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Evaluation of the Agatston Coronary Artery Calcium score using contrast enhanced CT-Coronary angiography

Badamsed Ts ; Lkhagvasuren Z ; Delgertsetseg D ; Batgerel O ; Dulamsuren T

Mongolian Medical Sciences.2023;203(1):3-7.

Background: In 1904, Monkeberg was first described about the coronary calcification which is the degenerative change that occurs with aging process, but the last decades many studies have been confirmed that coronary calcification was an active process same as the signaling pathways with bone mineralization. Coronary calcification increases the risk of myocardial infarction during bypass graft surgery and PCI (СМ СN. Shanahan, 1999). Goal: To evaluate Agatston Coronary Artery Calcium score using contrast enhanced CT-Coronary angiography. Objectives:
1. To assess Agatston Coronary Artery Calcium score
2. Age and gender relationship of coronary calcification Materials and Methods: We evaluated total 215 patients who were admitted to the Reference center of Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary Professor of the Third State Central Hospital awarded with the Red banner of the Labor diagnosed with the coronary calcification by contrast enhanced 64 slice CT (Philips Ingenuity CT 64) between 2020 to 2022. Patient’s age was considered into 6 groups and coronary calcification was assessed by Agatston’s score. The result of our study determined by common statistical averages and errors and probabilities of the indicators were determined by Student’s criteria. Result: When evaluating Agatston coronary artery calcium scoring by CT-coronary angiography, 11-400 Agatston score was predominantly in our study with p value of (P<0.001). Considering relationship of age and gender, coronary calcification occurs 42.3% of patients aged 50-69, male and female ratio was 1.7:1. Conclusions
1. We established Agatston coronary calcification 11-400 was occurred in 66.96% of the patients.
2. Coronary calcification predominantly occurred in 65% patients aged 50-69 years.

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Gastric cancer risk assessment based on serum pepsinogen

Ganchimeg D ; Bayarmaa N ; Tegshjargal B ; Batbold B ; Erkhembulgan P ; Sodnomtsogt L ; Tulgaa L

Mongolian Medical Sciences.2023;203(1):8-16.

Introduction: Cases of gastric cancer have been declining worldwide in recent years. However, gastric cancer incidence increased in the last decade in Mongolia. In Mongolia, over 80% of gastric cancer cases are diagnosed during the late stage. Several studies have revealed that serum pepsinogens (PGs) level reflects, indirectly, histological and functional characteristics of the gastric mucosa. Goal: We aimed to evaluate the risk of gastric cancer and its precancerous condition based on serum PGI, PGI/II biomarkers. Materials and Methods: This case-control study enrolled 114 subjects, including patients with gastric cancer (n=36), atrophic gastritis (n=40) and healthy controls (n=138). The questionnaires were obtained to determine risk factors. Serum PGI, PGII, and H. pylori IgG levels were measured by ELISA (Pepsinogen I ELISA; Pepsinogen II ELISA; H.Pylori IgG ELISA; BIOHIT Plc, Helsinki, Finland). PGI to PGII ratio was calculated. Patients were classified into the ABC(D) group according to Miki K approach. Also, we developed new scoring system based on some risk factors and serum PGI, PGI/II ratio. Logistic regressions were performed to evaluate risk and expressed by odds ratio (OR) and 95% confidence intervals (95%CI). Results: Mean age of the subjects was 60±10.9 years. H.Pylori was positive in 67 subjects. The serum PGI and PGI/II ratio levels were significantly decreased in gastric cancer and atrophic gastritis groups compared to the healthy control. According to classification ABC(D), group D (OR 5.04, 95% CI 1.13-22.50) had higher proportion of atrophic gastritis cases, group C (OR 6.19, 95% CI 1.04-36.78) had higher proportion of gastric cancer cases than others. Additionally, we created a risk prediction scoring system with a score ranging from 0 to 7, based on variables age, family history of gastric cancer, prior disease history, PGI and PGI/II ratio levels. For the atrophic gastritis patients, 17 (42.5%) were classified into medium-risk category (OR 4.49, 95% CI 1.38-14.58) and 17 (42.5%) were classified into high-risk category (OR 7.69, 95% CI 2.16-27.43). Whereas, 11 (30.6%) patients with gastric cancer were classified into medium-risk category (OR 4.35, 95% CI 1.13-16.85), 21 (58.3%) were classified into high-risk category (OR 14.25, 95% CI 3.60-56.43). Conclusion The methods based on serum PGI and PGI/II may identify a high risk population of gastric cancer and atrophic gastritis.

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Trifocal intraocular lens implantation to treat visual demands in Mongolian patients

Narangarav G ; Tsendjargal G ; Davaa D ; Uranchimeg D

Mongolian Medical Sciences.2023;203(1):17-21.

