1.MULTI DRUG RESISTANT TB PATIENTS SURGICAL TREATMENT
Rentsenmygmar Ts ; Sukhee E ; Munkhzul B ; Tsagaan B ; Batbayar D ; Javzandulam O ; Batzaya Ts ; Uuganbayar G
Journal of Surgery 2016;20(2):25-29
Introduction: We began treatment of
multi drug resistant tuberculosis first from
2003. At that time there was a 1960 cases and
most of the cases were from Ulaanbaatar,
Darkhan, Selenge, Tuv, Dornod provinces.
From all the cases only 62% or 1058 cases
were included in treatment. From that 336
patient or 19% deceased, 296 patient or 18%
didn’t get a treatment. We did this study
because there were never done any research
or study of surgical treatment of multi drug
resistant tuberculosis in Mongolia.
Materials and Methods: We studied
cases of patients who undergone lobectomy,
since 2007. There were 48 cases of 46
patients, 2 patients surgery were done on
both sides. Respondents aged between 14-
45, 25 male (52%), 23 female (48%), all
patients got a first - line anti-tuberculosis
treatment, such as cat-1, cat-1+cat-2 and 10
variants of these drugs. It was done based
on sputum culture test results of NCCD
TB surveillance and research department’s
laboratory.
Results: From the all patients only
77.08% had undergone surgery within the
first 3 years. 92% patients were diagnosed
with multi drug resistance TB only with the
sputum and sputum culture test results, and
the rest of the patients were diagnosed
using a tissue analyses on the above tests.
It was revealed that HR resistant -91.66%,
HR+(Z,E,S) -3 drugs resistant -18.78%,
HR+(ZSE)-4 or 5 drugs resistant. In the
patients TB lesion locations was on the right
upper lobe 54%, left upper lobe 31%, on
a both upper lobes 85%, cavernous fibrosis
tubercles 60%, combined TB lesions 77%,
tubercles 21%.87.5% of total patients
received a multi - drug resistant TB treatment
between 7 - 24 months prior surgery.
All 48 patients had a totally 69 surgeries.
Surgeries included 9% pneumonectomy,
28% lobectomy, 30% Wedge resection,
23% pleurectomy decortication, 7% Wedge
resection on both sides, one bilobectomy.
There were no complications during the
surgery but 5 of patients had an empyema
after surgery. No fatal cases.Three patients
out of 5 who had a surgery due to pulmonary
hemorrhage developed an empyema after
surgery. Drainage tubes were taken after
the surgery within 2-3 months.Therewere no
complication and escalations in the patients
who received a surgical treatment, after the
surgery from 6 months to 5 years.
Conclusion: In study it shows that surgical
treatment is effective to do after 6 months
of anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows that
combining of medical and surgical treatment
is healing up to 98% in the patients who
were rightly chosen according to surgical
indications.This research result shows that in
our country multi - drug resistant TB surgical
treatment complication is only 10.41%,
which is below in the other countries who
have same anti-tuberculosis drug treatment.
