1.Coronary Microcirculation in Acute Myocardial Infarction and the Clinical Significance of Artificial Intelligence-Based Software
Batzaya Ts ; Surenjav Ch ; Batmyagmar Kh ; Narantuya D ; Lkhagvasuren Z ; Tsolmon U
Mongolian Journal of Health Sciences 2025;88(4):231-237
Background:
Cardiovascular diseases (CVDs) is a third leading cause of non-communicable diseases and a leading cause
of mortality in Mongolia. Among these, acute myocardial infarction (AMI), a complication of coronary artery disease
(CAD), is a leading cause of cardiovascular mortality. In patients with AMI, both epicardial artery blood flow, observed
through coronary angiography, and coronary microcirculatory dysfunction (CMD) play critical roles in the disease’s
pathophysiology. Recent advancements have introduced artificial intelligence (AI)-based softwares which are capable of
analyzing coronary blood flow from coronary angiography images. The AI based softwares can assess not only epicardial
blood flow but also CMD in recent studies. In this review, we discussed the role of CMD in pathophysiology of AMI,
diagnostic approaches, the application of AI-based technologies, their clinical significance, and future directions.
Aim:
This review aims to explore the pathophysiological relationship of coronary microcirculatory dysfunction (CMD)
in the context of acute myocardial infarction (AMI), diagnostic methodologies, the application of artificial intelligence
(AI)-based technologies, and their clinical significance.
Hypotheses:
1. AI-based software allows for highly accurate assessment of coronary microcirculation during AMI.
2. CMD during AMI is associated with structural and functional changes in the heart.
3. CMD during AMI is related to disease prognosis and patient outcomes.
Methodology::
This narrative review was compiled using a systematic and logical approach, based on publicly available
recent clinical and biomedical research literature addressing the above hypotheses.
Conclusion
In recent years, AI-based image processing software has been developed to analyze angiographic images obtained during percutaneous coronary intervention (PCI) and treatment procedures. These tools show significant promise
for early detection and improved diagnosis of CMD during AMI, as well as for better assessment of short- and long-term
patient risk.
2.Beers criteria evaluation study on the treatment of Pyelonephritis
Nuraiym N ; Enhdalai O ; Lkhagvasuren Ts ; Maralmaa L ; Batkhuyag P
Mongolian Pharmacy and Pharmacology 2024;25(2):70-75
Introduction:
Globally, 10.5-25.9 million cases of pyelonephritis have been reported, and the nature of the disease is
changing over time. In Mongolia, as of 2022 diseases of the genitourinary system has increased from the
average of the last 10 years, and account for 9% of all diseases. The incidence rate by age group increased in
all age groups in 2022 compared to 2013, with the largest increase in the age group over 65 with 2,104 cases.
The basis of this study is to determine the use of PIM drugs based on the Beers criteria for the treatment of
patients diagnosed with pyelonephritis in our country. To study the use of drugs by inpatients diagnosed with
pyelonephritis (N10), (N11) in referral hospitals and the use of PIM drugs used in the treatment of elderly
people.
Methods:
A retrospective descriptive study was conducted on the medical history of a total of 150 patients diagnosed
with pyelonephritis (year 2023) at The State Secondary Central Hospital, The State Third Central Hospital,
and Hovd Regional Medical Centers. Among the 150 inpatients who participated in our study, 14.3% (n=18)
of 126 types of drugs were used for the treatment of pyelonephritis, and 85.7% (n=108) for the treatment of
multimorbidity and supportive treatment. Inpatients used 11 types of PIM drugs according to Beers criteria.
Nitrofurantoin 39% was used the most and amitriptyline 9.8% were the most used drugs affecting the central
nervous system.
Conclusion
11 types of drugs included in the inappropriate category for use in the elderly are risky and should not be
selected. Among them, nitrofurantoin 39%, from NSAIDs ketoprofen 19.5%, ibuprofen 7.3% were most used.
PIM drugs used for treatment in 2014 are still used in 2024, indicating the need for improved drug monitoring
in the elderly
3.Evaluation of the Agatston Coronary Artery Calcium score using contrast enhanced CT-Coronary angiography
Badamsed Ts ; Lkhagvasuren Z ; Delgertsetseg D ; Batgerel O ; Dulamsuren T
Mongolian Medical Sciences 2023;203(1):3-7
Background:
In 1904, Monkeberg was first described about the coronary calcification which is the degenerative change that occurs with aging process, but the last decades many studies have been confirmed that coronary calcification was an active process same as the signaling pathways with bone mineralization. Coronary calcification increases the risk of myocardial infarction during bypass graft surgery and PCI (СМ СN. Shanahan, 1999).
