1.Publication Overview of Sumbe Khamba Ishbaljir and Wonder of his Mindset
Oyun-Erdene B ; Bold SH ; Bolor B ; Ankhtsatsral L ; Ankhtuya P
Mongolian Medical Sciences 2014;170(4):68-72
Introduction: It is significant to translate medical texts having a beginning source of Ayurveda and identifyMongolian doctors, maaramba’s works and books on prescription as well as treatment methods that meetour culture, living condition and climate. Especially, we should clarify the new ideas includes innovatedtheories, which became paradigm not only Traditional Mongolian Medicine but also in Tibetan Medicine.Thus, it has become important to introduce and use in the training for students and practitioners the “FourAmbrosia Essences” and “Dictionary of Drug Identification” by Sumbe Khamba Ishbaljir (1704-1788).Goal: The aim of this study is to investigate “Four Ambrosia Essences” and “Dictionary of Drug Identificationby Sumbe Khamba Ishbaljir and to clarify the new idea of theory and treatment methods created by him.Materials and Method: “Source of Spring” (བདདུ ་ར་ིྩ ཆ་ུ རནུྱྒ ), “White Dew of Spring” (བདདུ ་ར་ིྩ ཟལི ་དཀར), “Drop of Spring”(བདདུ ་ར་ིྩ ཐགི ་པ), “Wedding of Spring” (བདདུ ་ར་ིྩ དགའ་སནོྟ ” by the Sumbe Khamba Ishbaljir were the main materials in thisstudy. In addition, we used to take some sort of sources and manuscripts that related to our studies andcomparative historical method, analysis and synthesis method were used in the studies.Results: According to resources we found, Sumbe khamba Ishbaljor detailed a number of new theoreticaland practical concepts which were never or seldom mentioned in The Four Medical Tantras, in his bookRashaany Dusal (“Drop of Spring”). He expanded the list of common diseases from three wind (khii), bile(shar), phlegm (badgan) to 6 (wind, bile, phlegm, blood, yellow fluid (shar us), nyan or khorkhoi (virus andbacteria) and prescribed treatments for each of them. In addition, he established a concept of 10 importantdiseases and gave them satiric names making them easy to read and understand as well as taught theways to treat them.Ishbaljir developed the traditional medicine and made a reform in it by the discovery of three more causesof diseases blood, bile us and bacteria in addition to the existing causes wind, bile and phlegm. His theorywas that disease causes are wind, bile, phlegm, blood, yellow fluid, and bacteria or virus individually and\or combined. Wind, bile, phlegm, blood, yellow fluid, and bacteria or virus called as diseases. Ishbaljir’sconcept of bacteria duplicates that of some Noble Prize laureates. At the beginning of the 20 century, anAustralian scholar Barry J. Marshall and J. Robin Warren won the Noble Prize for their discovery of the“Bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease” in 2005.Conclusions:1. Sumbe Khamba Ishbaljir expanded the list of common diseases from 3 wind (khii), bile (shar), phlegm(badgan) to 6 (wind, bile, phlegm, blood, yellow fluid (shar us), nyan or khorkhoi (virus and bacteria)and prescribed treatments for each of them.2. Sumbe Khamba Ishbaljir established a concept of 10 important diseases and gave them satiric namesmaking them easy to read and understand as well as taught the ways to treat them.3. The Four Medical Tantras did not mention stomach bacteria. It is pity that Sumbe Khamba Ishbaljirfound out the stomach bacteria disease in the 18th century.
2.THUNDERBEAT IN USE THYROID SURGERY
Tumur-Ochir Ch ; Shim Woo Jeong ; Munkhbat D ; Baasanjav D ; Bayarkhuu A ; Enkhbat G ; Erdene-Bolor B ; Naranbat L
Journal of Surgery 2016;19(1):64-69
Introduction: Last Decades, Date by date
medical developments providing friendly,
high-efficiency treatment equipment and
services in developed countries are working
toward an advanced, as our country medical
services are trying to that country’s technology
has been introduced. In our country every
day there is only surgical care necessary to
endocrine gland disorders, including most
common thyroid surgery. It is open and
robotic assistant endoscopic surgery in the
world. But robotic assistant endoscopic
surgery is too expensive and impossible in
our country. Thus we chose Thunderbeat
for open thyroid surgery in especially huge
enlarged goiter and vascularized goiter to try
prevent bleeding, recurrent laryngeal nerve
palsy and post operation hematoma and
other complications
Thunderbeat is new generation instrument
combines an advanced bipolar clamp to the
existing ultrasonic cutter.
