A study of the prevalence and risk factors of ischemic heart disease / Эрүүл мэндийн лаборатори

Аbstract@#Ischemic heart disease (IHD) remains one of the most important disorders associated with disability and mortality worldwide, and is one of the major causes of cardiovascular diseases in Mongolia. The objective of the current study was to determine the prevalence of IHD and its related factors in a general population in Mongolia.</br> We conducted a nationwide cross-sectional survey between March and September, 2009. General participants were recruited from urban to rural regions in a multistage random cluster sampling method. The diagnosis of IHD was based on the Rose questionnaire and electrocardiographic findings. A total of 369 (16.2%) subjects with IHD were diagnosed among 2280 participants. The prevalence of subjects with IHD was significantly increased by age: from 9.9% in individuals age 40-44 years compared to 17.7% in those over 60 years. Smoking habits (former and current) and non-frequent intake of fruits and vegetables were significantly positively associated with IHD in men, while heavy alcohol drinking habits and lower education period of time were significantly positively associated with IHD in women. </br> IHD was found to be prevalent, especially among people aged over 40 years, in Mongolia. Statistical factors related to IHD were found to be significantly different based on sex. The current data may provide relevant information to prevent IHD in the Mongolian population.

Aetiology of congenital pediatric cataract in Mongolia / Шинэ санаа Шинэ нээлт

Aim@#The aim was to determine etiology and clinical presentation of pediatric cataract during 1 year period@*Methods@#NCMCH is tertiary and referral center for all pediatric patients with cataracts in 21 provinces and UB. Database contains cases during 1 year period. We have recorded the following data from the medical histories of these patients: family history, current age, age at diagnosis, age at surgery either eye, morphology of cataracts, laterality, associated findings and other investigations which were performed as clinically indicated. We have operated 80 children in total during 1 year period, however the study included 68 patients (91), eyes excluding 12 patients.@*Results@#Of 68 children with cataract 76.% were non traumatic, 21,15% hereditary, 51,9% were congenital/infantile, 35.8% were unilateral, 44% were associated other ocular findings, 25% were associated systemic disease. 33.3% were diagnosed and operated 0-12 months. 73% of congenital/infantile cataract patients were nystagmus. Of traumatic cataract 76,5% due to penetrating trauma.@*Conclusions@#Patients of pediatric cataract 1/3 were usually diagnosed in 0-12 months. 1/3 of these patients were diagnosed congenital cataract whereas 1/4 were nystagmus. To add up associating congenital/infantile cataract with Down syndrome weren’t rare.

IDENTIFING SOME RISK FACTORS OF FEMALE INFERTILITY / Шинэ санаа Шинэ нээлт

@#BACKGROUND: Infertility rate among Mongolian couples was about 8.7% in 2003. According to researchers in Mongolia, the causes of infertility in male is about 25.6%, in female is about 45.8%, in both couples is 18.8% and unexplained infertility is about 9.8%. Women’s previous disease such as abdominal inflammatory diseases, disorders of pregnancy and surgical diseases of reproductive system can lead to infertility. Infertility has been setting 5th rank on list of human disability as shown as problem about quality of human life. METHODS: We surveyd about secondary infertile women, who has approved by inclusion criteria and determined infertility risks. We designed case-control study. We collected 52 data at “Post partum department” of “First Maternity Hospital” for control group, and 22 data at “Women stationary” of “First Maternity Hospital” for case group (ratio 2:1). Data analyzed by STATA for OR (logistic regression tests) and Microsoft Excel. RESULT: The most common previous disease is pelvic inflammatory disease (OR=2.2) р<0.001 before infertility situation. There was statistical reliability diseases. Including: female reproductive system surgery (OR=2.1), pelvic surgical diseases (OR=1.9) and complication of previous pregnancy (1.2). CONCLUSION: Pelvic inflammatory disease, surgical diseases of female reproductive system, complication of previous pregnancy and pelvic surgical diseases are the risk factors of female secondary infertility.

Comparative study of Mongolian and Bhutanese Traditional Medical Services.

