1.A systematic review: epidemiology, etiology and risk factors of stroke in young adults
Delgermaa Ts ; Juramt B ; Tsagaankhuu А
Mongolian Journal of Health Sciences 2025;88(4):6-14
Background:
The annual incidence of stroke in different regions of the world ranges from 100 to 336 per 100,000 pop
ulation, and mortality ranges from 36 to 136, and in Mongolia there are 220 new cases of stroke per 100,000 people and 113 deaths annually, making it one of the countries with the high stroke incidence rate.
Aim:
To conduct a systematic review of published sources on the epidemiology, causes, and risk factors of ischemic stroke in young people.
Materials and Methods:
The research sources were searched using keywords such as “Stroke”, “Definition”, “Epidemi
ology”, “Etiology”, “Risk factors”, “Young Adult”, “Ischemia”, “Hemorrhage”, “Silent stroke” from the works published in international platforms such as Cochrane Library, Datebase, Medline, PubMed, Google Scholar, and Web of Science, and relevant information and data were selected from the collected sources and a review article was developed.
Results:
According to the WHO MONICA project report, stroke incidence was reported in 16 countries, with 101–285 men and 47–198 women per 100,000 people aged 35–64 years, while in the United States it was 113.8 per 100,000 people under 55 years, of which 73.1 were cerebral infarctions per 100,000 people, and more than 10 percent were under 55 years. A recent study in Mongolia found that 21–26% of stroke patients were young people (20-50 year old), compared with 10–13% in Western countries. Among the traditional causes and risk factors for stroke in young people, arterial
hypertension accounts for 45-60%, smoking 40-60%, alcoholism 40-50%, heart disease 18-30%, dyslipidemia 30%, diabetes 13%, obesity 7-36%; among the specific risk factors, migraine accounts for 10-35%, taking hormonal contraceptives 10-22%, vasculitis 6-10%, blood clotting disorders 2-10%, vascular dissection 6-40%. According to the TOAST
classification, large vessel disease accounts for 16-17%, small vessel occlusion 14-15%, cardiac embolism 19-20%, other
determined etiologies 22-23% and undetermined 26-27%.
Conclusion
Epidemiological indicators of stroke vary significantly depending on the level of development of the country, geographical characteristics of the region, lifestyle, age, and gender (stroke incidence rate range: 100–336 per 100,000 population; mortality: 36–136 per 100,000 population). Mongolia is among the countries with high rates of stroke incidence and mortality (incidence rate 220 per 100 000, mortality 113 per 100 000 population). While stroke among
young people accounts for 10–13% of all cases in Western countries, this figure reaches 21–26% in Mongolia, which is
explained by a combination of traditional and specific risk factors. As stroke is becoming more common among younger
populations, it is essential to study its causes and risk factors in detail and to intensify efforts in diagnosis, treatment, and
prevention.
2.Management and monitoring of hypokalemia occurring during certain diseases
Temuulen Ts ; Maral B ; Baasanjargal B ; Agidulam Z ; Burenbayar Ch ; Ankhbayar D ; Tsogdulam S ; Amardulguun S ; Otgon-Erdene M ; Anujin G ; Khongorzul U1 ; Delgermaa Sh ; Odgerel Ts
Mongolian Journal of Health Sciences 2025;86(2):51-54
Background:
Hypokalemia is considered when the serum potassium level is less than 3.5 mmol/L. Clinical research indicates
that hypokalemia affects 20% of hospitalized patients, and in 24% of these cases, inadequate interventions result
in life-threatening complications. At present, there is no research available on the prevalence, management, and outcomes
of hypokalemia in hospitalized patients, which justifies the need for this study.
Aim:
The study aimed to examine the prevalence of hypokalemia and the effectiveness of its management in hospitalized
patients within the internal medicine department, in relation to the knowledge of doctors and resident physicians.
