1.Knowledge and attitude of women on cervical cancer risk factors, prevention and screening
Uranchimeg Ts ; Ganchimeg T ; Bayasgalan E ; Buyanjargal Ya ; Avirmed D
Mongolian Medical Sciences 2013;163(1):151-157
Introduction
Cervical cancer is one of the most common types of cancer in women worldwide. It can be prevented by identifying pre-cancer lesions at early stages using Pap smear screening and treating these lesions. Knowledge and attitude on cervical cancer and Pap smear tests are associated with actual participation in cervical cancer screening. Therefore, our study aimed to investigate cervical cancer and Pap smear knowledge and attitudes among Mongolian women.
Materials and Methods
A total of 671 women aged 30 to 60 years from urban and rural areas participated in the study. The multiple clusters sampling method was used. We examined the relations of socio-demographic characteristics with lack of knowledge and negative attitude towards Pap smear tests by using a multilogistic regression analysis.
Result
The response rate was 89% (671/750). 62% of the participants correctly answered less than 4 out of 8 questions about cervical cancer risk factors. Also 47,2% and 79,3% of the total number of the women had never heard of Pap Smear and HPV. Only 16,4% of the respondents have some knowledge about them. Almost all (93%) participants agreed that there is a defficiency of information about cancer and its screening.58% and 28% of respondents said that they would participate in Pap smear tests voluntarily and agree to vaccinate their daughters. Positive attitude on Pap smear tests was higher among women living in rural areas and those who have had a Pap smear test.
Conclusions
Cervical cancer and Pap smear knowledge and attitude among the women in Mongolia are low. Having higher education and higher income level did not ensure positive attitude to cervical cancer screening. Strategies for communicating accurate information about cervical cancer, prevention, and detection as well as risk and treatment of cervical cancer are needed.
2.Study results on serum iron level in liver disease
Batbold B ; Ganchimeg D ; Otgonbayar I ; AIdarmaa T ; Tserendash B
Mongolian Medical Sciences 2011;158(4):10-14
Background and purpose: Liver disease that caused by iron metabolism failure is called Hemochromatosis (clinically "Bronze diabetes", "Over spotted liver cirrhosis"). The two types of hemochromatosis are primary and secondary. Primary hemochromatosis is caused by a defect in the genes that control how much iron the human body absorb from food. Secondary hemochromatosis usually is the result of another disease or condition that causes iron overload. According to the study there is a real need to study the clinical reveals of hemachromatosis in Mongolian patients. The purpose of the study to determine the hemachromatosis in patients with liver cirrhosis and cancer.Materials and Methods: The study involved 50 patients with diagnosis liver cirrhosis and cancer (1st stage) who were hospitalized in Clinic of gastroenterology of Shastin clinical hospital and "Shagdarsuren" hepatic hospital from April to July, 2011. The special questionnaire was used in the study. The biochemical laboratory examinations were taken and analyzed in lab "MED ANALYTIC". Biochemical tests performed on HumaStar 80 fully automatic analyzer. Determination of Iron level was performed by Photometric colorimetric test for iron with lipid clearing factor (normality 37-148ug/dl), transferring level by Turbidimetric monoreagent for the quantitative determination of transferring (normality 170-340ug/dl), glucose level by (GOD-PAP method) Enzymatic colorimetric test for glucose method without Deproteinisation (normality 75-115ug/dl). The ferritin level performed by ELISA analyzer (normality 15-240ng/ml).Results: The patient's age was 25-86, the mid aging-55.42. From all patients (29 male and 21 female) who were participated in the study, the 25 were with diagnosis liver cirrhosis and 18 of them clinically has the Child Pugh "B" cirrhosis, 7 has Child Pugh "A". The other 25 patients were with diagnosis liver cancer first stage.According to biochemical analyzes iron (n=35;70%); ferritin (n=41;82%); transferring (n=27; 54%); sugar (n=21;42%) levels were elevated.During the liver disease caused by iron overloading the following clinical symptoms were observed:- Skin spotting, n=48 (98%)- Hepatomegaly, n=33 (66%)- Splenomegaly, n=28 (56%)- Diabetes mellitus symptoms, n= 30 (60%)- Cardiovascular disease, n=16 (32%)- Respiratory system disorders, n=11 (22%)- Gonadotrophy, n= 2 (4%)The average serum iron level in case of livercirrhosis was 189.84+18.5mg/dl, in liver cancer 160.4±13.91 mg/ dl, ferritin level in case of liver cirrhosis was 407.69+50.08ng/ml, transferrin 375.68±47.38mg/dl, glucose 121.1±7.15mg/dl, ferritin level in liver cancer was 391.67±47.79ng/ml, transferring 388.76±47.38mg/dl, glucose 114.59±5.78mg/dl.
