1.Central serous chorioretinopathy
Temuulen B ; Baasansuren G ; Byambadorj M ; Uranchimeg D
Mongolian Journal of Health Sciences 2025;85(1):257-262
Background:
Central serous chorioretinopathy (CSCR) is described by researchers as a condition that results from fluid
under the retinal pigment epithelium, originating from the choroid of the eye. This disease usually affects the central part
of vision and may resolve on its own over time, though in some cases, it can persist for long periods or recur. In our country, there is a lack of research regarding this condition, which led to the motivation for gathering and reviewing existing
works on this topic.
Aim:
To collect and analyze a review of the studies on central serous chorioretinopathy (CSCR).
Methods:
We reviewed and analyzed literature related to CSCR published in electronic sources such as Thomson Reuters, PubMed-central database, and Google Scholar using literature review methods.
Results:
CSCR is most commonly seen in individuals aged 35-55 years, with a significantly higher prevalence in men
(9.9/100,000) compared to women (1.7/100,000). Researchers found that the prevalence of CSCR is nearly the same
among populations in Europe, Africa, and Asia. CSCR typically affects one eye, but it occurs in both eyes in up to 40%
of cases. Weenink A (2001) studied the family members of 27 patients with bilateral CSCR, finding that 52% of family
members had been diagnosed with CSCR, and 27.5% of them had chronic CSCR in at least one eye. This suggests a
potential genetic predisposition to CSCR. According to researchers, while CSCR can be diagnosed clinically, additional
imaging techniques like fluorescein angiography and optical coherence tomography are frequently used to rule out other
diagnoses and guide treatment.
Conclusion
CSCR generally has a favorable prognosis, but recurrences and its effects on visual function indicate the
need for effective management strategies. To maintain long-term visual improvement, it is essential to provide healthcare
services tailored to the patient’s specific conditions and risk factors.
2.Quality Assurance of Gastrointestinal Endoscopy Unit - A Single Center Study
Sarantuya Ts ; Amarjargal B ; Tungalag B ; Khishgee D ; Amarmend T ; Delgertsog T ; Amarjargal E ; Sarantuya G ; Gan-Orshikh L ; Enkhjargal B ; Sarantsatsral D ; Burentungalag A ; Nandintsetseg B ; Tserendolgor Ts ; Sattgul Sh ; Javzanpagma E ; Suvdantsetseg B ; Khashchuluun O ; Ouynkhishig N ; Munkhtuya E ; Uranchimeg M ; Oyuntungalag L ; Myadagmaa B ; Bat-Erdene I ; Batgombo N ; Saranbaatar A
Mongolian Journal of Health Sciences 2025;86(2):165-170
Background:
Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety
and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement
system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional
and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators
specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services.
Aim:
To assess the quality indicators in gastrointestinal endoscopy unit.
Materials and Methods:
A retrospective single-center study was conducted by collecting data from the Intermed hospital’s
electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results
were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research
committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of
four quality indicators measured monthly; b) sample survey data from five categories of quality indicators.
Results :
Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning
score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased
during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was
5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation
quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma
detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes,
Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge
time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate
risk was 0.28% by the TROOPS evaluation during procedural sedation.
Conclusion
The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be
effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.
3.Neuroticism as a risk factor for anxiety, depression, and insomnia during the covid-19 pandemic
Enkhtuvshin R ; Mongoljin A ; Munkhzul E ; Uranchimeg M ; Oyundari G ; Yerkibulan A ; Khishigsuren Z
Diagnosis 2025;115(4):36-42
Background:
The COVID-19 pandemic has profoundly impacted global mental health, exacerbating anxiety, depression, and insomnia, with prevalence rates of 25–30%, 27–32%, and 30–45%, respectively—2–3 times higher than pre-pandemic levels. Neuroticism, a key personality trait from the Big Five model, characterized by heightened negative emotions and stress reactivity, has been linked to increased vulnerability. Meta-analyses show neuroticism triples anxiety risk (OR=3.21; 95% CI: 2.35–4.39) and correlates strongly with insomnia (r=0.46, p<0.001) and depression during the pandemic. In Mongolia, empirical data on neuroticism's role remains limited.
Objective:
This study examines whether neuroticism acts as a risk factor for anxiety, depression, and insomnia among hospitalized patients during COVID-19.
Methods:
A cross-sectional descriptive study enrolled 552 patients (72.3% COVID-19 cases, 27.7% controls) from tertiary hospitals in Mongolia (2024). Participants (mean age 52.8±15.5 years; 60.5% female) completed self-reported questionnaires: Eysenck Personality Inventory (EPI) for neuroticism, PHQ-9 for depression, GAD 7 for anxiety, ISI for insomnia, and PCL 5 for PTSD. Sociodemographics were assessed. Data were analyzed using SPSS 26.0 with chi-square tests (p<0.05 significance). Instruments showed high reliability (Cronbach’s α=0.81–0.89). Ethical approval was obtained from MNUMS Ethics Committee (No. 2024-Psy-17).
