1.Prevalence of occult hepatitis B virus infection among blood donors in Ulaanbaatar city, 2013
Tserendejid M ; Naranchimeg L ; Erdenebayar N
Mongolian Medical Sciences 2015;172(2):10-13
remains the most frequent transfusion-transmitted viral infection; thus, the term occulthepatitis B virus infection (OBI) was introduced. OBI is simply defined as serologically undetectable hepatitis Bsurface antigen (HBsAg-ve), despite the presence of circulating HBV DNA with or without the presence of HBVantibodies.GoalTo determine the prevalence of occult hepatitis B among blood donors and evaluate the presence of HBV DNAin HBsAg negative plasma samples.Materials and MethodsIt includes 16700 samples which donated in NCTM in Ulaanbaatar in 2013. We used to “triplex” PCR assay thatincluded the detect of hepatitis B virus HBV-DNA in addition HCV-RNA and HIV1/2-RNA for whom with absenceof serological markers of infection. The studies used molecular biology methods were performed with the help ofequipment (ROCHE COBAS S 201) and technology based on Real Time PCR (pool size: 6 donation) Then wechoose HBsAg negative, DNA positive samples and determined, anti-HBc and anti-HBs by serological methods,of ELISA Wantai HBc and HBs 3.0 tests.ResultsThe 14948 samples were detected serological negative in the total of 16700 samples. PCR test results show 35(0.23%) positive by HBV-DNA 29 (82.9%) of the 35 DNA positive blood donors were alone anti-HBc positive and3 (8.6 %) were anti-HBs, anti-HBc positive. 7(17.1%) were seronegative. Of the 35 OBI cases, 28 (80%) weredetected the first time they were screened for HBV DNA while 7 (20%) gave one more HBV PCR-nonreactiveresults before detection. Callback studies we determined 2 cases were pre-HBsAg window period.Conclusion:The prevalence of HBV DNA positive in HBsAg negative blood donors is found 0.2%. HBV NAT needs eitherextreme sensitivity or to be performed on individual donations to eliminate HBV DNA-containing units.
2.Results of psychotherapy in patients with mental and behavioural disorders due to use of alcohol
Erdenebayar L ; Erdenechimeg R
Mongolian Medical Sciences 2014;167(1):15-19
BACKGROUND. WHO experts had identified as 4 percentage of total mortality in our glob is due toharmful use of alcohol [1]. Prevalence of the mental and behavioral disorders due to use of alcohol isoccurred 13.6 percent among the population aged 15-65 years old, thereof 22.0% of man and 5.0%of women in the morbidity of Mongolia [2].Thus, study in clinical features in patients with mental and behavioral disorders due to use of alcoholand result of psychotherapy among patients are required in this field.OBJECTIVE: Identifying of the result of psychotherapy and study on withdrawal features amongpatients with mental and behavioral disorders due to use of alcohol is proposed objective of thisclinical research.MATERIALS AND METHODS: In first stage, researchers had been used AUDIT tools and selected 200patients with mental and behavioral disorders due to use of alcohol among the alcohol users. Second,withdrawal scale determined among the selected patients using by SAWS test. In third stage, resultsof psychotherapy among the patients with mental and behavioral disorders due to use of alcohol hadbeing compared with results of control group without psychotherapy. In statistical analysis, there isused CI at P<0.05andRR=p1/p2) at the CDC-EpiInfoOE2.3.RESULTS: Result of psychotherapy among patients in trial group with mental and behavioral disordersdue to use of alcohol was identified directly 80.1%, and after 3 months - 82.3% on SAWS test,respectively direct result was 64.20% (RR=1.2) and after 3 months - 47% (RR=1.8)among patientsof control group on SAWS test .Furthermore, results were 77.3%, and after 3 months - 75.3% on SADD test among trial grouppatients. Same time the direct result was 71.30% (RR=1.1), and after 3 months -66.50% (RR=1.1)among patients in control group on SADD test.
3.Results of screening for cytomegalovirus infection among blood donors in Ulaanbaatar, Mongolia
Tsogbadrakh B ; Naranchimeg L ; Erdenebayar N ; Munkhbayarlakh S
Mongolian Medical Sciences 2015;172(2):7-9
Background. Most people infected with Cytomegalovirus (CMV) have no signs or symptoms, but newborns andpeople with weakened immune systems are more at risk of developing signs and symptoms. CMV remains in thebody throughout a lifetime. Infected people may spread infection.Goal. The main aim of this study is to determine the prevalence of infection of cytomegalovirus (CMV) by enzymeimmunosorbent assay.Materials and Methods. In this study included subjects, age range of 17-60 years (total of 716) blood donorswho were served by the National center for transfusion medicine. Screening for Cytomegalovirus CMV IgG andIgM specific antibody concentrations determined using DIALAB ELIZA kits.Results. CMV-specific IgG antibodies were detected in 99.2% (710) of the studied subjects and, specific IgMantibodies in 0.1% (1). IgG antibodies positive individuals are compared to 4 blood groups and (p = 0.01) differencewas not statistically significant. IgG antibodies negative 6 individuals are included all in blood type B(III). IgMspecific antibodies positive (1) individual was in the age group 26-40 years, female and type of regular donor.Conclusion. We can conclude from our results of the determination of CMV IgG and IgM specific antibodiesshows that a number of risks of transfusion transmitted infection cytomegalovirus.