2. MULTI DRUG RESISTANT TB PATIENTS SURGICAL TREATMENT
Rentsenmygmar TS ; Sukhee E ; Munkhzul B ; Tsagaan B ; Batbayar D ; Javzandulam O ; Batzaya TS ; Uuganbayar G
Journal of Surgery 2016;20(2):25-29
Introduction: We began treatment ofmulti drug resistant tuberculosis first from2003. At that time there was a 1960 cases andmost of the cases were from Ulaanbaatar,Darkhan, Selenge, Tuv, Dornod provinces.From all the cases only 62% or 1058 caseswere included in treatment. From that 336patient or 19% deceased, 296 patient or 18%didn’t get a treatment. We did this studybecause there were never done any researchor study of surgical treatment of multi drugresistant tuberculosis in Mongolia.Materials and Methods: We studiedcases of patients who undergone lobectomy,since 2007. There were 48 cases of 46patients, 2 patients surgery were done onboth sides. Respondents aged between 14-45, 25 male (52%), 23 female (48%), allpatients got a first - line anti-tuberculosistreatment, such as cat-1, cat-1+cat-2 and 10variants of these drugs. It was done basedon sputum culture test results of NCCDTB surveillance and research department’slaboratory.Results: From the all patients only77.08% had undergone surgery within thefirst 3 years. 92% patients were diagnosedwith multi drug resistance TB only with thesputum and sputum culture test results, andthe rest of the patients were diagnosedusing a tissue analyses on the above tests.It was revealed that HR resistant -91.66%,HR+(Z,E,S) -3 drugs resistant -18.78%,HR+(ZSE)-4 or 5 drugs resistant. In thepatients TB lesion locations was on the rightupper lobe 54%, left upper lobe 31%, ona both upper lobes 85%, cavernous fibrosistubercles 60%, combined TB lesions 77%,tubercles 21%.87.5% of total patientsreceived a multi - drug resistant TB treatmentbetween 7 - 24 months prior surgery.All 48 patients had a totally 69 surgeries.Surgeries included 9% pneumonectomy,28% lobectomy, 30% Wedge resection,23% pleurectomy decortication, 7% Wedgeresection on both sides, one bilobectomy.There were no complications during thesurgery but 5 of patients had an empyemaafter surgery. No fatal cases.Three patientsout of 5 who had a surgery due to pulmonaryhemorrhage developed an empyema aftersurgery. Drainage tubes were taken afterthe surgery within 2-3 months.Therewere nocomplication and escalations in the patientswho received a surgical treatment, after thesurgery from 6 months to 5 years.Conclusion: In study it shows that surgicaltreatment is effective to do after 6 monthsof anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows thatcombining of medical and surgical treatmentis healing up to 98% in the patients whowere rightly chosen according to surgicalindications.This research result shows that inour country multi - drug resistant TB surgicaltreatment complication is only 10.41%,which is below in the other countries whohave same anti-tuberculosis drug treatment.
3.Харханд Адриамицинээр Үүсгэсэн Бөөрний Үрэвслийн Эмгэг Загварт Уламжлалт Сармисан Туулгын Үзүүлэх Нөлөөг Судласан Дүн
Guitsed A ; Zulaa G ; Ulaan ; Uuganbayar B
Journal of Oriental Medicine 2015;9(2):24-30
Abstract Experimental animals created in adriamycin-induced
nephropathy effects of traditional drug “Sarmisan tuulga” 1.7-3.9
times the amount of protein in the urine, serum triglycerides
contained 2.3 times and 3.4 times the total amount of cholesterol
reduction. And on disorders SOD increased 1.6-2 times the amount
of MDA's 1.5-1.7 times, TNF-α-1.3-1.7 times the amount of IL-8 is
1.8-1.9 times the amount of reduction. According to the results of
traditional drug “Sarmisan tuulga” in experimental animals acute
inflammatory kidney disorder created by the generation of fat,
protein exchange, antioxidant system loss, expedient gesture
cytokine and podotsit kidney renal protective effect by preventing
cell damage.
4.SURVEY FOR CUSTOMERS SATISFACTION OF THE HEALTH CARE ORGANIZATIONS IN 2016 OF DARKHAN-UUL PROVINCE
Oyun M ; Tuya B ; Uuganbayar G
Innovation 2017;11(4):32-36
BACKGROUND: Assessing the customer’s satisfaction of the health care services, professional organizations suggest the special methods to study what they want and don’t want and how much can pay for the service. For this purpose, we conducted the study to determine the satisfaction of the customers of Darkhan-Uul province health care organizations in 2016, according to the international experience.
The survey was conducted in the Darkhan-Uul province Health Department, in general hospitals, public and private medical institutions in 2015 and 2016 respectively.
On the basis of a unified methodology according to the order of the Ministry of Health No. 13 of 2014, the survey was conducted on the basis of a special questionnaire prepared in accordance with articles 22 and 23 of the Minister of Health No. 448.
The results of the consumer survey, customer satisfaction in Darhan-Uul province by 2016 were higher than in 2015, a good estimate of 1.4%, an average rating of 10.4% and below was a poor estimate of 11.8%. The survey shows the need to consider the issue of equality, which is a key issue in the field of human rights, the formulation of political environments and the regulation of their situation.
