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Safety and effectiveness of COVID 19 vaccine among pregnant woman

Nomin-Erdene L ; Nasantogtokh E ; Narantungalag L ; Jargalsaikhan B ; Altantuya Sh

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2168-2172.

Safety and effectiveness of COVID 19 vaccine among pregnant woman Introduction: Major International Organizations such as the World Health Organization (WHO), Centers for Disease and Prevention (CDC), American College of Obstetrics and Gynecology (ACOG) recommend that use of COVID 19 vaccine for people who are pregnant, breastfeeding and trying to get pregnant. Objective: To determine the safety and effectiveness of COVID 19 vaccine among pregnant woman. Materials and methods: In this prospective study, we collected data from pregnant woman who are receiving their antenatal care at the general hospitals of Ulaanbaatar city and National Center for Maternal and Child Health of Mongolia between July 1, 2021 and August 20, 2021. The survey data were collected four categories of questionnaires. An ultrasound scan performed to screening of fetal anomalies and to assess fetal growth at 12, 20, 28, 36 weeks of pregnancy. Results: Among the total of 420 pregnant woman, 193 (46.0%) have received COVID 19 vaccine and 227 (54.0%) were not. (1:1) The most commonly reported adverse events in pregnant participants were injection site pain (63.2%), myalgia (45.2%), headache (44.9%) and fatigue (40%). Furthermore, complications of pregnancy were 11.5% of vaccinated group and 7.8% of the other group and it has shown that pregnancy complications was not statistically significant in differentiating to the study groups (x^2 = 1.62, p = 0.205) Pregnant woman with COVID 19 infections were 73.6% (n=39) of unvaccinated group and 26.4% (n=14) of vaccinated group. Whether to relate between COVID 19 vaccination and COVID 19 infections were statistically significant in differentiating to the study groups. According to the result, COVID 19 vaccine has an effectiveness of 91% for the pregnant woman if they continue to administer the prevention method of COVID 19 infections (same as before the vaccination: wearing a mask, keep a safe distance). The risk of fetal anomalies at first trimester and 20 weeks gestation were not statistically significant in differentiating to the study groups. These results demonstrate that the COVID 19 vaccine does not affects fetus by now. Conclusions: In this study, COVID 19 vaccine does not increase a risk of pregnancy and medical complications. The prevalence of COVID 19 infection was statistically significant in differentiating to the both vaccinated and unvaccinated groups. It shows that COVID19 vaccines have became a crucial tools for reducing the incidence of COVID 19 infection in pregnancy.

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Velopharyngeal function: a comparison result of primary palatoplasty by various techniques

Erdenetsogt J ; Ayanga G ; Munkhdul A ; Khentii L

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2173-2179.

Velopharyngeal function: a comparison result of primary palatoplasty by various techniques Introduction: The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary cleft palate repair is velopharyngeal insufficiency, which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that velopharyngeal insufficiency causes in 5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary surgical method for each particular type of cleft palate. To compare velopharyngeal function using nasopharyngoscopy after primary CP repair Materials and methods: The patients who with congenital cleft palate and, underwent primary cleft palate repair in the Department of Maxillofacial surgery of the National Centre for Maternal and Child Health and had velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence and oronasal fistula postoperatively were excluded from the study. Cleft palate was classified according to the Veau system and Golding-Kushner scale of nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact test were used for statistical analysis. Results: A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von Langenbeck technique. Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow” technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in 48.1% and Von Langenbeck technique in 47.1% cases. Conclusions: The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.

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Effects of COVID-19 on pregnancy and delivery outcome: systematic review with meta-analysis

Nasantogtokh E ; Baljinnyam B ; Enkhmaa D ; Altantuya Sh

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2180-2185.

