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    Efficacy and Safety of Radiofrequency Ablation Versus Surgery for Thyroid Nodules
    (Mongolian National University of Medical Sciences, 2022-09-30)
    Otgonbayar Setevdorj
    ;
    Bayarmagnai Munkhjargal
    ;
    Ishdorj Tsedenish
    ;
    ;
    Objectives: To assess the efficacy and safety of radiofrequency (RF) ablation versus surgery for benign thyroid nodules for 24 months period. Methods: From January 2019 to January 2021, 200 patients with nodular goiters who underwent surgery (group A) and 183 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18 g internally cooled electrode were used. We compared the 2 groups in terms of efficacy, and safety during a 2-year follow-up. Results: Nodule type did not differ between groups, although in total 60.1 % were solid, 31.3 % were mixed, and 8.6 % were cystic. However, the number of nodules, median volume before surgery, and diameter of the nodule differed significantly. The median volume reduction was 34.6 % at 1 month, 56.1 % at 3 months, 70.6 % at 6 months, 73.9 % at 12 months, and 74.9 % at 24 months. Any volume reduction between follow-up intervals was statistically significant (p < 0.000). The most patients had no complications. However, surgical patients were more likely to have complications such as bleeding, hoarseness, and infection (14.5 %) than the RFA group (1.6 %). Conclusion: Surgical resection and radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules.
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    Prevalence and Risk factors of Infertility in a Mongolian Population
    (Springer Science and Business Media LLC, 2020-07-28) ; ;
    Sengebaljir, Davaakhuu
    ;
    ;
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    Бамбай булчирхайн цуллаг зангилааны өндөр давтамжит радио долгион эмчилгээний үр дүн
    (2022-06-12)
    С.Отгонбаяр
    ;
    М.Баярмагнай
    ;
    Б.Ботажан
    ;
    ;
    Ц.Ишдорж
    Үндэслэл: Дэлхийн нийт хүн амын ойролцоогоор 4-7% тэмтрэгдэхүйц Бамбай булчирхай бамбай булчирхайн зангилаатай. Хэрэв хэт авиагаар 50-иас дээш насны Бамбайн зангилаа хүн амд тандалт хийвэл бамбай булчирхайн зангилаа бараг 50%-иас дээш Түлэх илэрч магадгүйг цөөнгүй бүтээлд тэмдэглэсэн байна1,2. Манай орны хүн Бахуу амын дунд бамбай булчирхайн өвчлөл сүүлийн 10 жилийн хугацаанд 10000 хүн ам тутамд 33.2-89.7 болж өссөн байна. Бамбай булчирхайн өвчлөлийн насаар стандартчилсан түвшин 10000 хүн ам тутамд мөн ойролцоо 33.5-91.1 болж өсчээ. Бамбай булчирхайн өвчлөлийн хэтийн төлөв 2026 он гэхэд 10000 хүн ам тутамд 158.9 болж өсөх хандлага байна. Бамбай булчирхайн мэс засал сүүлийн 10 жилийн хугацаанд бамбай булчирхайн нийт өвчлөлийн 6.7-1.8% болж багассан байна. Олон улсын сүүлийн үеийн эмнэл зүйн заавраар ямар нэгэн зовуургүй, гоо сайханд сөрөг нөлөөлөөгүй зангилааг ажиглах тактик баримтлахыг зөвлөдөг. Гэвч зарим тохиолдолд ямар нэгэн эмчилгээ шаардлагатай болдог. УНТЭ-т бамбай булчирхайн RFA эмчилгээний (2019) шинэ аргыг нэвтрүүлснээр дарах болон бусад зовууртай том (>2.0мл), жижиг (<2.0мл) бүх төрлийн хэмжээтэй зангилаанд энэхүү эмчилгээг хийх боломж бүрдсэн юм. Зорилго: Бамбай булчирхайн цуллаг зангилааны RFA эмчилгээний үр дүнг судлах. Арга, аргачлал: Судалгааг УНТЭ-ийн ЕМЗТ-т 2019 оны 01 сараас 2021 оны 10 сарын хооронд хийв. Судалгаанд 183 тохиолдол, 485 зангилаанд үнэлгээ хийснээс цуллаг зангилаатай 150 тохиолдол байсан. RFA эмчилгээний өмнө зангилааны хэмжээг гурван хэмжээсээр, зовуур (VAS 1-10 оноо), гоо сайханд нөлөөлж буйг (0-3 оноо) оноогоор үнэлэв. Эмчилгээний дараа 1, 3, 6, 12, 24 дэх саруудад тус тус хяналт хийсэн. Хяналт бүрт зангилааны хэмжээ, зовуур, гоо сайхны оноогоор үнэлэв. Үр дүн: Судалгаанд хамрагдагсдын дундаж нас 49.4±10.5 жил байв. Хүйсийн хувьд эрэгтэй 5 (3.5%), эмэгтэй 145 (96.5%) байсан. Нэг зангилаа 67 (44.7%), олон зангилаа 83 (55.3%), зангилаа түлсэн дундаж хугацаа 2.05±2.20 минут тус тус байв. Зүүний дундаж урт 0.66 см байлаа (Хүснэгт 1). Эмчилгээний өмнөх медиан эзлэхүүн 1 сарын дараа 33.4 мл (CI 95%; 28.7-39.4), 3 сарын дараа 56.8 (CI 95%; 50.9-60.0), 6 сарын дараа 70.6 (CI 95%; 62.0-75.0), 12 сарын дараа 73.7 (CI 95%; 69.3-94.5), 24 сарын дараа 74.9 (CI 95%; 65.2-90.1) болж статистикийн хувьд ач холбогдол бүхий багассан (p=0.0001). Хэлцэмж: Che (2015) нарын судалгаагаар 12 сарын хугацаанд цуллаг зангилааны эзлэхүүн 84.8% багассан нь бидний судалгаатай харьцуулахад илүү их багассан бол Bernardi (2014) нарын судалгаагаа 68.4% багассан нь бидний үр дүнгээс бага хувиар жижгэрсэн байлаа. Aysan (2016), Kim (2006), Lim (2013) нарын цуллаг зангилаа түлсэний дараах дундаж эзэлхүүн багасалт 71.8% (54-92%) байгаа нь бидний судалгааны үр дүнтэй дүйж байна. Дүгнэлт: Бидний судалгаагаар RFA эмчилгээний дараах 24 сарын хугацаанд бамбай булчирхайн зангилааны эзлэхүүн 81.1% багасч, 12% бүрэн устаж, зовуур 62%, гоо сайхны үнэлгээ 48% сайжирсан ба амь насанд аюултай хүндрэл тохиолдоогүй нь энэхүү эмчилгээ үр дүн сайтай арга болох нь харагдлаа. Уг эмчилгээний давуу тал нь сорвигүй, ерөнхий унтуулга, даавар орлуулах эмчилгээ шаардлагагүй зэрэг олон давуу талтай гэж бид үзэж байна.
