Banzrai, Chimeglkham
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Товч нэр
Banzrai, Chimeglkham
Бүтэн нэр
Banzrai Chimeglkham
Латин нэр
Banzrai Chimeglkham
Албан тушаал
Судлаач
ORCID
12 results
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Item type:Publication, Comparison of outcome after thrombolytic therapy between young and old Mongolian patients with acute ischemic stroke(Elsevier BV, 2023-12-01); ; ; Tsagaankhuu Guntev - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Disability of stroke by its sybtypes in the population of Ulaanbaatar, Mongolia(Elsevier BV, 2023-12-01); ; ; ; Tuguldur Erdenedalai - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SARS-CoV-2 вирусын түгээмэл илэрч буй мутациуд(2021-09-01) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Монгол хүмүүст тохиолдох цустасалдах харвалтын үед бүлэн уусгах эмчилгээний үр дүнг судалсан нь(2023-05-18); Г.ЦагаанхүүҮндэслэл: Цустасалдах харвалтын (ЦТХ) цочмог үед эмнэлзүйн Тархины шигдээс шинж тэмдэг эхэлснээс хойш 4.5 цагийн дотор хэрэглэхийг зөвлөж Тромболиз буй эмчилгээний арга бол тархины цусан гүйдлийг хурдан сэргээх, Тавилан хагас ишемийн хүрээ өргөсөхөөс хамгаалахад рекомбинант эдийн Рекомбинант эдийн плазминоген идэвхжүүлэгчийг (РЭПИ) вен судсаар тарьж хэрэглэх – плазминоген бүлэн уусгах эмчилгээ (БУЭ) бөгөөд үүний үр дүнгийн талаарх судалгаа идэвхжүүлэгч Монголд нарийвлан хийгдээгүй байна. Зорилго: ЦТХ-ын шинж тэмдэг эхэлснээс 4.5 цагийн дотор Монгол хүмүүст бүлэн уусгах бэлдмэлийг (алтеплазе) вен судсаар тарьж, уг эмчилгээний аюулгүй байдал, үр дүнг судлах. Арга, аргачлал: Эмнэлэгт суурилсан ретроспектив ажиглалтын судалгааны аргаар ШУГТЭ-ийн харвалтын тасагт ЦТХ-ын улмаас 20132023 онуудад БУЭ хийлгэсэн нийт 105 өвчтөний үндсэн үзүүлэлт, Америкийн Эрүүл мэнд, Харвалтын үндэсний хүрээлэнгийн шалгуур (NIHSS), лабораторийн хийгээд дүрст шинжилгээний үзүүлэлтийг ашиглан дүн шинжилгээ хийв. БУЭ-ний эмнэлзүйн үр дүнг 3 сарын хугацаанд мэдрэлийн алдагдсан үйл-ажиллагааны сэргэлт “Сайн”, “Муу” гэсэн шалгуураар (Рэнкин оноо 0-2 vs 3-6) болон эмнэлэгт хэвтсэн хугацааны нас баралтын үзүүлэлтээр тогтоосон. ЦТХ-ын хүндрэлийг БУЭ-ний аюулгүйн хэрэгжилтийн протоколоор тодорхойлов. Ложистик регрессийн загварыг ашиглан, БУЭ болон алдагдсан үйл-ажиллагааны сэргэлт хоорондын хамаарлыг үнэлэв. Үр дүн: ЦТХ-ын шинж тэмдэг илэрснээс хойш БУЭ эхэлсэн дундаж хугацаа 203.78±44.15 мин байв (хэлбэлзэл 77-286 мин). ЦТХ-ын 3 сарын хяналтын хугацаанд 58 өвчтөнд (55.2%) “Сайн” үр дүн, 47 өвчтөнд (44.8%) “Муу” үр дүн гарсан бол нас баралт 19 тохиолдолд (18.1%) бүртгэгдэв. БУЭний “Сайн” үр дүнг таамаглах хүчин зүйлcэд нас <65 (p=0.038), NIHSS оноо <15 (p<0.001), жижиг судасны бөглөрөл (р<0.001), зүрхний гаралтай тромбоэмболи (p=0.019) тогтоогдсон бол эмнэлэгт хэвтэх үеийн NIHSS оноо >15 (OR 7.573, 95% CI 2.526-22.710, p<0.001), том артерийн тромбоз (OR 15.365, 95% CI 3.548-66.517, p< 0.001); ДРАГОН оноо >5 (дунд артерийн тодрол, ахимаг нас, эмнэлэгт хэвтэх үеийн глюкозийн түвшин, NIHSS оноо, харвалтын шинж илэрснээс БУЭ хүртэлх хугацааны нийлбэр оноо) (OR 5.228, 95% CI, 5.447-16.845, p<0.001) байх зэрэг нь “Муу” үр дүнг таамаглах бие даасан хүчин зүйлс болох нь тогтоогдов. Дүгнэлт: ЦТХ-ын хөнгөнөөс дунд зэрэгтэй, жижиг судасны бөглөрөл, зүрхний гаралтай тромбоэмболийн дэдхэв бүхий харьцангуй залуу (<65 нас) Монгол хүмүүст рекомбинант эдийн плазминоген идэвхжүүлэгч үр дүнтэй байна. - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, Portable HEPA filter air cleaner use during pregnancy and children's behavior problem scores: a secondary analysis of the UGAAR randomized controlled trialBACKGROUND: Developmental exposure to particulate matter (PM) air pollution may impair children's behaviors. Our objectives were to quantify the impact of reducing indoor PM using portable HEPA filter air cleaners during pregnancy on behavioral problems in children and to assess associations between indoor fine PM (PM2.5) concentrations during pregnancy and children's behavior. METHODS: This is a secondary