1. Fall Risk Assessment Among Residents of Ulaanbaatar
Bolor-Erdene M ; Amarsaikhan D ; Amarsaikhan L ; Borte E ; Myadagmaa J
Mongolian Journal of Health Sciences 2025;88(4):71-74
Background:
Globally, approximately 684,000 deaths occur annually due to falls. In Mongolia, 47 individual aged
between 45 and 85 have died as a result of falls. Therefore, there is a pressing need to assess fall risks among the general
population in Mongolia and identify risk factors to prevent accidents and injuries.
Aim:
To assess the risk of falls among individuals aged 45 years and older who are receiving care at tertiary-level referral
hospitals in Ulaanbaatar, Mongolia.
Materials and Methods:
A cross-sectional study was conducted involving 408 participants aged 45 years and above who
were attending tertiary-level hospitals in Ulaanbaatar. Fall risk was assessed using the internationally recognized Falls
Risk Assessment Tool (FRAT) questionnaire. Data were analyzed using SPSS version 26.0.
Results:
The mean age of the participants was 59.24±6.54 years; 40% were male and 60% were female. Among the
participants, 45.3% (n=185) were categorized as low risk, 33.6% (n=137) as moderate risk, and 21.1% (n=86) as high risk
for falls. Logistic regression analysis was performed to identify significant risk factors associated with falls. Key factors
included: slippery shoe soles (OR=0.226, 95% CI: 0.119–0.428, p=0.001), performing unexpected hazardous movements
while changing positions (OR=0.262, 95% CI: 0.143–0.480, p=0.001), use of assistive walking devices (OR=0.209, 95%
CI: 0.110–0.397, p=0.001), anxiety or unstable mental status (OR=0.276, 95% CI: 0.148–0.514, p=0.001), tendency
to resist instructions or behave stubbornly (OR=0.330, 95% CI: 0.183–0.596, p=0.001), difficulty in recognizing the
surrounding environment (OR=0.354, 95% CI: 0.187–0.671, p=0.001), and a history of previous falls (OR=4.737, 95%
CI: 2.151–10.429).
Conclusion
1. Based on the FRAT assesment, 45.3% of participants had low fall risk, 33.6% moderate risk, and 21.1% high risk.
2. Risk factors such as sudden movements, the use of assistive devices, and emotional instability significantly influence fall risk assessment, and individuals with a history of previous falls are 4.7 times more likely to experience
another fall.
2.Association between serum cryoglobulinemia and clinical manifestation in chronic hepatitis C patients
Amin-Erdene G ; Gantogtokh D ; Yumchinsuren Ts ; Dolgion D ; Bolor U ; Otgongerel N ; Enkhmend Kh ; Ganchimeg D ; Tulgaa L ; Sarnai Ts ; Batbold B
Mongolian Journal of Health Sciences 2025;88(4):92-99
Background:
The most common clinical manifestation of HCV infection, which includes both hepatic and extrahepatic
manifestations, is mixed cryoglobulinemia, which is characterized by the precipitation of certain proteins in the blood at
temperatures below 37°C (in vitro), aggregation, and deposition in the walls of small and medium-sized vessels, causing
vasculitis, which is clinically manifested by a triad of joint pain, fatigue, and rash on the soles of the feet. Cryoglobulinemia is commonly diagnosed in people with HCV infection, with a prevalence ranging from 10% to 70%. Vasculitis that
occurs when cryoglobulinemia is detected mainly affects the small vessels of the skin, kidneys, and peripheral nerves,
causing complications in other organ systems.
Aim :
To determine the prevalence of cryoglobulinemia in people with HCV infection, study it in relation to the stage of
liver fibrosis, and determine its clinical relevance.
Materials and Methods :
200 chronic HCV infected individuals were included in the study according to the inclusion
and exclusion criteria. After obtaining informed consent from each participant, a questionnaire was used to collect information, perform physical measurements, and collect peripheral blood samples. Complete blood count and biochemical
tests (liver and kidney function) were performed. The degree of liver fibrosis was assessed non-invasively (APRI, FIB4). The glomerular filtration rate was calculated electronically using the MDRD GFR Equation. Skin examination was
performed to assess the presence of rash, ulcers, and scarring on the shins and ankles of cryoglobulinemia. To determine
cryoglobulinemia, 8 ml of blood was collected in a tube without anticoagulant, and the sample was kept motionless for
1 hour at room temperature until clotting was complete. After centrifugation, the samples were separated and stored in a
refrigerator at +4°C for 7 days, and then at room temperature for 30 minutes, the precipitate was detected.
