1.Understanding and choice of medical students regarding to basic and specialised training in medicine
Mongolian Medical Sciences 2011;157(3):45-47
Background. Due to strengthening of understanding and scope for health service, in different countries of the World, there are wider range of medical specialized trainings newly emerged by quantity and quality. According to the researchers number of factors influence in choice of specialty among medical students and young professionals such as: age, gender, income status, judgement of vocation and prestige. Evaluation on understanding, choice and basic concepts of specialized training, among undergraduate medical stu¬dent and lack of information and research related to thi question lead to motivation and justification of this research. Goal. Goal of this research is to determine the understanding and choice of specialized postgraduate training among medical students. Objectives: 1. To determine the understanding of the basic and specialized vocational training among medical student 2. To determine the choice of the basic and specialized vocational training among medical student 3. To study choice of medical students on basic and specialized vocational training in relation to the needs of health sector. Material and methods. Research has been conducted among 157 medical students of HSUM who are at the 6th year and 74 medical students of Ach Medical institute and used cross-sectional study with quantitative and qualita¬tive descriptive methods. Statistic analysis has been done by SPSS-17 program. Results. 61 students or 26,4% of all participants had a sufficient knowledge about basic and specialized vocational training,where149 or 64,5% had a moderate knowledge, and 21 or 9,1% had an insufficient knowledge. Understanding of duration and fees of basic vocational training were higher than specialized training ( p<0.0001). Source of information of 118 or 51.1% of all participants were from schools and teachers, where 115 or 49.8% were from friends, but information gathered from doctors were more grounded than from other resources. Research shows 207 participants or 89.6% had decided on choice of basic vocational training and 24 participants or 10.4% had not decided yet. If we look into sectors, 53 participants or 25.6% have chosen internal medicine, 51 or 24.6% have chosen surgery, 33 or 15.9% have chosen obstetric and gynecology, 20or 9.6% have chosen ultrasound diagnostics. Among participants, 64.1% have chosen specialized vocational training, and 35.9% were no decision yet. Choice of basic vocational training was determined by gender: internal medicine ( p<0.001), obstetric and gynecol¬ogy (p<0.008), pediatric (p<0.041) were chosen by female students, and surgery(p<0.0001), orthopedic (p<0.007), were chosen by male students, But married students preliminary chosen fields like pediatrics ( p<0.040), imaging diagnostics (p<0.013). Speciality as a general practitioner or family doctor have been chosen by no ne of them. In our country medical specialists in obstetric and gynecology, pediatric, internal medicine, surgery, anaesthesiol¬ogy, intensive care and family medicine are highly in demand. For instance, there are 25 pediatric doctors, 30 anaesthesiologists, 40 gynecologists in need of due to the demand of the first and third maternal hospitals, National child and maternal health center and UB city Health department ( MOH, order 120). 71% of all participants have chosen by their own interest, 59.75% did not have any effort to seek imminent existing post and 67.1% did not know about job description and duties of chosen work. Conclusions: 1. More than half of all participants (64.5% ) have moderate knowledge on basic and specialized vocational train¬ing, and overoll understanding, fees, duration of basic vocational training are higher than of specialized training (p<0.0001). 2. 89.6% of all participants have chosen their basic training and major fields were internal medicine, surgery, ob¬stetric and gynecology, the preliminary choice depend on gender(p<0.001, p<0.0001, p<0.008). Also 64.1% of participants have chosen their specialized training direction 3. 71% of all participants have chosen by their own interest, 59.75% did not have any effort to seek imminent existing post and 67.1% did not know about job description and duties of chosen work.
