1.The problems ultrasonographic diagnosis of the pancreatic tumors
Badamsed Ts ; Jargalsaikhan S ; Baatarjan N ; Delgertsetseg D ; Saintegsh S ; Nomin-Erdene A
Mongolian Medical Sciences 2011;172(2):87-93
Introduction: Pancreatic cancer in young patients is usually correlated with chronic alcohol consumption and hereditary factor. Chronic pancreatitis, pancreatic trauma, pancreatic cyst, alcoholism, and diabetes mellitus are the most clearly established etiological factors (T.Y Flanders., W.S Foulkes., 1996). The cancer was located to the pancreatic head in 75% to the body in 15-20% and to the tail in 5-10% of cases (A.E Richard., 2005).
Goal: Determination of the US signs in pancreatic cancer and establishment standard (control) US diagnostic criteria.
Objectives:
1. To reveal direct and indirect US signs of pancreatic cancer.
2. To establish standardized US diagnostic criteria.
Materials and Methods: A prospective study was carried out in 35 patients with pancreatic cancer in a 4 years period between 2006-2010 (Shastin Central Hospital, Achtan Clinical Hospital). To each patient has being filled special investigation chart. Diagnosis was confirmed on the result of physical examination, laboratory investigation, abdominal conventional radiography, upper gastrointestinal contrast radiography, CT, MRI, ERCP and biopsy.
The results of the measurements were compared with the standardized control evaluation of Mongolian people (Ts.Badamsed.B.Tserendash).
Results: Our sample represents US signs in 35 patients with pancreatic cancer. On the basis of our study US sign were divided into two categories: direct and indirect signs.
Direct signs: a) irregular shape, b) irregular tumour edge, c) hypodensity, d) tumour size more than 2.1cm, e) different location.
Indirect signs: a) CBD distends, b) gallbladder distends, c) intra hepatic bile duct distend, d) pancreatic pseudo cyst, e) near-aortic limp node enlargement, f) splenomegaly. We consider that the upper mentioned US abnormality can be as control standard criteria for the US diagnosis of the pancreatic tumour. According to the study of V.N.Demidov and G.P.Sidorov (1987), the pancreatic cancer is located to head in 50-80%. In our series it was about 45.7%± 8.4. Irregular tumour shape in 60.0%±8.3, tumour hypodensity 80.0%±7.2, irregular tumour edge 68.6%±7.8, tumour clear definition 71.4%±7.6 which are the same with N.M. Mukharllyamov (1987).
Conclusions:
1. Were described direct and indirect US diagnostic signs in pancreatic cancer
2. The tumor location, shape, size, edge, consistency, intra and extra hepatic bile duct distend, gallbladder distend, near-aortic limp node enlargement are the basic control criteria for the diagnosis of pancreatic cancer.
2.The study result of the effect of Jirug-6 suppositories on vaginal candidiasis model in experimental animals
Yilina ; Nomin-Erdene U ; Enkhjargal D
Mongolian Journal of Health Sciences 2025;88(4):82-87
Background:
Vaginal candidiasis is a highly prevalent infectious disease among women caused by a wide range of pathogenic organisms. Although it can be treated with standard pharmacological methods, it has detrimental effects on women’s
reproductive health. The absence of research to date on the anti-vaginal inflammatory effects of Jirug-6 suppositories - a
traditional formulation derived from ancient medicinal recipes and long-used in traditional mongolian medicine has provided the rationale for conducting this study.
Aim:
Study of the effects of Jirug-6 suppositories on the vaginal inflammatory lesion model induced by Candida albicans.
Materials and Methods:
To establish the vaginal inflammatory lesion model in experimental animals, the inoculum was
prepared according to the McFarland standard method, and 10 µL of the inoculum was intravaginally administered daily
for 4 consecutive days. Fifty-six mice with induced vaginal candidiasis were divided into 7 groups. On treatment days 1,
3, 5, 7, and 10, the vaginal cavity of the mice was washed with 100 µL of phosphate buffer. From the lavage fluid, 20 µL
was collected, mixed with 480 µL of phosphate buffer, and thoroughly homogenized. Using a 20 µL micropipette, three
aliquots were inoculated onto Sabouraud Dextrose Agar (SDA) medium and incubated at 37°C for 48 hours. Colonies
were counted, and at the end of the experiment, serum was isolated from blood samples, and IFN-γ and IL-10 levels in
the samples were quantified using ELISA. Histopathological analysis was performed on vaginal tissues from the experimental animals.
