1.The result of quality parameters determination of amlodipine 10 mg tablet
Mongolian Medical Sciences 2012;162(4):103-106
BackgroundAmlodipine is one of the products included in Mongolian Essential Medicine list. Local drug manufacturers don’t produce this product and our country imports this product from several countries. Drug research institute has developed the technology to produce Amlodipine 10 mg tablet on the scientific basis and quality determination and stability study have to be performed.GoalThe main aim of this study was to perform quality determination of Amlodipine 10 mg tablet. In the framework of this study quality criteria were determined and HPLC method to determine amlodipine content was developed.Materials and MethodsThe appearance and average weight of tablet determined visual and weight test method instead of Mongolian national Pharmacopeia. Friability, disintegration time, dissolution characteristics determined SY-6D tablet tester equipment. Assay method was instead of British and Russian pharmacopeia used by Shimadzu HPLC equipment[3, 4]. Amlodidine besilate standard substance was made by Sigma-Aldrich company. The microbial limit test determined instead of Mongolian national Pharmacopeia.ResultsOn the result of this study the following results were received: average weight 0.177 g, weight range +6.5, - 2.1; tablet friability 99.57%, disintegration time 7 seconds, dissolution 97%, meet the requirement uniformity of dosage unit. HPLC method to determine amlodipine content was developed and suitable condition for HPLC was: column - octadecylsilane 5μm, 4.6 x 150 mm, mobile phase buffer-acetonitrile-methanol (50:15:35), detection - 237 mn. Bacteria, yeasts, mould and Escherichia coli were absence in Amlodipine 10 mg tablet.ConclusionsDetermined quality requirement of Amlodipine 10 mg tablet. The assay method developed suitable condition of HPLC instead of British pharmacopeia. Bacteria, moulds, yeast and Escherichia coli were absence in Amlodipine 10 mg tablet.
2.The correlation between of coronary atherosclerosis and lipid metabolism disorders
Purevsuren D ; Sodgerel B ; Tuvjargal CH
Mongolian Medical Sciences 2010;153(3):28-31
Introduction:The traditional lipid and lipoprotein levels in patients with familial combined hyperlipidemia (FCHL) are relatively mildly elevated and do not fully explain the increased risk of cardiovascular disease (CVD). Hypercholesterolemia, hypertriglyceridemia, and elevated levels of apolipoprotein-B (apo-B) characterize FCH. Familial combined hyperlipidemia (FCHL) is a common lipid disorder characterized by elevated levels of plasma cholesterol and triglycerides that is present in 10% to 20% of patients with premature coronary artery disease. The importance of plasma TG as an independent risk factor for CAD was recognized provided support for the earlier observation that plasma TG levels predict relative risk in relatives of FCHL patientsGoal: To study of correlation between of lipid metabolism disorders and coronary atherosclerosisObjectives:- To define correlation of parameters of lipid metabolism in ischemic and control groups- To compare number of injured coronary arteries and parameters of lipid in ischemic menResults:In our study we involved 86 patients who were investigated coronary angiography. Of them 72 (82.7%) patients revealed changes of coronary artery, and one vessel change was 30 (41.6%), two vessels changes were 28 (38.9%), and three vessels 14 (19.4%) respectively. Lipid levels were significantly increased in case group compared with controls. There were no significant difference in number of injured coronary artery and lipid level.Conclusion:In this study found triglyceride was high level than cholesterol, LDL in ischemic disease. Familial combined disorder of metabolism lipid is possible to depend on hyperlipoproteinemia IIB type. Apolipoprotein B (108.5±3.2 mg/dl) was increased compare with control group (89.6±3.4 mg/dl) in ischemic disease.
