1.BRAIN ABSCESS IN CHILDREN
Orkhontuul Sh ; Avaajigmed L ; Tsetsegdelger J ; Bolormaa I ; Dolgorjav B ; Amartuvshin B ; Enkhbold D
Journal of Surgery 2016;20(2):37-41
Introduction: A brain abscess is a
serious disease of the central nerve system.
We conducted this study to summarize the
clinical manifestations and outcomes of
brain abscesses.
Materials and Methods: A retrospective
chart review of pediatric patients diagnosed
with brain abscesses from November 2000 to
Jаn 2016 was performed at Shastin Medical
Hospital neurosurgery department.
Results: Twenty-five patients were
included in this study. On average, 1.67
cases per year were identified and the
median age was 4.3 years. The common
presenting clinical manifestations were fever
(18/25, 72%), seizure (12/25, 48%), altered
mental status (11/25, 44%), and signs of
increased intracranial pressure (9/25, 36%).
A total of 14 (56%) patients had underlying
illnesses, with congenital heart disease
(8/25, 32%) as the most common cause.
Predisposing factors were identified in 15
patients (60%). The common predisposing
factors were otogenic infection (3/25, 12%)
and penetrating head trauma (3/25, 12%).
Causative organisms were identified in 64%
of patients (16/25). The causative agents
were S. intermedius (n=3), S. aureus (n=3),
S. pneumoniae (n=1), Group B streptococcus
(n=2), E. coli (n=1), P. aeruginosa (n=1),
and suspected fungal infection (n=5). Seven
patients received medical treatment only
while the other 18 patients also required
surgical intervention. The overall fatality rate
was 16% and 20% of patients had neurologic
sequelae. There was no statistical association
between outcomes and the factors studied.
Conclusion: Although uncommon, a brain
abscess is a serious disease. A high level of
suspicion is very important for early diagnosis
and to prevent serious consequences.
2. BRAIN ABSCESS IN CHILDREN
Orkhontuul SH ; Avaajigmed L ; Tsetsegdelger J ; Bolormaa I ; Dolgorjav B ; Amartuvshin B ; Enkhbold D
Journal of Surgery 2016;20(2):37-41
Introduction: A brain abscess is aserious disease of the central nerve system.We conducted this study to summarize theclinical manifestations and outcomes ofbrain abscesses.Materials and Methods: A retrospectivechart review of pediatric patients diagnosedwith brain abscesses from November 2000 toJаn 2016 was performed at Shastin MedicalHospital neurosurgery department.Results: Twenty-five patients wereincluded in this study. On average, 1.67cases per year were identified and themedian age was 4.3 years. The commonpresenting clinical manifestations were fever(18/25, 72%), seizure (12/25, 48%), alteredmental status (11/25, 44%), and signs ofincreased intracranial pressure (9/25, 36%).A total of 14 (56%) patients had underlyingillnesses, with congenital heart disease(8/25, 32%) as the most common cause.Predisposing factors were identified in 15patients (60%). The common predisposingfactors were otogenic infection (3/25, 12%)and penetrating head trauma (3/25, 12%).Causative organisms were identified in 64%of patients (16/25). The causative agentswere S. intermedius (n=3), S. aureus (n=3),S. pneumoniae (n=1), Group B streptococcus(n=2), E. coli (n=1), P. aeruginosa (n=1),and suspected fungal infection (n=5). Sevenpatients received medical treatment onlywhile the other 18 patients also requiredsurgical intervention. The overall fatality ratewas 16% and 20% of patients had neurologicsequelae. There was no statistical associationbetween outcomes and the factors studied.Conclusion: Although uncommon, a brainabscess is a serious disease. A high level ofsuspicion is very important for early diagnosisand to prevent serious consequences.
3.First diagnosis of IgA nephropathy by renal biopsy in Mongolia
Baigalmaa S ; Buyan-Od D ; Bolor-Erdene G ; Otgonsuren D, Amartuvshin B ; Otgonchimeg I ; Enkhtamir E ; Galtsog L
Mongolian Medical Sciences 2015;172(2):35-41
BackgroundIgA nephropathy and MPGN are common glomerulonephritis in the world that progresses slowly andrenal function can even remain unchanged for decades. Clinically, it presents by isolated hematuria,proteinuria. Histologically, IgA nephropathy presents with acute glomerular damage, mesangial cellproliferation, endocapillary leucocyte infiltration, and crescent formations, these lesions can undergoresolution with sclerotic healing. Since 2013, renal biopsy has been done at the First Central Hospitalof Mongolia a few times. However, the confirmative diagnosis of IgA nephropathy and MPGN remainunknown in Mongolia by renal biopsy. Therefore, we intended to test renal biopsy techniques andconfirm its diagnosis by renal biopsy at the Second Central Hospital of Mongolia.MethodsUltrasound guided renal biopsy had been done for four patients by nephrologist at the Departmentof Nephrology of the Second Central Hospital of Mongolia. All four specimens were evaluated assatisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissuewas divided into two tips: one piece for routine H&E stain and special stains, including Masson’strichrome, and PAS stain; another piece for immunofluorescence by frozen section, which werestained with IgG, IgM, IgA and complement component 3 (C3). Each case was screened by threepathologists.Results:The case which shows mesengial widening, mesengial hypercellularity under the light microscopyor mesangial granular deposition of IgA and C3 by immunofluorescence was diagnosed as IgAnephropathy. We obtained crescent formation with glomerular adhesion in most cases. In addition, weobserved secondary MPGN in one case, which is caused by hepatitis C virus infection.Conclusion: Probably, it is a new step for developing pathologic diagnosis for nephrology in Mongolia.We needs further study for improving renal biopsy technique and confirming the diagnosis of IgAnephropathy and MPGN using electron microscopy and pathological report by oxford classification forIgA nephropathy.
