1.The identifi cation results for the diagnostic sensitivity of cervical liquid based cytology testing
Batchimeg Ts ; Gerelee Kh ; Sayamaa L ; Munkhtulga L ; Bayarmaa E
Mongolian Medical Sciences 2016;175(1):26-30
Introduction
Cervical cancer screening program is using conventional Pap smear (CPS) have been successfully
used in Mongolia, but new kind of test as “Liquid based cytology” (LBC) is not popular for screening.
This liquid based cytology testing might reduce the number of unsatisfactory smears, and increase the
accuracy of diagnosing.
Goal
The main aim of this study was to assess diagnostic accuracy and sensitivity of Liquid based cytology
versus Conventional Pap smear using ‘split-samples’ technique.
Materials and Methods
This was cross sectional study, total of 75 cervical split samples were included over a period of 2 months.
Split sample was obtained using cervix-brush. CPS was prepared from brush and the brush head was
suspended in the Liquid based vial and processed by LBC method and pap staining. Smears were
diagnosed by cytologists. Abnormal smears were concluded by cervical biopsy as a Golden Standard.
Results
There were 14%unsatisfactory smears in CPS and 6% in LBC; the main cause is insuffi cient cells, and
excess blood in CPS. LBC had diagnostic accuracy of LSIL was lower, but ASC-US was higher than
CPS was signifi cant. LBC (100%) was more sensitive than CPS (89%) was confi rmed by biopsy.
Conclusions: LBC testing was successfully reduced unsatisfactory smears rate. LBC samples offered
better clarity and uniform spread of smears, less time for screening and better diagnostic accuracy of
LSIL and ASC-US than CPS.
2. USING THE STRENGTHS AND DIFFICULTIES QUESTIONNAIRE (SDQ) TO SCREEN FOR CHILDREN BETWEEN 11-17 YEARS OLD IN A COMMUNITY SAMPLE
Bayarmaa V ; Nasantsengel L ; Batzorig B ; Chimedsuren O ; Tuya N
Innovation 2015;9(1):34-36
Child psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated.To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community.SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 1959 11- to 17-year-olds from the 2013 Mongolian National Center for Mental HealthMulti-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 66.8% (95% Cl 61.4-73.0%) and a sensitivity of 64.4% (59.9-71.3%). The questionnaires identified over 65% of individuals with conduct, hyperactivity, depressive and some anxiety disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs.Community screening programmers based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments
3.Urinary bladder cancer diagnosed by pathologic method
Bolortuya B ; Bayarmaa E ; Galtsog L
Mongolian Medical Sciences 2010;152(2):12-15
BACKGROUND: Urinary bladder cancer (UBC) ranks ninth in worldwide cancer incidence. It is the seventh most commonmalignancy in men and seventeenth in women. UBC tends to occur most commonly in individuals over 65 orolder men and the male to female ratio are 3:1. The vast majority (over 90%) of bladder cancers are transitionalcell or urothelial carcinoma. Many experts did favor the 1998 World Health Organization/international Societyof Urological Pathology (WHO/ISUP) formulation for urothelial neoplasm. The 2004 WHO had accepted thenomenclature used in 1998, the system is currently used in countries of the world. Histology is the gold standardof typing, grading and staging to determine prognosis of the disease and process tactics of treatment. This newclassification system is not been introduced in our country yet, so UBCs are still formulated with the WHO 1973system. And there are no noted studies for UBC yet in Mongolia, these reasons were the background to determinethe UBC pathology with international classification system and nature of UBC in Mongolians.OBJECTIVE: To classify urinary bladder cancer occurred in Mongolia with the current histological classification and determinesspecific characters of pathology.MATERIALS AND METHODS: In this study we evaluated 138 patients with UBC diagnosed in Urological department of Central UniversityHospital, biopsy materials of these patients are classified with WHO/ISUP(2004) and results were analyzed.RESULT: Of the 108 patients with urinary bladder tumor, 2 patients (2%) were diagnosed with papilloma, 13 patients (12%)with papillary urothelial neoplasm of low malignant potential, 93 patients (86%) diagnosed with UC. Of 93 patientswith bladder carcinoma, majority of patients (91/98%) were diagnosed with urothelial carcinoma, 2 patients (2%)were diagnosed with adenocarcinoma. 74 (79.5%) of study patients were male, 19 (20.5%) were female and themale to female ratio was 3.9:1. Older man (over 50) was 65 (88%). Of UC (91), 1(1%) was carcinoma in situ,38 (42%) low grade papillary carcinoma, 33 (36%) high grade papillary carcinoma, 19 (21%) were no papillaryurothelial carcinoma. Of bladder carcinoma (93), 29 (31%) were superficial cancer (pTa, pTis), 58 (62%) wereinvasive cancer (pT₁₋₄).CONCLUSION: Urinary bladder cancer is in the majority in urinary bladder tumor in our country and transitional cell or urothelialcarcinoma compresses 98%. The male to female ratio in patients with bladder carcinoma is 3.9:1, older men over50 years are overweening affected.