analysis of a single-blind parallel-group randomized controlled trial in which we randomly assigned 540 non-smoking pregnant women to receive 1 or 2 HEPA filter air cleaners or no air cleaners. We administered the Behavior Assessment System for Children (BASC-3) to caregivers when children were a mean age of 23 months, and again at a mean age of 48 months. Primary outcomes were the four BASC-3 composite scales: externalizing problems, internalizing problems, adaptive skills, and the behavioral symptoms index. We imputed missing data using multiple imputation with chained equations. The primary analysis was by intention-to-treat. In a secondary analysis, we evaluated associations between BASC-3 composite indices and modeled trimester-specific PM2.5 concentrations inside residences. RESULTS: We enrolled participants at a median of 11 weeks gestation. After excluding miscarriages, still births and neonatal deaths, our analysis included 478 children (233 control and 245 intervention). We observed no differences in the mean BASC-3 scores between treatment groups. An interquartile increase (20.1 µg/m3) in first trimester PM2.5 concentration was associated with higher externalizing problem scores (2.4 units, 95% CI: 0.7, 4.1), higher internalizing problem scores (2.4 units, 95% CI: 0.7, 4.0), lower adaptive skills scores (-1.5 units, 95% CI: -3.0, 0.0), and higher behavior symptoms index scores (2.3 units, 95% CI: 0.7, 3.9). Third trimester PM2.5 concentrations were also associated with some behavioral indices at age 4, but effect estimates were smaller. No significant associations were observed with PM2.5 concentrations during the second trimester or for any of the BASC indices when children were 2 years old. CONCLUSION: We found no benefit of reducing indoor particulate air pollution during pregnancy on parent-reported behaviors in children. Associations between indoor PM2.5 concentrations in the first trimester and behavioral scores among 4-year old children suggest that it may be necessary to intervene early in pregnancy to protect children, but these exploratory findings should be interpreted cautiously. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01741051.Scopus© Citations 11 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prenatal exposure to indoor PM2.5 and children's cognitive performance at 4 years of age: an observational analysis from the UGAAR randomized controlled trial(2026-10); ; ; Outdoor fine particulate matter (PM2.5) concentrations during pregnancy are linked to reduced cognitive performance in children. We previously reported that portable HEPA filter air cleaners use during pregnancy improved children's mean full-scale IQ (FSIQ), but no previous studies have evaluated the relationship between indoor PM2.5 during pregnancy and FSIQ in childhood. We conducted an observational analysis using data from the Ulaanbaatar Gestation and Air Pollution Research (UGAAR) randomized controlled trial. Using a previously developed model of weekly indoor PM2.5 concentrations, we estimated the average concentrations in participants' homes over the full pregnancy and in each trimester. When the children were four years old, we measured FSIQ using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV). We used multiple linear regression to assess the adjusted relationships between interquartile range (IQR) contrasts in indoor PM2.5 during pregnancy and FSIQ among 475 mother-child dyads. An 8.8 μg/m3 increase in indoor PM2.5 concentration over the full pregnancy was associated with a reduction of 1.4 points (95% CI: -3.4, 0.6) in mean FSIQ. The strongest association between PM2.5 concentrations and FSIQ was in the first trimester, when a 19.1 μg/m3 contrast was associated with a 2.8-point reduction (95% CI: -5.7, 0.2) in mean FSIQ. Indoor PM2.5, particularly during early pregnancy, may impair brain development, leading to lower mean FSIQ scores in four-year old children. These results, combined with our previous analysis of HEPA filter air cleaners, indicate that reducing PM2.5 exposure during pregnancy has beneficial effects on children's cognitive performance. