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Background@#Globally the incidence of stroke is not decreasing, and the deaths and disabilities caused by stroke is increasing every year, especially in low and low-middle income countries.</br> Long-term trends in stroke incidence in different populations have not been well characterized, largely as a result of the complexities associated with population-based stroke surveillance.</br> Having reliable data on stroke morbidity and mortality, as well as periodic identification of long-term trends will be important information for proper prevention planning in the population, monitoring the disease and further improving the quality of health care. @*Material and Method@#A prospective cohort study has been conducted in adult citizens (972409 in 2019, 925367 in 2020) of 6 districts of Ulaanbaatar from the 1st of January, 2019 to 31st of December, 2020. All first-ever and recurrent stroke cases were included using special software, developed for stroke registry, based on the WHO STEPS approach from participating radiology departments of state hospitals, district hospitals, and some private hospitals. Information of stroke death was obtained from forensic institute and state registration office of the capital city.</br> The trends of stroke incidence and mortality was compared to data between 1998-1999 and 2019- 2020 in UB. @*Results@#The age-standardized crude incidence rate per 100.000 person-years of stroke were 209.0/100.000 (n=1934) in 2019 and 194.0/100.000 (n=1821) in 2020 among adults of UB city. The above results were compared to 1998-1999 studies and the incidence rate declined by 94.0/100.000 in 2019-2020, whereas mortality rate increased by 10.0/100.000 in women aged 16-34. Stroke mortality was 11.6% in 1998 and 26.5% in 1999, while in our study it was 33.87% in 2019 and 29.71% in 2020. Although the incidence of stroke rates has decreased in 1998-1999, the mortality rate has not decreased significantly. @*Conclusion@#Morbidity and mortality rates among the population of Ulaanbaatar citizen remain highest in the world, compared to 20 years ago with overall morbidity declining but mortality has not decreased. </br> In recent years, the Government of Mongolia has been focused on reducing non-communicable diseases, but the primary and secondary prevention and control of stroke in the general population, as well as the acquisition of knowledge attitudes, practices and access to health care still need to be improved.
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Background@#Stroke is one of the leading causes of mortality and disability worldwide. Understanding sex differences in risk factors, clinical characteristics and death after stroke might provide valuable evidence for prevention and management of stroke. @*Aim@#We aimed to describe sex differences in risk factors, clinical characteristics and death after intracerebral hemorrhage (ICH) and ischemic stroke (IS) using hospital-based registry in 6 districts of Ulaanbaatar, Mongolia. @*Materials and methods@#We used hospital-based stroke registry in Ulaanbaatar Mongolia. From 2019 to 2020, total of 974 patients with acute ICH and 1612 patients with acute IS were enrolled in this study. The severity of stroke was measured by National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS). Risk factors for stroke were defined as patient’s history and their medical record. Death after stroke was registered at 28 days and 90 days by follow-up study. A comparison of categorical and continuous variables was analyzed using chi-squared test, Student’s t-test and Mann Whitney U test. Univariable and multivariable logistic regression analyses were also performed.@*Results@#The mean age of ICH patients was 58.41±11.56. There was significant difference in age (59 vs 57, p=0.009) between women and men. Men with ICH were more likely to drink alcohol (35.4% vs 5.2%, p=0.000) and to smoke (37.0% vs 8.4%, p=0.000) and to have arterial hypertension (72.7% vs 58.6%, p=0.000). However, there were no significant differences in other risk factors including atrial fibrillation, diabetes mellitus, prior stroke and other cardiac diseases. There were no sex differences in clinical characteristics including systole and diastole blood pressure, NIHSS scores and GCS. In our study, case fatality rate was 23.8% at 28 days and 1.9% at 90 days after ICH. By multivariable regression analyses, there were no significant association between sex and death at 28 days and at 90 days (OR:0.74; 95% CI:0.52-1.06, OR: 0.80; 95% CI:0.29-2.21).</br> The mean age of IS patients was 61.07±12.88. The women were older (63 vs 59, p=0.000) than men. Men with IS also were more likely to be current smokers (37.6% vs 9.0%, p=0.000), current drinkers (33.2% vs 3.4%, p=0.000) and to have arterial hypertension (74.7% vs 65.9%, p=0.000). There were no significant differences in other risk factors. For IS patients, there also was no sex difference in clinical characteristics. Case fatality rate was 13.3% at 28 days and 1.1% at 90 days after IS. By multivariable regression analyses, there were no significant association between sex and death at 28 days and at 90 days (OR:0.90; 95%CI: 0.64-1.26, OR:5.16; 95%CI: 0.99-23.9). @*Conclusion@#Our study showed sex differences in some vascular factors of both stroke subtypes which emphasized that we need to implement stroke prevention targeting sex-specific risk factors. While clinical characteristics and early mortality of intracerebral hemorrhage and ischemic stroke were not differed by gender.
