1. RESULTS OF RESEARCH CONDUCTED ON CYTOLOGICAL CHANGES OF DISEASES MOSTLY OCCURRING AMONG WOMEN
Munkhzul S ; Yumchmaa N ; Enkhtuul CH ; Myagmartseren B ; Oyunchuluun B
Innovation 2015;9(3):76-77
First Maternity Hospital in Ulaanbaatar has provided 1890 women, 2508 women and 3728 women in 2012, 2013 and 2014, respectively, for diseases in women. Uterine myoma, ovarian cysts, dysfunctional uterine bleeding, ovariandysfunction and endometriosis are commonly among women. These need to be diagnosed at early stages of the diseases. Endometrial carcinoma is detected in 5% of women under 40 years of age with over amount of hormone estrogen on a base of endometrial hyperplasia.Women with endometrial hyperplasia have 5% possibility to have endometriosis, endometroidcysts, ovarian cancer or uterine myoma and 0.5% possibility to have higher complication of disease. Therefore, we aimed to introduce the practical treatment with cytological analysis as a medical treatment and diagnosis method. The purpose of the research is to highlight the diseases mostly occurring in women, determine cytological changes and differences and improve the differential diagnosis.The research work has been carried out based on reports of cytological analyses undertaken by the National Centre of Pathology for 1310 patients, who were all of patients treated at the Inpatient Care Department in FMH in 2014. This study included in the cytological analyses at the National Centre of Pathology, by using special questinnaries and did retrospective study. 67.7% /888/, 27.8% /365/ and 4.3% /57/ of the above mentioned women were tested with cytological analyses due to surgical diseases, endocrinology diseases and inflammatory diseases, respectively. The average age is 39±58. The uterine myoma, the ovarian cyst and dysfunctional uterine bleeding have been more commonly occurred among the 35 diseases in women as 38.9% /510/, 15.7% /206/ and 16.7%/219/ of the women, respectively. For endometriosis cases, the ovarian endometriosis occurred with 3.7%, the fallopian tube endometriosis occurred 2.4%, the adenomyosis occurred 4.7% and the combined endometriosis occurred 0.5%.Based on the reports of cytological analyses on endometrial hyperplasia, the details show that the simple hyperplasia is 52.4% /178/ and the complex hyperplasia is 47.6% /162/.Compared with women without the HPV, a cervical intraepithelial neoplasia occurs to women with the HPVmore than 20 times. /p<0.001, OR=20.81/. It is statistically important that 2nd stage of adenomyosiscauses atypic cellular changes for 3 times. /p<0.001, OR=3.09/. In women, the uterine myoma, dysfunctional uterine bleeding and ovarian cyst disorders are most common. Average age of women with disease in women is 39.58.Compared with women without the HPV, a cellular change occurs to women with the HPV more than 20 times. /p<0.001, OR=20.81/.The 2nd stage of adenomyosis causes atypic cellular changes for 3 times. /p<0.001, OR=3.09/
2.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.
3.Results of study on road traffic accidents in relation to road condition between Baganuur and Ulaanbaatar
Myagmarjav J ; Bazarragchaa I ; Khashbat J ; Erdenetuya A ; Munkhzul N ; Tsevegjav TS
Mongolian Medical Sciences 2012;161(3):37-43
Background. In Mongolia, 320-350 people died per year due to traffic accidents. About 193 people were died in road of rural area. According to statistic, focusing on the accidents’ reason, about 94.9 percent of accidents are caused by faulty operation of driver and 0.4 percent is caused by road condition. Goal. The purpose of this study was to analyse the influence of road condition on the route Ulaanbaatar- Baganuur, where traffic accident have frequently occurred and through that find solutions to relieve the traffic accidents.Materials and Methods. Traffic safety was evaluated with coefficient of traffic safety that defined as divide the safe speed of vehicle on the road with invisible area such as crest and sag vertical curve and horzintal curve to the speed of vehicles from opposide direction. The average speed of vehicle on hill by having invisible of road curve inside, the end of road ascent and the road section that broke road asphalt surface were determined by stability and steering dynamic calculation.Result. According to the study, on the route Ulaanbaatar-Baganuur, within last three years, about 37 accidents were occurred. Accidents and conditions on the 14 stretches where accidents have frequently occurred were studied and analyzed by repetition, location and road condition and similarity of neighbor points, so on the 14 stretches, the accidents were occurred frequently. From those accidents, 24 people died and 87 people were injured. Classifying the accidents with 14 stretches, about 14 percent of accidents were occurred on the end of road ascent; 28 percent on straight section; 35 percent on curve; 16 percent on broken surface section of road; 7 percent on the place that road asphalt surface was missed partially. Decreasing the average speed of vehicle to 54.6 km/h on hill by having invisible of road curve inside, 64.2 km/h on the end of road ascent and 51.5 km/h on the road section that broke road asphalt surface were required.Conclusion. The coefficients of traffic safety are had between 0.30-0.81 on the sections that required limiting the traffic speed. In other words, the technical environment of traffic accidents consists on some points of this road.