Effects of COVID-19 on pregnancy and delivery outcome: systematic review with meta-analysis Introduction: The impact of Coronavirus infection disease (COVID-19) on during pregnancy, maternal outcome, and neonatal health is unclear. We aimed to measure about effect of Coronavirus infection to pregnancy, maternal outcome, and newborn health in systematic review with meta-analysis. Materials and methods: The systematic review and meta-analysis conducted PRISMA guidelines, recommended from Cochrane, based on database of studies and a hypothesis to determine the impact of COVID-19 on pregnancy, maternal, and neonatal outcome. We searched for eligible studies of databases from December 2019 to April 2021. Our dependent variables were preeclampsia, preterm birth and stillbirth. Independent variables were infection of COVID during pregnancy, and outcomes. We measured for primary outcome that are preeclampsia, preterm birth, and secondary stillbirth. The meta-analysis evaluated the quality of the observational study (Newcastle – Ottawa Scale) and included the results. Statistical analysis was performed using Rev Man 5.0 software. The ratio (OR) in meta-analysis was calculated using a meta-regression model (Random effect meta-analysis). The mean difference was measured and weighed 95.0% confidence interval. Results: We included 46 studies involving 459,789 participants. Coronavirus infection maybe associated with increase the risks of preeclampsia in pregnancy (B: 1.21, 95.0% CI: 1.01 - 1.25), premature birth (B: 1.91, 95.0% CI: 1.62–2.15), stillbirth (B: 2.2, 95.0% CI: 2.12–2.31. Conclusions: Coronavirus infection increases the risk of preeclampsia, premature birth and stillbirth. Furthermore, the studies are needed to collect more robust data to validate or substantiate these findings, better understand the impact of COVID on pregnancy in experiment, intervention, and cohort studies with Meta-Analysis.

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The study of clinical and epidemiological characteristics of coronavirus infection in children ages 0-18

Bolormaa T ; Amarjargal O ; Baljinnyam B ; Altantuya Sh

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2186-2190.

The study of clinical and epidemiological characteristics of coronavirus infection in children ages 0-18 Introductions: The coronavirus disease (COVID-19) has been spreading in Wuhan, Hebei Province, China since late 2019, and was declared a pandemic by the World Health Organization on March 11, 2020. Since the outbreak of the pandemic, the SARS-CoV-2 virus has been constantly mutating, and several new variants have emerged, dominating the world. These variants are characterized by differences in transmission, toxicity, and pathogenicity. Due to the lack of research on pediatric COVID-19 in Mongolia. Our goal was to study the symptoms and severity of children with COVID-19 and to compare clinical characteristics between Alpha and Delta of SARS-CoV-2 occurred in children. Material and methods: Clinical characteristics, laboratory and diagnostic test results of 450 children aged 0-18 years, confirmed by laboratory tests from March 30, 2021 to December 1, 2022 in the Isolation Department of COVID-19 infected children of the NCMCH, treatment and complications were studied retrospectively. Result: The study involved 450 children aged 0-18 years with laboratory-confirmed COVID-19 infection. According to the demographic variables, 263 (58.4%) boys and 189 (41.6%) girls. In terms of age group, 62.4% were aged 0-4 years, 17.5% were aged 5-9 years, 16.2% were aged 10-15 years, and 3.7% were children over 15 years old. Of these children, 231 (51.3%) were clinically confirm signs of alpha and 219 (48.7%) delta variant. In 8 cases, COVID-19 was vaccinated but became infected. Clinical features of alpha-type physical examination were 117 (51.6%), pale face and paleness (29.6%), and respiratory distress (40.0.0%). Clinical features of delta-variant bruising, pallor, and chest depression were predominant on physical examination. Conclusion: COVID-19 In children with alpha and delta variants, the most common symptoms of respiratory viral infections, such as fever and cough, were respiratory distress in alpha variant and respiratory and circulatory abnormalities signs in delta variant.

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The result of a study of prevalence, type and degrees Of hearing impairment in newborns and infants

Saruul Ch ; Zolzaya Ts ; Ariuntuya D ; Delgermaa B ; Bayalag B

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2191-2198.

