1.Long term effect of acute COVID-19
Dolgion D ; Natsagdorj U ; Sodgerel B
Mongolian Medical Sciences 2021;197(3):90-96
Most of the infected patients completely recovered after covid-19 infection. However, a substantial
proportion of patients who have been infected with SARS-CoV-2 continue to have symptoms long
past the time that they recovered from the initial phases of covid-19 disease. At NICE guideline,
1. Acute covid-19: signs and symptoms of covid-19 for up to 4 weeks,
2. Ongoing symptomatic covid-19: signs and symptoms of covid-19 from 4 to 12 weeks,
3. Post-covid-19 syndrome: signs and symptoms that develop during or after an infection consistent with covid-19, continue for more than 12 weeks and are not explained by an alternative diagnosis.
In addition to the clinical case definitions, ‘long covid’ is commonly used to describe signs and symptoms that continue or develop after acute covid-19. As the pandemic of covid-19 continues, numerous additional symptoms, such as fever, dry cough, shortness of breath, fatigue, myalgias, vomiting or diarrhea, headache and weakness. Other critical and severe complications of covid-19 can include impaired function of the heart, brain, lung, liver, kidney, and coagulation system. Early reports have now emerged on post-acute infectious consequences of covid-19, with studies from the United States, Europe and China reporting outcomes for those who survived hospitalization for acute covid-19. An observational cohort study from 38 hospitals in Michigan, United States evaluated the outcomes of 1,250 patients discharged alive at 60 day. Of 488 patients who completed the telephone survey in this study, 32.6% of patients reported persistent symptoms. Dyspnea while walking up the stairs 22.9% was most commonly reported, while other symptoms included cough 15.4% and persistent loss of taste/smell 13.1%. Post-hospital discharge care of COVID-19 survivors has been recognized as a major research priority by professional organizations.
2.Distribution of tick-borne diseases at Bulgan province, Mongolia
Rolomjav L ; Battsetseg J ; Bolorchimeg B ; Otgonbayar B ; Urangerel B ; Ganzorig G ; Natsagdorj D ; Bayar Ts ; Altantogtokh D ; Uyanga B ; Burmaajav B
Mongolian Medical Sciences 2022;199(1):24-33
Background:
Tick-borne encephalitis is human viral infection involving the nervous system and transmitted by the bite of infected tick. The TBE Virus is distributed in different geographical areas by three widespread subtypes of the virus: The Far East, Europe, and Siberia. The Far East type has a mortality rate was 30-35%, the European type has a mortality rate of 2.2%, and the Siberian type has a mortality rate of 6-8% (A.G. Pletnev, 1998) [2].
In recent years, human cases of tick-borne infections have been reported in 19 European countries and four Asian countries (Mongolia, China, Japan, and South Korea) [3].
Human cases of tick-borne encephalitis, tick-borne rickettsiosis, and tick-borne borreliosis have been registered in Mongolia since 2005. Deaths have been reported year by year [5].
During 2005 to 2021, tick-borne rickettsiosis (71.6%), tick-borne encephalitis (17.3%) and tick-borne borreliosis (52.9%) were confirmed by epidemiological, clinical and laboratory tests at the NCZD.
Tick-borne encephalitis was registered in 63 soums of 15 provinces and 9 districts of the capital city, of which 90% were infected with tick bites in Selenge and Bulgan provinces. The average mortality rate is 4.9% (14), of which 28.6% in Bulgan province and 2.7% in Selenge province.
Tick-borne encephalitis is the leading cause of death in Bugat soum of Bulgan province and more infected men about 40 years of age [7].
Purpose :
Collect ticks from selected soums of the provinces, identify tick species, species composition, distribution, tick densities, pathogens of tick-borne diseases, conduct population surveys to assess the risk of tick-borne infections, and identify tick-borne infections.
Material and Method:
Ticks were collected by flag from birch trees in birch forests and meadows with biotope and overgrown berries, determined morphological analyze and molecular biological investigation for detecting tickborne pathogens.
Questionnaires were collected from selected soum residents according to a specially designed randomized epidemiological and clinical survey card, collected information and forms were submitted to soum hospitals with a history of tick bites (according to clinical criteria). Serological tests were performed to detect IgG-specific antibodies to the collected serum mites.