Introduction: Intraocular lens (IOL) implants are monofocal and trifocal lenses which helps to clear up the vision after cataract surgery. Goal: In this work, we aimed to compare the monofocal and trifocal IOL implantation during phacoemulsification surgery. Materials and Methods: This study was conducted on 133 participants. Females comprised n=81, mean n=52 into equal groups. Preoperative and Postoperative cataract surgery UCVA and BCVA were measured and compared during the after 1 day, week 1, 2 weeks and month1. Statistical analysis: The results of the study were processed using the SPSS 25.0 program after coding the data and checking for typographical errors. The normality of the data distribution was tested by inspecting a histogram. Categorical variables were compared using the chi-square test or Fisher's test. Statistical significance was determined at a p-value lower than 0.05 Ethical statement: The study was approved by the Research Ethics Committee of the Mongolian National University of Medical Sciences (No.2021/05/21). All patients provided written informed consent before participating in this study. Results: The mean preoperative UCVA was 1.09±0.45D in monofocal IOL group, 0.99±0.49D in trifocal IOL group. At the first week: The mean postoperative UCVA at one week was 0.34±0.29D and 0.27±0.17D, in each group respectively. The mean postoperative BCVA in the first week was 0.28±0.27D and 0.20±0.15D in each group respectively. The mean postoperative UCVA at 1 month was 0.27±0.24D and 0.15±0.16D in each group, while BCVA was 0.26±24.94D and 0.06±0.63D.There was a highly significant statistical difference between the result of UCVA preoperative and the results of UCVA at the early and last postoperative follow up. Conclusion From our results, the best corrected visual acuity and was better for Trifocal group than Monofocal group. It is evident that post-operative near UCVA and BCVA was statistically significant at monofocal and trifocal groups.

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Comparison results of the population's COVID-19 preventive behaviours

Buuveidulam A ; Suvd S ; Chinzorig B ; Enkhtuya P ; Suvd B ; Dolgorkhand A

Mongolian Medical Sciences.2023;203(1):22-29.

Background: As of September 21, 2021, 65.3 percent of Mongolia's population was vaccinated at full dose. However, as of COVID-19 confirmed cases, Mongolia is in the top five countries in the West Pacific. This indicates that there is a lack of practice to prevention from coronavirus infection in the population. Goal : This survey aims to compare the level of knowledge, attitudes, and practices of the population towards coronavirus infection with the results of the baseline survey results Material and Methods: This is a cross-sectional study. A total of 1896 people aged 15-60 years old participated in the study. The survey data were collected using quantitative (questionnaire) and qualitative (observation) methods. The research methodology was approved at the Scientific Committee of the National Center for Public Health on November 9, 2021 (Protocol № 5) and the Medical Ethics Review Committee of the Ministry of Health on January 20, 2022 (Resolution №261) was issued the Ethical permission of the survey. Results: Out of 14 knowledge questions that should be known about coronavirus infection, survey participants had known in an average of 8.27 ± 3.73 (95%CI: 8.12-8.43) correct answers, which was lower than the results of the baseline study. The average knowledge score of the surveyed participants of the follow-up survey (9.23±3.2, 95%CI: 9.09-9.38) was smaller than the baseline survey by 0.96 percent. 54.5 percent of surveyed participants believed that the pandemic is “very dangerous”. However, it has decreased by 25.6 percent compared to the baseline survey. Positive attitudes toward the right place at the onset of symptoms of COVID-19 and non-discrimination against infected people are more prevalent in a population with a high average knowledge score. In the baseline study, the average duration to wear a mask was 29 hours, while in the follow-up survey, it was 4.2 hours, which shows improvement in the correct behavior. Conclusions As the population’s level of education increased, the average knowledge score on the coronavirus infection has increased, and the statistically significant high of the participant with higher education levels was 8.81±3.53 (p=0.0001). In the baseline survey, 64.9 percent of the participants had an attitude toward a discriminant person infected with COVID-19, whereas it was declined by 41.9 percent in the follow-up survey. The practice of wearing masks in crowded places and outdoors were increased by 6.8 percent from the baseline survey. Compared to the baseline survey results, in the follow-up survey, practices of wearing masks in the workplace or indoor environment (73.0%) had increased.

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A comparative study of the original articles about the springs in the explanatory literature on the Ma la ya'i mystery

Bilegsaikhan B ; Zolzaya B ; Buyant B ; Boldsaikhan B

Mongolian Medical Sciences.2023;203(1):30-34.