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Background@#Stroke is still one of the leading causes of morbidity and mortality worldwide. Registry-based data of stroke are scarce in low and middle-income countries such as Mongolia. We aimed to investigate the incidence and mortality of stroke in adult population of UB Mongolia by stroke registration method. @*Material and Method@#Covering 611265 (≥15 years old) adult citizens of three districts of Ulaanbaatar, a population-based prospective study was done from the first, January of 2019 to 31st, December of 2019. All first-ever and recurrent stroke cases were included using special software, developed for stroke registry, based on the WHO STEPS approach from participating radiology departments of state hospitals, district hospitals, and family clinics. Information of stroke death was obtained from forensic institute and state registration office of the capital city. @*Results @#In a 1-year study period, 1068 (women 39.1%) stroke cases were registered in people with 60.16±13.66 years old. Stroke incidence rate was 169.81/100000 including first-ever and recurrent events. Stroke incidence rate was higher in men and people with 80 and above years old. The ratio between IS and ICH was 1.14:1.0. Stroke mortality was 27.1% and mortality rate was 45.94/100000. The highest rate mortality was in ICH subtype, male population and older people. @*Conclusion@#We identified relatively high incidence and mortality rate of stroke in ICH indicating an urgent need for improvement of arterial hypertension control, health education and primary prevention mainly among men.
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Background@#Stroke is a leading cause of death and disability, especially in low-income and middle-income countries and it impacts a tremendous medical, emotional and fiscal burden on society. Due to advances in Western healthcare, the prevalence of stroke since 1970 has decreased by 42%, whereas it has more than doubled in low-income to middle-income countries. </br> Stroke is a heterogeneous, multifactorial disease regulated by modifiable and nonmodifiable risk factors. Approximately 80% of stroke events could be prevented by making simple lifestyle modifications. In fact, nationwide characterization of well-known stroke factors in all social backgrounds is essential, however; populations can differ significantly not only in their socio-behavioral, legal, and geographical conditions, but also from other, historically understudied. Therefore, it is crucial to determine characterization of risk factors for ischemic stroke among Mongolian population.@*Objective@#To determine etiology and risk factors for ischemic stroke among Mongolian population@*Material and methods@#Our study was conducted by case-control study design. Cases were patients with acute first stroke; controls were matched with cases, recruited in a 1.2:1 ratio, for age and sex. The case series study was conducted in Stroke center of Third State Central hospital from January 2017 to December 2017. Structured questionnaires were administered and physical examinations were done in the same manner in cases and controls. Self-reported history of hypertension and diabetes mellitus or blood pressure of 140/90 mm Hg and blood sugar 6.4 mmol/L or higher was used to hypertension and diabetes mellitus, respectively. Smoking status was defined as never, former, or current smoker. Alcohol use was categorized into never or former, low intake, moderate intake, and high or episodic heavy intake. Atrial fibrillation was based on previous history, review of baseline electrocardiograph results (for cases and controls). Odds ratios (OR) and logistic regression were calculated, with 95% confidence intervals. @*Results@#In total, 173 patients with ischemic stroke and 146 controls were included. The patients’ age ranged from 17 to 92, the mean age was 61.2. Ischemic stroke more frequent in man than women by 27.4%. Previous history of hypertension or blood pressure of 140/90 mm Hg or higher (OR 2.40, 95% CI 1.48-3.88), diabetes mellitus (OR 3.08, 95% CI 1.44-6.57), hyperlipidemia (OR 5.09, 95% CI 2.64-9.82) atrial fibrillation (OR 8.70, 95% CI 2.01-37.64 ), current smoking (OR 2.07, 95% CI 1.26-3.40), alcohol consumption (OR 4.75, 95% CI 2.58-8.73) were all significantly associated with ischemic stroke. The mean age was lower in patients with stroke of other determined etiology. The frequency of hypertension was higher in patients with lacunar infarct than other subtypes. Smoking was high frequent in patients with large artery atherosclerosis.@*Conclusion@#6 potentially modifiable risk factors were collectively associated with ischemic stroke and were different among ischemic stroke subtypes. The odds ratios of these risk factors are higher than other countries’ study.