Materials and Methods: M 51-years-oldwoman
was admitted to Mongol Hyundae
hospital because of front of neck pain, multi
nodular goiter, tachycardia, sweaty and not
controlling emotion.
Anamnesis: She diagnosed to
Thyrotoxicosis in 2005 and she took
medicine last ten years but not controlling
that poisoning. Status locals: Huge enlarged
goiter in front of her neck
Treatment plan:
1. Preoperative Preparation
2. Operation: Open total thyroidectomy
3. Medicine
4. Wound dressing
5. Observation
We did operation after day of admission
day, Patient is placed in a Semi erect position
with a folded sheet underneath the shoulders
so that the head is sharply angulated backward
on the multifunctional surgical table under
general anesthesia. We used thunderbeat
from muscular to all procedures, dissection
both thyroid gland and isthmus after Kocher
skin incision and sub skin tissue dissected.
There is no complication while procedure
and post operation days
Result: Nodular hyperplasia of thyroid
gland with focci of micro adenomatous
change
Conclusion: Thunderbeat in use open
thyroid surgery first outcomes blood loss
than 30ml, no injury of recurrent laryngeal
nerve and no penetration ligament of Berry
while procedure, second outcomes no
hematoma, painless, wound healing process
faster and short time hospitalization.
3.Results of thyroid hormone levels in women
Bolor B ; Bat-Erdene D ; Oyun-Erdene R
Mongolian Medical Sciences 2024;208(2):8-12
Introduction:
The average age of the population varies in every country of the world, which depends on the changes
that occur in the body during aging and many external and internal factors that affect it. Thyroid
hormones play an important role in ensuring and maintaining normal metabolic function throughout
life. Our country is located in a mountainous region of the mainland, the amount of iodine in drinking
water is low, and the amount of iodine taken from food is low, which creates the risk of iodine deficiency
disorders. Therefore, we aimed to study how the thyroid function changes with age in Mongolian
people.
Goal:
A comparative study of thyroid hormone secretion levels in adult women.
Material and Method:
In our study, 83 women over the age of 20 were selected based on the “Yu Bi Lab” diagnostic center.
Triiodothyronine (T3), thyroxine (T4), and thyrotropin (TSH) of the women participating in the study
were determined using the FHU method using the Magiwel ELISA diagnostic kit manufactured by
United Biotech.
Results:
81 women over 20 years of age participated in our study, the average age was 44.45±14.17, and the
participants were divided into 5 groups with 10 age intervals. 20-29 years 18% (n=15) average age
24.6±2.64, 30-39 years 22% (n=18) average age 33.6± 3.12, 40-49 years 16% (n=13) average age
45.15±1.67, 50-59 years 25% (n=20) average age 54.15±2.99, 60-69 years 19% (n=15) average age
63.73± 3.05, were.
Conclusion
1. When comparing T3 and T4 hormones by age group, T3 hormone is higher in the 30-39 age group
at 5.05 ng/ml. The T4 hormone gradually decreases with age.
2. Thyroiodin hormone increased with age. The relationship between the age of the participants
and TSH hormone was directly related to statistical age when calculated by Pearson’s correlation
coefficient (p=0.01).
