1. STUDY OF URODYNAMIC TEST USED IN DIAGNOSIS AND ANALYSIS OF TREATMENT EFFECT IN URINE INCONTINENCE
Purevjargal J ; Munkhzul S ; Gantuya S ; Ulziisuren CH ; Sarangoo KH ; Munkhzul A
Innovation 2015;9(3):28-31
Urine-incontinence is most significant disease in general population its rate between 10-47%. One of the most widespreeding 10 disease’s one is incontinence in USA, In European population 17%, In Russian 16%. Stress incontinence prevalence in Mongolian women, 78.1% was urban population, 21.9% was rural. In already diagnosed population 30% of them were non-treatment group, 32.25% were underwent surgical treatment. Early diagnose, right treatment option choice, value of surgical treatment all of its result is valuable in practice. Urogynecology Division of First Maternity Hospital Of Mongolia patients who underwent urodynamic machine their economic background, etiological factors, symptoms, maternal status, gynecological check up result all of these factors were calculated by PAD- test. Positive patients diagnostic and treatment options were determined by machine. Prospective study were done within 43 women who diagnosed by urodynamic machine. We reassumed pre and post – treatment patient’s incontinence symptoms by machine. 79.3% percent of women diagnosed with stress incontinence had a history of coffee or tea usage. / p<0.01, QR=0.38/. Birth injury such as vaginal or perineal tear showed statistically significant impact on urine incontinency (82%) /p<0.04, QR=0.31/. Among the signs of urine incontinence, dribbling of urine during physical load was a statistically significant sign of stress incontinence. /p<0.04, QR=0.38/ The result of Pad test showed significantly low statistic importance compare to stress incontinence/p<0.01, QR=0.35/. The result of Pad test showed significantly low statistic importance compare to stress incontinence /p<0.01, QR=0.35/. 41/95%/ women showed normal bladder volume while 5% showed low bladder volume which is lower than 300 ml. Residual urine more than 100 ml showed statistically significant relation with stress incontinence /p<0.03, Q=0.32/. The main symptom of stress incontinence in women was urine leakage /p<0.01, Q=0.44/. Stress incontinence prevalence was 44.8% and overactive bladder was 25% in 36-55 age group. Children weight showed no impact on stress incontinence and overactive bladder. 83% of participants had birth number of ≥ 2 showing the statistical significant impact of birth number in urine incontinence (р>0.05, QR=0.8). From all participants, 60% had stress incontinence, 19% had no abnormality, 9% had overactive bladder, 7% had mixed urine incontinence, and 5% had other diseases (urethral atrophy and obstruction). From total 43 participants, 22(51%) had surgical treatment, 4(9%) had chemical treatment, 3(7%) had combined surgical and chemical treatment, and 14 (33%) had physical exercise. From 21 women who received surgical treatment, 16 had improvement and 5 had no improvement. Analyzing the treatment result of urine incontinence by questionnaire and urodynamic test showed improvement in 75 % of patients received surgical and combined surgical chemical treatment and 80% of improvement in patients received chemical and exercise treatment.High number of birth, high usage of coffee and tea, birth injury especially perineal tear are statistically significant factors of stress incontinence development.Pad test is effective test used in diagnosis, treatment planning and monitoring treatment results of urine incontinence.Urine leakage symptom occurs 44% more in women with stress incontinence. 24% of women with stress incontinence were diagnosed without abnormality by urodynamic test. Urodynamic test has a diagnostic importance in treatment planning, individual treatment choice and increase of treatment effect in urine incontinence patients.
2.Some social and economic problems of mother’s who gave stillbirth
Jav B ; Chimedsuren O ; Munkhzul S
Mongolian Medical Sciences 2011;172(2):41-44
Objective: To clear up of influence of society, economy family and mood of pregnant mother who gave stillbirth.Material and Methods: We chose 50 mother’s who gave stillbirth by case group, 50 mother’s who gave normal birth by control group by randomized method, research was conducted by specially prepared card and descriptive method, we compared placenta of mother’s who gave stillbirth and normal birth by pathologic analyse and working out was done by using SPSS 14.0 programme and difference between index was concluded by X 2 and F criteria.Results: Normal birth of mother’s who participated in the research is 19(16.7%) at the age 11(84.6%), at the age of 40-44 normal birth 1(50.0%), stillbirth 1(50.0%) stillbirth risk is increased under 19 and over 35, it has statistic probability (p=0.026). In 5(17.9%) of mother’s who gave normal birth, 23(82.1%) of mother’s who gave stillbirth. A member of her family smokes, in 45(62.5%) of mothers who gave normal birth, in 27(37.5%) of mothers who gave stillbirth a member of a family does not smoke .Seeing from this smoking of a family member affect to stillbirth and it has statistic probability (p=0.000).18(54.5%) of mothers who live in ger, 12( 35.3%) of mothers who live in a yard and a house, 20( 60.6) mothers who live in a flat gave normal birth. Seeing from this condition of living in a yard or in a house is worse that condition of living in a flat, it influence to stillbirth, it has probability for statistic (p=0.055). Conclusion: When women gives birth to a child under 19 and over 35 increases risk of stillbirth. It has statistic probability (p=0.026). Smoking of family member affects to stillbirth, it has statistic probability (p= 0.000). Condition of living in a yard and house is worse than living in a flat, it affect to stillbirth, it has probability for statistics (p=0.055).
3.RESULTS OF DIAGNOSTIC AND OPERATIVE HYSTEROSCOPY WHICH STUDIED IN FIRST MATERNITY HOSPITAL
Enkhbat Ts ; Myagmartseren B ; Batgerel G ; Batnyam B ; Oyungerel Kh ; Unurgargal D ; Munkhzul S
Innovation 2015;9(3):16-19
Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.
4. 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/
5. RESULTS OF DIAGNOSTIC AND OPERATIVE HYSTEROSCOPY WHICH STUDIED IN FIRST MATERNITY HOSPITAL
Enkhbat TS ; Myagmartseren B ; Batgerel G ; Batnyam B ; Oyungerel KH ; Unurgargal D ; Munkhzul S
Innovation 2015;9(3):16-19
Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.
6.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).
7.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.
8.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.