This cross-sectional descriptive study was conducted in Bhutan and Mongolia in order to compare and evaluate the Mongolian and Bhutanese Traditional medical services. A structured questionnaire was administered to 202 patients from both the countries, aged 18 years and above. Furthermore, observation method was also applied in order to determine the facilities and the services in the hospitals. The study found out that although Bhutan and Mongolia are two distinct countries, the traditional medicine policies are quite similar because both are formulated keeping in mind the requirements of the World Health Organization (WHO). The human resource was found to be consisting of mostly qualified physicians who have graduated from the government recognized institutes in both the countries. However, the services provided by the hospitals show a considerable difference between the two countries. Further, this study also found that physicians and patients in both Mongolia and Bhutan are satisfied with the services provided but they aspire for improvement in the facilities that are available. Although the services and facilities in both Mongolia and Bhutan are quite similar, Mongolia exceeds in the number of services provided compared to Bhutan due to much more advancement in economic development.

Frequency of target organ damage among hypertensive outpatients in Ulaanbaatar / Монголын Анагаах Ухаан

INTRODUCTION: Poor controlled hypertension is associated with development of target organ damage and theassessment of target organ damage is important in the evaluation of all hypertensive patients as itprovides important information on the severity of the hypertension, the cardiovascular risk and guidemanagement of individual patient.GOAL: The aim of this study to determine frequency of target organ damage among hypertensiveoutpatients at district hospitals in Ulaanbaatar.MATERIAL AND METHODS:This was a cross-sectional hospital based study. Total 150 hypertensive outpatients aged 40-70years were consecutively recruited into the study at district hospitals in Ulaanbaatar. Standardizedquestionnaires were used to collect socio-demographic characteristics and data about diseasehistory that shows hypertensive complication. Target organ damage was assessed by physicalexamination, urine test, serum total cholesterol test, eye fundoscopy and ECG.RESULTS:Among study participants, 130 (86.7%) patients had at least one of the four hypertensive targetorgan damage studied. The most affected organ was the eye presenting as retinopathy observedin 109 (72.7%), followed by left ventricular hypertrophy 107 (71.3%), stroke 20 (13.3%), andproteinuria in 17 (11.3%) patients. Only 42 (28%) had controlled blood pressure, 108 (72%) of thestudy participants had uncontrolled blood pressure.CONCLUSION:This study showed a high frequency of target organ damage among hypertensive patients attendingmedical outpatient clinic. These findings illustrate the burden of uncontrolled hypertension in oursetting.

Survey on the prevalence of hypertention and risk factors among the people above 30 year-old of Bayankhongor province / Монголын Анагаах Ухаан

BackroundThe goal of the survey was to determine the prevalence of hypertension and common modifiable risk factors which is constantly increases and in highly lead of blood circulating system diseases among the people of Baynkhongor province in recent years, and also to find a reasonable ways to improve preventive actions for long life expectancy of the province residents.GoalThe goal of the survey was to determine the prevalence of hypertension and common modifiable risk factors among the people above 30 years old of Bayankhongor province.Objectives:1. To determine the prevalence of hypertension among the people above 30 years old of Bayankhongor province2. To determine the risk factors for hypertensionMaterials and Method:The cross-sectional survey used WHO STEPS survey methodology adapted to the countrys specifics. A total of 373 randomly selected above 30 year-old residents involved to the survey that all represented by ages, gender etc.Results:The survey result showed that about 41.3% of the target population who involved in the survey has the prevalence of hypertension and with no difference in all regions too. Men had significantly higher prevalence of hypertension compared to women as well (p=0.029), andit would occurs and happens more with the aging. Total of 34.6% of the target population who have the prevalence of hypertension (p=0.0001) have diagnosed and whereas men at risk about 66%. The survey result showed that the consumption of the pernicious habits of the population is high, and average daily serving of fruits and vegetables were (1.64 unit) once 3 more times less than the WHO recommendation. Daily salt intake was 9.8 grams per person (2 more times higher than the WHO recommendation) and nearly one in two persons were at increased risk for physical inactivity.Conclusions:The survey result showed that about 41.3% of the target population who involved in the survey has the prevalence of hypertension. In conclusion, the summary of combined hypertension risk factors demonstrates that 2 in 3 (65.9%) adults have 1-2 risk factors and 1 in 3 (30%) adults have three or more common modifiable risk factors. Twice as many young men (aged 30-49 years) than women have high 3 more risk factors.

