1.Childhood cancer in Mongolia: focusing on trend in incidence from 2008 to 2017
Erdenechimeg S ; Undarmaa T ; Oyunchimeg D
Mongolian Medical Sciences 2019;187(1):23-28
Introduction:
An international study coordinated by the International Agency for Research on Cancer (IARC) and published today in The Lancet Oncology shows that in 2001–2010, childhood cancer was 13% more common than in the 1980s, reaching an annual incidence rate of 140 per million children aged 0–14 years worldwide. Cancer incidence and mortality statistics reported by International Cancer Research Center (2016), over 300,000 children develop cancer worldwide each year, 215000 children aged 0-14 years and 85000 children aged 15-19 years. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. Based on the need for comparison of childhood cancer incidence in Mongolia to the global level, the study aimed to categorize cancer among children aged 0-19 years.
Goal:
To study the insidence rates and trend from childhood cancer last 10 year in Mongolia
Materials and Methods:
The study was conducted in 786 new cases childhood who were cancer diagnosed, between 2008 and 2017 year. Age-standardized incidence rates were calculated by the direct method using age-specific incidence rates and weights based on the age distribution of the standard world population
Results:
Over the past 10 years, childhood cancer accounted for 1.5% of total cancer in Mongolia. By WHO and IARC data, worldwide childhood cancer age standardized rate (ASR) is 106.0, in Mongolia childhood cancer ASR (101.6) is lower than world average.
The most common childhood cancers worldwide are: 1st leukemia, 2nd lymphoma, 3rd central nervous system cancer, 4th retinoblastoma, 5th soft tissue cancer. Over the past 10 years the most common childhood cancers in Mongolia are: 1st leukemia, 2nd central nervous system cancer, 3rd joint bone cancer, 4th lymphoma, 5th soft tissue cancer. Our country’s childhood cancer ASR is below compared to other countries, but expected growth rate is gradually increasing (3.0 per year).
Conclusions
1. Leukemia is the most common childhood cancer in worldwide and also in Mongolia.
2. By sex, childhood cancer incidence is higher in boys than girls.
3. By age group, childhood cancer incidence is the highest in 0-4 age group.
4. By region, childhood cancer incidence is the highest in central region.
5. The overall incidence of childhood cancer (1 million children) in Mongolia is expected to increase by 3.0 over the next 5 years.
2.The results of early detection program of uterine cervical cancer in Ulnaanbaatar
Uyanga G ; Oyunchimeg D ; Undarmaa T ; Enkhtuya SH
Mongolian Medical Sciences 2016;176(2):19-24
GoalTo evaluate the quality, results, and processing of cytology analyses of early detection program ofuterine cervical cancer implemented in Mongolia, which based on Pap test, at Ulaanbaatar city level.Materials and MethodsInformation was collected from the databases of the recalling system of screening program of theCancer registration and information unit of the NCC of Mongolia and districts pathology laboratoreis.Statistical significant level of 1.96 (95% CI) andthe margins of error 0.05 were considered andsample size was calculated by using the information that 10% of unsatisfied results appear onquality assurance of international level. Thus calculations were madefortotal of 1723 (585 positiveand negative 1138) samples, by collecting 287smears from each district.At the district level all the selected slides were reviewed blindly and compared to the previouscytological conclusion. Diagnostic validity was defined by calculating parameters such as specificityand sensitivity, positive and negative predicted values. The Kappa index criteriais used for statisticalcalculation of the cytological diagnosis conclusion matches.ResultsThe target group women coverage of cervical cancer screening program is 40.8%. Out of all positiveresults of early screening cytology, 77% were at an early stage and 23% were at an advanced stage.Thus positive signs were showed with increased detection results in early stage of uterine cervicalcancer (P = 0.05). Positive results of Pap test were follows; ASCUS (53.2%), ASC-H (10.0%), LSIL(19.2%), HSIL (13.4%), CIS (3.4%), and SCC (0, 8%). Out of total slides, 86.7% were as satisfactory.The test results conducted at the district level were90.1% of sensitivity, 88.8% of specificity and9.9% of false negative response. The discrepancy of results of cytology test in districts and repeatedseen is 31.4% (K = 0.749; p = 0.001).ConclusionThe coverage of cervical cancer screening program that has been implementing in our country isnot enough. There are problems at the district level including severe damages of uterine cervix andincomplete diagnosis. The quality of the cytology test is relatively unsatisfied.