The result of a study of prevalence, type and degrees Of hearing impairment in newborns and infants Introduction: Significant bilateral hearing loss is the most common congenital disorder of the newborn, occurring 2-3 times per 1000 live infants. In December 2012, for the first time in Mongolia, neonatal hearing screening was introduced at the National Center for Maternal and Child Health. We aimed at investigated the outcomes of neonatal hearing screening and diagnostics of type and degree of hearing loss in neonates and infants. Materials and methods: During the study period, 2019-2020, a total of 70,614 infants born in Urguu, Khuree, Amgalan maternity hospitals, Baganuur district health center, Intermed hospital, and the National Center for Maternal and Child Health were included in the prospective cohort study. The study was performed in three phases, following the clinical guidelines for neonatal hearing screening. Results from the well-baby newborn hearing screening program and diagnostic follow-up of referred children from 2019 to 2021 were included in calculating prevalence rates. Hearing loss was classified according to the degree and type. Results: A total of 94.1% of 70,614 children eligible for screening were included. A prevalence rate of bilateral hearing loss 2.23 per 1000 children was found. A prevalence rate of bilateral severe and profound hearing loss 1 per 1000 children was found. The mild sensorineural hearing loss 28 (26.0%) was most common in children, followed by moderate 19 (17,6%), severe 21 (19.4%), profound 19 (17.6%) and deaf 21 (19.4%). Conclusions: The coverage of hearing screening in maternity hospitals in Ulaanbaatar is relatively good (94.1%), but there is a repeat screening (62.1%) and follow-up and diagnostic tests (49.9%). shows that the system needs to be improved. Because of the well-by hearing screening program, reported results approximate prevalence rates of permanent hearing loss by severity.

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Correlation between delay time of surgery of congenital cataract and postoperative visual acuity

Shamsiya M ; Nasantogtokh E ; Uranchimeg D ; Davaa G ; Erdenetuya G

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;29(1):2096-2100.

Correlation between delay time of surgery of congenital cataract and postoperative visual acuity Introduction: Worldwide, child cataract is 1 to 15 cases per 100,000 children are diagnosed. In the International Classification of Diseases, pediatric cataracts are classified as congenital (Q12) and developmental (H26.0). Congenital cataract occurs in 1–3 out of 10,000 children, and if diagnosed, surgery is required without delay. International researchers report that congenital cataracts require semi-emergency surgery. It is also recommended that children with congenital cataracts be diagnosed after 3 months of age without surgery. Congenital cataracts are recommended for surgery in one eye within 6 weeks and in both eyes within 10 weeks. Early detection of congenital cataracts and emergency surgical treatment are important to improve postoperative visual outcome and quality of life. To investigate the correlation between the surgical delay time and postoperative visual acuity in children diagnosed with congenital cataracts. Material and methods: This study conduct based on the ophthalmic surgery department of the National Center for Maternal and Child Health, performed for a retrospective longitudinal study design. The study examined cases of congenital cataracts in both eyes and retrospectively follow patients who had congenital cataract surgery in 2018-2020 from the onset of symptoms to the postoperative period. The sample size was calculated using open.epi. We sampled participants for non-probabilistic purposes. The study included children 1 year of age and younger or with nystagmus, cataract with nuclear and polar morphology , and bilateral cataracts Statistical analysis was performed using STATA 16.0 software. The risk of delay time to visual acuity was determined by an ordinal regression model. Results: The study included 46 cases of congenital cataracts, under the age of 16. 61 percent of the children were male and 58.7 percent were from rural areas. The postoperative visual acuity of the children in the study was <0.09 in 52.2% (n = 24) and 0.1

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Short and long term impacts of outdoor air pollution on semen quality

Nomuundari O ; Algirmaa N ; Bolormaa D ; Nyamsuvd R ; Burmaa S

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;29(1):2101-2109.

