Some issues relating to the family health center, family doctors care and health services / Монголын Анагаах Ухаан

Background. The main target of this research paper on “Some issues relating to the family healthcenter, family doctors care and health services” is for the young doctors, and specifically family doctorsand to help their daily work routine. This paper focused on giving analyses on the principle of somescholars research paper about the general structure of family health center, and its practical activities.There are many issues related to social medical service, an example is the basic health service fromthe family health center. There must a model or classic form for providing medical service at the statefamily health center, general medical center and the first care of medical center. This research paperalso proposed a number of current issues in order to improve the quality, such as family health centerand its management structure.Goal. The reference of this paper is to define family health center service and financial management,based on the research survey. Moreover, it concludes the idea of improving and refreshing the healthsector from the smallest branch and implementing health care marketing in the public. This researchpaper contains followings: the structure of family health center, health insurance, medical service costper person in the family, training for family health center doctor and nurse, the history of family healthcenter origin and its development, home visit service, foreign countries experience on this sector, andthe system to simplifying II, III level medical service etc.Materials and Methods. In our country Mo.Shagdarsuren has changed section hospitals into familyhealth hospital who is doctor, one of the famous manager of health protection who is firstly managed cityUlaanbaatar to committee and district. In early 1990s doctor Ts.Mukhar organized control system of familyhealth in some sub cities who helps people to get better health program. He organized small hospitalitysystems of each sub cities and moved kids doctors to family health system. Since its establishment,the system was rapidly extending throughout the country. Researches for changing the management ofFamily Health Center (Udval.D, Bat Ochir.D) and for the future development of family hospital (Mukhar.Ts, Orgil.B) are proven to be useful in practical environment.Result. The importance of this advisory article is considering in improving the Family Health Careservice sufficiency and its quality coordinating with the writings or publications written by ourcountryfamous scientists. Health Sector reformation strategy and other materials to clarify the importanceprimary health care importance of the family health care and its doctors and it is necessary to hire thebest and most experienced doctors and social health figure in hospital primary service in modernsociety.Conclusion. In conclusion, the scholars believe that in this society, the doctors who are the best, mostexperienced, well- educated on general and family health center service, and trained well, work fromtheir bottom of heart, number of accident, and disease rate will gradually decrease. Therefore, thefacilities of the health center must be improved such as providing proper workplace with well equippedmedical facilities and medical diagnosing cameras etc.Additionally, known as “The left hand of a physician“ in other words, there is a high demand to preparewell educated, professionally independent and knowledgeable nurses for the family health center

Non-communicable diseases and leading causes of population morbidity / Монголын Анагаах Ухаан

BackgroundRestoring and reestablishing the Hospital Management and Organization Sector in the Institute of Medicine since 2010 was the significant organizational measure in the framework of the social health annual action that is of particular value getting researchers of medical research institutions and physicians and scientists of urban and rural area medical sectors involved in the activities to conduct the compilation survey on general situation of population sickness, its rate and on reducing the noncommunicable diseases rate and death rate making doctors and officials of the medical sector to worry about. Furthermore, the goal and objectives of the Hospital Management and Organization Sector of the Institute of Medicine will be directed to conducting the comparative survey “conjuncture” on the total sickness and statistical report registered at the national polyclinic, medical units and family hospitals of urban and rural area, realizing the innovation issuing recommendation and introduce the result in the practice of medical institutions.Summary and recommendationWriting on principal reasons of non- communicable diseases rate and death rate collecting data from the statistical survey summary in the framework of activities of the Institute of Medicine will be significant work for the activities of all physicians, scientists and researchers of whole health sector in making constant the research work in the future, conducting the complex prophylactic policy and expanding the practical measures of the result from the one hand and in realizing the annual goal and objective of social health from the other. As well as it was very significant in working out the research project regarding the non- communicable diseases rate in higher quality by the Sector for Social Health, Hospital Management and Organization of the Institute of Medicine, making conclusion on whole efficient result meeting the requirement and realizing it in future activities in reality.This time, we conducted the comparative survey on the population’s sickness situation and noncommunicable diseases rate by the compilation method and particularly the comparative survey on principal reasons of the sickness and their structure and submitted to publish. Furthermore, according to the tradition of previous generations, the Hospital Management and Organization Sector of the Institute of Medicine will organize the comparative survey on reducing and preventing the noncommunicable diseases rate and death involving the urban and rural medical institutions in these surveys and widely promote it through the media and theoretical and practical conferences.

