1.Characteristics of cerebral Infarction in young and old patients
Delgermaa Ts ; Tsagaankhuu G ; Tuvshinjargal D ; Baigalmaa G ; Tovuudorj A
Mongolian Medical Sciences 2016;177(3):10-19
Background
Ischemic stroke or cerebral infarction in young adults (20-50 years) is relatively frequent, accounting for
more than 10%-26% of all first strokes and its incidence rises steeply with age. Causes of “Young stroke”
are heterogeneous and while it generally has a good prognosis, it has a significant socioeconomic
impact, including functional deficits and financial costs. The most frequent causes of cerebral infarction
in young adults are cardio-embolism, hypertension, premature atherosclerosis, migraine, smoking and
hypercoagulable states.
Objective
The aim of this study was to compare characteristics of cerebral infarction between young (20-49 years)
and old (50-89 years) patients undergoing investigations and treatment according to one common
protocol in the tertiary hospital.
Methods
This Descriptive case series study was conducted in Department of Neurology of First State Central
Hospital from October 2014 to July 2016. During this study, we observed 220 patients with first-onset
of cerebral infarction from which 90 young patients (under 50 years) and 130 old one (above 50
years), based on prospective study. Data regarding the etiology and risk factors of the stroke, clinical
manifestations, and diagnostic test results of patients were examined during their hospital treatment as
well as a NIHSS, modified Rankin Scale scores, and Barthel Index at admission and discharge, also
at 21 day. Stroke subtyping was conducted in accordance with the Trial of Org 10172 in Acute Stroke
Treatment (TOAST) criteria.
Results
In total, 220 patients with cerebral infarction were included, from which 90 (40.9%) were 20-50 years
and 130 (59.1%) were 50-89 years. The proportion of males was higher among both groups: 61.1% vs.
70.0%. Common causes for cerebral infarction in the young patients were current smoking (53.3.1% vs.
37.8%), long-term alcohol consumption (51.1 vs. 12.3), cardiac embolism (36.0% vs. 16.2%), migraine
with aura (25.5% vs. 12.2%), infective diseases (15.6% vs. 0.8%), and oral contraceptive use (14.4
vs. 0%). Leading causes for ischemic stroke in old patients were the conventional risk factors such as
hypertension (75.4% vs. 38.9%), atherosclerosis (66.9% vs. 31.1), coronary artery disease (24.3% vs.
12%), and diabetes mellitus (26.9% vs. 6.7%). Most of the young stroke patients demonstrated good
functional outcomes, at the time of discharge (71.1% vs. 60%) and three weeks (86.6% vs. 66.2%)
patients had Rankin Scale scores in the range of 0-2.
Conclusions
There are significant differences between young and old patients with cerebral infarction regarding to risk
factors, etiological subtypes and improvement of functional deficits associated with the stroke. However,
severity of stroke on admittance is similar but three weeks outcome is different among young and old
patients with relatively rapid improvement of functional deficit in young stroke patients than old one.
