1. Results of treatment for sight-threatening diabetic macular edema
Anaraa T ; Uranchimeg D ; Baasankhuu J ; Bulgan T ; Munkhzaya TS ; Munkhkhishig B ; Oyunzaya L ; Urangua J ; Munkhsaikhan M ; Unudeleg B ; Khuderchuluun N ; Chimedsuren O
Innovation 2016;10(1):24-29
To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p<0.0001). There were significant difference detected between the bevacizumab and bevacizumab combined with laser treatment groups (p=0.004). At month 12, greater proportion of patients gained ≥10 and ≥15 letters and with BCVA letter score >73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.
2.Open broström-gould repair vs arthroscopic anatomical repair of the anterior talofibular ligament for chronic lateral ankle instability
Amgalankhuu O ; Shiirevnyamba A ; Batsukh S ; Erdenebold B ; Zoljargal S ; Naranbat L ; Munkhsaikhan T
Mongolian Journal of Health Sciences 2025;88(4):221-225
Background:
During inversion injuries of the ankle joint, the anterior talofibular ligament (ATFL) is the most commonly
injured structure. Injuries to the lateral collateral ligaments of the ankle, either in isolation or in combination with injury
to the calcaneofibular ligament (CFL), account for approximately 60-65% of all ankle ligament injuries. In recent years,
several studies have examined the impact of lateral ankle ligament injuries on lifestyle and overall health. Repeated inversion injuries-particularly those occurring three or more times-can lead to chronic ankle instability (CAI). In the treatment
of ankle instability, both open and arthroscopic surgical techniques are widely used internationally. In Mongolia, there is
an increasing clinical need to evaluate and compare the outcomes of arthroscopic versus open surgical repair of lateral
ankle ligament injuries. This need forms the basis of the current study.
Aim:
The comparative studies on open vs arthroscopic anterior talofibular ligament (ATFL) repair are limited. This study
aimed to compare the early therapeutic efficacy and cost between the traditional open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL for chronic lateral ankle instability.
Materials and Methods:
A total of 40 patients with chronic lateral ankle instability undergoing repair of the ATFL be
tween September 2024 and February 2025 were retrospectively included with a traditional open surgery (n=10) group
and an arthroscopy (n=17) group. The surgery duration, surgical cost, postoperative complications, and the preoperative/postoperative American Orthopaedic Foot & Ankle Society Score (AOFAS) and Karlsson-Peterson score were compared
between groups.
Results:
Compared to the anatomical group, the non-anatomical group had significantly shorter surgery and hospitalization durations. Three months after the operation, the AOFAS and Karlsson scores significantly improved in both groups.
Nevertheless, there was no significant difference in the AOFAS and Karlsson scores between groups at both preoperative
and postoperative assessments. No significant difference was found in the incidence of postoperative complications between the two groups.
Conclusion
1. These results suggest that open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL have
comparable therapeutic efficacy for chronic lateral ankle instability.
2. The arthroscopic surgery had a smaller incision, while the open Broström-Gould had a shorter surgery duration and
lower cost.
3.Significance of evaluation of D-dimer in COVID-19 patient: Case report
Bayarjavkhlan Ch ; Battulga Ch ; Buyanjargal E ; Byambalkham B ; Jargal-Erdene B ; Naranmandakh D ; Munkhsaikhan B ; Munkhbat T ; Oyungerel S ; Enkhnomin O ; Gantuya L ; Ulziitsetseg Ts
Health Laboratory 2021;14(2):23-32
Introduction:
Coronavirus infection 2019 (Ковид-19) is an infection caused by a novel virus and induces severe ARDS. КОВИД-19 pandemic has rapidly spreaded in 221 countries, 245,373,039 cases and 4,979,421 mortalities have been reported. Pulmonary and renal thrombotic angiopathy occur in patients with complications of ARDS, sepsis, and multi-organ failure. Elevated D-dimer in КОВИД-19 patients has been reported firstly by doctors in Wuhan, China. In addition, many studies have revealed that elevated D-dimer has been associated with the severity of the diseases, an increased rate of poor prognosis.
Objective:
We aim to determine D-dimer in КОВИД-19 patients, and patient condition a decrease of D-dimer level after administration of anticoagulant therapy.
Case report:
We introduce a rare case of КОВИД-19. Laboratory test results and the effect of anticoagulant therapy have been evaluated during the infection. 85 aged women were admitted with a diagnosis other than КОВИД-19. PCR for SARS-Cov-2 was negative on the previous day of admission, and Sars-Cov-2 Ag rapid test was also negative on the admission day. However, the D-dimer test result was much higher with 7120 ng/мл and X-ray and CT revealed a similar pattern to the КОВИД-19 patient. Then anti-Sars-Cov-2 test was positive with 4,08 COI. Based on laboratory test results of D-dimer, LDH, CRP, and CT pattern the patient was diagnosed with post-КОВИД-19 pneumonia, and anticoagulant therapy was initiated additionally to prevent hypercoagulation induced by КОВИД-19. D-dimer test taken before administration of anticoagulant therapy increased more to 10910 ng/мл. 3 days later D-dimer level decreased to 8180ng/мл and the patient’s condition was improved.
Conclusion
The evaluation of D-dimer of the patients with КОВИД-19 is highly significant. Anticoagulant therapy might be necessary for КОВИД-19 patients with high D-dimer level in serum. Further studies are needed to assess the long-term outcome of the illness and mortality.