1.Tooth loss and prosthetic rehabilitation among 35 to 44 years old people of bayangol district, ulaanbaatar city
Mongolian Medical Sciences 2012;161(3):33-36
Objective. The aim of this study was to evaluate tooth loss prevalence, denture types and prosthetic dental treatment needs among people of ages 35-44 of Bayangol District of Ulaanbaatar City. Materials and Methods 9351 subjects were examined and questionnaires were presented to partially and/ or totally edentulous subjects among patients of this research. The questionnaire consisted of questions; age, gender, education level, place of residence, problems with dentures, necessity for new denture. Results. Most of the people were partially edentulous (93.0%) and 6.0% was full dentate, 1.0% was complete edentulous. In this research, only 6% of the people are full dentate but 94.3% have missing teeth and it indicates that the most of the people are demanding partial denture treatment. Acrilic denture was consumed in (3159) 95.0% of total dental coverage, but only 116 people had fixed denture. Acrylic denture was consumed much more than removable partial denture and bridge, and it may be due to expensive price of bridge and implant. The number of female patients with complete dentures was more than the number of males, with opposing trend for partial dentures. Tooth loss is a major indicator of oral health among adults, which may be increased by the lack of access to care, certain chronic diseases and/or insurance status. Conclusions. Almost 940 people in each 1000 people of ages 35-44 or 9 of every 10 subjects of among patients of Bayangol District, Ulaanbaatar City have edentulism /р>0.001/. It has been estimated that 34.5% about adults of those with edentulism had prosthetic treatment and majority (95%) of them use acrylic denture. We can see that 94.3% of subjects among the patients of ages 35-44 in our research have had missing teeth and 60% of them had no any treatment and are demanding prosthetic treatment.
2.Re-survey study of environmental pollution in Khongor, Darkhan-Uul province
Unursaikhan S ; Burmaajav B ; Ichinkhorloo B ; Baatartsol D ; Govigerel B ; Bayasgalan B
Mongolian Medical Sciences 2011;157(3):48-51
Background Concentrations of lead, chromium, cadmium, mercury, arsenic and boron in waste water treatment sample and soil sample of Mich Company in Khongor, Darkhan-Uul province were detected with high concentration by WHO, UNEP and FAO study in 1998. Therefore, the conclusion was required to conduct environmental audit and to determine pollution frame and risks [1, 2]. According to recommendation of WHO, UNEP and FAO study, it is required to conduct re-survey study of environ¬mental pollution in Khongor, Darkhan-Uul province. Goal Study was aimed to conduct re-survey study of environmental pollution and human health exposure assessment in Khongor, Darkhan-Uul province. Objectives: 1. To determine environmental pollution by questionnaire study and chemical analysis for mercury, chromium, arsenic, lead, cadmium and boron in hair, blood, urine and environment. 2. To develop guidance for next actions. Results Average concentration of arsenic in soil sample of Mich Co, Ltd was 8.458 mg/kg or 1.4 fold higher (95%CI 5.472- 11.444) than reference value (6.0 mg/kg) in “MNS 5850:2008 -Soil quality. Reference value for soil pollutants and elements” standard and mercury and cadmium were not detected (Table 1). Chromium and boron were detected with acceptable level in water samples and average concentration of arsenic (0.0014 mg/l) was lower than reference value (0.01mg/l) in “MNS 900:2005 Drinking water, Hygiene requirements and control” standard. This result shows that there was not arsenic migration from soil to water. Concentrations of lead, cadmium, chromium, arsenic, boron and mercury in soil and water samples were detected with acceptable level (Table 1). Conclusions: 1. Lead, mercury, cadmium, chromium and boron levels in environmental samples of Khongor, Darkhan-Uul province were at subordinate level from reference values in national standards. 2. Arsenic concentrations in biological samples were determined as a higher level, but in environmental samples its amounts were corresponded with acceptable level. Thus there was not environmental pollution exposure to human health. Because of detoxication processes of contaminated moulds by mercury and cyanides in MICH company area, it is possible to this area polluted by arsenic or gold associated elements. Thus it is necessary to decrease arsenic pollution in soil. 3. Concentrations of cadmium, arsenic, lead and mercury in hair, urine and blood samples were less than refer¬ence value of Human biomonitoring commission of Germany (HBM), PHI of USA, Clinical chemist’s agency of Russia and Canadian medical research center. So, in Khongor soum had not those of toxic elements ex¬posure to human health. 4. The boron and chromium concentrations of hair, urine and blood samples exceeded the maximum admissible limits in half of all cases, while their amounts in environmental samples were at permissible level according to national standards. And there was no statistical significance correlation (p=0.735) between chromium and boron concentrations in biological and environmental samples.
