Background: Type 2 diabetes has increased risk of heart failure 2-4 times more than those in non-diabetic subjects. The early detection of asymptomatic ventricular dysfunction by using NT-pro BNP test in diabetic patients is the best strategy for decreasing morbidity and mortality of heart failure. Aim: The aims of this study were to detect asymptomatic cardiac ventricular dysfunction by using NT-pro BNP test in subjects with type 2 diabetes and to define the factors associated with elevated NT-proBNP. Materials and Methods: This cross-sectional study was included diabetic and non diabetic subjects aged from 35- to 64 years, who had no clinical symptoms of heart failure. Cardiovascular risk factors were detected by clinical examinations. NT-pro BNP determination was performed on an immunoassay analyzer (FIA1100, Getein Bio Medical Inc, China), which uses reagent strip to obtain quantitative NT-pro BNP results in plasma. The cut-off point for NT-pro BNP was 300 pg/ml. Results: A total of 536 subjects without clinical symptoms of heart failure were included in the study of which, 150 were diabetic and 386 were non diabetic. The mean age was 52.8 ± 7.8 years and 281 (52.4%) were females. Cardiac ventricular dysfunction was detected in 7.3% of diabetic and 5.2% of non diabetic subjects. Cardiac ventricular dysfunction in diabetic subjects was increased with age and non-significantly higher in females than in males (8.3% vs 6.4%, p>0.05). In the logistic regression analysis, uncontrolled hypertension (OR 3.80, 95% CI 1.07–13.44), long duration of disease (OR 5.30, 95% CI 1.36-20.66), and ageing (OR 5.40, 95% CI 1.29–22.88) were significantly correlated cardiac ventricular dysfunction in subjects with type 2 diabetes. Conclusion Cardiac ventricular dysfunction in subjects with type 2 diabetes was detected 1.4 times more than those in non diabetic subjects. The likelihood of positive NT-pro BNP test in subjects with type 2 diabetes was independently (p<0.05) associated with advanced age, uncontrolled hypertension and long duration of diabetes.

Background: Monocyte / High Density Lipoprotein Ratio (MHR) has become an inflammation marker of atherosclerotic cardiovascular diseases and is a handy and reliable diagnostic marker at a low cost. Objectives: to suggest MHR as a new inflammation marker for ASCVDs by comparing it with other risk factors of cardiovascular disease and assessing the significance in screening Methods: This study conducted during October to December 2019 is a hospital-based cross sectional study, with a total of 396 clients, all 20 to 64 years old, were selected as subjects of the study using a certain criteria. Results: 78.47% of the male subjects and 34.31% of female subjects were diagnosed with dislipidemia, which shows us that males were diagnosed more frequently. The study sample consisted of 274 (72.87%) men and 102 (27.13%) women with mean age of 36.6±8.42 years (range, 20-64 years), 78.47% were male and 34.31% were females. 66.49% of total participants were newly diagnosed with dyslipidemia. An age group of 30 to 40 years old were recorded with the highest cases of dyslipidemia. Monocyte / High Density Lipoprotein Ratio (MHR) were 7.88 and 12.82 in dyslipidemic and non-dyslipidemic subjects, respectively and showed that there is a statistically significant difference(p<0.05). The 10-year ASCVD risk of 113 people aged 40-64 years, which were classified in low risk group (<7.5%) and in high risk group (≥7.5%) were assessed by pooled cohort equation and the results shows that risk percentage were 65.14% and 34.86% and there is statistically significant difference in MHR, which were 10.58±4.80 and 14.07±4. 90 in respective groups. Conclusions Prevalence of dyslipidemia in preventive screening were high in a group of 20-62 years old and the group of those were estimated high The 10-year ASCVD risk, also had relatively higher MHR. Moreover, there is a positive relation between dyslipidemia and MHR. These results show that it is possible to use MHR as a new inflammation marker in ASCVDs for early detection purpose.

