1.Correlation study between of arterial hypertension and overweight/obesity
Khishigtogtoh Ts ; Narantuya Kh
Mongolian Medical Sciences 2011;172(2):101-105
Introduction. Arterial hypertension (AH) is one of the main causes of the cardiovascular diseases (myocardial infarction and heart failure). Arterial hypertension leads to complications such as cerebral insult, myocardial infarction, coronary artery disease, renal dysfunction and heart failure [2]. In our country, AH composes 41.8% of the cardiovascular diseases. 52% of the mortality due to cardiovascular diseases results from AH and its complication – cerebral insults [4]. It is obvious in the world that obesity and overweight as main risk factors of the AH influence negatively on human body and affect health harmfully. There, in our country, some studies have been conducted on prevalence of the AH and obesity. But there is no study that reveals correlation between obesity and arterial hypertension, therefore, the study aimed to study it.
Aim. The study aims to establish correlation between arterial hypertension and overweight/obesity among Mongolian people.
Materials and Methods: In the study have been involved 3411 people aged of 15-64. Out of them 1674 (49%) were men and 1737 (51%) were women. AH classification was used according to the National Guidelines of the Arterial Hypertension for Mongolian adults. In the study outcome analysis, the statistical program SPSS-12.0 was used for data creating, checking, processing and compiling of the results. Difference in the parameters was evaluated by Chi quadrates.
Results: Among people involved in the study, 29.3% had arterial hypertension and 70.7% had normal blood pressure. 18.6% of the total studied people had AH of I degree, 6.2% - AH of II degree and 4.5% - AH of III degree.
By regions of AH prevalence, in Ulaanbaatar, AH was 30.2%, in the Western region - 29.4%, in the Khangai region - 28.3%, in the Central region - 28.2%, in the Eastern region - 29.8%. There was no significant difference in AH prevalence for the regions (ℵ2=11.715, p<0.469). For overweight, obesity, by regions, in the Central region and Ulaanbaatar, overweight and obesity rate was higher than in other regions. The highest rate of the overweight, obesity observed in the people aged of 35-44 years (29.7-38.6%) which are most active ages for employment.
Conclusions:
1. Arterial hypertension incidence frequency correlated with Body Mass Index.
2. Arterial hypertension incidence becomes more frequent with increase in Body Mass Index.
3. Risk of arterial hypertension is 1.8 more frequent in I degree, 4.2 more frequent in II degree, 19 more frequent III degree of the obesity.
2.The prevalence of alcohol comsumption in herdsmen of bugat soum, Bulgan province
Garamjav Kh ; Erdenechimeg D ; Narantuya D ; Olziigerel G ; Enkhtuya P
Mongolian Medical Sciences 2013;163(1):107-111
Background
Mongolia has been undergoing an epidemiological transition since 1990s. As a result, lifestyle and health behavior related diseases such as cardiovascular diseases, diabetes, cancer and injuries are growing steadily and have become the leading causes of population mortality. According to the Mongolian STEPS Survey on the Prevalence of NCD Risk Factors (2009), the summary of combined NCD risk factors demonstrates that 1 in 5 (26.4%) Mongolian adults have three or more common
modifiable NCD risk factors and consumption of alcohol in the past 30 days was reported by 38.6% of the population.
Goal
The goal of the survey was to determine the prevalence of alcohol consumption among Bugat soum population of Bulgan province.
Materials and Methods
The cross-sectional survey used a questionnaire of the WHO STEPS survey and adapted it to the local specifics. Alcohol consumption was assessed using the concept of “standard drinks”. A total of 201 randomly selected 15-64 year old residents of both sexes of Bugat soum were involved in the survey. The survey data was collected in September, 2011. The survey data was fully collected using small handled computers (PDAs).
Results
The survey respondents, 30.3% consisting of males (16.9%) and females (41.2%) were past 12 months abstainers. Of the alcohol users, 69.7% (males 83.1% and females 58.8%) reported drinking during the past 12 months and 47.3% were current drinkers or reported alcohol use during the past 30 days. In contrary, 60.9% of males and 36.8% of females were current drinkers or reported alcohol use during the past 30 days. In terms of the frequency of alcohol use by respondents reporting drinking in the past 12 months, 39.3% drank occasionally, 21.4% drank alcohol for 1-3 days a month, 2.5% drank 1-4 days a week, 4.5% drank 5-6 days a week, and 2.0% reported daily consumption of alcohol.
Conclusions
The survey results showed that current drinking or consumption of alcohol in the past 30 days was reported by 47.3% in herdsmen of Bugat soum. Of these 60.9% are men and 36.8% are women. As for the quantity of consumption, the current drinkers consumed 13.3 standard drinks for men and 5.0 for women. Frequency of alcohol drinking was higher in males compared to females. The prevalence of binge drinking was 2.5% in men and 0.4% in women, and binge drinking was 6 times more common in males compared to females.
