Increased arterial vascular tone during the night in patients with essential hypertension.

The time-dependent incidence of cardiovascular events points to an important role of chronobiology for arterial properties. To evaluate arterial properties in patients with essential hypertension, we assessed arterial vascular tone during sleep at night in patients with essential hypertension and normotensive control subjects. Vascular tone was continuously quantified by the reflective index obtained by non-invasive digital photoplethysmography and an algorithm for continuous, investigator-independent, automatic analysis of digital volume pulse. During the first half of the night, the reflective index was significantly higher in 31 patients with essential hypertension compared to 30 normotensive control subjects (30.0+/-0.2 vs 28.8+/-0.2; P=0.001). In patients with essential hypertension, the reflective index significantly increased from 30.0+/-0.2 in the first half (from 2301 to 0230) to 30.7+/-0.2 in the second half (from 0231 to 0600) of the night (n=31; P=0.027). In normotensive control subjects the reflective index also significantly increased from 28.8+/-0.2 in the first half of the night to 30.2+/-0.2 in the second half of the night (n=30; P=0.001). An increase of the reflective index tone indicated systemic vasoconstriction as confirmed by cold pressure tests and a significant correlation between arterial vascular tone and sympathetic nerve activity measured by microneurography from the peroneal nerve. Photoplethysmographic determination of arterial vascular tone demonstrated a significant increase of systemic arterial vascular tone in patients with essential hypertension during the first half of the night compared to normotensive control subjects.

Hematological changes in peripheral blood of patient with covid-19 infection reported in Mongolia / Эрүүл мэндийн лаборатори

Introduction@#According to CDC guideline, common changes in patient admitted due to pneumonia caused by COVID-19 are lymphopenia (63%), leukocytosis (24-30%), leukopenia (19-25%). Neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), thrombocyte-lymphocyte ratio (PLR) are important to evaluate prognosis of infectious diseases as well as cancer. </br> Hematological tests are important for diagnosis, treatment and monitoring of patient with COVID-19. Our study objective was to determine the changes of leukocyte, lymphocyte, thrombocyte, NLR, LMR, and PLR in imported cases of COVID-19 into Mongolia.@*Method@#The data such as age, gender, and laboratory test of a total of 249 cases who admitted to National Center forCommuncable Diseases (NCCD) from March 11 to July 20, 2020 was collected from information system of clinical laboratory of NCCD. Peripheral blood tests were conducted by XN 550 which is fully automated hematological analizator of Sysmex corporation, Japan. Statistical analysis such as mean, standard deviation, probability range was done by Microsoft Excel SPSS -25 program.@*Result@#Regarding to gender, 163 (66.5%) were male and 86 (34.5%) were female. Mean age was 26 with range age of 11-80. Statistic analysis on leukocyte (mean 6.38 x 10⁹/L; P <0.000), thrombocyte (mean 283 x 10⁹/L P <0.000), neutrophil (mean 3.33 x 10⁹L; P <0.000), lymphocyte {mean 2.3 x 10⁹/L; P <0.000), NLR (mean 1.6, P <0.000), PLR parameter (mean 141.8 P <0.000> were revealed. Leukopenia (<3.98) were in 17 (6.8%), leukocytosis (>10.0) were in 11 (4.4%) cases. Lymphopenia (<1.18) were in 14 (5.6%), lymphocytosis (>3.74) were in 14 (5.6%) cases. Thrombocytosis (>369) were in 21 (8,4%), thrombocytopenia (<163) were in 4(1.6%) cases. Neutropenia (<1.56) were in 14 (5.6%) neutrophilia (>6.13) were in 15 (6%). The rest 220 (88.3%) cases have been determined no changes. PLR were 141.8 ±88.6, NLR were in 1.29 ±1.26 in 249 cases. Increased NLR and decreased PLR were in 10 (4.0%) and 114 (45.7%); increased PLR and decreased PLR in 31 (12.4%) and 28 (11.2%), respectively.@*Discussion@#Our result which is leukocytosis in 4.4%, leukopenia in 6.8%, lymphopenia in 5.6% of all imported eases ol"CO\ 1D-W. are similar to other studies. However, percentage of changes were lower than similar studies due to low rate of severe cases. It suggests, further studies clinical stages and severity of the infection need to be conducted.

COMPERATIVE STUDY OF CALCULATION ON STUDENT QUANTITATIVE POINT / Шинэ санаа Шинэ нээлт

