Efficacy of radiofrequency ablation for cystic thyroid nodules / Монголын Анагаах Ухаан

Background@#Thyroid nodules (TNs) are a common clinical issue, and their prevalence has been increasing over the last 2 decades [1] due to the widespread use of ultrasound (US) imaging. More than 50% of TNs are detected with US examination In the general population, while only 3–7% are detected with palpation [2]. Nodular goiter is the most common cause of thyroid disease in Mongolia, as in other countries. Recent guidelines suggest that a nodule without clinical symptoms should be treated with watchful waiting; however, some patients require treatment because of cosmetic problems or symptoms. There are several treatment options, but neither is perfect. The main treatment of the disease is still the traditional surgical resection. it still carries a 2–10% prevalence of complications, such as neck scarring, hypothyroidism, transient or definitive postoperative hypoparathyroidism, recurrent laryngeal nerve injury, and the recognized risks associated with general anesthesia [3,4]. Minimally invasive alternatives have been explored. Laser ablation, microwave ablation, HIFU, and radiofrequency ablation (RFA) are safe and effective techniques for the treatment of nodular goiter. it is possible to treat small nodules early and enlarge them before surgical intervention is indicated. We have introduced a new method of RFA treatment (2019) in our country. @*Purpose@#To assess the effectiveness of radiofrequency ablation (RFA) for cystic thyroid nodules. @*Material and Method@#This retrospective study was approved by the Research Ethics Committee of the Mongolian National University of Medical Sciences and informed consent was obtained from all patients before RFA. The study was conducted from 9th Jan 2019 to 15th Oct 2021, 485 nodules from 183 patients (M:F=9:174; mean age±SD=46.3±11.4 years) who met the eligibility criteria and provided written informed consent were enrolled at the First Central Hospital of Mongolia. Nodules were assessed pre-treatment and at 1, 3, 6, 12, and 24 months post-treatment. Nodule volume were recorded at each time point. </br>The primary endpoint was the volume reduction ratio (percentage) at 1, 3, 6, 12, and 24 months follow-up. @*Results@#For the primary outcome of nodule volume reduction, the absolute volume reduction at the 24-month follow-up was 45 (77.6%). Completely destroyed 10 (17.2%), volume increased by 3 (5.2%) (table. 3). The median volume reductions at the 1, 3, 6, 12, and 24-months follow-ups were 34.9%, 61.0%, 74.9%, 83.3% and 74.0% respectively. Median volume statistically decreased by a significant p=0.0001. At 3 months follow up after RFA, the nodules decreased most. All study subjects recovered without sequelae. Therefore, no patient experienced a life-threatening or delayed complication during the follow-up.@*Conclusion@#Our study demonstrates that RFA is a safe and effective treatment for cystic thyroid nodules. Advantages of RFA include no surgical scars or general anesthesia, low complication rates, and avoiding lifelong thyroid hormone replacement.

Identifiying some risk factors for female infertility in Mongolian population / Шинэ санаа Шинэ нээлт

Purpose@#Researchers suggest that the prevalence of infertility varies between developing and developed countries, with differences in infertility care, socioeconomic status, lifestyle, and reproductive disorders such as pelvic inflammatory disease and sexually transmitted infections being the main risk factors. The research project aims is to define risk factors for female fertility in the Mongolian population. @*Methods@#This study was conducted between 2016-2018 using a cross-sectional survey of analytical research. Participants were randomly selected from Ulaanbaatar and the Central, Western, Eastern, and Khangai provinces according to Mongolia’s regional geographic model. The contents of a questionnaire were comprised of 5 units with 95 questions including socio-economic, geographical, lifestyle, health education, reproductive health indicators, sexual behavior. General physical characteristics were measured according to the standard. @*Results@#The prevalence of the female fertility rate in the Mongolian population is 7.4%. Female participants were classified into 2 groups, namely infertile and fertile, and we developed a case-control study. Among the socio-economic factors influencing infertility, primary education aOR: 1.6 (95% CI 0.98-2.66), monthly household income lower than the average aOR: 1.1 (95% CI 0.77- 1.66), living in rural areas OR: 2.3 ( 95% CI 1.46-3.68) were crucial risk factors. As for reproductive and general health indicators, STIs aOR: 1.8 (95% CI 0.98-3.50), especially gonorrhea OR: 2.8 (95% CI 1.14-6.91), and thyroid disorders OR: 1.7 (95% CI 1.03). -2.97), grade 3 obesity OR: 3.8 (95% CI 1.05-13.95) are estimated risk factors for infertility.@*Conclusions@#Of all potential socio-economic factors, residence status, education and financial situation are significant for female infertility meanwhile reproductive health indicators include sexually transmitted infections, thyroid disease, and obesity.

