Within the spectrum of diagnostic procedures in hepatology, the procurement of a liver specimen plays an important role. The method has been diversifi ed to encompass not only different needle types for cutting and aspiration but also different routes proceeding transvenously or transcutaneously. Over the subsequent 50 years the technique of obtaining liver biopsy samples has been modifi ed regarding the approach, the needle type, and the combination with diagnostic imaging techniques such as ultrasound, computed tomography, angiography and laparoscopy. Histological analyses are capable of establishing the etiology of a chronic or acute liver disease, are determined the inflammatory activity (Grading), degree of fi brosis/cirrhosis (Staging), are relevant for the prognosis of the patient and for indication for cost-intensive as well as potentially side are effect-prone therapies. In general, the accepted mortality rate from liver biopsy is between 0,1% and 0,01%. Among the most feared complications of liver biopsies are hemorrhage, seeding of cancer cells, infections, and injury to the viscera. The increasing number of liver transplant patients within the hepatological spectrum requires regular, safe, and high quality biopsies and their appropriate.

INTRODUCTION:In connection with request and financial assistance of Swiss Development Agency ‘’Mercury exposureand health impact assessment study among small scale miners in mercury free technology, wasconducted by researchers of Toxicology division of NCPH.GOAL:To determine mercury exposure level in biological samples of local small scale miners from mercury freetechnology introduced area. To reveal chronic mercury intoxicated patients,MATERIALS AND METHODS:Totally 147 artisanal miners from 33 cooperatives for small scale mining from Bayan-Îvoo soum ofBayankhongor, Bornuur sum of Tuv, Bayangol, Mandal and Tunkhel sum of Selenge province areparticipated in this study and the study was performed by cross sectional study methods during April toDecember, 2014.Over all 147 participants were in the first part of study, 60.5% out of 147 (89 participants) were in secondparts, and another 35.4% (52 people) were participated to the third parts of study. The participants wereundergone in to toxicological, dermatological and neurological examinations and the WHO guidance formercury exposure determination was followed in this study.RESULTS:On the results of all testing we revealed that there were 2 cases of chronic mercury intoxicated patientsfrom each Bayangol Bornuur soum, 2 from Mandal soum, and 3 from Bayanovoo soum.Overall 7 patientswere diagnosed as chronic mercury intoxicated and it comprised 4.7%of (n=147) all involved participants.We have observed that average height of total medical examination number was (2.9) in Bornuur soum.It indicated that there will have higher number of patients would exist in Bornuur soum than others.Ourstudy result has shown that neurological symptoms like tremor and imbalance were more diagnosedamong participants from Mandal and Bayngol soums. It implies that the health of the small scale minersfrom this soum more affected and needed to be investigating further.CONCLUSIONS:Mercury is still being used among artisanal gold miners even thoughit is still illegal. Further medicalevaluation and assistance needed to be taken for newly diagnosed 7 patients.