4.First diagnosis of IgA nephropathy by renal biopsy in Mongolia
Baigalmaa S ; Buyan-Od D ; Bolor-Erdene G ; Otgonsuren D, Amartuvshin B ; Otgonchimeg I ; Enkhtamir E ; Galtsog L
Mongolian Medical Sciences 2015;172(2):35-41
BackgroundIgA nephropathy and MPGN are common glomerulonephritis in the world that progresses slowly andrenal function can even remain unchanged for decades. Clinically, it presents by isolated hematuria,proteinuria. Histologically, IgA nephropathy presents with acute glomerular damage, mesangial cellproliferation, endocapillary leucocyte infiltration, and crescent formations, these lesions can undergoresolution with sclerotic healing. Since 2013, renal biopsy has been done at the First Central Hospitalof Mongolia a few times. However, the confirmative diagnosis of IgA nephropathy and MPGN remainunknown in Mongolia by renal biopsy. Therefore, we intended to test renal biopsy techniques andconfirm its diagnosis by renal biopsy at the Second Central Hospital of Mongolia.MethodsUltrasound guided renal biopsy had been done for four patients by nephrologist at the Departmentof Nephrology of the Second Central Hospital of Mongolia. All four specimens were evaluated assatisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissuewas divided into two tips: one piece for routine H&E stain and special stains, including Masson’strichrome, and PAS stain; another piece for immunofluorescence by frozen section, which werestained with IgG, IgM, IgA and complement component 3 (C3). Each case was screened by threepathologists.Results:The case which shows mesengial widening, mesengial hypercellularity under the light microscopyor mesangial granular deposition of IgA and C3 by immunofluorescence was diagnosed as IgAnephropathy. We obtained crescent formation with glomerular adhesion in most cases. In addition, weobserved secondary MPGN in one case, which is caused by hepatitis C virus infection.Conclusion: Probably, it is a new step for developing pathologic diagnosis for nephrology in Mongolia.We needs further study for improving renal biopsy technique and confirming the diagnosis of IgAnephropathy and MPGN using electron microscopy and pathological report by oxford classification forIgA nephropathy.
5. THUNDERBEAT IN USE THYROID SURGERY
Tumur-Ochir CH ; Shim Woo Jeong ; Munkhbat D ; Baasanjav D ; Bayarkhuu A ; Enkhbat G ; Erdene-Bolor B ; Naranbat L
Journal of Surgery 2016;19(1):64-69
Introduction: Last Decades, Date by datemedical developments providing friendly,high-efficiency treatment equipment andservices in developed countries are workingtoward an advanced, as our country medicalservices are trying to that country’s technologyhas been introduced. In our country everyday there is only surgical care necessary toendocrine gland disorders, including mostcommon thyroid surgery. It is open androbotic assistant endoscopic surgery in theworld. But robotic assistant endoscopicsurgery is too expensive and impossible inour country. Thus we chose Thunderbeatfor open thyroid surgery in especially hugeenlarged goiter and vascularized goiter to tryprevent bleeding, recurrent laryngeal nervepalsy and post operation hematoma andother complicationsThunderbeat is new generation instrumentcombines an advanced bipolar clamp to theexisting ultrasonic cutter.Materials and Methods: M 51-years-oldwomanwas admitted to Mongol Hyundaehospital because of front of neck pain, multinodular goiter, tachycardia, sweaty and notcontrolling emotion.Anamnesis: She diagnosed toThyrotoxicosis in 2005 and she tookmedicine last ten years but not controllingthat poisoning. Status locals: Huge enlargedgoiter in front of her neckTreatment plan:1. Preoperative Preparation2. Operation: Open total thyroidectomy3. Medicine4. Wound dressing5. ObservationWe did operation after day of admissionday, Patient is placed in a Semi erect positionwith a folded sheet underneath the shouldersso that the head is sharply angulated backwardon the multifunctional surgical table undergeneral anesthesia. We used thunderbeatfrom muscular to all procedures, dissectionboth thyroid gland and isthmus after Kocherskin incision and sub skin tissue dissected.There is no complication while procedureand post operation daysResult: Nodular hyperplasia of thyroidgland with focci of micro adenomatouschangeConclusion: Thunderbeat in use openthyroid surgery first outcomes blood lossthan 30ml, no injury of recurrent laryngealnerve and no penetration ligament of Berrywhile procedure, second outcomes nohematoma, painless, wound healing processfaster and short time hospitalization.
6.The result of measured household indoor air quality, Ulaanbaatar, 2020
Oyun-Erdene O ; Tsegmed S ; Buuveidulam A ; Bolor B ; Bataa Ch ; Narantuya D ; Suvd B
Mongolian Medical Sciences 2020;194(4):74-83
Introduction:
Beginning 15 May 2019, the consumption of raw coal in Ulaanbaatar has been replaced by the
consumption of briquette fuel for the improvement of air quality according to Governmental Resolution
No.62 adopted in 2018. Since after this resolution has been in placed the number of CO poisoning
has been increased as of 18 December 2019, nine persons were died and 1394 people get a health
care service due to CO poisoning. However, it has been not been assessed briquette affect to the
indoor air quality and its health impact. Thus, it is need urge to define the indoor air quality effect of
briquette and its heath impact.