3.Correlation study between of arterial hypertension and overweight/obesity
Khishigtogtoh TS ; Narantuya KH
Mongolian Medical Sciences 2011;172(2):101-105
Introduction. Arterial hypertension (AH) is one of the main causes of the cardiovascular diseases (myocardial infarction and heart failure). Arterial hypertension leads to complications such as cerebral insult, myocardial infarction, coronary artery disease, renal dysfunction and heart failure [2]. In our country, AH composes 41.8% of the cardiovascular diseases. 52% of the mortality due to cardiovascular diseases results from AH and its complication – cerebral insults [4]. It is obvious in the world that obesity and overweight as main risk factors of the AH influence negatively on human body and affect health harmfully. There, in our country, some studies have been conducted on prevalence of the AH and obesity. But there is no study that reveals correlation between obesity and arterial hypertension, therefore, the study aimed to study it.Aim. The study aims to establish correlation between arterial hypertension and overweight/obesity among Mongolian people.Materials and Methods: In the study have been involved 3411 people aged of 15-64. Out of them 1674 (49%) were men and 1737 (51%) were women. AH classification was used according to the National Guidelines of the Arterial Hypertension for Mongolian adults. In the study outcome analysis, the statistical program SPSS-12.0 was used for data creating, checking, processing and compiling of the results. Difference in the parameters was evaluated by Chi quadrates.Results: Among people involved in the study, 29.3% had arterial hypertension and 70.7% had normal blood pressure. 18.6% of the total studied people had AH of I degree, 6.2% - AH of II degree and 4.5% - AH of III degree.By regions of AH prevalence, in Ulaanbaatar, AH was 30.2%, in the Western region - 29.4%, in the Khangai region - 28.3%, in the Central region - 28.2%, in the Eastern region - 29.8%. There was no significant difference in AH prevalence for the regions (ℵ2=11.715, p<0.469). For overweight, obesity, by regions, in the Central region and Ulaanbaatar, overweight and obesity rate was higher than in other regions. The highest rate of the overweight, obesity observed in the people aged of 35-44 years (29.7-38.6%) which are most active ages for employment.Conclusions:1. Arterial hypertension incidence frequency correlated with Body Mass Index.2. Arterial hypertension incidence becomes more frequent with increase in Body Mass Index.3. Risk of arterial hypertension is 1.8 more frequent in I degree, 4.2 more frequent in II degree, 19 more frequent III degree of the obesity.
4.TWO YEARS SURVIVAL IN PATIENTS WITH STEMI TREATED PRIMARY PCI
Batmyagmar Kh ; Surenjav Ch ; Amarjargal B ; Narantuya D
Innovation 2018;12(4):18-21
BACKGROUND: Acute myocardial infarction is leading cause of global morbidity and mortality and major health care burden in worldwide.
Previous studies demonstrated that restoration of myocardial tissue perfusion after primary PCI is significant factor of improved outcome.
In Mongolia, studying long term effects of primary PCI in patients with AMI and its’ association with coronary blood flow, tissue Doppler imaging, left ventricular global strain pattern in speckle-tracking echocardiography and risk factors are essential in theoretical and clinical practice.
AIMS: To determine long term effects of primary PCI in patients with AMI and its’ association with left ventricular strain pattern in speckle-tracking echocardiography, risk factors and patient prognosis.
METHODS: We used prospective cohort study design. We were selected 414 patients with AMI who treated by primary PCI between 2015 and 2016 at the State Third Central Hospital. Echocardiographic examination was conducted on Philips iE33 xMATRIX ultrasound machine. The PCI was performed according to the MNS:6379-2013 standard.
RESULTS: Mean age was 60±13 and majority of them were male 84% (n=347). Complete coronary perfusion (TIMI-3) was achieved in patients 88% (n=367) after primary PCI.
There was weak, negative correlation between coronary TIMI flow grade and left ventricular global longitudinal strain (r=-0.183, CI 95% -0.289 to-0.066, p<0.001). In patients with incomplete coronary perfusion (TIMI<3), mortality rate was significantly higher during 24 months follow-up.
After primary PCI, 24 months mortality was 9.9% (n=39). Cut-off value of left ventricular global longitudinal strain which predict long term (within 24 month follow-up) mortality was -12.93% (sensitivity 74.4%, specificity 74.3%). Mortality during 24 months follow-up was significantly different between left ventricular global longitudinal strain groups (log-rank test p<0.001) and mortality was higher in left ventricular global longitudinal strain ≥ -12.93% group.
CONCLUSION: Coronary no-reflow phenomenon is associated with long term mortality in patients with AMI. In patients with AMI who treated by PCI, long term mortality is predictable with left ventricular global longitudinal (≥-12.93%, p<0.001) strain.