3.The assessment of cognitive impairment in patients with Parkinson’s disease using by neuropsychological tests
Mongolian Medical Sciences 2012;161(3):25-29
Background: Cognitive impairment (CI) is common in Parkinson’s disease (PD) and 20%-80% of patients with PD will develop dementia over time. The Montreal cognitive assessment (MoCA) is a short cognitive screening tool for CI in PD patients. The mini-mental state examination (MMSE) often fails to detect early cognitive decline.Objective: The aim of this study is to compare MMSE to MoCA scores in Mongolian patients with Parkinson’s disease.Methods: Clinical history of 47 patients with diagnosis of PD in according to clinical criteria of the UKBBPD has been enrolled. The patients were assessed using Hoehn and Yahr stage (HY), Unified Parkinson’s Disease Rating Scale (UPDRS III parts), MMSE and MoCA. Patients normal and with CI were classified using cut-off MMSE and MoCA scores 25 or below.Results: Total 47 patients: 21 male (44.7%) and 26 female (55.3%) patients were included. The mean age was 64.2±2.6 years, the mean HY stage was 2.4±0.3 and the mean disease duration was 5.5±1.2 years. The mean MoCA score was 25.7±3.1 (SD 4.3; range 13-30) with the following distribution for categories: normal in 42.6% (20 cases) and CI in 57.4% (27 cases) of patients and the mean MMSE score was 27.2±0.8 (SD 2,8; range 18-30) with the following distribution for categories: normal in 72,3% (34 cases) and CI in 27,6% (13 cases) of patients with PD. Patients with cognitive impairment had advanced HY stage (p<0.05) and greater motor deficiency on UPDRS III (p<0.05) than patients without cognitive impairment. In contrast, there were no significant differences in age, disease duration and onset of disease. Cognitive impairments on the MoCA were seen in numerous cognitive domains, including visuospatialand executive abilities (40.4%), attention (57.4%), abstraction (53.1%), memory (93.6%) and language (68.0%), naming and orientation (8.5%) and on the MMSE were seen in some cognitive domains, including attention (36%), memory (57%) and language (23%) and orientation (19%) respectively.Conclusion:• 57.4% and 27,6% of the patients with PD have cognitive deficits based on their MoCA and MMSE score. This suggests that the MoCA will be more sensitive than the MMSE to detect cognitive impairment in PD patients.• Cognitive impairment was more common in PD patients with advanced HY stage and severe motor symptoms.• Attention, language and memory impairment, executive function and language were the most common patterns of CI in PD patients valued by the using of the MoCA and MMSE.
4. Hemangioma cases and treatment
Davaanyam L ; Ayanga G ; Erdenetsogt J ; Tserendulam D ; Bayasgalan R ; Batbayar B ; Uranchimeg D ; Bulgantamir E
Innovation 2016;2(1):18-20
Hemangiomas are common benign vascular tumors which about 70% to 80% of the lesions are found in the head and neck region. This study was conducted on 36 children with hemangioma who were referred to Orofacial Surgery Cabinet of Dental School of Health Sciences University of Mongolia and Orofacial Surgery Cabinet of National Center for Maternal and Child Health of Mongolia between 2013 and 2015.Of the 36 children referred for assessment, 72% were female, 55% were infants of 4 to 9 months old, and 83% of them were citizens. 58% of patients underwent cryotherapy,and 57% of patients underwent cryotherapy had 2 therapy sessions. 25% of patients receiver sclerotic therapy, and 67% of them had 2 therapy sessions. According to the locations of hemangiomas 30% of them were localized in infraorbital area. 72% of the participants are women and 55% are children age of 4-9 month which 83% of all participants were living in city. 58% of children with hemangioma are treated with cryotherapy which 57%of treatment finished by second visit. And 25% were treated by dehydration treatment which 67% were finished by second visit.