2.Some clinical issue of somatization disorder
Jargal B ; Delgermaa V ; Khishigsuren Z
Mongolian Medical Sciences 2013;165(3):37-40
Introduction. There is group of mental disorder characterized by several physical symptoms are not fully explained by general medical condition, individuals visit many doctors and undergo numerous physical examinations, diagnostic tests associated with their suffer but no physical cause can be found. A third somatoform pattern is somatization disorder, characterized by numerous and recurrent physical complaints that begin by age 30. The prevalence of this disorder is 1-2% among adult population and it is occurred more female than male. Goal. To study some clinical symptoms among people with somatization disorder. Materials and Methods. This study was conducted with quality research method semi-structure questionnaire among the 30 people, who admitted to state and private hospital and sanatorium in the Chingeltei, Songinokhairkhan, Khan-Uul, Sukhbaatar, Bayanzurkh and Bayangol district in Ulaanbaatar city province for medical care. We did random sampling for unexplained somatic symptom individuals by diagnostic criteria as followings: 1.Multiple, recurrent, clinically significant somatic complaints no physical cause can be found over the last 2 years. 2. There must be a history of a visit at least 3 times for professional medical help due to their constant suffer. 3. Did not accept their medical diagnose and conclusion, even though no evidence of somatic symptoms. Results. There were 20 female and 5 male patients in our study, aged 23-78 years old were involved into our interview, and the average age was 44±0.8. We were clarifying clinical symptoms, such as gastrointestinal, cardiovascular, sexual function and urinary tract for all participants. The most of participants occurred gastrointestinal symptoms, such as nausea, vomit and timpanists. Also, all of the participants experienced heart beat symptom. As four of the 5 males reported loss of libido and majority of the females occurred pollakuria and sensopathy symptoms.Conclusion. Gastrointestinal symptoms (nausea, vomit and timpanists), cardiovascular symptom (heart beat), sexual function and urinary tract (loss of libido and pollakuria) and sensor conversion (sensopathy) occur mostly for somatization disorder.
3. Some problems of medically unexplained somatic complains
Jargal B ; Khishigsuren Z ; Nasantsengel L ; Altanzul N ; Oyunsuren D ; Gantsetseg T ; Tuya B ; Erdenetuul N
Innovation 2013;7(2):59-63
People with unexplained somatic complains are high-rate users of healthcare and often receive expensive, unnecessary tests and treatments.To study causes of unexplained somatic complains and some clinical symptoms.There were selected 25 consumers who diagnosed unexplained somatic complains according to ICD-X criteria in our study. In addition, qualitative research was used as semi-structure questionnaire for themMajority of study samples were living unpleasant environment in their family, conflicts of their parents relationship and substance abuse of parents. Most of the participants occurred change of sensation.This disorder is associated with negative family environment.
4.Study result of the anxiety among abused child and adolescents
Altanzul N ; Tuya B ; Altanzul B ; Khongorzul D ; Jargal B ; Odkhuu E ; Khishigsuren Z
Mongolian Medical Sciences 2013;165(3):41-44
Background. The abuse experiences can change the normal development of the child with the consequences being visible after many years even throughout the whole life. The relation between childhood abuse and the psychiatric disorder in adulthood is reported in a great number of epidemiological studies and researches based on the clinical population surveillance. Numerous studies have significantly expressed the relation between childhood abuse and anxiety, the development of anxiety disorders. Limited research has shown a possible association between exposures to child abuse the risk of developing physical parameter changes as an adult.Goal. To study anxiety and some physical parameters among abused adolescentsMaterials and Method. There were selected46 abused children and 48 non abused children aged between 11-16 years old. The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a38-item selfreport questionnaire that assesses multiple symptoms of childhood anxiety disorders based on current diagnosticcriteria. The height, weight, heart rate, breath rate and blood pressure of all participants in the study were measured according to standardized methodology.Results. Average age of all subjects in the study was13.51±1.61 and 60% of them were female and 41% male. All anxiety symptoms of case group was statistically significance higher (p<0.01) than the control group. Significantly more abused children (147.09±10.16) showed stunting compared to 4 sm of non-abused (151.53±10.26).Conclusion. In the present study, abused children were 2.8 times as likely as children with no maltreatment. Also significant stunting was found among abused children identified does differ from the growth of children who are not abused.