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    Scopus© Citations 32
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    Epidemiologic features of metabolic syndrome in a general Mongolian population
    (SAGE Publications, 2015-05) ;
    Kotani, Kazuhiko
    ;
    ; ;
    Ganchimeg, Ulziibayar
    BACKGROUND: Although cardiovascular health is a crucial problem for Mongolian people, little information about metabolic syndrome, which is well known to be associated with the development of cardiovascular disease, is available in Mongolia. The aim of this study was to observe the epidemiological features of metabolic syndrome in a general Mongolian population. METHODS: This cross-sectional study was performed in 1911 general Mongolian subjects (717 men, 1194 women), who were ≥40 years old and free of ischemic heart disease, by using a dataset from a nationwide population-based cohort study in Mongolia. The prevalence of metabolic syndrome, as defined by International Diabetes Federation criteria, was determined. Alcohol consumption, smoking habits, and physical activity were evaluated. Education, marital status, income, and occupation were also examined as factors of socioeconomic status (SES). Their association with metabolic syndrome was determined by logistic regression models. RESULTS: The prevalence of metabolic syndrome was significantly higher in women (n=488, 40.6%) than in men (n=138, 19.4%). The prevalence of metabolic syndrome was high, especially in the Khangai region, in women. Moderate-to-high alcohol consumption was a significantly positively associated factor of metabolic syndrome in men [odds ratio (OR)=2.01; 95% confidence interval (CI) 1.15-3.51; adjusted odds ratio (AOR)=2.41; 95% CI 1.31-4.44] and widowed status was a significantly positively associated factor of metabolic syndrome in women (OR=1.61, 95% CI 1.18-2.18; AOR=1.49, 95% CI 1.07-2.08). CONCLUSIONS: Metabolic syndrome was prevalent in women compared with men among Mongolian adults. Preventive strategies aimed at men with a higher alcohol consumption and women with widowed status may help reduce metabolic syndrome, thereby improving cardiovascular health conditions in Mongolia.
    Scopus© Citations 10
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    A cohort study of chronic diseases for Mongolian people: Outline with baseline data of the Moncohort study
    (Springer Science and Business Media LLC, 2016-09) ; ;
    Kotani, Kazuhiko
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    Aoyama, Yasuko
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    Tsuboi, Satoshi
    Many Mongolian people suffer from non-communicable chronic diseases. In order to plan preventive strategies against such diseases, we designed a community-based prospective cohort study of chronic diseases, called the Moncohort study, in Mongolia. This is the first nationwide large-scale cohort study of chronic diseases. This paper describes the study's rationale, design and methods with baseline data. Mongolian residents aged ⩾40years were selected nationwide from many geographic regions in 2009. Data were collected on demographics, socioeconomic status, lifestyle, and anthropometric and biochemical measurements. In total, 2280 Mongolian residents were registered in the survey. Socioeconomic, lifestyle, anthropometric and biochemical characteristics were differentiated by gender and geographical area in descriptive data. Aging, low social class, physical inactivity and infrequent fruits intake were positively associated with histories of chronic disease in men, while aging was positively associated with histories of chronic disease in women. Factors associated with chronic diseases reveal gender-oriented strategies might be needed for their prevention. Detailed prospective analyses will illustrate the impact of risk factors on chronic diseases and lead to evidence for designing programs aimed at preventing chronic diseases and related disorders in Mongolia.
    Scopus© Citations 5