BACKGROUND: Cardiovascular diseases (CVDs) account for >17 million deaths globally each year and this figure is expected to grow to 23.6 million by 2030. According to the WHO report, one-third of ischemic heart disease is attributable to high cholesterol. There have been some claims that the atherogenic index of plasma (AIP), which is the logarithmic transformation of the just-mentioned ratio (TG/HDL-C), could be used as a significant predictor of atherosclerosis, and CVD as well. Thus, we aimed to study the relationship between AIP and cardiovascular risk factors. METHODS: The cross-sectional hospital based study was conducted including 117 participants aged between 40-72 years old without cardiovascular symptoms were recruited from Second General Hospital. After filled consent form, participants’ habits of smoking, alcohol usage, obesity, arterial hypertension and sedentary lifestyle were assessed through a structured questionnaire and physical examination. By using fully automated open-system analyzer, determinations of total cholesterol, triglycerides, low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) three times and glucose twice were performed simultaneously and then their averages were calculated. At least one abnormal lipid level was considered as “dyslipidemia”. The atherogenic index of plasma (AIP) was calculated as the logarithmically transformed ratio of molar concentrations of TG to HDL-C. Statistical analysis was performed using SPSS 22. RESULTS: Of total 117 participants ranging 40-72 years old, 45.3% were male and 54.7% were female with mean age 53.6±0.79. Regarding cardiovascular risk factors, 63.8% were physically inactive, 32.48% were smokers, 47% were alcohol user, 48% were hypertensive, and 18.26% were diabetic. The mean values plus standard error of lipid components were 195.5±6.09 mg/dL in cholesterol, 181.25±27.36 mg/dL in triglycerides, 60.6±1.39 mg/dL in HDL-C, 138.5±3.74 mg/dL in LDL-C, 6.27±0.26 mmol/L in fasting glucose. The dyslipidemia was detected in 54.7% of total participants and mean level of AIP was 0.33±0.03 (min=-0.52; max=1.51). The mean levels of 10 year and lifetime risk were 6.25±0.63% (min=0.2; max=33.5) and 43±1.53% (min=7.5; max=69), respectively. AIP had weak correlations with gender, smoking, anti-hypertensive drug usage, aspirin usage, 10 year and lifetime risks of CVD, hypertension, fasting glucose, body mass index, and dyslipidemia (0.2

Background: Spine disorder is the first cause of disability of workers below 45 years and economicalburden costs 20-50 billion us.dol, in European countries. Lumbar disc hernia estimates 40% of 30-50aged population in U.S and in Japan 26/10000. In last 5 years, spine surgeries increased in 4-5 timesdue intervertebral disc hernia, at Shastin State Third Central hospital of Mongolia.Goal: To populate new methods of surgical treatment for compressive lesions of spinal cord, spinalnerve root of cervix, thorax and lumbar spineMaterials and Methods: We did clinical research involving patients who had spine surgery at ourdepartment due “compressive lesion of spinal nerve root and spinal cord”. From, total 217 patients,excluded 9. Excluded cases are: declined from surgery 3, Arnold-Chiari malformation 5, and epiduralabscess 1. We collected data with permission of patient and did statistical analysis by IBM SPSS 17.Results: The surgery for intervertebral disc hernia takes 84.6% (176) of total surgery and 94.9% (167)of lumbar disease. Tumor of spinal cord estimates 9.1% (19) of total case, dominates in lumbar area(57.9%). We used posterior approach mostly, because it is frequently used in lumbar spine. The surgerycontinued 36-750 min (204.6, SD 128.5) ten patients (4.8%) had complications. In this project weused 5 surgical methods totally in solitary or combined. Spondilodesis is the most combined methodamong them. We used Oswestry disability index in Mongolia at first, to count treatment effect. Currentindex evaluated pre and post surgery period. Patient complaint and difficulty of daily life progressivelydecreased after surgery and almost disappeared at third month (p<0.00).Conclusion:1. It is possible to develop international standard surgical treatment of compressive lesions of spinalnerve root, spinal cord of cervix, thorax and lumbar spine in Mongolia.2. We used Oswestry disability index in Mongolia at first, so this questionnaire is simpler and accuratemethod for spine, spinal cord induced disability.3. Twenty seven point nine percent of patients who had surgical treatment has minimal to moderatedisability by Oswestry disability index, so it means we have to process standard of spine surgeryand increase non surgical treatment efficiency.4. Working ability recovers faster when spine surgery has been done.5. These new methods of spine surgery are cost effective than same surgery which will be doneabroad.