EVALUATION OF BONE MINERAL DENSITY AND RELATION WITH SERUM TOTAL TESTOSTERONE IN MEN / Шинэ санаа Шинэ нээлт

@#BACKGROUND. According to the International osteoporosis foundation, the incidence of osteoporose in men is increasing rapidly. Some investigations mention the serum testosterone hormone decreases by aging and may cause of osteoporose. Our study was aimed to evaluate relation between serum total testosterone and bone mineral density in men. MATEREALS AND METHOD. Relatively healthy 624 men aged between 18-87 were randomly selected from Mongolian 4 provinces and Ulaanbaatar city. Specially designed questionnaire was used in the survey. And some of measurement, Weight, height and BMI, was measured. Bone mass density was diagnosed according to the WHO criteria by the T-score. Serum total testosterone level were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the laboratory of MHI.The statistical result was analyzed by SPSS 22 program. RESULTS. The subjects mean age was 48.56±16.63, with a range of 18-87. The mean SOS was -4055.23±228.89. And the osteoporse was 14.6% (n=91) in all of participants. 152 participants were randomly selected from all participants and classified 2 groups(case and control) according to WHO osteoporosis criteria and evaluated relation between serum total testosterone and bone mineral density. The mean of serum total testosterone level was significantly low (8.80±2.67) in case group than (9.33±2.44) control group (p<0.05). Our study showed that positive correlation between bone mass density values at testosterone hormone (r=0.17 p<0.034). CONCLUSION. Our study showed decreased serum total testosterone hormone affected to decrease of bone mineral density.

Results of treatment for sight-threatening diabetic macular edema / Шинэ санаа Шинэ нээлт

To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.

Asbestos exposure at workplace / Шинэ санаа Шинэ нээлт

Asbestos is a human carcinogen, and prohibited to use in 55 countries. Thermal power plants, construction industries, locomotive repair shops and analytical laboratories in Mongolia use asbestos as thermal insulation material. This study investigated exposure to airborne asbestos in workplaces. Total of 85 air sampleswere collected from thermal power plants (n=4), locomotive repairshop (n=1), construction renovation workplace (n=1), construction material shop (n=1) and analytical laboratory (n=1).The air samples were collected and analyzed by NIOSH 7400 and 7402 standard analytical methods. The average of airborne asbestos concentration (0.72f/cm3) in the workplaces was 7.2 times higher than the occupational exposure limit (0.1f/cm3). Exposure to airborne asbestos was exceeded in insulation workplaces of the thermal power plants and locomotive repairshop.Airborne asbestos was detected from construction renovation worksite, construction material shop and analytical laboratory, but did not exceeded the occupational exposure level.

The study of socioeconomic and geographical factors that affect healthy aging of Mongolians / Шинэ санаа Шинэ нээлт

