1.Relationship between Drinking Water Fluoride Level and Dental Caries among Ulaanbaatar districts
Oyunkhishig Kh ; Khulan U ; Erdenechimeg N ; Bayarchimeg B ; Soyolmaa M ; Urjinlham J
Innovation 2016;2(1):32-34
The present study was conducted to assess relationship between drinking water fluoride levels and dental caries among 12 years old school children of 2 districts of Ulaanbaatar city, Mongolia.
A cross-sectional analytical study was conducted on 533 school children aged 12 years, selected from 6 schools of 2 districts of Ulaanbaatar city. 533 children were divided into 2 groups according to the fluoride concentration of the waters. The all children were examined oral examination, dental caries was assessed by the DMF-T index.
The result of the present study revealed that the caries prevalence in the study population was about 68,9%, and mean DMF-T was 3.05. Water fluoride concentration was highest in Khan-Uul district with 0.622ppm.
There was highest prevalence of caries in children who consume water from filtration system in both districts.
2. MENTAL HEALTH PROBLEMS AMONG SEXUAL MINORITY GROUP WITH HIV
Erdenechimeg R ; Khihigzuren Z ; Jargal B ; Tungalag M ; Davaalkham J
Innovation 2015;9(1):76-80
There were currently diagnosed by totally 177 cases with HIV in our country. The 82.3% of those were male and 72.9% of them were men sex with man. Sexual minority group especially men who intercourse with male are highly risk to HIV infection. By the study of 2011, which aimedto assess risk to exposure HIV infection among sexual minority group, 56.2% of all participants answered as had depression symptoms and 12.8% of them seen to psychologist and health workers. In addition, 2% of them used by injection of drug for last year, and 60.6% harmfully drank.The study was done by quantitative and qualitative methods and used specific designed questionnaire for sexual minority with HIV infection. Totally 26 consumers participated in our survey. Before the starting of the study, we introduced inform consent to all participants and if they agreed to participate, we coded research cards and collected the information.All participants were answered alcohol drink, and 46.1% of them determined with heavy drinking or harmful consumption by the AUDIT versus 7.8% were alcohol dependence. 65.3% oftotal participants used as smoke, 5 cases used cannabis; one of them has been used within last twelve months. In addition, 23.1% of all participants had anxiety and 15.3% had mild depression symptoms. Of the total 26 cases, 7 cases had suicide thinking related with sexual orientationand 2 cases had suicide thinking related with HIV infection. Those cases answered often feeling hopeless and helpless.In sexual minority group with HIV, alcohol and tobacco consumption was high, drug abuse was low. 15.3-23.1% of all participants had depression and anxiety symptoms. Suicide thinking has been occurred for those cases it means risk to suicide commitment.
3. Personal noise exposure of workers at Erdenet Mining Corporation
Bolormaa M ; Delgermaa V ; Naransukh D ; Erdenechimeg E
Innovation 2015;9(2):24-26
Noise exposure is one of most common health hazards at workplace. But,there is very limited data of about occupational exposure to noise at workplaces in Mongolia. This study evaluated noise exposure among the workers. In pilot study, noise pressure level was measured for 103 Mechanical factory and office workers forfull work shifts by A-weighting scale. Personal noise dosimeters, Etymothic R-200DW7 were used to measure noise level. Average noise pressure levels ofworkers were 87.56 dBA in mechanical factory, 86.29 dBA in mechanical shop and 90.24 dBA in casting shop. Noise levels in the casting shop were exceeded by 1.29-5.24 dB for Recommended Exposure Level (REL).
4. Relationship between Drinking Water Fluoride Level and Dental Caries among Ulaanbaatar districts
Oyunkhishig KH ; Khulan U ; Erdenechimeg N ; Bayarchimeg B ; Soyolmaa M ; Urjinlham J
Innovation 2016;2(1):32-34
The present study was conducted to assess relationship between drinking water fluoride levels and dental caries among 12 years old school children of 2 districts of Ulaanbaatar city, Mongolia.A cross-sectional analytical study was conducted on 533 school children aged 12 years, selected from 6 schools of 2 districts of Ulaanbaatar city. 533 children were divided into 2 groups according to the fluoride concentration of the waters. The all children were examined oral examination, dental caries was assessed by the DMF-T index.The result of the present study revealed that the caries prevalence in the study population was about 68,9%, and mean DMF-T was 3.05. Water fluoride concentration was highest in Khan-Uul district with 0.622ppm.There was highest prevalence of caries in children who consume water from filtration system in both districts.
