Emerging Challenges in Healthcare in Central Asia
Central Asian Journal of Medical Sciences.2015;1(1):1-4.
Central Asian Journal of Medical Sciences
2002 (v1, n1) to Present ISSN: 1671-8925
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The Role of Computer Aided Diagnosis (CAD) in Medical Imaging
Central Asian Journal of Medical Sciences.2015;1(1):5-15.
Objectives: We introduce the various methods of image analysis used for CAD. In addition, we provide a guide for the clinician through examples which use the CAD. Methods: Medical images consist of individual pixel elements, to which discrete brightness or color values are assigned. Various methods have been utilized for the analysis of these images. We introduce the five methods: shape analysis, texture analysis, parametric mapping analysis, classification methods and segmentation methods. Results: Various image analysis techniques used in the CAD are quantified by analyzing the various features of the lesion shown in the image. It is used as a process for deriving the best diagnosis for the disease through the comparison of the existing data. It proposes an example of a CAD system being studied using a variety of image analysis techniques. Conclusion: Nowadays, medical imaging has improved to show the functional state of the inner body. Furthermore, accelerated advances in computer-based technology have widely enlarged efficiency of saving, transmission and analysis. Improvement of CAD will expand the utilization range of CAD in 2D and 3D medical imaging. Also, we expect that CAD system will evolve the automatic diagnosis support system.
A Review of the Modern Mongolian Healthcare System
Central Asian Journal of Medical Sciences.2015;1(1):16-21.
Objectives: Known to most as the horse-loving homeland of Chinggis Khan, Mongolia is today a country of increasing geopolitical, economic, and popular cultural significance. But even as an increasing number of health workers visit the country, its healthcare system remains unexplored in the medical literature. Here follows a broad-brushstrokes overview of the modern medical system of Mongolia, its structure and challenges. It is comprised of an overview of the country's demographics, health profile, and medical history, followed by a brief summary of selected issues that affect the modern healthcare system. Methods: Descriptive single-case study consisting of clinical observations by the authors, original hospital-level data, and interviews with practitioners and policymakers. Results: The Mongolian healthcare system has performed well through the tumultuous transition from a socialist to a capitalist economy. Our analysis reveals three areas that require improvement: delivery of care, practitioner experience, and health systems administration. Conclusion: This article reviews not only the history and structure of the modern Mongolian healthcare system, but also its strengths and challenges. It is hoped that in explicating these issues, current and future efforts to assist Mongolian healthcare providers may be directed more constructively and efficiently.
Clinical Study of Posttraumatic Epilepsy
Central Asian Journal of Medical Sciences.2015;1(1):22-27.
Objectives: To study the manifestations of the paroxysms, the variants of the course, and to
determine the significant predictive factors for post-traumatic epilepsy (PTE) in Ulaanbaatar,
Mongolia. Methods: We obtained the histories of 109 PTE patients who came to district health
associations and the Central First Clinic in Ulaanbaatar from 2011 to 2013. We conducted
a questionnaire and performed clinical examination to evaluate seizures in accordance with
semiologic and international classification of epileptic seizures. Clinical data was matched
with the results of electroencephalography (EEG), computed tomography (CT), and magnetic
resonance imaging (MRI). Results: Of the 109 patients, 93 (85%) presented with secondary
generalized partial seizure (SGPS), 16 (15%) with partial seizure and 66 (60.5%) with motor
phenomena. The seizure frequency was not correlated with the structural brain abnormalities,
but there was an inverse association (r=-0.32, p<0.001) between seizure frequency and the
duration of PTE. PTE was positively correlated with severe injury, contusion, early onset of
seizures (p<0.05), and operative brain injury (p<0.005). Conclusion: Clinical features of PTE
were presented as secondary generalized seizure and motor phenomena in the majority of
patients. PTE was characterized commonly by long durations of high seizure frequency and
significantly affected by factors such as severity of head injury and operative brain injury.
Causes and Risk Factors for Early Neonatal Mortality in the Western Region of Mongolia
Central Asian Journal of Medical Sciences.2015;1(1):28-32.
Objectives: The incidence of perinatal, especially early neonatal mortality, has not been
reducing in the western region of Mongolia, therefore, the purpose of this study was to
identify causes and risk factors for early neonatal mortality in the western region of Mongolia.
