1.Results of study on family group practice’s human resources
Tsengelmaa B ; Orgil B ; Chimedsuren O
Mongolian Medical Sciences 2011;168(1):64-70
Introduction: First family group practices (FGPs) started to function in 1999 and there are 225 FGPs in Mongolia. FGP is a primary health care unit that renders medical assistance for all urban population in the country. Privatized FGPs act as contractors for state responsibility service and this one of the innovations that raises challenges to make primary health care services more accessible improve their quality and strengthen their human resources. Greater equity of service access and provision depends on structure and capacity of human resources of FGPs. Therefore, there is a need to study human resources provision and their specialization profile in FGPs.Objectives: To study human resource provision and its specialization profile in FGPs of Ulaanbaatar city.Design: Cross-sectional study Material and Methods: Developed registration checklists and questionnaire were used for collection data on human resources, their specialization and training needs.Settings: 77 FGPs in Ulaanbaatar were covered by the studyResults: There were 2273 people per one family doctor and 2233 people per one family nurse. This means that a family doctor and a family nurse provide services for population almost twice greater compared to required standards and it was observed in all districts of Ulaanbaatar. Most of family doctors (71.6%) graduated as basic doctors and only 10.5% of them specialized as family doctors or general practitioners. Some 15.5% of all selected family doctors attended an upgrading training in family practice and only 1.6% attended specialization training. There were 180 nurses covered by the study and 143 (79.4%), 24 (13.3%), 4 (2.2%) and only 2 (1.1%) of them were trained as general nurse, midwife, nursing assistant and family practice nurse, respectively. Some 20(11.1%) of nurses participated in the study attended some specialization training. Some 28% of family doctors stressed that they would like to attend upgrading training courses in family practice, 13% of them training on public health, 12% on healthcare management, 11% on imaging diagnostics, 8% on internal medicine, 6% on traditional medicine and 5% on child health. FGP’s nurses preference of training were as follows: 40%, 22%, 11%, and 18% were on general practice nursing, public health, management and physiotherapy, respectively.Conclusions: The FGP’s physicians and nurses have been provided service to population twice greater than in required standards, and there were only 1.6% and 1.1% of doctors and nurses attended family practice training, respectively. Therefore, there is a need to increase number of professionals in FGPs and provide specialization training to strengthen FGPs human resources.
2. Immunohistochemistry of prostate carcinoma
Erdenetuya N ; Amgalanzaya E ; Tsengelmaa J ; Erdenetsogt D ; Galtsog L
Innovation 2014;8(3):46-48
BACKGROUNDProstate cancer is the most frequent malignancy among men nowadays.METHODSImmunohistochemical expression of prostate-specific antigen (PSA) was retrospectively investigated in 10 patients admitted with clinical suspicion of the prostate cancer. Slides were collected from archived biopsiesandthey were stained for PSA.The final reaction product was evaluated as negative (0), weak/moderate positive (1), and intense positive (2).RESULTSGlandular prostate carcinoma was found in 40% (n=4) and undifferentiated carcinoma in 60% (n=6). The immunoreaction for PSA was intense positive in 30% (n=3), weak/moderate positive in 50% (n=5) and negative in 20% (n=2) of total cases.CONCLUSIONSWe concludethat PSA immunoreaction is helpful for the differential diagnosis based on our results.
3.Noise, vibration and general dust content in work place of mining, power plant and construction sectors, its hygienic assessment
Tsengelmaa A ; Erdenesuvd G ; Tsend-Ayush TS ; Unurtsetseg CH
Mongolian Medical Sciences 2015;173(3):23-26
BACKGROUND: Nowadays, in economy of Mongolia there are a lot of mining, construction, transportation and powerplant sectors with high risk, top rate of industrial accidents and occupational disease. Moreover, it’sbeen seen that noise, vibration and dust effect on worker’s health have a huge negative effects inthose sector’s workplaces.GOAL: Based on occupational condition assessment between 2010-2014 of Occupational condition andmonitoring department of Occupational Health Research Center, noise, vibration and general dustwere measured at workplace of mining, construction and power plant sectors.MATERIAL AND METHODS: Some issues of occupational hygiene were cross sectional studies. Based on archive of OHRC,information has been collected by fact methods. The results have been processed statistically onSPSS-17 statistic program and have been compared with relevant standards and normative.RESULTS: From 740 workplaces at 89 enterprises in 3 sectors, in 686 noises level has been measured. Theaverage level of noise measurements has been above the maximum allowed amount standards. Thehighest results were in sector of mining and construction.At total of 166 workplaces, the average vibration level was also above of maximum allowed amount.And also the highest results were seen in sector of mining.At total of 447 workplaces, the average general dust level was 3-5 times more than maximum allowedamount and the highest results were seen I sector of mining and construction.From some measurements of occupational hygiene at workplaces that attended in this study, generaldust amounts and vibration levels are straight low related and have a statistical importance.CONCLUTIONS:The amount of general vibration, noise and general dust in this research at sectors of construction,mining and power plant were higher than the standard of allowed amounts.