3. Public Health Service Needs of Pharmacy Customers
Narangerel B ; Erdenekhuu N ; Purevsuren S
Innovation 2016;10(1):30-34
Although all the pharmacy programs (1 public and 2 private) in Mongolia comply with the national standard for pharmacy higher education D 723400 (MNS 5323-126: 2012), competence based learning has not been introduced yet. Also, pharmaceutical public health service needs have not been assessed in community pharmacies of Mongolia. Our goal was to assess the learning needs of pharmacists’ public health competencies and link pharmacy education with the health needs of populations.This cross-sectional, in-pharmacy survey was conducted in a simple random sample of community pharmacies in 6 districts of Ulaanbaatar city central region, which provide price discount on selected drugs through national health insurance. The survey was developed with evidence for reliability and validity and focused on two main needs assessment: pharmaceutical public health (PPH) serviceprovision and PPH competencies learning. Open ended and 3 point scale (1=great benefit; 2=some benefit; 3=no benefit) questions were used to obtain: general information, public health service knowledge, and needs of learning PPH competencies. Descriptive statistics and comparisons using STATA 13 were performed.A total of 248 surveys were obtained (pharmacists n=82; customers n=166). Pharmacist knowledge/skills greatly impacted the public’s decision to use expanded services. The customers reported high levels (75.3%) of needs with pharmacists providing advice on health promotion and healthy life style. 47.6% of the pharmacists replied having knowledge on health promotion and disease prevention is a great benefit to their practice.Our findings indicate that the public is very interested in pharmaceutical public health services and believe they will benefit. Also pharmacists need to be trained ecessary competencies.
4. COMPARATIVE ANALYSIS OF SOME CAPSULES REGISTERED IN MONGOLIA
Ankhtuya B. ; Oyuntsetseg G. ; Purevsuren S.
Mongolian Pharmacy and Pharmacology 2013;2(1):42-
Introduction: Mongolian national drug manufacturers produce only 20% of required medicines and most raw materials used for the manufacturing are imported from China [1]. 2574 medicines and active pharmaceutical ingredients were registered in 2011 and 488 of them were antibiotics [2]. There were 36 medicine manufacturers and only two of them manufactured antibiotic capsules in 2010 [3]. In last year number of manufacturing capsule has been increasing.Aim: The main aim of this investigation was to define items of imported and manufactured capsules and do comparative analysis of some capsules and determine types of the capsule drugs registered in Mongolia.Material and methods: Registered medicine list of Mongolia and questionnaire with 22 questions, and capsules of 2 domestic and 3 foreign manufacturers were used for this investigation. Pharmacists working in seven domestic manufacturers were involved in the questionnaire study. Capsules were analyzed at the Drug Control Laboratory of Monos Pharm Manufacturer.Results, conclusion: 10.84% of registered medicines are capsules, of which 16.33% from India, 7.82% from China, 5.78% from Indonesia, 8.5% from Slovenia, and other countries. 3.4% of registered capsules are manufactured in Mongolia.All medicine manufacturers import hard gelatin capsules from China and use for the manufacturing. 71.4% of domestic manufacturers use technological parameters, 57.1% stability and dissolution, 28.5% chemical properties and interaction with active pharmaceutical ingredients and excepients as the main criteria for the capsule selection used for the manufacturing. 40.0% of capsules used for the manufacturing are 0 size capsule.72.2% of manufactured capsules are antibiotics. Quality parameters of imported and manufactured Quality of manufactured and imported Ampicilline capsules were determined in the frame of this investigation. All Ampicilline capsules were met the requirements of MNS 5097:2007.Conclusion: Items of imported and manufactured capsules, selection criteria of capsules used for the manufacturing were determined. Comparative quality analysis of Ampicilline capsule was done and some quality parameters of imported and manufactured Ampicilline capsule were in accordance of MNS 5097:2007.Key words: Ampicillin trihydrate 500 mg, dissolution testReference:1. д. Цэндээхүү, “Эмийн чанарûн хяналтûн зарим асуудалд”, “зшЭ-ийн хүртээмж, хэрэглээ, чанар, аюулгүй байдлûн талаар туршлага солилцъё” олон улсûн бага хурлûн илтгэлийн хураангуй; 2006.2. Эрүүл мэндийн үзүүлэлт 2011. згха-Эмг. уБ. 20113. Эрүүл мэндийн үзүүлэлт 2010. згха-Эмг. уБ. 20104. монгол улсûн эмийн бүртгэлийн жагсаалт 2013