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Introduction: Last Decades, Date by date medical developments providing friendly, high-efficiency treatment equipment and services in developed countries are working toward an advanced, as our country medical services are trying to that country’s technology has been introduced. In our country every day there is only surgical care necessary to endocrine gland disorders, including most common thyroid surgery. It is open and robotic assistant endoscopic surgery in the world. But robotic assistant endoscopic surgery is too expensive and impossible in our country. Thus we chose Thunderbeat for open thyroid surgery in especially huge enlarged goiter and vascularized goiter to try prevent bleeding, recurrent laryngeal nerve palsy and post operation hematoma and other complications Thunderbeat is new generation instrument combines an advanced bipolar clamp to the existing ultrasonic cutter. Materials and Methods: M 51-years-oldwoman was admitted to Mongol Hyundae hospital because of front of neck pain, multi nodular goiter, tachycardia, sweaty and not controlling emotion. Anamnesis: She diagnosed to Thyrotoxicosis in 2005 and she took medicine last ten years but not controlling that poisoning. Status locals: Huge enlarged goiter in front of her neck Treatment plan: 1. Preoperative Preparation 2. Operation: Open total thyroidectomy 3. Medicine 4. Wound dressing 5. Observation We did operation after day of admission day, Patient is placed in a Semi erect position with a folded sheet underneath the shoulders so that the head is sharply angulated backward on the multifunctional surgical table under general anesthesia. We used thunderbeat from muscular to all procedures, dissection both thyroid gland and isthmus after Kocher skin incision and sub skin tissue dissected. There is no complication while procedure and post operation days Result: Nodular hyperplasia of thyroid gland with focci of micro adenomatous change Conclusion: Thunderbeat in use open thyroid surgery first outcomes blood loss than 30ml, no injury of recurrent laryngeal nerve and no penetration ligament of Berry while procedure, second outcomes no hematoma, painless, wound healing process faster and short time hospitalization.
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Introduction: Last Decades, Date by datemedical developments providing friendly,high-efficiency treatment equipment andservices in developed countries are workingtoward an advanced, as our country medicalservices are trying to that country’s technologyhas been introduced. In our country everyday there is only surgical care necessary toendocrine gland disorders, including mostcommon thyroid surgery. It is open androbotic assistant endoscopic surgery in theworld. But robotic assistant endoscopicsurgery is too expensive and impossible inour country. Thus we chose Thunderbeatfor open thyroid surgery in especially hugeenlarged goiter and vascularized goiter to tryprevent bleeding, recurrent laryngeal nervepalsy and post operation hematoma andother complicationsThunderbeat is new generation instrumentcombines an advanced bipolar clamp to theexisting ultrasonic cutter.Materials and Methods: M 51-years-oldwomanwas admitted to Mongol Hyundaehospital because of front of neck pain, multinodular goiter, tachycardia, sweaty and notcontrolling emotion.Anamnesis: She diagnosed toThyrotoxicosis in 2005 and she tookmedicine last ten years but not controllingthat poisoning. Status locals: Huge enlargedgoiter in front of her neckTreatment plan:1. Preoperative Preparation2. Operation: Open total thyroidectomy3. Medicine4. Wound dressing5. ObservationWe did operation after day of admissionday, Patient is placed in a Semi erect positionwith a folded sheet underneath the shouldersso that the head is sharply angulated backwardon the multifunctional surgical table undergeneral anesthesia. We used thunderbeatfrom muscular to all procedures, dissectionboth thyroid gland and isthmus after Kocherskin incision and sub skin tissue dissected.There is no complication while procedureand post operation daysResult: Nodular hyperplasia of thyroidgland with focci of micro adenomatouschangeConclusion: Thunderbeat in use openthyroid surgery first outcomes blood lossthan 30ml, no injury of recurrent laryngealnerve and no penetration ligament of Berrywhile procedure, second outcomes nohematoma, painless, wound healing processfaster and short time hospitalization.
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BACKGROUND:Our previous study has shown that the prevalence and structure of the neurohereditary diseaseswere different by provinces and some form of these diseases as “indigenous” in some isolatedpopulation. There are some scientific results of our researches–genetics about consanguineous,which is more potential factor of community is some area of Mongolia. All these circumstance isgiving to carry out this study.MATERIALS AND METHODS:We used descriptive epidemiological method for revealing hereditary neurological diseases in thepopulation of 6 provinces (aimags) of Mongolia: Dornogobi (Easth-gobi), Sukhbaatar, Gobisumber,Central aimag, Bulgan, and Darkhan-Uul. Total population of these provinces is 363072. Thenumber of population in 6 provinces was fluctuated in the range from 15.000 (Govisumber) to 88.875(Darkhan-Uul). Prevalence was accounted for 100.000 populations.RESULTS:The prevalence of neurohereditary diseases makes up 17.08 cases per 100.000 populations amongthese 6 provinces. 79% of these are hereditary neuromuscular diseases i.e 49 patients from 29families. Myotonic dystrophia and genetic neuropathies Charcot-Marie-Tooth have comparativehigh prevalence over test forms of disease.The high rate neurohereditary diseases was established in the population of Bulgan (35.80•10-5),Sukhbaatar (31.17•10-5), and Dornogobi (21.33•10-5) provinces. Their prevalence’s prevailed in the7-10 times over rates Darkhan-Uul, 3-5 times over rates of Gobisumber aimags.No neuromuscular forms of neurohereditary diseases i.e spastic paraplegia (11.3%) andspinocerebeller ataxia (9.68%) accounts for 21% among all forms of neurohereditary diseases.The prevalence of neuromuscular diseases in the population of these six provinces is two times highthen the average rate of the population of Russia (1980 years). First reason is may be associatedwith high predisposition of based on consanguineous through reproductive way in some of theseprovinces of Mongolia.