5.Вenefits of vitamins, macro, and microelements to support the immune system during the corona virus (COVID-19)
Oyundelger D ; Bayasgalan J ; Tuvshinbayar B ; Tserenlkham B ; Erdenetsogt E
Mongolian Medical Sciences 2021;195(1):80-89
Nutrition is a key factor in the normal functioning of the immune system, and malnutrition is one of
the most common causes of immunodeficiency worldwide today. However, the public health policies
on immune system and infection lacks the nutritional strategy to ensure the optimal functioning of
the immune system Loss of cellular immunity, phagocyte function, blood protein complex, cytokine
synthesis, and A-immunoglobulin secretion are generally associated with protein-energy deficiency.
Some vitamins and minerals, such as A, B6, B12, C, D, E, folic acid, zinc, iron, selenium, magnesium,
and copper, plays an important role in the immune system function. Deficiency or low levels of
micronutrients can negatively affect the immune system and reduce the ability to fight infections.
6.Prevalence of micronutrients deficiency and micronutrient intake in pregnant women
Oyundelger D ; Bolormaa N ; Bayasgalan J ; Tuvshinbayar B ; Tserenlkham B ; Batjargal J
Mongolian Medical Sciences 2019;188(2):24-28
Background:
In order to study and evaluate the nutrition situation of the Mongolian people. The 2016-2017 NNS V
includes 5 different age groups from Mongolian’s four economic development regions and Ulaanbaatar.
The NNS V survey quantifies the prevalence of the nutrition conditions that are of greatest concern to the
population, particularly young children and pregnant women.
Goal:
To establish the prevalence of micronutrients deficiency and estimate micronutrient intake in pregnant
women
Materials and Methods:
Totally 2220 pregnant women included in cross-sectional study from urban and rural area. Survey
procedures consisted of interview, anthropometric measurements, clinical examinations, and the collection of biological (blood and urine) samples for pregnant women. Micronutrient deficiencies were assessed by tests for hemoglobin, serum, ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for determination of urinary iodine concentration.
Result:
The prevalence of anemia, as measured by hemoglobin, was 21.4% and the iron deficiency anemia
(IDA) was 10.5%, as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR) was 29.6%.
Prevalence of iron deficiency as measured by serum ferritin was also highest in Western 35.1% and lowest in Eastern region 21.5% (P<0.01). The prevalence of vitamin D in pregnant women was high with 75.4% and 4.4% of all pregnant women had sufficient vitamin D status. An additional 20.2% of pregnant women having insufficient levels. The median concentration of 120.5µg/l indicates inadequate iodine status in pregnant women, as the desired range for adequate iodine nutrition in pregnancy 150-249 µg/l.
Conclusion
1. One in every 5 pregnant women (21.4%) is anemic.
2. Vitamin D intake among pregnant women (7.3%) is very low, with 75.4% having vitamin D deficiency and vitamin D insufficiency –by 20.2%.
3. Median urinary iodine concentration of pregnant women is 120.2mg/l, considerably lower than WHO recommended reference range, indicating pregnant women are at risk of iodine deficiency.
4. Despite visible growth in vitamin and mineral supplements intake by pregnant women, compared to 2010, the infrequency of intake and failure to consume recommended number of supplements as
instructed in the relevant guides persist.
7.Unhealthy food consumption and prevalence of overweight and obesity of school children aged 6-11 years old
Bolormaa N ; Tuul B ; Batjargal J ; Enkhtungalag B ; Bayasgalan J ; Oyundelger D ; Tuvshinbayar B ; Davaasuren M ; Ganbolor D
Mongolian Medical Sciences 2020;194(4):38-45
Background :
Overweight and obesity are conditions of over nutrition resulting from consumption of more calories
than the body requires leading to excess body fat accumulation. The prevalence of both overweight
and obesity is increasing globally in all age groups in high, middle, and low-income countries and is
largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and
inexpensive, low-nutrient unhealthy foods high in energy [1].
The move away from traditional to “junk” foods often occurs at the same time as the move of populations
away from daily physical activity and increase in sedentary activities such as time spent in front of a
phone, computer, or television, furthering increasing the risk of becoming overweight. People who
are overweight or obese are at higher risk for serious health problems including hypertension, heart
disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity
is accompanied by a dramatic increase in prevalence of above mentioned chronic conditions in the
worldwide. While the long-term repercussions of overweight and obesity are severe, they are largely
preventable and treatable through healthy diets and healthy lifestyle behaviors [2].
Materials and Methods:
The fifth National nutrition survey (NNSV) was implemented in 21 provinces (aimags) in 4 socio-economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given
the regional differences in dietary patterns and nutrition status, target populations were stratified into
5 strata based on 4 regions and Ulaanbaatar with equal samples drawn from each stratum using a
cluster-randomized sampling design. In total, 1750 school children data on demographic and dietary
information collected by interview methods and anthropometric measurement results were used in
this study.