3.Relation between adherence factors and the phylogenetic group of extraintestinal pathogenic Escherichia coli
Munkhdelger Ya ; Nyamaa G ; Undarmaa G ; Oyunchimeg R ; Munguntuul T ; Altantsetseg D ; Munkh-Od Ts ; Sarantuya J
Innovation 2015;9(2):28-31
Extraintestinal pathogenic Escherichia coli (ExPEC), the specialized strains ofE.coli that cause most extraintestinal infections, represent a major but littleappreciated health threat. Phylogenetic analysis has shown that ExPEC is composedof four main phylogenetic groups (A,B1, B2, and D) and that virulent extraintestinalstrains mainly belong to groups B2 and D.In this study, we aimed to assess therelation between adherence virulence and phylogenetic groups of ExPEC.A total of 161 E.coli samples were collected. Out of these 17 (10.6%) werefrom pus, 66 (41 %) from urine, 78 (48.4%) from cervical swab. The phylogeneticgroups and 6 virulence genes (fimH, papC, papGII, papGIII, fa/draBC,andSfa/focDE) encoding adhesins were identified by triplex PCR. Phylogeneticgroups distribution was as follows: B1 10.5%, A 24.7%, B2 25.3%, and D 38.9%. Virulence genes prevalence was fimH 90.1%, papC 23%, papGII 16.8%, papGIII1.9%, Afa/draBC 11.8%, andSfa/focDE 5.6%. The cell surface protein (curli) wasdetected 50,3% by Congo red agar. In conclusion: The most isolated strainsbelonged to the phylogenetic group B2 and D. The phylogenetic groups weresignificantly associated with some genes encoding
adhesins (fimH, papC) and cellsurface protein (curli).
4.Current status of Cancer Incidence and Mortality, mean annual 2008-2012 in Mongolia
Undarmaa T ; Tubshingerel S ; Erdenechimeg S ; Badamsuren TS ; Tumurbaatar L
Mongolian Medical Sciences 2016;177(3):25-37
National cancer center of Mongolia has responsibility to produce National cancer registry annual reportwhich is collected cancer reports from primary, secondary and tertiary level of government hospitals andprivate hospitals, laboratories. MCR and indicators of incidence and mortality are important for planningand evaluation of all levels for cancer control, primary prevention, diagnosis, treatment, rehabilitation.ObjectiveThe aim of this study was to determine ASR and ASMRs of cancer incidence and deaths in Mongoliafrom 2008 to 2012 for comparing the results of data.Material and MethodsData on new cancer cases diagnosed in 2008-2012 in permanent residents of Mongolia, collected bycancer registry of the National Cancer Center, were used for the analysis. Incidence and mortality rateswere calculated as mean annual numbers per 100,000 residents. ASRs (Age-standardized incidencerate) and ASMRs (Age-standardized mortality rates) were calculated by the direct method from agespecificincidence and mortality rates, weighted to the World Population standard.ResultsFirst five most frequent cancers (liver, stomach, lung, esophagus, cervix uteri) comprise 76% of all newcancer cases.In males, the most frequent cancer site was liver, followed by stomach, lung, esophageal, colon andrectal cancer. In females, liver is in the first place, followed by stomach, cervical, lung, esophagealcancer.Mean annual crude incidence rate of all cancer sites was 155 per 100 000 population,in males 165, infamale 165 in 2008-2012 years.During this period, mean annual age-standardized incidence rate of all cancer sites was 218,3 per 100000 population, for male 258.9 in female 188.1with higher percentage of men.As we age, morbidity of the cancer increases approximately 2 fold in both sexes and also study revealsmen has more tendency to have cancer than women