4.Result of Immuno-Regulating Treatment in Active New Pulmonary TB Patients in Mongolia
Enkhtamir P ; Baatarkhuu O ; Naranbat N ; Yanjindulam P ; Enkhtuya S ; Munkhzul B ; Sarangoo G ; Oyungerel R ; Tsogtsaikhan S ; Altankhuu M
Mongolian Medical Sciences 2009;148(2):21-25
Background: Natural protection against Mycobacterium tuberculosis is based on cell-mediated immunity, which most importantly involves CD4+ and CD8+ T-cell subsets. Therefore, the evaluation of CD4+ and CD8+ T-cell profi les are important to evaluate cell-mediated immunity. Immuno-regulating therapy is important in increase of T cell subsets. Objective: To determine some T-cell subsets in active pulmonary tuberculosis patients following immunoregulating treatment in intensive phase of antituberculosis treatment, so to evaluate the treatment effect. Method: This study was conducted in TB clinic of National Center for Communicable Diseases (NCCD) between Aug 2008 and Mar 2009. CD4+ and CD8+-T cells were evaluated in 50 active pulmonary tuberculosis (infi ltrative form) cases before antituberculosis treatment (25 cases with Salimon-Study group, 25 cases without SalimonControl group) Patients with chronic disease, pregnant and alcohol users are excluded. The T cell subsets count was performed by FACSCount fl ow cytometer at the Immunology Laboratory of the NCCD,Mongolia.The monoclonal antibodies to CD3, CD4 and CD8 (Becton Dickinson) were used for the analysis. Result: CD4 count was 605,1242,7 cells/microL, CD8 count-470,92235,7 cells/microL, CD3 count-1130,7425,6 cells/microL, CD4/CD8 ratio was-1,480,67. CD4, CD8, CD3 cells were signifi cantly lower (P=0.05) in active pulmonary TB patients than in healthy Mongolian. And these subsets were signifi cantly lower in older patients (>50 age).There was no statistical signifi cance in sex and other age groups (p>0, 05). There were statistical signifi cances such as CD4 count, CD4/CD8 ratio (CD4-733,95314,38 cells/micro, CD4/CD8 ratio-1.870,7 in treatment group, CD4-570,54213.07 cells/micro, CD4/CD8 ratio-1.260.45 in control group) between TB and control group at the end of intensive phase of antituberculosis treatment (=0,05, =0,001). However, there were not any signifi cance CD8 count and CD3 count between two groups (CD8-423,68174,28 cells/microL, CD3-1212,27453,98 cells/microL in treatment group, CD8-500,67203,74cells/microL, CD3 -1139,33 386,47 cells/ microL in control group) (=0,05). Conclusion: 1. T cell subsets were signifi cantly lower in active,new,smear positive, pulmonary TB patients than in healthy Mongolians (p=0.05). 2. The statistical signifi cance is observed in 50 years and older TB patients (p=0.05). 3. CD4, CD4/CD8 were signifi cantly higher in patients treated with immuno-regulating treatment than in patients of control group (=0,05, =0,001).
5.IDENTIFICATION OF OSTEOPOROSIS RISK FACTORS
Nomundari B ; Arigbukh E ; Ujin Sh ; Delgerekh B ; Uurtuya Sh ; Erdenekhuu N ; Munkhzul M ; lkhagvasuren Ts ; Odkhuu E
Innovation 2018;12(1):16-20
BACKGROUND: According to International osteoporosis foundation report, osteoporosis is a multifactorial condition associated with an increased risk of fracture and is caused by social, behavioral and physiological factors. Overall incidence is increasing in every country due to people’s life style changes, diet and increased life expectancy.
OBJECTIVES: To evaluate the some hormonal effects in bone mineral density among Mongolian population.
METHODS: Bone density was measured in the distal one third of radius using the Sunlight Omnisense (Sunlight Medical, Rehovot, Israel) and classified into 3 groups according to WHO osteoporosis criteria. Normal participants were selected into control group and osteoporotic participants were selected into control group. We have evaluated PTH, calcitonin, 25-hydroxy vitamin D in case-control group.
RESULT: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. It was clear that PTH elevated group (>30.3pg/ml) had more risk of osteoporosis.
CONCLUSION: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. PTH elevation is risk factor in men.