Materials and Methods:
This hospital-based retrospective study included a total of 553 cases of patients hospitalized in
the Internal Medicine Department of the Mongolia Japan Hospital between January 2024 and August 2024. Patients with
a potassium level of <3.5 mmol/L were diagnosed with hypokalemia, and the effectiveness of potassium replacement
therapy was evaluated according to the method of supplementation employed.
Results:
The prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department was 9.8%
(54 cases). Based on the study criteria, 42 cases of hypokalemia were selected for further analysis, and a total of 118 potassium
replacements were performed through oral, intravenous, and mixed methods. Following potassium replacement
therapy, 37.3% (44) of patients achieved normalized potassium levels, while 62.7% (74) still had persistent hypokalemia.
Conclusion
According to the study results, the prevalence of hypokalemia among hospitalized patients in the Internal
Medicine Department is 9.8%. The method of potassium replacement and the severity of hypokalemia do not impact the
normalization of potassium levels, with the critical factor being the proper dosage of supplementation. The knowledge
of doctors and resident physicians regarding hypokalemia is insufficient, and there is a need to implement guidelines and
protocols for potassium replacement therapy in daily clinical practice.
3.Analysis of various risk factors associated with poor sleep quality
Purevdulam B ; Khishigsuren Z ; Tovuudorj A ; Tsagaankhuu G ; Delgermaa Ts
Mongolian Journal of Health Sciences 2025;85(1):207-213
Background:
Sleep quality is frequently highlighted in the literature as a key factor for overall health. Poor sleep quality
significantly affects both physical and mental health, diminishing quality of life and potentially harming personal finances. While this issue is influenced by various risk factors, no well-studied research has been conducted on it in Mongolia.
Aim:
The aim of this study was to assess the frequency of poor sleep quality among visitors to the Sleep center in Mongolia and to identify the factors associated with poor sleep quality.
Materials and Methods:
This study, conducted using a cross-sectional design, included 200 participants aged 18 to 65
years who visited the Sleep Center at the General Hospital for State Special Servants between January and May 2024.
Data were collected using a structured questionnaire. Sleep quality was assessed using the Mongolian version of the Pittsburgh Sleep Quality Index, with a global score above 6 indicating poor sleep. Participants were divided into two groups:
“Good sleepers” (n=105) and “Poor sleepers” (n=95). Socio-demographic and clinical variables such as age, sex, levels
of education were also recorded. The level of depression, anxiety, and stress was assessed using the DASS 21 (Depression
Anxiety Stress Scale) criteria. Univariate analysis was performed using the t-test, Mann-Whitney U test for continuous
data, the Х2 or Fishers’s exact test for categorical data, and logistic regression for multivariable analysis. A P-value of less
than or equal to 0.05 was considered significant.
Results:
Poor sleep quality, indicated by a PSQI global score above 6, was observed in 52.5% of the total participants.
Univariate analtysis’s test results showed that age, being female, having depression, anxiety, BMI ≥ 25, alcoholism,
comorbidities, and using concomitant medications were significantly associated with poor sleep quality (all p<0.05). In
the multivariate logistic regression analysis, 50 < age (OR 3.133, 95% CI, 1.245-7.884, p<0.05), BMI ≥ 25 (OR 2.084,
1.039-4.179, p<0.05), alcoholism (OR 3.018, 95% CI, 1.495-6.093, p<0.01) and depression (OR 15.957, 95% CI, 1.592-159.922, p<0.05) were identified as significant risk factors for poor sleep quality. Depression and alcoholism were associated with longer sleep latency and decreased daytime activity (p<0.05).
Conclusions
1. In our study, more than half of the participants experienced poor sleep quality.
2. Age over fifty, depression, BMI ≥ 25, and alcoholism emerged as independent significant risk factors for sleep disturbance. Alterations in sleep latency, sleep disruption, and impaired daytime functioning may be associated with
poor sleep quality.
