1.Usage of the automatic auditory brainstem response for the
Saruul Ch ; Zaya M ; Ganchimeg P
Innovation 2015;ENT(1):28-30
Hearing loss is likely to be the most common congenital abnormality in newborns, with a reported prevalence of 3 per 1000 live births. It is vitally important to diagnose infant hearing loss or deafness at its early stages. The automated auditory brainstem response (AABR) screener is a dedicated hearing screening device which provides information not only about the outer and middle ear and cochlea but also about the auditory pathway up to the brainstem.
The data presented were collected in the well-baby nursery. Overall, data from 5857 neonates screened from December 2012 to July 2015 were analyzed in this study. During 1-3 days after birth, they were analyzed with automated auditory brainstem response (AABR). Neonates referred the screening were scheduled for repeated diagnostic evaluation within a month. And newborns referred
again were sent to a specialist for further audiology analysis.
Out of the 5857 babies screened, 5050 passed bilaterally and 807 referred. The number of infants
referred for 2nd stage, post-discharge re-screening was 319. Of this group, 287 passed bilaterally and 32 failed the re-screening in one or both ears. Diagnostic testing was performed on all of the 32 infants who were referred. The resulting referral rate was 13.7% for first stage and 1,4% for second stage. The follow-up rate was 37%. The confirm rate was 0,13%. Profound bilateral sensor neural hearing loss was identified in 3 infants. Profound bilateral mixed hearing loss was identified in 1 infant.
Automated auditory brainstem response (AABR) was efficient in the early identification of newborn and infant hearing loss with high sensitivity and specificity rates. Due to the results of the study, 3 out of 5857 infants were diagnosed with a profound hearing loss and it’s approximately close to the results of other studies and statistics.
2.Results of investigation of lactate dehydrogenase activity in blood serum of mongolian population
Ganchimeg Ch ; Batbaatar G ; Odongua N ; Enebish D
Health Laboratory 2014;3(1):19-22
Abstract:
The lactate dehydrogenase (LDH) enzyme is widely distributed in tissue, particularly heart, liver muscle, and kidney. The LDH in serum can be separated into five different isoenzymes based on their electrophoretic mobility. Each isoenzyme is a tetramer composed of two different subunits. These two subunits have been designated heart and muscle, based on their polypeptide chains. There are two homotetramers, LDH-1 and LDH-5, and three hybrid isoenzymes.
Elevated serum levels of LDH have been observed in a variety of disease states. The highest levels are seen in patients with megaloblastic anemia, disseminated carcinoma, and shock. Moderate increases occur in muscular disorders, nephrotic syndrome, and cirrhosis. Mild increases in LDH activity have been reported in cases of myocardial or pulmonary infarction, leukemia, hemolytic anemia, and hepatitis.
This study aims to compare a LDH activity in comparatively healthy Mongolian population using highly sensitivity modern technology and evaluate their contents with age, sex, and work adults differences, For this purpose there were chosen 3742 healthy adults (1597 males and 2145 females). The enzyme activity were investigated in Mobio laboratory using fully automated analyzer COBAS Integra-400. Study results were assessed using Microsoft Excel SPSS-10 standard program and evaluation.
The study results show that mathematical mean of LDH activity of healthy Mongolian population is 322.6 u/l, quadratic mean of deviation is 44.9 u/l, and significant distribution is 187.2-442.6 u/l with p=0,99. The mathematical mean of LDH activity of healthy Mongolian man 187-444 u/l, but for women it is 187-438 u/l, with haven’t differences. The level LDH activity of healthy Mongolian population does not depend from age. The level LDH activity of healthy Mongolian population have differences from work adults.
Conclusion:
1.From the findings indicated LDH activity by 187.2-442.6 u/l.
2.Study findings shown LDH activity level not influenced for age and sex.
3.There fore we defined LDG activity level influenced physical and mental overload.
3. Usage of the automatic auditory brainstem response for the
Saruul CH ; Zaya M ; Ganchimeg P
Innovation 2015;ENT(1):28-30
Hearing loss is likely to be the most common congenital abnormality in newborns, with a reported prevalence of 3 per 1000 live births. It is vitally important to diagnose infant hearing loss or deafness at its early stages. The automated auditory brainstem response (AABR) screener is a dedicated hearing screening device which provides information not only about the outer and middle ear and cochlea but also about the auditory pathway up to the brainstem.The data presented were collected in the well-baby nursery. Overall, data from 5857 neonates screened from December 2012 to July 2015 were analyzed in this study. During 1-3 days after birth, they were analyzed with automated auditory brainstem response (AABR). Neonates referred the screening were scheduled for repeated diagnostic evaluation within a month. And newborns referredagain were sent to a specialist for further audiology analysis.Out of the 5857 babies screened, 5050 passed bilaterally and 807 referred. The number of infantsreferred for 2nd stage, post-discharge re-screening was 319. Of this group, 287 passed bilaterally and 32 failed the re-screening in one or both ears. Diagnostic testing was performed on all of the 32 infants who were referred. The resulting referral rate was 13.7% for first stage and 1,4% for second stage. The follow-up rate was 37%. The confirm rate was 0,13%. Profound bilateral sensor neural hearing loss was identified in 3 infants. Profound bilateral mixed hearing loss was identified in 1 infant.Automated auditory brainstem response (AABR) was efficient in the early identification of newborn and infant hearing loss with high sensitivity and specificity rates. Due to the results of the study, 3 out of 5857 infants were diagnosed with a profound hearing loss and it’s approximately close to the results of other studies and statistics.
