1.Review article of predisposing, risk factors and epidemiology of intervertebral disc hernia
Altan-Ochir S ; Enkhbold D ; Burmaa B
Mongolian Medical Sciences 2013;166(4):70-75
BackgroundDandy described first, about intervertebral disc hernia (1929). Mixter W.J and Barr J.S (1934) investigated that correlation of sciatica and lumbar disc hernia. Discectomy is most confirming surgery among all spine surgery. Asymptomatic lumbar disc hernia revealed in 70% of adult, by MRI. Spine disorder is first cause of disability of workers below 45 yrs, in European countries. International research for predisposing, risk factors of intervertebral disc hernia is widely confirmed, but diagnostic and treatment aspects are not completed.Materials and MethodsWe did computer aided search using key words “disc degeneration, risk factor, discectomy, lumbar disc hernia, spinal instrumentation” in online library: MEDLINE, E pub, PUBMED, HINARI, Mongolmed, years 1970-2011, also domestic research works from Central library of HSUM, Mongolia. We included article, case-control study, systematic review, case study.ConclusionIncidence and disability caused by lumbar disc hernia, requiring surgical treatment is common problem in world. By anatomical region, lumbar disc hernia is the highest. Research work revealed that patients who took surgical treatment different by gender (male:female=2:1), geographical region (US 160/100000, Switzerland 62/100000). At last 20 yrs, dramatically changed theory about predisposing factor of disc hernia. It is changed from mechanical load to genetic role. Disc degeneration disease is basis of disc hernia. Nucleus pulposus, annulus fibrosus losing own structure, containing moleculs, and water under degeneration. The risk factors are frequent heavy lifting, frequent twisting and bending, vibration, sedentary work, driving and overweight. The golden standard surgery of herniated disc of cervical area is anterior cervical discectomy and fusion (ACDF). Posterior screw fixation of lumbar vertebrae is most frequently confirming surgery among the world.
2.Study on home health care nursing needs in some provinces
Solongo D ; Naranchimeg S ; Orgil B ; Barsereedene B ; Munkhtuya TS ; Burmaa B
Mongolian Medical Sciences 2011;158(4):31-35
Introduction: In order to Implement the Mongolian government's 2000 provisions for national health care, on May 28,2004, the Health Minister approved the "Home Care Nursing Service and Rules for Caring and Nursing" according to resolution # 136 and indicated that family clinic nurses should provide home care nursing services [6'71. Interestingly, it is noted that throughout the world, nursing home services have not been limited to family clinic nurses but are being delivered by nurses with diverse areas of specialization.Goal: Purpose of the study is to determine needs for making home nursing services to the population in some province and soum.Objectives:1. To comparatively search needs for providing home nursing services to citizens in the province and soum which were involved to the study.2. To determine nursing type which is required at home3. To develop needs of nurses who make home nursing servicesMaterials and Methods: Conducted studies among the 1109 people from the 520 families in 17 soums of five provinces such as Orkhon, Bulgan, Arkhangai, Khuvsgul and Selenge. We have chosen the clients with anamnesis who are repeatedly served and treated at the hospital for our study and had interviews with them. Questionnaire for citizens consists of 2 basic chapters including 17 questions which determine demographic information and needs of home nursing services. We asked and searched about needs of Home Care Nursing assistances under the 3 basic groups such as General nursing, Treatment nursing and Specialized nursing. After inserting study data into the SPSS-17 program, checked it by appropriate statistical methods (t, x2, fisher exact) and checked if difference between groups and relations has statistical truth.Results: 35.89 percent of clients who got involved to the study answered that they are interested in taking nursing and caring services at home. Also we consider needs for having home nursing at home according to numerical indexes in the provinces involved to the study, clients mostly want to be injected by intramuscular (25.88%), intravenous (31.02%) and IV fluid (30.57%). As we consider specialized nursing assistances at home under the types of needs, health education and assistance for people suffered with hemorrhage and injured people occupy major percent. Clients who got involved to the training, were asked question "With whom do you want to be made nursing assistance at home?" and 75.6% of them answered that they prefer nurses of family clinic.Conclusions:1. It was observed that 35.89% of clients who got involved to the survey, want to receive home nursing assistance and demands for home nursing is being increased with aging.2. Also we conclude that nursing after hemorrhage, nursing for injured patients and nursing for patients with cardiovascular disease occupies higher percent and it shows that percent of cardiovascular diseases and injuries is relatively high and clients' needs to receive nursing assistance at home are faced problems after they were discharged from hospital.3. 75.6% of people who got involved to the study are interested in taking home nursing assistance and we reached to conclusion that it is suitable to train nurses according to it.