Goal:
To assess the indoor air quality of the household using the “improved briquette” and identify the
causes of the risk.
Material and Method:
This a cross-sectional survey, conducted from January 31, 2020 to April 31, 2020, data were obtained
by quantitative, qualitative (observation, interview) and direct indoor air quality measurement. The
survey sampling frame was 40 households in central 6 districts of Ulaanbaatar that used improved
fuels (20 households with a history of carbon monoxide poisoning and 20 households that were not
affected), and 14 households in the Nalaikh district that used raw coal, in total of 54 households were
participated. Indoor air quality was measured by PM2.5, PM10, CO, SO2, NO2, and microclimate per
household for 24 hours during a week.
The statistical data analysis was done by the SPSS-23 program and preformed required parametric
and non-parametric tests. The normality of the data was checked by the Kolmogorov-Smirnov test.
The most of data was not normally distributed. So, thus we used median and used relevant non-parametric tests. The average level of microclimate indicators, and air quality indicators were defined
as mean, median and its IQR and standard deviation. The 95% confidence intervals of mean and
frequencies were determined and used to differentiate group differences.
The Ethical permission to start the survey was approved by the 2nd meeting of the Ministry of Health
on February 4, 2020. The committee was reviewed and approved the research methodology based on
whether data collection technique and tools are considered the ethical issues, and whether provided
accurate information for make decisions to enroll to the survey for respondents.
Results:
According to the health statistic, from October 2, 2019 to March 31, 2020, a total of 2,768 people from 837 households were exposed to carbon monoxide poisoning. Of the total reported cases, 10 were
drunk, and 2 were due to other disease complications, and a total of 2,756 cases were confirmed
diagnosis as carbon monoxide poisoning.
Emissions of CO were recorded every 15 seconds and the results were calculated by conducting
continuous measurements per household for 24 hours a week. The level of CO emitted into the
indoor environment of households exposed by carbon monoxide had increased during the following
time from 7 am to 9 am in the morning, from 13 pm to 15 pm, from 18 pm to 20 pm in the evening, and
from 22 pm to 24 pm at night. During this period of time, the indoor air CO level had increased from
the WHO mild poisoning recommendation level.
Conclusion
It has been defined that the carbon monoxide emits to the indoor air households which are using an
improved fuel according to measurement the 30 minutes, 31-60 minutes, and 61-120 minutes after
burning.
7.The review about seed oils used in the treatment of traditional medicine
Odgerel B ; Delgermaa E ; Bold Sh ; Bolor B ; Bat-Erdene E
Mongolian Pharmacy and Pharmacology 2018;12(1):7-10
Background:
The basics of the development of the Traditional Medicine (TM) in the XXI century
are to study medical books created by physicians of the early period; and need to scientific - based
understanding the concepts in those scripts.
Goals:
To investigate the physical properties and the composition of saturated and unsaturated
fatty acids (FA) sesame oil which used the symptoms of the wind humor root diseases (the symbolic
terminology in TM) comparing with some vegetable oils or seed oils.
Materials and methods:
We are used “The Instruction Tantra” of “The Quintessence Tantras”,
“The Golden Decoration” (གསེར་རྒྱན།) of Darma maaramba Luvsanchoidog which is the explanation
scripts of “The Instruction Tantra”. The research was conducted through the method of original
manuscript analysis, the comparison method, induction and deduction method.
Results:
The sesame oil has the saturated FA (14.2%) and unsaturated FA (81.4%) and which
approximately amount with the olive oil (13.8%; 83.5%), sunflower oil (9.7%; 87.4%), corn oil
(12.9%; 82.3%), soybean oil (15.6%; 80.5%).
Conclusions
Sesame oil has saturated (14.2%) and unsaturated fatty acids (81.4%); and
has been used for the treatment of wind humor such as light, mobile, non-oily, cool nature –
external characteristics of body in Ancient Indian Ayurvedic Medicine. We can be substitute olive
oil, sunflower oil, corn oil, soybean oil which have rich of the amount of unsaturated FA (especially
high level of mono and poly unsaturated FA) instead of the sesame oil in the treatment.