@#BACKGROUND As a Mongolian National University of Medical Sciences student rating point is calculated by transferring into 42 level quantitative point in accordance with procedure which assess student approved byDirector with 1st attachment of order no. A/144 on December 15, 2015. However, the calculation,estimated by mathematics allocation, of the student rating point, letter point and quantitative is notbased on research also allocation of transferring the rating point into quantitative point is different foranother universities. These reasons mentioned previously have seriously become basis backgroundof our research. The main objective of this research is to compare model of transferring rating pointinto quantitative point. METHODS Research was completed by quantitative method that based on moment descriptive study, case study, model of mathematic and geometry modeling.Under our research objective we did compare study using rate point that transfer into quantitativepoint of student at MNUHS, accuracy and methodology all among the Mongolian state and private universities. Now Mongolian National University of Life Sciences, Etugen University and New Mongolia Medical University are using 5 level table that approved Ministry of Education Science, Mongolian National University is using 9 level scale, Mongolian University of Science & Technology, Mongolian State University of Education, Mongolian State University of Art&Culture are using 12 level scale while MNUHS is using 42 scale table that calculate student average point. We compared model of GPA calculation that rate point transfer into quantitative point by using all tables belong each Universities mentioned above. We have developed mathematical and geometrical modeling on each assessment since we started study and made statistical process based on modeling. RESULTS Some articles of the regulation to adapt the credit hours, evaluate students’ knowledge and ability during the training where providing the higher educational degree were not fulfilled. Hereto: The article of the guidance that are taking: 70 rating point considering to the letter D, 80 rating point considering to the letter C, 90 rating point considering to the letter B are not providing the 12 level module. The modules with staging 9, 12, 42 of the article on regarding measurement of 2, 3, 4 in 70, 80, 90 rating grade are not meeting requirements. According to the survey among 470 students who’s GPA higher 2.5 in the 42 level scale shows mostly. Also, the percentage of the students with GPA higher than 3 are in high level. In other words, 158 students (33.6% of 470 students) are meeting requirements of the national scholarship programs and other scholarships. The calculation of the correlation relationship of the rating point and grades converted to the digit rate that are using in all universities were the positive correlation, linear dependence. For the module with staging Person Correlation 9, its influence rate is 98.7 per cent that shows the highest rate comparing with other modules. To calculate Determination Percentage (r2), the module with staging 9 is 97.4 per cent or these digit grades have the highest capacity to show the rating grade. CONCLUSION Level models are able to rate in points or statistical significant. The high correlation between rating point and digit grade’s and determination percentage in the 9 level module showing more relevant in statistics and reporting capacity. The modules with staging 9, 12, 42 are not meeting requirements of the guidance.

Prepuce development in Mongolian boys / Монголын Анагаах Ухаан

BackgroundThe prepuce (foreskin) is a simple fold of skin formed from an outer keratinized layer and inner mucosallayer, lining a preputial sac and provides functions such as protective, erogenous, and immunologic. Theprepuce is normally non-retractile during neonatal development, as the inner epithelial lining of prepuceand glans adhere each other. Non retractile prepuces are common among young boys and normalpart of preputial development. However, unnecessary circumcision is widely practiced among youngadolescents due to poor understanding of foreskin and lack of medical indication.GoalTo assess preputial retractibility in Mongolian boys at various ages to determine natural process ofpreputial separation.Material and MethodsWe evaluated 1697 Mongolian boys aged 2 to 12. Preputial condition was classifi ed into 5 types basedon preputial retractability: type I-phimosis, type II–partial phimosis, type III–adhesion of prepuce, IV–normal, V–circumcised. We also prospectively evaluated 30 histological materials of patients (2-12 yearsold), who were treated by complete circumcision. The materials were fi xed 10% solution of formalin,embedded in paraffi n, stained with hematoxylin-eosin and examined by 3 pathologists.ResultsThe incidences of type I was 67.9% in 2 years old, 12% in 6years, and 4.1% in 10 years and1.1% in12 years old, respectively. On the contrary, the incidences of type IV were 15.4% in 2 years old, 29.8%in 6 years, 74.7% in 10 years and 91.6% in 12 years. Thecircumcisionswere0% in 2 years old, 5.7%in 6 years old, 2.9% in 10 years old and 5% in 12 years old. Most patients (76.7%) did not have anyhistological alterations of the skin and infl ammatory alteration, not lichen sclerosis, were observed in23.3% in histological examination followed by circumcision.Conclusion: Preputual separation increases with ages in boys and surgical treatment of the phimosisshould be performed with cautions.

Assessment of biliary complication after liver transplantation in Mongolia / Мэс засал

Introduction: A considerable proportionof adult living donor liver transplantation(LDLT) recipients experience biliarycomplication (BC), but there are few reportsregarding BC based on long-term studies ofa large LDLT population.Methods: The present study examinedBC incidence, from 16 adult and pediatricpatients (14 right liver and 2 left liver graft )between 2011 and 2016 First Central Hospitalof Mongolia.Results: The mean follow-up period was36±1 months. First Central Hospital has DDanastmosis (n=22) double DD (n=2) singlehepaticojejunostomy (n=3). There 3 caseshave biliary stricture after operation. One ofthe 3 cases has biliary laek 2 months laterafter the operation.Conclusion: Close surveillance for BCappears necessary for at least the first 3 yrafter LDLT. In terms of anastomotic stenosisrisk, HJ appears a better choice than DD forright liver grafts involving ducts less than 4mm in diameter.

