1. Assessment of contents of the “Community based rehabilitation” curriculum
Enkhtuguldur M ; Batbold G ; Batzorig B ; Erdenekhuu N ; Oyungoo B
Innovation 2015;9(4):14-17
In our country for developing these services closer to the population, providing home care and treatment can be conducted in order to get the patient’s health care refer to the family and sum based health centers should be carried out. At the family and sum hospitals are working graduators of medical university, who assisting health care of Community based rehabilitation. In those cases adoctor have a role to give health care services, and to mediate between disabled people and other health care services as physical therapy, speech therapy, prosthesis and orthotics care, disability surgery and other professional cares. Therefore, there is needs to determine training needs of Community based rehabilitation and to accommodate with study curriculum.To evaluate the curriculum content, retrospective databases and descriptive research method were used and research data was collected by previous data analysis, interview and surveillance.In the result, contents of the “Community based rehabilitation” curriculum in different medicaluniversities are generally the same. But the curriculum was more attached to the disease and its drug medications rather than reflecting to proper guidance and advice for patients and main idea of “Community based rehabilitation”. Availability of specific textbooks and handbooks is limited, hence the trainings are held using international declaration, annual report or guidelines. Also the specialists who teach the subject were inadequate. Relating the due subjects, teaching methods were various, such as problem solving and small group discussion, case study etc., and students were evaluated bytest, case solving, essay writing and for School of Medicine, MNUMS they use OSCE. In conclusion, content of the “Community based rehabilitation” curriculum in undergraduate medical education is not adequate, indefinite, and discordant and there is lack of specialized teachers. Additionally, the curriculum content was not applied to the WHO guidance. Therefore we developed“Community based rehabilitation” curriculum in each medical disciplines, available to be used in undergraduate medical education in further.
2. Needs assessment of faculties’ development on teaching methodology at MNUMS
Batbold G ; Baljinnyam B ; Khongorzul TS ; Batzorig B ; Oyungoo B ; Erdenekhuu N
Innovation 2016;2(1):30-31
Regardless the possession of any graduation and qualifications anywhere in order to train the doctors and medical professionals with the capabilities to work in any places there are the needs of the knowledgeable mentors to teach their knowledge, abilities and trends to the students in national, regional and international levels. This survey was started to determine the needs of the skills development of the mentors of the Mongolian National University of Medical Sciences under the mission to make it as one of the best 100 medical universities in the Asia-Pacific region and in order to create the favorable environment to accelerate the development of the university and creating a team consists from qualified mentors and researchers by improving the trainings, researches and clinical favorable environment including the quality improvement of the activities.The total of 333 mentors from the 5 structures and 3 branches of the Mongolian National University of Medical Sciences were surveyed to be developed by the University of Michigan including the use of the widely used questionnaires in the universities consisting from 7 groups and 81 questions to determine the needs of the mentors.The working range of the best medical mentors including their needs of the skills was studied. The 55.7% (50.4-61.0%) of the mentors included in the survey were told that the facilitation of the learning needed, 82.4% (78.3-86.5%) as the role models needed, 79.9% (75.6-84.2%) as the provision of the information is needed, 76.3% (71.7-80.9%) as 82.8% (78.8-86.9%) as the planning needed and 81.0% (76.8-85.2%) as the assessment of the training is needed.There is a need to develop the skills related to the 6 frameworks as the learning facilitation for the mentors, role model providers, information providers, resource developers, planners and assessors.
3.Knowledge and attitudes of Covid-19 vaccine in the target population vaccinated against coronavirus infection
Uugantuya L ; Azjargal G ; Batbold B
Mongolian Medical Sciences 2021;197(3):87-89
Introduction:
According to the World Health Organization, 251 vaccines against coronavirus
infection are under development. Although vaccination has been introduced nationwide to prevent
coronavirus infection, vaccine activity varies (50-95%), and the risk of infection and complications
may vary depending on the individual’s physical condition and immune activity. In addition, due to
the prevalence of variant of concern, which reduces the activity of some vaccines and increases
the risk of complications and mortality of COVID-19, each country and region needs to improve the
knowledge and attitudes of citizens about the vaccine. there is a need to study.
Goal:
To study the knowledge and attitudes of people who have been vaccinated against COVID-19
among the target population of Uvs province.
Materials and methods:
The study was conducted using a descriptive method of observational
research. Quantitative and qualitative methods were used to collect the survey data, and the data
were collected in April 2021 through a questionnaire. A random sample of 4,212 people from 11
organizations involved in the Covid-19 vaccine was randomly selected from 24 organizations, and
a total of 264 people were surveyed using 12 types of Covid-19 vaccine and analyzed using SPSS
software.
Result:
According to the results of the survey, 4212 people from 11 organizations and 24 people
from each organization were randomly selected from a total of 264 people. Mostly female participants
(57.5%) have been included in this study. 67.4% of the respondents reported that they do not feel
fear associated with vaccination and it means that most of the participants did not show any signs
of panic. 91.2% participants did not have any symptoms after the vaccination. 30.4% from total
participants was used anti-inflammatory or pain relief pills after vaccination at home. 45.8% of the
respondents self reported that they have moderate knowledge about Covid-19 vaccine.