Results :
A total of 200 people participated in the study, of which 71 were men (35.5%), the average age was 53.39±13.0.
Cryoglobulinemia protein precipitates were determined in a total of 148 people, of which 50 were men (33.8%), the
average age was 52.95±13.0. Cryoglobulinemia protein precipitates were detected in 89 people, or 60.1% of the study
participants. Of the total study participants, 176 (88.0%) had chronic hepatitis C (CHC). Of these, 57 people had CHC
with cryoglobulinemia. Comparing laboratory parameters, the mean GGT level in the cryoglobulinemia group was statistically significantly higher than in the non-cryoglobulinemia group (p=0.039). However, when laboratory parameters
were grouped by increasing or decreasing, AST and ALT levels were significantly higher in the cryoglobulinemia group,
indicating more hepatocellular damage (p<0.000). Increased creatinine levels may be associated with the risk of renal
dysfunction. The FIB-4 index and APRI index showed a more severe degree of fibrosis in the cryoglobulinemia group
(p<0.005; p<0.000). Univariate logistic regression analysis showed that age was associated with the occurrence of cryoglobulinemia (OR=2.48; 95% CI:1.31–4.70; p=0.005). Platelet count had a statistically significant positive effect in multivariate analysis (OR=14.38; 95% CI:1.26–163.89; p=0.032).
Conclusion
The prevalence of cryoglobulinemia among HCV-infected patients was 60.1%, and older age and decreased
platelet count among infected individuals were associated with the occurrence of cryoglobulinemia.
3.Efficacy of probiotic mouthwash in treatment of plaque-induced gingivitis
Khongorzul S ; Namuundari G ; Narantuul Ch ; Saranchimeg A ; Bolor N ; Khulan G ; Angar S ; Buyanbileg S ; Nyamsuren E ; Oyun-Enkh P ; Oyunkhishig Kh ; Bayarchimeg B
Mongolian Journal of Health Sciences 2025;88(4):112-116
Background:
In the treatment of plaque-induced gingivitis, in addition to mechanical plaque control, the use of chemical
plaque control such as mouth rinses for a certain period has shown a positive effect on treatment outcomes and prognosis.
Aim:
To evaluate the efficacy of a probiotic mouthwash in the treatment of plaque-induced gingivitis.
Materials and Methods:
A randomized controlled clinical trial was designed for a period of 2 weeks on 45 systemically
healthy subjects between 20 and 25 years having plaque-induced gingivitis. The study population was divided into three
groups. Group 1-15 subjects were advised experimental (probiotic) mouthwash. Group 2-15 subjects were advised positive control (chlorhexidine) mouthwash and Group 3-15 subjects into a negative control group. Oral prophylaxis was
done for all groups at baseline. After the proper oral hygiene instructions, groups 1 and 2 were instructed to rinse their
mouth with 15 ml of their respective mouthwashes, for 1 min twice daily, 30 min after brushing. Clinical parameters such
as Full mouth plaque score (FMPS), Full mouth bleeding score (FMBS) were assessed at baseline, 2 weeks respectively.
Results:
At baseline, there was no statistically significant difference between the groups in terms of FMBS and FMPS
mean values (p=0.174, p=0.887). At day 14, the FMPS, FMBS mean values were significantly reduced by all treatment
modalities ranking probiotic and chlorhexidine is greater than negative control group (p<0.001, p<0.001).
Conclusion
The probiotic mouthwash was effectively used as an adjunct to mechanical plaque control in the treatment
of plaque-induced gingivitis.