4.Pregnancy cases after embolization of uterine fibroids
Uranchimeg R ; Ganbaatar R ; Bayarmaa L ; Lkhagvasuren J
Mongolian Medical Sciences 2014;168(2):43-48
INTRODUCTION:Uterine leiomyoma occurs with broad range of 20-50% among reproductive aged women. It takessecond place of all women’s genital diseases that cause abnormal menstrual bleeding. Leiomyomadependent surgical frequency such as hysterectomy is around up to 80, 6%. Lately uterine fibroidembolization treatment is highly effective, less painful, and more rapid recovery, most importantlykeeping organ while maintaining the reproductivity, is successfully entered in practice. We successfullyperformed 40 cases first time in Mongolia and 8 of them conceived naturally after treatment.GOAL:To determine if arterial embolization in women with uterine fibroids (leiomyomata) is an effectivemethod to keep their reproductive organ intact.OBJECTIVES:• To study pregnancy cases in women who had uterine fibroid embolization• To monitor and determine the features of course of pregnancy and childbirth.• To evaluate uterine fibroids.MATERIALS AND METHODS:The study was conducted in 2009-2012. A total of forty women between 23-50 years of age,diagnosed with symptomatic uterine fibroid that received embolization treatment of dominatingarterial blood vessel feeding the uterine fibroids were involved in the study. Eight of the forty womenwho conceived naturally were selected for the study. The study focused on monitoring the course oftheir pregnancy and delivery and its outcome.RESULTS:Among 40 women who underwent bilateral uterine artery embolization, 31 (75.5%) were seeking tobecome pregnant, and 8 of the 31 (25, 8%) became pregnant, four having been nulliparous. Onepatient had two pregnancies. All 8 pregnancies were spontaneous. The mean time from embolizationto conception was 12±3, 5 months (range, 6-27 months). Three medical terminations occurred. Theother 5 pregnancies went to term; one pregnancy had to be terminated pre-term due to placentapraevia. 60% experienced threatened abortion and 1 case with advanced age mother complicatedwith mild preeclampsia. 62,5% of the women’s pregnancy ended with childbirth, of which one woman(20%) had vaginal delivery and the remaining four pregnancies (80%) ended with C-section. On anaverage, post-treated uterine fibroids decreased in volume by 94% in comparison to pre-treateduterine fibroids in the patients who became pregnant. All of the neonates were healthy with Apgarscores greater than8. The mean weight of the neonates was 3,189± 200 g (range, 2,100–3,800 g). One neonate waspreterm due to placenta praevia (2,100 g).CONCLUSION:1. Of the forty women that received arterial embolization treatment with uterine fibroid, thirty one(75, 5%) women desired to keep their uterine for further reproduction, of which eight women (25,8% of the patients) between the ages of 23-42 years (mean age=35) conceived naturally. Arterialembolization to treat women with uterine fibroids is an effective method for women who wish to keeptheir reproductive organ intact to conceive and reproduce.2. 60 percent of the women who conceived experienced threatened abortion and 20 percent of thewomen’s pregnancy had to be terminated pre-term due to placenta praevia. 62,5 percent of thewomen’s pregnancy ended with childbirth, of which one woman (20%) had vaginal delivery and theremaining four pregnancies (80%) ended with C-section.3. On an average, post-treated uterine fibroids decreased in volume by 94% in comparison to pretreateduterine fibroids.
5.To screen for child emotional and behavioral problems in a community sample
Bayarmaa V ; Nasantsengel L ; Batzorig B ; Tuya N ; Chimedsuren O
Mongolian Medical Sciences 2016;175(1):54-57
BackgroundIn accordance with WHO investigation, most of the mental disorders onset in childhood and 20 percentof children (1 of fi ve) with mental and behavioral disorder currently. In 2005, by assessment of mentalhealth system in Mongolia (WHO-AIMS) it was concluded that special attention needs to be given todevelop professional competence and services in the area of child and adolescents mental health so itis a reason of the this study.AimTo early identify common emotional and behavioral problems among children and identify risk factorsfor itMethodsThe study was randomly selected 3500 child aged between from 4 to 17 years in 5 districts of Ulaanbaatarcity and 46 soums of 11 aimags of Mongolia.A main tool is Strengths and Diffi culties Questionnaire (SDQ) and included the 25-item child andparent versions were used to record each informant’s perception of four problem domains/subscales.SDQ was differently used child ages such as child aged 6-10 years used by parent version child agedbetween11-17 years used by both child and parent versions.ResultsOf 2920 child who participated in the study, 382 (13%) studied in kindergarten, 2423 (82.9%) school. Anaverage age of participants was 10.9±4.ConclusionThe abnormal emotional reaction was dominantly occurred in urban girls aged between from 6 to 10years and the abnormal behavioral reaction was dominantly occurred in urban boys aged between from6 to 15 years. The family relationship was a risk factor for developing emotional and behavioral problemsin child.
