1.Long-term results of organ sparing surgical treatments of precancerous cervical lesions
Avirmed D ; Amarsanaa J ; Amarsanaa E ; Angarmurun D
Mongolian Medical Sciences 2010;153(3):31-35
Background: Cervical cancer is the most common cancer in female reproductive system. Since introduction of diagnostic modalities like Pap-tests, the detection pre-cancerous cervical lesions CIN1, CIN2 and CIN3 have increased dramatically. Early detection of pre-cancerous lesions enables performance of organ sparing treatments like LEEP, conization and cryotherapy.Aim: Since there are no studies in the field of organ sparing treatment of cervical cancer, we decided analyze the results of such treatments and calculate the:1. Five year survival of patients underwent organ sparing surgical procedures2. Fertility and reproductive function of these patientsMethod: LEEP (n-63), knife conization (n-22) and trachelectomy (total removal of cervix) (n-15) was performed in women of reproductive age (25-35 years old) at National Cancer Center. The treatment results were followed for 5 years and statistical analysis of survival and reproductive function were analyzed.Results: 87.7% of patients with CINI lesions had LEEP, 12.3 % had knife conization and 0% had trachelectomy. 44.4% of patients with CINI lesions had LEEP, 55.6 % had knife conization and 0% had trachelectomies respectively. For CINIII 6.2% of patients had LEEP, 0% had knife conization and 93% had trachelectomy.We performed organ sparing treatment in 100 patients, out of which 10% had cancer recurrence in LEEP treatment, 9.1% in knife conization and 0% in trachelectomy. Complications of hemorrhage were observed in 14% of patients, cervical tube obstruction in 3% and deterioration of chronic inflammations in 13% respectively. After the organ sparing treatment, menstrual cycle was normal in 75% of the all patients, 65% reached pregnancy. 9.2% of patients who reached pregnancy had stillbirth, 12.3% had abortion, and 78.5% had normal delivery. 80.4% of patients with pregnancy had natural labors, while19.6% of patients had ceasarean sections respectively. Conclusion: in Mongolia, LEEP, knife conization and trachelectomy methods are used since 2000. But the treatment results were not reported so far. 10% of patients treated by LEEP and 9.1% of patients treated by knife conization had tumor recurrence. Thus our treatment efficiency is above 90%. Up to 20% of patients had complications ranging from bleeding to cervical tube obstruction. We conclude that organ sparing cancer treatment allows better QOL (quality of life) for the patients and provides opportunity to have children.
2. LUNG DEVELOPMENT OF LOW BIRTH WEIGHT INFANT
Erdenetsetseg B ; Oyuntsetseg A ; Naranchimeg TS ; Solongo E ; Amarsanaa J
Innovation 2015;9(3):84-85
Neonatal mortality is declining in our FIRST MATERNAL HOSPITAL last few years but the number of preterm babies are increasing. Globally, the main causes of neonatal deaths are preterm birth complications (35 per cent), intrapartum-related complications (complications during labor and delivery) (24 per cent), and sepsis (15 per cent). Together, these three causes account for almost three quarters of all neonatal deaths.We have analyzed 51 medical records who have died in neonatal intensive care unit of Urgoo maternal hospital. 23 questionnaries were analyzed.Premature infant deaths basis of the mother’s birth disorders and mother abnormality. Furthermore, abruption placenta 25.1%, caesarian section 57.1%, hypertonus–21.4%.Prevention of fetal lung under development treatment did not affect 67.8% mortality. Chronic hypoxia is 46.4%, not a day mortality 25.4%, treating was 1–3 days mortality rate is 57.1% is the ability to live shows children die. Compared treated for complications premature infant mortality is 14.2%, causes premature infant mortality is ischemia of brain.Based on the study of maternal hospital mortality in the treatment of premature infants most important thing is CPAP machine it is premature to reduce infant mortality 30.7per cent. Is necessary to use with respiratory distress syndrome infant most important thing is surfactant treatment.
3.Top aspects of strategies on prevention and control of mycotoxins in foods
Tserendolgor U ; Ganzorig D ; Unursaikhan S ; Amarsanaa J ; Gerelmaa L ; Narandelger B ; Odonchimeg M
Mongolian Medical Sciences 2016;175(1):74-82
Afl atoxins are a type of mycotoxin produced by Aspergillus species of fungi, such as A. fl avus andA.parasiticus. Afl atoxins are the most potent hepatocarcinogen and mutagen among mycotoxins.Afl atoxins can effects a wide range of commodities, including crops, cereals, peanuts, maize, beans,and milk and fruits. Thus, we carried out a monitoring surveillance survey on the afl atoxins level in somefood commodities. In early stage of this survey we tested a total of 112 samples of foods including fl our,rice, peanuts, maize, dried fruits, milk, and cereals. According to the preliminary results of this survey,59 (52.7%) samples of foods including fl our, rice, peanuts, maize, dried fruits, milk, and cereals’ sampleswere positive for a total afl atoxins (AFB1+AFB2+AFG1+AFG2). Although levels of total afl atoxins in allsamples were at permissible limits by the commission regulation of EU, the strategies for the preventionand control of mycotoxin are required in Public health system and Agricultural organization in Mongolia.Since afl atoxins is the most well-known mycotoxin ever thoroughly studied and its prevention and controlhas been most successfully practiced in various countries, therefore, this paper will focus on the strategyfor the prevention and control of afl atoxins’s mycotoxin contamination food in Mongolia.
