Д.Өлзий

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Dashnyam Ulzii

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Endoscopic ischemic polypectomy for small-bowel polyps in patients with Peutz-Jeghers syndrome
(Georg Thieme Verlag KG, 2021-07)
Khurelbaatar, Tsevelnorov
;
Sakamoto, Hirotsugu
;
Yano, Tomonori
;
Sagara, Yuichi
;
Dashnyam, Ulzii
BACKGROUND: To decrease the risk of bleeding or perforation, ischemic polypectomy is performed using a detachable snare or endoclip with double-balloon endoscopy (DBE) for small-bowel polyps in patients with Peutz - Jeghers syndrome. The aim of this study was to determine the effectiveness and feasibility of ischemic polypectomy. METHODS: We retrospectively reviewed patients who underwent two or more sessions of ischemic polypectomy using DBE from July 2004 to August 2017. RESULTS: 67 therapeutic DBEs were performed in nine patients during the study period and 352 polyps were treated. The median observation period was 34 months (range 12 - 66). There was a declining trend over time in the median number of polyps > 15 mm treated per patient first DBE session 6, second 2, third 1.5, fourth 0.5, fifth 0.5; P = 0.11, Friedman test). No patient required laparotomy due to intussusception during the study period. One patient developed mild acute pancreatitis after the procedure. CONCLUSIONS: Ischemic polypectomy was feasible for the control of small-bowel polyps in patients with Peutz - Jeghers syndrome.
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Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease-related small intestinal strictures
(Wiley, 2023-04)
Dashnyam, Ulzii
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Nagayama, Manabu
;
Yano, Tomonori
;
Sakamoto, Hirotsugu
;
Mieno, Makiko
BACKGROUND: Endoscopic balloon dilation (EBD) is an effective, minimally invasive treatment for Crohn's disease (CD) related intestinal strictures. However, restenosis frequently occurs and requires repetitive EBD or surgical resection. Since previous studies could not evaluate restenosis based on stricture diameter, factors affecting restenosis after EBD were unclear. This study aimed to identify these factors by precisely measuring the diameter of small intestinal strictures in patients with CD. METHODS: This single-center retrospective study enrolled patients with CD with de novo small intestinal strictures who underwent two double-balloon enteroscopy sessions (EBD and follow-up) between January 2016 and October 2021. Clinical and endoscopic data were obtained from electronic medical records. A calibrated small-caliber-tip transparent hood was used to precisely measure stricture diameters. Multivariate analysis was performed to identify factors associated with restenosis. RESULTS: Forty-eight patients (37 male) were analyzed. The total number of strictures detected decreased from 162 to 143. The mean diameter of all strictures and the narrowest stricture in each patient increased significantly from 8.6 to 9.8 mm and from 7.6 to 8.7 mm, respectively. Thirty-two (67%) patients developed endoscopic restenosis. Multivariate analysis showed that the presence of ulcers at the follow-up session was a risk factor for restenosis (odds ratio 9.4, p = 0.01). Patients with complete mucosal healing at both sessions (n = 21) showed significant improvement in the narrowest stricture (+1.7 mm, p = 0.001). CONCLUSIONS: Maintenance of complete mucosal healing is significantly associated with avoiding restenosis after EBD in CD-related small intestinal strictures.
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Ischemic polypectomy using a diagnostic-type double-balloon endoscope with a modified detachable snare
(2023-12)
Ono, Yusuke
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Oguro, Kunihiko
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Yano, Tomonori
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Nagayama, Manabu
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Dashnyam, Ulzii
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Causes and Risk Factors for Early Neonatal Mortality in the Western Region of Mongolia
(Mongolian National University of Medical Sciences, 2015-09-25)
Solongo Tsedev
;
Ulzii Dashnyam
;
Gerelmaa Zagd
;
Burmaajav Badrakh
Objectives: The incidence of perinatal, especially early neonatal mortality, has not been reducing in the western region of Mongolia, therefore, the purpose of this study was to identify causes and risk factors for early neonatal mortality in the western region of Mongolia. Methods: A case-control study for neonatal mortality was conducted in 5 hospitals in western Mongolia in 2014. Cases and controls were chosen from the hospitals. Associated causes and risk factors for early neonatal mortality were identified with subgroup binary logistic regression analyses. Results: A total of 7749 live births occurred during the study period. The early neonatal mortality rate was 11.3 per 1000 births. Obstetric complications, obstetric chronic history, abruption of placenta, preeclampsia and maternal diseases influenced early neonatal mortality. Respiratory distress syndrome (OR=29.4; 95% CI, 12.78-67.65, p<0.05), perinatal asphyxia (OR=5.2; 95% CI, 2.81-9.63, p≤0.001), congenital malformation (OR=39.2; 95% CI, 5.11-302.1) and perinatal infections (OR =11.1; 95% CI, 3.64-34.28, p≤0.001) were the leading causes of newborn death in the first week. Conclusion: Overall, high rates of neonatal death demonstrate the need to improve the quality of health care and the control of delivery and factors influencing early neonatal mortality should be studied further at the national level.>
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Personal Exposure to Fine-particle Black Carbon Air Pollution Among Schoolchildren Living in Ulaanbaatar, Mongolia
(Mongolian National University of Medical Sciences, 2015-09-25)
Dashnyam, Ulzii
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Warburton, Nicole
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Brugha, Rossa
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Tserenkh, Ichinkhorloo
;
Davaasambuu, Enkhmaa
Objectives: To measure personal exposure to air pollution in children, in Ulaanbaatar, Mongolia. Methods: Since coal burning for domestic heating causes severe air pollution in Ulaanbaatar, we measured personal PM2.5 exposure for children aged 5-12 years during the winter 2013-2014. Results: Peak levels of black carbon PM2.5 exposure >200 µg/m3 between November and March varied significantly with time of day, with the highest peak 18:00-02:00, a nadir 02:00-07:00, followed by a second peak 07:00 -12:00, with another afternoon nadir 12:00-18:00. Children living in Ger districts in a Ger or wooden house, had the highest levels of PM2.5, >500 µg/m3 , with duration of personal peak exposure in Gers 8-fold longer than in wooden houses. Conclusion: Peak exposures in Gers were related to going outside, fire lighting and cooking, whereas in wooden houses peak exposures were related to going outside or opening the door. The least exposure for children was in an apartment or school with the windows shut. Significant levels of personal exposure also occurred during the commute to school, outside playtime, shopping trips and car rides. Opening the window of steam heated apartments for “fresh air cooling” as well as indoor smoking also produced important levels of personal exposure.

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