4. Clinical study of some traditional medicines for the treatment of ischemic heart disease (TMK00.2)
Bolor ; Nasandalai ; Alimaa T
Mongolian Journal of Health Sciences 2025;88(4):117-121
Background:
In traditional Mongolian medicine, ischemic heart disease are treated by balancing the body, promoting the
flow of khii and blood, improving the metabolism, suppressing inflammation, increasing heart strength, relieving pain,
and treating the disease according to its actual condition. Therefore, a study was conducted to investigate the effects of
traditional medicines Heart Agar-8 and Zandan-3 on ischemic heart disease.
Aim:
Studying the therapeutic effects of some traditional medicines used in the treatment of ischemic heart disease.
Materials and Methods:
Clinical trial was performed in an uncontrolled, single-centered, and open-study design. A total
of 48 patients with ischemic heart disease who met the inclusion criteria participated in the study. The study was conducted by giving people 3 grams of Heart Agar-8 and 3 grams of Zandan-3 medicine, each once a day, for a total of 3 weeks.
The results of the study were assessed before and after the study using the SAQ questionnaire, the chronic coronary syndromes (CCS) questionnaire, 6-minute walk test, and electrocardiogram. The research was conducted in accordance with
the appropriate ethical approvals (No. 24-25/03-01), (No. 2024-077) and confirmed by an informed consent form. Clinical
trial research results were processed using T-test, Paired T-test.
Results:
A total of 48 people diagnosed with ischemic heart disease (TMK00.2) were included in the study. The average
age of the study participants was 53.94±1.69, with the youngest being 44 and the oldest being 60. Regarding the gender
of the respondents, 15 (31.25%) were men and 33 (68.75%) were women. When comparing pre-treatment results with
post-treatment results using the SAQ, there were improvements in mobility (p<0.000), chest stability (p<0.012), chest
pain (p<0.000), treatment satisfaction (p<0.001), and quality of life assessment (p<0.000). When assessing chronic cor
onary syndrome in people, 44 or 91.6% of the total number of people included in the study had a level II score before
treatment, while 37 or 77.08% had a level I score after treatment, which was a statistically significant difference between
the pre-treatment and post-treatment indicators (p<0.034). Cardiac function was assessed by the 6-minute walk test,
which was 393.9±36.73 meters before treatment, or grade II, but improved to 456.83±48.6 meters after treatment, or grade
I (p<0.000).
Conclusions
1. People diagnosed with ischemic heart disease have shown statistically significant results when given the traditional
medicine Heart Agar-8 and Zandan-3 in combination with clinical trials.
2. The study participants experienced statistically significant improvements in mobility, usual activities, pain, and
depression, improved quality of life, and increased functional status in coronary heart disease.
5.Indoor Particulate Matter Concentration in Households of Darkhan City
Nyamdorj J ; Bolor M ; Maralmaa E ; Yerkyebulan M ; Ser-Od Kh ; Myagmarchuluun S ; Shatar Sh ; Gantuya D ; Gregory C. Gray ; Junfeng Zhang ; Ulziimaa D ; Damdindorj B ; Khurelbaatar N ; Davaalkham D
Mongolian Journal of Health Sciences 2025;85(1):25-29
Background:
A 2018 study on the global burden of disease, accidents, and risk factors reported that 1.6 million peo
ple died in 2017 due to household air pollution. Poor indoor air quality has been highlighted as a contributing factor to
respiratory diseases, cardiovascular conditions, and exacerbation of asthma and allergies. A 2019 study estimated that
long-term exposure to fine particulate matter (PM2.5) with a diameter of 2.5 micrometers or less reduces average life
expectancy by 1.8 years, with more severe effects in highly polluted regions. Additionally, a study by Miller et al. (2007)
found that prolonged exposure to PM2.5 increases the risk of cardiovascular diseases, particularly among women. Direct
measurement devices are highly effective in determining indoor PM2.5 concentrations, identifying sources of pollution,
tracking pollutant dispersion, and monitoring temporal variations. Studies suggest that direct measurement is an accurate,
cost-effective method that provides detailed data suitable for local conditions.
Aim:
To investigate the indoor air quality of houses and apartments in Darkhan city during the winter season using the
Purple Air monitoring device.
