1.To the Problem of Diagnosing Artery Disease of Lower Extremeties by Dopplerograph Method
Amarjargal G ; Oyun B ; Tserenchunt G
Mongolian Medical Sciences 2009;147(1):4-6
Aim and objective of the study. Aim of the study is to study artery disease of lower extremities by dopplerograph method. - To study dopplerograph symptom of artery disease of lower extremities. - To study dependence of age, sex and which vessel is at risk Material and Methods. We involved 61 cases which were done dopplerograph analyse because of artery disease of lower extremities at the centre of BestEMA from 2006 to January 2008 dopplerograph analyse was done by using Angiodin apparatus and by standard method divided them into 6 groups by 10 ages and studied by male and female. Results and Discussion. From 100 cases which the disease revealed in 37 artery blockade, in 27 artery stenosis in 36 hemodynamic changes revealed. In order to put differential diagnose of artery blockade and artery stenosis we defined LPI in all persons. In the period of artery blockade and artery stenosis of lower extremities form of artery stream is changed LPI is decreased below 1 depending on disease. These symptoms were common. By our study 40.9% of people with artery disease of lower extremities smoked more than 20 years and 27.3% had hyperglycemia more than 10 years. Result of our study suits to the study of A.G. Evdoximov (1999), V.G. Leluk (2003), Volmar (1996). Conclusion: 1. In 75.4% of people who were done dopplerograph analyse artery disease of lower extremities, artery blockade of lower extremities revealed in 45 stenosis in 37 and hemodynamic change in 42. 2. In the period of artery blockade and artery stenosis of lower extremities from of artery stream changes and decreases below LPI, These symptoms mostly revealed. 3. Artery blockade and artery stenosis are mostly occur in the hip and on males.
2.To the Problem of Diagnosing Disease of Venous of the Lower Limb by the Method of Dopplerography
Amarjargal G ; Oyun B ; Tserenchunt G
Mongolian Medical Sciences 2009;147(1):7-9
Disease of venous of the lower limb has been studied since the period of ancient Hippocrat, Glan and Avitsen and it occurred among the people not a few. Among the disease of venous of the lower limb, disease of venous dilatation occurs mostly (Savliev., B.S, 1999, Morosov, V, Savranski 2000). By recent study about 20% of population where industry developed highly, are affected by disease of venous. It occurs mostly among the people aged 25-55. In medical practice of our country since 1996, diagnosing method of dopplerography has been introduced and began to diagnose venous disease of lower limb in the recent years numbers of people involved in analyze because of acute and chronic insuffi ciency increased year by year. In up-todate phlebolog practice method of ultra sound diagnosing which is harmless to vascular and doesnt hurt is widely used and new methods have been introduced. Aim and Objectives. In order to realize aim of studying and diagnosing venous disease of the lower limb by the method of dopplerography, well solve the following objectives; -to study form and location of venous of the lower limb, to study dependence of age and sex of venous disease of the lower limb, to study symptom of dopplerography in the process of venous disease of the lower limb. Material and Methods. The study was done on the base of 120 patients material that was done dopplerography in the centre Best Ema of private structure in 2007-2008. We used dopplerographic apparatus such as: sonomed 325 and Angiodin. Conclusion 1. Venous disease of the lower limb revealed in 85% of people involved in the analyse. 2. 88.3% of people with venous disease of the lower limb were women aged 31-60. 3. In dopplerography in 37% - symptom of change of venous stream form and the breath is not coordinated, symptom of stream negative in the deep leg vascular after the test -89.4%., in superfi cial venous -10.6%.
3.To the Problem of Diagnosing General Artery Disease of Carotis by the Dopplerograph Method
Amarjargal G ; Tserenchunt G ; Boldbat P ; Oyun B
Mongolian Medical Sciences 2009;147(1):2-3
Aim and objective of studyTo study possibility of detecting Arteria carotis communis disease by dopplerosonography.Objectives:- To study dopplerography symptom which reveals in the period of Arteria carotis communis disease?- To study dependence of age, sex and artery pressure.Materials and Methods. Study was done on 100 patients who were analysed by dopplerosonograph at the centre of cerebrovessel diagnose BestEMA in 2006-2007. Study was done by using Angiodin ultrasonic dopplerosonograph apparatus and by standard method.Results: On 33 patients who were involved in the study functional defi ciency of Arteria carotis communis was revealed. Functional deficiency of carotis artery of one side was revealed on 12 patients, functional defi ciency of carotis artery of 2 sides on 21 patients, on 7 people had defi ciency of carotis artery hemodynamic over 30% and on 12 more than 50%. 84, 8% of people with functional defi ciency of general artery of carotis have hypertension at some extent. For age there were 19 males-32-77 aged and 14 females. There is Tendency of increasing defi ciency of Arteria carotis communis of 2 sides when the people become older. By dopplerosonograph analyse, when defi ciency of Arteria carotis communis increases speed of blood stream decreases, survey changes, becoming without window, sound /noise/ of stream changes and peripheral resistance increases. Such symptoms are mostly revealed.Conclusion:1. By dopplerosonograph analyse on 33% defi ciency because of Arteria carotis communis sclerosis was revealed.2. 90% of functional defi ciency of Arteria carotis communis occurs on people who are more than 40 years old.3. In the period of general artery scleroses of carotis speed of artery stream decreases survey and noise are changed, peripheral resistance increases. These symptoms are revealed.4. 84.8% of people, on whom carotis artery defi ciency was revealed, hypertension increases at some extent.