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Portable HEPA Filter Air Cleaner Use during Pregnancy and Children's Cognitive Performance at Four Years of Age: The UGAAR Randomized Controlled Trial(American Chemical Society (ACS), 2022-06); ; ; BACKGROUND: Developmental exposure to air pollution is associated with diminished cognitive abilities in observational studies, but no randomized controlled trial has examined the effect of reducing air pollution on cognition in children. OBJECTIVES: We sought to quantify the impact of reducing exposure to particulate matter (PM) during pregnancy on children's cognitive performance at 4 y of age. METHODS: In this single-blind, parallel-group, randomized controlled trial in Ulaanbaatar, Mongolia, we randomly assigned 540 nonsmoking pregnant women (268 intervention and 272 control) to receive 1-2 portable high-efficiency particulate air (HEPA) filter air cleaners or no air cleaners. The air cleaners were used from a median of 11 wk gestation until the end of pregnancy. The primary outcome was full-scale intelligence quotient (FSIQ) assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) when children were a median of 48 months old. We imputed missing outcome data using multiple imputation with chained equations, and our primary analysis was by intention to treat. RESULTS: After excluding known miscarriages, stillbirths, neonatal deaths, and medical conditions that impeded cognitive testing and imputation, 475 (233 control and 242 intervention) children were included in our analyses. In an unadjusted analysis, the mean FSIQ of children who were randomly assigned to the intervention group was 2.5 points [95% confidence interval (CI): -0.4, 5.4 points] higher than that of children in the control group. After adjustment to account for an imbalance in preterm birth between groups, the effect estimate increased to 2.8 points (95% CI: -0.1, 5.7). CONCLUSIONS: Reducing PM air pollution during pregnancy may improve cognitive performance in childhood. https://doi.org/10.1289/EHP10302.Scopus© Citations 21 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Incidence and outcomes for stroke in Ulaanbaatar, Mongolia, during 2019-21: a prospective population-based study(2023-06); ; ; BACKGROUND: In the absence of reliable data to quantify the burden of stroke, we aimed to determine the incidence and outcome of stroke through the conduct of a prospective population-based study in Ulaanbaatar, Mongolia, during 2019-21. METHODS: All cases of stroke were identified through surveillance of multiple overlapping sources of hospitalised, ambulatory, and deceased individuals, using standardised diagnostic criteria in adult (aged ≥16 years) residents of the six urban districts of Ulaanbaatar, Mongolia (population person-years, N=1 896 965) between Jan 1, 2019, and Dec 31, 2020. Data on sociodemography, medical history, and management were collected. Crude and standardised incidence were calculated for first-ever stroke and its major pathological subtypes, and reported with 95% CIs. Outcomes were 28-day case fatality ratios and functional recovery on the modified Rankin scale at 90 days and 1 year. FINDINGS: 3803 strokes in 3738 patients were identified, of which 2962 were first-ever incident cases (mean age 59 years [SD 13], 1161 [39·2%] females). Annual incidence of first-ever stroke (per 100 000) was 156·1 (95% CI 150·5-161·8) on a crude basis, 171·6 (157·5-185·6) when age-adjusted to the Mongolian population, and 140·3 (136·7-143·9) when age-adjusted to the world population. World-adjusted incidence of pathological subtypes were 66·6 (95% CI 64·8-68·3) for ischaemic stroke, 54·5 (53·0-56·1) for intracerebral haemorrhage, and 18·7 (18·3-19·1) for subarachnoid haemorrhage. Men were twice as likely to suffer ischaemic stroke and intracerebral haemorrhage as women, but the risks were similar for subarachnoid haemorrhage; these