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Background: Our previous study has shown that the prevalence and structure of the neurohereditary diseases were different by provinces and some form of these diseases as “indigenous” in some isolated population. There are some scientific results of our researches–genetics about consanguineous, which is more potential factor of community is some area of Mongolia. All these circumstance is giving to carry out this study.Materials and Methods: We used descriptive epidemiological method for revealing hereditary neurological diseases in the population of 6 provinces (aimags) of Mongolia: Dornogobi (Easthgobi), Sukhbaatar, Gobisumber, Central aimag, Bulgan, and Darkhan-Uul. Total population of these provinces is 363072. The number of population in 6 provinces was fluctuated in the range from 15.000 (Govisumber) to 88.875 (Darkhan-Uul). Prevalence was accounted for 100.000 populations.Results: The prevalence of neurohereditary diseases makes up 17.08 cases per 100.000 populations among these 6 provinces. 79% of these are hereditary neuromuscular diseases i.e. 49 patients from 29 families. Miltonic dystrophia and genetic neuropathies Charcot-Marie-Tooth have comparative high prevalence over test forms of disease.The high rate neurohereditary diseases was established in the population of Bulgan (35.80•10-5), Sukhbaatar (31.17•10-5), and Dornogobi (21.33•10-5) provinces. Their prevalence’s prevailed in the 7-10 times over rates Darkhan-Uul, 3-5 times over rates of Gobisumber aimags. No neuromuscular forms of neurohereditary diseases i.e spastic paraplegia (11.3%) and spinocerebeller ataxia (9.68%) accounts for 21% among all forms of neurohereditary diseases. The prevalence of neuromuscular diseases in the population of these six provinces is two times high then the average rate of the population of Russia (1980 years). First reason is may be associated with high predisposition of based on consanguineous through reproductive way in some of these provinces of Mongolia.
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BackgroundEarly detection of minor strokes and their treatment that aim to prevent from complications into severe strokes is a process of secondary prevention. There is a need to extensively use image diagnostics (CT, MRI) because signs are obscure, at times without focal neurological sign but can have special mental or psychological syndromes. The start of minor stroke studies in Mongolia will enable further deepening of these studies in future and give an impetus to identification of theoreticaland practical aspects together with further improvement of diagnostics, treatment and prevention of minor strokes.GoalTo develop and introduce the diagnostic criteria of ischemic and hemorrhagic minor strokes in accordance to the concepts of minor strokes and to treat minor stokes in order to prevent complications into severe strokes.Materials and MethodCurrently there are no globally accepted diagnostic criteria for minor stroke. We support the 1981 WHO criteria of minor strokes as strokes neurological signs of which disappear in relatively short period of time. There is a general notion that it should mean all light forms of stroke other than severe strokes. In cases of neurological signs of a minor stroke, complete recovery and elimination of the symptoms take up to 3 weeks. Most scholars tend to consider ischemic lacunar strokes (arising from occlusion of arteriole vessels deep in the brain and with size of 0.5-20 mm) as minor strokes. We maintained the concept that characteristic features of these strokes are their limited focal areas and the following neurological symptoms: pure motor, pure sensory, light ataxia, etc. We also duly considered a suggestion (D. German, L. G. Koshchug et al, 2008 ) to define minor hemorrhagic strokes as strokes with diameter less than 2 cm and blood volume less than 5 cm3.We identified 60 patients with minor strokes, involved in monitoring using special research template (with a term of at least 1.5years) and involved in pathogenesis treatment. In the treatment, we maintained a principle of differential diagnosis of ischemic stroke symptoms. Specifically, we differentiated the following: signs related to an atherotromb, cardio-embolic, lacunar, hemodynamic, hemorheologic pathogenesis. To verify the diagnoses, we used MRT and CT image tests. We executed paraclinic tests in order to identify risk factors: Doppler-duplex-sonography, brain angiography, blood lipid fraction, ECG, EchoCG, heart Holter, blood hemorheology test, and identified the most affecting factors (hereditary factors, excess weight, smoking etc).Results: Our study identified the following clinical forms: lacunar stroke, non-lacunar