4.To the Problem of Diagnosing Disease of Vertebral Artery in the External Part by the Method of Angiography
Amarjargal G ; Boldbat P ; Tserenchunt G ; Oyun B ; Enkhtuul T
Mongolian Medical Sciences 2009;147(1):9-11
Background. Nowadays more attention is paid to the study of blood supply of the brain in during headache with various causes. Blood supply of the branch is supplied by 2 pairs of carotis and vertebral artery and 2/3 of it in the carotis and 1/3 of it by the vertebral artery. (Farekas et al., 1963) disease with various causes of the vertebral artery in the external part of the cranium or abnormal system have been studied from ancient un the external part of the cranium, lengthening, aplasia and hypoplasia, change of neck vertebra disk affect to dynamic change of back artery blood supply. By scholar maisel fold of vertebral artery is 40%. Stenoses-18%, hypoplasia-10% vertebral artery through c 3-c5 vertebra occurred 12-20%., abnormal system of vertebral artery and location occur more than carotis artery and it has more dependence on external part of the cranium. Study of disease of vertebral artery in the external part of the cranium by the method of angiography hasnt been done in our country. Aim of research work: We aimed at diagnosing disease of vertebral artery in the external part by the method of angiography and studying its form, case, age and sex dependence. Conclusion: 1. Change of vertebral artery revealed 62.3% 2. Fold of vertebral artery in the 6th level 42% in v2, 3 level -9% revealed. 3. Vertebral artery is congenitally narrow (aplasia, hypoplasia)12%., through v3-5, vertebra-13%. 4. 58% of the people with vertebral artery disease occupy females.
5.Results of Studying Villas Circle Ring System by the Method of Angiography
Boldbat P ; Amarjargal G ; Tserenchunt G ; Oyun B ; Enkhtuul T
Mongolian Medical Sciences 2009;147(1):11-12
Background. In the process of infarction, important mechanism of blood supply deficiency is collateral blood supply. There are a lot of various collaterals which are able to supply in the period of necessity of human brain. Collateral which forms in the level of villas circle (ring) in the cranium is the most important front and back artery cord of brain form villas circle (ligament) as a result of these arteries possibility of forming collateral blood supply in the period of blood insufficiency in vertebral and carotis and between magisterial artery of 2 sides of brain opens. It is rare when the system of villas circle (ring) is complete (full), artery cord is narrow (hypoplasia, aplasia) or none, villas circle(ring) loses its complete and it becomes open on the front and at the back part. By the researchers study hypoplasia of artery cord occurs in 20-40% because it branches off from other artery. By Yu.M. Nixitins study vertebral artery of the brain branches off the form the artery into carotis and it open at back part-was 25%, study of system of villas circle (ring) by angiography hasnt been done. Aim. We aimed at the diagnosing villas circle system by angiographic method and studying its incompleteness, form cause, age and sex dependence. Materials and Methods. We studied material of 595 patients who were done angiography of the brain because of acute and chronic deficiency of blood supply of the brain in 2007-2008 at the third clinical hospital by P.N.Shastin in the cabinet of angiography came from clinic, district and Achtan Elit hospital. We clarified magisterial arteries and villas circles in the cranium by the standard method in 2 sides used polydiagnostic 2 digital subtraction equipment of Philips form of Japan. We evaluated artery system, location, form and size and studied age and sex dependence.75% of verographer solution not more than 80-100ml was injected into the artery. Conclusion: 1. Incompleteness of circle revealed in 31.7 % 2. Open case of villas circle in the front part was in 41.5 % 3. Open case of villas circle at the back revealed in 58.4% 4. Studying villas circle, evaluating collateral blood supply is necessary to blood supply deficiency in particular to define blood deficiency insult.