6.Contemporary treatment guidelines for managing вenign uterine tumors
Uranchimeg R ; Ganbaatar R ; Bayarmaa L ; Lkhagvasuren J
Mongolian Medical Sciences 2015;172(2):115-122
Uterine leiomyomas are common (20-50%) in women of reproductive age. It is a benign tumor and it ranks second place among genital organ disorders in women.To date, abdominal laparotomy and laparoscopic surgical treatment (myomectomy and hysterectomy) are widely used to manage symptomatic leiomyomas.Although, hysterectomy is considered to be a radical method to manage uterine leiomyomas, women who have had hysterectomy are left totally infertile and they also are at risk to develop post-surgical and post-anesthetic complications. The advantage of myomectomy is to preserve women’s fertility and menstrual function but, the probability of recurrence of leiomyoma is 15-30% [1, 2]. Furthermore, depending on the location, size and number of fibroids, duration of surgery lingers, volume of blood loss is high and the risk to develop post surgical adhesions are high too.In recent, more than a decade period, effective and minimally invasive new, non-surgical methods to manage uterine leiomyomas have been introduced in many countries around the world. These methods have short recovery period and are advantageous to women to preserve their reproductive organ and fertility. They include: uterine artery embolization, uterine artery occlusion via transvaginal route and MRI– guided focused ultrasound surgery of uterine fibroids. Antiprogesterone-low-dose mifepristone for uterine leiomyomas are being introduced as well.In our country, managing leiomyomas surgically is still occupying high rate among surgical treatments. Further, to prevent and reduce complications of surgical treatment and to preserve organ, it is essential and imperative to introduce some of the above- mentioned contemporary non-surgical methods.
7.Mongolian Telepathology Network (MonTelNet)
Erdenetsogt D ; Galtsog L ; Bayarmaa E ; Oberholzer M
Mongolian Medical Sciences 2014;169(3):42-46
IntroductionMongolian rural population lack of access to adequate health services due to the fact that they live remotefrom urban hospitals. With the rapid spread of telemedicine in most countries, has been promoted as apromising tool to address deficiencies in delivering health care in developing countries.In late 2008 the Swiss Surgical Team (SST) started the telemedicine project MonTelNet in Mongolia incollaboration and with financial support of the Swiss Agency for Development and Cooperation (SDC).GoalThis study aims at evaluating the diagnostic accuracy of such a service by reviewing 212 telepathologydiagnoses delivered to the local experts in Ulaanbaatar between January 2009 and June 2013.Materials and MethodsUnder the MonTelNet project all province (Aimag) hospitals were equipped with hardware necessaryfor practicing telemedicine, in particular with computers with digitalized microscopes and cameras. Thesoftware CampusMedicus® (CM) was developed together with Klughammer GmbH. Software and alldata and comments exchanged over the MonTelNet are stored on a central server. Each of the originaldiagnoses issued through the CM telepathology (TP) server was compared to an independent reviewdiagnosis based on the original glass slides.RESULT For 188 specimens (89.9%) the TP diagnosis were completely identical with the review diagnosison the original glass slide. 12 specimens (5.7%) showed minor discrepancies (clinically identical) and 5specimens (2.4%) showed moderate discrepancies which were not clinically relevant. four cases (1.9%)exhibited a marked discrepancy (clinically relevant) between the TP diagnosis and the review diagnosis.Three specimens were classified as “other”.DISCUSSION The results of the study show a very high accuracy of the TP diagnosis provided. The TPdiagnoses differed markedly from the review diagnoses based on the original glass slide in only 1.9%of the 212 cases. 89.9% of all cases showed complete concordance between TP and review. Thesefigures are comparable to figures from other evaluations of static image telepathology.Conclusion:1. The results of the study show a very high accuracy (94.7%) of the TP diagnosis provided. TheTP diagnoses 89.9% of all cases showed complete concordance between TP and conventionalreview.2. Problem with image selection show a different picture and occur more often in cases with markeddiscrepancies between TP and review - χ2-test shows significant correlation (p<0.001).