5.RESULT OF 7-YEAR STUDY ON RESTENOSIS AND THROMBOSIS IN AFTER PCI TREATMENT SETTING
Lkhagvasuren Z ; Narantuya D ; Batmyagmar Kh ; Erdembileg D ; Bayaraa T ; Byambatsogt L ; Erdenechimeg M
Innovation 2018;12(4):6-9
BACKGROUND. The aim of this study was to investigate the prognostic impacts of drug-eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI) and risk factors of stent restenosis.
MATERIAL AND METHODS. We conducted a retrospective cohort study based on the Angiographic diagnostic and treatment Department of 3rd State Central Hospital of Mongolia. Patients who had undergone coronary stenting between 2000 and 2017 were recruited and monitored until the end of 2010.
RESULTS. Among a total of 4520 selected patients with a mean age of 58±7 years, 2125 subjects had BMS and 2395 subjects had DES. The incidence of stent restenosis and stent thrombosis were significantly lower in the DES (37; 1,5%) group as compared with the BMS (201; 9,4%) group. Patients who have stent restenosis presented comorbidities, such as diabetes 214(47,8%), hypertension 54(22,6%), prior PCI 21(8,2%), re-infarction 12(5,04%), chronic kidney disease 16(6,7%), hyperlipidemia 21(8,2%).
СONCLUSION. Implantation of DES was related to better outcomes than for BMS, in terms of reducing restenosis and stent thrombosis after PCI. STEMI patients who have co morbidities have greater risk of stent stenosis and thrombosis
6.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.
7.Carbon monoxide poisoning, 2016-2020, Mongolia
Oyun-Erdene O ; Suvd B ; Buuveidulam A ; Narantuya Kh ; Bataa Ch ; Burmaajav B
Mongolian Medical Sciences 2021;196(2):46-54
Rationale:
Carbon monoxide (CO) is a colorless, odorless gas produced by carbon-containing substances, most
commonly incomplete fuel and biomass combustion. Carbon monoxide deprives the human body
of oxygen, leads to severe poisoning and death. In 2017, there were 137 new cases of carbon
monoxide poisoning per 1,000,000 people worldwide, and 4.6 deaths per 1,000,000. The global
incidence of carbon monoxide poisoning has remained steady over the previous 25 years, while
mortality has decreased by 36-40%. Every year in Mongolia, 700-840 persons are hospitalized for
carbon monoxide poisoning. Also, there has been a lack of study into the prevalence and causes of
carbon monoxide poisoning and death.
Goal:
Study the dynamics of morbidity and mortality cases caused by carbon monoxide poisoning in
Mongolia.
Objectives:
To analyze the carbon monoxide poisoning morbidity recorded in Mongolia between 2016-2020.
To analyze the carbon monoxide poisoning mortality reported in Mongolia between 2016-2020.
Material and Methods:
The survey was conducted utilizing data from outpatient and inpatient poisoning and deaths reported
in 2016-2020 with the goal of studying carbon monoxide poisoning and mortality in Mongolia.
Workplace exposure poisoning was excluded from quantitative data on carbon monoxide poisoning
(fires, suicidal, accidental and domestic explosions, accidents, external effects).The statistics analysis
was performed using 23 versions of the SPSS program, to estimate a distribution of new cases
and fatalities per 10,000 population depended on age, sex, average number of hospital days, and
standard error. ArcGIS version 10.8 was used to map the locations.
Results:
Acute carbon monoxide poisoning. Carbon monoxide poisoning was 0.01-0.31 cases per 10,000
population during 2016 and 2018. Between 2019 and 2020, it increased to 1.5-1.9 cases per 10,000
population, with up to 37% of those admitted to hospitals. In the last five years, carbon monoxiderelated deaths have been reported in 0.1-0.3 cases per 10,000 population. The amount of hours firing
of the households increases every year in September, when the colder season begins. Incidences
of death and intentional poisoning were reported in Arkhangai, Uvurkhangai, Khuvsgulaimags, and
Ulaanbaatar. The average age of poisoning patients admitted to the hospital was 33 ± 19.5 years old
(minimum 2 months, maximum 81). In terms of gender, women registered for 58.4 (734) percent of
all cases. The average number of days spent in the hospital was 3.4± 3.7 days.
Carbon monoxide poisoning-related mortality. During the previous five years (2016-2020), 353 people
died in Mongolia as a result of carbon monoxide poisoning, although 1.4 percent, or five people, died
in hospitals, one case in Bayan-Ulgii, Zavkhan, and Uvs aimags, and two cases in Ulaanbaatar.
