1. NON-ORGANIC SUBSTANCES IN URINE DURING NEPHROLOGY NEPHROLITHIASIS
Khongorzul B ; Saruul P ; Bolortuya B ; Bolormaa TS ; Urnaa Т ; Bolormaa N ; Erdenetsetseg N ; Shatar SH
Innovation 2015;9(3):170-173
Risk of nephrotith disease increases relating with using high hardened water, not suitable diet, being sensitive for some kind of food products. Then for Mongolia, particularly Bulgan province which is located in basin of the Selenge river is consisted in regions which have high hardened water. Sickness rate of renal diseases especially nephtolith disease is high in population of Selenge soum of Bulgan province. It was main reason of choose this subject and investigate non organic substances in urine of population and determine risks of nephtolith disease for them. To determine оne of the factors affecting the formation of the disease is to study the composition of drinking water and investigate non organic substances in urine. We used cross-sectional methodology for our study. Our study was conducted from June, 2013 to November, 2014. Household water used portable water dissemination and homes with private wells and water samples from the river.Drinking water analyzed of the chemistry parameters (13 substances) in the chemistry and toxicology laboratories in Orkhon aimag. There was 300 urine analyze was done and 62 of them was confirmed nephtolith disease with it. We investigated non-organic substances in their urine. Interviews people in the study, the average age was 43.26±14.7. 64.2% of participants was answered that they use ground water (private groundwater wells), 25.4% use external water (the well water), 8.1% use river water, 2.3 use pure water when asked about their water supply. Composition of samples from drinking water standard was near to the standard assessments by comparing the maximum amount of. We were considered the most important water pH, solids, iron, chlorine analysis compares removable wells and private wells. Hardness for 53.3% of the well of 2.5-3.5 mg/l with hard water, private wells, 60.0% of 4.6-5.5 mg/l solids by of water. Wells chlorides portable 66.7% 14.4-25.3 mg/l, and private wells 13.3% of 4.3-14.3 mg /l. 20.7 percent of survey identified as the kidney and urinary tract diseases. Urat salt (32.1%), compound of urat and sodium (32.1%), oxalate (14.5%), sodium (13.4%), compound of oxalate and sodium (6.4%), phosphate (1.5%) was determined in urine analyze. It was close to the water content of the standard performance. The well water solids of 2.5-3.5 mg/l and private groundwater wells solids of 4.6-5.5 mg/l. And the well chlorides 14.4-25.3 mg/l and private groundwater wells chlorides 4.3-14.3 mg/l.Urat and compound of urat and sodium are dominated in composition of stone during nephrolith disease (p=0.043).
2.Results of the determination of iodine content in household salt
Otgonjargal S ; Enkhjargal Ts ; Gantuya P ; Bolormaa N ; Dorjkhand B
Health Laboratory 2017;6(1):5-9
Justification:
Iodine is a micronutrient essential for human health. 92% of the required iodine human organism obtains with food. One of methods to supply the required amount of iodine is the use of iodised salt. The overall goal of our study was to determine the actual consumption of iodised salt by households.
Materials and Methods:
Samples of salt consumed by 20173 households from five regions (Western, Mountainous, Central, Eastern regions and Ulaanbaatar city) of Mongolia were collected and their iodine contents were determined according to MNS 5168:2002.
Results:
Out of the total analyzed salt samples, 19.1 % were non-iodised, 2.8% had low iodine content, 77.5% had appropriate level of iodine and 0.6% had high level of iodine.
When the salt iodine contents were evaluated by the country regions, it was revealed that the households in Western (31.4%) and Mountainous (20.57%) regions consumed salt that was not iodised. 84.5% of
the Ulaanbaatar city households consumed salt with appropriate level of iodine.
Conclusions
1. 19.1 % of the surveyed households consume non-iodised salt, 2.8% consume salt with low iodine content, 77.5% consume salt with appropriate level of iodine and 0.6% consume salt with high level of
iodine.