Background. Low back pain is a frequently encountered symptom. Although 70-80% of the entirepopulation have low back pain complaints in their lives, only 2-4% of them require surgical intervention.’Department of Neurosurgery, Shastin 3rd Central Hospital about 200 patients who undergo back surgery,while 90% of patients who have prolapsed lumbar disc surgery from 2010 to 2012. There are variousstudies indicating that exercise improves pain and disability in chronic low back pain and in those whohave had surgery. The main objectives of the postoperative rehabilitation programmes are to accelerateand maximize function recovery as much as possible, and to prevent further injury by restricting theprogression of degenerative changes. We evaluated the effectiveness of rehabilitation treatments thatare used in our department which is the first time in our country.Goal. To evaluate the effectiveness of rehabilitation after lumbar discectomy.Materials and Method. We examined 83 patients were included the Shastin central hospital, Departmentof neurosurgery and rehabilitation after lumbar discectomy at a single level and operated in the periodfrom May 15, 2013 to September 15, 2014. All patients were evaluated at the beginning and at theend of treatment by Oswestry Disability Index which is a specific functional questionnaire for back pain.Pretreatment values are one month after surgery and posttreatment values three months after surgery.All patients received the intensity specific exercise and back school education programme 3 days aweek for eight weeks.Results. All patients pain intensity are reduced after treatment evaluated by VAS (p<0.000). Functionalability had significantly increased after treatment which is evaluated by Oswestry Disability Index in allpatients (p<0.000). 46 from all patients had minimal disability before treatment and this number wasincreased in to 79 after treatment. The number of moderate and severe disabled patients ability wasincreased after treatment.Conclusion: Back school education and specific exercise programme should be one of the parts oftreatment after lumbar discectomy. After treatment was increased functional ability and early painrelief.

BackgroundDandy described first, about intervertebral disc hernia (1929). Mixter W.J and Barr J.S (1934) investigated that correlation of sciatica and lumbar disc hernia. Discectomy is most confirming surgery among all spine surgery. Asymptomatic lumbar disc hernia revealed in 70% of adult, by MRI. Spine disorder is first cause of disability of workers below 45 yrs, in European countries. International research for predisposing, risk factors of intervertebral disc hernia is widely confirmed, but diagnostic and treatment aspects are not completed.Materials and MethodsWe did computer aided search using key words “disc degeneration, risk factor, discectomy, lumbar disc hernia, spinal instrumentation” in online library: MEDLINE, E pub, PUBMED, HINARI, Mongolmed, years 1970-2011, also domestic research works from Central library of HSUM, Mongolia. We included article, case-control study, systematic review, case study.ConclusionIncidence and disability caused by lumbar disc hernia, requiring surgical treatment is common problem in world. By anatomical region, lumbar disc hernia is the highest. Research work revealed that patients who took surgical treatment different by gender (male:female=2:1), geographical region (US 160/100000, Switzerland 62/100000). At last 20 yrs, dramatically changed theory about predisposing factor of disc hernia. It is changed from mechanical load to genetic role. Disc degeneration disease is basis of disc hernia. Nucleus pulposus, annulus fibrosus losing own structure, containing moleculs, and water under degeneration. The risk factors are frequent heavy lifting, frequent twisting and bending, vibration, sedentary work, driving and overweight. The golden standard surgery of herniated disc of cervical area is anterior cervical discectomy and fusion (ACDF). Posterior screw fixation of lumbar vertebrae is most frequently confirming surgery among the world.

Abstract The aim of this study is to compare the effects of traditional and conventional treatment of chronic pyelonephritis. Total of 100 patients diagnosed with chronic pyelonephritis were enrolled in the study. Traditional medicines included following: Sugmel-10, Sarichun, Yuna-4, Sema-3, and Sojid-11. Conventional medicines included following: ciprofloxacin, cefasolin, and negram. After 10-14 days of treatment questionnaire, physical examinations, and laboratory tests were performed. In 90% of patient treated with traditional medicines, changes of smell and color of urine was disappeared. Back pain and dysuria was reduced in 89.7% and 75% of patients respectively. While in control or conventional treatment group, changes of smell and color of urine was completely disappeared and back pain and dysuria was reduced in 80% and 88% of patients respectively. Pasternatskii’s symptom and arterial hypertension was reduced in about 58% and 77% of patients respectively. Bacterial growth (Escherichia coli and Staphylococcus aureus) was ceased in 39.4% and reduced in 46.4% of patients treated with traditional medicines. It was ceased in 60% and reduced in 30% of control patients.Traditional medicines reduced signs and symptoms of chronic pyelonephritis. Bacterial growth was ceased or reduced by traditional treatment. Traditional medicines are effective as conventional medicines for treatment of chronic pyelonephritis.