Results:
In the experimental animals, Jirug-6 suppositories 0.4 mg/kg dose exhibited the mildest clinical signs of hyperemia, swelling, hemorrhage, infiltration, or fluid loss into soft tissues in the vaginal and cervical regions (p<0.01). For
cervical inflammation, Jirug-6 suppositories 0.4 mg/kg demonstrated a strong anti-inflammatory effect with a score of
1.99±0.78, which was comparable to the positive control group (p<0.01). In serum, the concentrations of IFN-γ and IL-10
in Jirug-6 suppositories 0.4 mg/kg were determined to be 8.18±0.61 and 7.91±1.30, respectively, showing reduced levels
similar to those of the positive control group (p<0.01).
Conclusions
1. Jirug-6 suppositories reduce inflammatory symptoms and suppresses fungal dissemination during the vaginal lesion
model induced by C. albicans.
2. At a Jirug-6 suppositories 0.4 mg/kg demonstrates anti-inflammatory effects by increasing IFN-γ concentration and
decreasing IL-10 concentration in the C. albicans-induced vaginal lesion model. Furthermore, it enhances immunity
and reduces swelling during inflammation, exhibiting positive therapeutic effects against clinical symptoms.
3.Acute and chronic toxicity effects of traditional medicine Shimshin-6
Nomin-Erdene J ; Dejidmaa B ; Erdenechimeg Ch ; Munkhtsetseg D ; Chimedragchaa Ch
Mongolian Journal of Health Sciences 2025;86(2):143-148
Background:
In traditional medicine, the Shimshin-6 formulation, which consists of Rheum undulatum L., Hippophae
rhamnoides L., Zingiber officinalie Roscoe, Saussurea Lappa C.B.Clark, Sal ammoniacum, Tronae veneni, is recommended
for women experiencing menstrual retention disorders. In recent years, Shimshin-6 has been widely used to
promote postpartum uterine involution for women and our study aimed to evaluate and determine the acute and chronic
toxicity effects of Shimshin-6.
Aim:
To evaluate and substantiate the acute and chronic toxicity effects of Shimshin-6.
Materials and Methods:
The acute toxicity of Shimshin-6 was evaluated using the rapid method described by V.B. Prozorovsky
(1978) by administering intraperitoneal injections of the medicinal extract in white mice to determine the lethal
dose. The active dose was determined following the methodology of I.P. Zapadnyuk (1983). Chronic toxicity was evaluated
in Wistar rats according to the OECD 407 (2008) guidelines. The test animals were administered Shimshin-6 in tablet
form (90 mg/kg and 180 mg/kg) and decoction form (tang) (162 mg/kg) daily for 60 days. At the end of the experiment,
biochemical and complete blood analyses were conducted, along with histopathological examination of major organs.
The study was conducted with ethical approval granted by the Ethics Committee of the Mongolian National University of
Medical Sciences (MNUMS) on October 25, 2024.
Results:
The LD50 for Shimshin-6 tablets was 4.47 (3.39–5.1) g/kg, indicating low acute toxicity based on the K.K.
Sidorov classification. The LD50 for the decoction form was 8.1 (7.1–9.4) g/kg, suggesting it is non-toxic. Regarding
chronic toxicity, platelet count was significantly reduced compared to the healthy control group: Shimshin-6 tablet group:
46% reduction at 90 mg/kg and 29.7% reduction at 180 mg/kg. Shimshin-6 decoction group: 60.5% reduction at 162 mg/
kg. Additionally, hemoglobin levels in the decoction group (162 mg/kg) decreased by 15.7% (p<0.05). Biochemical analysis
showed a 36.3% reduction in total cholesterol (LDL-C) levels in the tablet group (180 mg/kg) and decoction group
(162 mg/kg) compared to the control (p<0.05).
Conclusion
Shimshin-6 tablets showed low acute toxicity in experimental mice. However, long-term administration may
lead to a reduction in platelet count.