4. Quantitive assessment of bone marrow trephan biopsy
Tsengelmaa J ; Bakhitbol ; Enkhzul E ; Erdenetsogt D ; Enkhtuya SH ; Bayarmaa E
Innovation 2016;10(3):38-41
In United States, person is diagnosed with blood cancer in every 3 minutes. In 2015, there were 1.665.540 total cancer cases and 9.4% of them lymphoma and leukemia . In 2015, there were 95 cases of lymphoma in Mongolia when compared 4 times increase to 2015 from 2010 . Bone marrow examination is an established diagnostic modality in the evaluation of various hematological disorders. BM examination can serve to establish or confirm a primary diagnosis of lymphoma or to determine the extent of disease dissemination for staging purposes. Biopsy is essential for diagnosis in a dry tap or blood tap which occurs when the marrow is fibrotic or densely cellular. Only a biopsy allows a complete assessment of marrow architecture and pattern of distribution of any abnormal infiltrates. In 2015.01-2016.01 fifty five bone marrow biopsies were retrieved from the files of the National First Clinical Hospital-Department of Hematology. These all statistical analysis was performed using by SPSS 17. Bone marrow processing and staining: The hematologist is instructed to place the freshly obtained BMTB specimens directly into buffer substance fixative and transport it immediately to the histopathology department, on the same day as the procedure.The next morning (after 20–24 h), the solution is decanted (with a strainer) and the biopsy specimen is washed in distilled water for 30 min. The biopsy specimens are left to decalcify for about 6 h before being processed and embedded in paraffin wax, with procedures similar as for other specimens.Sections, 1-mm thick (microtome set for 1 mm sections), are cut from the paraffin-wax blocks with the routine rotary microtomes in the laboratoryA total of 55 cases were reviewed from December 2014 to November 2015. The age of the subjects ranged from twenty two years to seventy eigth years with a male predominance (1.7:1). Data of 55 trephine biopsies were reviewed. The percentage of trephine biopsies in different length ranges was calculated. Twenty two biopsieswere of recommended length, i.e., ≥1.5 Cm while remaining 33 were less than the recommended length. The rate of positivity for diagnosis was 95.4% in group-1, 94.1% in group-2, 63.6% in group-3 and 40% in group-4 In all cases in our study 73% (n=40) were satisfactory and 27%(n=15) unsatisfactory slides .Our study showed that 40% trephan biopsies were of revommended length i.e >=1.5cm with 95.4% positive of diagnosis. However biopsies measuring 1-1.4 cm also had comparable result 94.1% .
5.The report on baseline survey for use of mercury-based medical devices in health care organizations of Mongolia
Ichinkhorloo B ; Ulziisaikhan S ; Tsengelmaa M ; Enkhtsetseg SH ; Unursaikhan S
Mongolian Medical Sciences 2010;153(3):72-77
Goal: To conduct mercury-based medical devises used in health care organizations and develop strategy and recommendations on futher activityMaterial and Methods:A cross-sectional study design was used. Totally 578 units of 38 governmental and private health care organizations inUlaanbaatar, Darkhan, Erdenet cities and Uvurkhangai aimags were conducted in the survey. The survey was conductedby means of a questionnaire given to the medical workers and doctors to complete. There were 3 parts of questions. Thefirst part of the questionnaire dealth with the use of mercury-based medical devices, working, transportation and storageconditions, and waste management. The second section was concerned with knowledge, attitude and practice (KAP) ofmedical personals for safety handling, storage and disposal of mercury containing devices. The third part of the questionnairedealth with the dental amalgam.Mercury concentration of dental amalgam samples were detected by portable mercury vapor analyser RP-91, PYRO-915+ in the Poison Information Center of Public Health Institute. Data processing was done by using statistical programSPSS-10.Conclusions:1. Mercury containing devices such as thermometer, blood pressure sphygmomanometer, energy saving fluorescencelamp and termostates were used in urban and rural hospitals. There are not any regulations for safe handling,storage, and transportation and disposal system of mercury containing divices.2. Knowledge on handling, storaging and disposing mercury based devices are not enough among the medical personals.The current situations for inapproiprate disposal system can be posed to increase riskes of environmentalpollution with mercury.3. Knowledge on health impact of spilled mercury from broken mercury based medical devices is not enoughamong the medical workers. Safety manual for handling, storage and disposal of mercury based medical devicesand promotion materials for health adverse effect and prevention methods have not been developed.4. 14.7% of the investigated dental hospitals and cabinets were used dental amalgam for treatment. Of these wasinvolved the fist stage hospitals. Dental amalgams were imported from China and Russia. Any special recommendationsand rules for safe use, storage and disposal of dental amalgam have not developed.
6.Outcomes of retinopathy of prematurity screening at National Center For Maternal And Child Health
Tsengelmaa Ch ; Erdenetuya G ; Tsogzolmaa G ; Gantuya M ; Amgalan P ; Enkhtuya S ; Altantuya Ts ; Bayalag M
Innovation 2021;14(1-Ophthalmology):22-25
Purpose:
To investigate the outcomes of ROP screening of retinopathy of prematurity (ROP).
Methods:
This was a prospective of prematurity infants screened ROP from 2020 April 13th to
April 28th 2020 and from 2020 June 08 th to June 22th 2020 and prospective cohort study of
premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery.
Demographic factors, diagnosis and clinical course were recorded. Indirect ophthalmoscopy
and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and
images were taken. Each eye was evaluated by the pediatric ophthalmologist and aimag’s
ophthalmologist for the presence or absence of ROP, zone of vascularization, stage, plus disease,
and aggressive posterior ROP (AP-ROP). The diagnosis and classification of ROP for this current
study were determined by examination using indirect ophthalmoscopy, and treatment plans
were determined according to the International Classification for ROP and the Early Treatment for
ROP Study (ET-ROP).2,13
Results:
A total of 90 premature infants with BW ≤ 2000g and/or GA ≤ 34 weeks were screened for
ROP during the study period. 8 (8.8%) of the 90 infants screened required treatment. The 8 infants
who received ROP treatment had a mean GA of 28.5 ± 1.7 weeks, mean BW of 1237.5 ± 125.42g,
mean PMA of 36 weeks and mean follow-up time of 2 months.
Conclusion
After treatment, resolution of ROP was noted in approximately 100 % of the patients
who had treatment-requiring ROP.