1.Diagnostic yield and safety of CT-guided transthoracic core needle biopsy for mediastinal lesions (A 10-year single-center cohort study)
Tuvshinbayar J ; ; Enkhsaruul L ; Gonchigsuren D ; Baasanjav N ; Ichinnorov D ;
Mongolian Journal of Health Sciences 2026;97(7):76-82
Background:
Mediastinal lesions encompass a broad spectrum of malignant and benign conditions, and histopathological confirmation is often required to guide appropriate management. Computed tomography (CT)-guided transthoracic core needle biopsy (CNB) is a less invasive alternative to surgical biopsy; however, data on its diagnostic performance and safety in Mongolia remain limited.
Aim:
To evaluate the diagnostic yield and safety of CT-guided transthoracic CNB for mediastinal lesions and to identify factors associated with diagnostic outcomes and procedure-related complications.
Materials and Methods:
This retrospective–prospective observational cohort study included 58 CT-guided transthoracic CNB procedures performed in 55 patients with mediastinal lesions. CT characteristics, histopathological diagnoses, procedural variables, and complications were analyzed. Fisher’s exact test, Pearson’s χ² test with Monte Carlo simulation, and the Mann–Whitney U test were applied, with Holm adjustment for multiple comparisons.
Results:
The median age was 57 years [IQR, 46–67], and 63.6% of patients were male. Malignancy was confirmed in 76.4%, while 21.8% had non-malignant disease. A specific diagnosis was established in 54 of 58 procedures, yielding a diagnostic yield of 93.1% (95% CI, 83.6–97.3%). CT lesion composition, internal characteristics, and mediastinal location were not significantly associated with diagnostic category (all p>0.05). The overall complication rate was 6.9%, with CIRSE grade ≥3 complications occurring in 1.7%. All complications occurred when the needle-path depth exceeded 7 cm, an association that remained significant after Holm adjustment (adjusted p=0.007).
Conclusion
CT-guided transthoracic core needle biopsy is a highly effective diagnostic procedure with a favorable safety profile for mediastinal lesions. A needle-path depth >7 cm may indicate increased procedural risk and warrants validation in larger studies.
2.The prevalence of overweight and obesity among men aged 15-49 in Mongolia
Tuvshinbayar B ; Ganzorig T ; Oyundelger D ; Delgermaa D ; Bayasgalan J
Mongolian Medical Sciences 2025;214(4):32-37
Background:
Men’s health is a vulnerable associated with higher risk behaviors and is less considered
to their health compared to women. According to NSO, of the total population, 49.3 percent
were males and 50.7 percent were females in Mongolia. There is a difference in average
life expectancy between man and woman, and males live in average eight years (9.2) fewer
compared to females.
Objective:
To determine nutrition status among men aged 15-49 in Mongolia
Materials and Methods:
The target population was divided into 5 strata based on Mongolia’s socio-economic regions
and Ulaanbaatar City. 1950 men aged 15-49 were randomly selected. The confidence
interval was set at 95%, with a precision of ±5% or less for all indicators. The sample size
was sufficient to obtain representative data on the nutrition status of men at the national level
and to calculated using WHO recommendation for adults.
Ethics consideration:
The survey methodology was discussed at the Scientific committee
of National Center for Public Health, on February 6, 2023. Ethics approval was obtained
from Medical Ethics Review Committee under the Ministry of Health on March 27, 2023. All
participants were participated voluntarily and written informed consent were obtained from
participants.
Results:
The prevalence of overweight and obesity among men was 57.4%, with 17.0% classified as
obese. Overweight and obesity rates were highest in men aged 30-39 years (62.2%) and 40
49 years (64.5%) among other age groups.
Conclusion
In Mongolia, the prevalence of overweight and obesity among men aged 15–49
increased by 9.4 percentage point to reach 57.4%, since 2017 and 17.0% of men aged
15-49 years are now classified as obese, with biggest increase in age group 20-29. The
prevalence of obesity was higher among men in the above-average and affluent groups
(20.0% and 20.6%) compared to men aged 15-49 living in the average and below-average
income groups (10.8% and 13.1%).
Conclusion: In Mongolia, one in two men age between 15-49 years were overweight and obese. The
prevalence of overweight and obesity has increase age between 30-49 years compared with
other groups.