5.RESULT OF 7-YEAR STUDY ON RESTENOSIS AND THROMBOSIS IN AFTER PCI TREATMENT SETTING
Lkhagvasuren Z ; Narantuya D ; Batmyagmar Kh ; Erdembileg D ; Bayaraa T ; Byambatsogt L ; Erdenechimeg M
Innovation 2018;12(4):6-9
BACKGROUND. The aim of this study was to investigate the prognostic impacts of drug-eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI) and risk factors of stent restenosis.
MATERIAL AND METHODS. We conducted a retrospective cohort study based on the Angiographic diagnostic and treatment Department of 3rd State Central Hospital of Mongolia. Patients who had undergone coronary stenting between 2000 and 2017 were recruited and monitored until the end of 2010.
RESULTS. Among a total of 4520 selected patients with a mean age of 58±7 years, 2125 subjects had BMS and 2395 subjects had DES. The incidence of stent restenosis and stent thrombosis were significantly lower in the DES (37; 1,5%) group as compared with the BMS (201; 9,4%) group. Patients who have stent restenosis presented comorbidities, such as diabetes 214(47,8%), hypertension 54(22,6%), prior PCI 21(8,2%), re-infarction 12(5,04%), chronic kidney disease 16(6,7%), hyperlipidemia 21(8,2%).
СONCLUSION. Implantation of DES was related to better outcomes than for BMS, in terms of reducing restenosis and stent thrombosis after PCI. STEMI patients who have co morbidities have greater risk of stent stenosis and thrombosis
6. SURGICAL REHABILITATION OF NERVUS FACIALIS LESION
Erdenechuluun B ; Jargalkhuu E ; Zaya M ; Enkhtuya B ; Olziisaikhan D ; Gansukh B ; Jargalbayar D ; Ariunchimeg M ; Dolgorsuren L ; Adiya T ; Chuluunsukh D ; Erdenechimeg B ; Batkhishig B ; Altantsetseg Z ; Ranjiljov V ; Delgerzaya E ; Baigal M
Innovation 2016;2(2):13-16
There are a lot of influencing factors of facial nerve palsy; experts believe that is most likely caused by a Virus (54%) and Bacterial infections. Noninfectious causes of facial nerve palsy induce tumors (28%) and less commonly influences head trauma (18%). The retrospective analysis of WHO, in 2012. There are some cases of postoperative complication in middle ear surgery is facial nerve palsy and the total recovery outcome of function was not good. From 2013 to 2016 in EMJJ hospital, Mongolia, we enrolled 16 cases with facial nerve damaged in intratympanic canal but we could not recruit some patients with facial palsy over 6 months. Each subject was tested with pure tone test, ABR, Tympanometry. These were performed for the detection of hearing loss after Temporal bone injury. Then we also investigated location of facial nerve damages of patients by MRI and CT before reconstructive surgery. After that surgery, all patients were given corticosteroid treatment (20mg/day) and physical therapy performed such as acupuncture for a week. Study results revealed that 6 cases after 18 days, 2 cases after 30 days, 1 patient after 45 days of reconstructive surgery regained good symmetry. Therefore, we considered that, postoperative treatments like physical therapy with B12, steroid had good benefits for operation result and to shorten the recovery time. There was a patient who had damaged facial nerve in the tympanic segment during Mastoidectomy. In that case, we performed cable nerve grafting using the r.auricularismagnium but we could not recover facial nerve function. Traumatic facial nerve paralysis is the second most common type. We discussed that performing reconstruction surgery within first 3 months after intratemporal facial nerve injury is extremely desirable and more effective. In our opinion, nerve recovery might be not successfully cause of injured myelin sheet of facial nerve during middle ear surgery.
