lowprevalence of this disease (till 10 per 100.000 pop).
10.Prevalence of epilepsy and its specifics by age and sex among the rural population of Mongolia
Baasanjav D ; Erdenechimeg YA ; Oyungerel B ; Sarantsetseg TS ; Chimeglkham B ; Khandsuren B
Mongolian Medical Sciences 2010;153(3):13-17
Background: The data of prevalence of epilepsy in rural provinces among general population in Mongolia is rare. Goal:The study aimed to identify prevalence rate of epilepsy and its characteristics by age and sex among the population in eight provinces (Bayan-Ulgii, Bayankhongor, Gobi-Altai, Zavkhan, Uvurkhangai, Dundgobi, Orkhon and Hentii) of Mongolia.Material and Мethod: This study in the listed aimag populations was carried out by retrospective application and using a questionnaire developed according to a methodology approved by the Academic Council of the Medical Science Institute. For verification of the epilepsy diagnosis, the study based on neurologist examination and EEG. In some suspect cases we used neuroradiological tests including СT and MRI. The diagnosed patients were registered using a special form. The study involved diagnostic examinations of 627762 (306482 males; 321280 females) persons that had at least two unprovoked seizures in their lives. For each case of positive diagnosis we calculated the prevalence rate per 1,000 population in each category of extended age groups (1-12 months, 1-2, 3-4, 5-6, 7-8, 9-10, 11-12, 13-15, 16-17, 18-22, 23-27, 28-32, 33-37, 38-42, 43-47, 48-52, 53-59, and above 60) and by sex.Result: There were 1407 cases (785 males; 622 females) of diagnosed epilepsy among the studied population. The cumulative prevalence rate for all aimags was studied 2,24 (males- 2,56; females-1,93) per 1,000 population. The relatively high prevalence rates per 1,000 population were observed in Gobi-Altai (5,14), Dundgobi (3,31), and Orkhon (2,48) whereas the lowest rate was in Bayankhongor (1, 38). A differential look by sex reveals a high sex gap 6,20 for males and 4,12 for females in Gobi-Altai while Dundgobi (males- 3,84; females- 2,80), Orkhon (males-2,91; females-2,08); Uvurkhangai (males -2,20; females -1,73) show little difference by sex (P>0,05).As for the differences by the detailed age groups, all aimag data shows that prevalence for males ranges between 0,14(1- 12 months) and 5,17 (48-52) and for females between 0,24 (above 60) and 3,82 (38-42). The highest prevalence rate among male population was observed in 48-52 age group, 6,21/1000; followed by age groups 33-37 (2,93/1000); 53-59 (2,84/1000); 38-42 (2,81/1000); and 18-22 (2,38/1000). The highest prevalence rate among female population was observed in 43-47 age group 5,49/1000 followed by 38-42 (5,48/1000); 33-37 (4,0/1000); 53-59 (3,35/1000).Epilepsy prevalence in age groups younger than 11-12 tends to fall for both male and female population. Gender difference in prevalence is that males tend to have higher rates 2,56 than females 1,93 ( P<0,05).Conclusion:1. The general epilepsy prevalence among some rural populations in Mongolia is 2,24 (M -2,56; F-1,93) per 1,000 population.2. The cumulative by all studied aimags data reveal relatively high prevalence rate in age groups of 18-59. This level might be related to men’s vulnerability to traumas and factors of vascular origins while in women it might relate to their physiological transformations of pregnancy delivery and menopause.3. Epilepsy prevalence in age groups under 12 years old tends to fall for both male and female population which might be related to the low level of examination and diagnosis of these diseases among children.4. Compared to some foreign scholars’ data, Mongolia’s epilepsy prevalence rate does not qualify it among the high rate countries.