5.Аnti-inflammatory activities of traditional Mongolian drug garidi-5
Uuganbayar B ; Ariunaa Z ; Oldokh S ; Chimedragchaa CH ; Munkhzul G ; Sugarjav E ; Molor-Erdene P
Mongolian Medical Sciences 2013;165(3):61-65
Introduction. Garidi-5, a traditional medicine composed of 5 herbs including Terminalia chebula Retz., Aconitum Kusnezoffii Reichb., Acorus calamus L., Saussurea lappa L., and musk of Moschus moschiferus, has been used in traditional Mongolian medicine as an analgesic and antibacterial medicine. The present work was undertaken to evaluate the traditional drug Garidi-5 for its analgesic and anti-inflammatory activity.Materials and Methods. The method of Winter et al. was used to study acute inflammation. Rats in groups of five each were treated with vehicle, Garidi-5 (20, 80 and 200 mg/kg, p.o.) and Indometacin (10 mg/kg) one hour prior to Carrageenan injection. 0.1 ml of 1% Carrageenan was injected into the subplantar tissue of left hind paw of each rat. Swelling of carrageenan injected foot was measured at 0, 0.5, 2, 4 h using Plethysmometer (UGO Basile, Italy)). The right hind paw was injected with 0.1 ml of vehicle.Results. The Garidi-5 (20, 80 and 200 mg/kg) significantly (P<0.01) inhibited carrageenan induced rat paw edema as compared to control group. Maximum inhibition of paw edema was observed with Garidi- 5 (80 and 200 mg/kg) at 4 h when compared to the control group (Tab.1). In assay data, the TNF-α, IL-1β and IL-6 secretion in serum were highly elevated by carrageenan induction but administration of Garidi-5 signifi cantly reduced serum secretion of inflammatory mediatorsas compared to vehicle group (Tab. 2).Conclusion. In conclusion, Traditional drug Garidi-5 have anti-in flammatory properties. The potential efficacy of Garidi-5 to treat inflammation is based in a part on the hy pothesis that it will suppress the proinflammatory cytok ines resulting in less oedema.
6.Аnti-inflammatory activities of traditional mongolian drug garidi-5
Uuganbayar B ; Ariunaa Z ; Oldokh S ; Chimedragchaa CH ; Munkhzul G ; Sugarjav E ; Molor-Erdene P
Mongolian Medical Sciences 2013;166(4):52-56
Introduction. Garidi-5, a traditional medicine composed of 5 herbs including Terminalia chebula Retz. Aconitum Kusnezoffii Reichb., Acorus calamus L., Saussurea lappa L., and musk of Moschus moschiferus, has been used in traditional Mongolian medicine as an analgesic and antibacterial medicine. The present work was undertaken to evaluate the traditional drug Garidi-5 for its analgesic and anti-inflammatory activity.Materials and Methods. The method of Winter et al. was used to study acute inflammation. Rats in groups of five each were treated with vehicle, Garidi-5 (20, 80 and 200 mg/kg, p.o.) and Indometacin (10 mg/kg) one hour prior to Carrageenan injection. 0.1 ml of 1% Carrageenan was injected into the subplantar tissue of left hind paw of each rat. Swelling of carrageenan injected foot was measured at 0, 0.5, 2, 4 h using Plethysmometer (UGO Basile, Italy)). The right hind pawwas injected with 0.1 ml of vehicle.ResultsThe Garidi-5 (20, 80 and 200 mg/kg) significantly (P<0.01) inhibited carrageenan induced rat paw edema as compared to control group. Maximum inhibition of paw edema was observed with Garidi-5 (80 and 200 mg/kg) at 4 h when compared to the control group (Tab.1). In assay data, the TNF-α, IL-1β and IL-6 secretion in serum were highly elevated by carrageenan induction but administration of Garidi-5 signifi cantly reduced serum secretion of inflammatory mediators as compared to vehicle group (Tab. 2). ConclusionIn conclusion, Traditional drug Garidi-5 have anti-in flammatory properties. The potential efficacy of Garidi-5 to treat inflammation is based in a part on the hy pothesis that it will suppress the proinflammatory cytok ines resulting in less oedema.