2. Preoperative local staging of colorectal carcinoma in Mongolian patients using computed tomography
Orkhon G ; Nergui B ; Narantsatsralt J ; Gonchigsuren D ; Tuvshinjargal D
Innovation 2015;9(4):34-37
In Europe, colorectal cancer (CRC) is the second most frequent malignancy and the second commonest cause of death from cancer. -The prognosis of CRC patients is dependent on the stage of disease at the time of diagnosis. Contrast-enhanced computed tomography (CT) examinations allows simultaneous assessment of tumor’s local staging, estimation of its possible invasion into neighboring organs, and detection of nodal and distant metastases; which is essential for appropriate treatment planning and estimation of its outcomes. The lack of reports on CT findings in CRC in Mongolia, increase in CRCmorbidity, and significant potential benefits of early detection served as background for this study.We investigated subjects with histologically proven adenocarcinoma who underwent CRC-related operative treatment either at National Cancer Center, First State Central Hospital, or Ulaanbaatar Songdo Hospital (UBSH) in 2009-2012. We retrospectively reviewed and analyzed from the UBSH’ database their preoperative CT, colonoscopy, surgical and pathohistologic reports using PACSPLUS,OCS operation systems. CECT examinations were performed at Siemens Somatom 64 multidetector scanner.Countrywide, 111 patients underwent surgery for colorectal cancer in 2009-2012. Totally, we involved86 subjects, whose age ranged from 25 to 87 years (mean 61.3years ±13.7SD). The F: M= 48 (55.8%) :38 (44.2%).The CECT determined T2 staging in 10/86 (11.6%),T3 in 61/86 (70.9%); T4 in 15/86 (17.4%);a significant difference in T-staging between CECT and histopathological examination (х2=41.28, p=0.00 (p<0.05)) was found. The CECT detected no peritumoral lymphadenopathy (N0) in 39/86 (45.3%), N1 in 18/86 (20.9%) and N2 in 29/86 (33.7%) patients; there was a significant difference in N-staging between CT and histopathological evaluation (х2=17.74, p=0.007(p<0.05)). For T-staging, CECT evaluation yielded sensitivity of 50% in T2 , 83.6% in T3, 71.4% in T4 staging; Diagnostic accuracy of CT for T2 staging was 89.7%, for T3- 78.2%, for T4- 88.7%. For N-staging, CECT had sensitivity of 88.2%, specificity of 64% and accuracy of 73.8%.Preoperative colorectal cancer patients in Mongolia receive initial MDCT in late stage. The similarsensitivity in staging of T-parameter to that of the international comparable studies. Nodal heterogeneity on CECT was more sensitive for nodal metastases than the size.
3.Preoperativelocalization of colorectal cancer tumor in Mongolian patients using colonoscopy and computed tomography
Orkhon G ; Nergui B ; Gantuya G ; Gonchigsuren D ; Tuvshinjargal D
Mongolian Medical Sciences 2014;170(4):39-41
Purpose: To evaluate colorectal cancer localization in preoperative patients in Mongolia using CECTand endoscopyMaterials and Methods: Totally 10575 optic colonoscopy examinations were performed at UlaanbaatarSongdo Hospital between January 2009 and December 2012. From these examinations, colorectal cancerwas detected in 218 cases; from them 175 had CT examinations. From patients with CT examinations,111 underwent surgery at UBSH, National Cancer Center, State Central Hospital. (64MDCT SiemensSomatom). Only 86 patients with colorectal carcinoma proved by endoscopic or operative pathologywere included into this study. We retrospectively reviewed from the UBSH’ database their preoperativeCT, colonoscopy, surgical and pathohistologic reports using PACSPLUS, OCS operation systems. Toclassify colorectal tumor localization, we divided colon into 8 anatomic parts. The size of tumor wasmeasured as longest dimension visible on CT examination.Results: Study population’s age range was 25-87 age (mean 61.3years ±13.7SD). F: M= 48 (55.8%):38 (44.2%). Urban residents composed 58 (67.4%), rural- 27 (31.4%), foreigner- 1 (1.2%). Tumor sizerange on CT was 0-13 ñì (mean 6.5±2.2 ñì) . Colonoscopy and CT detected colorectal cancer in rectumin 30(34.9%) and 31 (36.1%), in sigmoid colon in 21(24.4%)’’’ and 19(22.1%), in hepatic flexure- 9(10.5%) and 9(10.5%), retrospectively. Double (synchronous) colorectal cancer was detected in 1(1.1%)at colonoscopy and in 2 (2.2%) at CT.Conclusions: The 60-69 age group composed the largest group (38.4%) in colorectal cancer patients,with slight predominance of urban residents over rural and higher female predilection. Sigmoid andrectum are shown to have highest incidence in colorectal cancer. To our best knowledge, it is firstpublication on detection of synchronous colorectal cancer in Mongoliaby both CT and colonoscopy.CT examination is less risky and reliable method to evaluate the entire colonic length in patients withcolorectal cancer suspicion, if observers are skilled in detection of CT signs of colorectal cancer.