6.To the Problem of Diagnosing Disease of Vertebral Artery of External Part of Cranium by Duplex-Sonography
Amarjargal G ; Oyun B ; Tserenchunt G ; Enkhtuul T
Mongolian Medical Sciences 2009;147(1):13-14
Background. Disease of vertebralis and insufficiency of blood supply occur not a few, it decreases lab our ability much, complaints such as: headache, to feel giddy, to blur eyes, fatigue heartache, neck becomes stiff and unbalance reveal. By some researches study 25-30% of blood supply insufficiency of cranium occupies artery disease 65% of vertebral artery insufficiency occupies disease of external part of cranium we have introduced duplex sonography method by using medison Pico-ACE apparatus since 2006 and it gave possibility of revealing artery disease of external cranium. The most causes of artery disease occupy congenital and acquired deficiency such as: aplasia, hypoplasia and vertebra skin. Revealing and diagnosing these disease early is the confronted problem of society and health and it attracts attention of doctors and specialists of angioneurological branch. Aim of research work: We aimed at the study of diagnosing disease of artery of vertebral of external part of cranium by the method of duplex-sonography and studying dependence of type, size, form, case, age and sex. Materials and Methods. We did the study on 100 people who was done duplexsonographic diagnose because of blood supply insufficiency of cranium in the centre of diagnose of private structure Best Ema. We did analyse of DSG by using MedisonPicoACE apparatus by the stand and method, divided them into 6 groups in 10 age and studied type, size, location speed of stream, age and sex. Conclusion: 1. By duplex-sonography, in 18% hypoplasia of vertebral artery revealed, in 88.8% of it hemo-dynastic change revealed. 2. In 24% of patients involved in the study artery fold revealed, in 62.5 hemo-dynastic change revealed. 3. The main method of analyze which reveals location, size and dynamic and diagnosis vertebral artery of external part of cranium is DSG.
7.Therapeutic properties and adverse effects of valproate
Naranbat N ; Munkhzul D ; Amarjargal M ; Batbaatar G ; Tovuudorj A
Mongolian Medical Sciences 2012;161(3):64-69
Complete seizure control is the single most important determinant of good quality of life for patients with epilepsy and the chronic nature of the disorder requires that antiepileptic drugs (AEDs) be administered for many years, often for a lifetime. Therefore, long-term experience is of particular importance in evaluating the efficacy and safety of an AED. Valproic acid increases γ-aminobutyric acid (GABA) synthesis and release and potentiates GABAergic transmission in specific brain regions and it also has also been found to reduce the release of the excitatory amino acid β-hydroxybutyric acid and to attenuate neuronal excitation mediated by activation of N-methyl-D-aspartate (NMDA) glutamate receptors. In addition to these effects, valproic acid exerts direct actions on excitable membranes, including blockade of voltage-dependent sodium channels. Valproate is generally regarded as a first-choice agent for most forms of idiopathic and symptomatic generalised epilepsies. Many of these syndromes are associated with multiple seizure types, including tonic-clonic, myoclonic and absence seizures, and prescription of a broad-spectrum drug such as valproate has clear advantages in this situation. The elimination half-life is in the order of 9 to 18 hours, but shorter values (5 to 12 hours) are observed in patients comedicated with enzymeinducing agents such as phenytoin, carbamazepine and barbiturates. The most commonly reported adverse effects of valproate include gastrointestinal disturbances, tremor and bodyweight gain. Other notable adverse effects include encephalopathy symptoms (at times associated with hyperammonaemia), platelet disorders, pancreatitis, liver toxicity and teratogenicity. According to the some study results, endocrine manifestations of reproductive system disorders, including polycystic ovary syndrome, may be more common in women treated with valproate than in those treated with other AEDs.
8.A case of moya-moya syndrome in mongolia
Baasanjav D ; Ariunaa J ; Oyun B ; Boldbat R ; Khandsuren B ; Byambasuren TS ; Amarjargal G
Mongolian Medical Sciences 2010;153(3):78-81
In this published case of a male patient B., 53, has some epidemiological specifics. There is transient ischemic attack (TIA) syndrome, particularly while with clear mind there is sudden temporary paralysis of left leg and arm and loss of ability to speak. Temporary refers here to a period of 2-3 minutes after which everything gets back to normal. The incidence occurred again in two days during the medical treatment.MRA test concluded on the presence of obvious stenosis at the beginning part of both sides of a.cerebri media. The mentioned blood vessel pictures were undefined. Hence selected catheter angiography has been done with a purpose to establish the presence of a full occlusion or clogging stenosis in a.cerebri media and to clarify which specific vessels are being mobilized for the collateral supply. This test established that the a.cerebri media had full occlusion on both sides.A duplex sonography conducted in order to clarify characteristics of the clogging (blocking) process concluded the presence of gradual thickening of and blocking in intima (inner wall) of a. carotis interna. Based on these tests we considered that despite the atherosclerosis symptoms (Ischemia in ECG, 20 years of smoking,being male and aged 53, etc), this case had conditions of gradual (slow progressing) arteriopathy. Thus because of the presence in this case simultaneous arteriopathy process (gradually progressing and causing the blocking) in addition to atherosclerosis syndromes we consider it as a Moya-Moya syndrome. The disease of Moya-Moya is mostly found in children and youth and is a unique arteriopathy considered unrelated with atherosclerosis.
