1.Risk Factors and Clinical Characteristics of Pulmonary Embolism Among Mongolian Patients
Javzan-Orlom D ; ; Chuluunbileg B ; Gantogtokh D ; Enkhtuguldur M ; Munkh-Erdene D ; Zolzaya B ; Enkh-Amgalan Ts ; Altankhuyag N ; Amgalandari B ; Badamsed Ts ; Tumur-Ochir Ts ; Solongo B
Mongolian Journal of Health Sciences 2025;90(6):55-62
Background:
The annual incidence of pulmonary thromboembolism is reported to be 39–115 cases per 100,000 population,
with rates of 60–120/100,000 in Western countries and 10–20/100,000 in Asian countries. In Mongolia, few studies
revealed the prevalence of risk factors and clinical manifestations of acute pulmonary embolism. Over the past 30 years,
the incidence of risk factors for non-communicable diseases, which are mainly triggered by lifestyle and social parameters,
has rose. Moreover, environmental conditions such as cold climate, hypoxia, and blood hyperviscosit may contribute
to higher incidences of acute pulmonary embolism in high-altitude regions. This condition is potentially fatal and can
become impair quality of life.
Aim:
We aimed to compare risk factors and clinical characteristics based on age and sex, and to evaluate laboratory findings
and diagnostic tests among Mongolian patients diagnosed with acute pulmonary embolism.
Materials and Methods:
This retrospective research included total 232 patients meeting inclusion criteria. The information
was collected from patient histories, including general demographics, risk factors, comorbidities, symptoms, and
physical examination findings. Laboratory analyses included complete blood count, coagulation profile, and immunological
markers (D-dimer, NT-proBNP, troponin, protein C, homocysteine, and C-reactive protein), as well as selected
imaging parameters. We used Wells and Geneva scoring systems to assess probability of acute pulmonary embolism and
Pulmonary Embolism Severity Index to determine disease severity. Differences by age and sex were analyzed using independent
t-tests for continuous variables and chi-square tests for categorical variables.
Results:
Among participants with acute pulmonary embolism, the prevalence of tobacco and alcohol use was significantly
higher among males (p<0.001). Among comorbidities, arterial hypertension and other pulmonary diseases were more
common in males, whereas cardiac diseases were more frequent in females (p=0.028). Participants aged 65 years and
older showed higher rates of comorbid conditions and regular medication use (p<0.001). The most common symptoms
were dyspnea (90.9%), chest pain (74.2%), cough (70.5%), leg pain (38.9%), hemoptysis (20.7%), and cyanosis (9.3%).
According to sPESI scoring, 69.8% (n=162) were at high risk of death within 30 days, with no significant difference by
sex. However, mortality risk within 30 days was significantly higher in participants aged 65 years and above (p<0.001).
As increasing age, the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were elevated, indicating an acute
inflammatory response (p=0.001). Contrast-enhanced CT scans revealed that 95 participants (44.2%) had main pulmonary
artery involvement, with no significant sex difference, though involvement of the main pulmonary artery was more
frequent in those aged 65 and older.
Conclusion
Dyspnea, chest pain, and cough were the most common symptoms among patients diagnosed with acute
pulmonary embolism. The 30-day mortality risk associated with it was higher among males and increased with advancing
age.
2. Assessment of contents of the “Community based rehabilitation” curriculum
Enkhtuguldur M ; Batbold G ; Batzorig B ; Erdenekhuu N ; Oyungoo B
Innovation 2015;9(4):14-17
In our country for developing these services closer to the population, providing home care and treatment can be conducted in order to get the patient’s health care refer to the family and sum based health centers should be carried out. At the family and sum hospitals are working graduators of medical university, who assisting health care of Community based rehabilitation. In those cases adoctor have a role to give health care services, and to mediate between disabled people and other health care services as physical therapy, speech therapy, prosthesis and orthotics care, disability surgery and other professional cares. Therefore, there is needs to determine training needs of Community based rehabilitation and to accommodate with study curriculum.To evaluate the curriculum content, retrospective databases and descriptive research method were used and research data was collected by previous data analysis, interview and surveillance.In the result, contents of the “Community based rehabilitation” curriculum in different medicaluniversities are generally the same. But the curriculum was more attached to the disease and its drug medications rather than reflecting to proper guidance and advice for patients and main idea of “Community based rehabilitation”. Availability of specific textbooks and handbooks is limited, hence the trainings are held using international declaration, annual report or guidelines. Also the specialists who teach the subject were inadequate. Relating the due subjects, teaching methods were various, such as problem solving and small group discussion, case study etc., and students were evaluated bytest, case solving, essay writing and for School of Medicine, MNUMS they use OSCE. In conclusion, content of the “Community based rehabilitation” curriculum in undergraduate medical education is not adequate, indefinite, and discordant and there is lack of specialized teachers. Additionally, the curriculum content was not applied to the WHO guidance. Therefore we developed“Community based rehabilitation” curriculum in each medical disciplines, available to be used in undergraduate medical education in further.
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