1.Analysis of the Predicted Size for Permanent Canine and Premolars
Yanjindolgor Kh ; Odonchimeg D
Mongolian Medical Sciences 2009;148(2):6-8
Introduction:
Among those prediction methods for estimating size of unerupted canine and premolars, Moyers and Tanaka-Johnston methods are most widely used, though the method-using radiograph is more accurate. Significant differences in tooth size exist among different ethnic groups. Therefore, an accurate prediction method for American white maybe less accurate for Mongolians.
Objective:
The purposes of the study were to develop new regression equations for predicting the size of the unerupted permanent canine and premolars in Mongolian children.
Methods:
Eighty-four males and eighty-three females in total 167 sets of dental cast of the permanent dentition aged 14.20.96 years were included in this study. The criteria of subjects selecting were following: all permanent teeth erupted (third molars may not be present), Angle I class fi rst molar relationship, no fi lling and no caries, no history of orthodontic treatment.
The mesio-distal crown diameters were measured with a caliper to an accuracy of 0.05 mm. The data were processed with SPSS16.0 software package. Independent t-test and regression analysis were used for statistical analysis.
Results:
The development new linear regression equations with predictor sum 21|12 for predicting the size of the canine-premolar segment was based on the normative standard of mesio-distal crown diameters of permanent teeth in Mongolian children. The following new regression equations were developed for unerupted canines and premolars in Mongolian children Y=9.07+0.57*x in maxillary, Y=8.43+0.55*x in mandible arch.
Discussion:
This study confi rmed that the use of Moyers and Tanaka-Johnston prediction methods for mixed dentition analysis among Mongolian children were unsuitable. Both methods underestimated the size of caninepremolar segments.
Conclusions:
The following new regression equations were developed for interrupted canine and premolars in Mongolian children: y=9.11+0.57*x in maxillary and y=8.43+0.55*x in mandible arch.
2. A C OMPARISON OF SYSTEMIC AND INHALED CORTICOSTEROID THERAPY IN PATIENTS WITH EXACERBATION OF COPD
Odonchimeg P ; Ichinnorov D ; Choijamts G
Innovation 2013;7(3-S):38-43
Objective: To compare the efficacy of systemic and inhaled corticostcroid in patients with acute exacerbation of COPD.Methods: In this randomized, parallel-group study 80 patients (average age 59,7±7.7) were randomized to receive inhaled corticosteroid (fluticasone propionate 1000-1200 meg/daily, n -40) or systemic corticosteroid (intravenous dcxamethasone 4-8 mg every 24 hours, n-40). Outcome variables included the lung function tests (FEV1, FVC, FEV1/FVC), 6MWT, and 1 Symptoms. 2. Activity and 3. Impact components of St George's Respiratory Questionnaire for t OPD patients (SGRQ-C).Results: In group with systemic corticosteroid increased the FF.V1 from 63.5±9 to 68.118.1, FVC from 78.7±11.8 to 86.6±11, FEV1/FVC from 64.918.7 to 69.917.3; score of SGRQ-C improved I.from 58.5114.3 to 31 5ÈË 2. from 60.6116.7 to 37.7117.2, 3.1'rom 44.9+14.5 to 21.5113. In group wi«fi fluticasone propionate increased the FEV1 improved from 64.719 to 68.718.5, FVC from 79.7111.3 to 88.1110.7, and FEV1/FVC from 64.9+8.6 to 69.517.5; score of SGRQ-C I .from 58.5111.1 to 36.4113,0. 2.from 59.9117.2 to 39.1 + 16.8. 3.from 45.7114.7 to 23.5+13.8. The difference in efficacy of treatment in two groups was not significant.Conclusion:I fioth inhaled and systemic GSs improve airflow and lung function test in C'OPI) patients with ^cute exacerbation.2.1 ligh dose of ICSs may be an alternative to systemic corticosteroid in the treatment of non-severe acute exacerbation of COPD.3. Using of systemic and inhaled corticosteroids improve quality of life in COPD patients with acute exacerbation.