7. Results of the otosclerosis surgery treatment
Jargalkhuu E ; Erdenechuluun B ; Zaya M ; Bazarmaa B ; Jargalbayar D ; Gansukh B ; Enkhtuya B ; Olziisaikhan D ; Chuluunsukh D ; Batkhishig D ; Erdenechimeg D
Innovation 2015;ENT(1):36-39
Otosclerosis is a disease that involves the cochlea and it is developed when the structure ofconnecting tissue in the area of stapedius and the oval window has changed and become unmovable.Consequently, conductive hearing loss and therefore severe sensorineural hearing loss are caused.The causes of otosclerosis have not been discovered yet but many factors impact on this disease. Anyresearch works has not been done on otosclerosis in Mongolia until now and we have conducted theresearch in 2008-2013. Therefore, we aimed to identify the hearing condition after surgery treatmentof otosclerosis.41 patients /47 ears/ who were diagnosed of having otosclerosis with conductive hearing loss, nomiddle ear infection through the comprehensive ear and hearing examinations were selected in thisstudy which was done at EMJJ Clinics between 2007 and 2013. The hearing improvement after thesurgery has been tested under bone and air conduction frequency 500, 1000, 2000, 4000, 8000 Hzand the results before and after the surgery were statistically processed on Excel 2010 and SPSS 17.0software programs. Stapedotomia and Stapedoectomia surgery approaches were applied and afteropening of attics, the hearing bones are palpated and the diagnosis of stapes otosclerosis is confirmedby the surgeon, who removes the stapes. Then a titanium K-piston (prosthese or implant) is thenplaced into this opening and connected to the malleus, or the incus.Out of 41 patients (85.4% female) involved in the study and 36 people had one ear side otosclerosisand 5 people had both ear otosclerosis. After the surgery 25 patients did not have dizziness andvomiting symptoms and 14 patients did not have dizziness with movement after 12 hours, andfor 4 patients all symptoms were disappeared after 24 hours. As for the result from the hearingexamination after 21, 60 days of the surgery, bone conduction was normal, air conduction, andhearing for 32 patients improved completely, and after 120 days of the surgery, the hearing of 33patients improved completely, bone conduction became 2000 Hz at 4000 Hz frequency 12-15 dB,average of air conduction 15,4±10,1 dB, bone-air gap 10,4±3,1 dB for 5 people, and bone conduction2000 Hz-4000 Hz, at 8000 Hz frequency 20-40dB, air conduction became 25-45dB 10,4±5,1db for 9patients and all patients had no hearing loss except for 4 people who still had tinnitus.After surgery stapedotomia and stapedoectomia for the otosclerosis, the hearing improvement was95.2% and it has been concluded that there is full possibility to perform surgeries of stapedotomia andstapedoectomia for the otosclerosis in Mongolian situation.
8.Sex differences on risk factors, clinical characteristics and early death of stroke
Khandsuren B ; Punsaldulam B ; Bolormaa D ; Uuriinmuya M ; Mandakhnar M ; Oyungerel B ; Sarantsetseg T ; Tuguldur E ; Erdenechimeg Ya ; Baasanjav D ; Chimeglham B
Mongolian Medical Sciences 2021;197(3):40-47
Background:
Stroke is one of the leading causes of mortality and disability worldwide. Understanding
sex differences in risk factors, clinical characteristics and death after stroke might provide valuable
evidence for prevention and management of stroke.
Aim:
We aimed to describe sex differences in risk factors, clinical characteristics and death after
intracerebral hemorrhage (ICH) and ischemic stroke (IS) using hospital-based registry in 6 districts
of Ulaanbaatar, Mongolia.
Materials and methods:
We used hospital-based stroke registry in Ulaanbaatar Mongolia. From
2019 to 2020, total of 974 patients with acute ICH and 1612 patients with acute IS were enrolled in
this study. The severity of stroke was measured by National Institutes of Health Stroke Scale (NIHSS)
and Glasgow Coma Scale (GCS). Risk factors for stroke were defined as patient’s history and their
medical record. Death after stroke was registered at 28 days and 90 days by follow-up study. A
comparison of categorical and continuous variables was analyzed using chi-squared test, Student’s
t-test and Mann Whitney U test. Univariable and multivariable logistic regression analyses were also
performed.
Results:
The mean age of ICH patients was 58.41±11.56. There was significant difference in age (59
vs 57, p=0.009) between women and men. Men with ICH were more likely to drink alcohol (35.4% vs
5.2%, p=0.000) and to smoke (37.0% vs 8.4%, p=0.000) and to have arterial hypertension (72.7% vs
58.6%, p=0.000). However, there were no significant differences in other risk factors including atrial
fibrillation, diabetes mellitus, prior stroke and other cardiac diseases. There were no sex differences
in clinical characteristics including systole and diastole blood pressure, NIHSS scores and GCS. In
our study, case fatality rate was 23.8% at 28 days and 1.9% at 90 days after ICH. By multivariable
regression analyses, there were no significant association between sex and death at 28 days and at
90 days (OR:0.74; 95% CI:0.52-1.06, OR: 0.80; 95% CI:0.29-2.21).
The mean age of IS patients was 61.07±12.88. The women were older (63 vs 59, p=0.000) than men.
Men with IS also were more likely to be current smokers (37.6% vs 9.0%, p=0.000), current drinkers
(33.2% vs 3.4%, p=0.000) and to have arterial hypertension (74.7% vs 65.9%, p=0.000). There were
no significant differences in other risk factors. For IS patients, there also was no sex difference in
clinical characteristics. Case fatality rate was 13.3% at 28 days and 1.1% at 90 days after IS. By
multivariable regression analyses, there were no significant association between sex and death at 28
days and at 90 days (OR:0.90; 95%CI: 0.64-1.26, OR:5.16; 95%CI: 0.99-23.9).