4.A study of tissue biomarkers in gastric cancer and its precursors
Nyam-Erdene N ; Tsogzolmaa Sh ; Batchimeg B ; Nomin-Erdene D ; Tuul B ; Оyunbileg N ; Zorigoo Sh ; Ganchimeg D ; Munkhbayar S ; Baasanjav N ; Tulgaa L
Mongolian Medical Sciences 2024;209(3):21-28
Background:
Specifically, stomach cancer ranks as the fifth leading cause of cancer morbidity
and mortality worldwide. Early-stage detection significantly improves survival rates,
with over 90% of patients diagnosed at stages I and II living beyond five years. To
improve the early detection of gastric cancer, it is necessary to complement the
conventional method of endoscopic examination with biomarker analysis. We aimed
to compare biomarkers such as pepsinogen C (PGC), matrix metalloproteinase 2
(MMP2), matrix metalloproteinase 9 (MMP9), and the cell proliferation marker Ki-67
with immunohistochemical analysis.
Purpose:
A comparative study and evaluation of biomarkers for the early detection of gastric
cancer.
Materials and Methods:
The study was conducted using a retrospective cohort design. Research ethics
issues were discussed at the meeting of the Medical Ethics Control Committee of
the Ministry of Health on October 13, 2023, and permission to start the research
was obtained (Resolution No. 23/051). The information was gathered based on the
criteria for K29.3, K29.4, K31, and C1 diagnoses according to the international ICD
10 classification, and participants were selected accordingly. Proteins such as PGC,
MMP2, MMP9, and Ki-67 were examined using a tissue microarray kit and evaluated
through immunohistochemical analysis.
Results:
Negative gastric tumor markers PGC, Ki-67, MMP2 and MMP9 were evaluated
by immunohistochemical analysis. The mean PGC protein staining values were
6.20±2.61 for chronic superficial gastritis, 5.45±2.47 for atrophic gastritis, 3.61±2.0 for
metaplasia, and 3.31±1.75 for gastric cancer, with statistically significant differences
between the groups (P<0.001). The mean Ki-67 protein staining values were 0.1 ±
0.4 for chronic superficial gastritis, 0.33 ± 0.55 for atrophic gastritis, 0.09 ± 0.39 for
metaplasia, and 2.62 ± 0.78 for gastric cancer, also showing statistically significant
differences (P<0.001). The mean MMP2 and MMP9 protein staining values were
0.2±0.76 and 1.2±2.04, respectively, for chronic superficial gastritis; 0.28±0.52
and 3.28±2.82 for atrophic gastritis; 0.35±1.04 and 1.12±1.45 for metaplasia; and
1.38±2.11 and 5.29±2.51 for gastric cancer, with all differences being statistically
significant (P<0.001).
Conclusion
PGC protein, a negative tumor marker, decreases during the transition
from a gastric cancer precursor to cancer. MMP2 protein, a marker of cell migration
and metastasis, has little diagnostic value, while the expression of MMP9 and the Ki
67 are highly effective in gastric cancer. Immunohistochemical analysis of endoscopic
biopsy tissue to detect the negative tumor marker PGC, the positive marker Ki-67,
and MMP9 can be used for early detection of gastric cancer.
5.Outcomes of measures to prevent dose selection errors (2023-2024)
Nomin-Erdene Ts ; Tserennyam D ; Delgermaa Ts ; Orgilmaa Ts ; Mungunchimeg M ; Khulan M ; Khulan A ; Nina M ; Erdenetuya M
Mongolian Journal of Health Sciences 2025;87(3):154-160
Background:
A drug related problem is defined by the Pharmaceutical Care
Network Europe Association as an an event or circumstance involving drug
therapy that actually or potentially interferes with desired health outcomes.
One critical aspect of preventing such errors is proper dose adjustment, which
plays a vital role in the diagnosis and treatment of disease. For instance, adjusting
the dose of warfarin based on the patient’s INR level is essential. In
a 1995 study conducted in England, clinical pharmacists recommended target
doses of angiotensin-converting enzyme (ACE) inhibitors for patients with
chronic heart failure. As a result, patients experienced a significant reduction
in pulmonary and peripheral edema, along with improved exercise test outcomes.
At the Mongolian-Japanese Hospital of the Mongolian Medical University
of Science and Technology, it is important to analyze dosage-related
issues identified by clinical pharmacists and inform healthcare professionals
about common dosage selection errors and associated risks.
Aim:
We analyzed issues related to medication dosage.
