1.Prevalence of Micronutrient Deficiencies Among Mongolian Pregnant Women
Oyundelger D ; Bolormaa N ; Munkhjargal L ; Munkhtamir M ; Davaasuren M ; Amarsanaa B ; Delgermaa D ; Ganzorig T ; Munkhtsetseg P ; Bayasgalan J
Mongolian Medical Sciences 2025;214(4):24-31
Background:
Vulnerable populations at risk of micronutrient deficiencies include children and women,
especially pregnant women, lactating mothers, infants and young children. According to
WHO guidelines, a population with a micronutrient (vitamin and mineral) deficiency of more
than 20% is considered a public health problem.
Although Mongolia has made significant progress in improving the nutritional status of the
population, especially children and women, the 2024 VI survey found that micronutrient
deficiencies are high among pregnant women.
The MMS (Multi-ingredient Micronutrient Supplement) distributed to pregnant women by
soum and household health centers contains all the essential vitamins and minerals for
pregnant women, but coverage has remained inadequate for more than 10 years.
Goal:
To establish the prevalence of micronutrients deficiency in pregnant women
Materials and Methods:
Totally 2796 pregnant women included in cross-sectional study from urban and rural
area. Survey procedures consisted of interview, anthropometric measurements, clinical
examinations, and the collection of biological (blood and urine) samples for pregnant
women. Micronutrient deficiencies were assessed by tests for hemoglobin, serum, ferritin,
soluble transferrin receptor (sTfR), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for
determination of urinary iodine concentration.
Statistical processing :
The data from the survey questionnaires were entered into a database created in the
“EpiData 3.1” software environment. The data created and verified in the EpiData software
environment were converted to the “SPSS–25” program, and statistical analysis was also performed using the SPSS-25 program. The results table was prepared using Microsoft
Word 2021 and Microsoft Excel 2021 programs.
Research ethics:
The research methodology was discussed at the meeting of the Medical Ethics Review
Committee under the Ministry of Health on 2023.03.27 (23/017), and permission to conduct
the study was obtained
Result :
The prevalence of anemia, as measured by hemoglobin, was 22.3% and the iron deficiency
anemia (IDA), as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR)
was (39.8%/9.0%). Prevalence of iron deficiency as measured by serum ferritin was also
highest in Western 41.9% and lowest in Khangai region 40.2% (P<0.01). The prevalence of
vitamin D deficiency among pregnant women was high at 92.5%, and 7.5% of all pregnant
women had adequate vitamin D status. The median concentration of 76.4µg/l indicates
inadequate iodine status in pregnant women, as the desired range for adequate iodine
nutrition in pregnancy 150-249 µg/l.
Conclusions
1. 22.3 percent of pregnant women are anemic, and the prevalence of anemia has not
decreased from 2017 levels and remains common.
2. The prevalence of iron deficiency (as measured by ferritin levels) was 39.8 μg/L and the
soluble transferrin receptor level was 9.0 μg/L, which is higher than previous studies.
3. The prevalence of vitamin D deficiency among pregnant women remains common, with
76.6% having severe or moderate deficiency, and 15.9% having mild deficiency.
2.Quality of life and caregiver burden in caregivers of patients with cancer
Innovation 2020;14(2):22-26
Background:
The World Health Organization (WHO) estimates that the number of cancerrelated deaths will increase by 45 percent between 2008 and 2030. Following this estimate, many projects and programs have been implemented to improve cancer prevention, diagnosis, and treatment, but the number of new cancer cases and deaths is increasing worldwide. In 2018, 6073 new cancer cases were registered in Mongolia.2 As of 2018, there are 19,427 cancer patients under the supervision of aimag and district oncologists. In our country, 78.8 percent of all cancers are diagnosed in stage 3.4 and are transferred to palliative care. However, in our country, there is a lack of research on the family, caregiver burden and quality of life of patients receiving palliative care. Therefore, we aimed to assess the caregivers of burden and quality of life of family of cancer patients in this study.