Results:
Overall, 79.5% were depression free, 84.8% anxiety-free, and 77.5% insomnia-free. High neuroticism (n=381) was significantly associated with depression (24.4% vs. 11.7%, p<0.001), anxiety (18.6% vs. 7.6%, p<0.001), insomnia (28.3% vs. 9.4%, p<0.001), and any mental disorder (21.3% vs. 7%, p<0.001), but not PTSD (p=0.472). Cholerics (n=200) showed elevated risks (depression 29.5%, insomnia 34.5%, p<0.001), while sanguines/phlegmatics were protective. Verbal expression and trust levels showed no significant associations.
Conclusion
Neuroticism significantly heightens risks for anxiety, depression, and insomnia during COVID-19, underscoring the need for targeted psychological interventions. Temperament-informed screening could enhance prevention strategies in crisis settings.
4.Assessment of the biofilm-forming ability of Staphylococcus aureus
Amgalanzaya D ; Batzaya B ; Uranchimeg R ; Badmaarag M ; Sarantuya J ; Munkhdelger Ya
Diagnosis 2025;115(4):43-50
Staphylococcus aureus (S. aureus) is a clinically significant pathogen widely distributed in food production environments. Its ability to form biofilms on food contact surfaces enhances 50 environmental persistence, increases antibiotic resistance 10–1500-fold, and poses serious challenges for food safety and public health. In Mongolia, data on the biofilm-forming ability of S. aureus in meat processing and retail environments are limited. A cross-sectional study was conducted on 437 samples collected from meat supply and retail sites, including raw meat, aprons, counters, trolleys, and workers’ hands. Isolation and confirmation of S. aureus were performed using MNS 6308:2012 and ISO 6888-1:2021 standards, followed by PCR amplification of the species-specific nucA gene (270 bp). Biofilm formation was evaluated using the microtiter plate assay with 0.5% glucose supplemented tryptic soy broth and optical density at 490 nm, and confirmed by scanning electron microscopy (SEM). Statistical analyses were performed using chi-square tests with p< 0.05 considered significant. Of the 437 samples, 14.2% (62/437) were contaminated with S. aureus. Contamination was higher in retail markets (25.9%) than supply sites (9.3%). Among isolates, 40.3% exhibited biofilm-forming ability: 29.0% weak, 9.7% moderate, and 1.6% strong. Biofilm formation did not significantly differ by sampling site or sample type (p>0.05). SEM imaging revealed distinct biofilm architectures with polysaccharide matrices at 80,000× magnification. A considerable proportion of S. aureus isolates from meat processing and retail environments exhibited biofilm forming ability, posing a potential risk for cross-contamination and persistent foodborne transmission. Strengthened hygiene and sanitation measures are essential to control biofilm-associated S. aureus contamination in Mongolia’s meat production and supply chain.
5.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.
6.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.
7.Clinical features of ophthalmology in thyroid disease
Oyungerel B ; Erdenezul G ; Misheel B ; Uranchimeg D ; Chimedlkhamsuren G ; Nomin-Erdene M ; Sarantuya J
Innovation 2021;14(2-Ophthalmology):6-10
Background:
TED (thyroid eye disease) is an inflammatory disease of the orbit caused by
autoimmune diseases of the thyroid, which adversely affect the vision, appearance, and quality
of life. Exophthalmos and eyelid retraction are the main features of TED, which can lead to ocular
motility, diplopia, optic neuropathy, and permanent vision loss. The study aims to determine the
most common clinical signs of TED in Mongolians and define whether there is a correlation with
the levels of thyroid autoantibodies.
Methods:
The study involved 102 patients with TED and 81 patients with Graves’ ophthalmopathy.
The clinical features of TED were identified and evaluated by activity score (CAS) and severity of
GO using the European Group of Graves’ Orbitopathy (EUGOGO).
Results:
The mean age of TED patients was 42.6±11.2, which was younger than GD patients
(P=0.012). The current smoker was 24 patients (23.5%) with TED, which is relatively higher than GD
(P=0.0001). The most common ocular signs were eyelid retraction 80 (78.4%), proptosis 77 (75.5%),
diplopia 14 (13.7%) and 4% vision loss. There were no differences in proptosis between the right (18
mm, median) and left eye (17.8 mm, median) (P>0.05). The mean CAS score was 3.09±1.72 and
varied depending on gender and smoking. According to EUGOGO, 62.7% of the patients were
moderately severe. Only 7 % of the patients were in the sight-threatening stage, presenting optic
neuropathy and corneal breakdown. The mean TSI level in patients with TED was 37.95 ± 35.41 IU
/ ml, which was 2.7 times higher than the mean in patients with GD.
Conclusions
Eyelid retraction and exophthalmos are the most common clinical signs of TED.
Early diagnosis of these features can prevent complications of the disease. Determining serum TSI
levels will help in the treatment and monitoring of TED.