8. SOIL SEED BANK STUDY
Densmaa B. ; Bayarmaa L. ; Suvd-Erdene E.
Mongolian Pharmacy and Pharmacology 2015;7(2):95-98
The survival of seeds in the soil is characterized by the ambient concentration of seed and seed distribution and seed maturation. Seedlings grown in a fully developed in the future viability of the plant growth shows revival. Ecological restoration of this important natural seed bank study could also be considered, assuming of Bogd Khan Uul “Shajin khurkh” around the goal of soil seed reservation. Goal to achieve the following objectives. Including:1. To learn soil seed stydies2. To familiarize with the methodology andresearch, make the research methodologyinto own3. To study soil seed bank around BogdKhan mountain “Shajin khurkh”Key words: Bogd Khan Mountain; soil; seed bankIntroductionNowadays, environmental problems aroundthe world, our country prone to desertifi cation gene pool of rare and endangered native plant conservation and is close to extinction benefi cial for some drugs, food and technical plant species restoration, conservation and proper use is a challenge today. With an easy transition to a market economy gain a group of people interested in nature pillage of rare animals and plants remove, and the intense drought shifting in recent years in Mongolian Gobi desert steppe has desertifi cation across the region. Natural conditions, rehabilitation of forest trees, shrubs and plants shrubs planted seeds and seedlings preparation step is performed to transfer. It is not possible to recover plant ecology without seeds. To destroy the vegetation limited nature of the environment and human infl uence in the work of restoring scientifi c conduct acomprehensive study to ensure that it is desirable to restore the ecology of the soil seed reserves in the area, primarily to determine what research.Materials and methodsThe location of points of GPS (Geographicalposition system) established with the help ofapparatus and measuring 10x10m area of each point and each of any two points each 1m2 5 this site soil samples from 5 repeats. Studies using soil samples takenin 2013-2014 according to German scientists K.Tomsony research methodology to test performance.Bogd khan ‘’Shajin khurkh’’ mountain thestudy are shown
9. The comparative study of thyroid isotope scanning and FNA cytology in the nodular lesion of thyroid gland
Suren O ; Tuul B ; Puregmaa KH ; Sаyamaa L ; Ulzii-Orshikh N ; Enkhtuya B ; Bayarmaa E ; Ganzorig B
Innovation 2016;10(3):32-36
Thyroid nodular lesions are the common clinical problem in the world. A variety of tests have been employed to separate benign from malignant thyroid nodules. These tests include isotope scanning and fine needle aspiration cytology (FNAC). Our research was based on the fact that the comparison of FNAC and thyroid isotope scan in thyroid nodule was not researched in Mongolia. Therefore, we want to evaluate the specimen adequacy of FNAC, and compare its result to thyroid isotope scanning in patients with thyroid nodule. The research was conducted on archive materials of FNAC and thyroid isotope scanning of patients with thyroid nodule who were treated in surgical department of The First Central Hospital from 2012 to 2015, and the statistic analyze was done by using SPSS 20 under the auspices of School of Pharmacy and Bio-Medicine,Department of pathology, Mongolian National University of Medical Sciences. We have collected the FNAC of 807 patients, including 34 patients (4.2%) were males and 773 patients (95.8%) were females. FNA cytology results were interpreted as benign in 495 cases (61.3%), follicular lesion of undetermined significance in 31 cases (3.8%), follicular neoplasm in 9 cases (1.1%) suspicious in 17 cases (2.1%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). We have got the result of thyroid isotope scanning of 43 (5.32%) patients out of 807 cases. On thyroid scan, 18 patients (41.9%) having cold nodule were labeled as suspicious for malignancy, 25 patients (58.1%) had hot nodule. The FNA diagnosis of 25 patients with a hot nodule following: 1 patient (4%) with neoplasm, 17 patients (68%) with benign results, 6 patients (24%) had non-diagnostic. The FNA diagnosis of 18 patients (41.9%) with cold nodule following: 1 patient (5.5%) with follicular lesion of undetermined significance, 10 patient (55.5%) with benign, 5 patient (27.7%) with non-diagnostic, 2 patient (11.1%) had malignant. The FNAC results were interpreted as benign in 495 cases (61.3%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). Two patients out of 18 patients with cold nodule diagnosed as malignancy by FNAC. The sensitivity and specificity of thyroid isotope scanning was 96% and 16.6%, respectively.