Materials and Methods:
A cross-sectional study was conducted with a targeted sample of 128 households in Darkhan
city. The study examined factors such as stove type, type of coal used, annual and daily coal consumption, frequency of
heating, and chimney sealing conditions. To collect data, the Purple Air monitoring device was installed in each house
hold for a month, after which it was retrieved. During retrieval, participants completed a questionnaire. The questionnaire
consisted of 55 questions across 7 pages at the time of device installation and 25 questions across 3 pages at the time of
device retrieval. The collected data was analyzed using SPSS 25.0.
Results:
A total of 128 households in Darkhan city participated in the study. The average duration of residence in the
current home was 9.5 years, with no statistically significant variation. The distribution of housing types was as follows:
traditional Mongolian gers (40.6%), houses (39.1%), and apartments (20.3%). The 24-hour average PM2.5 concentration
was highest in gers (70.9 μg/m³), followed by houses (46.8 μg/m³) and apartments (22.8 μg/m³), with a statistically significant difference (p=0.0001). PM2.5 levels were most variable in gers, followed by houses and then apartments. House
holds using central heating (apartments) had an average 24-hour PM2.5 concentration of 22.8 μg/m³, whereas households
using stoves (gers and houses) had a significantly higher concentration of 59.4 μg/m³ (p=0.0001). However, there was
no statistically significant difference between traditional and improved stoves. Among study participants, 21.4% reported
that someone in their household smoked indoors. Additionally, 86.5% regularly burned incense, candles, or herbs, while
99.2% did not use an air purifier.
Conclusion
The indoor particulate matter concentration in houses and gers in Darkhan was 59.4μг/m3. Variations in
stove types, poor chimney sealing limited space, and frequent gaps and cracks contribute to increased spread of indoor
air pollutants.
6.Studying the relationship between Cryoglobulinemia and liver fibrosis in patients with chronic Hepatitis C virus infection
Amin-Erdene G ; Gantogtokh D ; Turmanduul Ch ; Yumchinsuren Ts ; Dolgion D ; Enkhmend Kh ; Bolor U ; Otgongerel N ; Ganchimeg D ; Tegshjargal B ; Tulgaa L ; Batbold B
Diagnosis 2024;111(4):10-19
Introduction:
Hepatitis C virus (HCV) infection has both hepatic and extrahepatic manifestations, and it is one of the leading cause of liver transplantation. There’s limited research on extrahepatic symptoms of chronic HCV in Mongolia, thus we aimed to investigate the relationship between cryoglobulinemia and it’s related factors.
Methods:
The study included 200 participants with active HCV, collecting blood samples for various tests (biochemical analysis, kidney function, and cryoglobulinemia detection). The degree of liver fibrosis was assessed using APRI and FIB4 scores, and the study evaluated other health conditions through a questionnaire. Statistical analysis was performed using SPSS-26.
Results:
Out of 200 participants, 148 checked for cryoglobulin precipitation and 89 (60.1%) were positive. There
was a statistically significant age difference between those with and without cryoglobulinemia (54.62 vs. 50.44 years). A higher percentage of participants with cryoglobulinemia had significant liver fibrosis (10.8% vs. 4.7% without). Liver fibrosis scores tended to increase with age, especially in men.
Conclusion
Liver fibrosis scores above 3.25 are associated with older age, lower platelet counts, elevated AST and ALT levels, and the presence of cryoglobulinemia. FIB4 scores were higher in men with active HCV and cryoglobulinemia.
7.Metabolic changes of overweight and obese adults
Yumchinsuren Ts ; Dolgion D ; Ganchimeg D ; Enkhmend Kh ; Otgongerel N ; Gantogtokh D ; Amin-Erdene G ; Bolor U ; Tegshjargal S ; Batbold B ; Shiirevnyamba A ; Tulgaa L
Diagnosis 2024;111(4):97-104
Introduction:
The worldwide prevalence of obesity and its metabolic complications have increased substantially in recent decades. According to the World Health Organization (WHO) indicate that in 2016, over 1.9 billion
adults were overweight and, of these, over 650 million were obese. Obesity is a major risk factor for heart disease, type 2 diabetes, steatotic liver, chronic liver disease, stroke, and some cancers. The global prevalence of obesity and its associated comorbidities continue to increase on a pandemic scale.