4.Study of prevalence of smoking and risk factors in school girls of the 6-11th grades
Erdenebayar L ; Elena K ; Munkhtuya S
Mongolian Medical Sciences 2013;163(1):95-100
IntroductionIn the total increase in the rate of smoking in the population of Mongolia, the smoking rate among women of the age of 15-24 years old increased up to 4.2% which is higher by 1.9 points against the level of the year 2005. The average age of starting smoking among women decreased by 3 years compared to 2005 evidencing the increase in the prevalence of smoking among the female population. However, there is no study on prevalence of smoking focusing on school age girls. Researches on the prevalence of smoking and KAP of the population shall play an important part in reduction of tobacco consumption, assisting smoking cessation and determining the effective forms of anti-tobacco communications.Materials and MethodsThe study of the tobacco consumption and risk factors among the school age girls of the 6-11th grades is a cross-sectional study covering the school age girls of 6-11th grades of Suhbaatar, Chingeltei, Bayangol and Songinokhairkhan districts of Ulaanbaatar and Uvurkhangai, Khovd, Dornod and Umnugobi aimags. The participants of the study were selected by random sampling. The study used qualitative and quantitative methods. The study involved 1208 school age girls of 6-11th grades. The data of the survey was analyzed with SPSS software.ResultsEvery third or 33.7% of the schoolchildren of 6-11th grades smoke. The rate of smoking is as twice higher in the metropolitan settings as in provincial aimags. The answer that there are smokers in the family given by 64% of the respondents implies that two in three target age school girls are exposed to second-hand smoking. Every fifth of the girls find themselves in tobacco affected areas daily. Of the target age/gender group, 36.5% reported that they buy cigarettes in kiosks, shops and stores and one in each two schools have any form of tobacco selling points within 100 meters which implies a potential impact of the surrounding environment. Around 90% of the participants of the quantitative survey were able to correctly list the health hazards of smoking, however, the qualitative survey results demonstrate that they have confusions on the health hazards of smoking and have insufficient understanding of the long term effects of smoking.Conclusions:1. Girl in the metropolitan settings smoke more than in provincial settings.2. Smoking at schools and public places are common in both metropolitan and provincial areas.3. The smoking behaviors of the girls are influenced by their and peers. insufficient knowledge 4. It was identified by the research that all smoking girls in the capital and in provinces are wishing to quit smoking.5. Though the girls receive information on tobacco from mass media, friends and Health Education subject, the information received through these channels are insufficient to impact their knowledge and change their behavior.6. The number of school children exposed to the impact of tobacco tends to increase by their age.
5.Attitude towards to blood donation among population, Mongolia, 2019
Oyuntsetseg D ; Suvd B ; Enkhjargal A ; Erdenebayar N
Mongolian Medical Sciences 2019;190(4):38-47
Background:
Blood is an important resource, both for planned treatments and urgent interventions. It can help
patients suffering from life-threatening conditions live longer and with a higher quality of life, and
supports complex medical and surgical procedures. According to WHO recommendation at least 1%
of the population of any country needs to donate their blood to accommodate the basic clinical needs
of the country. Accordingly, we aimed to assess existing attitudes of the general population towards on blood donors.
Materials and Methods:
The survey identified attitude of the population on blood donation and factors influencing them, using
quantitative and qualitative methods. The survey covered a population aged 18-60 years. SPSS
software version 21 was used for data analysis of the survey. The survey protocol and methodology
were reviewed and approved by the Scientific Committee at the NCPH. The Medical Ethical Committee
at the MOH reviewed the survey materials and issued an approval (2015/3).
Results:
The survey covered in total 3,782 people and there are 59.2% of surveyed respondents said they
have never thought of becoming a voluntary blood donor. Positive attitude on blood donation is
higher with statistical significance among women (59.0%), 18-25 years old (43.7%) and UB residents
citizens with higher education. As education level increases the number of respondents who thought
about donating blood is also increases. 16.1% of them had a history of blood donation before and
38.2% said they never thought about it. Twenty point four percent of respondents thought blood
donation brings some kind of risk. Nevertheless of the education level of surveyed respondents,
the percentage of answer blood donation is not risky for a person was the most common answer.
