1. A COMPARATIVE STUDY OF ANXIETY SYMPTOMS AND SALIVARY CORTISOL IN ABUSED ADOLESCENTS
Altanzul N ; Sarantsetseg T ; Enkhtuya D ; Odkhuu E ; Khishigsuren Z
Innovation 2015;9(1):24-27
WHO informed that across world an average of 565 young eople aged 10 to 29 die every day through interpersonal violence. Some studies mentioned that anxiety was most frequently occurred as one of the psychological onsequences among victims of child abuse. Recent research on effects of adverse early life experiences on central nervous system as stress systems (hypothalamus-pituitary-adrenal axis-HPA) has provided a greater understanding of the link between childhood abuse and susceptibility to anxiety disorder. Therefore, this research was done to study nxiety among abused adolescents, some physical parameters and level of cortisol in saliva.Total number of participants were 149 children aged between 11-16 years (number cases were 53, matched control subjects were 96). The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a 38-item self-report uestionnaire that assesses multiple symptoms of childhood anxiety disorders based on current diagnostic criteria. All participants were measured the cortisol in the saliva by Cortisol ELISA kit, Sigma, USA. Average age of all subjects in the study was 13.52±1.57 and 102 of all subjects were female and 47 were male. All anxiety symptoms of case group was statistically significance higher (p<0.01) than control group. The average amount of salivary cortisol of case group was (21.3±8.1 ng/ml) statistically significantly lower (p<0.01) than average amount of control group (31.56±16.9 ng/ml). Anxiety was more frequently occurred among abused children and blunted cortisol responses might indicate a level of impaired HPA functioning that could constitute a vulnerability to psychopathology with exposure to anxiety.
2.The results of early detection program of uterine cervical cancer in Ulnaanbaatar
Uyanga G ; Oyunchimeg D ; Undarmaa T ; Enkhtuya SH
Mongolian Medical Sciences 2016;176(2):19-24
GoalTo evaluate the quality, results, and processing of cytology analyses of early detection program ofuterine cervical cancer implemented in Mongolia, which based on Pap test, at Ulaanbaatar city level.Materials and MethodsInformation was collected from the databases of the recalling system of screening program of theCancer registration and information unit of the NCC of Mongolia and districts pathology laboratoreis.Statistical significant level of 1.96 (95% CI) andthe margins of error 0.05 were considered andsample size was calculated by using the information that 10% of unsatisfied results appear onquality assurance of international level. Thus calculations were madefortotal of 1723 (585 positiveand negative 1138) samples, by collecting 287smears from each district.At the district level all the selected slides were reviewed blindly and compared to the previouscytological conclusion. Diagnostic validity was defined by calculating parameters such as specificityand sensitivity, positive and negative predicted values. The Kappa index criteriais used for statisticalcalculation of the cytological diagnosis conclusion matches.ResultsThe target group women coverage of cervical cancer screening program is 40.8%. Out of all positiveresults of early screening cytology, 77% were at an early stage and 23% were at an advanced stage.Thus positive signs were showed with increased detection results in early stage of uterine cervicalcancer (P = 0.05). Positive results of Pap test were follows; ASCUS (53.2%), ASC-H (10.0%), LSIL(19.2%), HSIL (13.4%), CIS (3.4%), and SCC (0, 8%). Out of total slides, 86.7% were as satisfactory.The test results conducted at the district level were90.1% of sensitivity, 88.8% of specificity and9.9% of false negative response. The discrepancy of results of cytology test in districts and repeatedseen is 31.4% (K = 0.749; p = 0.001).ConclusionThe coverage of cervical cancer screening program that has been implementing in our country isnot enough. There are problems at the district level including severe damages of uterine cervix andincomplete diagnosis. The quality of the cytology test is relatively unsatisfied.