3.Gastric cancer: the current status and risk factors
Ganchimeg D ; Nasanjargal T ; Tegshjargal B ; Bayar D ; Bolor-Erdene T ; Batbold B ; Otgonbayar I ; Sodnomtsogt L ; Tulgaa L
Mongolian Medical Sciences 2018;186(4):68-74
Gastric cancer has been and still considered one of the most common causes of cancer-related mortality
and it continues to be a major public health issue. The incidence and mortality of gastric cancer in Mongolia is the highest in the world. For this reason, this paper provides the information about current status of gastric cancer in Mongolia in the first section. Morbidity and mortality of gastric cancer increased steadily during the last decade. In the second section we overview the most important factors that can accelerate the risk of gastric cancer. Evidence from case-control, cohort studies and meta-analysis have suggested that the risk of gastric cancer is related to several factors including genetics, Helicobacter pylori, other factors related to the environment and lifestyle. Risk factors could have different effects on the onset and the evolution of gastric cancer.
4.Measuring serum pepsinogen level for screening early stage of gastric cancer
Dashmaa A ; Chinzorig M ; Erkhembayar E ; Nasanjargal T ; Bayar D ; Ganchimeg D ; Batbold B ; Tulgaa L ; Erkhembulgan P
Mongolian Medical Sciences 2018;186(4):86-92
Gastric cancer is the second leading cause of death worldwide. About half of the incidence of stomach
cancer has been reported in East Asian countries. In Mongolia, gastric cancer is the second most common cancer in males and the third most common in females. The age-standardized mortality rate for gastric cancer was 29.3 per 100,000 in 2016, ranking second after liver cancer. Pepsinogen (PG) is a proenzyme of pepsin, by chief and mucous neck cells in the gastric mucosa. On the basis of the source of secretion, PGs are subdivided into 2 types: PG I and II. PG I is only secreted from the fundic glands in the corpus of the stomach, whereas PG II is secreted from the corpus, as well as the pyloric glands in the antrum and proximal duodenum. PG is excreted mainly into the stomach lumen, but approximately 1% diffuses into the blood stream. Atrophic gastritis and intestinal metaplasia are well-known risk factors for gastric neoplasms including dysplasia. To identify these premalignant gastric conditions, histological biopsy or image-enhanced endoscopy is performed. Gastric cancer is usually preceded by a decades-long precancerous process driven by Helicobacter pylori infection and environmental conditions with well-defined successive lesions. In the advanced stages, they are characterized by glandular atrophy and intestinal metaplasia. These changes involve loss of the original glands and result in decrease of the mass of chief cells of the gastric corpus, where PGI is produced. Loss of chief cells leads to lower PGI levels and PGI/PGII ratio in the peripheral blood. Serum PG levels are therefore a key tool to be used in screening programs. Serum PG measurements could provide a simple and noninvasive method for screening gastric neoplasms.
5.Familial Hypercholesterolemia
Ganchimeg D ; Otgonbayar I ; Batbold B ; Tulgaa L ; Sodnomtsogt L
Mongolian Medical Sciences 2018;186(4):60-67
Familial hypercholesterolemia (FH) (OMIM#143890) is the most common metabolic autosomal disorder. The prevalence of the homozygous FH has been reported as 1 in a million in the general population, compared to much more mild form heterozygous FH with prevalence of 1 in 200-500. Mutations in the low-density lipoprotein receptor (LDLR), apolipoprotein B (ApoB), proprotein convertase subtilin/kexin9 (PCSK9), and low-density lipoprotein receptor adapter protein 1 (LDLRAP1) genes have been linked to FH. These mutations result in a disorder in low-density lipoprotein cholesterol (LDL-C) catabolism, and significantly increasing the levels of LDL-C, total cholesterol in serum, leading to specific clinical signs such as tendon xanthoma, corneal arcus, cardiovascular diseases, and early death from coronary heart disease if left unattended. Therefore, there is an ardent need for early diagnosis followed by aggressive therapeutic intervention and lifestyle modification. Currently, FH can be diagnosed either clinically or genetically. There have three main clinical diagnostic criteria for FH: the US MedPed Program, the Simon Broom Register Group in the UK, and the Netherland’s criteria. The occurrence of so many different LDLR mutations and their widespread distribution throughout the gene imposes severe practical limitations on simple genetic screening. Indeed, exon by exon sequencing of LDLR and other genes in each patient is the best screening genetic methods of choice. Although the hypercholesterolemia associated with FH can be controlled with cholesterol-lowering drug therapy (statins and other), patient response can vary
quite widely.