3.The diagnosis and surgical treatment for compressive lesions of spinal nerve root, spinal cord of cervix, thorax and lumbar spine in Mongolia
Enkhbold D ; Altan-Ochir S ; Khusayan KH ; Batchuluun B ; Byambatsend B ; Burmaa B
Mongolian Medical Sciences 2014;170(4):19-24
Background: Spine disorder is the first cause of disability of workers below 45 years and economicalburden costs 20-50 billion us.dol, in European countries. Lumbar disc hernia estimates 40% of 30-50aged population in U.S and in Japan 26/10000. In last 5 years, spine surgeries increased in 4-5 timesdue intervertebral disc hernia, at Shastin State Third Central hospital of Mongolia.Goal: To populate new methods of surgical treatment for compressive lesions of spinal cord, spinalnerve root of cervix, thorax and lumbar spineMaterials and Methods: We did clinical research involving patients who had spine surgery at ourdepartment due “compressive lesion of spinal nerve root and spinal cord”. From, total 217 patients,excluded 9. Excluded cases are: declined from surgery 3, Arnold-Chiari malformation 5, and epiduralabscess 1. We collected data with permission of patient and did statistical analysis by IBM SPSS 17.Results: The surgery for intervertebral disc hernia takes 84.6% (176) of total surgery and 94.9% (167)of lumbar disease. Tumor of spinal cord estimates 9.1% (19) of total case, dominates in lumbar area(57.9%). We used posterior approach mostly, because it is frequently used in lumbar spine. The surgerycontinued 36-750 min (204.6, SD 128.5) ten patients (4.8%) had complications. In this project weused 5 surgical methods totally in solitary or combined. Spondilodesis is the most combined methodamong them. We used Oswestry disability index in Mongolia at first, to count treatment effect. Currentindex evaluated pre and post surgery period. Patient complaint and difficulty of daily life progressivelydecreased after surgery and almost disappeared at third month (p<0.00).Conclusion:1. It is possible to develop international standard surgical treatment of compressive lesions of spinalnerve root, spinal cord of cervix, thorax and lumbar spine in Mongolia.2. We used Oswestry disability index in Mongolia at first, so this questionnaire is simpler and accuratemethod for spine, spinal cord induced disability.3. Twenty seven point nine percent of patients who had surgical treatment has minimal to moderatedisability by Oswestry disability index, so it means we have to process standard of spine surgeryand increase non surgical treatment efficiency.4. Working ability recovers faster when spine surgery has been done.5. These new methods of spine surgery are cost effective than same surgery which will be doneabroad.