Materials and Methods:
A retrospective study was conducted to examine
problem related to dosage detected through prescription monitoring at the
Mongolian Japanese Hospital of the Mongolian National University of Health
Sciences from 2023 to 2024.
Results:
Out of a total of 2340 drug-related problem identified across five
inpatient wards during this period, 581 (100%) were related to dosage. Clinical
pharmacists performed prescription review on approximately 67% of all
inpatients, which was consistent between years. However, medication-related
problems tended to decrease from 41.1% (n=1499) in 2023 to 22.3% (n=841)
in 2024 (p=0.05). The majority of dose-related problems, 75.6% (n=440), were
overdoses. Medication-related problems were most common in the surgical
department, with 59.5% (n=346) (p=0.001). The most frequent dosage-related
errors involved exceeding the daily dose of diclofenac, administering higher-
than-recommended doses of ceftriaxone, failing to adjust cefotaxime for
renal function, and using inappropriate doses of metronidazole in patients with
impaired liver function. The leading cause of these errors was failure to adhere
to guideline-recommended dosing, which accounted for 71.3% (n=415)
of cases (p=0.001). When dosage-related recommendations were provided to
physicians before of treatment, acceptance rates increased by 14% (p=0.001).
These interventions resulted in an estimated cost saving of 1.267.219₮ and a
reduction of 363 injections.
Conclusion
Therefore, clinical pharmacist-led prescription review can help
reduce the risk of dosage errors, lower associated healthcare costs, and alleviate
the burden on medical staff.
6.Clinical features of ophthalmology in thyroid disease
Oyungerel B ; Erdenezul G ; Misheel B ; Uranchimeg D ; Chimedlkhamsuren G ; Nomin-Erdene M ; Sarantuya J
Innovation 2021;14(2-Ophthalmology):6-10
Background:
TED (thyroid eye disease) is an inflammatory disease of the orbit caused by
autoimmune diseases of the thyroid, which adversely affect the vision, appearance, and quality
of life. Exophthalmos and eyelid retraction are the main features of TED, which can lead to ocular
motility, diplopia, optic neuropathy, and permanent vision loss. The study aims to determine the
most common clinical signs of TED in Mongolians and define whether there is a correlation with
the levels of thyroid autoantibodies.
Methods:
The study involved 102 patients with TED and 81 patients with Graves’ ophthalmopathy.
The clinical features of TED were identified and evaluated by activity score (CAS) and severity of
GO using the European Group of Graves’ Orbitopathy (EUGOGO).
Results:
The mean age of TED patients was 42.6±11.2, which was younger than GD patients
(P=0.012). The current smoker was 24 patients (23.5%) with TED, which is relatively higher than GD
(P=0.0001). The most common ocular signs were eyelid retraction 80 (78.4%), proptosis 77 (75.5%),
diplopia 14 (13.7%) and 4% vision loss. There were no differences in proptosis between the right (18
mm, median) and left eye (17.8 mm, median) (P>0.05). The mean CAS score was 3.09±1.72 and
varied depending on gender and smoking. According to EUGOGO, 62.7% of the patients were
moderately severe. Only 7 % of the patients were in the sight-threatening stage, presenting optic
neuropathy and corneal breakdown. The mean TSI level in patients with TED was 37.95 ± 35.41 IU
/ ml, which was 2.7 times higher than the mean in patients with GD.
Conclusions
Eyelid retraction and exophthalmos are the most common clinical signs of TED.
Early diagnosis of these features can prevent complications of the disease. Determining serum TSI
levels will help in the treatment and monitoring of TED.
7.Correlation between the individual body constitution in traditional medicine and some biochemical parameters
Xilinqiqige ; Tserentsoo B ; Tsend-Ayush D ; Delgerekhzaya E ; Nomin-Erdene U ; Hao Feng ; Chang Qing ; Dorjbat S ; Siqin
Mongolian Journal of Health Sciences 2025;85(1):159-163
Background:
From the perspective of traditional medicine, researchers believe that the individual’s innate quality has
a reciprocal effect on the physiological level. The study of body-specific quality differences is important for improving
disease risk prediction, diagnosis, and treatment approaches. Therefore, explaining the features of traditional medicine
with some physiological parameters and establishing the relationship between them is clinically significant and important
for predicting disease risk and developing individualized treatment methods, which is the basis of this research.
Aim:
To establish the correlation between an individual’s innate unique constitution and specific biochemical indicators.