6.Change of serum lipid profiles during antiviral therapy in chronic hepatitis C
Batbold B ; Gantsetseg G ; Tulgaa L ; Ganchimeg D ; Sodnomtsogt L ; Chia-Yen D
Mongolian Medical Sciences 2018;186(4):14-22
Background :
Low triglycerides and cholesterol was associated with hepatitis C virus (HCV) infection. Chronic HCV infection is the main cause of liver injury and it may influence to serum lipid levels. We aimed to evaluate the effect of antiviral treatment on the change of lipid profiles during interferon-based anti-HCV treatment.
Material and Methods :
Totally 863 patients who completed the interferon-based antiviral therapy in Kaohsiung Medical University Hospital were included in this present study. The lipid profile measured and assessed in the baseline of the treatment and after 6 months of completion of the treatment.
Results :
The most of the patients (81.2%) were achieved sustained virological response (SVR) by antiviral therapy. There was no significant difference between baseline triglycerides (TG) levels in the SVR group and non SVR groups. The TG levels at 6 months after completion of the treatment was significantly elevated in SVR group (102.9±57.0 mg/dL, p=0.0001) but did not elevated in non SVR group (94.5±45.6 mg/dL, p=0.690) compared with baseline TG levels.
After adjusting patients by four indexes for fibrosis (FIB4) in cut-off point 3.25, serum TG levels significantly increased in low FIB4 group (103.2±57.9 mg/dL, p=0.0001) but not in high FIB4 group (98.1±49.6 mg/dL, p=0.095) after 6 months end of the treatment. Serum TG level was increased greater in patients who had low FIB4 score and patients who achieved SVR (baseline 89.1±34.8 mg/dL; 6 months after treatment 104.3±59.3 mg/dL, paired T test p=0.0001).
Conclusion
The eradication of HCV is the main cause of the increase of lipids after Pegylated Interferon and Ribavirin treatment.
However advanced fibrosis also has an effect in increase of TG after the treatment.
7.The effect of nutrition risk factors for esophageal and gastric cancer
Enkhmyagmar D ; Tulgaa L ; Nasanjargal T ; Batbold B ; Ganchimeg D ; Tegshjargal B ; Bolor-Erdene T ; Bayar D ; Erkhembayar E ; Chinzorig M ; Dashmaa A ; Tsegmed S
Mongolian Medical Sciences 2019;187(1):80-86
Gastric and esophageal cancer is a significant global health issue. The epidemiology of these tumors has significantly increased over the past several years especially in developing and developed countries. Many dietary exposures have been proposed to protect against or increase risk for esophageal and gastrointestinal (GI) cancers, including poor diets, foods, individual nutrients, methods of food preparation, and habits of consumption. Overweight/obese status is associated with an increased risk for many cancer types such as esophageal, gallbladder, kidney, pancreatic and
gastric cancer. The association between obesity and cancer is strong. Nowadays there is a recognized decrease in incidence and mortality of distal gastric cancer and an increase in incidence and mortality of proximal esophageal cancer. In Mongolia, gastric cancer is the second most common cancer in males and the third most common in females. It is very important to understand how diet and nutrition affect to gastric and esophageal cancers. In this review we will discuss the effect of diet in locally advanced gastro-esophageal cancer. Although we tried to conclude all published articles about gastric and esophageal cancers in Mongolia.
In this survey, is considered dietary risks into 5 groups as following;
• Insufficient nutrition education(don’t know food and nutrients significance and food hygiene, don’t know right consumption of food)
• Bad habits (hot tea and meals, salty tea and food, low consumption of fruits and vegetables, sometimes eating breakfast, most of daily energy of food in the night, high amount of sugar, a drink of caffeine, overweight and etc.)
• Food processing technology (such as overcooking, pickling, preserving, frying, excessive salt in tea fried and etc).
• Chemical contaminants in food products (various inorganic fertilizers, heavy metals and etc.)
• Household economic capacity is influencing
Diet can be used as a tool to evoke the positive/desirable biological responses of an organism aiming to maximize health and protection against diseases (chronic/non-communicable diseasesparticularly cancer) by mostly means of prevention.