5.Trends of health care professionals toward adverse drug reaction reporting
Narankhuu E ; Erdenetuya M ; Purevsuren S ; Baysgalan B ; Sarnaizul E ; Tungalag B
Mongolian Medical Sciences 2013;164(2):59-62
IntroductionThe detection of adverse drug reactions has become increasingly significant because of introduction of a large number of potent toxic chemicals as drugs in the last two or three decades. Adverse drug reaction (ADR) monitoring and reporting activity is in its infancy in Mongolia. The important reason is lack of awareness and lack of interest of healthcare professionals in ADR reporting and documentation.GoalTo evaluate implementation and trends of health care professionals toward adverse drug reaction reporting at first, second and tertiary level hospitals.Materials and MethodA prospective study was carried out in first and second level hospitals of Khentii, Dundgovi, GoviAltai, Selenge and Uvurkhangai provinces, Sukhbaatar, Songinokhairkhan district hospital and First maternaty hospital. From tertiary level hospitals were selected First national hospital, Third national hospital, National center of oncolgy, National center of traumatolgy. The questionnaire survey involved total of 175 doctors and pharmacists.ResultsThe study result have shown that most of health care profeesionals (76 – 80%) of first and tertiary level hospitals have known about legal bases and theie duties for the ADR reporting than health care professionals (69%) of secondary level hospitals. And, pharmacists more activily involve in ADR reporting than doctors. The main reasons of healthcare professionals ADR underreporting were lack of time to report, lack of awarness about ADR and not knowing importance of ADR repoting. The implementetion extent of ADR reporting was in tertiary level hospital better than in secondary level hospitals. Lacking of clinical pharmacists and clinical pharmacologists and unproper activitity of Drug therapeutic committee in secondary level hospitals were the reason of poor implementing and underreporting of ADR.ConclusionThe study result has shown that there is needed to encourage doctors to the adverse drug reporting activity and implementation of drug safety should be strengthen in each level of health care system.
6.The structure of disease among children department of maxillofacial surgery
Purevsuren B ; Ayanga G ; Norovpil Ts
Mongolian Medical Sciences 2018;185(3):88-93
Introduction:
The department of Maxillofacial surgery of the National Center for Maternal and Child Health (NCMCH) has a nationwide tertiary medical service on the patients who is with congenital orofacial
anomalies, facial injury, nonmalignant tumors of this area, and inflammations of maxillofacial area
following dental caries and other reasons as well. For the last years nationwide the number of inpatient of the department has been growing constantly meaning that the necessity of medical care for
our countries for children is also growing. Therefore by studying and analyzing the structure of the
illness of the department will be able to determine the most frequent orofacial illness among children
in our country, to prevent them, define the treatment plan.
Aim:
To clarify what disease in the Maxillofacial area mainly occurs among Mongolian children.
Materials and Method:
We included all patients who underwent emergency and planned surgery in the department of Max-illofacial surgery, NCMCH between 2014-2015.
We used descriptive and case-control method based on the information of inpatients history record
between 2014.01.01-2015.01.01 at the department of Maxillofacial surgery, NCMCH and using our
own –designed, pre-screened survey card.
Statistical data processing is done using Microsoft Office-2017 and SPSS for windows programs,
and the results are shown illustrated method. The survey identified the incidence and frequency of
each disease classification, and analyzed the characteristics of the child’s age, sex, and residency.
Result:
The most of patients, who involved in this study were with the inflammation of maxillofacial area
(57%), and the congenital orofacial clefts (24.4%).
In total 3300 children from 0-18 years old admitted at the department of Maxillofacial surgery and
Infants study for orofacial surgery treatment were involved in this study.
Among which were 1803(54.6%) male, 1497(45.4%) female. Considering the residency, 2525(76.5%)
children from Ulaanbaatar and 775 (23.5%) children from countryside. The most of patients, who
involved in this study, were with the inflammation of maxillofacial area (57%), and the congenital
orofacial clefts (24.4%).