3. INCLUSION OF LONG TERM-CHRONIC MENTAL HEALTH PATIENTS FROM INPATIENT CARE AT NCMH IN CBR PROGRAMS
Ganchuluun O ; Enkhtaivan B ; Odonchimeg D
Innovation 2015;9(1):97-99
Health expenditure towards mental health is only 2% of all other health expenditure allocated to public health. Currently almost 64% of all that fraction xpendituregoesto hospital based care. It means that there is lack of resources or limitation for development of community basedmental health services in this country, where hospital based mental health system is still remain in place. Long term chronic patients occupied most hospital beds are usually homeless, have no caregivers, no family protection or have a families that could not support their mentally ill members. Traditionally National Center for Mental Health has been offering community based rehabilitation scheme in form of developing labor skills but its coverage and accessibility remains short. In other words it is open for those who admitted to an inpatient service only.For last years the center has been forged partnership with international NGO namely AIFO in cooperation to gradually expand its works toward development of community based rehabilitation programs for people with mental health problems. Study basis is a current need for an expansion and coverage of mental health care and services and priority development of community based services over inpatient care.To asses a current situation of long term chronic patients admitted to inpatient service, their inclusion to CBR programs, expansion possibility of mental health servicesTotal 450 cases of history were registered in an inpatient care in 2013. 170 cases of them were belong to long term patients (1 and over years) with 94 male (55.3% )and 76 female (44.7%) patients. From perspective of age: adult (30-49 years old) consists of main percentage (66.4%)of long term patients. 64 (57.1%)of that age group patients have diagnosis of schizophrenia. Age group of 10-19 years old consists of 0.6% with mental retardation diagnosis. Research shows that long term patients mostly have affective disorders, organic psychosis, mental retardation and schizophrenia. Schizophrenic patients consist of most percentage (52.9%) of long termpatients. Inpatient stay duration spans from 1 to 36 years for long term patients and 17 patients of them have been on permanent basis at the center. These inpatient care users usually have been re-admitting after from 2 weeks to 1 month of duration breaks and they all suffer fromschizophrenia.Currently 170 patients out 450 or 1 in 3 admitted to inpatient service department at NCMH are chronic patients. 80.6% of those frequent users consist of labor intensive 20-49 year olds. Need to develop and conduct community based rehabilitation programs at primary, secondaryand tertiary level of public health services, include chronic patients and also need to set up a nursery for chronic mental health patients.
4.Global strategy for diagnosis, management and prevention of chronic obstructive pulmonary disease
Mongolian Medical Sciences 2010;153(3):93-99
Introduction:Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease characterized by airflow limitation that is not fully reversible. The prevalence and burden Of COPD are projected to increase in the coming decades due to continued exposure to COPD risk factors and the changing age structure of the world’s population. COPD is one of the most important causes of death in most countries. The Global Burden of Disease Study has projected that COPD, which ranked sixth as the cause of death in 2000, will become the third leading cause of death worldwide by 2020. The chronic airflow limitation characteristic of COPD is caused by a mixture of small airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema). Airflow limitation is best measured by spirometry, as this the most widely available, reproducible test of lung function. COPD itself also has significant extrapulmonary (systemic) effects that lead to comorbid conditions. The goals of treatment of patients with stable chronic obstructive pulmonary disease (COPD) include: maintaining optimal health, symptom relief, preventing progression of disease, increase exercise tolerance, preventing complications and exacerbations, improving control of symptoms, enabling the patient to function to the greatest extent possible, improving quality of life. Home treatment usually works well for most people, but others with very severe disease may need hospitalisation. With early diagnosis, lifestyle changes (e.g., smoking cessation), and appropriate treatment, many people can lead normal and productive lives.