minor stroke, and hemorrhagic minor stroke. Among the minor strokes, the lacunar stroke dominates (48%), the nonlacunar stroke is the next (27.7%), and the hemorrhagic was found to be the least common 25%. From among a host of risk factors, arterial hypertension is dominant (86%) either alone or in combination with such other diseases as diabetes, atherosclerosis etc. Diabetes occurrence was 5 cases (8,3%) which is fewer than in some foreign studies.The clinic of minor stroke also varies. The strength and expression of their symptoms compared with those of severe strokes are unique in the following:- Relatively lighter and recover faster as a result of treatment even in acute forms,- Some are without specific clinical signs (“silent stroke”).- Some minor strokes have micro focal signs, for example, “pure motor”, pure sensory, ataxia etc, in other words, the signs are limited.- In cases of lacunar strokes, predominantly deep brain arterioles are damaged.- Whereas in non-lacun strokes, embolic, ateroma, thrombotic mechanisms are predominant suchas distal branches of big artery. - In cases of hemorrhagic minor strokes, arteriopathy distortions occur not only in depth of brain but also in any small lobar vessels of brain.- Focal lesions have some variations by their pathological locations and minor stroke signs.In non-lacunar strokes (25%), the focal damages predominantly occur in branches of large intra/extra cranial arteries. In cases of lacunars strokes, the focal lesion is not in branches of large intracranial vessels, but is predominantly in basal ganglia, deep white matter, thalamus, pons and in area of deep penetrating arterial vessels. However, focal infarcts in cerebella may occur in any form of minor strokes.ConclusionAccording our study there were identified 3 subtypes of minor stroke. The finding is that lacunars and hemorrhagic minor strokes are more likely to give grounds to severe strokes. From this, it can be concluded that there are specific factors in the population of Mongolia to affect the genesis of minor strokes, namely, arterial hypertension which is directly related with these forms of minor strokes. We appropriate the WHO criteria of minor stroke that is neurological signs of a minor stroke, complete recovery and elimination of the symptoms take up to 3 weeks. In treatment of minor stroke, we suggest that minor strokes should be treating by pathogenetic therapy. Namely, antihypertensive therapy for lacunar infarction, anti-aggregation therapy for nonlacunar infarction and haemostatic and antihypertensive therapy for hemorrhagic minor stroke.
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The purpose of the present study was to elucidate genealogical and clinical features of hereditary neuropathy in the several kindreds of Gobi-Altai province.Materials and Methods: In the present study, we investigated five kindreds originated from Bayan-Uul sum, Gobi-Altai province on the basis of previous surveys. Each participant was enrolled for genealogical and neurological examinations according to specific questionnaire. We also collected biological samples for further genetic study. Genomic DNA was isolated from biological samples, and quantitative analysis of DNA was determined by spectrophotometer and Picogreen assays.Results: Twenty members from five kindreds were investigated. Genealogical analysis revealed that there is a linkage between two kindreds within the families enrolled into study, whereas no association was revealed among the other pedigrees. As a phenotype of the hereditary neuropathy, the clinical features were inherited in every generation, and the inheritance was not dependent on the gender. In neurological examination, age of hereditary neuropathy onset was detected as follows. The clinical features appeared in the first decade of life in 4 patients, in the second decade of life in 5 patients, and for the other members the disease started in the age of over 20 years. Common clinical features of hereditary neuropathy were characterized by hypomimic- and mask shape face, muscular atrophy of upper and lower limbs, and pes cavus. Interestingly five female patients had similar gynecological problems. Conclusions:1. The hereditary neuropathy exists in the kindreds of Bayan-Uul sum, Gobi-Altai province and the type of inheritance could be categorized as autosomal dominant.2. Onset of hereditary neuropathy disease was started mostly in the second decade of life. Common clinical features of hereditary neuropathy were characterized by hypomimic- and mask shape face, muscular atrophy of upper and lower limbs, and pes cavus. Apart from general clinical features, the specific complications related to metabolic disorders and pregnancy was detected.