Goal:
To evaluate Agatston Coronary Artery Calcium score using contrast enhanced CT-Coronary angiography.
Objectives:
1. To assess Agatston Coronary Artery Calcium score
2. Age and gender relationship of coronary calcification
Materials and Methods:
We evaluated total 215 patients who were admitted to the Reference center of Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary Professor of the Third State
Central Hospital awarded with the Red banner of the Labor diagnosed with the coronary calcification by contrast enhanced 64 slice CT (Philips Ingenuity CT 64) between 2020 to 2022. Patient’s age was
considered into 6 groups and coronary calcification was assessed by Agatston’s score. The result of our study determined by common statistical averages and errors and probabilities of the indicators
were determined by Student’s criteria.
Result:
When evaluating Agatston coronary artery calcium scoring by CT-coronary angiography, 11-400 Agatston score was predominantly in our study with p value of (P<0.001). Considering relationship of age and gender, coronary calcification occurs 42.3% of patients aged 50-69, male and female ratio was 1.7:1.
Conclusions
1. We established Agatston coronary calcification 11-400 was occurred in 66.96% of the patients.
2. Coronary calcification predominantly occurred in 65% patients aged 50-69 years.
4.Workplace stress level study regarding the some health factors
Otgonbaatar D ; Lkhagvasuren Ts ; Naranbaatar N ; Munkhkhand J
Mongolian Medical Sciences 2020;192(2):45-50
Background:
Over the past 20 years, world wide scale social and economic reforms, technological breakthroughs,
and the population growth (increased by 1.64 billion), especially in urban areas, have had a negative
impact on human health; changes in living and working conditions (environmental and air pollution),
population density, traffic jam, unhealthy lifestyles, workload, and work stress – all contribute to non-communicable diseases – are increasing. According to researchers from Stanford University in the
United States, “Stress plays a key role in the development of behavioral disorders such as poor diet,
lack of exercise, alcohol and tobacco use, and addiction. Furthermore, these behavioral disorders
play a major role in the development of metabolic disorders and cancer, such as hypertension,
cardiovascular disease such as myocardial infarction, and diabetes and obesity. “Stress, in particular,
depends on the type of workplace, work environment, and occupation in which the person spends
most of their life.
Materials and Methods:
The study is covered 473 nurses from the specialized tertiary level hospitals in Mongolia. We
determined their perceived work stress by the WPS (3 parts 57 questions) questionnaire of American
scientist Rice. The work stress results were analytically analyzed with the cross-sectional method
regarding the nurses’ arterial blood pressure.
Results:
Totally 473, or 121, 89, 146, and 117 nurses participated from NCTO (1), NCMH (3), NCID (4), and
NCC (4). In present study, 34 or 7.2% of 18-24 year olds, 139 or 29.4% of 25-30 year olds, 99 or
20.9% of 31-40 year olds, 169 or 35.7% of 41-50, and 32 or 6.8% over 51 year olds. The study was
conducted by collecting an age group similar to the age pyramid of nurses working in the hospital.
The participants illustrated low levels of work stress in 7.6%, medium levels in 27.1%, and high levels
of work stress in 65.3%, respectively. When we examine whether the level of stress exposure of
nurses differs between the groups by high, medium, and low levels of workplace stress, the analysis
of one factor variance confirms the statistical real difference (F = 3.071), (p = 0.028).
The study results revealed that long lasted accumulated work stress trigger the hypertention.
Conclusion
The onset of stress in a nurse’s workplace depends on many different social factors,
such as age, gender, organizational characteristics, organization, place of work, and years of
experiences. In conclusion, we agreed with Spruil Tanya et al., that chroronic stress at work can be
the reason for the high blood pressure.
5.IDENTIFICATION OF OSTEOPOROSIS RISK FACTORS
Nomundari B ; Arigbukh E ; Ujin Sh ; Delgerekh B ; Uurtuya Sh ; Erdenekhuu N ; Munkhzul M ; lkhagvasuren Ts ; Odkhuu E
Innovation 2018;12(1):16-20
BACKGROUND: According to International osteoporosis foundation report, osteoporosis is a multifactorial condition associated with an increased risk of fracture and is caused by social, behavioral and physiological factors. Overall incidence is increasing in every country due to people’s life style changes, diet and increased life expectancy.
OBJECTIVES: To evaluate the some hormonal effects in bone mineral density among Mongolian population.