4.Oswestry Disability Index is evaluated in rehabilitation after lumbar discectomy
Davaajav B ; Delgermaa S ; Batgerel O ; Burmaa B ; Enkhbold D ; Altanochir C ; Khuayan KH ; Byambatsend D ; Baljinnyam A
Mongolian Medical Sciences 2014;170(4):25-29
Background. Low back pain is a frequently encountered symptom. Although 70-80% of the entirepopulation have low back pain complaints in their lives, only 2-4% of them require surgical intervention.’Department of Neurosurgery, Shastin 3rd Central Hospital about 200 patients who undergo back surgery,while 90% of patients who have prolapsed lumbar disc surgery from 2010 to 2012. There are variousstudies indicating that exercise improves pain and disability in chronic low back pain and in those whohave had surgery. The main objectives of the postoperative rehabilitation programmes are to accelerateand maximize function recovery as much as possible, and to prevent further injury by restricting theprogression of degenerative changes. We evaluated the effectiveness of rehabilitation treatments thatare used in our department which is the first time in our country.Goal. To evaluate the effectiveness of rehabilitation after lumbar discectomy.Materials and Method. We examined 83 patients were included the Shastin central hospital, Departmentof neurosurgery and rehabilitation after lumbar discectomy at a single level and operated in the periodfrom May 15, 2013 to September 15, 2014. All patients were evaluated at the beginning and at theend of treatment by Oswestry Disability Index which is a specific functional questionnaire for back pain.Pretreatment values are one month after surgery and posttreatment values three months after surgery.All patients received the intensity specific exercise and back school education programme 3 days aweek for eight weeks.Results. All patients pain intensity are reduced after treatment evaluated by VAS (p<0.000). Functionalability had significantly increased after treatment which is evaluated by Oswestry Disability Index in allpatients (p<0.000). 46 from all patients had minimal disability before treatment and this number wasincreased in to 79 after treatment. The number of moderate and severe disabled patients ability wasincreased after treatment.Conclusion: Back school education and specific exercise programme should be one of the parts oftreatment after lumbar discectomy. After treatment was increased functional ability and early painrelief.
5. Phytochemical composition and biological activity of Aconitum naviculare (brϋhl) stapf
Lkhaasuren R ; Enkhbold G ; Sodgerel D ; Tsedensodnom Ch ; Oyunkhuyag S ; Burmaa D ; Khurelbaatar L
Mongolian Medical Sciences 2023;205(4):59-66
Aconitum navicular (Brϋhl) Stapf, a Himalayan endemic, is an endangered medicinal herb of the alpine
region. A search was made under the Latin Name Aconitum navicular (Brϋhl) Stapf. to summarize the
use of phytochemical and biological information on the use of ethnomedicine available for the species.
The keyword “Aconitum navicular (brϋhl) Stapf.” was collected and compiled from the rankings of
PubMed, Web of Science, Google Scholar and other scientific websites. Phytochemical analysis done
so far has led to the isolation of 14 alkaloids, 3 flavonoid glycosides, and 4 phenolglycosides. Most
commonly, aqueous extract of this plant has been used against various kinds of fever, bitter tonic
and intoxicating liquors. In addition, Aconitum species contain the most diterpenoid alkaloids, and
this compound is bioactive and somewhat toxic. Many studies have shown that diterpenoid alkaloids
exhibit cytotoxic, antioxidant, antimicrobial, analgesic, and anti-inflammatory biological activities. We
hope this information will be useful in future research and development of this valuable medicinal plant.
6.A Comparative Study of Traditional And Conventional Treatment Of Chronic Pyelonephritis
Enkhbayar M ; Enkhjargal D ; Amarzaya D ; Sarantsetseg G ; Burmaa B ; Munkhzul D ; Khishigjargal S
Journal of Oriental Medicine 2012;3(2):8-8
Abstract The aim of this study is to compare the effects of traditional and conventional treatment of chronic pyelonephritis. Total of 100 patients diagnosed with chronic pyelonephritis were enrolled in the study. Traditional medicines included following: Sugmel-10, Sarichun, Yuna-4, Sema-3, and Sojid-11. Conventional medicines included following: ciprofloxacin, cefasolin, and negram. After 10-14 days of treatment questionnaire, physical examinations, and laboratory tests were performed. In 90% of patient treated with traditional medicines, changes of smell and color of urine was disappeared. Back pain and dysuria was reduced in 89.7% and 75% of patients respectively. While in control or conventional treatment group, changes of smell and color of urine was completely disappeared and back pain and dysuria was reduced in 80% and 88% of patients respectively. Pasternatskii’s symptom and arterial hypertension was reduced in about 58% and 77% of patients respectively. Bacterial growth (Escherichia coli and Staphylococcus aureus) was ceased in 39.4% and reduced in 46.4% of patients treated with traditional medicines. It was ceased in 60% and reduced in 30% of control patients.Traditional medicines reduced signs and symptoms of chronic pyelonephritis. Bacterial growth was ceased or reduced by traditional treatment. Traditional medicines are effective as conventional medicines for treatment of chronic pyelonephritis.