Studying arterial hypertension uncontrol among the population of Selenge province / Монголын Анагаах Ухаан

Background During the last ten years cardiovascular disease has became one of the priority cause of death in Selenge province, while 23.9 cases in 10.000 population. Studying cause of increasing cardiovascular disease by year and year, connecting with arterial hypertension control and influenced factors is our research work background.GoalTo determine uncontrolled arterial hypertension and evaluate its influenced factors among the population with arterial hypertension in Selenge province.Objectives:1. Research uncontrolled arterial hypertension among the population2. Determine factors that influence uncontrolled arterial hypertensionMaterials and Metods: Research model: Population based moment model of analitic research is used to survey control of population with arterial hypertension. Research coverage and Sampling: Eruu, Zuunburen, and Khutul soums were chosen from 23 soums including center of Selenge province through the random sampling. And then 480 people with arterial hypertension, aged above 18 years were participated in the research. Data was analysed by SPSS 17 program. Collecting information method: Situation of arterial hypertension control is taken by questionnaire method developed by collaboration with WHO and International Association of Arterial Hypertension, and whether follow the drug treatment instruction of physicians is evaluated by MMAS questionnaire method developed by Association of Control Case Managment of America. Arterial hypertension, weight and height of participants were measured. Although people with arterial hypertension under 140-90 mm.Hy are reported “people who are controlling their arterial pressure in normal rate”.ResultsTotally 480 people with arterial hypertension, aged above 18 years were chosen from of Eruu, Zuunburen, and Khutul soums and center of Selenge province. Approximetly, 29.1 percent were male, 70.8 percent were female and average age was 52.43. About 34 percent were high education, 85.8 percent were married and 34.4 percent were retired people. According to the survey, 68 people or 14.1 percent were controlled their arterial pressure/hypertension in normal rate, 412 people or 85.8 percent were uncontrolled their arterial pressure/hypertension in normal rate. Because of the arterial hypertension 59 percent of the participants were under control of physicians. Also there was difference on age and gender with statistical benefit. (p=0.001) People who can control arterial pressure in normal rate were 12.7 percent of people under control of physicians.Conclusions:About 85.8 percent or 412 people with arterial hypertension were uncontrolled, 90 percent were male and 84.1 percent were female. Because of the arterial hypertension, 59 percent of the participants were under control of physicians. But 87.3 percent of them cannot control their arterial pressure/ypertension in normal rate. Physicians control, employment, body mass index and following drug treatment instruction were the factors influence on arterial hypertension control.

Some results of the study of adults' lung ventilation function in Ulaanbaatar city / Монголын Анагаах Ухаан

Introduction: According to World Health Organization, air pollution is a major environmental risk to health and is estimated to cause approximately 1.6 million premature deaths worldwide per year. The air pollution of Ulaanbaatar city is rising year after year.Goal: The aim of this study was to define the lung function of adults in Ulaanbaatar.Materials and Methods: 1196 adults were randomly chosen aged over 20 years of Ulaanbaatar city. Of them 238 subjects were excluded because they had at least one of the following: a history of lung diseases including asthma, COPD, pulmonary tuberculosis, lung fibrosis; symptoms of chronic cough, wheeze, or dyspnea; history of thoracic surgery; history of major acute illness in the past 3 months; or a history of respiratory tract infection in the past 4 weeks. Besides demographic data, information on smoking habits was collected. The lung ventilation function of subjects was checked using a spirometry EasyOne, calculating the indexes Forced expiratory volume 1sec (FEV1), forced vital capacity (FVC), FEV1/FVC ratio. Lung function measurements followed a standardized protocol and fulfilled the ATS criteria.Results: Of the respondents, 486 were males (50.7%) and 472 were females (49.3%). There was a negative correlation between each lung function and age (p<0.05). The lung function was significantly lower in female than in male, for FEV1, FVC (male - FEV1 3.66±0.659 L, FVC 4.467±0.716 L, female-FEV1 2.663+0.559 L, FVC 3.237+0.586 L). In overall, FVC, FEV1 was decreased by 34.5, 37.2 percent, respectively compared with European LLN value.Conclusion: The mean value for FEV1, FVC, FEV1/FVC ratio was 3.17±0.78 L, 3.86+0.89 L and 82.02±6.75 % in overall, respectively.