Methods: A case-control study for neonatal mortality was conducted in 5 hospitals in western
Mongolia in 2014. Cases and controls were chosen from the hospitals. Associated causes and
risk factors for early neonatal mortality were identified with subgroup binary logistic regression
analyses. Results: A total of 7749 live births occurred during the study period. The early
neonatal mortality rate was 11.3 per 1000 births. Obstetric complications, obstetric chronic
history, abruption of placenta, preeclampsia and maternal diseases influenced early neonatal
mortality. Respiratory distress syndrome (OR=29.4; 95% CI, 12.78-67.65, p<0.05), perinatal
asphyxia (OR=5.2; 95% CI, 2.81-9.63, p≤0.001), congenital malformation (OR=39.2; 95%
CI, 5.11-302.1) and perinatal infections (OR =11.1; 95% CI, 3.64-34.28, p≤0.001) were the
leading causes of newborn death in the first week. Conclusion: Overall, high rates of neonatal
death demonstrate the need to improve the quality of health care and the control of delivery
and factors influencing early neonatal mortality should be studied further at the national level.
Body Composition Characteristics and Anthropometric Measurements of Older Mongolian Adults
Central Asian Journal of Medical Sciences.2015;1(1):33-40.
Objectives: The purpose of our study is to examine characteristics of body composition and
anthropometric measurements in older Mongolian adults. Methods: This cross-sectional study
included 268 individuals aged 45 years and older who visited national hospitals over a period
of one month. Body weight, BMI, waist circumference (WC) and other body circumferences,
and body composition (body fat percentages, fat-free mass index, skeletal mass index) were
measured and the Short Physical Performance Battery (SPPB) score was used to test the physical
performance. Results: The sample was composed of 73.7% women and 26.3% men, and
the mean age was 58.1±8.9. All measurements were relatively higher than the normal range
in older Mongolian adults. Obesity in women was relatively higher than men. 77.1% of all
participants were obese according to BMI, 92.5% were obese according to body fat percentage,
and 96.2% were centrally obese according to WC. Among people aged 45-64 years, prevalence
of obesity increased and then decreased in ages 65-74 years. Age was significantly correlated
with WC and the SPPB score was indirectly correlated with age (p<0.05). Conclusion: Obesity
in older Mongolian adults is comparatively higher for women and tends to increase with age.
The Study of Diagnostic Methods and Sequencing for Trichomoniasis in Mongolia
Central Asian Journal of Medical Sciences.2015;1(1):41-48.
Objectives: The aim of this study was to determine the usefulness of a diagnostic method for trichomoniasis that uses sequencing of the Tv-E650 gene. Methods: Totally 109 patients visited Ulaan Tuuz Hospital, National Center of Communicable Disease, Ulaanbaatar and were examined for trichomoniasis using wet mount examination, Papanicolaou (Pap) smear, culture and PCR. A family of 650 base pair (bp) long repeats from the T. vaginalis genome, designated as the Tv-E650 family, was sequenced for five Mongolian strains. Results: As a result, 21.1% (23/109) were positive by wet mount, 18.3% (20/109) were positive by Pap smear, 28.4% (31/109) were positive by culture and 36.6% (40/109) were positive by PCR. The differences among the strains are single-nucleotide and 2-nucleotide substitutions and insertions or deletions. The sequence uniformity of the strains as well as the presence of identical mutations in different isolates suggest efficient sequence homogenization mechanisms. In blast results, the Tv-E650 repeat family is conserved in all T. vaginalis strains examined, regardless of their diverse geographical origin. Conclusion: The Tv-E650 repeat family of T. vaginalis is a simple, rapid sensitive and specific accurate method for identification and diagnosis of trichomoniasis.
Risk Factors of Arterial Hypertension Among Mongolian Nurses
Central Asian Journal of Medical Sciences.2015;1(1):49-55.