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Introduction: There are still MS has been diagnosed in Mongolia during last 40 years, there is a lack of information regarding to geographical distribution and ethnic differences in origins of MS. That is why our main purpose is to do study the prevalence rate of MS in populations of UB city. Goal: To determine the prevalence rate of MS in adult populations of Ulaanbaatar (UB) City.Materials and Methods: To study the morbidity of MS in Mongolia using statistical data; to determine the prevalence rate of MS using hospital-based design and following the “door-to-door” methods. Results: MS morbidity analysis of five-year statistical data (2003-2007) showed an average of 178 per 100000; morbidity level in both rural and urban settings was 7.0 per 100000; among them 43% were patients in the 30-40-year-old age group. According to our study the prevalence rate of MS in UB City for a adult population of 100,000 above the age of 16 was 10.3; Rate of prevalence in females is 4 times more than in males (15.8 vs 4.2); the highest prevalence rate in females was in the 40-49 year-old age group (31.3); in males was in the 50-59 year-old age group (14.9). It is shown by disease dominating middle-aged women and older men relatively (p<0.05). In our clinical study of 67 MS patients, the mean age was 41.79±8.76. The age at onset ranged from 18-50 years (31.5± 9.2-for females; 37.3± 9.7-for males). Conclusion: The average morbidity rate of MS in Mongolia by statistical analysis from 2003-2007 data was 7.0 per 100,000 people; with a female-to-male ratio of 2:1. The prevalence rate of MS in adult populations of Ulaanbaatar for 100,000 people was 10.3; with a “chi”-square for females that was 4 times higher compared to males.
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Background. The prevalence of hereditary spastic paraplegia or Shtrumpel disease is very various in studied countries of the world. It fluctuated between 0.43 (Bulgaria) and 72.4 (South African Republic) per 100’000 population.Method. In this study which is a part of a general epidemiological study of some hereditary neurological diseases in Mongolia since 1997, authors established the prevalence of myotonic dystrophy among 1.7 million population from 14 aimags and the capital city Ulaanbaatar during the period from 1997 to 2010.Goal. The study aimed to establish the prevalence of hereditary spastic paraplegia (HSP) in Mongolia.Material and Method. This study is part of a general study of the epidemiology of hereditary neurological diseases in population of 14 aimags (provinces) and the capital city Ulaanbaatar (the total population covered by the study was 1’738’000) which is being carried out since 1997. The sizes of population in aimags and the city ranged from 47,800 (Southgobi) to 605,292 (Ulaanbaatar). This study report extrapolates the prevalence nationwide. Diagnosis was established by mainly clinical characteristicsResult. Study revealed 47 patients from 15 families. The prevalence of HSP by aimags was established from 0 to 13.48 per 100’000 population (Uvs aimag). The average nationwide prevalence (1’700’000 above) was established at 2.70/100’000. There are revealed 9 cases (19.1%) in ages of 0 and 14, 6 cases (12.8%) in ages of 14-19, 27 cases (57.5%) in ages of 20- 49 and 5 cases (10.6%) in age above 50.Conclusion1. By prevalence of HSP Mongolia belongs to countries with average prevalence. But the prevalence rates differ by aimags. Patients with HSP in Ulaanbaatar (11 cases) were covered by molecule-genetic analysis by types of the disease, revealing occurrences of II and IV subtypes. 2. Of all patients, 90% are below 50 years of age pointing to the early morbidity with this disease in the context of their early mortality. The situation reveals the need of further moleculegenetic and clinical studies of the types of this disease and of improvement of clinical and genetic counseling of HSP patients.
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In this published case of a male patient B., 53, has some epidemiological specifics. There is transient ischemic attack (TIA) syndrome, particularly while with clear mind there is sudden temporary paralysis of left leg and arm and loss of ability to speak. Temporary refers here to a period of 2-3 minutes after which everything gets back to normal. The incidence occurred again in two days during the medical treatment.MRA test concluded on the presence of obvious stenosis at the beginning part of both sides of a.cerebri media. The mentioned blood vessel pictures were undefined. Hence selected catheter angiography has been done with a purpose to establish the presence of a full occlusion or clogging stenosis in a.cerebri media and to clarify which specific vessels are being mobilized for the collateral supply. This test established that the a.cerebri media had full occlusion on both sides.A duplex sonography conducted in order to clarify characteristics of the clogging (blocking) process concluded the presence of gradual thickening of and blocking in intima (inner wall) of a. carotis interna. Based on these tests we considered that despite the atherosclerosis symptoms (Ischemia in ECG, 20 years of smoking,being male and aged 53, etc), this case had conditions of gradual (slow progressing) arteriopathy. Thus because of the presence in this case simultaneous arteriopathy process (gradually progressing and causing the blocking) in addition to atherosclerosis syndromes we consider it as a Moya-Moya syndrome. The disease of Moya-Moya is mostly found in children and youth and is a unique arteriopathy considered unrelated with atherosclerosis.
