1.First successful whole lung lavage for pulmonary alveolar proteinosis in Mongolia: A Case Report
Amartuvshin G ; ; Altanzul L ; Ichinnorov D ; ; Naidansuren Ts ; Solongo B ; Densenbal D ; ; Tumen-Ulzii G ; ; Allabyergyen M ; Tumurjin G ; Khaliun P ; Tamir L ; Erdenetuya E ; Byambasuren S ; Ankhzaya B ; Ganbold L ; Manaljav Ts ;
Mongolian Journal of Health Sciences 2026;93(3):212-216
Background:
Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by the accumulation of surfactant within the alveoli, leading to impaired gas exchange and respiratory insufficiency. Although the disease is uncommon, it significantly affects patients’ quality of life and requires specific diagnostic and therapeutic approaches. Whole lung lavage (WLL) is considered the standard treatment; however, it has not been widely implemented in Mongolia. We report the first successful case of WLL performed for PAP in Mongolia.
Case Presentation:
A 56-year-old male presented with dyspnea. Chest computed tomography demonstrated a bilateral “crazy paving” pattern. Bronchoalveolar lavage fluid was positive for periodic acid–Schiff (PAS) staining, and anti–GM-CSF antibodies were detected, confirming the diagnosis of PAP. WLL was performed under general anesthesia using a double-lumen endotracheal tube with bronchoscopic guidance. One lung was ventilated with 100% oxygen while the contralateral lung was sequentially lavaged with 800–1000 mL of warm (37°C) saline per cycle until the effluent became clear. A total of approximately 20 liters of saline was used.
Result:
The procedure was completed successfully without complications. Following treatment, the patient showed marked clinical improvement with reduced dyspnea and increased exercise tolerance. Oxygen saturation improved from 88% to 93%, and spirometric parameters (FVC, FEV₁) demonstrated improvement. Chest imaging revealed a reduction in pulmonary opacities.
Conclusion
This case demonstrates the successful implementation of whole lung lavage (WLL) in Mongolia and highlights its importance in improving the diagnostic and therapeutic capacity for rare pulmonary diseases such as pulmonary alveolar proteinosis. The procedure resulted in significant improvement in clinical, functional, and radiological parameters, consistent with findings from international studies. Early diagnosis of PAP and the adoption of standardized protocols in accordance with international guidelines are essential to optimize treatment outcomes and enhance patients’ quality of life.
2.Health professional’s knowledge, attitude and practice (KAP) on air pollution
Otgonbayar D ; Tsegmid S ; Suvd B ; Oyun-Erdene O ; Buuveidulam A ; Zolzaya D ; Oyunchimeg D ; Chinzorig B ; Amartuvshin Ts ; Enkhtuya P ; Narantuya D
Mongolian Medical Sciences 2020;193(3):54-58
Introduction:
Soum and family health care centers (primary health care centers) provide public health services to
reduce the negative effects of air pollution on health. In order to decrease the risk factors due to air
pollution, it is crucial for health professionals, who are providing health care services to the public,
to have the knowledge, attitude and practice to give an advice for residents on how to protect their
health from air pollution. The “Air pollution and child health” report from WHO recommended that
responsibility of health professionals must include knowing the latest information on air pollution,
doing a research, spreading the knowledge, educating families and community and learning from
them as well, proposing solutions, and finding a solution for policy developers and decision makers
in other sectors. Therefore, we conducted this survey with purpose to determine the long-term effects
of air pollution on population psychology and lifestyle and to evaluate the level of knowledge, attitude,
and practice of health professionals on how to protect a health from air pollution.
Goal:
Evaluate the level of knowledge, attitude, and practice of health professionals on air pollution.
Material and Methods:
In 2019, this study conducted a cross-sectional design and collected quantitative and qualitative
data. 88.4% of (n=532) health professionals from 48 secondary health care centers (SHCC) and 64
family health care centers (FHCC), which are agents that implement UNICEF project, in Bayanzurkh,
Songinokhairkhan districts and Bayankhongor aimag were participated in the survey.
Results:
97.4% of the participants agreed that air pollution has negative effects on human health. 99.5% of
participants did not know the Mongolian standard for the acceptable level of air pollutant particulate
matter (PM) and 73.1% of all participants did not receive information about air quality index. 82.1% of
participants regularly give prevention advice with the purpose of protecting maternal and child health
from air. The participants who worked for more than 21 years and who are older than 51 years old
were more likely to give advice (p<0.05). As for the reasons for not giving advice about air pollution
for protecting the maternal and child health, 29.2% of participants answered the service time is not
enough, and 22.9% mentioned the lack of knowledge and information. 30.5% (162) of participants were not satisfied with their skill to give an advice on how to protect maternal and child health from
air pollution. 86.8% of participants indicated that they did not receive proper training on air pollution
and prevention from air pollution.
Conclusion
There is a need to provide training and information on how to protect maternal and child health from
air pollution for health professionals.
Result Analysis
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