Short and long term impacts of outdoor air pollution on semen quality Introduction: Ulaanbaatar is one of the most polluted capital cities1. In winter, the average daily PM2.5 level of pollution is 687 micrograms per cubic meter, which is 80 times higher than the WHO recommended safe level2. Air pollution contributes to a variety of diseases, including cardiovascular disease, chronic obstructive pulmonary disease, and neurological disorders and infertility3. According to the World Health Organization, 48 million couples and 186 million people worldwide are infertile4, 5. Factors affecting semen quality include chronic diseases, urogenital infections, environmental pollution, lifestyles, and geographical location of nations12,13 . Fine particles and toxins (PM10, SO2, NO2, PM2.5) in ambient air pollution affect the maturation of male gametes and activate DNA damage, cell apoptosis, oxidation, and inflammation14,15. According to researchers, foreign Ambient air pollution affects semen quality, but there is little evidence. Therefore, more research is needed in this regard. Materials and methods: The survey was conducted from January 1, 2020 to April 31, 2021 based on the retrospective longitudinal survey model based on the NСМCH-Infertility Reproductive Center. To measure sperm quality, the sample was diluted for 15 to 60 minutes, stored at 20 to 37 degrees Celsius, and viewed under a microscope at 200x magnification using a Makler Chamber instrument for 1 hour to determine sperm motility and concentration. Count 200 sperm in the field of view and evaluate and classify sperm motility. Measurement of air pollutants: The average daily amount of air pollutants in Ulaanbaatar is determined by the average of 6 guard stations of the Meteorological and Environmental Research Agency. The study used 24-hour measurement data of 4 air pollutants (SO2, NO2, PM2.5, PM10) at 1-hour intervals. Total measurement results from October 1, 2019 to December 31, 2020 are included. Statistical analysis of the survey was performed using STATA 16.0 software. Statistical analysis of the survey was performed using STATA 16.0 software. After clearing and sorting the survey data, if the missing value is 10 percent or less of the total data, the variable is deleted and analyzed. Results: High levels of air pollution have a negative effect on semen volume and sperm count. For example, an increase in particulate matter (PM2.5) in the ambient air by 1 μg / m3 reduces the amount of semen by 0.002 ml and the number of sperm by 17.0 thousand. However, when the amount of PM10 particles increases by 10 μg / m3, the concentration in the semen decreases by 1.14 million. Outdoor air pollution is likely to have a long-term negative impact on semen quality. For example, when the amount of PM2.5 particles in the ambient air increases by 1 μg / m3, the number of sperm in the semen decreases by 81.0 thousand after 3 months. However, if the average amount of SO2 in the ambient air increases by 1 μg / m3, the number of sperm in the semen will decrease by 1.49 million after 3 months. Conclusions: 1. The use of toxic habits in the two groups of men from Ulaanbaatar, who were treated at the andrology laboratory of the National Center for Obstetrics and Gynecology, did not differ statistically. 2. PM10 levels are 129.111.6 μg / m3 higher than the average daily levels of air pollutants in Ulaanbaatar, which indicates a level of adverse health effects. 3. Long- and short-term exposure to ambient air pollutants can adversely affect semen volume and sperm count.

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BI-RADS assessment using for diagnosis of invasive ductal carcinoma

Munkhzaya S ; Ariuntungalag B ; Nasantogtokh E

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;29(1):2110-2113.

BI-RADS assessment using for diagnosis of invasive ductal carcinoma Introduction: Scientific evidence is needed to introduce non-invasive and effective diagnostic methods for early detection of breast cancer. One of these methods is the BI-RADS (Breast Imaging Reporting and Data System) assessment, which has entered the field of imaging. However, in the United States, 58% of all cases diagnosed negatively by ultrasound (BI-RADS1-3) were diagnosed by breast biopsy. The significance of BI-RADS assessment in Invasive Ductal Carcinoma will be investigated in the National Cancer Center of Mongolia Materials and methods: The study was conducted using the descriptive design from January 2021 to August 2021, based on the National Cancer Center of Mongolia. The study data were initially collected using a database of tissue and immunohistochemical analyzes and breast ultrasound. Of the 75 women aged 23-86, 81.3% were diagnosed with breast cancer. Results: The study found that 75.4% of women diagnosed with breast cancer by biopsy had a suspected BI-RADS cancer (4a-5). In addition, a woman's age is a statistically significant predictor variable in the diagnosis of peritoneal breast cancer (ROC = ROC = 0.736, p = 0.006). Conclusions: BI-RADS assessment can be used for invasive ductal carcinoma. Our study retrospectively included only women with cancer and other breast disease. In the future, it is necessary to study in detail the relationship between BI-RADS evaluation indicators and invasive ductal carcinoma.