5.Lead residue and health risk in some commonly consumed imported food products among Mongolian population
Enkhtungalag B ; Gereljargal B ; Tuvshinbayar B ; Oyundelger D ; Unurtsetseg CH ; Davaadulam B ; Tserenlkham B ; Khishigtogtokh D ; Sodnomtseren B ; Jargal E ; Batkhishig O
Mongolian Medical Sciences 2014;168(2):71-76
IntroductionThe imported food products are more than 60 percent of total food consumption of Mongolia. Thelead residue in food products causes chronic and acute poisoning to the human health when exceedsmaximum residues limits, and human exposure and significant public health problems in many partsof the world.GoalTo assess lead residues and health risk of some commonly consumed imported food productsamong Mongolian population.Objectives:1. To determine consumption of some imported food products of Mongolian population;2. To investigate lead residue in some commonly consumed imported food products;3. To assess potential health risk related lead residue.Materials and MethodsThe research used analytic study of cross-sectional study design. Randomly selected 1290 people’simports food consumption was analyzed by questionnaire and body weight measurements. Tooksamples from 145 import products, identified lead residue with Academy of Sciences Soil ResearchLaboratory`s, ASS (USA, 2002) equipment.Results60.7% of imported food samples were lead residues exceeded to Maximum Residues Limits, suchus mean lead residues in meat product were 1.55 mg/kg, in milk product 1.22 mg/kg, in cerealproducts 1.15 mg/kg, in vegetables 1.57 mg/kg, in fruit and fruit juice 1.03 mg/kg, in alcohols drink1.31 mg/kg, and in tea 1.93 mg/kg (p=0.001). Estimated Provisional Tolerable Weekly Intake (PTWI)of lead exposure for survey responses was 0.079mg/kg body weight.Conclusions:1. 60.7% of imported food samples were lead residues exceeded to Maximum Residues Limits,such us mean lead residues in meat product, milk products, fruits and vegetables.2. Imported vegetables (54.0%), cereal 8.4% products (15.5%), fruit and fruit juice (11.8%), andmilk products (8.4%) is main contributing to lead residues in imported food.3. Estimated Provisional Tolerable Weekly Intake (PTWI) of lead exposure for survey responseswas 0.079mg/kg body weight, which is 3.2 times higher than toxicological guidance (PTWI 0.025mg/kg per 1 kg human body weight) and the high health risk level.
6.Identifying relation of anxiety and salivary cortisol among abused children
Altanzul Kh ; Munkhtulga G ; Tsend-Ayush A ; Oyunbileg O ; Jargal B ; Odkhuu E ; Khishigsuren Z
Innovation 2013;7(2):44-48
WHO informed that across world an average of 565 young people aged 10 to 29 die every day through interpersonal violence. Some studies mentioned that anxiety was most frequently occurred as one of the psychological consequences 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 anxiety among abused adolescents, some physical parameters and level of cortisol in saliva.
There were selected 20 abused children and 40 non abused children aged between 11-16 years old and lived in Ulaanbaatar city. The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a 38-item self-report questionnaire 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,
Average age of all subjects in the study was 13.52±1.57 and 59% of them were female and 41% 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 (18.65±7.08) statistically significantly lower (p<0.01) than average amount of control group (32.15±20.99).
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.
7. Identifying relation of anxiety and salivary cortisol among abused children
Altanzul KH ; Munkhtulga G ; Tsend-Ayush A ; Oyunbileg O ; Jargal B ; Odkhuu E ; Khishigsuren Z
Innovation 2013;7(2):44-48
WHO informed that across world an average of 565 young people aged 10 to 29 die every day through interpersonal violence. Some studies mentioned that anxiety was most frequently occurred as one of the psychological consequences 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 anxiety among abused adolescents, some physical parameters and level of cortisol in saliva.There were selected 20 abused children and 40 non abused children aged between 11-16 years old and lived in Ulaanbaatar city. The Spence Children’s Anxiety Scale (SCAS; Spence, 1997) is a 38-item self-report questionnaire 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, Average age of all subjects in the study was 13.52±1.57 and 59% of them were female and 41% 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 (18.65±7.08) statistically significantly lower (p<0.01) than average amount of control group (32.15±20.99).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.
8. MENTAL HEALTH PROBLEMS AMONG SEXUAL MINORITY GROUP WITH HIV
Erdenechimeg R ; Khihigzuren Z ; Jargal B ; Tungalag M ; Davaalkham J
Innovation 2015;9(1):76-80
There were currently diagnosed by totally 177 cases with HIV in our country. The 82.3% of those were male and 72.9% of them were men sex with man. Sexual minority group especially men who intercourse with male are highly risk to HIV infection. By the study of 2011, which aimedto assess risk to exposure HIV infection among sexual minority group, 56.2% of all participants answered as had depression symptoms and 12.8% of them seen to psychologist and health workers. In addition, 2% of them used by injection of drug for last year, and 60.6% harmfully drank.The study was done by quantitative and qualitative methods and used specific designed questionnaire for sexual minority with HIV infection. Totally 26 consumers participated in our survey. Before the starting of the study, we introduced inform consent to all participants and if they agreed to participate, we coded research cards and collected the information.All participants were answered alcohol drink, and 46.1% of them determined with heavy drinking or harmful consumption by the AUDIT versus 7.8% were alcohol dependence. 65.3% oftotal participants used as smoke, 5 cases used cannabis; one of them has been used within last twelve months. In addition, 23.1% of all participants had anxiety and 15.3% had mild depression symptoms. Of the total 26 cases, 7 cases had suicide thinking related with sexual orientationand 2 cases had suicide thinking related with HIV infection. Those cases answered often feeling hopeless and helpless.In sexual minority group with HIV, alcohol and tobacco consumption was high, drug abuse was low. 15.3-23.1% of all participants had depression and anxiety symptoms. Suicide thinking has been occurred for those cases it means risk to suicide commitment.
