1.Validity and Reliability Measurement of the Knowledge and Attitude Survey Regarding Pain Tool Mongolian Version
Battsetseg T ; Nyamaa D ; Enkhtuul Ch ; Bayarjargal Kh ; Enkhtuvshin S ; Orgilmaa R
Mongolian Journal of Health Sciences 2025;85(1):102-105
Background:
Nurses spend the most time with patients when providing medical care, making them a crucial factor in
ensuring appropriate and effective treatment. Their assessment skills play a vital role in pain management.
Aim:
This study aims to determine the validity and reliability of the Mongolian version of the Knowledge and Attitudes
Survey Regarding Pain (KASRP).
Materials and Methods:
A cross-sectional, quantitative study was conducted using the Knowledge and Attitudes Survey
Regarding Pain (KASRP) questionnaire. A total of 145 nurses from the surgical, emergency, and intensive care units of
the National Trauma and Orthopedic Research Center (NTORC), the National Cancer Center of Mongolia (NCCM), and
the National Center for Maternal and Child Health (NCMCH) participated in the study. Statistical analysis was performed
using SPSS-25 software.
Results:
The study included 115 female and 30 male nurses, with an average age of 37.21±7.50 years and an average
work experience of 13.43±7.57 years. The face validity index (FVI) for each item ranged from 0.81 to 1.00. The content
validity index (CVI) for each item ranged from 0.66 to 1.00. The internal consistency of the questionnaire was assessed
using Cronbach’s alpha, which was found to be 0.88.
Conclusion
The Mongolian version of the KASRP demonstrates satisfactory face validity, content validity, and reliability, making it suitable for practical application.
2.Risk factors for common mental disorders in hospitalized patients during the covid-19 pandemic
Enkhtuvshin R ; Yerkyebulan M ; Munkh-Uchral D ; Enkhnaran T ; Mongoljin A ; Munkh E ; Uranchimeg M ; Maidar E ; Amarsaikhan A ; Amirlan B ; Otgonbayar R ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):32-38
Background:
The COVID-19 pandemic has profoundly impacted mental health, particularly exacerbating conditions
such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD), and emotional disorders among hospitalized
patients. This study examined the prevalence of COVID-19-related mental health issues and risk factors in hospitalized
patients affiliated with MNUMS, compared to a control group.
Aim:
To assess the prevalence of mental health disorders such as depression, anxiety, insomnia, and post-traumatic stress
disorder (PTSD), and to identify their associated risk factors.
Materials and Methods:
The study was conducted at hospitals under MNUMS, including the Mongolian-Japanese Hospital,
Central Hospital, and the National Center for Maternal and Child Health. A total of 552 participants (399 case
group, 153 control group) who were hospitalized were included. Depression (PHQ-9≥10), anxiety (GAD-7≥10), insomnia
(ISI≥15), and PTSD (PCL-5≥33) were assessed using standardized scales. Analysis was performed using chi-square tests
and binary logistic regression (crude odds ratio [cOR]/adjusted odds ratio [aOR], 95% confidence interval [CI]), adjusted
for group, age, and sex.
Results:
In the case group, depression (23.1% vs. 13.7%, p=0.015, cOR=1.884 [1.124-3.156]), anxiety (16.8% vs. 11.1%,
p=0.096), and any mental disorder (18.0% vs. 13.7%, p=0.225) were higher, while insomnia was lower (19.5% vs. 30.1%,
p=0.008). PTSD was low overall (1.8% vs. 0.7%, p=0.333). Risk factors included female sex (p<0.001, cOR=0.362 for
depression in males), younger age (p=0.004), unemployment (p=0.017), and prior trauma (p<0.001). COVID-19 symptoms
(difficulty breathing) increased the risk of depression (p<0.001, cOR=2.828 [1.708-4.682]).
Conclusion
Hospitalization for COVID-19 increases the risk of depression and anxiety, modulated by demographic,
clinical, and socioeconomic factors. Targeted interventions for vulnerable groups are essential.
3.Changes in mental health following COVID-19 infection: results of a prospective cohort study in mongolia
Enkhtuvshin R ; Mongoljin A ; Munkh.E ; Uranchimeg M ; Yerkyebulan A ; Munkh-Uchral D ; Enkhnaran T ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):39-44
Background:
COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the
WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first
case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus
affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways
(e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global
studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al.,
BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected
individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National
Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but
long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and
PTSD among COVID-19 patients over 12 months, compared to a control group.
Aim:
To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic
stress disorder (PTSD) among individuals who have had COVID-19
Materials and Methods:
In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited
from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021
and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12
months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases
were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and
multivariable logistic regression (p < 0.05).
Results:
Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12
months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p =
0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19
group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios
confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and
individuals aged 40–59 years were at elevated risk.
Conclusions
1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times
higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control
group.
2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected
after 12 months; this resolution is posited to be associated with the adaptive capacity of the population.
3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.