2. The iodine level is appropriate in 84.5% of salt consumed by Ulaanbaatar city households.
3.Prevalence of stunting among infants and young children in Mongolia
Otgonjargal D ; Gereljargal B ; Batjargal J ; Bolormaa N
Mongolian Medical Sciences 2011;158(4):63-69
Introduction. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. A lack of a sustained decrease in low birth weight and young child malnutrition is associated with the failure to provide nutritious food in adequate quantities to pregnant and breastfeeding women and children up to two years of age. The most recent estimate from the 2005 MICS survey of the prevalence of wasting is 2.8 percent, stunting is 26.8 percent, and underweight is 7.4 percent among children aged 0-59 months in Mongolia.Goal. To assess the current nutritional status of 0-59 months old children of Mongolia, and identify next steps to improve child nutrition.Materials and Methods. This cross-sectional survey was conducted in 21 aimags of 4 economic regions of the country and in the city Ulaanbaatar. A total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey.Results. The distribution of length/height-for-age Z-scores of the surveyed children was shifted to the left compared to the WHO Child Growth Standard. The weighted average z-score and its standard deviation was 0.78±1.5, which is characteristic of high proportion of "short" children in Mongolia. Of the surveyed children, 15.6% (95%CI 12.7¬18.9) were stunted about one-third of stunted children had severe stunting. The prevalence of stunting was highest in the Western Region, the differences between this region and all other regions were statistically significant. Rural children had statistically significantly prevalence rates of overall stunting, moderate stunting, and severe stunting compared to their urban counterparts. Underweight and stunting were much more prevalent in children who had a low birth weight. Of those with a low birth weight, 35.5% (95%C118.4- 57.3) were underweight and 54.1% (95%CI 35.3-71.8) stunted, but there were no wasted children.Conclusions:1. In rural area the prevalence of stunting among in 0-59 months old children was highest than urban area's children.2. The prevalence of stunting was highest in the Western Region and remains at "high" level according to WHO classification.3. Underweight and stunting were much more prevalent in children who had a low birth weight4. The high rate of stunting among under five year olds is likely related to dietary behavior, and requires further study and intervention efforts.
4. RESULT OF PREMALIGNANT LESION OF CERVIX BY COLPOSCOPY AND DETERMINATION OF SOME RISK FACTORS
Batnyam B ; Unurjargal D ; Ariunbuyan D ; Gantulga D ; Bolorjargal E ; Bolormaa N
Innovation 2015;9(3):68-69
Cervical cancer is commonly caused by infection with human papilloma virus(HPV) and some risk factors are involved in the etiology of it.1 All over the world 437000 people are diagnosed with cervical disorders and half of them die due to cervical cancer.2 Annually 12000 new cases of cervical cancer are detected and 5000 women die because of it. In Spain about 2000 women are determined in the 3rd and 4th stage of the disease per year.3 Over the period 2000-2008 cervical cancer rate is 8 %among all cancers in Mongolia. Approximately 16 % of women’s cancer is cervical cancer. 4 In developing nations prevalence rate of cervical cancer is higher because of malnutrition, quality and framework for early detection are not satisfying and some reproductive risk factors also influence on it. 5 Worldwide diagnosing early and rapid management of precancerous condition and cervical abnormalities turn into main issue. Therefore based on these detection of premalignant lesion of cervix by colposcopy the main objective of the study. The overall goal of the study is to detect the premalignant lesion of cervix by colposcopy and determine of some risk factors and study the results.A total of 71 women, who are treated in Women’s inflammatory disease unit, Infertility and Women’s endocrine disorder unit are recruited for the cross sectional study. The women, who conducted the study were selected by accidently and colposcopy was done. They also have completed special questionnaires. The data were analyzed using the SPSS 19.0, Windows Office. The average age of the women was 38±9.4. Colposcopy was done 90.1% (n=64) of women, 9.9% (n=7) of women had not colposcopy. Among the women who had colposcopy, biopsies were taken 56.3% (n=36). During colposcopy we analyzed condition of cervix then we took biopsy from suspected areas and sent it histology laboratory. We compared predictive diagnosis, histology results after colposcopy and 33.3% (n=12) were identified as normal, CIN I was 52.7%, (n=19), CIN II was 5.5% (n=2), CINIII was 2.7% (n=1), cervical cancer is confirmed in 5.5% (n=2). We studied risk factors that can influence the cervical disorders among the women recruited in the study and age of first sexual intercourse (r=0.356, p=0.033), number of abortion (r=0.412, p=0.029) were statistically significant. However age of the women, parity, usage of contraceptive pills, smoking, number of sexual partners were statistically not significant.(p>0.05) When women’s age of first sexual intercourse is younger, cervical cancer disorder occurs30% greater comparing to women having first sexual intercourse later, (p<0.05, R=0.3), when number of abortion increases cervical cancer disorder increases 40%(p<0.05, R=0.41).F-1 to recruit osteoprogenitor /mesenchymal stem cells in the bone regeneration process.