Conclusion
Our study showed sex differences in some vascular factors of both stroke subtypes
which emphasized that we need to implement stroke prevention targeting sex-specific risk factors.
While clinical characteristics and early mortality of intracerebral hemorrhage and ischemic stroke
were not differed by gender.
9.Incidence and mortality of stroke in Ulaanbaatar and its last 20 years’ trend
Oyungerel B ; Chimeglham B ; Erdenechimeg Ya ; Sarantsetseg T ; Bolormaa D ; Tuguldur E ; Uuriintuya M ; Mandakhnar M ; Khandsuren B ; Punsaldulam B ; Tovuudorj A ; Baasanjav D ; Burmaajav B
Mongolian Medical Sciences 2021;197(3):64-79
Background:
Globally the incidence of stroke is not decreasing, and the deaths and disabilities
caused by stroke is increasing every year, especially in low and low-middle income countries.
Long-term trends in stroke incidence in different populations have not been well characterized, largely
as a result of the complexities associated with population-based stroke surveillance.
Having reliable data on stroke morbidity and mortality, as well as periodic identification of long-term
trends will be important information for proper prevention planning in the population, monitoring the
disease and further improving the quality of health care.
Material and Method:
A prospective cohort study has been conducted in adult citizens (972409 in
2019, 925367 in 2020) of 6 districts of Ulaanbaatar from the 1st of January, 2019 to 31st of December,
2020. All first-ever and recurrent stroke cases were included using special software, developed for
stroke registry, based on the WHO STEPS approach from participating radiology departments of state
hospitals, district hospitals, and some private hospitals. Information of stroke death was obtained
from forensic institute and state registration office of the capital city.
The trends of stroke incidence and mortality was compared to data between 1998-1999 and 2019-
2020 in UB.
Results:
The age-standardized crude incidence rate per 100.000 person-years of stroke were
209.0/100.000 (n=1934) in 2019 and 194.0/100.000 (n=1821) in 2020 among adults of UB city. The
above results were compared to 1998-1999 studies and the incidence rate declined by 94.0/100.000
in 2019-2020, whereas mortality rate increased by 10.0/100.000 in women aged 16-34. Stroke
mortality was 11.6% in 1998 and 26.5% in 1999, while in our study it was 33.87% in 2019 and 29.71%
in 2020. Although the incidence of stroke rates has decreased in 1998-1999, the mortality rate has
not decreased significantly.
Conclusion
Morbidity and mortality rates among the population of Ulaanbaatar citizen remain
highest in the world, compared to 20 years ago with overall morbidity declining but mortality has not
decreased.
In recent years, the Government of Mongolia has been focused on reducing non-communicable
diseases, but the primary and secondary prevention and control of stroke in the general population,
as well as the acquisition of knowledge attitudes, practices and access to health care still need to be
improved.
10.A population-based stroke registry in Ulaanbaatar: preliminary result
Oyungerel B ; Chimeglkham B ; Erdenechimeg Ya ; Sarantsetseg T ; Bolormaa D ; Tuguldur E ; Uuriintuya M ; Khandsuren B ; Mandakhnar M ; Baasanjav D ; Tovuudorj A ; Burmaajav B
Mongolian Medical Sciences 2020;193(3):11-21
Background:
Stroke is still one of the leading causes of morbidity and mortality worldwide. Registry-based data of
stroke are scarce in low and middle-income countries such as Mongolia. We aimed to investigate the
incidence and mortality of stroke in adult population of UB Mongolia by stroke registration method.
Material and Method:
Covering 611265 (≥15 years old) adult citizens of three districts of Ulaanbaatar, a population-based
prospective study was done from the first, January of 2019 to 31st, December of 2019. All first-ever
and recurrent stroke cases were included using special software, developed for stroke registry, based
on the WHO STEPS approach from participating radiology departments of state hospitals, district
hospitals, and family clinics. Information of stroke death was obtained from forensic institute and state
registration office of the capital city.
Results :
In a 1-year study period, 1068 (women 39.1%) stroke cases were registered in people with 60.16±13.66
years old. Stroke incidence rate was 169.81/100000 including first-ever and recurrent events. Stroke
incidence rate was higher in men and people with 80 and above years old. The ratio between IS and
ICH was 1.14:1.0. Stroke mortality was 27.1% and mortality rate was 45.94/100000. The highest rate
mortality was in ICH subtype, male population and older people.
Conclusion
We identified relatively high incidence and mortality rate of stroke in ICH indicating an urgent need for
improvement of arterial hypertension control, health education and primary prevention mainly among
men.