5. Relation between adherence factors and the phylogenetic group of extraintestinal pathogenic Escherichia coli
Munkhdelger YA ; Nyamaa G ; Undarmaa G ; Oyunchimeg R ; Munguntuul T ; Altantsetseg D ; Munkh-Od TS ; Sarantuya J
Innovation 2015;9(2):28-31
Extraintestinal pathogenic Escherichia coli (ExPEC), the specialized strains ofE.coli that cause most extraintestinal infections, represent a major but littleappreciated health threat. Phylogenetic analysis has shown that ExPEC is composedof four main phylogenetic groups (A,B1, B2, and D) and that virulent extraintestinalstrains mainly belong to groups B2 and D.In this study, we aimed to assess therelation between adherence virulence and phylogenetic groups of ExPEC.A total of 161 E.coli samples were collected. Out of these 17 (10.6%) werefrom pus, 66 (41 %) from urine, 78 (48.4%) from cervical swab. The phylogeneticgroups and 6 virulence genes (fimH, papC, papGII, papGIII, fa/draBC,andSfa/focDE) encoding adhesins were identified by triplex PCR. Phylogeneticgroups distribution was as follows: B1 10.5%, A 24.7%, B2 25.3%, and D 38.9%. Virulence genes prevalence was fimH 90.1%, papC 23%, papGII 16.8%, papGIII1.9%, Afa/draBC 11.8%, andSfa/focDE 5.6%. The cell surface protein (curli) wasdetected 50,3% by Congo red agar. In conclusion: The most isolated strainsbelonged to the phylogenetic group B2 and D. The phylogenetic groups weresignificantly associated with some genes encodingadhesins (fimH, papC) and cellsurface protein (curli).
6.OUTCOME OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Tuvshintugs B ; Gantsooj N ; Undarmaa T ; Bolortungalag P ; Sainbileg D ; Enkhtuul S ; Enkhzul D ; Burenjargal P
Innovation 2018;12(3):12-16
BACKGROUND: There are two general types of age-related macular degeneration: dry and wet. During wet or neovascular age-related macular degeneration new abnormal vessels grow and leak in the macula. As anti-vascular endothelial growth factor (anti-VEGF) was invented, it revolutionized the treatment of nAMD by inhibiting the progress of this disease. The incidence of AMD increases as life expectancy grows and there is a growing need to study this disease. We aimed to evaluate the outcome of anti-VEGF therapy for the treatment of nAMD and the incidence of ocular serious adverse events (SAE) after injections.. METHODS: In our retrospective, single-center study, medical records of patients receiving a single dose of anti-VEGF treatment (Bevacizumab) for nAMD between 17th of April, 2016 and October, 2017 were evaluated. Outcome measures were the change in the baseline visual acuity (VA) score at post-injective month one, incidence of ocular SAE and patients’ baseline characteristics affecting VA. Patients, whose treatment were started before April 2016 and had anti-VEGF treatment for the diseases other than nAMD, were excluded.. RESULTS: 15 eyes in 15 patients between 52 and 85 years of age received single dose of anti-VEGF (Bevacizumab/Avastin) injection. The mean baseline VA improved from pre-injective average of 0.21 to post-injective 1-month average of 0.37 by Snellen. Furthermore, there was no vision loss or other severe adverse effects, such as endophthalmitis, vitreous hemorrhage, retinal detachment, traumatic cataract after 4 weeks. CONCLUSION: Anti-vascular endothelial growth factor therapy has promising short-term outcomes on treating neovascular age-related macular degeneration.