Background: Valerian (Valeriana officinalis) and Hops (Humulus lupus) are famous herbs in throughout world. Both medicinal herbs have been used for insomnia in European, Asian traditional medicine for centuries. Valmedin consists from mixed herb extracts of Valerian and Hops. It possess antidepressant, anti-anxiety effect, and improves sleep efficiency. Aim : The aim of this study was to evaluate quality control parameters for standardization of Valmedin pellet and assess toxicity of Valmedin pellet. Methods: In the present study pellets was prepared by extrusion-spheronization technique. The pellet size was determined by sieve analysis using sonic separator. The extract of Valmedin formulation was prepared in pellet (dragee). Valmedin pellet was subjected to analysis for physiochemical parameters, phytochemical studies, heavy metals and quality parameters according to Mongolian pharmacopoeia (2002,). The lethal dose at 50% (LD50) was calculated according to Prozorovskii. In the test chronic toxicity was used two doses of the concentrated extract of Valmedin (0.25; 0.5 g/kg) and assessed parameters (ALT, ALP, AST, bilirubin, total protein, TNFα, IL-6). Result: First of all, the quality of biological active components and physiochemical parameters of individual herbs including Valerian, Hops and Metha L have been fulfill the basic requirements of standardization herbal medicines. Moisture content of Valmedin pellets was 1.6 ±0.01%. Total tannin and valerenic acid content found to be 0.051±0.05, 0.71±0.02% for a pellet. Levels of heavy metals was within the permissible range of standard.
In the acute toxicity study, the LD50 value of the concentrated extract from Valmedin was 1.56 g/kg (i.p). No significant changes in body weights of treated animals. In the hematological and biochemical analyses of Valmedin in dose of 250 mg/kg has shown no significant change in the levels of ALT, AST, ALP and levels of RBC and WRC counts in blood serum. Valmedin at dose of 500 mg/kg after chronic injection lower sign levels of ALT, ALP enzymes, and total protein compared with the control group I. It increases significantly levels of AST enzyme, glucose in blood serum. By hematological analyses, Valmedin in dose of 500 mg/kg elicited decrease in the level of hematological parameters such as white blood cells and red blood cells count in whole blood. Likewise, treatment of Valmedin in doses of 250 and 500 mg/kg did not induce any change in the levels of TNF and IL-6 cytokines. Conclusion Pellets of Valmedin containing Valerian, Hops, and Metha were successfully made achieving degrees of quality, physical stability compatible with the requirements for standardization and formulation.

BACKGROUND. The 84.4 percent of newly diagnosed patients with diabetes have obesity in Mongolia. Nowadays, prevalence of obesity has increased steadily in Mongolia. Diabetic patients with viral hepatitis has high risk of having liver cirrhosis. Therefore, screening of fatty liver and liver fibrosis in diabetic patients is more important. The main diagnosing method of fatty liver and liver fibrosis is liver biopsy and histology but so far, we are able to detect viral infection using viral marker and determine fibrosis stage of NAFLD in patients who has diabetes mellitus type 2. Using noninvasive method determining liver fibrosis involve many researches to reveal new biomarkers and technics to find out liver fibrosis. Japanese researchers has found The Wisteria floribunda agglutinin- positive human Mac-2-binding protein (WFA+-M2BP) was recently shown to be a liver fibrosis glycobiomarker with a unique fibrosis-related glycoalteration.This biomarker helps to determine liver fibrosis stage in fatty liver disease and viral hepatitis. There is no research to reveal viral infection, fatty liver and liver fibrosis in diabetic patients in Mongolia, so far. So it is necessary to study revealing viral infection, fatty liver disease and to determine stages of fibrosis using WFA+-M2BP to screen liver fibrosis in diabetic patients. OBJECTIVE. To identify viral infection, HCV/HBV in patients with diabetes and to compare liver function and diabetes control for diabetic patients with liver disease. METHODS. We collect data from 25thNovember, 2015 to October of 2016. We got permission of research from the patients by handwriting signature who diagnosed Diabetes mellitus in National University Hospital. Haemotology, biochemistry test, coagulogramm, immunology test are evaluated in 415 patients in clinical laboratory of National university hospital. By the objective, the diabetes patients with viral hepatitis will attend to second step of research. We used HISCL 5000 apparatus of Sysmex Japan to do immunology tests. Also we use SPSS 19.0 and EXCEL program. RESULT. There were 294 patients and by WHO classification of ages 20-29 aged patient (n=4), 30-39 aged(n=19), 40-49 aged(n=65), 50-59 aged(n=126), 60-70 aged(n=48), over 70 aged(n=14)or 53.24±9.43. 146 patients are male,148 patients are female.By BMI 29.9±1.14.By blood test, thrombocytes counted 256.6±11.7;in coagulogramm the prothrombin time was 111.7±31.4; in biochemistry test total bilirubin 16.46±10.6; AP 364.7±192.3;AST 35.7±45.7; ALT 42.8±45.5; GGT 86.53±123.4;albumin 42.06±23.95;total cholesterol 6.04±2.47;triglyceride 5.72±34.5;HbA1c 8.83±5.92; in immunology testsanti-HCV 29.37±18.87 (n=58); HBsAg 590.134±1013.7 (n=23); M2BP (COI) counted 2.24±2.19. CONCLUSION. There were 58 diabetic patients with C viral infection and 23 diabetic patients with B viral infection. By WFA+-M2BP glycobiomarker, we found that diabetic patients with viral hepatitis has more liver fibrosis.