9. ASSESSMENT OF ORAL HYGIENE OF DEPRESSIVE DISORDER PEOPLE
Jargal B ; Delgermaa J ; Khishigsuren Z ; Altanzul N ; Altanzul B ; Erdenesuvd N ; Bilegsaikhan P ; Altanchimeg KH ; Nyamsuren M
Innovation 2015;9(1):38-40
The oral hygiene is not relatively good cause of smoking, ignoring oral hygiene, not having enough self-care skills and independent living in case mental illness. Their grinding the teeth, serotonin decreases when the people are depressed and then it makes the carbohydrates increases, loses the sense of taste. Therefore they use a lot of sweet, the salivary output decreases, increase in the number of lactobacili and then it makes the cause ofabnormal disease detections including tooth decay, trigeminus neural pain in temporomandibular joint /TMJ/, oral yeast infection, oral bad breath, burning sensation of the tongue, chronic facial pain. Also the oral can disease detects from drug causes like using the anti-depression drugs for at least 6 months.Using analytical research permanent design, I got 55 patients to take part in the survey who are staying in 5th flat , National Clinic of Mental Health from 22nd of September 2014 until 26th of September. When I do the research for history of their patients: among the diagnosis of 16 people disorder depressed, the 13 patients agreed to have a preventive examination voluntary, one of them declined to do it. I use many methods of researching like questionnaire methods interview method, prevention oforal cavity and clinical examinations, respectively Study shows that curriculum contents of School of Nursing, Mongolian National University of Medical Sciences have comparatively less contents of understanding about healthy person, assessment on human, giving advice healthy human, path anatomy, physiology, communication skills.The most of the survey participant patients have holes in their teeth, gum inflammation, and tongue stress disorder. It shows that it decreased to pay attention on their oral hygiene associated with symptoms and it effects directly related to the decrease in salivary output.Depressed People are so bad at paying attention to their oral hygiene habits.
10.Significance of evaluation of D-dimer in COVID-19 patient: Case report
Bayarjavkhlan Ch ; Battulga Ch ; Buyanjargal E ; Byambalkham B ; Jargal-Erdene B ; Naranmandakh D ; Munkhsaikhan B ; Munkhbat T ; Oyungerel S ; Enkhnomin O ; Gantuya L ; Ulziitsetseg Ts
Health Laboratory 2021;14(2):23-32
Introduction:
Coronavirus infection 2019 (Ковид-19) is an infection caused by a novel virus and induces severe ARDS. КОВИД-19 pandemic has rapidly spreaded in 221 countries, 245,373,039 cases and 4,979,421 mortalities have been reported. Pulmonary and renal thrombotic angiopathy occur in patients with complications of ARDS, sepsis, and multi-organ failure. Elevated D-dimer in КОВИД-19 patients has been reported firstly by doctors in Wuhan, China. In addition, many studies have revealed that elevated D-dimer has been associated with the severity of the diseases, an increased rate of poor prognosis.
Objective:
We aim to determine D-dimer in КОВИД-19 patients, and patient condition a decrease of D-dimer level after administration of anticoagulant therapy.
Case report:
We introduce a rare case of КОВИД-19. Laboratory test results and the effect of anticoagulant therapy have been evaluated during the infection. 85 aged women were admitted with a diagnosis other than КОВИД-19. PCR for SARS-Cov-2 was negative on the previous day of admission, and Sars-Cov-2 Ag rapid test was also negative on the admission day. However, the D-dimer test result was much higher with 7120 ng/мл and X-ray and CT revealed a similar pattern to the КОВИД-19 patient. Then anti-Sars-Cov-2 test was positive with 4,08 COI. Based on laboratory test results of D-dimer, LDH, CRP, and CT pattern the patient was diagnosed with post-КОВИД-19 pneumonia, and anticoagulant therapy was initiated additionally to prevent hypercoagulation induced by КОВИД-19. D-dimer test taken before administration of anticoagulant therapy increased more to 10910 ng/мл. 3 days later D-dimer level decreased to 8180ng/мл and the patient’s condition was improved.
Conclusion
The evaluation of D-dimer of the patients with КОВИД-19 is highly significant. Anticoagulant therapy might be necessary for КОВИД-19 patients with high D-dimer level in serum. Further studies are needed to assess the long-term outcome of the illness and mortality.