Introduction: There is a sutra named “Detail explanatory of Ma la ya'i mystery and the giver everything wanted” (Ma la ya'i dka' 'grel 'dod pa 'jo ba) written by Mi'i nyi ma mthong ba don ldan, a Tibetan, which is considered as one of the undisputed ancient articles of Indian and Tibetan Medicines and to which Mongolian medical researchers in Mongolia and in Inner Mongolia, China haven't paid attention yet, so it is still not included in the scope of medical research work until now.
The sutra has an advantage that the place where the spring comes out is written in detail. Therefore, we now should thoroughly analyze the source place and features of the springs in order to convey a clear orderly understanding to future scholars by summarizing the research aligning it with traditional medical theory, and schematically mapping. Goal: To make clearer the scholars' views of the four mountains included in the book “Rsta b’ai rgyud” and its theoretical and other concepts, as well as to analyze and conclude the interrelationships and features of springs in Ma la ya'i mountain. Materials and Methods: In this research, I have studied the theory of Four mountains included in the book “Rsta b’ai rgyud” using the analyzing methods for original and source documents and summarized by the method of analysis and synthesis, as well as chosen the literature named “Detail explanation of Ma la ya'i mystery and the giver everything wanted” by sampling method and shown making sketch for the interrelations and features of springs by Hermeneutic method. Results: As descried by a person named Gyutog yontan mgonpo (Gyutog yontan mgonpo) in terms of Foreign, Domestic and Secret Medicine Palaces, and according to the relevant sutras and mantras that said about them, the springs have the ability to heal diseases with the participation of earth directions, flora and fauna around the mountain and other factors. The sketch was clearly shown for the springs. Conclusion I believe that the debates about the Medicine Palace are highly dependent on the chronology in which the researchers lived and their own traditional ways. Currently, the five explanatory manuscripts written through XII - XX centuries about Medicine Palaces and Springs in Ma la ya'i Mountain have been found, among which, specially, the section written about the springs in the sutra named “Detail explanatory of Ma la ya'i mystery and the giver everything wanted” is a big thick book that was made at the level of "Great Explanation" in terms of its content. Therefore, I consider that this literature has become a new cognitive valuables added to the modern research resource because the knowledge of springs was presented greatly in depth and detail in this paper work.

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Diagnostic and treatment feature of heart – disease in fever change

Ganbaatar A ; Zolzaya B ; Erdenechuluun J ; Wang Huan

Mongolian Medical Sciences.2023;203(1):35-38.

Introduction: Mostly fever change influences for heart and vital vessel and it is important for future treatment to compare difference of diagnosis and treatment feature of heart-disease in fever change. Goal: To compare difference of pain, feature, treatment and diagnosis when reduced fever change in heart Materials and Methods: The study was conducted using methods of ‘Comparing manuscript sources studies’, ’Analyses and syntheses’ for determining numbers and described with ‘Hermeneutics’ methodology. The study was based on approved methodology and ethical review in December 2018 Result: Fever could be directly matter of death because it should be needed to pay attention for method of treatment, to make research for general medicine of fever, to make research other organs & heart, to take medicine within ice sweet, to reduce fever and to treat through cautery, oily cream and ointment. Conclusion
1. Most diagnostic and pain of fever influence for heart and it depends on process of fever accordance with our research collection.
2. It is possible to consider similarly pain, diagnosis and treatment of heart pneumonia and heart fever based on classification of general heart disease of science of medicine.

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Allium polyrhizum Turcz.ex Regel results of aboveground research

Oyun-Erdene R ; Gereltu Borjihan

Mongolian Medical Sciences.2023;203(1):39-43.

Introduction: Human beings have been using raw materials of plant and animal origin for the treatment of various diseases. Nowadays, in developed and developing countries, plant raw materials are widely used in traditional medicine, health care, and food supplements, and they are used as raw materials in pharmaceutical production, making up a large part of the world pharmaceutical market. Therefore, research activities are intensively carried out to determine the chemical composition and mineral content of plant-derived raw materials and explain the mechanism of action. Goal: Allium polyrhizum Turcz.ex Regel determination of chemical compounds macro and micro elements and amino acids Material and Methods: Allium polyrhizum Turcz.ex Regel was collected and prepared from Huvut shar Khoshun, Shili River Province, Institute of Mongolia medicine chemistry, Inner Mongolia university, Inner Mongolia Key Laboratory Medicine Chemistry. then it was made into a type with 0.075 mm particle size by a grinding machine. Result: Dete-rmining the elemental composition of plant raw materials is important for determining the therapeutic value and safety of the plant. Some elements in Allium polyrhizum Turcz.ex Regel were determined by X-ray fluorescence method. Conclusions
1. In this study, the content of 7 elements in the above-ground part of Allium polyrhizum Turcz was determined using the XRF analysis method. Of the macro and micro elements such as Ca, K, Mn, Fe, Na, Zn, and Mg, which are essential for the human body, potassium (K) 49.7 mg/kg, calcium (Ca) 45.7 mg/kg, and sodium (Na) 31.0 mg/kg are the most had a high concentration.
2. Among various amino acids involved in protein synthesis, glutamic acid 1.89 mg, aspartic acid 1.48 mg, and alanine 1.00 mg were identified.