5.Water quality analysis of Kharaa and Orkhon river
Tuya E ; Nyamsuren L ; Khongorzul B ; Undarmaa P ; Amardulam N ; Khishigt J ; Burmaajav B ; Bolormaa I
Mongolian Medical Sciences 2015;171(1):25-29
INTRODUCTION:According to the report from 2010, Mongolian water consumption was 550 million cubic meter andapproximately 9.1% of the total Mongolian population obtain their water from inadequate hygiene waterresources - springs and rivers. Due to non-hygiene water usage has caused water-born communicableand non communicable diseases among the population. In the last years there has been issue of pollutionof one of the Mongolia’s more representative river Selenge and its following rivers -Kharaa, Orkhon andit is necessary to evaluate water pollution of these rivers.GOAL:To determine water chemical and biological pollution of Kharaa and Orkhon river and to evaluate waterqualityMaterials and MethodsWe collected water, sediments and macro invertebrates sample from three points of river -upstream,midstream, downstream and for Kharaa river the samples were collected from Tunkhel, Mandal andBayangol soum, fo Orkhon river the sequence was Orkhontuul, Orkhon, Khushaat soum. Samples werecollected June, August, October of 2011, 2013.In water sample, we determined physic-chemical 15 parameters including temperature, pH, total dissolvedsolids, conductivity, smell, color, hardness, sulfate, chloride, nitrate, nitrite, ammonia, dissolved oxygen,biological oxygen demand and mercury using their standard methods. Macro invertebrate samples werecollected to evaluate water quality and we determined mercury in sediments and macroinvertebratesamples to evaluate mercury contamination.RESULT:Physic-chemical results of the water showed that water of Kharaa, Orkhon rivers were classified lowmineralized, soft water and nutrient pollution indicators for ‘slightly polluted’category. For dissolved andbiochemical oxygen, they were belong to the category of ‘pure water’.There were no correlation between 2012 and 2013 results and mercury in water, sediments and macroinvertebrates were qualified standard value.CONCLUSION:According to research results water quality of Kharaa, Orkhon river was good and have less pollution andit is possible to use in household consumption after proper cleaning and disinfection.
6.Comparative study of the average level of serum selenium in adult mongolians by geographic regions
Oyundelger D ; Bolormaa N ; Enkhtungalag B ; Batjargal J ; Tuvshinbayar B ; Nyamragchaa CH ; Tserenlkham B ; Tserenchimed S
Mongolian Medical Sciences 2015;174(4):7-11
Background: Disorders in the human body due to selenium defi ciency are associated with geographiclocation or environment, especially selenium concentrations in water and in soil. Selenium concentrationsin the blood of populations around the world, varies greatly. To date, no research has been conducted onaverage serum selenium level of adult Mongolians.Goal. To conduct a comparative study on the average serum selenium level of adult Mongolians bygeographic regions.Materials and Methods. In this study were participated 2339 healthy subjects randomly selectedfrom sampling units based on 4 geographical regions of Mongolia. For the study were used thequestionnaire and biochemical methods. Blood samples were collected from all subjects and serumselenium concentration was measured by the thermo fi sher scientifi c analyzer using atomic absorptionspectrophotometer method.Result: The mean serum selenium level in adult Mongolians was 0.78 μmol/l. A comparative analysisshowed a statistically signifi cant difference (ð<0.0001) in the mean serum selenium level of adultMongolians living in different geographic regions. In particular, the mean serum selenium level ofadult Mongolians was 0.85 μmol/l in the Altai Mountain, 0.57 μmol/l in Khangai mountain, 1.0 μmol/l inGobi, 0.71 μmol/l in Dornod steppe regions and thus indicator was 0.75 μmol/l among adult citizens ofUlaanbaatar. Majority of residents living in Khangai mountain and Dornod steppe regions were at a riskof selenium defi ciency.Conclusions:1. Comparative analysis of the average serum selenium level of adult Mongolians by region showedthat the Gobi region has highest (1.0 μìîë/ë) and Khangai region has the lowest (0.57 μìîë/ë).2. Study fi ndings showed that 7 – 8 individuals out of 10 residents of Dornod steppe and Khangairegions were at the risk of selenium defi ciency.