Aim:
To determine metabolic changes in overweight and obese adults and their related diseases based on some parameters of anthropometric and laboratory tests.
Materials and Methods:
This study was conducted with a case-control design in 2023–2024. There were 150 participants in
the study, 50 in the control group with normal weight, 50 in the overweight (BMI<29.9kg/m2)
case group, and 50 in the obesity (BMI>30kg/m2) case group. Subjects of three groups were matched by age (±1) and sex. We estimated anthropometric parameters and biochemical
laboratory analysis including glucose, lipid, ferrum, and liver parameters. CBC All statistical analysis was performed using SPSS 23 software. Categorical variables were described by numbers and percentages, and the numerical variables were characterized by the median (min and max) for the normal distribution, and mean± standard deviation for the non-normal distribution. The statistical
tests utilized were the Chi-square, Fisher’s exact, student t-test, and Mann–Whitney tests. Ethical approval for the survey was obtained from the Medical Ethics Committee under the Ministry of Health Of Mongolia in January 2023.
Results:
The participants' average age was 46.73±11.45, with 60% being women (90) and 40% being men (60). The prevalence of central obesity and fat % were 52.3% and 37.2%, respectively. Between study
groups, there were significant differences in fat% (p=0.004), central obesity (p<0.001), FBG (p=0.024), cholesterin (p=0.017), LDL (p=0.018), HDL (p=0.003), ferrum (p=0.010), АЛАТ (p=0.020), and GGT (p<0.001).
Conclusion
In overweight and obesity groups, the body fat, fasting blood glucose, cholesterol, LDL, and ALT levels are
increased. These changes often lead to conditions like type 2 diabetes, arterial hypertension, steatotic liver disease, and liver fibrosis. Therefore, it is important to develop plans for prevention, early detection,
public awareness, and intervention programs targeting obesity in the general population.
8. Does air pollution affect liver disease?
Bolor B ; Enkhjargal A ; Burmaajav B
Mongolian Medical Sciences 2024;207(1):52-59
Liver disease accounts for approximately 2 million deaths per year worldwide and is responsible for
4% of all deaths. Acute hepatitis accounts for a smaller amount of mortality, with complications from
cirrhosis and other chronic liver diseases being the main causes of death. It is mostly brought on
by nonalcoholic liver disease, alcohol abuse, infections (chronic hepatitis B and C viruses), and air
pollution.
In the last 10 years, the number of deaths caused by hepatocellular carcinoma has been continuously
increasing in Mongolia, and it ranks first in the world in terms of deaths caused by hepatocellular
carcinoma per 100,000 population, which is 8 times higher than the world average.
Mongolia is one of the most polluted countries in the world. Globally it is estimated that 9 out of 10
breathe polluted air and about 7 million deaths are attributed to air pollution. Studies on epidemiology
have found an association between ambient air pollution and some liver diseases, including cirrhosis,
liver cancer, and fatty liver disease related to metabolic disorders. This is an issue with global health.
Exposure to PM2.5 is linked to the development of inflammation, which may be a major risk factor
in the advancement of non-alcoholic fatty liver disease. According to the literature review, exposure
to PM is associated with systemic inflammation, a rise in plasma triglycerides, LDL and VLDL, pro
inflammatory cytokines, and insulin resistance.
Many epidemiological and ecological studies were done in Mongolia on air pollution and health.
However, it is still not clear how much ambient air pollution can cause cirrhosis and non-alcoholic fatty
liver disease incidence in Mongolia.
9.Results of thyroid hormone levels in women
Bolor B ; Bat-Erdene D ; Oyun-Erdene R
Mongolian Medical Sciences 2024;208(2):8-12
Introduction:
The average age of the population varies in every country of the world, which depends on the changes
that occur in the body during aging and many external and internal factors that affect it. Thyroid
hormones play an important role in ensuring and maintaining normal metabolic function throughout
life. Our country is located in a mountainous region of the mainland, the amount of iodine in drinking
water is low, and the amount of iodine taken from food is low, which creates the risk of iodine deficiency
disorders. Therefore, we aimed to study how the thyroid function changes with age in Mongolian
people.
Goal:
A comparative study of thyroid hormone secretion levels in adult women.