8.Issue in late diagnosis of gastric cancer
Tulgaa L ; Ganchimeg D ; Chinzorig M ; Erkhembayar E ; Tegshjargal B ; Nasanjargal T ; Dashmaa A ; Bayar D ; Tsegmed S ; Bolor-Erdene T ; Otgonbayar I ; Batbold B
Mongolian Medical Sciences 2019;187(1):42-47
Introduction:
Gastric cancer is still one of the most leading causes of mortality in the world. The highest mortality rate of gastric cancer is estimated in Mongolia. South Korea and Japan, where leading the incidence of gastric cancer, mortality rates are observed in 51th and 31nd rank respectively. In Mongolia, gastric cancer is the second leading site, after liver cancer.
Goal:
We aimed to determine the cause of late diagnosis of gastric cancer and to evaluate supply of upper endoscopy devices and human resource for gastric cancer in the general hospital of provinces and districts.
Materials and Methods:
In this study, 84 patients suffering from gastric cancer (42 patients in III, IV TNM stage; 42 patients in I, II TNM stage)were investigated in National Cancer Center, Mongolia. A survey questionnaire which included age, gender, education, income, risk factors and clinical questions was detected from all patients. And we conducted study of supply of upper endoscopy devices and human resource for gastric cancer in general hospitals of from 21 provinces and general hospitals of 6 districts by questionnaire.
Results:
Seventy three(86.9%) patients were over 50 years old and the highest rates of gastric cancer were in group of 61-70 years (40.5%). From the results, the reason to visiting hospital was significantly different between two groups. 55.1% of patients suffering from early-stage gastric cancer were voluntarily diagnosed by upper endoscopy. In contrary, 55.8% of patients suffering from late-stage gastric cancer have visited the hospital due to worsening symptoms or dysphagia and vomiting. Factors such as age, gender, education, employment status and income had no significant effect on late diagnosis of gastric cancer. In totally 24(89%)general hospitals out of 27 had upper endoscopy devices and 22 (81.5%) hospitals had endoscopist. Although 75% of total general hospitals conduct
annual cancer screening, 64% of them do not perform the endoscopy in annual screening.
Conclusion
In our country, late diagnosis of gastric cancer is related to the attitudes of patients for preventing and screening disease. Therefore, it is important to improve the health education of the population and to develop healthy, right attitudes and practices. And the study revealed that general hospitals have insufficient for upper endoscopy devices and human resource.
9. A study to determine actual daily consumption of drinking and residential water for households in Ulaanbaatar
Zolzaya D ; Suvd B ; Amgalan G ; Tsegmed S ; Bolor B ; Soyombo G ; Oyun-Erdene O ; Altangerel B ; Oyunchimeg D ; Enkhjargal A ; Bolormaa I ; Tsogtbaatar B
Mongolian Medical Sciences 2024;208(2):39-47
Introduction :
Water is a vital resource for human existence and is essential for daily food processing, preparation,
washing, hygiene, and sanitation. Furthermore, providing the population with safe drinking water is one
of the pressing problems of the world and some regions.
In recent years, population density and the scale of commercial and industrial activities, as well as clean
and dirty water consumption were increased in the capital city. As a result of these, ground and surface
water resources are becoming scarce and polluted.
Therefore, assessment of daily drinking and residential water consumption of Ulaanbaatar should be
determined to use drinking water properly in daily life and water loss. This study assessed the actual
amount of households’ daily water consumption.
Goal:
The purpose of this study is to determine the daily consumption of drinking water for households in ger
areas and apartments in Ulaanbaatar.
Materials and Method:
This study covers 30 households in ger areas and 15 apartment households, in Ulaanbaatar.
Household members performed 6-10 types of measurements every day, within 7 days. As a result of
these measurements, actual consumption of water quantity used for drinking and household purposes
was calculated. Statistical analysis was done by SPSS Version 21 to calculate the true probability of
difference between parameters.
Result:
67.9% of the households in the ger areas were 4-5 family members. The average daily household
consumption of drinking and domestic water were 68.3 ± 3.57 L (95% 61.3-75.3), the minimum
consumption was 12 L, and the maximum was 227 L. Average of the household water consumption
water was 97.6-108.9 liters during the weekends, and water consumption was statistically higher than
weekdays (p=0.001; p=0.01).