7.Age and gender comparative study on the average serum selenium level of adult mongolians
Bolormaa N ; Batjargal J ; Ouyundelger D ; Erdenetsogt E ; Enkhtungalag E ; Tserenlkham B ; Tuvshinbayar B ; Tserenchimed S ; Namsrai M
Mongolian Medical Sciences 2014;170(4):5-9
IntroductionThe trace elements selenium is a constituent of the antioxidant enzyme glutathione peroxidase. Becauseit boosts the body’s antioxidant capacity, selenium is thought to have some ability to control cell damagethat may lead to cancer. Selenium low status has been linked to increased risk of various diseases, suchas cancer and heart disease.GoalInvestigate serum selenium level of adult mongolians and conduct age and gender coparartive analysisof the serum selenium content.Materials and MethodsCross sectional study was performed among the 2339 apparently healthy Mongolians of both gendersaged ≥18 years. In the study were used questionnaire and biochemical methods. Blood samples werecollected from all subjects and serum selenium concentration was measured by atomic absorptionspectrophotometry method using thermo fisher scientific analyzer.ResultsThe mean and confidence interval of serum selenium level in adult Mongolians was 0.78 μmol/l (95%CI0.77-0.79) and there was no significant difference between genders. Thus the mean was 0.77 μmol/l(95%CI 0.76-0.80) among women and in men it was 0.78 μmol/l (95%CI 0.76-0.80). Data analysisrevealed that older age group individuals were at risk of lowered serum selenium level. In particular,the oldest age group of over 60 years (females: 0.74 μmol/l, 95%CI 0.70-0.77; males: 0.68 μmol/l,95%CI 0.64-0.71). The difference in selenium status between age groups was statistically significant inboth sexes. The overall prevalence of serum selenium concentrations indicative risk of deficiency was59.7%, with no significant differences in the prevalence by genders. Survey findings revealed that riskof selenium deficiency had statistically significant difference between age groups among the surveyedmen.Conclusion: The mean value of serum selenium in adult Mongolians was 0.78 μmol/l and there was nosignificant difference between genders.
8.ЭС СУДЛАЛЫН ШИНЖИЛГЭЭНИЙ ЧАНАРЫН ГАДААД ХЯНАЛТЫН АСУУДАЛД
Bolorchimeg Kh ; Tuul B ; Narantuya N ; Bolormaa O ; Tserenpil B ; Bayarmaa E ; Sayamaa L
Innovation 2017;11(2):26-28
BACKGROUND. Uterine cervical cancer is the fourth leading cause of cancer deaths
in women worldwide. In our country, cervical cancer is second most common cancer
in women. Uterine cervical smear (Papanicolaou test) remains an effective and widely
used method for early detection of precancerous and cancerous lesions. Since 2002,
the cervical smear was introduced to the clinical practice of our country. However,
there is no study to performed external quality assurance of cervical smear until now.
MATERIALS AND METHODS. We selected 20 glass slides of uterine cervical smear, the
diagnosis was approved by histopathology. Each chosen slides were evaluated by four
cytologists of A, B, C, D hospitals with hidden clinical information, independently.
RESULTS. The sensitivity of A, B, C and D hospitals were 87.5%, 93.3%, 93.3%, and 93.3%,
respectively. The specificity of A, B, C and D hospitals was 85.7%, 85.7%, 75%, and 66.6%,
respectively. The diagnostic concordance of A, B, C and D was 70%, 75%, 50%, and 55%,
respectively. The agreement of cytological diagnosis was moderate (kappa = 0.55),
moderate (kappa = 0.43), fair (kappa = 0.37), and fair (kappa = 0.33) in A, B, C, and D
hospitals, respectively. CONCLUSION: The external quality assurance in cytopathology
is needed in Mongolia. The diagnostic concordance method would be applicable in
our country to improve diagnostic agreement.