Objectives: This study aims to survey the prevalence and risk factors of hypertension (HTN)
among nurses. Methods: Data was collected from 528 nurses of 23 hospitals in Ulaanbaatar
(UB) and local hospitals in other regions. We randomly selected day-shift only nurses (264) and
shift nurses (264), collected blood samples, administered a health survey questionnaire, and
processed data with SPSS 19.0 statistic software. Results: Overall, 8% of participants who
work for shift and 7.2% of day working nurses are smokers (p<0.0001). 3.2% of shift working
nurses and 3.8% day working nurses use overuse alcohol (p<0.0001). The day working nurses
and the shift working nurses and compared their BMI to measured normal (42.1% and 36.4%)
overweight (39.7% and 43.9%), obesity (18.2% and 19.7%) (p<0.02), central obesity normal
(39.4% and 34.5%), and central obesity≥ 80 (60.6% and 65.5%), body fat percentages are
normal (29.2% and 16.1%) and increase (70.8% and 73.9%), visceral obesity are normal
(65.9% and 63.3%) and increase (34.1% and 36.7%). Nurses (day-work and shift-work) who
have arterial HTN are detected by normal (72.3% and 59.1%), prodromal period (14.4% and
16.7%), 1st stage (12.1% and 19.7%), 2nd stage (1.2% and 4.5%) (p<0.002). Working time of
nurses detected that shift working nurses’ arterial hypertension amount is higher than day time
working nurses. Conclusion: 24.2% of shift working nurses have HTN is showed that higher
than day time working nurses. Hypertension is directly related to overweight, obesity, visceral
obesity and high blood glucose level. (p<0.0001).
Central Asian Journal of Medical Sciences.2015;1(1):56-59.
Objectives: The goal of this study is to evaluate expression of the HPV16/18 L1 in cervical
tissues in correlation with lesion grade. Methods:A total of 96 specimens were analyzed in this
study. There were 50 cases diagnosed as low-grade squamous intraepithelial lesion (LSIL) and
46 cases diagnosed as high-grade (H-) SIL. All cases were submitted for immunohistochemistry
with anti-HPV16 /18 L1 antibody. Results: The positive rate of HPV16 L1 and HPV18 L1 was
identified in 61 (64%) and 21 (22%) of all cases. There was a statistically significant difference
for HPV18 (X2 = 0.599, p<0.05), but not for HPV16 (X2 = 0.024, p>0.05) in the two SIL
groups. In addition, 27 cases had no HPV16/18 L1 expression and 13 cases had HPV16/18 L1
co-expression. Conclusion: Lack of HPV L1 capsid protein in cervical lesions may serve as a
prognostic marker of enhanced malignant potential. There is still a critical need to find other
molecular surrogate markers, which can provide accurate information about which precursor
lesions would progress toward cancer.
Central Asian Journal of Medical Sciences.2015;1(1):60-66.
Objectives: According to Tibetan-Mongolian traditional medicine theory, humans are
classified into three main individuals based on the Rlung, Mkhris or Badgan symbolic code (SC).
Our objective was to research the relationship between some parameters of membrane-redox
potentials three-state line system in relation to the human constitutions of traditional medicine.
Methods: The quantities ratio for the SC of Rlung, Mkhris, and Badgan was determined by the
Doc-Am-I program. We determined the lipid profile, erythrocyte membrane resistance capacity
and body mass index. Results: It was shown that the concentration of serum lipids, body mass
index and membrane resistance capacity of individuals of the Badgan SC group was increased
with statistical significance in comparison to the other two groups. Our study revealed that
people of Rlung SC group were characterized by the highest concentration of malondialdehyde
and the lowest rate of membrane resistance capacity compared to people of the other two SC
groups. Conclusion: Our study defined the relevance of the membrane redox potentials threestate line system in connection to the human constitutional types such as the abstractly coded
classifications of Rlung, Mkhris, and Badgan of traditional medicine.
Country
Mongolia
Publisher
Selenge Press
ElectronicLinks
http://www.cajms.mnEditor-in-chief
Damdindorj Boldbaatar
cajms@mnums.edu.mn
Abbreviation
Cent Asian J Med Sci
Vernacular Journal Title
ISSN
2413-8681
EISSN
2414-9772
Year Approved
2017
Current Indexing Status
Currently Indexed
Start Year
2015
Description
The Central Asian Journal of Medical Sciences (CAJMS) is an official English publication of the Mongolian National University of Medical Sciences. CAJMS aims to advance knowledge in medicine, dentistry, public health, nursing, pharmacy and traditional medicine. CAJMS also aims to promote contact between basic and clinical medicine and dentistry. CAJMS is an international journal and has a special focus on research conducted in Central Asian countries including Afghanistan, China, Kazakhstan, Kyrgyzstan, Mongolia, Russia, Tajikistan, Turkmenistan, and Uzbekistan.
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