4.A Study on the Learning Motivation and Engagement Level of Generation Z Students
Otgontsend O ; Ganbaatar B ; Odgerel B ; Ariunaa J ; Enkhbold D ; Delgermaa S ; Orgilmaa R ; Solongo D
Mongolian Journal of Health Sciences 2025;90(6):200-204
Background:
Generation Z students, born after 1995, are characterized by their ability to multitask, low tolerance for
traditional learning methods, impatience, short attention span, and preference for working independently rather than
collaboratively. They are also considered more vulnerable to mental health challenges compared to previous generations.
Aim:
To assess the level of academic engagement among Generation Z students studying in the School of Nursing.
Materials and Methods:
This descriptive, cross-sectional quantitative study was conducted from February 1 to April
1, 2025. A total of 420 students majoring in nursing, midwifery, physical therapy, occupational therapy, and traditional
medicine nursing at the School of Nursing, Mongolian National University of Medical Sciences, participated in the study.
The Student Course Engagement Questionnaire (Handelsman, 2005) was used to evaluate students’ engagement levels.
The reliability of the questionnaire was confirmed with a Cronbach’s α of 0.955. Statistical analysis was performed using
SPSS version 25, and results were considered statistically significant at p<0.05.
Results:
Among the 420 participants, 91.9% were female and 8.1% were male. By major, 57.1% studied nursing, 22.6%
midwifery, 8.8% physical therapy, and the remainder were from other disciplines. Student engagement was analyzed
across three domains: academic involvement, personal responsibility and effort, and learning attitude and motivation.
Pearson correlation analysis revealed strong positive correlations between academic involvement and personal responsibility/
effort (r=0.828), learning attitude and motivation (r=0.825), and between responsibility/effort and learning attitude/
motivation (r=0.903) (p<0.01). Age showed a weak positive correlation with year of study (r=0.381), while major and
year of study had a weak negative correlation (r= -0.146) (p<0.01). Year of study and learning motivation also showed a
weak negative correlation (r=-0.107, p<0.05).
Conclusion
The learning motivation and class engagement of Generation Z nursing students were found to be strongly
correlated with their sense of responsibility, effort, and learning attitude (r=0.82–0.90, p<0.01). Most students demonstrated
consistent participation and motivation to learn, showed less interest in traditional teaching approaches, and preferred
practical training.
5.The result of determination of some risk factors of hearing loss, deafness in neonates and infants
Saruul Ch ; Delgermaa B ; Bayalag M
Mongolian Journal of Obstetrics, Gynaecology and Pediatrics 2022;31(1):2260-2264
The result of determination of some risk factors of hearing loss, deafness in neonates and infants
Background: Newborns born prematurely or with high risk for hearing loss are 10 times more likely to develop hearing loss than well babies. Also, 1 out of 50 newborns hospitalized in the neonatal intensive care unit are at risk of hearing loss. The risk factors of hearing loss and deafness in children was first developed and tracked by Joint Committee on Infant Hearing in 1972, and has been further refined and updated since then. The last update was made in 2007 and used worldwide. The risk factors of hearing loss for children vary by age.
Materials and methods: A case-control study was performed to identify some risk factors for the development of hearing loss and deafness in neonates and infants. The research case group included all the cases in which the diagnosis of congenital hearing loss or deafness was confirmed by the auditory brainstem response test (ABR) in the 3 stages of the study or the stage of diagnosis confirmation, while the control group included infants whose diagnosis was not confirmed and normal hearing was confirmed by the auditory brainstem response test (ABR). The study groups were selected in 1:1 ratio.
Results: The perinatal disorders (OR 7.67; 95% CI; 3.61-16.34; p=<0.0001), genetic predisposition (OR 8.45; 95% CI; 1.04-68.46; p=0.045), PCOS (OR 2.85; 95% CI; 1.27-6.41; p=0.011), premature birth (OR 3.90; 95% CI; 1.27-6.41; p=<0.0001), hearing of children with congenital malformations (OR 16.55; 95% CI; 2.15-127.01; p=0.007) reduction and deafness are statistically significant.