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Early detection of bronchial asthma in children and establishment of a national continuous monitoring system

Tsevegmid U ; Solongo O ; Naranmandakh J ; Undrakh A ; Oyunchimeg A ; Nasantogtokh E

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;29(1):2114-2120.

Early detection of bronchial asthma in children and establishment of a national continuous monitoring system Introduction: Bronchial asthma - a chronic inflammatory disease with recurrent allergic reactions characterized by increased sensitivity of the bronchi to various factors, swelling of the bronchial mucosa, excessive mucus secretion, and narrowing of the airways due to severe muscle contraction. Early detection of bronchial asthma in childhood, its prevalence, and the establishment of a continuous monitoring system to assess the effectiveness of follow-up treatment Materials and methods: It is mild in children, but is ready to be severe. If left untreated for a long time, the structure of the bronchi changes irreversibly and becomes ineffective. There are cases of death due to risk factors for irritability and asthma. In the first objective of the study, the National Center for Maternal and Child Health (NCMCH) Children's Counseling Polyclinic, Respiratory Pathology Department, and the Children's Department of the General Hospital of 21 aimags and 9 districts were used to determine the prevalence of Acute respiratory infections, implemented outpatient (2019-2021). Within the scope of objectives 2 and 3 of the study, a self-controlled case-control study model was used to assess the diagnosis of asthma in the case group based on the GINA-2018 guideline evaluation and clinical and laboratory tests based on the GINA protocol treatment. The parameters were taken, the pre-treatment parameters were recorded and compared in the control group, and the results were calculated. Results: When the prevalence was determined by the Acute respiratory infections level, there were 11 cases per 1,000 children. 80.8% of cases of asthma were caused by asthma 1-5 times a year, and the majority or 96.5% were aged 0-9 years. Allergies include plant (42.9%), food (25.4%), and pet (14.3%) allergies under the age of 4, all types of allergies between the ages of 5-14, and plant allergies 15-19 years, (9%), food (21.4%), pet (14.3%), environmental moisture and mold allergies (14.3%). Among the 89 children treated according to GINA guidelines, 64.0% used spices or allergenic foods, 13.5% used antibiotics, 6.7% used paracetamol, and 13.5% used other drugs. Children with asthma were assessed according to GINA guidelines and monitored and treated for 1 year (0.0001), the number of cases of asthma (p = 0.035) and the number of people receiving emergency care (p = 0.042) decreased statistically. There was a statistically significant difference of 2%, nocturnal cough decreased by 15.2%, and whooping cough decreased by 1.4%. Conclusions: The prevalence of asthma was 11 cases per 1,000 children. The main causes of allergies are plants, food and pets. The number of coughs, hospitalizations and emergency room visits decreased with GINA treatment.

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Outcomes of retinopathy of prematurity screening

Tsengelmaa Ch ; Erdenetuya G ; Tsogzolmaa G ; Gantuya M ; Amgalan P ; Enkhtuya S ; Altantuya Ts ; Bayalag M

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;29(1):2121-2124.

Outcomes of retinopathy of prematurity screening Background: Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants weighing about 1250 grams or less that are born before 31 weeks of gestation (a full-term pregnancy has a gestation of 38-42 weeks). The smaller a baby is at birth, the more likely that baby is to develop ROP. This disorder — which usually develops in both eyes — is one of the most common causes of visual loss in childhood and can lead to lifelong vision impairment and blindness. ROP was first diagnosed in 1942. Our goal was to investigate the outcomes of ROP screening of retinopathy of prematurity (ROP). Materials and 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. 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). 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. Conclusions: After treatment, resolution of ROP was noted in approximately 100 % of the patients who had treatment-requiring ROP

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