METHODS: Bone density was measured in the distal one third of radius using the Sunlight Omnisense (Sunlight Medical, Rehovot, Israel) and classified into 3 groups according to WHO osteoporosis criteria. Normal participants were selected into control group and osteoporotic participants were selected into control group. We have evaluated PTH, calcitonin, 25-hydroxy vitamin D in case-control group.
RESULT: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. It was clear that PTH elevated group (>30.3pg/ml) had more risk of osteoporosis.
CONCLUSION: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. PTH elevation is risk factor in men.
6.Heart remodeling in children after endovascular and surgical сorrection of atrial septal defect
Baasanjav N ; Davaatseren Ts ; Lkhagvasuren Z ; Bayaraa T ; Damdinsuren Ts ; Ariuntsatsral E
Mongolian Medical Sciences 2018;185(3):18-22
The study of indices of heart remodeling was performed in children with secondary atrial septal defects (ASDs) after either endovascular or surgical repair of the defects. The data analysis showed that serious ASDs lead to diastolic left ventricular (LV) dysfunction. Recovery of LV function occurred during the first day following endovascular repair or after six months following surgical correction. Maximum reduction of dilatation of the right heart chambers after ASD repair is recorded in the early postoperative period and keeps during follow up, regardless of the method for the defect repair. We found a significant depression in mechanical activity of left atrium after surgical repair with the recovery one year after the procedure.
7.Healthy live guidance based on human characteristic types by traditional Mongolian medicine
Tuul Kh ; Munkhdelger D ; Sosorbaram L ; Lkhagvasuren Ts
Mongolian Pharmacy and Pharmacology 2018;13(2):14-17
Introduction:
Traditional Mongolian medicine contents a whole idea of preventive medicine.
Traditional Mongolian medicine main theory is “Rlung-Mkhris-Badgan” which is composed human
body. These elements confirm human healthy during metabolite balance but when any of these
lacks or exists in an excessive amount, then there is an illness. Understanding on the theory “Rlung-Mkhris-Badgan” by modern medicine there are called cell universal regulation system.[1] A striking
feature of metabolism is the similarity of the basic metabolic pathways and components of “Rlung-Mkhris-Badgan” even vastly different metabolic pathways. Human has own Rlung-Mkhris Badgan`s
portion differently when they were born, during all life must obey their attribute manner. There are
seven individualities which expressed human characters.
Furthermore in traditional Mongolian medicine have richness experience of concerning with
three elements unbalanced time to come disease early diagnosis and remedy them effectively. Accordingly organic body must adaption four seasons` biological accommodation and follow up four
seasons` suitable food technology and climate condition.
Purpose:
1. To determine human characteristic types by traditional Mongolian medicine main theory.
2. To suggest healthy live advice for people who participate randomized in preventive medical examination by used modern and traditional medical diagnostic methods.
Method:
Biomedicine and Clinical Pharmacy Department doctor teachers were organized “Healthy
life starts every day right habit” topic preventive medical examination for all students of Mongolian
University of Pharmaceutical Sciences 09-29 days of September, 2016. Participant by diagnosed
medical basic physical examination methods and filled out questionnaire in human characteristics
based traditional Mongolian medicine main theory.
Results:
There had 513 participants, 29 of them were “rlung” characteristic personality, 26 of
“mkhris” characteristic personality, 22 of them “badgan” characteristic personality, 163 of them “rlung
and mkhris” combined characteristics, 118 of them “rlung and badgan” combined characteristics”, 68
of them “Badgan and Mkhris” combined characteristics, 87 of them were composite characteristic
personalities.
Conclusion
1. Determined 85% of participants are respectively combined and composed types of characteristic personalities, and these participants supposed to be better metabolism balance. Determined 15% of
participants are one element dominantly personalities.
2. We made a Healthy Life Guidance depending on human characteristics.
8.УЛААНБААТАР ХОТЫН ХҮҮХДИЙН ХӨГЖЛИЙН БЭРХШЭЭЛИЙГ ИЛРҮҮЛСЭН ҮР ДҮНГЭЭС
Narantuya B ; Lkhagvasuren Ts ; Chimedsuren O
Innovation 2017;11(2):134-135
BACKGROUND: Children’s development and childhood disability are a public health issues
to their consequences on quality of life and productivity not only for affected children
but also for families and populations as a whole. WHO and the World Bank estimate
that more than a billion people live with some form of disability, which equates to approximately
15% of the world’s population (1). Citing the Global Burden of Disease study
of 2004, the World Report further estimates that amongst those aged 0-14 years, roughly
5.1% of all children (93 million) live with a ‘moderate or severe’ disability and 0.7%, or 13
million children, live with severe difficulties.