3.Вenefits of vitamins, macro, and microelements to support the immune system during the corona virus (COVID-19)
Oyundelger D ; Bayasgalan J ; Tuvshinbayar B ; Tserenlkham B ; Erdenetsogt E
Mongolian Medical Sciences 2021;195(1):80-89
Nutrition is a key factor in the normal functioning of the immune system, and malnutrition is one of
the most common causes of immunodeficiency worldwide today. However, the public health policies
on immune system and infection lacks the nutritional strategy to ensure the optimal functioning of
the immune system Loss of cellular immunity, phagocyte function, blood protein complex, cytokine
synthesis, and A-immunoglobulin secretion are generally associated with protein-energy deficiency.
Some vitamins and minerals, such as A, B6, B12, C, D, E, folic acid, zinc, iron, selenium, magnesium,
and copper, plays an important role in the immune system function. Deficiency or low levels of
micronutrients can negatively affect the immune system and reduce the ability to fight infections.
4.Unhealthy food consumption and prevalence of overweight and obesity of school children aged 6-11 years old
Bolormaa N ; Tuul B ; Batjargal J ; Enkhtungalag B ; Bayasgalan J ; Oyundelger D ; Tuvshinbayar B ; Davaasuren M ; Ganbolor D
Mongolian Medical Sciences 2020;194(4):38-45
Background :
Overweight and obesity are conditions of over nutrition resulting from consumption of more calories
than the body requires leading to excess body fat accumulation. The prevalence of both overweight
and obesity is increasing globally in all age groups in high, middle, and low-income countries and is
largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and
inexpensive, low-nutrient unhealthy foods high in energy [1].
The move away from traditional to “junk” foods often occurs at the same time as the move of populations
away from daily physical activity and increase in sedentary activities such as time spent in front of a
phone, computer, or television, furthering increasing the risk of becoming overweight. People who
are overweight or obese are at higher risk for serious health problems including hypertension, heart
disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity
is accompanied by a dramatic increase in prevalence of above mentioned chronic conditions in the
worldwide. While the long-term repercussions of overweight and obesity are severe, they are largely
preventable and treatable through healthy diets and healthy lifestyle behaviors [2].
Materials and Methods:
The fifth National nutrition survey (NNSV) was implemented in 21 provinces (aimags) in 4 socio-economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given
the regional differences in dietary patterns and nutrition status, target populations were stratified into
5 strata based on 4 regions and Ulaanbaatar with equal samples drawn from each stratum using a
cluster-randomized sampling design. In total, 1750 school children data on demographic and dietary
information collected by interview methods and anthropometric measurement results were used in
this study.
Ethical considerations:
The survey protocol was discussed at the Scientific Committee of the Public Health Institute (recently
named by National Center for Public Health) and granted by order of director of Scientific committee
of PHI on 28th June, 2016. Ethical approval for conducting the NNS V was obtained from the Medical
Ethics Committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey
was voluntary, oral and written informed consent were obtained from adult caregivers of each children.
Results:
Consumption of unhealthy or junk (high-calorie, low-nutrient) foods in the past week was nearly
universal (99.0%) among school children 6-11 years of age. Over half of children (51.4%) consumed
junk foods at least once per week and 45.7% consumed junk foods a few times a week. Consumption
of sugar-sweetened beverages was high with 80.9% of children consuming these at least once in the
past week. Overall consumption of fried foods was lower than consumption of junk foods or sugar-sweetened beverages with 22.7% of children not consuming any fried foods in the past week and only
8.5% of children consuming fried foods a few times per week. Consumption of sweet foods was high
with nearly all children having consumed sweet foods in the past week, 45.9% of children 6-11 years
having consumed sweet foods a few times per week.
The prevalence of overweight (BMI > +1 SD) was 22.2% and prevalence of obesity (BMI > +2 SD)
was 6.4%. Overweight prevalence was higher in boys (26.6%) compared to girls (17.8%) and in
urban (23.9%) compared to rural (17.6%) areas with the highest prevalence in Ulaanbaatar (25.6%)
compared to other regions. Children 6 years old (26.1%) and 7 years old (25.6%) had a higher
prevalence of overweight than older children.