8.Effect Of Iris Ventricosa Pall On Ccl4-Induced Hepatic Injury In Rats
Uranzaya D ; Ariunaa Z ; Uuganbayar B ; Purevsuren G
Journal of Oriental Medicine 2012;3(2):20-20
Species of the genus Iris (Iridaceae) comprises more than 1500
species and 14 species are growing in Mongolia. These are
used in Mongolian traditional medicine espesially for treatment
of cancer and inflammation. Various biologically active
substances have been determined in genus Iris family of plants
such as flavones and isoflavones, peltogynoids (Irisoid A, B, C,
D and E), saponins, coumarins and benzoquinones. Iris
ventricosa is one of the genus Iris family plants.
The aim of the present study is to evaluate hepatoprotective
effects of Iris ventricosa on carbon tetrachloride (CCl4)-induced
liver injury in rats.
The underground part of Iris ventricosa Pall was collected in
September, 2011 in the botanical garden of Botanical Institute of
Mongolia. Serum levels of aspartate aminetransferase, alanine
aminetransferase, and alkaline phosphatase were determined.
Histological study was also carried out. Aqueous and spirituous
extracts (100 mg/kg) of Iris ventricosa significantly reduced
levels of aspartate aminetransferase, alanine aminetransferase,
and alkaline phosphatase in rats administered CCL4.
Histopathological examination revealed that CCL4-induced
changes in the liver were ameliorated by Iris ventricosa
treatment.
This is the first study that has shown the hepatoprotective effect
of Iris ventricosa Pall in rats administered CCL4. The
hepatoprotective effect of Iris ventricosa can be related to its
potent antioxidative and anti-inflammatory activities. Neutralizing
reactive oxygen species by nonenzymatic mechanisms and
enhancing the activities of natural antioxidant enzymes of the
liver may be the main mechanisms of the hepatoprotective effect
of Iris ventricosa on CCl4-induced liver injury in rats.
9.Some Results Of Pharmacological Researchof Traditional Drug Jonlon-5
Davaadulam P ; Uuganbayar B ; Oldokh S ; Munkhzul G
Journal of Oriental Medicine 2015;9(2):36-45
Traditional drug Jonlon-5 have been widely used in the clinical
practice for recent years in traditional medicine. The study was
conducted on the experimental animal wistar rats by the
carrageenan induced mice paw edema (Winter et al. 1962, Vogel,
2002) methods. We performed chemical and pharmacological
investigation was based and implemented scientific research
laboratory of Institute of Traditional Medicine and Technology. The
Jonlon-5 significantly (P<0.05) inhibited carrageenan induced rat
paw edema as compared to control group. TNF-α secretion was
magnified by carrageenan injec¬tion (387.2 pg/ml). TNF-α secretion
was reduced, com¬parable to carrageenan group, as a respond to
extract administration. Administration of Jonlon-5 significantly
reduced inflammatory mediator secretion TNF-α by 20.8%, IL-1 β –
41.7%, to be close to inhibition level of Indo¬methacin
administration. Jonlon-5 significantly decreased (P<0.05) of serum
malondialdehyde (MDA) 16.5% in animal model.
10.Аnalgesic Activities Of Traditional Mongolian Drug Garidi-5
Uuganbayar B ; Ariunaa Z ; Oldokh S ; Chimedragchaa Ch ; Sugarjav E ; Molor-Erdene P ; Munkhzul G
Journal of Oriental Medicine 2013;4(1):64-70
Garidi-5, a traditional medicine composed of 5 herbs including
Terminalia chebula Retz., Aconitum Kusnezoffii Reichb., Acorus
calamus L., Saussurea lappa L., and musk ofMoschus moschiferus,
has been used in traditional Mongolian medicine as an analgesic and
antibacterial medicine. The aim of the study was to evaluate the
central and peripheral analgesic action of traditional mongolian drug
Garidi-5 in experimental animal models. Analgesic activity was
assessed by tail flick method (for central action) and l acetic acid-
induced writhing test (for peripheral action). Garidi-5 extract (20
mg/kg, 80, 200mg/kg p.o.) and aspirin (100 mg/kg) showed
significant peripheral analgesic activity (p<0.05). Garidi-5 extract (20
mg/kg, 80, 200mg/kg p.o.) and Morphin (10 mg/kg, i.p.) also showed
significant central analgesic activity (p<0.05). Conclusion: Biological
activity substances were detected in the Traditional drug Garidi-5.
Traditional drug Garidi-5 has analgesic effects.