Materials and Methods:
The innate unique constitution of individuals was determined using electronic data, and the
relationships between their characteristics and levels of uric acid, creatinine, urea, and glucose in the blood were analyzed.
Results:
A total of 102 participants were included in the study. Among them, the Shar-Khi constitution was the most prevalent, with 28 cases (27.45%), while the Khi-Badgan constitution was the least common, with 13 cases (12.75%). Individuals with the Khi-Shar constitution exhibited the highest urea level at 4.47 ммоль/л, whereas those with the Badgan-Shar
constitution had the lowest at 4.15 ммоль/л. The uric acid level was highest in individuals with the Shar-Khi constitution
at 316.15 µmol/L and lowest in those with the Badgan-Shar constitution at 261.36 µmol/L (p<0.001).
Furthermore, individuals with the Badgan-Khi constitution had the highest creatinine level at 73.51 µmol/L, while those
with the Badgan-Shar constitution had the lowest at 63.97 µmol/L (p<0.001). The blood glucose level was highest in
individuals with the Khi-Badgan constitution at 4.59 ммоль/л and lowest in those with the Khi-Shar constitution at 4.21
ммоль/л. Kidney function indicators, particularly creatinine, significantly correlated with blood glucose levels (r=0.67,
p<0.01). Higher uric acid and creatinine levels were associated with elevated blood glucose levels. These findings suggest
that variations in urea, uric acid, and creatinine levels among different unique constitutions could be utilized to predict
the risk of kidney disease or diabetes.
Conclusion
Depending on the individual characteristics of traditional medicine, kidney and blood sugar parameters
are different and related to each other, and can assess the state of diabetes and kidney disease. Determining the inherent
characteristics of an individual is considered important for improving the diagnosis, treatment, and prevention of diabetes
and kidney disease.
8. Impact of Individual Temperament on the Immune Response After COVID-19 Vaccination
Burenjargal B ; Dashpagam O ; Shatar Sh ; Khongorzul T ; Ariunzaya B ; Zolmunkh N ; Gansukh Ch ; Ulziisaikhan B ; Chimidtseren S ; Baasanjargal B ; Enkh-Amar B ; Nomin-Erdene Ts ; Davaalkham D ; Tsogtsaikhan S ; Batbaatar G
Mongolian Journal of Health Sciences 2025;88(4):47-51
Background:
The first confirmed case of COVID-19 in Mongolia was reported on November 11, 2020. In response, the
government imposed a nationwide lockdown, which significantly impacted the population’s mental health. Heightened
levels of stress, anxiety, loneliness, and depression during the pandemic altered individuals’ psychological stability and
behavior. Personality traits—defined as relatively stable patterns of emotion, cognition, and behavior—play a key role in
stress responses and emotional regulation under pressure. Emerging evidence suggests that these psychological factors
may influence the immune system’s responsiveness, including vaccine-induced antibody production.
Aim:
To evaluate the association between post-vaccination antibody responses and personality types following two doses
of COVID-19 vaccines.
Materials and Methods:
A total of 738 participants who received two doses of COVID-19 vaccines (AstraZeneca
ChAdOx1, n=29; Pfizer-BioNTech, n=119; Sinopharm BBIBP, n=590) and had no prior SARS-CoV-2 infection were enrolled. Serum samples were collected 21–28 days after the second dose, and SARS-CoV-2 RBD (S) IgG antibodies
were measured using ELISA (Proteintech Inc., USA). Personality types were assessed using a 56-item temperament
questionnaire developed by A. Belov, categorizing individuals into classical temperament types (choleric, phlegmatic,
sanguine, melancholic). Logistic regression and ROC analysis were used to examine associations between personality
types and antibody response.
Results:
The presence of an antibody response was significantly higher among individuals with a melancholic temperament, and significantly lower among those with a phlegmatic temperament. Furthermore, antibody titers were higher in
participants with melancholic and sanguine temperaments and lower in those with a phlegmatic type.
Conclusions
1. During the early period following the second dose of COVID-19 vaccination, the antibody response was higher
in individuals with a pure melancholic temperament, while it was lower in those with a phlegmatic temperament.
2. After the second dose of the Sinopharm BBIBP COVID-19 vaccine, antibody titers were higher in individuals with
pure melancholic and sanguine temperaments, and lower in those with a phlegmatic temperament.