Result and conclusion
Collected 121 ticks (120 I. persulcatus and 1 D. nuttalli) and not wound egg, larvae, nymphs. By molecular biological investigation detected 3.5% of I.persulcatus from Khutag-Undur soum of Bulgan province, 3.5% of anaplasmosis, and 14.1% of I.persulcatus mites from Bugat soum. 1.5% borreliosis, 3.1% anaplasmosis.
Detected DNA of 100% tick-borne rickettsiosis from D.nutalli ticks and determined circulation of infection among tick in Bugat and Khutag-Undur soums of Bulgan province.
247 people were surveyed, 56 blood serum from cases. Detected Q fever, erysipelas, and anaplasmosis, tick-borne borreliosis 3 (5.4%), tick-borne rickettsiosis 26 (46.4%), Japanese encephalitis 3 (5.4%), tick-borne encephalitis tick-borne rickettsiosis 6 (13.0%), tick-borne rickettsiosis tick-borne borreliosis 1 (1.8%), tick’s rickettsiosis Japanese encephalitis 1 (1.8%), tick-borne encephalitis tick-borne borreliosis 1 (1.8%).
By investigation, vaccination (88%) and wearing long-sleeved shirts and pants (81%) were the most effective ways to prevent tick bites (81%) [15]. According to our research, the percent of population knowledge in Bulgan province was insufficient (40.9%) which there is a lack of information, training and advertisement among the population in the province.
3.Clinical repercussions of Glanders (Burkholderia mallei infection) in a Mongolia (A case report)
Rolomjav L ; Bayar Ts ; Agiimaa Sh ; Chuluunchimeg Eo ; Natsagdorj B ; Unursaikhan U ; Uyanga B ; Davaakhuu D
Mongolian Medical Sciences 2022;200(2):33-39
The microbiologist, who aged 44 man has work with glander DNA extraction between January and March at 2022, was developed sumptoms with fever, headache, muscle pain, weakness, cut throat, cough at 4 March, 2022. On March 7, he had tested Covid-19 and the result was negative. He was given 1gr tefazoline by eight-time interval for two days. Despite completing the therapy, episodes of fever and headache increased. A medical evaluation, which included MRI test was no disorder was developed. On March 12, painful with leg and developed muscle pain. He continued to difficulty to walk and cough, fever and weakness. On March 13, he has admitted hospital with diagnoses pneumonia.
He had continued sign with pneumonia in both lung, fever, infiltration with right leg, cough, headache, and glandule node in hospital. By PCR test, glander DNA was detected in sputum in National Center for Zoonotic Diseases laboratory. He recovered 20 days in hospital.
He has 12 days incubation period and infection route was by worked with glander strain and it was pneumonia form with laboratory-acquired human glanders.
Human glander case is rare in Mongolia. Three human glander cases had registered in 1966, 1972, 1977 among prison’s horse herder in Mongolia.
4.Result of studying lower extremity arterial occlusive disease by CTA-TASC classification of aorta-iliac and femoral popliteal lesions
Badamsed Ts ; Jargalsaikhan S ; Delgertsretseg D ; Tsetsegmaa B ; Sodgerel B ; Bayaraa T ; Galsumiya L ; Natsagdorj U ; Pilmaa Yo
Mongolian Medical Sciences 2021;197(3):52-58
Background:
Lower extremity arterial diseases are chronic stenosis of the artery and occlusive arterial diseases,
which are commonly caused by atherosclerosis. Prevalence of lower extremity arterial diseases has
positive proportional relationship with age of the patients. Furthermore, prevalence of lower extremity
arterial disease is 16% among the males over the age of 60, whereas prevalence among same aged
woman is 13%. Among the age group of 38 to 59 age, 60 to 69 age and 70-82 age group, prevalence
of lower extremity arterial disease was 5.6%, 15.9%, and 33.8%, respectively.
Goal:
Identifying lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC
classification of aorta-iliac and femoral popliteal lesions.
Obiective:
1. To identify age and sex of the patients with lower extremity arterial occlusive disease and chronic
stenosis of arteries.
2. To identify lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC classification of aorta-iliac and femoral popliteal lesions.