4.Dietary exposure and liver cancer risk assessment of aflatoxins in foods consumed in Mongolian people
Tserendolgor U ; Gerelmaa L ; Ganzorig D ; Amarsanaa J ; Unursaikhan S ; Narandelger B ; Odonchimeg M
Mongolian Medical Sciences 2016;176(2):36-46
This cross-sectional survey was conducted in seven district of the capital city Ulaanbaatar ofMongolia, and border post in Zamiin-Uud, and Altanbulag province from March to December 2015.A total of 380 samples including 70 flours, 114 rice’, 41 various peanuts, 15 maize and maizeproducts, 24 milks, 6 yoghurts, 39 beers, 27 dried fruits and 44 herbal teas were randomly collectedfrom supermarkets, hypermarkets, department stores, factories, and bazaars in Ulaanbaatar city,and Zamiin-Uud, and Altanbulag province.HPLC (High performance liquid chromatography), and enzyme-linked immunosorbent assay (ELISA)were used for the total aflatoxins (B1+B2) and aflatoxin M1 detection.The survey found that (148) 38.9% of all analysed food samples were contained aflatoxins (B1+B2),and aflatoxin M1 were ranging from 0.0094 μg kg-1to 2.4μg kg-1. The levels of aflatoxins (B1+B2)were below the maximum tolerance limit in EU and worldwide regulations. Mean concentrationlevel of aflatoxins (B1+B2) was 0.17 μg kg-1 in all positive samples. Mean daily low and high foodintake were respectively, 63 g and 245 g. Based on the daily food consumption data, estimatedexposure dose of aflatoxins (B1+B2) was 0.16734 mg kg-1bw day-1 in individuals with a daily low foodintake, and 0.65078 mg kg-1bw day-1 in individuals with a daily high food intake (95th percentile). Theexposure dose of aflatoxins from daily high food intake exceeds the estimated provisional maximumtolerable daily intakes, 0.4 μg kg-1 body weight day-1 for adults with hepatitis B (Kuiper-Goodman,1998). Furthermore, estimated excess cancer risk values to liver cancer incidence by ingestion ofthese foods for aflatoxins (B1+B2) and aflatoxin M1were calculated to be 0.0448 mg kg-1bw day-1forindividuals negative for hepatitis Band 1.344 mg kg-1bw day-1 for individuals positive for hepatitis B.Thus, the findings of our survey showed that the potential hazard associated with aflatoxin in foodin Mongolia has not been serious. However, most researchers suggested that no level of aflatoxinexposure is considered safe.Conclusion: Currently, the levels of the total aflatoxins and aflatoxin M1 were lower than the maximumpermissible levels in UE and the USFDA, and worldwide regulations. Currently, estimated exposuredose of the total aflatoxins and M1aflatoxin through daily high food intake was risked in populationwith hepatitis B virus. However, in Mongolian population has not been excess liver cancer risk.
5.Total Aflatoxin Contamination of Various Peanuts
Gerelmaa L ; Tserendolgor U ; Burmaajav B ; Ganzorig D ; Amarsanaa J ; Unursaihkan S ; Odonchimeg M ; Narandelger B
Mongolian Medical Sciences 2016;178(4):51-57
ObjectiveThis study aimed to assess the prevalence of the total aflatoxin in peanuts, and their concentration level.Material and MethodThis cross-sectional survey was conducted in seven district of Ulaanbaatar, the capital city of Mongolia,from March to December 2015.A total of 41 samples of peanuts were randomly collected from the survey area, from March to December2015. An ELISA test was used for detection the total aflatoxins(B1+B2). The relative humidity andtemperatures of the storage areas were measured at the time of sampling the peanut.ResultsThe Frequency statistics analysis showed that 61% of all analyzed peanut samples had detectablelevels of the total aflatoxinat 0.05 μg kg-1. The prevalence of samples contaminated with the totalaflatoxins(B1+B2) were higher among analysed samples of the tree nuts, peanuts imported from China,and canned nuts (P<=0.01). Levels of the total aflatoxins were less than the maximum permissible limitsof 15 μg kg by the regulation of European Union and worldwide. The mean values of the storage relativehumidityat the time of sampling peanuts were higher than the recommended storage relative humidity incorn cereals (<13%). Furthermore, the mean values of the storage temperatures at the time of samplingpeanuts were higher in groundnut peanuts, cedar’s nut and peanuts imported from China than therecommended level of the storage temperature in corn cereals (10°C-21°C).Conclusion:The prevalence of the total aflatoxin in peanuts was higher. The level of the total aflatoxins were less thanthe maximum permissible limits of 15 μg kg-1 by the regulation of European Union and worldwide. Thestorage relative humidity and temperatures of peanuts may encourage the growth of fungi-producingaflatoxins. Thus, a national strategy for the elimination of aflatoxin in foods is needed in Mongolia.