But respondent who is only literal and uneducated were don’t know about whether it has a risk or
not (385.37=2א, p=0.000001). Also, respondents failed to donate their blood because the family not
allowed, afraid, risk of infection, doesn’t want and had a busy schedule.
Conclusion
There is a high tendency to donate blood populations of young people aged 20-29, women, residents
of Ulaanbaatar, and uneducated and highly educated. The majority of respondents agreed that blood
donating is charity and a good deed. The leading causes of blood donation is the education, gender,
the desire of doing a good deed, peer influence and health condition.
6.Obstructive Sleep Apnea Screening Using a Piezo-Electric Sensor.
Urtnasan ERDENEBAYAR ; Jong Uk PARK ; Pilsoo JEONG ; Kyoung Joung LEE
Journal of Korean Medical Science 2017;32(6):893-899
In this study, we propose a novel method for obstructive sleep apnea (OSA) detection using a piezo-electric sensor. OSA is a relatively common sleep disorder. However, more than 80% of OSA patients remain undiagnosed. We investigated the feasibility of OSA assessment using a single-channel physiological signal to simplify the OSA screening. We detected both snoring and heartbeat information by using a piezo-electric sensor, and snoring index (SI) and features based on pulse rate variability (PRV) analysis were extracted from the filtered piezo-electric sensor signal. A support vector machine (SVM) was used as a classifier to detect OSA events. The performance of the proposed method was evaluated on 45 patients from mild, moderate, and severe OSA groups. The method achieved a mean sensitivity, specificity, and accuracy of 72.5%, 74.2%, and 71.5%; 85.8%, 80.5%, and 80.0%; and 70.3%, 77.1%, and 71.9% for the mild, moderate, and severe groups, respectively. Finally, these results not only show the feasibility of OSA detection using a piezo-electric sensor, but also illustrate its usefulness for monitoring sleep and diagnosing OSA.
Heart Rate
;
Humans
;
Mass Screening*
;
Methods
;
Sensitivity and Specificity
;
Sleep Apnea, Obstructive*
;
Sleep Wake Disorders
;
Snoring
;
Support Vector Machine
7.Automatic Prediction of Atrial Fibrillation Based on Convolutional Neural Network Using a Short-term Normal Electrocardiogram Signal
Urtnasan ERDENEBAYAR ; Hyeonggon KIM ; Jong Uk PARK ; Dongwon KANG ; Kyoung Joung LEE
Journal of Korean Medical Science 2019;34(7):e64-
BACKGROUND: In this study, we propose a method for automatically predicting atrial fibrillation (AF) based on convolutional neural network (CNN) using a short-term normal electrocardiogram (ECG) signal. METHODS: We designed a CNN model and optimized it by dropout and normalization. One-dimensional convolution, max-pooling, and fully-connected multiple perceptron were used to analyze the short-term normal ECG. The ECG signal was preprocessed and segmented to train and evaluate the proposed CNN model. The training and test sets consisted of the two AF and one normal dataset from the MIT-BIH database. RESULTS: The proposed CNN model for the automatic prediction of AF achieved a high performance with a sensitivity of 98.6%, a specificity of 98.7%, and an accuracy of 98.7%. CONCLUSION: The results show the possibility of automatically predicting AF based on the CNN model using a short-term normal ECG signal. The proposed CNN model for the automatic prediction of AF can be a helpful tool for the early diagnosis of AF in healthcare fields.
Atrial Fibrillation
;
Dataset
;
Delivery of Health Care
;
Early Diagnosis
;
Electrocardiography
;
Methods
;
Neural Networks (Computer)
;
Sensitivity and Specificity
8.The treatment of the leg deep vein thrombosis
Suvd S ; Gundegmaa Ts ; Baasanjav N ; Erdenebayar A
Mongolian Medical Sciences 2018;185(3):147-151
Thrombosis is a term for a blood clot occurring inside a blood vessel. R. Virchow postulated that
abnormalities in blood flow, hypercoagulability of the blood, and injury to the vessel wall are causally
related to thrombus formation. Many of the risk factors for deep vein thrombosis aretrauma for 9.3-
18.8%, birth for 16-17.3%, surgery for 14.3-30.3%, infection disease for 9.7-15.9%, cancer for 3.5%,
heart disease for 4.6% and 6.9-11.8% of deep vein thrombosis is an indistinct cause. Pain, swelling,
warmth, edema and redness in the affected leg are common symptoms.The diagnosis of deep vein
thrombosis of the leg can be difficult with clinical findings and history being unreliable. The National
Institute of Health and Care Excellence has evidence based recommendations on the prevention
and management of a wide range of health conditions. Here: incorporation of a clinical predication
score, D-dimer, and venous duplex ultrasound. The D-dimer blood test measures degraded fibrinogen, which is raised in patients with a clot. However, it cannot confirm deep vein thrombosis, as
D-dimer can be raised in other conditions including malignancy, infection, pregnancy, post-surgery,
inflammation, trauma, disseminated intravascular coagulopathy, and renal impairment. There are
two types venous ultrasound as the first line investigation for suspected deep vein thrombosis.