5.Quality of life of chronic obstructive pulmonary disease patients
Odonchimeg P ; Ichinnorov D ; Choijamts G
Mongolian Medical Sciences 2012;162(4):14-19
Chronic obstructive pulmonary disease (COPD) is a disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. Pathological changes characteristic COPD are found in the proximal airways, peripheral airways, lung parenchyma, and pulmonary vasculature.GoalTo evaluate corticosteroid therapy effects in patients with acute exacerbation of COPDMaterial and MethodsWe examined the efficacy of corticosteroid (CS) therapy in 45 patients who admitted to Department of Pulmonology at Shastin`s Central Hospital during 2011-2012 and met GOLD criteria of COPD exacerbation. All patients randomly divided into two groups. Patients received from randomization inhaled corticosteroids (flixotide 1000 mcg/daily or frenolyn 800-1200 mcg/daily), systemic corticosteroid (intravenous prednisone 30- 60 mg every 24 hours). In evaluation of efficacy of treatment we use lung function tests and St George`s Respiratory Questionnaire for COPD patients (SGRQ-C).Results45 patients (average age 59, 6±7.9) were enrolled in our study. 23 patients were randomly assigned to high dose of inhaled corticosteroids (ICS), 22 to intravenous prednisone. Outcomes of treatment were evaluated by 1. Symptoms, 2. Activity and 3. Impact components of SGRQ-C and FEV1, FVC, FEV1/FVC. The difference in quality of life and lung functional tests between ICS and prednisone was not significant. Score of SGRQC in two groups improved with CS therapy from 1. 50,8±1,7 2. 63,9 ±10,7 3. 45.2±15,0 to 1. 27,3±4,2 2. 40,8±9.5 3. 22,7±9,7 The changes of lung functional tests were 1.FEV1 65,7±10,7 2.FVC 80,5±12,0 3.FEV1/ FVC 65,1±8,7 before and 1.FEV1 69,4±9,2 2.FVC 88,3±11,1 3.FEV1/FVC 69,5±7,8 after treatment. Incidence of hyperglycemia and hypertension observed with prednisone. In some patients who used ICSs we detect throat hoarse.Conclusions:1. Both inhaled and systemic GSs improve airflow and lung function test in COPD patients with acute exacerbation.2. After treatment improve quality of life in COPD patients with acute exacerbation.3. High dose of ICSs may be an alternative to systemic prednisone in the treatment of no severe acute exacerbation of COPD.
6.Impact of ADRB2 gene rs1042713 and rs1042714 polymorphisms on COPD
Chimedlkhamsuren G ; Jambaldorj J ; Odonchimeg P ; Ichinnorov D ; Sarantuya J
Mongolian Medical Sciences 2016;175(1):17-20
IntroductionMany factors can contribute to the occurrence of COPD. Recent studies have pointed to the notion thatpolymorphism of candidate genes may also play a signifi cant role in COPD pathogenesis.GoalTo investigate the association of polymorphisms in ADRB2 and TNF-α genes with COPD.Materials and MethodsWe genotyped three SNPs included rs1042713 and rs1042714 in ADRB2, rs1800629 in TNF-α gene,using PCR-RFLP method.ResultsThere is no statistically signifi cant difference was observed for TNF-α rs1800629 between case andcontrol groups. Genotype frequency of the homozygote Gly16 (rs1042713) was more frequent in COPDpatients than controls (OR=3.25; 95%CI, 1.58–6.66, p=0.0037). Also, haplotype frequency of Gly/Gly16+Gln/Glu27 was signifi cant difference among cases and controls (OR=5.03; 95%CI, 1.8–14.2,p<0.01).Conclusion:Overall, ADRB2 rs1042713 and rs1042714 polymorphisms are associated with increased susceptibilityto the development of COPD. Further studies in large groups of patients with COPD are needed toaddress other genetic risk factors.