Material and methods:
Study sample consisted of 237 patients, who were diagnosed with lower extremity arterial occlusive
disease and chronic stenosis of arteries from 2019 to 2020 at reference centre on Diagnostic Imaging
na after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central
Hospital. Computed angiogram images of lower extremity arteries were examined. Contrast agent
“Ultravist” was pumped by automatic syringe. Lower extremity arterial occlusive disease and chronic
stenosis of arteries are categorized by CTA-TASC classification of аorta-iliac and femoral popliteal
lesions. The youngest participant was 20 years old and the oldest participant was 76 years old.
Common statistical measurements such as means and standard errors were calculated. Probability
of results were checked using Student’s test.
Results:
We have found following results: 185(78.1%±3.0) cases out of 237 diagnosed patients with lower
extremity arterial occlusive disease and chronic stenosis of arteries are males and 52(21.9%±3.0)
cases are female. Distribution of lower extremity arterial occlusive disease and chronic stenosis of
arteries by the age group of patients are: up to 20 years of age is 3 (1.3%±0.7), 21 to 40 years of age
is 14(5.9%±1.5), 41 to 60 years of age is 86(36.3%±3.1) and over the age of 61 is 134(56.5%±3.2).
It is statistically highly significant that experiencing lower extremity arterial occlusive disease and
chronic stenosis of arteries among the age group of over 61(P<0.001).
The result of lower extremity arterial occlusive disease and chronic stenosis of arteries by the CTA-TASC classification of aorta-iliac and femoral popliteal lesions are: CTA-TASS аorta-iliac lesions
A-16(6.8%±1.8), B-8(3.4%±1.2), C-12(5.1%±1.4), D-41(17.3%±2.5), CTA-TASS femoral popliteal
A-41(17.29%±2.5), B-53(22.36%±3.6), C-47(19.83%±2.6), D-96(40.5%±3.2), respectively.
Conclusions
1. Lower extremity arterial occlusive disease and chronic stenosis of arteries occurs 46.5% over the
age of 60 and 78.1% of the patients are males.
2. Following two categories have identified more than the rest, 17.3% CTA-TASC classification of
аorta-iliac lesions, type D and 23.3% CTA-TASC classification of femoral popliteal lesions, type D.
5.Coronary computed tomography angiography (CCTA) signs of unstable plaques of coronary artery disease
Badamsed Ts ; Delgertsretseg D ; Jargalsaikhan S ; Erdenechimeg E ; Sodgerel B ; Bayaraa T ; Galsumiya L ; Natsagdorj U ; Pilmaa Yo
Mongolian Medical Sciences 2021;197(3):48-51
Background:
The American Heart Association estimates that more than 1 million people die each
year from acute coronary heart disease and half a million from acute coronary syndrome, and
that $ 115 billion a year is spent on diagnosing and treating coronary heart disease [Word Health
Organization, 2013].
Goal:
In this study we aimed to using coronary computed tomography angiography (CCTA) to
diagnose unstable plaques in coronary artery disease.
Material and methods:
From 2018 to 2021, we performed a coronary computed tomography
angiography (CCTA) scan with a Philips Ingenuity 64-slice computed tomography (64 MD-CT)
device and examined 47 patients diagnosed with unstable coronary artery disease at the Reference
centre on Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary
professor of the State Third Central Hospital.
Common statistical measurements such as means and standard errors were calculated. Probability
of results were checked using Student’s test.
Result:
In studying signs of coronary computed tomography angiography (CCTA) to diagnose unstable
plaques in coronary artery disease that coronary artery diameters more widening to compared healthy
artery 16(34.0%±6.9), low density sites clarify in plaque (lower than +30HU)- 14(29.8%±6.7), small
calcification detect in plaque 36 (74.5%±6.4), ring liked additional density (lower than +130 HU)
sees in edge of plaque (Halo sign)-9(19.2%±5.8), plaque edge roughness, erosion liked changes- 18
(38.3%±7.1), rupture of intima (dissection)- 8(17.0%±5.5).
Conclusion
We detect that computed tomography angiography (CCTA)’s specific signs of unstable
plaque of coronary artery disease are coronary artery diameters widening, low density sites clarify in
plaque (lower than +30HU), small calcification detect in plaque, ring liked additional density (lower
than +130 HU) sees in edge of plaque (Halo sign), plaque edge roughness, erosion liked changes
and rupture of intima.