8.Involvement of Vitamin D in Immune system
Baljinnyam T ; Batchimeg B ; Zolzaya D ; Ganchimeg D ; Lkhaasuren N ; Oyungerel G ; Munkhtsetseg B ; Khaliun M ; Khulan U ; Bilguun E ; Batkhishig M ; Tulgaa L ; Bilegtsaikhan Ts ; Munkhbayar S ; Munkhtuvshin N ; Munkhbat B
Mongolian Medical Sciences 2020;192(2):51-59
Research of function of vitamin D on immune system has been studying since the study revealed
that vitamin D receptor is expressed on the surface of the immune cells. 1,2-dihydroxyvitamin
D3 [1,25(OH)2D], physiologically active form, can be generated through hydroxylation of
25-hydroxyvitamin D3 [25(OH)D], inactive form of vitamin D, in a liver, connecting with specific VDR
make biological action. Vitamin D make different biological actions depends on connecting with
different immunological cells. Some studies indicated that Vitamin D plays pivotal role in antibacterial
innate immune responses through regulating reaction of the main cells as macrophages and dendritic
cells. Moreover, calcitriol, the active form of vitamin D, is connected with VDRE, modulates the innate
immune response through directly inducing expression of catelicithin and β-defensin as antimicrobial
peptides, reducing secretion of IL-1b, IL-6, TNF-a, RANKL, COX-2 as proinflammatory cytokines and
increasing production of IL-10, an anti-inflammatory cytokine. Vitamin D plays in proliferation and
differentiation of T and B cells and regulates the activities of over 500 genes. Vitamin D differently
impacts on per se stages of T cells’ proliferation. Vitamin D indirectly mitigates the differentiation from
immature B cells to plasma B cells while it directly impacts on regulation of overloaded production of
antibodies in plasma B cells. In conclusion, vitamin D modulates the innate- and adaptive immune
response through regulation on activation of APCells, proliferation and differentiation of immune cells,
secretion of some antibacterial peptides.
9.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.
10.The effect of “Cibo” ointment on burn wound in rats
Munkh-Erdene R ; Davaasambuu T ; Batchimeg B ; Bayanmunkh A ; Ganchimeg G ; Tsetsegmaa S ; Lkhagva L ; Khurelbaatar L
Mongolian Pharmacy and Pharmacology 2022;20(1):45-56
Abstract:
Burn injury causes considerable incidence of disability, increase of hospitalization and rehabilitation. It is a crucial factor of morbidity and mortality, throughout the world, especially in the developing countries. Burn wound healing is a complex process including inflammation, granulation, and regeneration of the skin tissue. There are many animal and mineral derived agents applied for burn wounds treatment. For example, minerals and animal yellow marrow are applied as standard topical therapy in healing of burn wounds in the history. Specially, Mongolian camel’s (Camelus Bactrianus) yellow marrow and cinders have been used the healing effect standard topical antimicrobial for burn wounds for several centuries. The present study aimed to determine the healing effect of “CIBO” ointment with animal and mineral raw materials on third -degree burn wound in rats.
Introduction:
In our study, we selected an ointment containing a combination of yellow marrow and cinder. In ancient times, Mongolians used camel yellow marrow to relieve joint pain, spread people who had been bedridden for a long time due to the disease, and to prevent caries, and to use it on open wounds. In traditional medicine, cinder has been used as a mineral raw material and has been used to treat frostbite and burns.
Material and methods:
In the Vivar Department of the Pharmacology Sector of the Drug research institute, 18 Wistar white rats weighing 182-220 g fed in one environment for (12 hours a day/12 hour a night) were randomly selected and divided into the following groups. These are: negative control, Group 1 “Yellow marrow + Uvs black cinder”, Group 2 “Yellow marrow + Uvs brown red cinder”, Group 3 “Yellow marrow + Chinese red cinder”, Group 4 “Yellow marrow + Chinese white cinder”, Standard “Mebo” wound ointment. The wound area was prepared by scraping the hair 5 cm from the back of the test animal’s skull. The prepared area was sterilized with 70% ethanol and 10% iodine solution, resulting in a third-degree burn wound of 2.4 cm2. Wound experiential’s ointments were applied once daily for a total of 28 days, and wound healing was evaluated at 0, 3, 7, 14, 21, and 28 days after pathogenesis, with 16.1-pixel accuracy. Photo confirmed using a SONY brand camera.
Result:
“CIBO” ointment contains four deferent cinders which are from collected from deferent area and that have been shown to good affect burn wounds, and is more compatible with yellow marrow than Group 4 (Yellow marrow+Chinese white cinder).
Wound healing variables of control group compared with group 4 (Yellow marrow + Chinese white cinder) increased by 11.1% on the 3th day, 4% on the 7th day, 44.8% on the 14th day, and 54.5% on the 21st day. On the 28th day, healing and regeneration were accelerated by 50%.
Conclusion
The group 4 (Yellow marrow + Chinese white cinder) has been shown to have a pharmacological action of rapid healing and regeneration of burn wounds caused by experimental rats. It has also been shown to have pharmacological action to regenerate skin tissue and suppress inflammation caused by burns. Inclusion of Chinese white cinder in “CIBO” ointment promotes regeneration and healing of “CIBO” ointment.