Methods:
The survey was conducted between November 2017 and December 2018 using an
analytical instantaneous model. The survey data were collected from caregivers of cancer
patients at the National Cancer Center, Ulaanbaatar District Health Center, Green Ger, and
Iveel Hospice. Quality of life was assessed using the WHO WHOQOL-BREF method. The caregiver
burden of cancer patients receiving palliative care was assessed using the Caregiver burden
inventory international standard questionnaire.
Results:
The study involved 180 caregivers aged 20 to 72 years. 82.8 percent of the total guardians
are women and 17.2 percent are men. The quality of life of the caregivers surveyed was 65.0
percent. In terms of the quality of life of caregivers, the environment is 59.9 percent, social
relations 69.2 percent, psychological 70.8 percent, and physical 64.0 percent. The quality of
life of caregivers was rated 69.8 percent for men and 64.0 percent for women, or relatively low
for women. A statistically significant indicator is that the quality of life of caregivers decreases
as patients spend more time per day (p = 0.013). The average workload score for caregivers is
32.97±11.8 for men and 40.53±14.9 for women, which is a statistically significant difference. The
inverse relationship between caregiver quality of life and workload is a statistically significant
indicator. / r = - 0.61 /.
Conclusions
The quality of life of caregivers participating in the study decreased. In addition,
91.7 percent have a caregiver burden level of 2 and more, which indicates that the caregivers
of cancer patients are overworked. According to the results of the linear regression analysis, the
quality of life decreases by 0.56 units when the caregiver’s workload increases by 1 unit.
3. Clinical and pathological analysis of rejection cases after kidney transplantation
Enkhtamir E ; Galtsog L ; Ulzii-Orshikh N ; Bayambadash B ; Munkhjargal B ; Od-Erdene L ; Uranchimeg B ; Saruultuvshin A ; Chimidtseren S ; Tsogtsaikhan S ; Batbaatar G ; Munkhzol M
Innovation 2016;10(2):48-51
Kidney transplantation is the best alternative treatment for end-stage renal disease and health-related quality of life and survival of the patients are improved compared with dialysis. Worldwide, more than 1.4 million patients with CKD receive renal replacement therapy with incidence growing by approximately 8% annually.1 Unfortunately, despite significant improvement in graft function, kidney transplants can still fail due to acute rejection and chronic allograft nephropathy.2 Kidney biopsy after transplantation, which has evaluated by Banff 09 classification is usefull method for diagnose of transplanted kidney disease.3,4Kidney graft rejection was diagnosed in 10 renal allograft biopsy specimens (bs) obtained from transplant patients followed up at our institute between 2015 and 2016. All specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgA, IgM, IgG and complement component (C3, C4, C1q, C4d). All the renal biopsies were examined by the same pathologist.Out of 117 transplantations, 10 episodes of rejection selected. Among the 10 patients, 30% had an acute T cell rejection and 70% had a chronic allograft nephropathy. Interstitial inflammation (i1-7) was present in 7 bs (70%), tubulitis (t1-4,t2-2) in 6 bs (60%), transplant glomerulitis (g1-1, g2-2, g3-1) in 4 bs (40%), transplant interstitial fibrosis (ci1-2, ci2-2, ci3-2) in 6 bs (60%), tubular atrophy (ct1-6, ct2-2, ct3-1) in 9 bs (90%), mesangial matrix increase (mm1-5) in 5 bs (50%), vascular fibrosis intimal thickeness (cv1-3) in 3 bs (30%), arteriolar hyaline thickening (ah1-5) in 5 bs (50%), tubulitis (ti1-6, ti2-3, ti3-1) in 10 bs (100%) and peritubular capillaritis (ptc1-1, ptc2-2, ptc3-1) in 4 bs (40%). C4d deposition was present very mild in wall of the vessels and peritubular capillaries. Because of not good working Methenamin silver stain, we couldn’t demostrate glomerular basement membrane changes (cg) fully.We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis. C4d deposition in the wall of the vessels and peritubular capillaritis is not always present in biopsy specimens of transplant glomerulopathy.
Result Analysis
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