Conclusion: The perinatal disorders (OR 5.31), genetic factors (OR 10.01), congenital malformations (OR 2.65), ear disorders (OR 8.94), and premature birth (OR 2.57) are statistically significant factors in the development of hearing loss and deafness in neonates and infants.
6.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.
7.Result the subtypes and effectiveness of functional endoscopic sinus surgery(FESS) using a microdebrider
Batbold B ; Zoljargal A ; Radnaatseren L ; Enkhsumyaa N ; Enkhsaikhan B ; Undrakh E ; Nasantogtokh E ; Bayartsetseg P ; Delgermaa B
Mongolian Journal of Obstetrics, Gynaecology and Pediatrics 2020;28(2):2051-2057
Result the subtypes and effectiveness of functional endoscopic sinus surgery(FESS) using a microdebrider
Introduction: Chronic rhinitis in children has been on the rise in recent years, and polyps account for the majority of benign nasal cancers in children. Surgery is necessary when drug treatment is ineffective. We use pediatric rhinoplasty. Aimed at calculating the subtypes and effectiveness of Functional endoscopic sinus surgery(FESS) using a microdebrider.
Material and methods: The survey was conducted between March and April 2020, based on the Otolaryngology Surgery Department of the National Center for Maternal and Child Health, using the cross-section of analytical design under Objectives 1 and 2 and the longitudinal design under Objective 3. Under Objectives 1 and 2, participants' information was collected from a pre-prepared questionnaire from their medical history. The questionnaire has four chapters that provide general information about the patient, clinical signs, surgical structure, and biopsy results. The pain was assessed by the “Sino-Nasal Outcome Test (SNOT-20)”. A total of 98 patients were included in the statistical analysis of the survey results using the STATA 15.0 program, and the results of the surgery were evaluated by 20 patients.
Results: In children with chronic rhinitis, the SNOT20 test showed a statistically significant difference of 1.6 ± 0.6 before surgery and an average of 0.51 ± 0.11 after surgery.
Conclusion: In chronic rhinitis, FESS with microdebrider surgery is an effective treatment for children.
8.The most frequently used medical raws for the treatment of
Delgermaa E ; Ambaga M ; Khurelchuluun B ; Bolor B ; Bazarragchaa
Mongolian Pharmacy and Pharmacology 2019;15(2):12-15
Background:
Some findings of an artifacts have revealed that nature based the raw have been used for the treatment of mankind's diseases over 60 000 years ago. WHO estimates that about 80 percentage of the world's population are consume the traditional medical care, and uses more than 21,000 plant species for therapeutic purposes. In order to help guide its member countries the World Health Organization (WHO) has developed The WHO Traditional Medicine Strategy 2014-2023. Some of the strategic actions in this document include:
• To develop and share appropriate research methodologies and criteria for evaluating the safety, efficacy, and quality of TM (Traditional Medicine) products;
• To study and explain the disease prevention, health maintenance, the diagnosis and the treatment of the TM disease according to the evidence based scientific studies.
Objectives:
to determine the most frequently used medicinal plants for the treatment of "Rlung" in the TM.
Methods:
The comparison method, the synthesis and analysis method, the induction and deduction method, the listing and sorting method, the inspecting and arrange method, and the methods of documents' drafting were used in this study.
Results:
It is shown that over 80 raw materials of plant, mineral and animal origins has to list within 32 drug recipes which used "Rlung" disease of TM. The first five raw materials from these 80 ingredients have been repeatedly lists zadi - 30, agar (black, white, red agar) -19, arur-19, lish -18, and nin shosh -18 times.
Conclusion
The most frequently used the raw materialin the treatment of "Rlung" diseases is the seeds of Myristica fragrans Houtt. which contains a lot of the saturated acids with membrane-enhancing effects and strong antioxidant substances.