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Lung cancer is a public health dilemma

Unurjargal Ts ; Enkhjargal A ; Khorolsuren L ; Burmaajav B

Mongolian Medical Sciences.2023;203(1):44-52.

Lung cancer has the highest mortality rate in the world and is the most common cancer type in Asiancountries. In developed countries, new cases and lung cancer among women tend to increase, while in less developed countries, the death rate of this cancer is high and its prevalence is higher among males.
Moreover, in many studies conducted in recent years worldwide, a sample of the studies containing early detection, diagnosis, and treatment that can be implemented at the national level was translated and compiled.
Improvement of public health education, availability of health care services, an increase of human resource capacity, implementation of early detection programs among the public, and early detection with a reduced dose of KTG among the target group are expectations of the public health sector.
Special attention should be paid to issues such as reducing smoking among the people of Mongolia, immediately solving the problem of air pollution in central areas, assessing and reducing the risk factors of occupational diseases of mining workers, and introducing modern methods of treatment and diagnosis in health care services. The time has come to take multifaceted measures to prevent lung cancer, which has a high global disease burden and economic burden, with public participation.

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Health risks of overweight and obesity among children

Otgonjargal D ; Bayasgalan J ; Anu P

Mongolian Medical Sciences.2023;203(1):53-58.

: Childhood obesity is, according to the WHO, one of the most serious challenges of the 21st century. More than 100 million children have obesity today. Globally, the prevalence of obesity and overweight tripled in the child and youth populations from the mid-1970s (about 4%) to 2016 (greater than 18%). In 2016, more than 330 million children and adolescents were affected by overweight or obesity globally. It is estimated that by 2030 nearly 30% of all children will be affected by overweight or obesity. For this reason, childhood obesity is a major public health problem worldwide.
This study summarizes and reviewed research findings related to childhood obesity and health risks. Overweight and obesity are defined as an abnormal or excessive accumulation of fat that can harm health. Obesity has a multifactorial origin that involves both genetic and environmental factors. Several studies showed that excess body fat increased the risk of multiple comorbidities, such as high blood pressure, coronary heart disease, type 2 diabetes, insulin resistance, and cancer. According to the results of the research, the mother's nutritional status and obesogenic environments have a great influence on childhood obesity. A summary of the results of many studies concluded that childhood obesity is more likely to develop non-communicable diseases in adulthood. The global prevalence of overweight in children aged 5 years or under has increased modestly, but with heterogeneous trends in low and middle-income regions, while the prevalence of obesity in children aged 2–4 years has increased moderately. Overweight or obesity during childhood has important short-term and long-term consequences. Conclusion In recent decades, the prevalence of obesity in children has increased dramatically. For the successful implementation of activities to prevent overweight and obesity in children, it is necessary to create a supportive environment and to promote health.

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Vaping and e-cigarettes: a new public health concern

Buuveidulam A ; Suvd S ; Enkhmunkh E ; Suvd B

Mongolian Medical Sciences.2023;203(1):59-65.

Electronic cigarettes are handheld electronic vaping devices which produce an aerosol by heating an e-liquid. The e-liquid typically contains humectants and flavorings, with or without nicotine; once vaporized by the atomizer, the aerosol (vapor) provides a sensation like tobacco also smoking the heating process can lead to the generation of new decomposition compounds that may be hazardous. Heavy metals, organic compounds, and particles smaller than PM2.5 were found on the puff of the electronic cigarette, also in 2012 International agency research cancer, introduced PM2.5 human carcinogen substance. Therefore, e-cigarette liquid products should be subjected to regulatory control to ensure consistent nicotine delivery. Global youth tobacco survey Mongolia 2019 asked about e-cigarette use status and 3.5% (95% CI: 2.6-4.6) of students currently used electronic cigarettes while one in ten students (10.1%, 95% CI: 8.3-12.2) had ever used electronic cigarettes. E-cigarette advertising is on television and radio in many countries that have long banned similar advertising for cigarettes and other tobacco products and may be indirectly promoting smoking conventional cigarettes. Smoke-free policies protect nonsmokers from exposure to toxins and encourage smoking cessation. Introducing e-cigarettes into clean air environments may result in population harm if use of the product reinforces the act of smoking as socially acceptable or if use undermines the benefits of smoke-free policies.

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