Conclusion
1. Consumption of unhealthy foods and drinks is common to 6-11 year olds group, with almost all
children (99.2%) consuming any type of unhealthy foods and drinks at least once per week, in
particular, 8 out of 10 children were found consuming sugary drinks and/or deep fried food.
2. The consumption of unhealthy foods was not differing by child’s sex, there were revealed
significant differences between living area and regions. Proportion of the school children 6-11
years of age was relatively higher in Ulaanbaatar city and urban settings.
3. The prevalence of overweight and obesity in school children aged 6-11years sharply increased
from 2010 NNS IV level and reached 22.2% and 6.4%, respectively. Among children with obesity
consumption of any unhealthy foods and sugary drinks were 1.4–1.9 times higher than nonobese children, respectively.
5.Prevalence of micronutrients deficiency and micronutrient intake in pregnant women
Oyundelger D ; Bolormaa N ; Bayasgalan J ; Tuvshinbayar B ; Tserenlkham B ; Batjargal J
Mongolian Medical Sciences 2019;188(2):24-28
Background:
In order to study and evaluate the nutrition situation of the Mongolian people. The 2016-2017 NNS V
includes 5 different age groups from Mongolian’s four economic development regions and Ulaanbaatar.
The NNS V survey quantifies the prevalence of the nutrition conditions that are of greatest concern to the
population, particularly young children and pregnant women.
Goal:
To establish the prevalence of micronutrients deficiency and estimate micronutrient intake in pregnant
women
Materials and Methods:
Totally 2220 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), retinol-binding protein (RBP), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for determination of urinary iodine concentration.
Result:
The prevalence of anemia, as measured by hemoglobin, was 21.4% and the iron deficiency anemia
(IDA) was 10.5%, as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR) was 29.6%.
Prevalence of iron deficiency as measured by serum ferritin was also highest in Western 35.1% and lowest in Eastern region 21.5% (P<0.01). The prevalence of vitamin D in pregnant women was high with 75.4% and 4.4% of all pregnant women had sufficient vitamin D status. An additional 20.2% of pregnant women having insufficient levels. The median concentration of 120.5µg/l indicates inadequate iodine status in pregnant women, as the desired range for adequate iodine nutrition in pregnancy 150-249 µg/l.
Conclusion
1. One in every 5 pregnant women (21.4%) is anemic.
2. Vitamin D intake among pregnant women (7.3%) is very low, with 75.4% having vitamin D deficiency and vitamin D insufficiency –by 20.2%.
3. Median urinary iodine concentration of pregnant women is 120.2mg/l, considerably lower than WHO recommended reference range, indicating pregnant women are at risk of iodine deficiency.
4. Despite visible growth in vitamin and mineral supplements intake by pregnant women, compared to 2010, the infrequency of intake and failure to consume recommended number of supplements as
instructed in the relevant guides persist.
6. THE TREATMENT OUTCOME OF HEPATOCELLULAR CANCER
Gan-Erdene B ; Chinburen J ; Narmandakh TS ; Altanchimeg N ; Onon B ; Sanchin U ; Bilguun G ; Ankhbayar E ; Tuvshinbayar M
Journal of Surgery 2016;19(1):37-40
Introduction: Hepatocellular carcinoma(HCC) is the 6th most common cancer inthe world, but the first most commoncause of cancer death in Mongolia. Thereis no universally accepted consensuspractice guidelines for HCC owing to rapiddevelopments in new treatment modalities,the heterogeneous epidemiology and clinicalpresentation of HCC worldwide.Methods and Materials: This study wasconducted in the department of generalsurgery of Second Central Hospital ofMongolia between 2015 and 2016 on a totalof 36 patients with hepatocellular carcinoma.Results: The average of operationtime is a 132.2 min, the hospital stay 18.2days. Postoperative bleeding was 2.7% (1),encephalopathy 5.4% (2), wound infection5.4% (2), and incisional hernia 8.1% (3).There were not bile leak during 30 dayspostoperative day.Conclusion: Postoperative complicationis a comparable to different researcher.There were no death within first month.