4.Evaluation of air pollution prevention consultation, Ulaanbaatar
Zolzaya D ; Bolor B ; Oyunchimeg D ; Enkhtuya P ; Tsegmed S ; Bolormaa I ; Chinzorig B ; Amartuvshin T ; Suvd B
Mongolian Medical Sciences 2022;199(1):74-82
Introduction:
Mongolia’s capital hosts about half the country’s total population, and its air pollution ranks among the highest in the world during winter. Air pollution is linked to reduced fetal growth, preterm birth, low birth weight, impaired cognitive intra-uterine development, impaired cognitive development, and even spontaneous abortion. Antenatal care includes fetal development monitoring, prevention of anemia, immunization against infectious diseases, prevention of sexually transmitted diseases, and any health risk factors such as environmental pollution.
Health care measures for pregnant women and children under one year of age have the potential to be highly effective because they are directly aimed at reducing pneumonia in children. As such, we need to conduct this survey to determine whether pregnant women were satisfied with the information and advice on air pollution prevention provided by health facilities and to take evidence-based measures.
Materials and Methods :
The survey data were collected using quantitative and qualitative research methods. In this study, a total of 958 pregnant women participated from Songinokhairkhan district, Bayanzurkh district, and Bayankhongor province center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation, and environment of the Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. The research methodology was discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2).
Results :
The survey covered 958 pregnant women aged 16-45 in Bayanzurkh district Songinokhairkhan district, and Bayankhongor province. During antenatal care visits, the majority of pregnant women (BZD- 56.9%, SKHD- 68.3%, BKH province - 86.7%) were advised by their health specialists to go outside for fresh air, while women in Ulaanbaatar (BZD- 18.9%, SKHD- 24.7%) received the information and advice at the lowest percentage. Pregnant women in Ulaanbaatar were less involved in air pollution training than in Bayankhongor. Participants in the air pollution prevention training rated it as “satisfied” regardless of location. 37.2% of pregnant women obtained information on protecting their health from air pollution from the board of Family Health Center and 34% from their district health centers. 86.1% of the participants were able to obtain information on air pollution on their own, while 86% of them got information from their family and friends.
Conclusion
The percentage of pregnant women getting medical advice, training, and information on air pollution prevention from hospitals during their antenatal care visits was the highest in rural areas. Moreover, their level of satisfaction with counseling had been rated as “satisfied”. Pregnant women often seek information on air pollution prevention from non-professional sources, such as their family and friends.
5.Satisfaction of health care and services for parents and guardians with 0–5 years-old children
Bolor B ; Enkhtuya P ; Tsegmed S ; Oyunchimeg D ; Zolzaya D ; Bolormaa L ; Chinzorig B ; Amartuvshin T ; Suvd B
Mongolian Medical Sciences 2021;196(2):37-45
Introduction:
Within the framework of health sector reform, the development of the organization, the responsibility
of doctors and medical professionals, and the improvement of ethics, quality and safety of care and
services are top priorities. Customer satisfaction is important for the implementation of this operation
based on results and quality. The WHO Recommendation states that health professionals have a key
role to play in providing information and advice to citizens and their families on how to prevent, mitigate
and address air pollution, and how to inform the general public and decision-makers. ADB, the Ministry
of Health, and UNICEF report that information and promotional materials on air pollution prevention
are scarce and do not provide advice to clients. Therefore, it is the reason for conducting a survey to
determine the level of satisfaction of clients receiving child health care.
Materials and methods:
The survey data were collected using quantitative and qualitative research methods. In this study, totally
1160 guardians of children aged 0-5 participated from Songinokhairkhan and Bayanzurkh district and
Bayankhongor aimag center. The overall satisfaction of health services is calculated using the three
dimensions namely: satisfaction with health service, operation and environment of Health Organization.
Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”,
“Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after
entering the survey data into SPSS-23, creating a database, and performing error control. Research
methodology discussed at the meeting of the Academic Council of the National Center for Public Health
on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the
MOH (Stagnant №2).