5. Intraperitoneal acute toxicity study of Tetima herbal compound extract, in experimental animals
Anar E ; Yeruult CH ; Batkhuyag P ; Khaliun N ; Narantungalag D ; Tuvshinjargal TS
Innovation 2015;9(4):42-45
The Mongolian plants considered to possess medicinal properties may contain novel compounds since they are exposed to severe conditions; such plants could become good candidates for modern drug discovery programs. Daurian Thermopsis (Thermopsis lanceolata R.Br.= Th.dahurica Czefr.), Gobian Thyme (Thymus gobicus Tschern.) and Mogilev Mallow (Malva mohileviensis Downer) are separately used as mucolytic and anti-inflammatory treatment in non-conventional medicine. Therefore, weprepared extract of these herbals compound called as a Tetima and to evaluate it’s acute toxicity. It isimportant to produce mucolytic effective new pharmaceutical preparation used for upper and lowerrespiratory tract inflammatory disease.Tetima herbal compound extract was prepared in ethanol, the ratio of herbals to ethanol was 1:10. Healthy 25 white albino mice (male weighing between 17-30 gram) used in this study. They were kept in large airy cages in groups of 5 animals per cage with free access to food and water. Five doses (8-20 g/kg) were then chosen for the determination of intraperitoneal LD50 in mice and given to five groups of albino mice. The animals were observed for first 2 hours and then at 6th and 24th hour for any toxicsymptoms. After 24 hours, the number of deceased mice was counted in each group. The percentage of animals that died at each dose level was transformed and then LD50 determined by the methods of Karber and Pershin.G.N.The LD50 of Tetima herbal compound in mice was determined to be 14.3 g/kg after intraperitonealinjection. There was no difference occurred between Karber and Pershin methods to evaluate acute toxicity. In the animals receiving intraperitoneal injection, the abdominal muscle contractions and ataxia was observed, which persisted for few hours. At the 6th hour they were drowsy and less responsive. The severity of these effects was related to the level of dose. However, at 24th hour most of the survivors had recovered from these symptoms.Tetima herbal compound extract is a relatively safe, particularly when given intraperitoneal inject toexperimental animals.
6. Study of Salmonella cell lysis activity by bacteriophage
Ulziijargal E ; Oyunbileg J ; Tumenjargal D ; Tuvshinjargal G
Health Laboratory 2016;5(1):27-31
Background:Bacteriophages act only host bacterial pathogen selectively not affecting the normal microflora of the human digestive tract, not causing allergies. Also found that the bacteriophage preparations don’t have taste, smell and preparation technology doesn’t affect the structure of bacteriophage. Using of bacteriophages for treatment is safe and has established that they are very effective against multi-drug resistant bacteria according to conducted clinical studies. In our country is using the Bacteriophage preparate which is based on local strain of Salmonella Typhi. Nowadays there is no research data whether environmental physical and chemical factors can affect the Bacteriophage activity.Aim:To study whether the environment physical and chemical factors might influence on Bacteriophage of Salmonella Typhi.Materials and Methods:In this study, were used the test strains of the Salmonellatyphimurium, Salmonella typhi and Bacteriophage of Salmonella Typhi. All procedures are performed according to Mongolian National Standard MNS ISO 2416-94, 3317-94 and Bacteriophage of Salmonella Typhi.Our study was established that physical and chemical factors: temperature of water bath, chloroform action time interval, procedure to kept biopreparates all can affect bacteriophage lysis activity.Conclusions:Any use of bacteriophages did not reveal any adverse effects. From the Bacteriophage of Salmonella Typhi preparations kept up to 3 years can be isolated bacteriophage strains by our improved method.