8.Correlation between delay time of surgery of congenital cataract and postoperative visual acuity
Shamsiya M ; Nasantogtokh E ; Uranchimeg D ; Davaa G ; Erdenetuya G
Mongolian Journal of Obstetrics, Gynaecology and Pediatrics 2021;29(1):2096-2100
Correlation between delay time of surgery of congenital cataract and postoperative visual acuity
Introduction: Worldwide, child cataract is 1 to 15 cases per 100,000 children are diagnosed. In the International Classification of Diseases, pediatric cataracts are classified as congenital (Q12) and developmental (H26.0). Congenital cataract occurs in 1–3 out of 10,000 children, and if diagnosed, surgery is required without delay. International researchers report that congenital cataracts require semi-emergency surgery. It is also recommended that children with congenital cataracts be diagnosed after 3 months of age without surgery. Congenital cataracts are recommended for surgery in one eye within 6 weeks and in both eyes within 10 weeks. Early detection of congenital cataracts and emergency surgical treatment are important to improve postoperative visual outcome and quality of life. To investigate the correlation between the surgical delay time and postoperative visual acuity in children diagnosed with congenital cataracts.
Material and methods: This study conduct based on the ophthalmic surgery department of the National Center for Maternal and Child Health, performed for a retrospective longitudinal study design. The study examined cases of congenital cataracts in both eyes and retrospectively follow patients who had congenital cataract surgery in 2018-2020 from the onset of symptoms to the postoperative period. The sample size was calculated using open.epi. We sampled participants for non-probabilistic purposes. The study included children 1 year of age and younger or with nystagmus, cataract with nuclear and polar morphology , and bilateral cataracts Statistical analysis was performed using STATA 16.0 software. The risk of delay time to visual acuity was determined by an ordinal regression model.
Results: The study included 46 cases of congenital cataracts, under the age of 16. 61 percent of the children were male and 58.7 percent were from rural areas. The postoperative visual acuity of the children in the study was <0.09 in 52.2% (n = 24) and 0.1
9.Eye injuries and traumatic cataract in children
Shamsiya M ; Yanjinlham Kh ; Battsesteg B ; Unursaikhan S ; Uranchimeg D ; Davaa G
Mongolian Journal of Obstetrics, Gynaecology and Pediatrics 2020;28(2):2041-2050
Eye injuries and traumatic cataract in children
Background: Ocular trauma in children accounts for 8% to 14% of the total injuries. Childhood eye injury is different from adult ocular trauma in terms of the objects involved in causing injury, evaluation, and management protocols. This study aimed at investigating the current causes, types and outcomes of pediatric ocular and traumatic cataract.
Materials and methods: A retrospective observational study of all children admitted to hospital with ocular trauma and traumatic cataract in NCMCH over a 2 years period.
Results: There were 126 cases representing, 68.3% were boys and 31.7% girls. 81 8 % were boys and 18-2 % girls. The risk of eye injury in girls was low and stable at all ages, except toddler age, but in boys the risk grew markedly at the age of 4-6 years. The commonest cause of injury was a sharp objects. Other important causes were wooden sticks, pen, pencil and fell from high. Overall, open-globe injuries had a higher frequency (42%) than closed-globe injuries (26.9%). The home was the commonest environment for an eye injury (47.6%). Regarding persons causing the injury, by themselves (61%) was the commonest, followed by child’s friends (24.6%). Total 15.6% of patients retained visual acuity 20/40 or better, while 44.4% of patients resulted visual acuity less than 20/400. In case of traumatic cataract, total 33.3% of patients retained visual acuity 20/40 or better, 14.8% of patients resulted visual acuity less than 20/400
Conclusion: This study describes the clinical characteristics of patients hospitalized for ocular trauma at NCMCH. Health education and awareness are essential tools that can prevent avoidable blindness due to ocular trauma in the pediatric population.
10.Aetiology of congenital pediatric cataract in Mongolia
Shamsiya M ; Urantsetseg D ; Uranchimeg D ; Davaa G
Innovation 2019;13(1-Ophthalmology):18-22
Aim:
The aim was to determine etiology and clinical presentation of pediatric cataract during 1
year period
Methods:
NCMCH is tertiary and referral center for all pediatric patients with cataracts in 21
provinces and UB. Database contains cases during 1 year period. We have recorded the
following data from the medical histories of these patients: family history, current age, age at
diagnosis, age at surgery either eye, morphology of cataracts, laterality, associated findings and
other investigations which were performed as clinically indicated. We have operated 80 children
in total during 1 year period, however the study included 68 patients (91), eyes excluding 12
patients.
Results:
Of 68 children with cataract 76.% were non traumatic, 21,15% hereditary, 51,9% were
congenital/infantile, 35.8% were unilateral, 44% were associated other ocular findings, 25%
were associated systemic disease. 33.3% were diagnosed and operated 0-12 months. 73% of
congenital/infantile cataract patients were nystagmus. Of traumatic cataract 76,5% due to
penetrating trauma.
Conclusions
Patients of pediatric cataract 1/3 were usually diagnosed in 0-12 months. 1/3
of these patients were diagnosed congenital cataract whereas 1/4 were nystagmus. To add up
associating congenital/infantile cataract with Down syndrome weren’t rare.
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