7. DETECTING FOR WORK BURNOUT SYNDROME AMONG WORKERS OF NCMH, USING MBI SCALE
Odonchimeg D ; Khishigsuren Z ; Khongorzul D ; Munkh E ; Bayarmaa B ; Enkhtaivan B ; Baatarjav O ; Tsendsuren Z ; Selenge E
Innovation 2015;9(1):20-23
Mental health team includes a psychiatrist, a psychiatric nurse, psychologist and social workers. Mental health workers are more stressful than other sector’s workers. Mental workers are working with mental patients, who have chronic,severe and poor prognosis disorders for long time, and may have Work Burnout Syndrome (WBS). Worldwide, many researches are used Maslach Burnout Inventory (MBI) for assessing WBS. Our goal was to detect risk factors of WBS among mental health workers. We conducted the survey among workers mental (doctors, nurses and assistant nurses) and study design was a descriptive cross-sectional. We are used a questionnaire, is including MBI. Our subjects were 103 workers, who were 27 (26,2%) doctors, 32 (31,1%) nursesand 44 (42,75) nurse- assistant. They were 15 (14,6%) male and 88 (85,4%) female and average age was 38.21 (SD = 8.92). The worker’s average professional working year was 13.09 (SD = 9.76). Most of subjects (n=63 61.2%) were shift-workers and they (n=99 96.1%) have high workload. We determined 3 groups by level of MBS among mental workers, such as the group with EE’s high scale (n = 27; 27%), thegroup with DP’s high scale (n = 23; 22.8%) and the group with PA’s high scale (n = 50; 50.5%).MBS was high among NMHC’s workers. However their work time is low, but theyhave risk factors for MBI such as high workloads, shift work, number of patients. Workers of emergency department had termination burnout syndrome more than other acute departments. This was associated with working condition.
8.Aflatoxins in Food and Human Health Risk
Tserendolgor U ; Amarsanaa G ; Ganzorig D ; Unursaikhan S ; Gerelmaa L ; Odonchimeg M ; Narandelger B
Mongolian Medical Sciences 2015;173(3):44-49
Aflatoxins are the secondary metabolites of the fungi namely, Aspergillus flavus and A. parasiticus. They can colonize and contaminate grain before harvest or during storage. There are about twenty related secondary forms of aflatoxins, and subtypes B₁, B₂, G₁, G₂. These aflatoxins frequently contaminate the foods and feeds (Yu J et al, 2000, Imanaka BT et al, 2007). Aflatoxin B1, the most toxic, is a potent hepatocarcinogenic and genotoxigenic metabolites that have been classified as group I carcinogens by International Agency of Research on Cancer (International Agency for Research on cancer, 1993). Aflatoxin M1 is found in milk of lactating cows that have consumed feeds contaminated with aflatoxin B₁. Aflatoxin M₁ was originally classified as a Group 2B human carcinogen in 1993, but subsequent evidences of its cytotoxic, genotoxic and carcinogenic effects led to a new categorization of aflaoxin M1 as Group I (International Agency for Research on cancer, 2002). Aflatoxins can affect a wide range of commodities, including crops, cereals, oilseeds, spices, tree nuts, milk, meat, and dried fruit (Wilson DM et al, 1994, Bao L et al, 2010). Mongolia has been imported foods about 60 percent of food demands including wheat, flour, rice, milk, dairy products, peanuts and maize. This situation is required to study aflatoxin contamination in food in Mongolia. Epidemiological studies have found that dietary exposure to aflatoxin and chronic infection with hepatitis B, C virus are three major risk factors for HCC (Viviani et al. 1997; Hall et al. 2003). HCC as a result of chronic aflatoxin exposure has been well documented, presenting most often in persons with chronic hepatitis B virus (HBV) infection (Wild and Gong, 2010). The risk of liver cancer in individuals exposed to chronic HBV infection and aflatoxin is up to 30 times greater than the risk in individuals exposed to aflatoxin (Groopman et al., 2008). According to the WHO, the national liver cancer incidence rates was 54.1 per 100.000 population, the prevalence of HBV and HCV infection in 11.8%, 15.6% were respectively (J.Abarsanaa, 2012). This situation is a serous public health problem in Mongolia. Thus, we aimed to carry out the monitoring surveillance survey on the aflatoxin contamination level in some food.