However, 98.6 percent of them died prematurely at home or in poisoned places due to a lack of
access to health care. The average age of carbon monoxide poisoning deaths cases was 35 ± 19.9
years old, and 71.7 (253) percent were male. The Ulaanbaatar, Selenge, Uvs, and Dornod aimags
had the lowest death rate of 0.08-0.21 per 10,000 population, while Khuvsgul and Arkhangai aimags
had the highest death rate of 0.96-1.57 per 10,000 population.
Conclusions
Carbon monoxide poisoning among the population rises during the winter season, however, in the
previous five years, 96.5 percent of cases have been poisoned accidentally, particularly 82.6 (1035)
percent of cases reported in Ulaanbaatar. According to socioeconomic factors, 41.6 (529) of the
cases were male, with an average age of 36.5±15.4 years.
During the preceding five years, carbon monoxide-related mortality in Mongolia was between 0.2 per
10,000 people. Without medical attention, 99.2% of cases died at the exposed location or area. The
death rate in Khuvsgul aimags was low, whereas it was high in Ulaanbaatar city. The average age of
premature deaths was 35±19.9 years, and 71.7 (253) percent were male.
8.Risk factors of stomach cancer
Unursaikhan S ; Tsegmed S ; Oyundari B ; Sainsanaa Kh ; Narantuya D
Mongolian Medical Sciences 2021;196(2):95-101
Various studies conducted worldwide emphasized the importance of identifying gastric cancer risk
factors for better prevention and further incidence reduction. A total of 52 identified risk factors for
gastric cancer were classified into nine categories in which diet, lifestyle, and infections are leading
causes. Gastric cancer morbidity and mortality has an increasing trend annually in our country. In
Mongolia, only 1% is diagnosed in the carcinoma stage, 3% in the first stage, 11% in the second
stage, 43% in the third stage, 42% in the fourth stage.
The “Gastric cancer risk factors study, 2018” by L.Tulgaa, and D.Ganchimeg confirmed smoking on
an empty stomach as a risk factor. B.Gantuya et al`s (2018) study on gastric cancer and helicobacter
infection, as well as S.Tsegmed et al`s (2012) gastric cancer prevalence, its risk factors study, had
similar results.
B.Gantuya et al (2018) identified the excessive consumption of salt among the gastric cancer
diagnosed population in Mongolia. Also, L.Tulgaa and D.Ganchimeg et al`s “Gastric cancer risk
factors study, 2018” results reported the daily consumption of salt in tea is a risk for gastric cancer.
L.Tulgaa et al`s (2018) study participants had irregular mealtime such as dinners are at a very late
hour, the meals aren`t chewed well, leftover meals, and seasoning consumption. These characteristics
were significantly different in two groups with a statistically important result.
Furthermore, the study results suggested a need to provide practical advice on healthy eating to the
population as 50% of the participants consumed more than 5 high-risk food products for esophageal
and gastric cancer along with combined risk factors.
9.First case of endovascular surgery with rotablation
Lhagvasuren Z ; Baasanjav N ; Batmyagmar Kh ; Narantuya D ; Erdembileg D ; Batzaya Ts ; Gereltuya Ch
Mongolian Medical Sciences 2020;191(1):96-99
Introduction
In 1987 Jerome Ritchie, David Auth and colleagues first introduced rotational atherectomy (rotablation)
as a technique for the endovascular treatment of obstructive atherosclerotic disease. Rotational
atherectomy covers 3-5% of all procedures in big PCI centers, while <1% in smaller centers. By
study of Warth DC et al. in 1994, at early period when it was first introduced, procedure complication
of rotablation was about 40%, those with coronary dissection 29%, coronary artery occlusion 11.2%,
side branch occlusion 1.8%, distal occlusion 0.9%, no relow phenomenon 6.1%, severe vasospasm
13.8% and vascular perforation 1-2%.
By advanced techniques and technologies that kind of complications reduced significantly, it occurs
as same as other PCI procedures.
In our country PCI procedure was first introduced in Third State Central Hospital in 2000, since then
20 years has passed. During this period coronary intravascular diagnosis and treatment developed
progressively performing 14751 PTCA procedures, of those 8355(56,6%) PCI cases. By statistics
of 2017, myocardial infarction occurred 1145.6 in 10000 population, showing sharp increase, and
cardiovascular mortality became number one cause and has tendency to increase further.
To inform first outcome of rotational atherectomy of atherosclerosis that is severely calcified and
unavailable to introduce balloon catheter or stent. To conduct atherectomy treatment methods,
accustoming professionals, order and get ready the treatment materials for necessity.
We successfully performed rotablation in severely calcified mLAD of 56 years of male patient by
staged PCI, whose infarct related artery Lcx was revascularized 3 months previously. As a result the
patient was fully revascularized, the balloon catheter passed through the narrowing and stent was
implanted successfully.