patterns were consistent across age-groups. The predominant risk factors were hypertension seen in 1363 (63·1%) of 2161, smoking in 596 (26·8%) of 2220, regular alcohol consumption in 533 (24·0%) of 2220, obesity in 342 (16·1%) of 2125, and diabetes in 282 (12·7%) of 2220. There was little use (0·9%) of thrombolysis for acute ischaemic stroke, partly due to delays in presentation after the onset of symptoms (median 16·0 h [IQR 3·0-48·0]). The 28-day case-fatality rate was 36·1% (95% CI 34·3-37·9) overall, and 14·8% (12·8-16·7) for ischaemic stroke, 52·9% (49·9-55·8) for intracerebral haemorrhage, and 54·3% (49·4-59·1) for subarachnoid haemorrhage. Corresponding figures for poor functional outcome at 1-year, defined by scores of 3-6 for death or dependency on the mRS, were 61·6% (95% CI 59·8-63·4), 47·5% (44·7-50·3), 77·0% (74·5-79·5), and 61·8% (57·0-66·5), respectively. INTERPRETATION: The urban population of Ulaanbaatar, Mongolia, has a high incidence of stroke, particularly for intracerebral haemorrhage and subarachnoid haemorrhage, from which half of patients die within 1 month and more than two-thirds are either dead or dependent at 90 days. Although the overall incidence of stroke is similar to other countries, it occurs at a mean age of 60 years, which is at least 10 years younger than in high-income countries. These epidemiological data can inform the implementation of future programmes and scale-up activities for the primary and secondary prevention of stroke, and in the organisation of systems of care. FUNDING: Science and Technology Foundation of the Ministry of Education, Culture, and Science of Mongolia and The George Institute for Global Health.Scopus© Citations 10 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Portable HEPA filter air cleaner use during pregnancy and children's autistic behaviors at four years of age: The UGAAR randomized controlled trialBACKGROUND: Developmental exposure to airborne particulate matter (PM) may increase children's risk of developing autism spectrum disorder. We quantified the impact of reducing PM exposure during pregnancy on the development of autistic traits in children. We also assessed associations between indoor fine PM (PM2.5) concentrations during pregnancy and autistic traits. METHODS: In this parallel-group randomized controlled trial, we randomized 540 non-smoking pregnant women to receive HEPA filter air cleaners or to a control group, which did not receive air cleaners. We administered the Social Responsiveness Scale (SRS-2) to caregivers when children were a median of 48 months (range: 48 to 51 months). Our primary outcome was the SRS-2 total T-score. We imputed missing data using multiple imputation with chained equations and our primary analysis was by intention to treat. In secondary analyses, we estimated associations between full pregnancy and trimester-specific indoor PM2.5 concentrations and T-scores. RESULTS: We enrolled participants at a median of 11 weeks' gestation. Our analysis included 478 children (233 control, 245 intervention). The intervention reduced average indoor PM2.5 concentrations by 29 % (95 % CI: 21, 37 %). The mean SRS-2 total T-score was 0.5 units lower (95 % CI: -2.5, 1.5) among intervention participants, with evidence of larger benefits for children at the high end of the T-score distribution. An interquartile range (9.6 µg/m3) increase in indoor PM2.5 during pregnancy was associated with 1.8-unit (95 % CI: 0.3, 3.2) increase in mean SRS-2 total T-score. Effect estimates for PM2.5 concentrations by trimester were smaller and confidence intervals spanned no effect. CONCLUSION: Reducing indoor PM during pregnancy had little impact on mean autism-related behavior scores in children. However, indoor PM2.5 concentrations during pregnancy were associated with higher scores. Exposure to particulate matter during pregnancy may influence the development of autistic traits in childhood. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01741051.Scopus© Citations 10