Ethical considerations:
The survey protocol was discussed at the Scientific Committee of the Public Health Institute (recently
named by National Center for Public Health) and granted by order of director of Scientific committee
of PHI on 28th June, 2016. Ethical approval for conducting the NNS V was obtained from the Medical
Ethics Committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey
was voluntary, oral and written informed consent were obtained from adult caregivers of each children.
Results:
Consumption of unhealthy or junk (high-calorie, low-nutrient) foods in the past week was nearly
universal (99.0%) among school children 6-11 years of age. Over half of children (51.4%) consumed
junk foods at least once per week and 45.7% consumed junk foods a few times a week. Consumption
of sugar-sweetened beverages was high with 80.9% of children consuming these at least once in the
past week. Overall consumption of fried foods was lower than consumption of junk foods or sugar-sweetened beverages with 22.7% of children not consuming any fried foods in the past week and only
8.5% of children consuming fried foods a few times per week. Consumption of sweet foods was high
with nearly all children having consumed sweet foods in the past week, 45.9% of children 6-11 years
having consumed sweet foods a few times per week.
The prevalence of overweight (BMI > +1 SD) was 22.2% and prevalence of obesity (BMI > +2 SD)
was 6.4%. Overweight prevalence was higher in boys (26.6%) compared to girls (17.8%) and in
urban (23.9%) compared to rural (17.6%) areas with the highest prevalence in Ulaanbaatar (25.6%)
compared to other regions. Children 6 years old (26.1%) and 7 years old (25.6%) had a higher
prevalence of overweight than older children.
Conclusion
1. Consumption of unhealthy foods and drinks is common to 6-11 year olds group, with almost all
children (99.2%) consuming any type of unhealthy foods and drinks at least once per week, in
particular, 8 out of 10 children were found consuming sugary drinks and/or deep fried food.
2. The consumption of unhealthy foods was not differing by child’s sex, there were revealed
significant differences between living area and regions. Proportion of the school children 6-11
years of age was relatively higher in Ulaanbaatar city and urban settings.
3. The prevalence of overweight and obesity in school children aged 6-11years sharply increased
from 2010 NNS IV level and reached 22.2% and 6.4%, respectively. Among children with obesity
consumption of any unhealthy foods and sugary drinks were 1.4–1.9 times higher than nonobese children, respectively.
8.Body iron store and prevalence of iron deficiency In Mongolian children aged 6-59 months
Bolormaa N ; Bayasgalan J ; Batjargal J ; Enkhmyagmar D ; Oyundelger D ; Enkhtungalag B ; Munkhtstetseg P
Mongolian Medical Sciences 2020;192(2):18-26
Background:
Iron is an essential mineral needed for physical and cognitive development with iron needs greatest
during pregnancy, infancy, childhood, and adolescence. Iron is vital throughout the lifespan as it
is a component of haemoglobin, the protein responsible for transporting oxygen from the lungs to
body cells for energy production. Iron deficiency results from a depletion of body iron stores due to
increased iron needs, inadequate dietary iron intake, reduced iron absorption, or loss of iron from
infections caused by malaria, hookworms, and other intestinal parasites. In advanced stages, iron
deficiency leads to iron deficiency anaemia, a condition of low red blood cells and reduced oxygen-carrying capacity.
Goal:
This study aimed to determine body iron stores in Mongolian children aged 6-59 months, and estimate
prevalence of iron deficiency among of studied children.
Materials and Methods:
In this study were used materials that collected during the fifth national nutrition survey conducted
in 21 provinces of 4 economic regions and 8 districts of Ulaanbaatar city of Mongolia. The fifth
national nutrition survey was household based survey; therefore sampling unit was household
with 5 year-old child. We had used demographic information collected by interview methods and
laboratory examination results on ferritin, soluble transferrin (sTfR), C reactive protein (CRP) and
α1-acid glycoprotein (AFP) in serum samples collected from 6 to 59 months old children, pregnant
women and 15–49 year-old men living in child’s households. Serum Ferritin and soluble transferrin
(sTfR) were used as a biomarker for iron store and iron deficiency and C reactive protein (CRP)
and AFG were used as indicators for acute and chronic infection. The determination of iron status
is challenging when concomitant infection and inflammation are present because of confounding
effects of the acute-phase response on the interpretation of most iron indicators. Effects of C reactive
protein (CRP) and AGP concentrations on estimates of ID according to serum ferritin (SF) and soluble
transferrin receptor (sTfR) were considered in the study.