Conclusion
Based on the result of our study the highest incidence among the participants was inflammation of
maxillofacial area with 57% in which odontogenic periostitis was the most frequent with 21.6%. Congenital orofacial clefts and disorders was the 2nd most frequent with 24.4%. Inflammation of maxillo-facial area was most frequent in 0-2 age group with 33.7%, and mostly in male. Considering there
were residency with 83.2% highest in Ulaanbaatar and mostly in Bayanzurkh district with 24.7%.
7.The structure of odontogenic inflammation among children
Purevsuren B ; Ayanga G ; Norovpil Ts
Mongolian Medical Sciences 2020;194(4):3-9
Introduction:
The department of Maxillofacial surgery of the National Center for Maternal and Child Health (NCMCH)
has a nationwide tertiary medical service for the children who is with congenital orofacial anomalies,
facial injury, nonmalignant tumors of this area, and inflammations of maxillofacial area following
odontogenic infection and other reasons as well. For the last years the number of the patients who
are with odontogenic inflammation on the department has been growing constantly meaning that
the necessity of medical care for our countries for children is also growing. Therefore by studying
and analyzing the structure of the odontogenic inflammation and to determine the most frequent
odontogenic inflammation among children in our country, to prevent them, define the treatment plan.
Aim:
To clarify what kind of odontogenic maxillofacial inflammatory diseases mainly occurs among
Mongolian children.
Materials and Method:
We included all patients who are with odontogenic inflammation and underwent emergency and
planned surgery in the department of Maxillofacial surgery, NCMCH between 2014-2018.
We used descriptive method based on the information of inpatients history record between 2014.01.01-
2018.12.31 at the department of Maxillofacial surgery, NCMCH and using our own –designed, prescreened survey card.
Statistical data processing is done using Microsoft Office-2019, SPSS for windows and STATA
programs, and the results are shown illustrated method. The survey identified the incidence and
frequency of each disease classification, and analyzed the characteristics of the child’s age, sex, and
residency.
Result :
In total 3533 children with odontogenic inflammation, whom age range is 0-18 years old, admitted at
the department of Maxillofacial surgery for the surgical treatment were involved in this study.
Among which 1452(41.1%) male, 2081(58.9%) female. Considering the residency 2918(82.5%)
children from Ulan-Bator and 615 (17.5%) children from countryside. The most of patients, who
involved in this study were with odontogenic periostitis of maxillofacial area (67.5%), most were girls
and preschool age (3-5 ages).
Conclusion
Based on the result of our study the most frequent inflammation was odontogenic periostitis of maxilla
and mandible bone with 67.5%. The odontogenic phlegmon of orofacial area was the 2nd most
frequent with 25.1%.
Inflammation of maxillofacial area was most frequent in 3-5 age group (preschool age) with 41.4%,
and mostly in male. Considering the residency with 82.5% highest in Ulanbator.
8.To determine the probability of developing heart defect seguence method that degects seguence in dna nucleotide of responsible genes for most common heart defects
Baasanjav N ; Sodnomtsogt L ; Purevsuren D ; Badamsed TS ; Sodgerel B ; Tuvjargal CH ; Achitmaa M
Mongolian Medical Sciences 2014;168(2):18-24
BACKGROUND:Congenital heart defects (CHD) turn out to be the leading cause of infant mortality in their first yearafter infectious diseases. Per 1,000 infants, born with CHD, about 19-75 failed to survive. It revealsthe fact that CHD is a major cause of childhood mortality in worldwide. Beyond the progress ofmedicine and surgery, the cause of CHD is not fully defined. The majority of studies reveal that CHDis triggered by many factors, such as the genetic and environmental factors.Based on the evidences of the sequence of the human genome and advances in moleculartechnology, genetic factors play a major role. Per 100 newborninfants, they’re found one child, bornwith a CHD is concerned as a highly frequent incident for birth anomaly. Only 0.5% of these congenitaldefects enable to be inherited in accordance with Mendel’s genetic laws, which is associated withthe change and mutation of a single gene. Many