4.Treatment outcomes of patients diagnosed with mental disorders after discharge from hospitalization during the covid-19 pandemic
Enkhtuvshin R ; Mongoljin A ; Munkh E ; Uranchimeg M ; Yelik M ; Amirlan B ; Yerkyebulan A ; Munkh-Uchral D ; Maidar E ; Amarsaikhan A ; Enkhnaran T ; Оtgonbayar R ; Nasantsengel L ; Khishigsuren Z
Mongolian Medical Sciences 2025;213(3):3-14
Background:
The COVID-19 pandemic has triggered a global mental health crisis. According to WHO
estimates, anxiety and depression rose by 25% in the first year. In the post-COVID era, over
70% of patients experience depression, anxiety, insomnia, PTSD, and OCD, which can persist
for up to 24 months. Hospitalized individuals face heightened risks due to infection severity,
treatment stress, and social isolation. However, studies examining treatment outcomes and
influencing factors remain limited. In Mongolia, mental health issues escalated sharply from
2020 to 2022; WHO data indicate that anxiety and stress were prevalent among healthcare workers and patients. Children and youth were particularly affected, with UNICEF studies
emphasizing the urgent need for intervention. Suicide rates increased from 18.3 per 100,000.
Long-term research on post-COVID mental disorders is scarce, impeding policy formulation.
This study evaluates treatment outcomes in COVID patients and identifies key factors. By
comparing case and control groups at 3 and 12 months, it uncovers differences in symptoms
and treatment responses. The comparative design assesses statistical significance via
P-values and subgroup success rates for CBT and SSRI therapies. Findings will enhance
Mongolia’s mental health services. Larger-scale studies are essential moving forward.
Objective:
To evaluate treatment outcomes for post-COVID mental disorders and identify influencing
factors. To analyze differences in psychological symptoms and treatment between case
(COVID-19 positive) and control groups over 3 and 12 months.
Material and Method:
Retrospective comparative analysis of records from 281 patients (cases n=181, controls
n=100) at a unified hospital from 2020-2022. At 12 months, n=200 (cases n=100, controls
n=100). Patients were categorized by anxiety, depression, insomnia, and stress-related
symptoms, with P-values calculated. Detailed subgroup analysis (n=47 treated patients) was
conducted.
Results:
At 3 months, cases showed higher anxiety (56.4%, P=0.002), depression (41.4%, P<0.001),
and insomnia (58%, P=0.107). At 12 months, differences lessened but anxiety (52%, P=0.023)
and depression (35%, P=0.042) remained significant. COVID-related new symptoms were
elevated in cases (e.g., depression 24.3%, P<0.001). Treatment subgroup success was
95.7% (P<0.001), with duration influencing outcomes (P=0.03).
Conclusion
Post-COVID mental symptoms persist long-term in cases, and extended treatment
durations yield better results. Larger studies are required
5.The results of cervical cancer early screening in women aged between 30-60 years, resident at the 4th khoroo of Bayangol district
Enkhtuvshin Ts ; Udaanjargal D ; Munkhtsetseg B ; Tuyajargal B
Diagnosis 2024;110(3):62-67
Introduction:
According to statistics from the World Health Organization, more than 19.2 million population were diagnosed with cancer in 2020, and 9.9 million population died from cancer. Furthermore, Mongolia leads the world in terms of cancer mortality. In Mongolia, 5981 new cancer incidences were registered in 2021, including cervical cancer, which accounts for 5.2 percent. The average incidence rate of cervical cancer is 19.1 cases per 100,000 females, and the mortality rate is 9.6 cases per 100,000 females, which is high in the region. As of 2021, 68,163 females have undergone early screening of cervical cancer. This represents 28.6 percent of eligible women. It can be seen that the rate of early screening of cervical cancer is low. Thus, it is essential to increase the percentage of early screening by providing knowledge regarding cervical cancer in women.
Purpose:
The study is aimed to screen the women for cervical cancer and make a conclusion among women, living in the 4th khoroo of Bayangol district.
Material and method:
The study was conducted using an analytical cross sectional design. A total of 100 women aged between 30 and 60 years of the 4th khoroo of Bayangol District were randomly chosen, cervical Pap tests were performed, and STATA13 software was used for statistical analysis.
Result:
- Out of a total of 100 females participating in the study, 79% were married, 24.9% had an abortion, 82% do not use contraception, and 17% were post menopausal.
- 80% of the women who participated in the study had a healthy cervical cytology or no tumor cells, while 62% had vaginitis (coccobacillus 71%).
Conclusion
Cervical pap smear results that are healthy or not precancerous indicate good coverage.
6.Efficacy of tenofovir alafenamide in the treatment of chronic hepatitis B infection
Tuvshinbayar N ; Amaraa R ; Burmaajav B ; Gegeebadrakh B ; Dulguun B ; Enkhtuvshin D
Mongolian Medical Sciences 2019;188(2):17-23
Introduction:
Worldwide, an estimated two billion people have evidence of HBV infection, and approximately 240 million have CHB. In this study, a representative group of Mongolian adults was tested for hepatitis B virus (HBV) in 2017. The prevalence estimates of HBV the general Mongolian adult population were found to be 11.1%, respectively.