4. Results of investigation of lactate dehydrogenase activity in blood serum of mongolian population
Ganchimeg CH ; Batbaatar G ; Odongua N ; Enebish D
Health Laboratory 2014;3(1):19-22
Abstract:The lactate dehydrogenase (LDH) enzyme is widely distributed in tissue, particularly heart, liver muscle, and kidney. The LDH in serum can be separated into five different isoenzymes based on their electrophoretic mobility. Each isoenzyme is a tetramer composed of two different subunits. These two subunits have been designated heart and muscle, based on their polypeptide chains. There are two homotetramers, LDH-1 and LDH-5, and three hybrid isoenzymes. Elevated serum levels of LDH have been observed in a variety of disease states. The highest levels are seen in patients with megaloblastic anemia, disseminated carcinoma, and shock. Moderate increases occur in muscular disorders, nephrotic syndrome, and cirrhosis. Mild increases in LDH activity have been reported in cases of myocardial or pulmonary infarction, leukemia, hemolytic anemia, and hepatitis.This study aims to compare a LDH activity in comparatively healthy Mongolian population using highly sensitivity modern technology and evaluate their contents with age, sex, and work adults differences, For this purpose there were chosen 3742 healthy adults (1597 males and 2145 females). The enzyme activity were investigated in Mobio laboratory using fully automated analyzer COBAS Integra-400. Study results were assessed using Microsoft Excel SPSS-10 standard program and evaluation.The study results show that mathematical mean of LDH activity of healthy Mongolian population is 322.6 u/l, quadratic mean of deviation is 44.9 u/l, and significant distribution is 187.2-442.6 u/l with p=0,99. The mathematical mean of LDH activity of healthy Mongolian man 187-444 u/l, but for women it is 187-438 u/l, with haven’t differences. The level LDH activity of healthy Mongolian population does not depend from age. The level LDH activity of healthy Mongolian population have differences from work adults.Conclusion:1.From the findings indicated LDH activity by 187.2-442.6 u/l.2.Study findings shown LDH activity level not influenced for age and sex.3.There fore we defined LDG activity level influenced physical and mental overload.
5.НЯРАЙ БОЛОН ХӨХҮҮЛ ХҮҮХДИЙН СОНСГОЛ БУУРАЛТЫГ ЭРТ ҮЕД ОНОШЛОХ НЬ
Saruul Ch ; Delgermaa B ; Zaya M ; Ganchimeg P
Innovation 2017;3(3):18-20
BACKGROUND. Hearing loss is likely to be the most common congenital abnormality in newborns, with a reported prevalence of 1 to 2 per 1000 live births. It is vitally important to diagnose infant hearing loss or deafness at its early stages. Early detection and intervention is critical to prevent the adverse consequences of a delayed diagnosis on speech, language and cognitive development. Universal screening of hearing loss has been introduced in practice with distortion product of otoacoustic emission (DPOAE). The automated auditory brainstem response (AABR) screener is a dedicated hearing screening device which provides information not only about the outer and middle ear and cochlea but also about the auditory pathway up to the brainstem.
METHODS. The study was descriptive and based on a retrospective analysis of the two year period databases (2014-2016) from the newborn hearing screening program. We have started the hearing screening from December 2012. Between 2014 to 2017 we have been screened total of 11218 newborns. We tested automated audiotory brainstem response of the newborns in their 1- 3 days of birth, using Maico MB11 Beraphone machine (German) according to the Joint Committee on Hearing Screening guidence. We assessed the test result of “pass” as “normal hearing, “refer” as to rescreen and tested again after 1 month. Infants referred again were gone to a specialist for further audio logic analysis (behavioral tests, auditory brainstem response, otoacoustic emissions and auditory steady state response).
RESULTS. Our study was the first in Mongolia. Total of 10290 newborns passed bilaterally out of 11218 and 1323 referred in the first screening. For the rescreen test, 1088 out of 1134 infants resulted with “pass” and 46 infants with “refer”.
For those infants, we did ABR test in their 3 and 6 months, and result of 9 children (18 ears) have bilateral profound hearing loss, 2 children (2 ears) have bilateral mixed profound hearing loss and 13 (26 ears) have bilateral profound conductive hearing loss.
Coverage rate was 34,7%. First refer rate was 11,7%. Follow rate was 39,7%.
We conducted the cochlear implantation surgery for 2 children out of 11. Currently, we are preparing other infants with bilateral profound hearing loss of 0-3 years old for the follow up CI surgery.
CONCLUSION. In Mongolia, the data of infant hearing difficulties and prevalence of deafness is lacking. Although newborn hearing screening program has been approved in 2014 and brought opportunities to conduct universal neonatal hearing screening program. But at the moment, its only available at NCMCH which located in Ulaanbaatar city. 11 cases have a bilateral profound hearing loss out of 11218 newborns. Our study result shows similiar pattern (1.1 - 1.3 ear deafness in every 1000 birth. Lenarz et all.2008). Automated audiotory brainstem response was efficient in early identification of newborn hearing loss with high sensitivity and specification rates. Small population in the remote locations, high birth percentage, short period in the hospital after birth, lack of technology and human resources, and other factors result in higher level of referral rate newborn hearing screening and lower level of follow up and confirmation rate referals in Mongolia.