9.Visual and anatomical outcomes of vitrectomy surgery in rhegmatogenous retinal detachment
Oyunzaya L ; Amarjargal S ; Zolboo A ; Khongorzul G ; Balmira Ye ; Tseevanjid Ya ; Surenjav Z ; Ganzaya G
Innovation 2021;14(2-Ophthalmology):12-15
Background:
To determine the visual and anatomical outcomes after rhegmatogenous retinal
detachment surgery.
Methods:
Case files of patients who had surgery for rhegmatogenous retinal detachment at the
3rd state central hospital May 2019 and May 2021 were reviewed. Information obtained included
age, sex, presenting and post-operative visual acuity, anatomical reattachment, post- operative
complications and causes of treatment failure.
Results:
Risk factors for retinal detachment included myopia in 8 eyes (32%), trauma in 7 eyes
(28%), prior cataract surgery in 2 eyes (8%). 22 eyes (88%) presented with macula off while 3 eyes
(12%) presented with macula partly or completely attached. Visual acuity at presentation was
<0.01 in 15 eyes (60%). Following surgery, retina was attached in 23 eyes (92%) and remained
detached 2 eyes (8%). Visual acuity after surgery was 0.1< 17 eyes, 0.4< 7 eyes. Visual acuity
improved in 23 eyes (84%), remained the same in 2 eyes (8%).
Conclusion
Myopia and trauma are important risk factors for Rhegmatogenous Retinal
Detachment. Majority of patients in this setting presented late with Rhegmatogenous Retinal
Detachment and this was responsible for relatively poor visual outcomes despite good anatomical
results after surgery. Proper screening of eyes at risk and education of patients is important for
preventing visual loss due to retinal detachment.
10.Hormonal and lipid profile in infertility women with polycystic ovary syndrome
Algirmaa N ; Amarjargal O ; Battulga G ; Altaisaikhan Kh ; Munkhtsetseg D ; Bolorchimeg B
Mongolian Medical Sciences 2020;194(4):17-24
Introduction:
PCOS prevalence is 5-10 percent among reproductive age women in worldwide. It is caused by
imbalance of sex hormones which ultimately leads to menstrual irregularities, infertility, anovulation
and other metabolic disturbances. Most women with chronic anovulation is caused by polycystic
ovary syndrome [PCOS] The Rotterdam criteria is useful diagnostic tool for PCOS. In Mongolia
there is almost no study on PCOS related infertility and there are increasing trend infertility among
reproductive aged women with PCOS, lead us to conduct the study.
Objective:
The aim of this study was to estimate incidence of PCOS and to study clinical and biochemical
characteristics of PCOS among infertility women.
Material and Methods:
We used the cross-sectional and case control study designs. Total 1334 infertility women enrolled
in this study. The study was conducted after approval from the Ethical and research review board of
the hospital, and written informed consent was taken from all the women. Among 114 women with
PCOS were found by Rotterdam’s criteria at the Infertility and reproductive department, National
Center for Maternal and Child Health, between December, 2018 - 2019. Total of 43 females with
PCOS were screened among 1334 infertile women. All parameters were assessed either with ELISA
in 43 infertile PCOS women and 17 age matched apparently healthy controls diagnosed according
to Rotterdam consensus. IDF diagnostic criteria for MS was used. The PCOS patients divided into
following groups: (1) with MS ( n=42) and (2) without MS (n=72).
Results:
The main age, body mass index (BMI), and duration of infertility were 28.7±4.1 years, 27.3±5.2 kg/
m² and 4.4±3.1y, respectively. Among patients 57.9% of them have oligomenorrhea, 22.8% with
amenorrhea, primary infertility 57.0% and 51.9% with hirsutism and acne 50.8%. As a result of
hormone assays were LH 9.3±3.5mIU/ml, LH/FSH 1.6 ±0.83 [0.1-3.6], AMH 6.1ng/ml ±3.6 /2.9-21.0/.
The prevalence of MS was 36.8%. The variables including age (30.9±4.9), body mass (75.9±11.6kg)
and also some metabolic parameters which is hypertension (133.6/88.4±13.6 mm Hg), WC (94.1±8.6
cm) and high triglyceride (1.8±1.0 mmol/l) were observed in MS group compared to without MS group.
Conclusion
Among 1334 women with infertility, the incidence of PCOS 8.7% (116), close to the prevalence in
other countries. Considering the diagnose was confirmed of three criteria by the Rotterdam criteria.
We found out that the prevalence of metabolic syndrome was 35.3% among infertility women with
PCOS. Age, BMI, WC, amenorrhea, acne and acanthosis nigricans, were highly related to metabolic
syndrome.