The water consumption of residential households with 3 family members accounted for the majority
(30.8%) in this study. The average daily consumption of drinking and domestic water was 297.67±19.7
liters. There was no statistically significant difference (p=0.96) in week. The average daily water
consumption including drinking and residential was 270.3-335.97 L.
The total daily drinking and residential water consumption per person was 15.57 L for households in ger areas and 90 L for apartment households. Calculating the daily water consumption of households in ger areas, 60.3% of it is used for laundry, washing dishes, food preparation, washing face and hands, and clothes, 31% for drinking, and 8.7% for outdoor water use. While apartment households, approximately 94.1%, were used for household and 5.9% for drinking purposes.
Research ethics approval :
This study was discussed at the meeting of the Academic Council of the National Center for Public
Health. In addition, this study was carried out according to the methods and methods discussed and
approved at the meeting of the Medical Ethics Control Committee of the Ministry of Health (Resolution
No. 08).
Conclusion
The total daily consumption of drinking and residential water per person were 15.57 litres for the
households in the ger areas and 90 litres for the apartment households. It implies that it does not exceed
the WHO recommendations
10.Study on the risk factors of gastric cancer
Tulgaa L ; Ganchimeg D ; Enkhmyagmar D ; Tegshjargal B ; Nasanjargal T ; Ulziisaikhan B ; Dashmaa A ; Bayar D ; Bolor-Erdene T ; Erkhembayar E ; Chinzorig M ; Serjbayar G ; Batbold B
Mongolian Medical Sciences 2020;192(2):37-44
Introduction:
In 2018, a total of 901 new cases of gastric cancer were recorded, of which 64.8% in males and
34.2% in females. The incidence rate of gastric cancer was 28.5 per 100 000 population, which 38.2
for males and 19.2 for females.
Goal:
We aimed to investigate the associations between some risk factors and gastric cancer among the
Mongolian population.
Materials and Methods:
A case-control study was conducted between November 2017 and September 2019. We selected
120 cases from National cancer center of Mongolia who newly diagnosed gastric cancer. And 120
controls were selected by matching by sex, age and the place of residence. Informed consents
were obtained from all subjects. All subjects were personally interviewed with researchers used by a
structured questionnaire consisting of 86 questions. The SPSS 21 (version 16.0, SPSS Inc., Chicago,
IL, USA) software was used for all analyses.
Results:
The mean age was 59.2±11.4 (26-85) years. Habits of having dinner after 6.00 pm (OR 1.42, 95%CI
1.11-1.83, p=0.008), having leftover meals (OR 2.22, 95%CI 1.27-3.86, p=0.008), daily consumption
of tea with salt (OR 1.97, 95%CI 1.18-3.30, p=0.01), smoking on an empty stomach (OR 2.44,
95%CI 1.11-5.37, p=0.033), weekly consumption of ham and smoked meat (OR 1.5, 95%CI 1.17-
2.13, p=0.02), and consumption of fat grease (OR 2.09, 95%CI .03-4.24, p=0.038) were significantly
increased gastric cancer risk. In contrast, habit of eating at regular times (OR 0.43, 95%CI 0.25-0.73,
p=0.002), chewing thoroughly (OR 0.39, 95%CI 0.23-0.67, p=0.001), cooking meat thoroughly until
it’s tender (OR 0.48, 95%CI 0.25-0.97, p=0.047), daily consumption of vegetables (OR 0.45, 95%CI
0.27-0.76, p=0.003), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p=0.026) were
significantly reduced gastric cancer risk. Furthermore, having first-degree relatives diagnosed with
gastric cancer had 2-3 fold higher increased risk of gastric cancer (parents OR 2.88, 95%CI 1.07-
7.78, p=0.038, sibling (OR 3.09, 95%CI 1.09-8.81, p=0.036). Also, previous records of the digestive
disease increased risk of gastric cancer (OR 3.65, 95%CI 2.10-6.35, p<0.0001).
Conclusion
Dietary habits, family history of gastric cancer and previous records of digestive disease were
associated with risk of gastric cancer. Thus, prevention effort could be focused on the population with
a family history of gastric cancer, changing bad dietary habit and screening precancerous disease of
gastric cancer.