To the Problem of Diagnosing Disease of Vertebral Artery of External Part of Cranium by Duplex-Sonography / Монголын Анагаах Ухаан

Background. Disease of vertebralis and insufficiency of blood supply occur not a few, it decreases lab our ability much, complaints such as: headache, to feel giddy, to blur eyes, fatigue heartache, neck becomes stiff and unbalance reveal. By some researches study 25-30% of blood supply insufficiency of cranium occupies artery disease 65% of vertebral artery insufficiency occupies disease of external part of cranium we have introduced duplex sonography method by using medison Pico-ACE apparatus since 2006 and it gave possibility of revealing artery disease of external cranium. The most causes of artery disease occupy congenital and acquired deficiency such as: aplasia, hypoplasia and vertebra skin. Revealing and diagnosing these disease early is the confronted problem of society and health and it attracts attention of doctors and specialists of angioneurological branch. Aim of research work: We aimed at the study of diagnosing disease of artery of vertebral of external part of cranium by the method of duplex-sonography and studying dependence of type, size, form, case, age and sex. Materials and Methods. We did the study on 100 people who was done duplexsonographic diagnose because of blood supply insufficiency of cranium in the centre of diagnose of private structure Best Ema. We did analyse of DSG by using MedisonPicoACE apparatus by the stand and method, divided them into 6 groups in 10 age and studied type, size, location speed of stream, age and sex. Conclusion: 1. By duplex-sonography, in 18% hypoplasia of vertebral artery revealed, in 88.8% of it hemo-dynastic change revealed. 2. In 24% of patients involved in the study artery fold revealed, in 62.5 hemo-dynastic change revealed. 3. The main method of analyze which reveals location, size and dynamic and diagnosis vertebral artery of external part of cranium is DSG.

Results of Studying Villas Circle Ring System by the Method of Angiography / Монголын Анагаах Ухаан

Background. In the process of infarction, important mechanism of blood supply deficiency is collateral blood supply. There are a lot of various collaterals which are able to supply in the period of necessity of human brain. Collateral which forms in the level of villas circle (ring) in the cranium is the most important front and back artery cord of brain form villas circle (ligament) as a result of these arteries possibility of forming collateral blood supply in the period of blood insufficiency in vertebral and carotis and between magisterial artery of 2 sides of brain opens. It is rare when the system of villas circle (ring) is complete (full), artery cord is narrow (hypoplasia, aplasia) or none, villas circle(ring) loses its complete and it becomes open on the front and at the back part. By the researchers study hypoplasia of artery cord occurs in 20-40% because it branches off from other artery. By Yu.M. Nixitins study vertebral artery of the brain branches off the form the artery into carotis and it open at back part-was 25%, study of system of villas circle (ring) by angiography hasnt been done. Aim. We aimed at the diagnosing villas circle system by angiographic method and studying its incompleteness, form cause, age and sex dependence. Materials and Methods. We studied material of 595 patients who were done angiography of the brain because of acute and chronic deficiency of blood supply of the brain in 2007-2008 at the third clinical hospital by P.N.Shastin in the cabinet of angiography came from clinic, district and Achtan Elit hospital. We clarified magisterial arteries and villas circles in the cranium by the standard method in 2 sides used polydiagnostic 2 digital subtraction equipment of Philips form of Japan. We evaluated artery system, location, form and size and studied age and sex dependence.75% of verographer solution not more than 80-100ml was injected into the artery. Conclusion: 1. Incompleteness of circle revealed in 31.7 % 2. Open case of villas circle in the front part was in 41.5 % 3. Open case of villas circle at the back revealed in 58.4% 4. Studying villas circle, evaluating collateral blood supply is necessary to blood supply deficiency in particular to define blood deficiency insult.

To the Problem of Diagnosing Disease of Vertebral Artery in the External Part by the Method of Angiography / Монголын Анагаах Ухаан

Background. Nowadays more attention is paid to the study of blood supply of the brain in during headache with various causes. Blood supply of the branch is supplied by 2 pairs of carotis and vertebral artery and 2/3 of it in the carotis and 1/3 of it by the vertebral artery. (Farekas et al., 1963) disease with various causes of the vertebral artery in the external part of the cranium or abnormal system have been studied from ancient un the external part of the cranium, lengthening, aplasia and hypoplasia, change of neck vertebra disk affect to dynamic change of back artery blood supply. By scholar maisel fold of vertebral artery is 40%. Stenoses-18%, hypoplasia-10% vertebral artery through c 3-c5 vertebra occurred 12-20%., abnormal system of vertebral artery and location occur more than carotis artery and it has more dependence on external part of the cranium. Study of disease of vertebral artery in the external part of the cranium by the method of angiography hasnt been done in our country. Aim of research work: We aimed at diagnosing disease of vertebral artery in the external part by the method of angiography and studying its form, case, age and sex dependence. Conclusion: 1. Change of vertebral artery revealed 62.3% 2. Fold of vertebral artery in the 6th level 42% in v2, 3 level -9% revealed. 3. Vertebral artery is congenitally narrow (aplasia, hypoplasia)12%., through v3-5, vertebra-13%. 4. 58% of the people with vertebral artery disease occupy females.