Introduction:Cardiovascular disease morbidity has been continuously increased among the population of Khangai region in the last 10 years - as of year 2010 for instance the rate was 1.5 more in Arkhangai aimag and 1.2 more in Khuvsgul aimag compared to the average rate nationwide. This research study was conducted due to the higher rates listed above in the region and the need to clarify various issues related to the medical care being provided with respect to the illness.Goal:It was deemed necessary to analyze the existing situation of early detection, monitoring and treatment of arterial hypertension among the population of the chosen province and to develop improved methodology.Objectives:1. To study the early detection of arterial hypertension2. To examine whether or not the clients are being given the needed recommendations related to the arterial hypertension monitoring and medicine treatmentMaterials and Methods:Cross sectional, organization based survey with 52 questions was carried out among 87 doctors/professionals of 17 soum and 100 family and aimag's general hospital of Orkhon, Bulgan, Arkhangai, Huvsgul and Selenge aimag. SPSS-17 program and Fisher test was used to generate and develop information.Results:Each soum, inter - soum and provincial doctor is responsible for checking/measuring the arterial pressure of their respective registered number of population by the percentage listed below: Soum doctor-56%, inter-soum doctor-50%, aimag's doctor-46,9% (p=0.19). Body weight and height are being irregularly measured on each chosen level (52.9%-62.5% p=0.67). Similarly the BMI is also being irregularly determined (42, 9% - 54, 5% p=0.07).From all the patients who have an arterial hypertension, 54.3%-55.6% are being monitored by dispensary and 11.1%-14.3% (p=0.53) are being regularly monitored in the chosen medical organizations. Although it is required to repeatedly measure and monitor the arterial pressure depending on its level the result shows that no planned monitoring is being done for the 77.8% of the patients. It is not sufficient for a sound and family doctor to recommend the regular use of antihypertensive the 48.6%, inter- sound doctor 43% and aimer's doctor 29% ( p= 0.40).Conclusions:1. The arterial hypertension - early detection practice is shown to be inadequate at the Chosen health care level (p=0.19).2. For the most clients with the arterial hypertension (59.9% p= 0.40), recommendations on regularly using antihypertensive is not being done - half the clients (54.3% - 55.6%) with the arterial hypertension are not being monitored.

Introduction: In order to Implement the Mongolian government's 2000 provisions for national health care, on May 28,2004, the Health Minister approved the "Home Care Nursing Service and Rules for Caring and Nursing" according to resolution # 136 and indicated that family clinic nurses should provide home care nursing services [6'71. Interestingly, it is noted that throughout the world, nursing home services have not been limited to family clinic nurses but are being delivered by nurses with diverse areas of specialization.Goal: Purpose of the study is to determine needs for making home nursing services to the population in some province and soum.Objectives:1. To comparatively search needs for providing home nursing services to citizens in the province and soum which were involved to the study.2. To determine nursing type which is required at home3. To develop needs of nurses who make home nursing servicesMaterials and Methods: Conducted studies among the 1109 people from the 520 families in 17 soums of five provinces such as Orkhon, Bulgan, Arkhangai, Khuvsgul and Selenge. We have chosen the clients with anamnesis who are repeatedly served and treated at the hospital for our study and had interviews with them. Questionnaire for citizens consists of 2 basic chapters including 17 questions which determine demographic information and needs of home nursing services. We asked and searched about needs of Home Care Nursing assistances under the 3 basic groups such as General nursing, Treatment nursing and Specialized nursing. After inserting study data into the SPSS-17 program, checked it by appropriate statistical methods (t, x2, fisher exact) and checked if difference between groups and relations has statistical truth.Results: 35.89 percent of clients who got involved to the study answered that they are interested in taking nursing and caring services at home. Also we consider needs for having home nursing at home according to numerical indexes in the provinces involved to the study, clients mostly want to be injected by intramuscular (25.88%), intravenous (31.02%) and IV fluid (30.57%). As we consider specialized nursing assistances at home under the types of needs, health education and assistance for people suffered with hemorrhage and injured people occupy major percent. Clients who got involved to the training, were asked question "With whom do you want to be made nursing assistance at home?" and 75.6% of them answered that they prefer nurses of family clinic.Conclusions:1. It was observed that 35.89% of clients who got involved to the survey, want to receive home nursing assistance and demands for home nursing is being increased with aging.2. Also we conclude that nursing after hemorrhage, nursing for injured patients and nursing for patients with cardiovascular disease occupies higher percent and it shows that percent of cardiovascular diseases and injuries is relatively high and clients' needs to receive nursing assistance at home are faced problems after they were discharged from hospital.3. 75.6% of people who got involved to the study are interested in taking home nursing assistance and we reached to conclusion that it is suitable to train nurses according to it.