10.To the problem of colorectal cancer and its pathological diagnose
Adilzaya D ; Galtsog L ; Hosbayar T ; Battulga A ; Tuul B ; Bayarmaa E
Mongolian Medical Sciences 2010;153(3):42-47
BackgroundColorectal cancer takes the second place in the highly developed countries morbidity increases, for females it takes place after breast cancer, for males after lung cancer colorectal cancer occupies about 3-5% from the cancer of digestive tract. In the western Europe, united states of America it occuries 12.6% on males and 14% on females, for Pathological structure it occurs mostly in the proximal part and adenocarcinoma is diagnosed 95%. Colorectal carcinoma occurs more at the age of 20-40 but people aged 40-50 are mostly affected and males are affected more. Lately it has tendency of increasing amond the population 40-120 case on 100000 in a year approximately 5-10 people are affected newly. For our country by health statistical information colon cancer was 94 from it 49 occur on females, cancer of rectal and anus canal was 237, from it 99 occur on females, 37 case of colorectal cancer are registered newly in a year approximately, 19 occurs on females cancer of rectal and anus canal was 45 from them 16 are registered newly on females the number of patients with colorectal cancer has tendency of increasing. Among Mongolian population morbidity of colorectal cancer is increasing nowadays but any research has not been done to reveal pathology early and to diagnose. This became base of our research work.GoalAim of our study is to define peculiarity of colorectal cancer and its early pathology and to study some factor of aetiology connectea with cancer forming.Objectives:1. To define peculiarity of pathology of colorectal cancer.2. To diagnose early pathology of colorectal cancer by pathological method.3. To diagnose colorectal carcinoma by international histological classification and determine cell secretion degree.4. To define some genetic peculiarity of factors which affects to colorectal carcinoma.Novelty of research workNovelty of research work is to study colorectal carcinoma and its early pathology in combination with the method of endoscopy and molecular biology.Materials and MethodsIn the research 315 biopsy material of 142 patients with colorectal carcinoma of 2004-2008, 56 biopsy material of colorectal endoscopy of 2007-2008 are involved.1. Histological basic painting method.2. Method of molecular biology. We revealed affect of human papilloma virus infection in 39 surgical and endoscopyic material by using general GP5, GP6, MY11 primer in PSR.ResultsIn our study totally 198 people were involved from them (average age 45.8+ - 0.4), 46.0%(n=91)-male, 54% (n=107) female. If we see people involved in the study by age classification, 8 (5.9%) at the age of 20-29, 21 (10.3%) at the age of 30-39, 39 (19.3%) at the age of 40-49,45 (22.4%) at the age of 50-59, 56 (27.7%) at the age of 60-69, over 70-79 (14.3%). If we see colorectal carcinoma by anatomical location most location was in 45 (22.7%) in sigma, 52 (26.2%) in rectus. Seeing from endoscopic biopsy analyse pathology which involved whole colorectus occupied 10 (35.6%). By international histological classification of cancer which was adopted from WHO. In our study polyp occupies 21 (10.6%), adenoma 24(12.1%), adenocarcinoma 137 (69.2%), metastatic carcinoma 6 (3%), chronic inflammation or with change dysplasia 10 (5.1%). If we see endoscopic biopsy analyse it is 56 (28.3%) of people involved in the research. Hyper plastic polyp 21 (36.1%), adenoma 6 (25%), adenomatous polyp 8 (33.3%) occupces, Tubular adenoma polyp 7 (29.2%), villous adenoma 3 (12.5%) from carcinoma adenomatous carcinoma occupces 98 (71.5%), mucous carcinoma 7 (5.1%), carcinoma with flat cell 8 (5.8%), carcinoma with ring cell 5 (5.1%), carcinoma witout secretion 13 (9.5%), carcinoma with metastases 6 (4.3%), one of factors of etiology which affects to colorectal carcinoma is human papilloma virus. In the biopsy material of surgery and endoscope involved in the research it reveals negative in sensitive primer which reveals all the type of papilloma virus.Conclusions:1. Colorectal carcinoma occurs 19.3% at the age of 40-49, 22.4% at the age of 50-59, 27.7% at the age of 60-69, it has tendency of increasing rohen age becomes older. It occurs 14% over 70.2. By location of anatomy colorectal carcinoma it occupies 50-60% in sigma and rectus.3. Noncarcinomous polyp of colorectal carcinoma is situated in many parts of intestine carcinoma with many polyp occupies 35.6%of total carcinoma.4. By histological classification mostly carcinomous and noncarcinomous carcinoma of epithel and adenomous cell originated occupy.5. Papilloma virus hasn’t been releaved in the sample endoscopic sample.