Conclusion
Overall knowledge of people from Uvs province was insufficient. However, attitude was
good enough.
4.Laparoscopic cholecystectomy in surgical treatment of acute cholecystitis
Baasanjav N ; Batbold B, Bastuya ; Altangerel D ; Ganbaatar M ; Lochin TS ; Erdenebold D ; Gankhuyag G
Mongolian Medical Sciences 2015;171(1):13-15
BACKGROUND:Acute inflamed process in gallbladder stand no more in the list of contraindication for its laparoscopicremoval, although specifity of operational technics need to be elaborated in details.PURPOSE:The purpose of the study to determine feasibility and specifity of laparoscopic cholecystectomy.METHODS AND MATERIALS:Based on standard instructions three holes were punched on the front wall of the abdominal cavity forinsertion of fibroscopic instrument, Olympus-2008, Model-Uni 3, input-120/240V, 50/60Hz, 150VA. Patientselection included 108 individuals hospitalized during 2009-2013 in the department of urgent surgery, IIIShastin Clinical Hospital.RESULTS:Average ages of the patients were 38. Clinical diagnosis based on signs and symptoms revealed at thephysical examination confirmed by echosonographic investigation for final diagnosis. Specificity of surgicaltechnics were incision and infusion of large amount of antibiotic solution into the inflamed gallbladder at theinoculation; use blunt edge for inoculation of the duct and artery of gallbladder; switching to open surgeryin case of revealed massive enzymatic infiltration and adhesive scars.CONCLUSION: Laparoscopic cholecystoectomy is feasibility operative procedure having advantages anddisadvantages, requiring necessary preventive measures of the complications.
5.Correlation between interleukin-4 and advanced fibrosis in chronic hepatitis C patients
Serjbayar G ; Bolor U ; Chia-Yen D ; Batbold B
Mongolian Medical Sciences 2021;197(3):26-32
Background:
Various cytokine dynamics has been associated with chronic hepatitis C virus (HCV)
infection. We hypothesized that cytokines have an important role in fibrosis development in HCV
infection.
Methods:
All patients received liver biopsies to validate the severity of chronic hepatitis when enrolled
in this study. Fluorescent Bead immunoassay was used to measure the following serum cytokine
levels: Interferon γ, tumor necrosis factor α, interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and
IL-12. Various statistical analyses were used as appropriate.
Results:
From all the liver biopsy proven 92 HCV-infected patients, 49 (53.3%) were male, 23 (25%)
patients had advanced (fibrosis grades 3-4) fibrosis, and the mean age of the study population was
51.9 ± 9.4 years. Elevation of baseline IL-4 level (>490 pg/mL) was associated with liver fibrosis grade
by X2 test (odds ratio [OR] = 2.99; 95%, CI = 1.02-8.78; p = 0.042) and multivariate logistic regression
(OR = 4.26; 95% CI = 1.13-16.02; p = 0.032). Also, IL-4 had strong diagnostic value in advanced liver
fibrosis by using area under receiver operating characteristics curve analysis. Assessment of fibrosis
score was consequently developed from our findings and compared with other noninvasive serum
markers to assess liver fibrosis.
Conclusion
This study provides evidence that increased IL-4 expression predicted advanced liver
fibrosis in treatment of HCV-infected patients.
6.Change of serum lipid profiles during antiviral therapy in chronic hepatitis C
Batbold B ; Gantsetseg G ; Tulgaa L ; Ganchimeg D ; Sodnomtsogt L ; Chia-Yen D
Mongolian Medical Sciences 2018;186(4):14-22
Background :
Low triglycerides and cholesterol was associated with hepatitis C virus (HCV) infection. Chronic HCV infection is the main cause of liver injury and it may influence to serum lipid levels. We aimed to evaluate the effect of antiviral treatment on the change of lipid profiles during interferon-based anti-HCV treatment.
Material and Methods :
Totally 863 patients who completed the interferon-based antiviral therapy in Kaohsiung Medical University Hospital were included in this present study. The lipid profile measured and assessed in the baseline of the treatment and after 6 months of completion of the treatment.
Results :
The most of the patients (81.2%) were achieved sustained virological response (SVR) by antiviral therapy. There was no significant difference between baseline triglycerides (TG) levels in the SVR group and non SVR groups. The TG levels at 6 months after completion of the treatment was significantly elevated in SVR group (102.9±57.0 mg/dL, p=0.0001) but did not elevated in non SVR group (94.5±45.6 mg/dL, p=0.690) compared with baseline TG levels.
After adjusting patients by four indexes for fibrosis (FIB4) in cut-off point 3.25, serum TG levels significantly increased in low FIB4 group (103.2±57.9 mg/dL, p=0.0001) but not in high FIB4 group (98.1±49.6 mg/dL, p=0.095) after 6 months end of the treatment. Serum TG level was increased greater in patients who had low FIB4 score and patients who achieved SVR (baseline 89.1±34.8 mg/dL; 6 months after treatment 104.3±59.3 mg/dL, paired T test p=0.0001).