Background: The correlation between hepatitis B, C viruses (HBV, HCV) and B cell non-Hodgkin’s Lymphoma (B-NHL) and reducing mortality have been studied extensively worldwide Objective: In this study, we aimed to determine the prevalence of HBsAg and anti-HCV positive cases among B-NHL patients and its influence on the survival rate of these patients (on ≤12 months). Materials and Methods: We have done a retrospective analysis on patients who aged over 20 years and newly diagnosed at the Hematology Center of the First State Hospital between 2015-2018. The patients’ information was collected according the study ethics. We divided the patients into 2 groups, survival rate less than 12 months (≤12 months) and survival rate more than 13 months (≥13 months), and compared them regarding age, gender, seroprevalence, and Ann-Arbor stage. Results: Overall, 226 patients (107 males and 119 females with average 54.4) were enrolled in the study. There were 15% HBsAg positive and 41,6% anti-HCV positive cases, while Baatarkhuu et al. (2005) reported (11.8%, 15.6%; p=0.160, p<0.00001) and Bekhbold et al. (2013) reported (11.1%, 10.6%; p=0.055, p<0.00001) in apparently healthy population. Moreover, anti-HCV positive cases among B-NHL patients were higher (p<0.00001) than those (27%) among hepatocellular carcinoma (HCC) patients and same (p=0.404) with those (39%) among liver cirrhosis patients in Mongolia (Bolormaa et al., 2009). Furthermore, 72.0% of all subjects in III-IV stages was accounted for HBsAg, anti-HCV positive group which had ≤12 months, while 52.1% of them was accounted for HBsAg, anti-HCV positive group which had ≥13 months and was statistical significantly lower (p=0.02). Conclusion Anti-HCV and HBsAg positive cases might contribute to survival rate with the B-NHL patients diagnosed at the III-IV stages. HCV prevalence among B-NHL subjects was significantly higher than that among the general population prevalence and was same with anti-HCV positive prevalence among the HCC.

Background: Chemotherapy-related acute exacerbation or hepatitis flares related to HCV positive B cell non-Hodgkin’s lymphoma (B-NHL) is one of the significant clinical issues Material and Method: We studied anti-HCV incidences among patients newly diagnosed with B-NHL, from 2015 to 2018. Survey data were collecting from medical history, electronic medical record system of First Central Hospital was acquired and collected according to the research ethics (approved by Ethics Committee of Ministry of Health, No.4 on June 19, 2017). Also, cases of chemotherapy-related acute exacerbation (AE) for HCV-RNA positive cases were studied. Student’s t-test or nonparametric statistics were utilized to test for statistically significant differences in continuous variables, whereas the chi-square or Fisher’s exact test was used for categorical variables. p<0.05 was considered statistically significant. Results: The study showed that 39.5% of 233 cases with B-NHL are anti-HCV positive. Anti-HCV positive prevalence among B-NHL subjects was significantly higher compared to the general population. Chemotherapy-related AE occurred in 21.05% for the anti-HCV positive group and 36.36% for HCV-RNA positive group. Furthermore, before chemotherapy alanine aminotransferase (ALT) median was 15.2 for the group without AE, whereas it was 48.2 for the group with AE (p<0.01). Conclusions Our study showed that the prevalence of anti-HCV positive among B-NHL patients was significantly higher than the general population prevalence. For all cases of AE, HCV-RNA was positive, and these patients were treated with only chemotherapy without any anti-viral treatment. Anti-viral therapy needs to be introduced urgently to prevent AE since liver fibrosis is aggravated quickly after AE.