As the proportion of aged population has been increasing worldwide by the rapid development of socio-economy, health science, and educational level that affect the policy against health service and social welfare, one of the urgent issues of Mongolian society and medical science facing is to develop healthy aging process and prevention of pathological aging. As we know, healthy aging process depends upon several factors such as heritage, biological and physiological internal factors, living condition, climate, geography, socio-economy, nutrition, drinking water, lifestyle etc,. Thus, the development of healthy aging and its influential factors is an immediate issue of Mongolian medicine and society.A cross-sectional regression analysis has been used to measure socioeconomic and physiological factors for longevity. Total of 1897 participants aged less than 80 are randomly collected from Ulaanbaatar city and Mongolian 4 regions.Total of 1897 participants, less than 80 years old are involved in this study. People in an urban area are higher than those in countryside. About housing condition, 63.5% of total participants are in apartment at UB and 37.8% is in House and 44.3% in Mongolian Ger. Estimating participant’s income, 25% of relatively healthy population is below than the minimum of subsistence. However 50% of elderly people aged between 75-80 is below than minimum of subsistence. Comparing income level by age and gender income is decreased while age is increased, males are relatively higher than females. Middle income people are by 20.9%, high income people are by 57.7% less the risky than low income people. Unhealthy status is increased by 1.0% while a year of smoking, LDL by 96.5%, HDL by 94.7%, Triglycerid by 71.2%, CAVI by 91% increase risks respectively.Below indicators are more influential for the healthy aging of Mongolian elderly people as follows, education level (ρ-0.001), household income (OR=0.423, ρ<0.0001), living conditions (OR=0.326, ρ<0.05), LDL (OR=0.035, ρ<0.0001), HDL (OR=0.053, ρ<0.0001), glucose (OR=0.014, ρ<0.0001), CAVI (OR=0.090, ρ<0.0001). Higher density of healthy aged populations is found in the central region of Mongolia where altitude is 1000-1500 meters above than sea level (MASL) and temperature is between 0-6 Celsius.

CORRELATION OF AIR POLUTION AND PRETERM BIRTH RATE / Шинэ санаа Шинэ нээлт

Over the last decade a large number of studies have investigated the possible adverse effects of ambient air pollution on birth outcomes. For preterm births the evidence as yet is insufficient to their infer causality. Our study goal was to study the associations between air pollution exposures during pregnancy and preterm birth for a 6 years period (January 2008 through December 31, 2013) in Ulaanbaatar, Mongolia. We used a logistic regression adjusting for gestational age, parental education level, parity and infant age. The preterm birth varied with maternal age, maternal education level, maternal pregnancy order and season after adjusting covariates. Young maternal age, maternal less education level, early and older birth order, spring season, not married status and higher number of pregnancy order t are risk factors for low birth weight. The correlation of preterm birth and air pollution was observed in the second and the third trimester of pregnancy. The preterm birth rates were associated with the average of combined air pollutants concentrations such us PM10, NO2 and SO2 in the preceding 6 weeks.

Secondhand smoke exposure among bar and nightclub employees mongolia / Монголын Анагаах Ухаан

BackgroundAt smoking except of current person the non-smoked people of that environment are suffering much the effect of which would be considered to as “passive smoking”. In result of smoking in offices, bar and nightclub, gers and apartments the air of current internal environment would be contaminated through toxic and cancer originating combinations. In regard of our country, Mongolia has entered into the International anti-tobacco convention and there are in progress certain arrangements toward reduction of smoking, study of its negative effects and smoking habit. Unfortunately there is deficit of researches determining the content of tobacco nicotine in offices and public places, form one hand. From other hand there is lack of scientific arguments and facts proving negarive effects of passive smoking and its influences upon environment, people and children. Therefore, we have conducted present research work.GoalThe main objectives this study were to assess secondhand smoke exposure in bar employees and determine air and hair nicotine concentrations.Materials and MethodsWe have carried out present research work according to instant method by involving 10 bars and entertainments and placing 2 air monitors in each bar. There were involved 5 persons from current places, questioned and taken hair samples of 50 employees. At determining nicotine content of air and hair we have used the method of gas chromatography.ResultsTheir average age was 22.3. As we have taken sample in 10 bars and entertainments of Ulaanbaatar city the average content of nicotine counted 14.78 μg/mg. It is 2-3 times more than other countries. The nicotine content in hair of smoking staff is at average 18.06 μg/mg and in hair of non-smoking staff at average 4.24 μg/mg. The more are business hours, the much increases the content of nicotine in hair.Conclusions:This study found very high levels of exposure to secondhand smoke in bars and nightclubs from Ulaanbaatar, Mongolia. Of high concern, time weighted air nicotine concentrations measured in this study were markedly higher than concentrations measured in bars and nightclubs from several African, American, Asian and European countries. Implementing a comprehensive smoke-free legislation that protects workers and customers from exposure to secondhand smoke is urgently needed in Mongolia.