7.Comparative study of the average level of serum selenium in adult mongolians by geographic regions
Oyundelger D ; Bolormaa N ; Enkhtungalag B ; Batjargal J ; Tuvshinbayar B ; Nyamragchaa CH ; Tserenlkham B ; Tserenchimed S
Mongolian Medical Sciences 2015;174(4):7-11
Background: Disorders in the human body due to selenium defi ciency are associated with geographiclocation or environment, especially selenium concentrations in water and in soil. Selenium concentrationsin the blood of populations around the world, varies greatly. To date, no research has been conducted onaverage serum selenium level of adult Mongolians.Goal. To conduct a comparative study on the average serum selenium level of adult Mongolians bygeographic regions.Materials and Methods. In this study were participated 2339 healthy subjects randomly selectedfrom sampling units based on 4 geographical regions of Mongolia. For the study were used thequestionnaire and biochemical methods. Blood samples were collected from all subjects and serumselenium concentration was measured by the thermo fi sher scientifi c analyzer using atomic absorptionspectrophotometer method.Result: The mean serum selenium level in adult Mongolians was 0.78 μmol/l. A comparative analysisshowed a statistically signifi cant difference (ð<0.0001) in the mean serum selenium level of adultMongolians living in different geographic regions. In particular, the mean serum selenium level ofadult Mongolians was 0.85 μmol/l in the Altai Mountain, 0.57 μmol/l in Khangai mountain, 1.0 μmol/l inGobi, 0.71 μmol/l in Dornod steppe regions and thus indicator was 0.75 μmol/l among adult citizens ofUlaanbaatar. Majority of residents living in Khangai mountain and Dornod steppe regions were at a riskof selenium defi ciency.Conclusions:1. Comparative analysis of the average serum selenium level of adult Mongolians by region showedthat the Gobi region has highest (1.0 μìîë/ë) and Khangai region has the lowest (0.57 μìîë/ë).2. Study fi ndings showed that 7 – 8 individuals out of 10 residents of Dornod steppe and Khangairegions were at the risk of selenium defi ciency.
8.Food consumption and dietary behaviors of secondary schoolchildren
Enkhmyagmar D ; Tuvshinbayar B ; Nyamragchaa CH ; Oyundelger D ; Batjargal J ; Tserenlkham B
Mongolian Medical Sciences 2015;174(4):30-35
Introduction. Population life expectancy and health status are directly related to adolescent health,as many chronic disease conditions are affi liated with adolescence. The Mongolia GSHS, 2010 wasstudied dietary behavior and some risk factors belong to non communicable diseases of secondaryschoolchildren among surveyed children. Overall, 5.5% of students have eating habits that are healthybased on the WHO recommendations developed form the Mongolian Ministry of Health. One in sixstudents (15.9%) ate fruits and vegetable fi ve or more times per day. 27.3% of students consumeddairy products valuable for childhood growth two or more times per day. More than one in four students(27.6%) drank carbonated beverages and soft drinks one or more times per day.Findings of this survey show that attention is needed into adolescence and period of young children toprevent and decrease NCD and thus this was a background of our study.Goal. Determine schoolchildren’s food consumption and dietary behavior.Material and Methods. The 2013 Mongolia GSHS employed a two-stage cluster sample designto produce is preventative sample of students in grades 7-12. In total, 60 schools (25 schools fromUlaanbaatar city and 35 rural, respectively) and 203 classes were selected to participate in the MongolianGSHS.School level: The fi rst-stage sampling frame consisted of all schools (urban, rural, public, or private)containing any grades 7-12. Schools were selected systematically with probability proportional to schoolenrollment size.Class level: The second-stage sampling frame consisted of randomly selecting intact classrooms(using a random start) from each school to participate. All relevant classes in each selected school wereincluded in the sampling frame. All students in the sampled classrooms were eligible to participate in theGSHS (2013).