1.Some problems in arterial hypertension medical care
Burmaa B ; Otgonbayar R ; Chimedsuren O ; Lkhagvasuren TS ; Munkhtuya TS
Mongolian Medical Sciences 2011;158(4):15-17
Introduction:Cardiovascular disease morbidity has been continuously increased among the population of Khangai region in the last 10 years - as of year 2010 for instance the rate was 1.5 more in Arkhangai aimag and 1.2 more in Khuvsgul aimag compared to the average rate nationwide. This research study was conducted due to the higher rates listed above in the region and the need to clarify various issues related to the medical care being provided with respect to the illness.Goal:It was deemed necessary to analyze the existing situation of early detection, monitoring and treatment of arterial hypertension among the population of the chosen province and to develop improved methodology.Objectives:1. To study the early detection of arterial hypertension2. To examine whether or not the clients are being given the needed recommendations related to the arterial hypertension monitoring and medicine treatmentMaterials and Methods:Cross sectional, organization based survey with 52 questions was carried out among 87 doctors/professionals of 17 soum and 100 family and aimag's general hospital of Orkhon, Bulgan, Arkhangai, Huvsgul and Selenge aimag. SPSS-17 program and Fisher test was used to generate and develop information.Results:Each soum, inter - soum and provincial doctor is responsible for checking/measuring the arterial pressure of their respective registered number of population by the percentage listed below: Soum doctor-56%, inter-soum doctor-50%, aimag's doctor-46,9% (p=0.19). Body weight and height are being irregularly measured on each chosen level (52.9%-62.5% p=0.67). Similarly the BMI is also being irregularly determined (42, 9% - 54, 5% p=0.07).From all the patients who have an arterial hypertension, 54.3%-55.6% are being monitored by dispensary and 11.1%-14.3% (p=0.53) are being regularly monitored in the chosen medical organizations. Although it is required to repeatedly measure and monitor the arterial pressure depending on its level the result shows that no planned monitoring is being done for the 77.8% of the patients. It is not sufficient for a sound and family doctor to recommend the regular use of antihypertensive the 48.6%, inter- sound doctor 43% and aimer's doctor 29% ( p= 0.40).Conclusions:1. The arterial hypertension - early detection practice is shown to be inadequate at the Chosen health care level (p=0.19).2. For the most clients with the arterial hypertension (59.9% p= 0.40), recommendations on regularly using antihypertensive is not being done - half the clients (54.3% - 55.6%) with the arterial hypertension are not being monitored.
2.Study on home health care nursing needs in some provinces
Solongo D ; Naranchimeg S ; Orgil B ; Barsereedene B ; Munkhtuya TS ; Burmaa B
Mongolian Medical Sciences 2011;158(4):31-35
Introduction: In order to Implement the Mongolian government's 2000 provisions for national health care, on May 28,2004, the Health Minister approved the "Home Care Nursing Service and Rules for Caring and Nursing" according to resolution # 136 and indicated that family clinic nurses should provide home care nursing services [6'71. Interestingly, it is noted that throughout the world, nursing home services have not been limited to family clinic nurses but are being delivered by nurses with diverse areas of specialization.Goal: Purpose of the study is to determine needs for making home nursing services to the population in some province and soum.Objectives:1. To comparatively search needs for providing home nursing services to citizens in the province and soum which were involved to the study.2. To determine nursing type which is required at home3. To develop needs of nurses who make home nursing servicesMaterials and Methods: Conducted studies among the 1109 people from the 520 families in 17 soums of five provinces such as Orkhon, Bulgan, Arkhangai, Khuvsgul and Selenge. We have chosen the clients with anamnesis who are repeatedly served and treated at the hospital for our study and had interviews with them. Questionnaire for citizens consists of 2 basic chapters including 17 questions which determine demographic information and needs of home nursing services. We asked and searched about needs of Home Care Nursing assistances under the 3 basic groups such as General nursing, Treatment nursing and Specialized nursing. After inserting study data into the SPSS-17 program, checked it by appropriate statistical methods (t, x2, fisher exact) and checked if difference between groups and relations has statistical truth.Results: 35.89 percent of clients who got involved to the study answered that they are interested in taking nursing and caring services at home. Also we consider needs for having home nursing at home according to numerical indexes in the provinces involved to the study, clients mostly want to be injected by intramuscular (25.88%), intravenous (31.02%) and IV fluid (30.57%). As we consider specialized nursing assistances at home under the types of needs, health education and assistance for people suffered with hemorrhage and injured people occupy major percent. Clients who got involved to the training, were asked question "With whom do you want to be made nursing assistance at home?" and 75.6% of them answered that they prefer nurses of family clinic.Conclusions:1. It was observed that 35.89% of clients who got involved to the survey, want to receive home nursing assistance and demands for home nursing is being increased with aging.2. Also we conclude that nursing after hemorrhage, nursing for injured patients and nursing for patients with cardiovascular disease occupies higher percent and it shows that percent of cardiovascular diseases and injuries is relatively high and clients' needs to receive nursing assistance at home are faced problems after they were discharged from hospital.3. 75.6% of people who got involved to the study are interested in taking home nursing assistance and we reached to conclusion that it is suitable to train nurses according to it.
3.НУГАС-БУЛЧИНГийН ХАТАНГИРАЛ ӨВЧНИЙ ГЕНЕТИК ОНОШЛОГОО
Uranchimeg B ; Oyungerel Ts ; Jambaldorj J ; Munkhtuya T
Innovation 2017;11(2):62-65
BACKGROUND. Spinal muscular atrophy (SMA MIM#253300) is a heterogeneous group of neuromuscular disorders caused by degeneration of anterior horn cells. Spinal muscular atrophy is the second most common autosomal recessive disorder. The first substantive descriptions of SMA occurred at the end of the 19th century when Werdnig and Hoffman characterized the features of autosomal recessive SMA. SMA is broadly classified into four major categories characterized by the age of onset as well as severity of the disease. Clinically proximal weakness, predominantly athropy, upper muscle athropy and other muscle weakness including of facial, scapula and respiratory were reported. SMA is inherited by X chromosomal, autosomal recessive and dominant mode. In our study, we recruited an individual diagnosed with SMA, without SMN1 gene mutation to investigate BICD2 mutation. Peripherial blood from the patient and his family members were taken to extract genomic DNA according to commercial protocol. Amplification of target gene was done by special primers. DNA sequencing was done to detect a mutation. As a result, we identified a mutation in location c.484 C>T of third exon of BICD2 gene. This mutation is was a heterozygous in mother’ and child’ DNA, SIFT and Polyphen program was used to detect its pathogenic effect. We also checked by Grantham matrix score is 180.0 representing it,s changing acid and alkaline feature in this amino acid. We diagnoses a suspected case with SMA by his clinical symptoms as a SMA type III, Kugelberg-Belander desease. We detected a mutation of BICD2 gene in a patient with SMA. This mutation altered acid and alkaline checked by Grantham matrix. This mutation has never reported before, showing 100% pathogenic effect on protein function, but because of highly penetrate feature of this disease makes its inheritance mode of autosomal dominant pattern.