9.Top aspects of strategies on prevention and control of mycotoxins in foods
Tserendolgor U ; Ganzorig D ; Unursaikhan S ; Amarsanaa J ; Gerelmaa L ; Narandelger B ; Odonchimeg M
Mongolian Medical Sciences 2016;175(1):74-82
Afl atoxins are a type of mycotoxin produced by Aspergillus species of fungi, such as A. fl avus andA.parasiticus. Afl atoxins are the most potent hepatocarcinogen and mutagen among mycotoxins.Afl atoxins can effects a wide range of commodities, including crops, cereals, peanuts, maize, beans,and milk and fruits. Thus, we carried out a monitoring surveillance survey on the afl atoxins level in somefood commodities. In early stage of this survey we tested a total of 112 samples of foods including fl our,rice, peanuts, maize, dried fruits, milk, and cereals. According to the preliminary results of this survey,59 (52.7%) samples of foods including fl our, rice, peanuts, maize, dried fruits, milk, and cereals’ sampleswere positive for a total afl atoxins (AFB1+AFB2+AFG1+AFG2). Although levels of total afl atoxins in allsamples were at permissible limits by the commission regulation of EU, the strategies for the preventionand control of mycotoxin are required in Public health system and Agricultural organization in Mongolia.Since afl atoxins is the most well-known mycotoxin ever thoroughly studied and its prevention and controlhas been most successfully practiced in various countries, therefore, this paper will focus on the strategyfor the prevention and control of afl atoxins’s mycotoxin contamination food in Mongolia.
10.Dietary exposure and liver cancer risk assessment of aflatoxins in foods consumed in Mongolian people
Tserendolgor U ; Gerelmaa L ; Ganzorig D ; Amarsanaa J ; Unursaikhan S ; Narandelger B ; Odonchimeg M
Mongolian Medical Sciences 2016;176(2):36-46
This cross-sectional survey was conducted in seven district of the capital city Ulaanbaatar ofMongolia, and border post in Zamiin-Uud, and Altanbulag province from March to December 2015.A total of 380 samples including 70 flours, 114 rice’, 41 various peanuts, 15 maize and maizeproducts, 24 milks, 6 yoghurts, 39 beers, 27 dried fruits and 44 herbal teas were randomly collectedfrom supermarkets, hypermarkets, department stores, factories, and bazaars in Ulaanbaatar city,and Zamiin-Uud, and Altanbulag province.HPLC (High performance liquid chromatography), and enzyme-linked immunosorbent assay (ELISA)were used for the total aflatoxins (B1+B2) and aflatoxin M1 detection.The survey found that (148) 38.9% of all analysed food samples were contained aflatoxins (B1+B2),and aflatoxin M1 were ranging from 0.0094 μg kg-1to 2.4μg kg-1. The levels of aflatoxins (B1+B2)were below the maximum tolerance limit in EU and worldwide regulations. Mean concentrationlevel of aflatoxins (B1+B2) was 0.17 μg kg-1 in all positive samples. Mean daily low and high foodintake were respectively, 63 g and 245 g. Based on the daily food consumption data, estimatedexposure dose of aflatoxins (B1+B2) was 0.16734 mg kg-1bw day-1 in individuals with a daily low foodintake, and 0.65078 mg kg-1bw day-1 in individuals with a daily high food intake (95th percentile). Theexposure dose of aflatoxins from daily high food intake exceeds the estimated provisional maximumtolerable daily intakes, 0.4 μg kg-1 body weight day-1 for adults with hepatitis B (Kuiper-Goodman,1998). Furthermore, estimated excess cancer risk values to liver cancer incidence by ingestion ofthese foods for aflatoxins (B1+B2) and aflatoxin M1were calculated to be 0.0448 mg kg-1bw day-1forindividuals negative for hepatitis Band 1.344 mg kg-1bw day-1 for individuals positive for hepatitis B.Thus, the findings of our survey showed that the potential hazard associated with aflatoxin in foodin Mongolia has not been serious. However, most researchers suggested that no level of aflatoxinexposure is considered safe.Conclusion: Currently, the levels of the total aflatoxins and aflatoxin M1 were lower than the maximumpermissible levels in UE and the USFDA, and worldwide regulations. Currently, estimated exposuredose of the total aflatoxins and M1aflatoxin through daily high food intake was risked in populationwith hepatitis B virus. However, in Mongolian population has not been excess liver cancer risk.