Conclusion
The eradication of HCV is the main cause of the increase of lipids after Pegylated Interferon and Ribavirin treatment.
However advanced fibrosis also has an effect in increase of TG after the treatment.
7.Study on the risk factors of gastric cancer
Tulgaa L ; Ganchimeg D ; Enkhmyagmar D ; Tegshjargal B ; Nasanjargal T ; Ulziisaikhan B ; Dashmaa A ; Bayar D ; Bolor-Erdene T ; Erkhembayar E ; Chinzorig M ; Serjbayar G ; Batbold B
Mongolian Medical Sciences 2020;192(2):37-44
Introduction:
In 2018, a total of 901 new cases of gastric cancer were recorded, of which 64.8% in males and
34.2% in females. The incidence rate of gastric cancer was 28.5 per 100 000 population, which 38.2
for males and 19.2 for females.
Goal:
We aimed to investigate the associations between some risk factors and gastric cancer among the
Mongolian population.
Materials and Methods:
A case-control study was conducted between November 2017 and September 2019. We selected
120 cases from National cancer center of Mongolia who newly diagnosed gastric cancer. And 120
controls were selected by matching by sex, age and the place of residence. Informed consents
were obtained from all subjects. All subjects were personally interviewed with researchers used by a
structured questionnaire consisting of 86 questions. The SPSS 21 (version 16.0, SPSS Inc., Chicago,
IL, USA) software was used for all analyses.
Results:
The mean age was 59.2±11.4 (26-85) years. Habits of having dinner after 6.00 pm (OR 1.42, 95%CI
1.11-1.83, p=0.008), having leftover meals (OR 2.22, 95%CI 1.27-3.86, p=0.008), daily consumption
of tea with salt (OR 1.97, 95%CI 1.18-3.30, p=0.01), smoking on an empty stomach (OR 2.44,
95%CI 1.11-5.37, p=0.033), weekly consumption of ham and smoked meat (OR 1.5, 95%CI 1.17-
2.13, p=0.02), and consumption of fat grease (OR 2.09, 95%CI .03-4.24, p=0.038) were significantly
increased gastric cancer risk. In contrast, habit of eating at regular times (OR 0.43, 95%CI 0.25-0.73,
p=0.002), chewing thoroughly (OR 0.39, 95%CI 0.23-0.67, p=0.001), cooking meat thoroughly until
it’s tender (OR 0.48, 95%CI 0.25-0.97, p=0.047), daily consumption of vegetables (OR 0.45, 95%CI
0.27-0.76, p=0.003), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p=0.026) were
significantly reduced gastric cancer risk. Furthermore, having first-degree relatives diagnosed with
gastric cancer had 2-3 fold higher increased risk of gastric cancer (parents OR 2.88, 95%CI 1.07-
7.78, p=0.038, sibling (OR 3.09, 95%CI 1.09-8.81, p=0.036). Also, previous records of the digestive
disease increased risk of gastric cancer (OR 3.65, 95%CI 2.10-6.35, p<0.0001).
Conclusion
Dietary habits, family history of gastric cancer and previous records of digestive disease were
associated with risk of gastric cancer. Thus, prevention effort could be focused on the population with
a family history of gastric cancer, changing bad dietary habit and screening precancerous disease of
gastric cancer.
8.Influence of rs16924159 polymorphism of IL-33 gene on asthma susceptibility
Chimedlkhamsuren G ; Uyangakhorol N ; Batbold O ; Ichinnorov D ; Sarantuya J
Innovation 2020;14(2):67-71
Background:
Interleukin-33 (IL-33) cytokine plays a crucial role in asthma pathogenesis. Recent
studies have established that IL-33 activity was increased in serum, airway smooth muscle and
epithelial cells from patients with asthma and this increase positively correlates with asthma
severity. We hypothesized that several genetic variations that contributing IL-33 expression
and activity, which may risk factor for susceptibility to asthma. In this study, we examined the
association between rs16924159 single nucleotide polymorphism (SNP) of IL-33 gene and asthma
susceptibility.
Methods:
51 asthma patients and 54 healthy volunteers were involved in this case-control
study. Blood sample was collected for genomic DNA extraction. rs16924159 SNP genotyping was
performed by the allele specific-polymerase chain reaction (AS-PCR) method. Statistical analysis
was performed using STATA 13.0 software.
Results:
The groups were matched for age, gender and body mass index (p>0.05). The distribution
of rs16924159 allele and genotypes among patients and controls was found in accordance with
those expected by the Hardy-Weinberg equilibrium (p=0.088). Adenine (A) allele frequency of
rs16924159 was significantly different between case and control groups (OR = 1.91, 95% CI = 1.04-
3.51, p = 0.037). Also, homozygote A/A (OR=6.53, 95% CI 0.68-62.38, p=0.104) and heterozygote
(OR=2.08, 95% CI 0.93-4.62, p=0.073) genotypes were more frequent among asthma patients than
in controls.
Conclusions
From these findings, we conclude the A allele of rs16924159 SNP in IL-33 gene
may be contributing to asthma susceptibility, increasing the carrier`s risk to the development of
asthma.