BYPASS SURGERY BY GRAFTING ARTERY MAMMARIA INTERNA ONTO CORONARY ARTERY DURING OPEN HEART SURGERY / Шинэ санаа Шинэ нээлт

According to the 2013 WHO survey, the world’s leading cause of death is a coronary heart disease which is accounted for 12.9%. Bypass surgery by grafting Artery mammaria interna to the left anterior descending coronary artery is more clinically significant and has long become an international standard. Aim: To study the outcomes in patients who undergone a bypass surgery ofgrafting the Artery mammaria interna to the left anterior descending coronary artery in an open heart surgery. In 2014 in the case-control study conducted at the Shastin 3rd National Central Hospital, 8 patients who undergone a bypass surgery of grafing Artery mammaria internasinistra to the left anterior descending coronary artery were selected for a case group and 8 patients with bypass grafting of a superficial vein of the leg to the coronary artery were selected as a control group. Related diseases, heart function, type of grafting performed, and post-operative complications were studied. The successful bypass surgeries of grafting the Artery mammaria interna sinistra to the left anterior descending coronary artery without complications in the case group in 2014 has demonstrated that the Mongolian cardiosurgical team was able to successfully and fully introduce this innovative approach that has become an international standard of coronary artery surgery. The introduction of this method enables to eliminate angina pectoris symptoms in patients, restore and improve heart contractions, reduce the chances of a repeat heart attack, and thus, to improve the patient’s ability to live and work normally.

Adiponectin level in aging male of Mongolia / Монголын Анагаах Ухаан

INTRODUCTION: Adipose tissue exclusively secretes adiponectin, a 244–amino-acid protein that regulates themetabolism of lipids and glucose and circulates quite abundantly in plasma. Adiponectin were still stronglyassociated with an increased diabetes risk in men; but the association for women was no longer statisticallysignificant. Adiponectin decreases insulin resistance and body weight by increasing lipid oxidation in muscleand other organs such as the pancreas and liver.GOAL: To define of adiponectin level in aging man living in Ulaanbaatar city.MATERIALS AND METHODS: Randomly selected 84 men aged 35-90 years old were involved to this study. Veinblood were collected, the serum were separated and were frozen until assayed by immunosorbent assay.Morning baseline adiponectin were determined in the sera. We used ELISA kit from Mesdia company (Korea).RESULT AND DISCUSSION: Average age of all participants was 56.82±12.55 years and was divided in three agegroups: 35-60 (31.1%), 61-74 (10%), 74-90 (5.55%). Levels of adiponectin were inversely associated with BMI(r=-0.103), WC (r=-0.173), and TG (r=0.143) and directly associated with age and HDL-C (r=0.117, p<0.001).All people were divided by NCEP criteria in two groups: metabolic syndrome group and healthy control group.Average adiponectin level in metabolic syndrome group was 4.83±7.10 ug/ml, in healthy group it was 5.71±7.53ug/ml, which shows that adiponectin level is significantly lower in people with metabolic syndrome.CONCLUSION: Adiponectin level was lower in people with metabolic syndrome and it has inverse correlation withwaist circumference.

Pilot study on metabolic syndrome prevalence among aging male / Монголын Анагаах Ухаан

INTRODUCTION: Main reasons of metabolic syndrome are obesity and overweighing, which are becoming a global worldwide problem. Obesity is both a prevalent condition worldwide and a well-known, modifiable risk factor for various diseases, including diabetes. In a recent review article, waist circumference (WC) and body mass index (BMI) were reported as established risk factors for diabetes. GOAL: To define the prevalence of metabolic syndrome among Mongolian aging man living in Ulaanbaatar city MATERIALS AND METHODS: Randomly selected 180 men aged 35-90 years old were involved to this study. All were informed and written consent was given by each individual. The metabolic syndrome was defined by NCEP definition: high blood pressure, high waist circumference, higher fasting sugar, triglyceride and HDL-cholesterol. Anthropometric parameters like waist circumference (WC), weight, height, blood pressure and blood chemical parameters like glucose, triglyceride (TG), HDL-cholesterol (HDL-Ch) were measured by automatic biochemical analyzer. RESULT AND DISCUSSION: Average age of all participants was 56.82±12.55 years and was divided in three age groups: 35-60 (n=112), 61-74 (n=47), 74-90 (n=17). The characteristics of participants are shown Mongolian men in 38.8 % (70) of all participants had a metabolic syndrome and in compare to T.Baysgalan’s study, implemented in 2007 was higher. In our opinion it depends on our study participant’s age, because in our study number of elderly were predominating than mentioned survey. Waist circumference in metabolic syndrome group is higher than in healthy control group (p<0.05). Triglyceride level does not change with aging, but in our study participants, the TG level was negatively correlated with aging in metabolic syndrome group (r = -0.307). HDL-cholesterol is abundantly circulating molecule in human plasma and shows anti-atherogenic effect. In our participants HDL-Ch decreases with aging (r=-0.174). CONCLUSION: Our pilot study present that metabolic syndrome prevalence reaches 38.8% of total aged, male participants, and it is leads to implement and provide an investigation in large range, including urban and rural areas of the country.