7.The treatment outcome оf the patients with infectious keratitis
Undarmaa T ; Tumurbaatar B ; Burenjargal P ; Bayarmaa E ; Sayamaa L
Innovation 2021;14(1-Ophthalmology):26-31
Background:
Infectious keratitis is a disease caused by inflammation, infection, and other
ocular damage to the outer and other deep layers of corneal epithelium. It is a major cause of
monocular blindness and visual disability worldwide regardless of age and gender. Therefore, we
aimed to determine the clinical features and risk factors of infectious keratitis among Mongolians
and to identify the causative microorganism and compared them with the treatment results.
Methods:
We collected the data of 149 patients who diagnosed as infectious keratitis at the
Ophthalmology Department of the First State Central Hospital in 2017-2020 and using a case series
model of descriptive study. Statistical analysis was calculated using Stata14 software.
Results:
The majority of patients in our study were male, with a male-to-female ratio is 2.1:1. The
cause of infectious keratitis were categorized and eye injury-induced keratitis accounted for the
highest percentage of 38.3% (n=57), with the majority being men 73.7% (n=42) (p=0.028). As for the
type of treatment, antibacterial drugs 103 (69.1%) and evisceration 27(45%) predominate.
Conclusion
Our study shows that the majority of infectious keratitis in Mongolia is due to trauma
in male patients. Forty-five percent of all surgeries involve evisceration surgery, which reduces the
client's quality of life.
8.Associations of XRCC1 S326C (rs25487) gene Polymorphism in Myelodysplastic syndrome
Undarmaa O ; Narmandakh B ; Avirmed Kh ; Khosbayar T ; Odgerel Ts ; Batchimeg N
Health Laboratory 2017;7(2):21-25
Introduction:
Base excision repair (BER) is mainly responsible for the correction of small base changes of DNA damage. BER pathway involved many enzymes including OGG1 and XRCC1. The defective DNA repair is associated with an increased risk of various cancers including hematologic malignancies-leukemia and myelodysplastic syndrome (MDS). However, it is deniably these polymorphisms alter the susceptibility and clinical outcome of MDS patients.
The aim:
This study was to evaluate the impact of polymorphisms in gene encoding one protein of BER system: XRCC1 Arg399Gln in MDS and healthy population.
Methods:
In this study, we recruited 60 health control group [median 47.9 years, 9 MDS subjects [median 56.6 years] were included in this study. Genotyping was carried out by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Allele and genotype frequencies were calculated by direct counting.
Result:
The frequencies of genotypes of XRCC1 Arg399Gln were as follows: Arg /Arg 1 (11%), Arg/Gln 6 (66%), Gln/Gln 2 (22%) in MDS and Arg /Arg 18.4%, Arg/Gln40%, Gln/Gln41.6% in health control for XRCC1 Arg399Gln. The result revealed that genotypes Arg399Gln increased the risk of MDS
In conclusion
this study is the first to analyze XRCC1 SNPs and their associated risk of MDS in Mongolian samples. To fully understand the role of DNA damage and DNA repair in the MDS, prospective studies are needed and other genes (OGG1 Ser326Cys, MUTYH Gln324His, APE Asp148Glu) of base excision repair pathway should be analyzed.
9.ASYMMETRY OF PREOPERATIVE INCISION DESIGN MARKINGS FOR UPPER BLEPHAROPLASTY
Undarmaa T ; Myeong Yeon Yi ; Young-Hoon Ohn ; Sun Young Jang
Innovation 2018;12(3):18-21
BACKGROUND: Loss of skin elasticity due to redundancy of the upper eyelid (dermatochalasis) and falling of the upper eyelid border to a lower position (blepharoptosis) are often the earliest signs of facial aging.