“Nationwide health survey based on schools in Mongolia 2013” covered 5393 schoolchildren (age 12-18) from 59 public and private schools. Coverage rate was 89% and total response rate was 88%.Result. According to the WHO recommendations, 18.6 percent (95%CI 17.2-20.1) of students consumedfruits and vegetables fi ve or more times per day. Additionally, consumption of fruits and vegetablesdecreases as age and grade increase.Totally, 31.3 percent (95%CI 29.3-33.3) of students consumed dairy products such as milk, yogurt andcheese two or more times per day in the past month. In addition, 33.0% (95%CI 30.5-35.5) of malestudents eat dairy products compared to 29.5% of female students; that is males consume 3.5% morefruits and vegetables; however there is no statistical difference. On the other hand, 43.4 percent ofchildren aged 12 years or younger consumed dairy products, 32.9 percent of children aged 13 to 15years old and 24.8 percent of children aged 16 years old or older consume dairy products; thus, showinga decreasing trend with age.One of three (33.6%) of students drank carbonated beverages one or more times per day during the pastmonth. Consumption of carbonated beverages differed between males and females (37.6% vs. 29.7%)and increased by age. By age group, high consumption of carbonated and soft drinks was observedamong students aged 16 years old or older (34.4-35.2 percent), while 33.8 percent of children aged13-15 years old, and 29.4 percent of students 12 years old or younger consumed carbonated and softdrinks.Amongst all students, 55.3 percent (95%CI 52.0-69.3) ate breakfast “usually or always”, 26.1 percentate breakfast “sometimes”, and 13.7 percent ate breakfast “rarely or never”. About 1.9% of studentswent hungry to school “usually or always” during the past one month because of insuffi cient food in theirhome.Among participated school children, 26.4 percent (95%CI 21.5-31.9) of students ate fast food three ormore times within the last seven days at restaurants such as Max Burger, Mondonald and their schoolcafeteria. Percentage of students that ate regularly at fast food restaurants or school canteens wasincreased by 8% than the indicator of the previous survey result.Conclusion1. Fruits and Vegetables: One in fi ve students consumed fruits and vegetables in accordance withthe dietary guidelines for healthy eating and this indicator are increased by 2.7% compared to theprevious study.2. Dairy products: Consumption of dairy products is increased by 4% compared to the previous study;however, it is decreased with age.3. Carbonated Beverages: Consumption of carbonated beverages by students was at similar level inboth, urban and rural areas, and it is increased by 6 points from the previous study level, especiallyhigher consumption was observed among male students.4. Fast Food: Percentage of students that ate regularly at fast food restaurants or school canteens wasincreased by 8% than the indicator of the previous survey result.
9.Age and gender comparative study on the average serum selenium level of adult mongolians
Bolormaa N ; Batjargal J ; Ouyundelger D ; Erdenetsogt E ; Enkhtungalag E ; Tserenlkham B ; Tuvshinbayar B ; Tserenchimed S ; Namsrai M
Mongolian Medical Sciences 2014;170(4):5-9
IntroductionThe trace elements selenium is a constituent of the antioxidant enzyme glutathione peroxidase. Becauseit boosts the body’s antioxidant capacity, selenium is thought to have some ability to control cell damagethat may lead to cancer. Selenium low status has been linked to increased risk of various diseases, suchas cancer and heart disease.GoalInvestigate serum selenium level of adult mongolians and conduct age and gender coparartive analysisof the serum selenium content.Materials and MethodsCross sectional study was performed among the 2339 apparently healthy Mongolians of both gendersaged ≥18 years. In the study were used questionnaire and biochemical methods. Blood samples werecollected from all subjects and serum selenium concentration was measured by atomic absorptionspectrophotometry method using thermo fisher scientific analyzer.ResultsThe mean and confidence interval of serum selenium level in adult Mongolians was 0.78 μmol/l (95%CI0.77-0.79) and there was no significant difference between genders. Thus the mean was 0.77 μmol/l(95%CI 0.76-0.80) among women and in men it was 0.78 μmol/l (95%CI 0.76-0.80). Data analysisrevealed that older age group individuals were at risk of lowered serum selenium level. In particular,the oldest age group of over 60 years (females: 0.74 μmol/l, 95%CI 0.70-0.77; males: 0.68 μmol/l,95%CI 0.64-0.71). The difference in selenium status between age groups was statistically significant inboth sexes. The overall prevalence of serum selenium concentrations indicative risk of deficiency was59.7%, with no significant differences in the prevalence by genders. Survey findings revealed that riskof selenium deficiency had statistically significant difference between age groups among the surveyedmen.Conclusion: The mean value of serum selenium in adult Mongolians was 0.78 μmol/l and there was nosignificant difference between genders.
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