The aim of treatment for deep vein thrombosis are:
• The prevention of a thrombus progress
• Decrease the risk of the pulmonary embolism
• The reduction of the thrombus expansion or resolution.
• The prevention of the post thrombotic symptoms
• Decrease the mortality of vein thrombosis
Guidelines from NICE and ACCP recommended direct oral anticoagulants as first line treatment for
deep vein thrombosis. Direct oral anticoagulants include direct factor Xa inhibitors apixaban, rivaroxaban, and edoxaban, and a direct thrombin inhibitor dabigatron
9.Usage of blood and blood product
Oyuntsetseg D ; Enkhjargal A ; Erdenebayar N ; Suvd B ; Burmaajav B
Mongolian Medical Sciences 2020;193(3):47-53
Background:
A blood product is any therapeutic substance derived from human blood, including whole blood
and other blood components for transfusion, and plasma-derived medicinal products. Medicinal
(medical therapeutic) products derived from human donations of blood and plasma play a critical
role in health care. Safe, effective and quality-assured blood products contribute to improving and
saving millions of lives every year, as they: address child mortality and maternal health, dramatically
improve the life expectancy and quality of life of patients suffering from life-threatening inherited
disorders, such as haemophilia, thalassaemia and immune deficiency, and acquired conditions
such as cancer and traumatic haemorrhage and support complex medical and surgical procedures,
including transplantation. An insufficient or unsafe blood supply for transfusion has a negative impact
on the effectiveness of key health services and programmes to provide appropriate patient care in
numerous acute and chronic conditions. Ensuring access of all patients who require transfusion to
safe, effective and quality-assured blood products is a key component of an effective health system
and vital for patient safety.
Although the number of blood donors is increasing, there are still insufficient human and financial
resources for encouraging the growing demand of blood and blood products and new blood donors.
Material and Methods:
We collected secondary data by using using the order forms of hospitals that used blood and
blood products registered in the National Center for Blood Transfusion Research in 2017-2019 in
accordance with the retrospective survey method.
In total 34,119 hospital order information sheet was entered into computer in excel program, and
converted into SPSS 23 software, descriptive parameters were calculated and analyzed.
Results:
Compare to the 2017 (n=9076), the demand of blood product was increased by 21.8%, and 54.8%
in 2019. There are 51.9% (95%CI: 51.2-52.5) of total users are male, which is statistically significant.
The mean age of blood product users were aged 48.58±21.32, the youngest user was aged 1 and
the oldest age was 99. The demand of blood products were increased by growing of the age of users.
The product usage of age group of 46-55 was 17.8% and has trend to increase year by year. In
total, 11.3% of total blood product was utilized for children and 72.3% of them were aged less than 5
years old. 73.0% of total blood products were utilized in specialized hospitals, 14.6 % of them were
used in aimag and district level hospitals and 11.3% of them were used in private clinics. 24.4% of
blood products utilization was used for diseases of digestive system (К00-К93), 22.1% of them were
used for diseases of the blood and blood-forming organs and certain disorders involving the immune
mechanism, and 19.5% of them were used for the cancer (C00-C97) disease patient’s treatment.
Conclusion
Since after new treatment guidance was introduced the blood and blood products usage had been
increased.
10.Identification of Sleep Apnea Severity Based on Deep Learning from a Short-term Normal ECG
Erdenebayar URTNASAN ; Jong-Uk PARK ; Eun Yeon JOO ; Kyoung Joung LEE
Journal of Korean Medical Science 2020;35(47):e399-
Background:
This paper proposes a novel method for automatically identifying sleep apnea (SA) severity based on deep learning from a short-term normal electrocardiography (ECG) signal.
Methods:
A convolutional neural network (CNN) was used as an identification model and implemented using a one-dimensional convolutional, pooling, and fully connected layer.An optimal architecture is incorporated into the CNN model for the precise identification of SA severity. A total of 144 subjects were studied. The nocturnal single-lead ECG signal was collected, and the short-term normal ECG was extracted from them. The short-term normal ECG was segmented for a duration of 30 seconds and divided into two datasets for training and evaluation. The training set consists of 82,952 segments (66,360 training set, 16,592 validation set) from 117 subjects, while the test set has 20,738 segments from 27 subjects.
Results:
F1-score of 98.0% was obtained from the test set. Mild and moderate SA can be identified with an accuracy of 99.0%.
Conclusion
The results showed the possibility of automatically identifying SA severity based on a short-term normal ECG signal.