3.Early diagnosis of nephropathy in patients with hypertension
Naran-Ulzii S ; Ariunaa T ; Baigalmaa E ; Ariuntsetseg N ; Enkhtuya J
Mongolian Medical Sciences 2011;172(2):45-49
Background: High blood pressure is both a cause and a complication of chronic kidney disease. As complication, high blood pressure may develop early during course of chronic kidney disease and is associated with adverse outcomes, in particular faster loss of kidney function and development of cardiovascular disease. The purpose of this study is early detection of chronic kidney disease in patients with hypertension by defining the prevalence of microalbuminuria.Methods: The study population consisted of 169 subjects with a hypertension. Individuals were considered to have hypertension if the blood pressure measured greater than 140/90 mmHg or if they were taking blood pressure lowering medications. Microalbuminuria was defined as 20 mg/l or greater. Results: We are presenting data on 169 subjects :male 38 (22.5%) female 131 (77.5%), average age 51.6±0.89 At screening, 14.8% of all participants were smokers, 62.1 % engaged in low levels of physical activity, 72.8% - were having tea with salt (table1). Microalbuminuria and renal failure, as GFR<60 ml/ min/1.73 m2, were documented in 34.3% and 16.6% of subjects, respectively. There is positive correlation between MAU and increasing-range of blood pressure (table2). Correlation was found between albuminuria and GFR(r= -0.2 p<0.01) and serum creatinine(r=0.31 p<0.01) the regression result has shown that GFR is associated with MAU and serum creatinine (table 3).Conclusions:1. In 34.3% of patient with hypertension was found nephropathies with MAU2. Microalbuminuria is increased with decline of GFR and raise of systolic blood pressure. GFR decline is with the raise of age and serum. It is important to implement in clinical practice screening of MAU hypertensive patients.3. In 2/3 of all screened subjects was found 1 and more risk factors for CVD.
4. Study of practical significance the first embrace
Otgontugs L ; Bolortuya B ; Oyun-Erdene L ; Saruul P ; Urnaa T ; Enkhtuya T ; Shatar SH
Innovation 2016;10(2):32-36
The Western Pacific Region have the highest neonatal mortality rate of any country in the world. It has 37 countries and areas with approximately 1.8 billion people which comprises one-fourth of the total world population. The First Embrace It is care for all mothers and newborn infants. The components of the First Embrace are immediate and thorough dying, appropriately timed clamping and cutting of the cord, skin to skin contact and initiating exclusive breastfeeding for all newborns. Aim: First embrace and Early Essential Neonatal Care the importance of infant seeks to to learn some of the problems faced by identifying the skills of medical personnel. We were conducted in this study by a cross sectional questionnaire in order to assess the knowledge, attitude and practices of healthcare providers about essential newborn care and administrated a structured questionnaire to evaluate instruments and materials of the maternity wards.Skin to skin contact and a mother first embrace is the beginning of a healthy life is to reduce the newborn mortality. And the first embrace is improves the children’s immunity. We determined urgent problems for EENC including a lack of maternal health education, inadequate salaries for health care providers, a lack of essential medicines and commodities for birth preparation and numbers of health care providers delivering neonatal intensive care are increased due to the stillbirth rate has increased dramatically year by year.The first embrace is important to reduce neonatal mortality rate and 92.0% of all participants have the enough experiences for the first embrace care and 80.3% of all participants for the EENC.
5. SURGICAL REHABILITATION OF NERVUS FACIALIS LESION
Erdenechuluun B ; Jargalkhuu E ; Zaya M ; Enkhtuya B ; Olziisaikhan D ; Gansukh B ; Jargalbayar D ; Ariunchimeg M ; Dolgorsuren L ; Adiya T ; Chuluunsukh D ; Erdenechimeg B ; Batkhishig B ; Altantsetseg Z ; Ranjiljov V ; Delgerzaya E ; Baigal M
Innovation 2016;2(2):13-16
There are a lot of influencing factors of facial nerve palsy; experts believe that is most likely caused by a Virus (54%) and Bacterial infections. Noninfectious causes of facial nerve palsy induce tumors (28%) and less commonly influences head trauma (18%). The retrospective analysis of WHO, in 2012. There are some cases of postoperative complication in middle ear surgery is facial nerve palsy and the total recovery outcome of function was not good. From 2013 to 2016 in EMJJ hospital, Mongolia, we enrolled 16 cases with facial nerve damaged in intratympanic canal but we could not recruit some patients with facial palsy over 6 months. Each subject was tested with pure tone test, ABR, Tympanometry. These were performed for the detection of hearing loss after Temporal bone injury. Then we also investigated location of facial nerve damages of patients by MRI and CT before reconstructive surgery. After that surgery, all patients were given corticosteroid treatment (20mg/day) and physical therapy performed such as acupuncture for a week. Study results revealed that 6 cases after 18 days, 2 cases after 30 days, 1 patient after 45 days of reconstructive surgery regained good symmetry. Therefore, we considered that, postoperative treatments like physical therapy with B12, steroid had good benefits for operation result and to shorten the recovery time. There was a patient who had damaged facial nerve in the tympanic segment during Mastoidectomy. In that case, we performed cable nerve grafting using the r.auricularismagnium but we could not recover facial nerve function. Traumatic facial nerve paralysis is the second most common type. We discussed that performing reconstruction surgery within first 3 months after intratemporal facial nerve injury is extremely desirable and more effective. In our opinion, nerve recovery might be not successfully cause of injured myelin sheet of facial nerve during middle ear surgery.
6.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.
7.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.