Some risk factors of bronchial asthma in adults / Монголын Анагаах Ухаан

Introduction: In recent years, there is no scientific epidemiological data about prevalence and risk factors of bronchial asthma among population in Mongolia. Goal: The aim of this study was to define some risk factors of bronchial asthma among urban adults. Materials and Methods: 1201 adults were randomly chosen aged over 20 years who lives in different districts of Ulaanbaatar city. The participants were interviewed using a modified questionnaire of “Global Initiative for Asthma” - GINA. Besides demographic data, information on smoking habits and atopic symptoms was collected. Univariate and multivariate logistic regression modeling was performed to calculate odds ratio of various potential risk factors. The lung function of subjects was checked using a spirometry Easyone, calculating the indexes Forced expiratory volume 1sec (FEV1), forced vital capacity (FVC), FEV1/FVC ratio. Results: Of the respondents, 606 were males (50.5%) and 595 were females (49.5%). Asthma was more frequent in female than in male. The prevalence of wheezing and physician-diagnosed asthma was higher in overweight and obese than in normal weight. The BMI was higher in group with wheezing than in group without wheezing (p<0.01). 54% of subjects with bronchial asthma were smokers. The mean value for FEV1 was 2.86±0.85 L and FVC was 3.60±0.94 L in overall and the lung function was lower in smokers than in non-smokers with bronchial asthma. 28.4% of subjects with allergic rhinitis has current asthma, while 11.6% of subjects without allergic rhinitis has asthma (p<0.01). Conclusion: Female sex, advancing age, history of allergic rhinitis, tobacco smoking and body mass index were associated with significantly higher odds of having asthma.

Prevalence of hepatitis b virus carriage and vaccination coverage rate among 4-6 year-old children in ulaanbaatar / Монголын Анагаах Ухаан

INTRODUCTION: Hepatitis B virus (HBV) infection is a highly endemic in Mongolia. Consequently, complications of HBV including livercirrhosis and primary hepatocellular carcinoma, are crucial public health problems in the country. Since 1991, hepatitisB vaccination has been an integrated part of Mongolia’s Expanded Programme of Immunization (EPI). Since the HBVvaccination program has been implemented in Mongolia, there are few studies of HBV prevalence among children, itis essential to assess the effectiveness of HBV vaccination through the prevalence of hepatitis B virus carriage (i.e.,HBsAg) among children in Ulaanbaatar.GoalTo assess prevalence of HBV carriage and vaccination coverage among 4-6 year-old children in UlaanbaatarMATERIAL AND METHODS:∎ A representative, population based cross-sectional study was implemented in Ulaanbaatar.∎ A retrospective descriptive study design was used to estimate the HB vaccination coverage among 4-6 year-oldchildren in Ulaanbaatar.∎ A total of 2200 children, ages 4 to 6 years, were sampled using a stratified conducted, with stratified, multistage,random cluster design from 40 sub districts of 5 districts in Ulaanbaatar.∎ The children, aged 4 to 6 years, (n=1988) were tested for serological marker of HBV HBsAg.∎ All data (dose, species, and date) of the HepB vaccination were collected from the immunization record of thechildren.∎ Closed and open ended questionnaires were asked by parents to assess some social and demographicfactors.RESULT:Of the 2200 children sampled 183 children were not present at their home address and 29 children refused to participatein the study. Thus, 1988 children participated from Ulaanbaatar city (353 of from Khan-Uul district, 440 from Bayanzurkhdistrict, 400 from Bayangol district, 344 from Sukhbaatar district, 451 from Songinokhairhan district) (Response proportion90.3 percent). The mean age of children was 4.97±0.8 years with a range of 4-6 years; 1023(51%) were boys. Rapidtest results are available for all 1988 children; 0.3 percent (n=6) of whom were HBsAg carriers. HBsAg prevalence of4,5 and 6 year-old children were 0.15 percent, 0.43 percent and 0.32 percent, respectively. No association betweengender and HBsAg was identified. The administration of HB vaccine birth dose, HepB2 and HepB3 were 98.2 percent,94 percent, and 91 percent, respectively. Among children with immunization cards, 1089 (81.5 percent) children werecompletely vaccinated, 237 (17.7 percent) incompletely vaccinated and 11(0.8 percent) not vaccinated with hepatitisB vaccine. Prevalence of HBsAg carriage among children with immunization record was 0.18 percent and withoutimmunization records was 0.46 percent.CONCLUSION:Prevalence (0.31 percent) of HBV carriage among the young generation meaningfully declined compared with those ofprevious studies in Ulaanbaatar as a result of Expanded Program of Immunization. There was no significant associationbetween age or sex and HBsAg carriers.