In April 2017, EASL added a drug newly approved for treatment of CHB, tenofovir alafenamide (TAF) to
their list of recommended first-line therapies. The requirement for long-term therapy in chronic HBV highlights the importance of these efficacy and safety trends, however their true clinical relevance is yet to be established and further studies with long-term follow up and real-world clinical data are needed.
Goal:
Evaluate for result of tenofovir alafenamide in the treatment of chronic hepatitis B infection.
Materials and Methods:
The clinical trials have evaluated TAF in HBeAg-positive and HBeAg-negative chronic HBV
patients. The trials have similar designs and are randomized, double blind, non-inferiority studies.
The primary efficacy endpoint was the proportion of patients with HBV DNA<29 IU/ml at week
24 and 48. Other prespecified efficacy endpoints were the proportion of patients with HBsAg
seroncoversion to anti-HBs at week 24 and 48. Key secondary safety end- points at week 24 and 48
included the percentage change in T-score, and Z-score bone mineral density (BMD), percentage
change in BMD and change from baseline serum creatinine.
Results:
The primary efficacy endpoint, an HBV DNA level <29 IU/ml at week 24, was achieved by 120
(59.1%) of 203 patients receiving TAF, which was non-inferior to the 63 (55.2%) of 114 patients
receiving TDF who had an HBV DNA<29 IU/ml. After 24 weeks of treatment, patients receiving
TAF had significantly smaller reductions in bone mineral density (BMD) compared with patients
receiving TDF.
Conclusion
The development of TAF, specifically designed to deliver potent antiviral activity but with an
improved safety profile compared with TDF, is therefore timely.
7. ENDOMETRIOSIS – CLINICAL PRESENTATION, PROGNOSTIC VALUE OF IMMUNOLOGIC AND CYTOLOGICAL EXAMINATION
Unurjargal D ; Ariuntsetseg A ; Enkhtuvshin U ; Sainkhuu B ; Legshidnyam B ; Dashdemberel B ; Odbaigal T ; Aina K ; Narantuya D ; Enkhbat B ; Ganhuyag B ; Bolorchimeg B
Innovation 2015;9(3):20-24
Endometriosis is described as a chronic inflammatory disease, characterized by endometrial-like tissue, found outside the uterine cavity which cause chronic pelvic pain, infertility,dysmenorrhea. The prevalence of endometriosis is difficult to determine accurately but in asymptomatic women, the prevalence of endometriosis ranges from 2- 22 %, depending on the population studied , in infertile women 20-50 % and in those with pelvic pain, between 40-50% (Balasch, 1996; Eskenazi, 2001; Meuleman, 2009).Endometriosis is found 7-10% of reproductive agewomen and 20-90% in with chronic pelvic pain, infertility cases. Pathogenesis of endometriosis is not yet fully understood but one potential cause of the disease is retrograde menstruation which results in the deposition of endometrial tissue into the peritoneal cavity. Today a composite theory of retrograde menstruation with implantation of endometrial fragments in conjunction with peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Susceptibility to endometriosis is thought to depend on the complex interaction of genetic, immunologic, hormonal and environmental factors. To determine prevalence and severity of clinical symptoms, compare meta-analysis to changes the clinical value of serum CA-125 and peritoneal fluid cytology in women with endometriosis of Ulaanbaatar city. We had selected total of 60 woman with endometriosis which were registered from January to December 2014 in gynecologic clinic of First Maternity Hospital. The research group registered in questionnaire with 28 questions. During the inspection laboratory analysis of serum CA-125, ultrasound analysis and peritoneal fluid cytology were done. Assessment of pelvic pain by means of a 10-point linear analog scale / pain score/ which provided by International Pain Association. The research result was worked out by prospective method. Average age of patients 33.4±8.9. Pain location: Chronic pelvic pain 30%; Dysmenorrhea 28.3%; Dysparunea 10%; Pain during defecation 6,7%; Without pain -25%. Average level of Serum СА125 was 38.13±20.6. Location of endometriosis: adenomyosis - 8.4%, endometrioma-15% endometriotic lesion at cul de suc 68.3%, rectal involment 1.7%, tubal lesion-3.3%, combined 3,3%. 76.7% of surgery for endometriosis have done by laparoscopy and 23.3% by laparotomy. Ultrasound examination result: endometrioma d=0-2cm-1.7%, d= 3-5cm-36.2%, d=6-8cm-10.3%, d=9cm<-12.1%. Cytology result: Peritoneal fluid contains 75% of erythrocytes, mesothelial cells and it needs to further study.CONCLUSION:Most of patient /58.3%/ had chronic pelvic pain and dysmenorrhea. The severity of pain was significantly improved after operative laparoscopy. /p<0.05%/51,7% of patient had infertility problem.Value of serum CA-125 was higher in study group with large sized and not clear content ovarian endometrioma by ultrasound examination. /p<0.05%/The local environment of peritoneal fluid surrounding the endometriotic implant is immunologically dynamic and links the reproductive and immune systems. Peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Peritoneal fluid contains a variety of free floating cells, including macrophages, mesothelial cells, lymphocytes, erythrocytes, eosinophils and mast cells. In our cytology results: peritoneal fluid contains 75% of erythrocytes, mesothelial cells.
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