Upper eyelid blepharoplasty is an effective procedure to establish a good eyelid position, and is the most common facial cosmetic procedure [1]. When performing upper eyelid blepharoplasty, eyelid symmetry is essential for a satisfactory surgical outcome. Even if not possible, every surgeon tries to achieve complete symmetry when performing aesthetic eyelid surgery [2]. Several previous studies by surgeons with > 10 years of experience reported how preoperative incision markings should be made to achieve satisfactory surgical outcomes and excellent surgical results for upper eyelid blepharoplasty [3-7]. However, none of these studies investigated naturally occurring asymmetry when applying a preoperative design for upper blepharoplasty incision markings.
During the preoperative design step, we noticed certain asymmetric tendencies. We therefore characterised these differences to ensure a more effective preoperative design for upper blepharoplasty incision markings for both eyelids. METHODS: This retrospective study examined 22 patients who underwent bilateral upper blepharoplasty surgery resulting from senile dermatochalasis and/or blepharoptosis. The initial preoperative incision design markings were drawn with the patient sitting upright. Then, with the patient in a supine position, preoperative design photographs were taken. We measured medial canthal excision angle (MCA), maximal lid excision height (MLH), maximal lid excision width (MLW), peak point angle, and peak point distance and compared measurements between both upper eyelids designs using Image J software. RESULTS: The mean MCA for the right side (30.68 ± 10.16°) was significantly different to that for the left side (35.39 ± 13.82°; p < 0.001). The mean MLH for the right side (1.17 ± 0.24 cm) was significantly different to that for the left side (1.24 ± 0.25 cm; p = 0.002). The mean MLW for the right side (0.72 ± 0.19 cm) was significantly different to that for the left side (0.77 ± 0.21 cm; p = 0.011). The mean peak point angle for the right side (15.67 ± 5.09°) was significantly different to that for the left side (18.11 ± 5.49°; p = 0.001). The mean peak point distance for the right side (2.41 ± 0.31°) was significantly different to that for the left side (2.22 ± 0.28 cm; p = 0.001). CONCLUSION: In upper blepharoplasty, the preoperative incision marking design measurements of the left side were significantly greater than those of the right side. The symmetry can therefore be maximised by including the asymmetries in the preoperative design.
10.RECURRENCE RATE WITH USE OF INTRAOPERATIVE MITOMYCIN C AND CONJUNCTIVAL AUTOGRAFT FOLLOWING PTERYGIUM EXCISION
Gantsooj N ; Undarmaa T ; Tuvshintugs B ; Tumur G ; Bolortungalag P ; Sainbileg D ; Enkhzul D ; Tumurbaatar B ; Burenjargal P ; Enkh-Oyun Ts
Innovation 2018;12(3):28-30
BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva
onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations
(UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in
developing pterygium among other environmental factors (hot, dry, windy, dusty and
smoky environments and hereditary factors. The main histopathological change in primary
pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include
foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and
cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing
the patient’s discomfort, but they do not cure the disease. After surgical removal there are
still many recurrences regardless of the method used. Autologous conjunctival grafting seems
to be the best method, given both the low recurrence rate and high safety. As described first
by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with
infrequent and relatively minor complications. The primary disadvantage of this technique
is the prolonged operative time required when compared to the bare sclera technique.
These disadvantages are outweighed by the lack of sight-threatening complications and the
relatively low recurrence rate, which made this procedure gain popularity in many centers.
The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing
the recurrence rate to a minimum.
METHODS: This retrospective case series, single center study was conducted on 239
patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department
of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic
examination before the surgical intervention. Data were collected through a prepared
questionnaire. Postoperative follow-up examination sheets were evaluated. Data
for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17..
RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and
62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5
years old.
There is no statistical significance between the stages of the disease and its post-operative
outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative
pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred
pterygium had underwent pterygium excision without conjunctival autograft.
MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium
excision.
CONCLUSION: The relationship between pterygium stage and its post-operative recurrence
was not statistically significant (P=0.683).
The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001)
which showed significant statistically.
There was no recurrence after pterygium excision with MMC (P≤0.001).
The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our
outcome.