found that most congenital anomalies dependupon mutation or change in multiple genes and other relevant factors. As a result of the progressivedevelopment of molecular biology in the past 20 years discovered a range of genes involved in fetusformation, development, growth and control of processes. In our country case, corrective surgeryfor CHD dominates among all cardiovascular surgery in Mongolia. Particularly, for all incidents donesome corrective surgery of congenital heart defects, atrial septal defect operation occupies 42.44%,in other word it is a substantial part of the CHDoperation (D.Tsegeenjav, 2009). Molecular geneticsstudy of infant born with heart defects and simultaneous anomaly of other organ system researchstill has not been done for Mongolian population. In many cases the diagnosis of CHD is delayeduntil their adulthood, which is a research gap to address without further delay and the finding mustbe applied in practice in the near future.GOAL:The aim of the research is to conduct a molecular genetic study of children, born with CHD andcombined abnormalities of other organs and systems, identify gene lesion, location and characteristicsof mutations, pathogenetic mechanism of congenital defects and anomalies among the Mongolianpopulation.RESULT:For this study, there are 118 patients, with congenital heart disease, received surgical treatmentin the cardiovascular department of III central state hospital named P.N. Shastin, involved afterconfirmed diagnosis through objective and instrumental investigations (ECG, Fluoroscopy, EchoKG).The 118 healthy family members of patients sampled as a control group. According to the diagnosisof patients with congenital heart defect, such as atrial septal defects-95 (81.2% ± 3.6), ventricularseptal defects-17 (14.5% ± 3.3), patent ductusarteriosus- 2 (1.7± 0 .0%) have combined severedefects - 4 (3.3% ± 1.0). Out of 118 patients with congenital heart defects, 32.2% (38 patients)was male, whereas women accounted for 67.8% (80 patients) with average age of 22, 3 ± 12.9(minimum 1.0 year, maximum 51 year). These comprised 42.4% in 1-17 years old (average age10 ± 5.27) and 57.6% in 18-51 years old (average age 31 ± 9.54). The 33.9% ± 4.4 (40 patients) of operated patients responded the questionnaire that they have a hereditary heart defect. Shortnessof breath, heart pain, and recurrent pneumonia were the main complaints of patients with CHDthat significantly authentic to statistical probability. From the taken 118 blood samples, 95 werediagnosed ASD, in 7 diagnosed VSD, in 2 diagnosed PDA, in 4 diagnosed combined defects. Forthe 95 samples, we decided to examine the ASD associated GATA4, TBX5gene. It draws attentionto the fact that 81.2% of all congenital heart defects found only ASD. To examine the ASD genes inthe sample, the following changes have occurred. The study found 8 variants of mutations formingASD. It includes on exon 1 Gly 93 Ala (c.278G> C), on exon 1 P163S (c.487C>T).CONCLUSIONS:1. Patients with ASD alone occupy 81,2% of all heart defects in our study.2. For the samples of ASD, the study found 8 different mutations of GATA4.3. In the sample of blood not found TBX5 gene mutation.4. In the samples, one patient with dextrocardiasitusinvertus was combined with congenital heartdefects found E359Xfs (c.1075delG) deletion variation on exon3.
9.The apolipoprotein B/A-1 ratio in practically healthy participants with normolipidemia
Sodgerel B ; Pilmaa Yo ; Galsumiya L ; Purevsuren D ; Badamsed Ts
Mongolian Medical Sciences 2019;189(3):3-9
Introduction:
Studies demonstrated that the apolipoprotein B/apolipoprotein A-I (Apo B/apo A-I) ratio predicts
cardiovascular risk better than any of the cholesterol indexes. Apo B and Apo A-1 are assumed to be
superiormarkers for lipoprotein abnormalities [1,2]. The concentrations of Apo B and Apo A-1 are associated with cardiovascular disease more strongly than the corresponding lipoprotein cholesterol fractions, the discriminant value of these apoproteins in absolute terms appears to be less important than of their ratio (the Apo B/Apo A-1 ratio) [3, 5-7]. The Apo B/Apo A-1 ratio reflects the balance of atherogenic and antiatherogenic lipoproteins in plasma [4]. Multiple clinical and epidemiological studies have confirmed that the Apo B/Apo A-1 ratio is a superior marker for cardiovascular disease compared with lipids and lipoproteins or their ratios [8, 9].