Many children younger than 5 years in developing countries are exposed to multiple
risks, including poverty, malnutrition, poor health, and other risks, which are affect their
cognitive, motor, and social emotional development. There are few research result and
national statistics on the childhood disabilities of under 5 years children in Mongolia.
OBJECTIVES:The objective of the screening was to determine the rate of disabilities in
children aged 9 months to 5 years in Ulaanbaatar.
MATERIALS AND METHODS: Population based cross-sectional study design used childhood
disabilities screening among under 5 years children in Ulaanbaatar. TQ-(ten questions)
screening method used to determine childhood disabilities. The structured interview
checklist (TQ) and a guide to collect background and risk factors information were
administered in a face-to-face interview of the child’s caregivers. The screening covered
8838 children from 6 districts, Ulaanbaatar.
RESULTS: The study covered totally 8838 children (50.4 %) were male and 193 (48.4 %)
were female. Over 81 % of the persons responding to the questions were mothers of the
children, 10 % fathers. 9 % were the child’s relative and child’s sibling. Based on the ‘ten
questions’ screen, 1960 out of 8838 children were positive (disabled).
CONCLUSIONS: The positive rate of disabilities by TQ was a higher. At the post verification
stage there is need to estimate sensitivity, specificity and negative predictive value of TQ.
The second step of evaluation among positive cases should take diagnosis by comprehensive
evaluation and clinical assessment.
9.Correlation between serum parathyroid hormone, 25-hydrohyvitamin D and bone mass density
Ujin Sh ; Arigbukh E ; Delgerekh B ; Munkhzol M ; Nomundari B ; Uuriintuya Sh ; Erdenekhuu N ; Lkhagvasuren Ts ; Odkhuu E
Innovation 2016;10(2):38-41
Osteoporosis is a disease in which the density of bone is decreased with consequent increase in bone fragility and susceptibility to fracture risk. Vitamin D deficiency may cause secondary hyperparathyroidism and low bone mineral density. Our study was aimed to assess relation between vitamin D status and parathyroid hormone and bone density in adults.
Relatively healthy 369 participants aged between 20-60 were randomly selected from Ulaanbaatar city. Specially designed questionnaire was used in the survey. Bone mass density was diagnosed according to the WHO criteria by the T-score. Respondents serum calcium and phosphorus levels were described by the fully automated analyzer (Cobas Integra 2800, Germany). Serum parathyroid hormone and 25-hydroxivitamin D levels were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the Molecular biology laboratory of MNUMS.The statistical result was analyzed by SPSS 21 program.
The subjects mean age was 47.61±12.92, with a range of 20-83. The mean T-score was -0.60±2.17. Our study showed that negative correlation between bone mass density values at parathyroid hormone (r=-0.58, p<0.05), 25-hydroxyvitamin D (r=-0.48, p<0.05) and serum calcium (r=-0.21, p<0.05).
Our study showed increased serum parathyroid hormone led the releasing calcium from bone and decreasing bone mass density.
10. Correlation between serum parathyroid hormone, 25-hydrohyvitamin D and bone mass density
Ujin SH ; Arigbukh E ; Delgerekh B ; Munkhzol M ; Nomundari B ; Uuriintuya SH ; Erdenekhuu N ; Lkhagvasuren TS ; Odkhuu E
Innovation 2016;10(2):38-41
Osteoporosis is a disease in which the density of bone is decreased with consequent increase in bone fragility and susceptibility to fracture risk. Vitamin D deficiency may cause secondary hyperparathyroidism and low bone mineral density. Our study was aimed to assess relation between vitamin D status and parathyroid hormone and bone density in adults.Relatively healthy 369 participants aged between 20-60 were randomly selected from Ulaanbaatar city. Specially designed questionnaire was used in the survey. Bone mass density was diagnosed according to the WHO criteria by the T-score. Respondents serum calcium and phosphorus levels were described by the fully automated analyzer (Cobas Integra 2800, Germany). Serum parathyroid hormone and 25-hydroxivitamin D levels were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the Molecular biology laboratory of MNUMS.The statistical result was analyzed by SPSS 21 program.The subjects mean age was 47.61±12.92, with a range of 20-83. The mean T-score was -0.60±2.17. Our study showed that negative correlation between bone mass density values at parathyroid hormone (r=-0.58, p<0.05), 25-hydroxyvitamin D (r=-0.48, p<0.05) and serum calcium (r=-0.21, p<0.05).Our study showed increased serum parathyroid hormone led the releasing calcium from bone and decreasing bone mass density.
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