Background: A biological lifespan (ageing) refers to determination of levels of country development, change, and decline in operations of organism system and structure. A biological age indicates a normal state of body, organism structure and functions depending on calendar ageing; and determines the changing of bio-markers5 . In modern theoretical and methodological view traditional medical “wind, bile, phlegm” are “initial elements” and “mind properties” of the human body (Dagvatseren B., 2003). By the theory of traditional medicine the “wind, bile, phlegm” elements are all together been in whole human body and their regulate with function of the human body. The “wind, bile, phlegm” elements are defined by their characters. It may possible correlative measure of “wind, bile, phlegm” and biological ageing. Introduction: In the resent years the occurrences of cardiovascular diseases and related metabolic syndrome have been increased in Mongolia and Asian countries. Mongolians’ mean average of human lifespan is 66.54 years (data of 2008) and Mongolia stays at the medium level of human development. According to the health statistical data of 2008 among total deaths caused by cardiovascular diseases 43.1 percent belongs to hypertension, 30.7 percent – to ischemic heart diseases. Due to epidemiological study 3.2% of adults younger than 44 years, 10.27% of people aged from 45 to 54 years, 36.54% of age group from 55 to 64 years, 34.61% of people aged from 65 to 74 years suffer from ischemic heart diseases (Tsegeenjav D., 2003). Therefore it is required to use healthy life-style to prevent Mongolian people from cardiovascular diseases by matching and combining their reach tradition and custom of live regime, organism peculiarities by regulating their meal, behavior with advanced medicine preventative methods in accordance with urbanization and nomadic cattle-breeding conditions. Aim: The aim of study was investigation of biological ageing status and traditional medical constitutional correlation of Mongolians during ischemic heart disease. MATERIALS AND METHODS. Research was done by the method of Randomized Controlled Trail during 2007-2009 at the Department of Traditional Medicine and Angiography of Shastin Central Hospital, School of Traditional Medicine, HSUM and Medical Research Institute. Research was done due to permission from the Ethical Commission 01/01 of Ministry of Health, Mongolia (2007), and followed international standard of research with the involving of human sources. A total of 240 healthy people - volunteers (control group) and 150 patients with diagnosed ischemic heart diseases (case group) underwent the research. People were aged from 40 to 69 years of age, 57.4% were male and 42.6% were female. Risk factors of the heart coronary disease are studied within the people, who participated in research study and biological ageing is defined for those participants. A biological age was studied in order to determine (B.P.Voitenko, 1991) biomarkers. Investigation of traditional medical body constitutional types was obtained using a self-reported questionnaire, including human habits, speech and emotions. Ischemic heart diseases diagnosed by echocardiography and angiography. Also bio-chemical and lipid regulation indices such as cholesterol, triglyceride, and high, low densities lipoprotein were determined for both groups. RESULT The 5% of examined people have had a primary school education, 31% - high school education, 30% - college education, and 34% higher education out of 390 participants. In case of smoking, the biological age of smokers in 8 years longer than non-smokers, the biological and calendar ageing levels are equal in control group of participants. Difference between biological and calendar ages of alchohol users and non-users are less in 2nd group.Bological age of people, who do regular physical exercises, is 2.5 years longer than calendar age. Biological age of people with genetic heart desease is 2.09-2.22 years shorter, biological age of people with extra weight of body was 2.57-4.37 years shorter than normal people.Traditional medical constitutional types were determined and correlated within biological ageing and ischemic changes of cardiovascular system for each age category. Healthy people’s biological age with “bile-phlegm” constitution is late by the chronological age; “wind-bile” and “phlegm-wind” constitution groups’ biological age are faster than the chronological age. People aged from 50 to 59 show faster biological age than chronological one. Ischemic heart diseases diagnosed in total of 150 examined people. 26.9% of diagnosed participants have had damage of left coronary artery, 31.4% - damage of anterior branch between left coronary artery ventricular (p