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Background: The data of prevalence of epilepsy in rural provinces among general population in Mongolia is rare. Goal:The study aimed to identify prevalence rate of epilepsy and its characteristics by age and sex among the population in eight provinces (Bayan-Ulgii, Bayankhongor, Gobi-Altai, Zavkhan, Uvurkhangai, Dundgobi, Orkhon and Hentii) of Mongolia.Material and Мethod: This study in the listed aimag populations was carried out by retrospective application and using a questionnaire developed according to a methodology approved by the Academic Council of the Medical Science Institute. For verification of the epilepsy diagnosis, the study based on neurologist examination and EEG. In some suspect cases we used neuroradiological tests including СT and MRI. The diagnosed patients were registered using a special form. The study involved diagnostic examinations of 627762 (306482 males; 321280 females) persons that had at least two unprovoked seizures in their lives. For each case of positive diagnosis we calculated the prevalence rate per 1,000 population in each category of extended age groups (1-12 months, 1-2, 3-4, 5-6, 7-8, 9-10, 11-12, 13-15, 16-17, 18-22, 23-27, 28-32, 33-37, 38-42, 43-47, 48-52, 53-59, and above 60) and by sex.Result: There were 1407 cases (785 males; 622 females) of diagnosed epilepsy among the studied population. The cumulative prevalence rate for all aimags was studied 2,24 (males- 2,56; females-1,93) per 1,000 population. The relatively high prevalence rates per 1,000 population were observed in Gobi-Altai (5,14), Dundgobi (3,31), and Orkhon (2,48) whereas the lowest rate was in Bayankhongor (1, 38). A differential look by sex reveals a high sex gap 6,20 for males and 4,12 for females in Gobi-Altai while Dundgobi (males- 3,84; females- 2,80), Orkhon (males-2,91; females-2,08); Uvurkhangai (males -2,20; females -1,73) show little difference by sex (P>0,05).As for the differences by the detailed age groups, all aimag data shows that prevalence for males ranges between 0,14(1- 12 months) and 5,17 (48-52) and for females between 0,24 (above 60) and 3,82 (38-42). The highest prevalence rate among male population was observed in 48-52 age group, 6,21/1000; followed by age groups 33-37 (2,93/1000); 53-59 (2,84/1000); 38-42 (2,81/1000); and 18-22 (2,38/1000). The highest prevalence rate among female population was observed in 43-47 age group 5,49/1000 followed by 38-42 (5,48/1000); 33-37 (4,0/1000); 53-59 (3,35/1000).Epilepsy prevalence in age groups younger than 11-12 tends to fall for both male and female population. Gender difference in prevalence is that males tend to have higher rates 2,56 than females 1,93 ( P<0,05).Conclusion:1. The general epilepsy prevalence among some rural populations in Mongolia is 2,24 (M -2,56; F-1,93) per 1,000 population.2. The cumulative by all studied aimags data reveal relatively high prevalence rate in age groups of 18-59. This level might be related to men’s vulnerability to traumas and factors of vascular origins while in women it might relate to their physiological transformations of pregnancy delivery and menopause.3. Epilepsy prevalence in age groups under 12 years old tends to fall for both male and female population which might be related to the low level of examination and diagnosis of these diseases among children.4. Compared to some foreign scholars’ data, Mongolia’s epilepsy prevalence rate does not qualify it among the high rate countries.
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BACKGROUND: Multiple sclerosis is spreading in population of Mongolia last 30 years. But there are rare of the date ofprevalence of this disease in Mongolia. So we have studied the prevalence of this disease in population of 8 provinces(aimags) of Mongolia in 2008 year.GOAL: To reveal and establish prevalence and clinical characteristic of multiple sclerosis (MS) in population of 8 aimags(provinces) of Mongolia.METHOD: Revealing of patients with multiple sclerosis in population was made by neurologists, which are possessedof clinical method for revealing or confirm the diagnosis and were taken in register the patients only with confirmeddiagnosis. This study was conducted in following 8 aimags of Mongolia: Bayan-Ulgii, Bayankhongor, Gobi-Altai,Dundgobi, Uvurkhangai, Zavkhan, Khentii, and Orkhon; total population of these aimags is 627762 (m-306482, f-321279). The prevalence of this disease was calculated for 100.000 populations.RESULTS: There have been revealed total 35 patients in 8 aimags. The prevalence for 100.000 population is 5,57 (m-2,61; f-8,40) and has been fluctuated in provinces in range from 1,81 (Uvurkhangai aimag) till 13,28 (Khentii aimag) for100 000 population.The rest 6 provinces (aimags) have prevalence in range from 4,17 (Dundgobi) till 6,38 (Bayan-Ulgii).All patients were distributed by clinical characteristic in next main forms:Cerebro-spinal form in 22 patients (62,8%) among them optico-myelitis in 9 cases (40,9%); Spinal form in 6 patients(17,1%); Cerebral form in 4 cases (11,4%); only optical form in 3 cases (8,6%).Pure spinal, cerebral and optic forms are diagnosed in patients, which have duration of disease no more 6-7 years.By the courses of disease all patients distributed in courses the beginning with acute attack incomplete recovery(remissions) revealed in 18 patients (51,4%), more rapid but steadily progressive course in 5 cases (14,3%), acutesevere attacks course in 5 patients (14,3%).CONCLUSION:1. Multiple sclerosis is spreading in population of Mongolia in last 30 years after 1980.2. The prevalence of this disease in population of 8 provinces (aimags) of Mongolia in 2008 year is 5,57 cases (inmen-2,61; in women-8,40) for 100.000 population. The rates of prevalence of the disease by aimags are oscillated inrates from 1,81(Uvurkhangai) till 13,28 (Khentii) for 100.000 population.3. The women suffered more in 3 time than in man and optic form revealed in 34,2 % cases (in 12 patients). Theage of beginning of the disease was fluctuated in age from 16-19 years old till 60 above years old.4. By level of prevalence of this disease Mongolia now is belonging to countries of the world, which have lowprevalence of this disease (till 10 per 100.000 pop).