9.Urinary iodine status in 6-11 years old children and pregnant women
Khishigbuyan D ; Enkhjargal Ts ; Gantuya P ; Bolormaa N ; Sodnomtseren B
Health Laboratory 2017;6(1):10-14
Background:
Iodine is a micronutrient essential for mental and physical development. One of ways to prevent from iodine deficiency is sufficient intake of iodine with food. The WHO approved method for assessment of the population’s iodine status is measurement of the concentration of iodine in urine.
Goal:
The goal of the survey was to assess the iodine status in 6-11 years old children and pregnant women.
Materials and Method:
1697 children of 6-11 years of age and 900 pregnant women were selected from 21 aimags and Ulaanbaatar city. Concentrations of iodine in their urine were determined using the Sandell-Kolthoff reaction method.
Results:
The median amount of urinary iodine in 6-11-year-old children was 143.45 µg/L which was within the WHO recommended range (100.0-199.9 µg/L). 31.82% of the surveyed children had their urinary iodine less than 100 µg/L which indicated a risk of iodine deficiency. The highest frequency of children with urinary iodine less than 100 µg/L was observed in western regions (53.9%) and the lowest
percentage was observed in eastern regions (17.8%).
The median concentration of urinary iodine in pregnant women was 111.35 100 µg/L which was lower than the WHO recommended value (≥150 µg/L). The median amount of urinary iodine was 127.81 µg/L for the women in Ulaanbaatar city and for those in rural areas was 108 µg/L. The overall percentage of the
women with low urinary iodine was 64.1%.
Conclusions
1. The median urinary iodine concentration in 6-11 years old children is within the WHO recommended
range, whereas the median concentration in pregnant women is lower than the WHO recommended value.
2. 31.8% of the surveyed children and 64.1% of the pregnant women are at risk of iodine deficiency.
3. The frequency of iodine deficiency is highest in western region and is lowest in eastern and central regions.
10.The prevalence of low birthweight infants: national nutrition survey-2017
Otgonjargal D ; Davaasuren M ; Tuul B ; Bolormaa N ; Batjargal J
Mongolian Medical Sciences 2020;191(1):32-37
Background:
Weight at birth is a good indicator of the mother’s health and nutrition status during gestation and
a child’s chances for survival, growth, long-term health, and psychosocial development. Low birth
weight (defined as less than 2500 grams) poses a range of serious health risks for children.
Objective:
To assess the prevalence of low birth weights (LBW).
Materials and Methods:
The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern,
Khangai, Western) and the capital city of Ulaanbaatar. A total of 2250 children aged 0-59 months.
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. For the selection of households in urban areas, the
process involved first selecting 30 khoroos (clusters), then khesegs, and then households with a child
0-59 months of age.
Ethical considerations :
The survey methodology was discussed at the Scientific Committee of the Public Health Institute
(recently named by National Center for Public Health) and granted the PHI Directors Order on
28th June, 2016. Ethics approval for conducting the NNS V, was obtained from the Medical Ethics
Committee under the Mongolian Ministry of Health.
Results:
Almost all (99.5%) children in the sample were weighed at birth with 5.0% weighing less than 2500
grams at birth and 12.6% weighing over 4000 grams at birth. The prevalence of low birth weight was
slightly higher among girls than boys, however high birth weight was much more common in boys
(15.9%) compared to girls (9.5%). Prevalence of low birth weight was highest in Western region
(9.6%) and the poorest households (7.8%) while the prevalence of high birth weight was highest in
Ulaanbaatar (13.8%) and wealthiest households1 (16.4%). High birth weight was more than double
among children of overweight (17.5%) and obese (17.3%) mothers compared to children of normal
weight (8.4%) or underweight (7.0%) mothers. Among singleton births, women <29 years of age had
higher LBW rates than did those 30-39 years of age in both years, irrespective of birth order. LBW
rate was more than double among mothers in kazak ethnic groups (13.8%).
Conclusions
The younger age of the mother was more likely to develop low birth weight, and it was twice as high
among mothers in Kazak ethnic groups. Therefore, adolescents and women of reproductive age
needed to improve the health education and to identify the causes and risk factors of low birth weight
among mothers in Kazak ethnic groups.