1.Prediction of possible brain death donors among patients who died due to spontaneous intracerebral hemorrhage (Using the Third State Central Hospital as an example)
Duuriimaa S ; Uurtsaikh G ; Nandinbayar M ; Gansuvd O ; Lkhamtsoo N
Mongolian Journal of Health Sciences 2026;91(1):134-138
Background:
The rate of brain death organ donation is continuously increasing worldwide. Intracerebral hemorrhage (ICH) is the leading cause of brain death and accounts for 30-68% of organ transplant cases.
Aim:
To identify the predictors of brain death (BD) upon admission to the intensive care unit (ICU) of comatose patients with spontaneous intracerebral hemorrhage (ICH).
Materials and Methods:
A prospective observational study was conducted on ICH deaths in the Stroke Department of Third State Central Hospital from January 1 to December 31, 2018, and statistical analysis was performed using SPSS 22.0. Approval for the study was obtained from the Research Council of the Third State Central Hospital.
Result:
The study included 138 (13.1%) inpatient stroke deaths in the Stroke Unit, of which 90 were ICH, 30 subarachnoid hemorrhage, and 18 ischemic strokes (p=0.006). Considering the age limit of up to 70 years, which is the criterion for brain-dead donors in Mongolia, out of the 42 ICH cases, 24 (57.1%) were male, and 18 (42.9%) were female (p=0.326). The mean age of these cases was 52.88±7.34, the mean GCS score at the time of hospitalization was 4.55±2.56, the mean NIHSS score was 31.5±7.81, and the mean volume of hematoma formed in 30 cases was 175.92±169.96 cm3 (each p<0.05). Mechanical ventilation durations occurred mostly in the first 0-2 hours and 2-6 hours (31% each), with the longest duration at 6-12 hours.
Conclusion
Patients with ICH who present with poor mental status on hospital admission (GCS<7), severe stroke on clinical assessment (NIHSS>32), extensive cerebral hemorrhage on computed tomography (CT) imaging, and early requirement for mechanical ventilation have a high likelihood of progression to brain death. These patients therefore represent a significant potential pool of organ donors.
2.Cerebral malaria: rare case
Duuriimaa S ; Orkhontuul O ; Narangerel D ; Lkhagvasuren D ; Lkhamtsoo N
Mongolian Journal of Health Sciences 2025;90(6):229-236
Background:
Malaria is caused by parasite of the genus Plasmodium and considered one of the biggest public health
issues because almost half of the world’s population is at risk of contracting malaria. It causes 2% of the world’s total
deaths and millions of clinical infections. In 2022, 94% of cases and 95% of deaths occurred in the WHO African Region.
Cerebral malaria the most severe neurological complication of infection with Plasmodium falciparum malaria. It is a
clinical syndrome characterized by coma and asexual forms of the parasite on peripheral blood smears. The neurological
complication, induced by cerebral malaria is irreversible and lethal, therefore it is of great significance to unravel its exact
etiology, which may be beneficial for the effective management of this severe disease.
In Mongolia, malaria normally not present unless the disease was contracted abroad. Considerable attention in malaria
control and elimination is needed, yet, increasingly, domestic hospitals are unfamiliar with it, and so there is a risk of
being overlooked. The following is the second case, to our knowledge, of cerebral malaria in Mongolia.
Conclusion
Although Mongolia is not a malaria-endemic region and routine malaria testing is not commonly performed,
the number of imported cases is increasing due to the growing mobility of the population—travel, study, tourism, and
peacekeeping missions to Africa and Southeast Asia. Therefore, neurologists should be aware of the possibility of cerebral
malaria when evaluating patients with neurological deficits who have a history of travel to malaria-endemic areas. This
case highlights important clinical, imaging, and laboratory considerations for suspecting and diagnosing malaria in such
patients.
3.Some aspects of chronotype and sleep quality in shift nurses
Khulan D ; Basbish Ts ; Duuriimaa S
Mongolian Medical Sciences 2024;208(2):21-29
Introduction:
5-10% of shift workers experience severe shift insomnia and sleepiness. A nurse specialist stays by
the client's side 24 hours a day, assesses and monitors their physical condition, and provides nursing
care. In a comparative study on the work activity among shift nurses, night shift nurses were less
active (40%) and more fatigued (53.3%) than day shift nurses.
An aspects of chronotype and sleep quality in shift nurses does not established in Mongolia and the
data is very rare, and we aimed to conduct this study.
Goal:
To study shift schedule, sleep quality and individual chronotype of shift nurses.
Materials and Methods:
This study is a cross-sectional study. The survey was completed between July 1, 2023 and December
31, 2023, and included a total of 117 nurses who met the inclusion and exclusion criteria of the BZDGH,
SKDGH, and KUDGH research. In collecting research data, the questionnaires "Insomnia Severity
Index", which is a commonly used international standard questionnaire for assessing insomnia, The
Munich Chrono Type Questionnaire for assessing individual chronotype, and "Karolinska Sleepiness
Scale" were used.
The ethical approval:
The ethical approval for the study was obtained by a decision of the Ach Medical University-Ethical
Committee on Research on June 30, 2023 (2023/02/05).
Statistical analysis :
Results were calculated using SPSS - 21.0 v program by a descriptive statistic, and the Pearson
correlation analysis.
Results :
The average score of the Insomnia Severity Index (ISI) was 12.60±6.38, which is the sub threshold
for clinical insomnia. But the average Karolinska Sleepiness Scale (KSS) score for sleepiness is
4.41±2.50, or moderate alertness during the shift. Workday sleep-wake pattern and non-workday
sleep-wake pattern are correlated (r=0.44, p=0.001). Also, individual chronotype is correlated with
chronotype of non-working days (r=0.23, p=0.02).
Conclusions
Nurses' sleep quality levels were pre-clinical insomnia and moderate alertness during shifts for sleepiness.
Working and non-working day sleep-wake patterns are different, chronotype is medium early type. The
sleep-wake pattern of weekdays and the sleep-wake pattern of non-workdays are related to each other.
The chronotype of the individual is related to the chronotype of non-working days.
4. Determining attitude toward profession of nursing students
Innovation 2015;9(2):40-42
Nursing is the largest group of health system, possessing considerable potential power that could be influential on the quality of health care services system. One of the important aspects of the development of nursing education and promotion of nursing strategies is a positive attitudeof nursing students. The present study was determine the attitude and perception toward the nursing profession.A cross-sectional study design was used. 496 nursing students from School of Nursing, HSUM,Ach, Etugen, Nursing Faculty, Ulaanbaatar university and Enerel medical institute were involved in this study using a nursing professional attitude and perception questionnaire. 5,65% of participating 496 nursing students were (n=28) male, and 94,35% (n=468) were female. 64% (n=316) of them studies for a bachelor degree, and 36% (180) for a diploma in nursing. Most of them or 85,28 % students have evaluated this profession is the most responsibility. And72,58% of them think after graduating will be that very satisfied. 86,09 % nursing students think that is very pleasure profession for helping patients. In generally these results had showed that most students had positive attitude toward their profession but we have revealed that 40,9% (203) of nursing students wanted to change theirfield.
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