ABSTRACT
BACKGROUND: The study of epidemiology of hereditary neurological diseases in Mongolia began a few years ago. Itcovered a few aimags (provinces) (D.Baasanjav, 2000-2005). Previous studies have shown, that hereditary neurologicaldiseases are not rare in Mongolia and structure and prevalence of these diseases vary by aimags. Mo n g o l i ahas 21 aimags (administrative provinces), each with a population from 45000 till 110440. In some “isolated” populationsspecific neurological hereditary diseases can be marked as “indigenous”. So the epidemiological study of hereditaryneurological diseases in Mongolia is one of the urgent medical shortcoming in Mongolia.MATERIAL AND METHOD: We used descriptive epidemiological method for revealing hereditary neurological diseases infamilies in population of 8 provinces (aimags) of Mongolia, Bayan-Ulgii, Bayankhongor, Govi-Altai, Zavkhan, Dundgobi,Khentii, Orkhon, Uvurkhangai, total of 627,000 population. The population of these aimags fluctuated in the range from47959 (Dundgobi) to 110440 (Uvurkhangai). Diseases were diagnosed by neurologists using clinical and genealogicalmethods.RESULTS: The study revealed 77 patients in 40 families in the studied population with variety of neurological hereditarydiseases. The overall prevalence of hereditary neurological diseases for 100,000 population is 12,26. The prevalencevaries by aimags from 2,08 (Dundgobi) to 32,50 (Gobi-Altai) per 100.000 population. The prevalence and their rangeby nosological structure per 100000 population in aimags are: myotonic dystrophy 5.41 widely varying by aimags: from4.66 in Bayankhongor to 27.09 in Gobi-Altai; Charcot-Marie-Tooth syndrome 1.59 and ranging from 2.08 in Dundgobito 4.66 in Bayankhongor; Duchenne muscular dystrophy -0.79 and ranging from 0.90 in Uvurkhangai to 3.19 in Bayan-Ulgii; the limb girdle muscular dystrophy -0.95 and ranging from 1.81 in Uvurkhangai to 4.66 in Bayan-Ulgii; Strumpellfamilial spastic paraplegia -0.95 for total pop and ranging from 2.71 in Uvurkhangai to 5.41 in Bayankhongor; familialparoxysmal myoplegia -0.79 for total pop. and range from 2.22 in Orkhon to 5.41 in Gobi-Altai; spinocerebellar ataxia -0.47 for total pop. (3.91-in Zavkhan); bulbo-spinal amyotrophy -0.32(only in Bayankhongor); spinal amyotrophy of adults-0.16(only in Uvurkhangai); arthrogryposis with myodystrophy -0.63 (only in Khentii); kyphoscoliosis with myodistrophyand nanism -0.16 (1.06 in Bayan-Ulgii)A comparatively high prevalence of all neurological hereditary diseases per 100.000 pop. was established in Gobi-Altai(32.50), Orkhon-26.56, Bayankhongor-15.16, Bayan-Ulgii -11.70 rates; the low prevalence - in Dundgobi-2.08 and-Zavkhan-3.91.The hereditary neuromuscular diseases among all hereditary neurological diseases taken up 71.9% i.e 55 patients from29 families. The myotonic dystrophy is tops the list of neuromuscular diseases (61.8%)CONCLUSION: Hereditary neurological diseases have a relatively high prevalence among the population of Mongolia,specially the neuromuscular diseases; so the control of these diseases in the country is one of the special priorityproblem of the national health care.