To the Problem of Diagnosing Disease of Venous of the Lower Limb by the Method of Dopplerography / Монголын Анагаах Ухаан

Disease of venous of the lower limb has been studied since the period of ancient Hippocrat, Glan and Avitsen and it occurred among the people not a few. Among the disease of venous of the lower limb, disease of venous dilatation occurs mostly (Savliev., B.S, 1999, Morosov, V, Savranski 2000). By recent study about 20% of population where industry developed highly, are affected by disease of venous. It occurs mostly among the people aged 25-55. In medical practice of our country since 1996, diagnosing method of dopplerography has been introduced and began to diagnose venous disease of lower limb in the recent years numbers of people involved in analyze because of acute and chronic insuffi ciency increased year by year. In up-todate phlebolog practice method of ultra sound diagnosing which is harmless to vascular and doesnt hurt is widely used and new methods have been introduced. Aim and Objectives. In order to realize aim of studying and diagnosing venous disease of the lower limb by the method of dopplerography, well solve the following objectives; -to study form and location of venous of the lower limb, to study dependence of age and sex of venous disease of the lower limb, to study symptom of dopplerography in the process of venous disease of the lower limb. Material and Methods. The study was done on the base of 120 patients material that was done dopplerography in the centre Best Ema of private structure in 2007-2008. We used dopplerographic apparatus such as: sonomed 325 and Angiodin. Conclusion 1. Venous disease of the lower limb revealed in 85% of people involved in the analyse. 2. 88.3% of people with venous disease of the lower limb were women aged 31-60. 3. In dopplerography in 37% - symptom of change of venous stream form and the breath is not coordinated, symptom of stream negative in the deep leg vascular after the test -89.4%., in superfi cial venous -10.6%.

To the Problem of Diagnosing Artery Disease of Lower Extremeties by Dopplerograph Method / Монголын Анагаах Ухаан

Aim and objective of the study. Aim of the study is to study artery disease of lower extremities by dopplerograph method. - To study dopplerograph symptom of artery disease of lower extremities. - To study dependence of age, sex and which vessel is at risk Material and Methods. We involved 61 cases which were done dopplerograph analyse because of artery disease of lower extremities at the centre of BestEMA from 2006 to January 2008 dopplerograph analyse was done by using Angiodin apparatus and by standard method divided them into 6 groups by 10 ages and studied by male and female. Results and Discussion. From 100 cases which the disease revealed in 37 artery blockade, in 27 artery stenosis in 36 hemodynamic changes revealed. In order to put differential diagnose of artery blockade and artery stenosis we defined LPI in all persons. In the period of artery blockade and artery stenosis of lower extremities form of artery stream is changed LPI is decreased below 1 depending on disease. These symptoms were common. By our study 40.9% of people with artery disease of lower extremities smoked more than 20 years and 27.3% had hyperglycemia more than 10 years. Result of our study suits to the study of A.G. Evdoximov (1999), V.G. Leluk (2003), Volmar (1996). Conclusion: 1. In 75.4% of people who were done dopplerograph analyse artery disease of lower extremities, artery blockade of lower extremities revealed in 45 stenosis in 37 and hemodynamic change in 42. 2. In the period of artery blockade and artery stenosis of lower extremities from of artery stream changes and decreases below LPI, These symptoms mostly revealed. 3. Artery blockade and artery stenosis are mostly occur in the hip and on males.

To the Problem of Diagnosing General Artery Disease of Carotis by the Dopplerograph Method / Монголын Анагаах Ухаан

Aim and objective of studyTo study possibility of detecting Arteria carotis communis disease by dopplerosonography.Objectives:- To study dopplerography symptom which reveals in the period of Arteria carotis communis disease?- To study dependence of age, sex and artery pressure.Materials and Methods. Study was done on 100 patients who were analysed by dopplerosonograph at the centre of cerebrovessel diagnose BestEMA in 2006-2007. Study was done by using Angiodin ultrasonic dopplerosonograph apparatus and by standard method.Results: On 33 patients who were involved in the study functional defi ciency of Arteria carotis communis was revealed. Functional deficiency of carotis artery of one side was revealed on 12 patients, functional defi ciency of carotis artery of 2 sides on 21 patients, on 7 people had defi ciency of carotis artery hemodynamic over 30% and on 12 more than 50%. 84, 8% of people with functional defi ciency of general artery of carotis have hypertension at some extent. For age there were 19 males-32-77 aged and 14 females. There is Tendency of increasing defi ciency of Arteria carotis communis of 2 sides when the people become older. By dopplerosonograph analyse, when defi ciency of Arteria carotis communis increases speed of blood stream decreases, survey changes, becoming without window, sound /noise/ of stream changes and peripheral resistance increases. Such symptoms are mostly revealed.Conclusion:1. By dopplerosonograph analyse on 33% defi ciency because of Arteria carotis communis sclerosis was revealed.2. 90% of functional defi ciency of Arteria carotis communis occurs on people who are more than 40 years old.3. In the period of general artery scleroses of carotis speed of artery stream decreases survey and noise are changed, peripheral resistance increases. These symptoms are revealed.4. 84.8% of people, on whom carotis artery defi ciency was revealed, hypertension increases at some extent.