Goal:
We determined the variation limits of the Apo B/Apo A-1 ratio in healthy participants with normolipidemia
and the relationship of this ratio with other lipid parameters.
Material and Methods:
A total of 146 normolipidemic healthy participants aged 25–60 years were included in the study.
Anthropometric measurements (height and weight) and other personal information were obtained during the clinical examination and the interview. Participants were included in the study using the following criteria:
1. body mass index < 30 kg/m2;
2. TC < 5.2mmol/L;
3. triglycerides (TG) ≤1.7 mmol/L;
4. HDL-C ≥1.03 mmol/L ( woman), ≥ 1.29 mmol/L (male) .
The plasma levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apo A-I, Apo B and Apo B/Apo A-1 were determined after a 12 h fasting period. The non-HDL-C was calculated as the difference between the TC and HDL-C. Most research data emphasized that the values for the Apo B/Apo A-1 ratio that define a high cardiovascular risk were proposed to be 0.9 for men and 0.8 for women. Statistical Analysis. The statistical analysis was performed using SPSS 21.0 (USA). Differences between the groups were analyzed using the Mann-Whitney test and the chi-squared test. Correlations between the indices were assessed using
the Spearman’s rank correlation. A value of < 0.05 was accepted as statistically significant.
Results:
The relationship of ratio of apolipoprotein (Apo) B/Apo A-1 with other indicators of lipid metabolism in
healthy people with normal lipidemia was analyzed. The Apo B/Apo A-1 ratio in the studied normolipidemic
subjects was 0.69 ± 0.17. The percentage of subjects with the Apo B/Apo A-1 ratio exceeding 0.9 (the
accepted risk value of cardiovascular disease) was 36.3 %.The subjects with Apo B/Apo A-1>0.9 were
characterized by higher HDL-C levels and atherogenic Aпo B, Apo B/Apo A-1 but lower values Apo A-1.
Conclusion
The subjects with normolipidemia the unfavorable Apo B/Apo A-I ratio> 0.9 had more atherogenic lipid
profile.
10.Study on lipid profile values in Mongolian adults
Pilmaa Yo ; Sodgerel B ; Galsumiya L ; Purevsuren D ; Badamsed Ts
Mongolian Medical Sciences 2019;189(3):10-15
Introduction:
Cardiovascular Disease (CVD) is a major cause of morbidity and a leading contributor to mortality in both
developed and developing countries. With rapid socioeconomic development, CVD has reached epidemic
proportions in developing countries in recent decades. Dyslipidemia, elevated level of plasma cholesterol,
together with arterial hipertension, is the main modifiable risk factor atherosclerosis and cardiovascular
diseases (CVD) development. Surveys to monitor and measure dyslipidemia burden in a Mongolian
population has not been conducted in recent years and the available data on the prevalence, types,
and associated factors of dyslipidemia in the general population is relatively insufficient and outdated.
Monitoring of lipid profile at populational level is an important instrument of prevention medicine, applied
for CVD populational risk assessment.
Goal:
Evaluate comparisons of adult blood lipid levels in age, gender and location.
Material and Methods:
In this study, 500 people aged 25-65 were classified into age groups (47.1% for males and 52.9% for
females). Blood plasma in total cholesterol (TC), triglyceride (TG), high density (HDL-C) and low density
(LDL-C) lipoprotein-cholesterol, apolipoprotein - ApoA1, Apo B and ratio of ApoB / ApoA1 were estimated.
Statistical analysis was performed using SPSS 22.0
Results:
Mean age of the participants was 48.8±14.2 years old. Mean values for male TC-4.85±0.92 mmol/l, TG-1.58±1.19 mmol/l, LDL-C-3.24±0.98 mmol/l, HLD-C-1.62±0.21, for women- 4.47±0.96 mmol/l, 1.22±0.47
mmol/l, 2.95±1.01 mmol/l, 1.77±0.23 mmol/l respectively. The mean blood TC,TG levels tended to
increase with age group in male compared to women. The prevalence of an increased blood LDL-C levels
or risks for an increased blood LDL-C was statistically significantly high in male.
Conclusion
The prevalence of lipid was shown as high, that demands respective prevention and management.