Results:
84.7 percent of the respondents were parents of children aged 0-5 years. Their average age is 34,
most of them have higher education, and 43.0 percent of them have a household income of 500,000-1
million MNT. Guardians of children aged 0-5 years in Bayanzurkh District were “dissatisfied” with the
Family Health Center’s dressing room, wardrobe, toilet and parking lot. Guardians of children aged
0-5 years in Songinokhairkhan district were “dissatisfied” in the parking lot and toilet of the health
organization. Guardians of children aged 0-5 years in Bayankhongor aimag were satisfied with the
services, operation and environment of the health organization. Studies have shown that 76.5 percent
of the guardians did not receive air pollution risk training. As for difficulties in preventing air pollution,
31.4 percent of the surveyed population answered that they cannot change their living and working
environment to prevent air pollution.
Conclusion
It shows the health care organizations need to improve the hospital environment as well as to provide
training how to protect children from air pollution risk for guardians.
6.2014-2016 ОНД УЛААНБААТАР ХОТОД ТОЛГОЙН ГЭМТЛИЙН УЛМААС НАС БАРСАН ТОХИОЛДЛУУДЫГ СУДАЛСАН ДҮН
Dolgormaa D ; Amartuvshin T ; Selenge T ; Sergelen B ; Batbayar Kh ; Tserenbat M ; Bayarmaa E
Innovation 2017;11(2):108-110
BACKGROUND OF STUDY: For the past 10 years, accidents and trauma are ranking third
in the cause of Mongolian population’s death. Russian scientists have defined that skull
and brain trauma comprise of 40% of the total traumas and is one of the serious injuries
that have damaging effect to the health. Defining its creation, injury period, death
cause in the leading direction of science of forensic medicine in our country are still the
urgent issues. Nowadays little research which studied case mortality due to accident
and trauma has been studied, this became background of our research work.
PURPOSE OF STUDY: To study cause and peculiarity of pathology of case mortality due
to brain trauma, in the condition of our country and to consider the result.
OBJECTIVE OF STUDY:
To study the cause, some risks of head injury.
To define pathology of case mortality due to head injury.
MATERIAL AND METHODOLOGY: We did retrospective study in 555 case material of an
autopsy of case mortality of head injury of forensic medicine and research department
of national institute of forensic science. Statistical work out was done by Microsoft excel
and extensive index.
RESULT OF STUDY: 84.5% (n=459) is male and 15.5% (n=86) is female out of our 555 involved
cases and the gender ratio is 5:1. The most or 81% of the research participants
had head injuries due to hitting with firm and dull stuffs and 15.9% head injury as a result
of traffic accident follows in the second place. To analyze from the characteristics of
mortality, 93% is subarachnoid hemorrhage, subdural, epidural hematoma, 64% is brain
tissue injury were detected.
CONCLUSION: Young manhood men mortality that has head injury resulted from the
firm and dull things occupies most of the percentage in our research. The head injury
can lead to the mortality of his ordinary process.
7.Health professional’s knowledge, attitude and practice (KAP) on air pollution
Otgonbayar D ; Tsegmid S ; Suvd B ; Oyun-Erdene O ; Buuveidulam A ; Zolzaya D ; Oyunchimeg D ; Chinzorig B ; Amartuvshin Ts ; Enkhtuya P ; Narantuya D
Mongolian Medical Sciences 2020;193(3):54-58
Introduction:
Soum and family health care centers (primary health care centers) provide public health services to
reduce the negative effects of air pollution on health. In order to decrease the risk factors due to air
pollution, it is crucial for health professionals, who are providing health care services to the public,
to have the knowledge, attitude and practice to give an advice for residents on how to protect their
health from air pollution. The “Air pollution and child health” report from WHO recommended that
responsibility of health professionals must include knowing the latest information on air pollution,
doing a research, spreading the knowledge, educating families and community and learning from
them as well, proposing solutions, and finding a solution for policy developers and decision makers
in other sectors. Therefore, we conducted this survey with purpose to determine the long-term effects
of air pollution on population psychology and lifestyle and to evaluate the level of knowledge, attitude,
and practice of health professionals on how to protect a health from air pollution.
Goal:
Evaluate the level of knowledge, attitude, and practice of health professionals on air pollution.
Material and Methods:
In 2019, this study conducted a cross-sectional design and collected quantitative and qualitative
data. 88.4% of (n=532) health professionals from 48 secondary health care centers (SHCC) and 64
family health care centers (FHCC), which are agents that implement UNICEF project, in Bayanzurkh,
Songinokhairkhan districts and Bayankhongor aimag were participated in the survey.
Results:
97.4% of the participants agreed that air pollution has negative effects on human health. 99.5% of
participants did not know the Mongolian standard for the acceptable level of air pollutant particulate
matter (PM) and 73.1% of all participants did not receive information about air quality index. 82.1% of
participants regularly give prevention advice with the purpose of protecting maternal and child health
from air. The participants who worked for more than 21 years and who are older than 51 years old
were more likely to give advice (p<0.05). As for the reasons for not giving advice about air pollution
for protecting the maternal and child health, 29.2% of participants answered the service time is not
enough, and 22.9% mentioned the lack of knowledge and information. 30.5% (162) of participants were not satisfied with their skill to give an advice on how to protect maternal and child health from
air pollution. 86.8% of participants indicated that they did not receive proper training on air pollution
and prevention from air pollution.
Conclusion
There is a need to provide training and information on how to protect maternal and child health from
air pollution for health professionals.