9.СОНСГОЛЫН ХҮНД ХЭЛБЭРИЙН БУУРАЛТТАЙ ХҮНД CONNEXIN 26 ГЕНИЙН МУТАЦИЙГ ТОДОРХОЙЛСОН ТӨСӨЛТ АЖЛЫН ЗАРИМ ҮР ДҮН
Jargalkhuu E ; Chen-Chi Wu ; Delgermaa B ; Zaya M ; Myagmarnaran N ; Chuluun-Erdene Ts ; Khongotzul G
Innovation 2018;12(3):10-14
BACKGROUND. Sensorineural hearing impairment (SNHI) is the most common inherited
sensory defect, affecting about 3 per 1000 children. More than 50% of these patients
have a genetic cause (i.e. hereditary hearing impairment; HHI). Mutations in certain
genes were noted to be extraordinarily popular in the deaf patients across different
populations, making molecular screening feasible for these common deafness genes.
One of the most important characteristics that we have learned concerning hereditary
hearing loss is that common deafness genes and their mutations are usually different
according to the ethnic background. As demonstrated in our previous studies performed
in Taiwanese patients, the mutation spectrums of common deafness genes, such as the
GJB2 gene and the SLC26A4 gene, are different from those in the Caucasian or even
other Asian populations. These findings further underscore the indispensability of the
collection of local data in terms of genetic counseling.
In the collaborative project, we have successfully established a cohort of >100 hearingimpaired
families, and clarified the genetic epidemiology of deafness in the Mongolian
population. We identified several special deafness mutations such as GJB2 c.23+1G>A,
c.559_604dup, and SLC26A4 c.919-2A>G, and our results revealed that Mongolian
patients demonstrate a unique genetic profile in deafness as compared to other
East Asian populations (paper in preparation). Meanwhile, by organizing a seminar at
National Taiwan University Hospital in March 2017, we have transferred crucial concepts
and techniques regarding how to perform genetic testing for deafness to the Mongolian
colleagues. In the future, we plan to strengthen the mutual collaboration by expanding
the clinical cohort and upgrading the genetic examination platform using the NGS
techniques.
10.ДУНГИЙН СУУЛГАЦ МЭС ЗАСЛЫН ДАРААХ СОНСГОЛ ХЭЛ ЯРИА ЗАСЛЫН ЭМЧИЛГЭЭНИЙ ҮР ДҮНГИЙН ЯВЦ
Oyun G ; Saruul Ch ; Ariuntuya D ; Delgermaa B ; Arivjih O ; Radnaatseren L
Innovation 2018;12(3):15-17
BACKGROUND. Over 5% of the world’s population or 466 million people have disabling
hearing loss (432 million adults and 34 million children). Profound sensorineural hearing
loss and deafness can be treated successfully with a cochlear implant. A cochlear
implant (CI) stimulates the auditory nerve, bypassing the defective cochlea, and
provides auditory information to the developing brain, thus improving oral language.
Children, who receive an early diagnosis of deafness and proper speech rehabilitation,
and undergo early cochlear implantation, are able to develop auditory and linguistic
skills at par with their hearing peers.
METHOD. 6 deaf patients who underwent unilateral Cochlear Implantation at the
NCMCH from January 2017 to June 2018 were included in the study. Participants were
divided into 3 groups on the basis of age at which participants underwent implantation.
RESULTS. Pre-op average MAIS was 1,6/40, Category of Auditory Performance (CAP)
- 0,77 and SIR - 0,7/5 in all implanted age groups. Score increased over time to attain
average score MAIS -29.6/40, CAP- 3.3/7 SIR-2.7/5 in all implanted groups at one year
after implantation.
CONCLUSION. There is a need for more research on patient age and gender
composition, and outcomes of cochlear implantation and hearing devices in this
study population. A robust set of study measures would provide statistical significance.
Parent-child relationships affect hearing and speech therapy results, so there’s a need
to improve parents’ knowledge regarding these therapies.
Result Analysis
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