Ethical considerations :
The survey protocol was discussed at the scientific committee of the Public health institute and approved by director of scientific committee of PHI on June 28, 2016. Ethical approval for conducting
the survey, including obtaining biological samples was obtained from the Medical ethics committee
under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary,
oral and written informed consent was obtained from each participants and adult caregivers of under
5 year-old children.
Results:
Biomarkers of iron status were adjusted with inflammation indicators and estimated iron deficiency
(ID) and total body iron store in 1732 children 6-59 month-olds. The study findings showed that
adjusted mean concentration of serum ferritin and soluble transferrin receptor was 33.7 µg/l and
8.8 mg/l in children age of 6-59 months, respectively. The calculated total body iron store by using
adjusted SF and soluble transferrin receptor was 2.8 mg/kg among surveyed children. Iron deficiency
was estimated by using 2 different biomarkers among selected population group. The prevalence of
iron deficiency estimated by using SF was 20.7% in children 6-59 months. Iron deficiency in children
defined by using serum soluble transferrin receptor was 27.7%.
Conclusions
1. The average serum ferritin and soluble transferrin receptor concentrations was 33.7 µg/l and 8.8
mg/l in children age of 6-59 months, respectively. Total body iron store estimated by using SF
and soluble transferrin was 2.8 mg/kg among surveyed children.
2. The prevalence of iron deficiency estimated by using SF and sTfR was 20.7% and 27.7% in
children 6-59 months, respectively. According to the WHO recommendation, prevalence of iron
deficiency among Mongolian children aged 6-59 months is classified as “prevalent”.
3. Overall proportion of children with low body iron store was 22.4%. The prevalence of iron
depletion is relatively common in boys, young children aged 6–23 months, and rural children
aged 6-59 months.
9.Results of a study on breastfeeding practices
Otgonjargal D ; Tuul B ; Davaasuren M ; Bolormaa N ; Ganbolor D ; Batjargal J ; Bayasgalan J
Mongolian Medical Sciences 2021;195(1):31-37
Background:
Breastfeeding is the ideal food source for all newborns globally. Proper feeding of infants and young
children promotes optimal growth and development, especially in the critical window from birth to 2
years of age. Exclusive breastfeeding for 6 months and continued breastfeeding for the first 2 years of
life protects children from infection, provides an ideal source of nutrients, and is economical and safe.
Objective:
To assess the indicators of infant feeding practices among 0- 23 months old children.
Materials and Methods:
The NNS V was implemented in 21 aimags (provinces) in 4 economic regions (Central, Eastern,
Khangai, Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle
and nutrition status, target populations were stratified into 5 strata based on economic region and
Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling
design [1]. The infant and young child feeding indicators assessed in the NNS V were based on
the mother’s or caretaker’s report of breastfeeding and consumption of foods and fluids by the child
during the day or night prior to being interviewed.
Results:
83.7% of children under 2 years started breastfeeding within 1 hour of birth and though almost all
children were ever breastfed (97.9%), a slightly higher percentage of girls were ever breastfed overall
and within 1 hour of birth. Children 0-5 months were categorized according to whether they were
exclusively breastfed or predominantly breastfed, with the former only allowing vitamins, mineral
supplements, and medicine and the latter also including plain water and non-milk liquids. Among
children 0-5 months of age, 58.3% were exclusively breastfed and 65.3% were predominantly
breastfed, having received other liquids or foods in addition to breast milk. The prevalence of exclusive
breastfeeding was lowest in the 4th wealth index quintile (46.5%) and wealthiest quintile (54.0%)
households.
Conclusions
Exclusive breastfeeding and early initiation of breastfeeding practices are unacceptably low in
Mongolia; 20% of newborns are not breastfed within 1 hour of birth and more than 40% of infants
under 6 months of age are not exclusively breastfed and therefore, not receiving optimum nutritional
and immunity benefits from breast milk. Strengthening IYCF counselling in all regions and wealth quintiles to support women to practice optimal breastfeeding, along with counselling and awareness
of timely and adequate complementary feeding for children under 2 years of age, should be a top
priority for public health and as it is a key strategy to reduce malnutrition in children.