Material and Method:
In our study, 83 women over the age of 20 were selected based on the “Yu Bi Lab” diagnostic center.
Triiodothyronine (T3), thyroxine (T4), and thyrotropin (TSH) of the women participating in the study
were determined using the FHU method using the Magiwel ELISA diagnostic kit manufactured by
United Biotech.
Results:
81 women over 20 years of age participated in our study, the average age was 44.45±14.17, and the
participants were divided into 5 groups with 10 age intervals. 20-29 years 18% (n=15) average age
24.6±2.64, 30-39 years 22% (n=18) average age 33.6± 3.12, 40-49 years 16% (n=13) average age
45.15±1.67, 50-59 years 25% (n=20) average age 54.15±2.99, 60-69 years 19% (n=15) average age
63.73± 3.05, were.
Conclusion
1. When comparing T3 and T4 hormones by age group, T3 hormone is higher in the 30-39 age group
at 5.05 ng/ml. The T4 hormone gradually decreases with age.
2. Thyroiodin hormone increased with age. The relationship between the age of the participants
and TSH hormone was directly related to statistical age when calculated by Pearson’s correlation
coefficient (p=0.01).
10. A study to determine actual daily consumption of drinking and residential water for households in Ulaanbaatar
Zolzaya D ; Suvd B ; Amgalan G ; Tsegmed S ; Bolor B ; Soyombo G ; Oyun-Erdene O ; Altangerel B ; Oyunchimeg D ; Enkhjargal A ; Bolormaa I ; Tsogtbaatar B
Mongolian Medical Sciences 2024;208(2):39-47
Introduction :
Water is a vital resource for human existence and is essential for daily food processing, preparation,
washing, hygiene, and sanitation. Furthermore, providing the population with safe drinking water is one
of the pressing problems of the world and some regions.
In recent years, population density and the scale of commercial and industrial activities, as well as clean
and dirty water consumption were increased in the capital city. As a result of these, ground and surface
water resources are becoming scarce and polluted.
Therefore, assessment of daily drinking and residential water consumption of Ulaanbaatar should be
determined to use drinking water properly in daily life and water loss. This study assessed the actual
amount of households’ daily water consumption.
Goal:
The purpose of this study is to determine the daily consumption of drinking water for households in ger
areas and apartments in Ulaanbaatar.
Materials and Method:
This study covers 30 households in ger areas and 15 apartment households, in Ulaanbaatar.
Household members performed 6-10 types of measurements every day, within 7 days. As a result of
these measurements, actual consumption of water quantity used for drinking and household purposes
was calculated. Statistical analysis was done by SPSS Version 21 to calculate the true probability of
difference between parameters.
Result:
67.9% of the households in the ger areas were 4-5 family members. The average daily household
consumption of drinking and domestic water were 68.3 ± 3.57 L (95% 61.3-75.3), the minimum
consumption was 12 L, and the maximum was 227 L. Average of the household water consumption
water was 97.6-108.9 liters during the weekends, and water consumption was statistically higher than
weekdays (p=0.001; p=0.01).
The water consumption of residential households with 3 family members accounted for the majority
(30.8%) in this study. The average daily consumption of drinking and domestic water was 297.67±19.7
liters. There was no statistically significant difference (p=0.96) in week. The average daily water
consumption including drinking and residential was 270.3-335.97 L.
The total daily drinking and residential water consumption per person was 15.57 L for households in ger areas and 90 L for apartment households. Calculating the daily water consumption of households in ger areas, 60.3% of it is used for laundry, washing dishes, food preparation, washing face and hands, and clothes, 31% for drinking, and 8.7% for outdoor water use. While apartment households, approximately 94.1%, were used for household and 5.9% for drinking purposes.
Research ethics approval :
This study was discussed at the meeting of the Academic Council of the National Center for Public
Health. In addition, this study was carried out according to the methods and methods discussed and
approved at the meeting of the Medical Ethics Control Committee of the Ministry of Health (Resolution
No. 08).
Conclusion
The total daily consumption of drinking and residential water per person were 15.57 litres for the
households in the ger areas and 90 litres for the apartment households. It implies that it does not exceed
the WHO recommendations
Result Analysis
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