1.Effects of flavanone on cancer cells viability
Jadamba Ch ; Erdenezaya O ; Iderjavkhlan S ; Burnee M ; Gurbadam A ; Temuulen D ; Darambazar G ; Oldokh O ; Enkhmaa D ; Giimaa N
Mongolian Journal of Health Sciences 2025;88(4):28-32
Background:
In recent years, scientists have found that certain natural compounds have significant potential in cancer
prevention and early-stage cancer treatment. Flavanones, a class of polyphenolic compounds found in plants, vegetables,
seeds, fruit peels, and flowers, have been identified to possess anticancer, antioxidant, anti- inflammatory, and antibacterial bioactivities. Cancer has become a major global challenge in terms of both economic and public health concerns.
Global statistics indicate that 22.8% of deaths are attributed to non-communicable diseases, and 16.8% are caused by
cancer, accounting for one in four and one in six deaths, respectively.
Aim :
To investigate anticancer effects of Iris Tenuifolia-derived flavanone on cancer cell lines.
Materials and Methods :
The study was conducted at the Bio-Medical Research Institute of the Mongolian National Uni
versity of Medical Sciences, investigating the effect of flavanones on cancer cell viability under in vitro conditions using
the MTT assay. In the study, colon, liver, and lung cancer cells were cultured, stabilized, and used for the experiments.
Colorectal cancer cells (MC38), liver cancer cells (HepG2), and lung cancer cells (A549) were revived, cultured, and
stabilized for use in the experimental procedures. Statistical analysis of the results was performed using Microsoft Excel
2010, and graphs were generated using GraphPad Prism 8. Differences between groups were analyzed using Student’s
t-test, and a p-value of <0.05 was considered statistically significant.
Results :
We treated MC38, HepG2, and A549 cancer cells with different concentrations of flavanone (2.5 µM, 5 µM, and
10 µM) for 24 to 48 hours to evaluate cell viability. Flavanone inhibited A549 cell viability by 2.5 μM-10%, 5 μM-25%,
and 10 μM-38%, respectively. For HepG2 cells, flavanone treatment at concentrations of 5-10 µM reduced cell viability by 28–58%. No statistically significant effect on the viability of MC38 cells was observed following treatment with flavanone at concentrations ranging from 2.5 to 10 µM. Additionally, although MC38 inhibited cell viability in a dose-de
pendent manner in cell cultures, it had a statistically significant effect at higher concentrations of 30-200 μM (p<0.01).
Conclusion
Flavanone inhibits the cancer cell viability in a dose and time dependent manner
2.Management and monitoring of hypokalemia occurring during certain diseases
Temuulen Ts ; Maral B ; Baasanjargal B ; Agidulam Z ; Burenbayar Ch ; Ankhbayar D ; Tsogdulam S ; Amardulguun S ; Otgon-Erdene M ; Anujin G ; Khongorzul U1 ; Delgermaa Sh ; Odgerel Ts
Mongolian Journal of Health Sciences 2025;86(2):51-54
Background:
Hypokalemia is considered when the serum potassium level is less than 3.5 mmol/L. Clinical research indicates
that hypokalemia affects 20% of hospitalized patients, and in 24% of these cases, inadequate interventions result
in life-threatening complications. At present, there is no research available on the prevalence, management, and outcomes
of hypokalemia in hospitalized patients, which justifies the need for this study.
Aim:
The study aimed to examine the prevalence of hypokalemia and the effectiveness of its management in hospitalized
patients within the internal medicine department, in relation to the knowledge of doctors and resident physicians.
Materials and Methods:
This hospital-based retrospective study included a total of 553 cases of patients hospitalized in
the Internal Medicine Department of the Mongolia Japan Hospital between January 2024 and August 2024. Patients with
a potassium level of <3.5 mmol/L were diagnosed with hypokalemia, and the effectiveness of potassium replacement
therapy was evaluated according to the method of supplementation employed.
Results:
The prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department was 9.8%
(54 cases). Based on the study criteria, 42 cases of hypokalemia were selected for further analysis, and a total of 118 potassium
replacements were performed through oral, intravenous, and mixed methods. Following potassium replacement
therapy, 37.3% (44) of patients achieved normalized potassium levels, while 62.7% (74) still had persistent hypokalemia.
Conclusion
According to the study results, the prevalence of hypokalemia among hospitalized patients in the Internal
Medicine Department is 9.8%. The method of potassium replacement and the severity of hypokalemia do not impact the
normalization of potassium levels, with the critical factor being the proper dosage of supplementation. The knowledge
of doctors and resident physicians regarding hypokalemia is insufficient, and there is a need to implement guidelines and
protocols for potassium replacement therapy in daily clinical practice.
3.Central serous chorioretinopathy
Temuulen B ; Baasansuren G ; Byambadorj M ; Uranchimeg D
Mongolian Journal of Health Sciences 2025;85(1):257-262
Background:
Central serous chorioretinopathy (CSCR) is described by researchers as a condition that results from fluid
under the retinal pigment epithelium, originating from the choroid of the eye. This disease usually affects the central part
of vision and may resolve on its own over time, though in some cases, it can persist for long periods or recur. In our country, there is a lack of research regarding this condition, which led to the motivation for gathering and reviewing existing
works on this topic.
Aim:
To collect and analyze a review of the studies on central serous chorioretinopathy (CSCR).
Methods:
We reviewed and analyzed literature related to CSCR published in electronic sources such as Thomson Reuters, PubMed-central database, and Google Scholar using literature review methods.
Results:
CSCR is most commonly seen in individuals aged 35-55 years, with a significantly higher prevalence in men
(9.9/100,000) compared to women (1.7/100,000). Researchers found that the prevalence of CSCR is nearly the same
among populations in Europe, Africa, and Asia. CSCR typically affects one eye, but it occurs in both eyes in up to 40%
of cases. Weenink A (2001) studied the family members of 27 patients with bilateral CSCR, finding that 52% of family
members had been diagnosed with CSCR, and 27.5% of them had chronic CSCR in at least one eye. This suggests a
potential genetic predisposition to CSCR. According to researchers, while CSCR can be diagnosed clinically, additional
imaging techniques like fluorescein angiography and optical coherence tomography are frequently used to rule out other
diagnoses and guide treatment.
Conclusion
CSCR generally has a favorable prognosis, but recurrences and its effects on visual function indicate the
need for effective management strategies. To maintain long-term visual improvement, it is essential to provide healthcare
services tailored to the patient’s specific conditions and risk factors.
4.The Correlation Between Prognostic Indicators of Chronic Liver Diseases and Certain Blood Test Parameters
Munkhtsetseg M ; Allabyergyen M ; Temuulen Ts ; Narangere .B ; Temuulen E ; Sumiyabazar A ; Bolormaa B ; Munkhuu A ; Dorjzodov D ; Munkhbat R ; Odgerel Ts
Mongolian Journal of Health Sciences 2025;86(2):191-195
Background:
Hepatocellular carcinoma (HCC) is a primary liver cancer originating from liver cells, classified as a chronic
liver disease. This cancer ranks third in the world in terms of mortality rate. The MELD (Model for End-Stage Liver
Disease) and Child-Pugh scoring systems are utilized to assess the prognosis of chronic liver diseases. Based on studies
suggesting that certain blood test indicators, particularly red cell distribution width (RDW), could be used to predict the
prognosis of liver cancer and other cancers, as well as serve as diagnostic markers, this topic was chosen to evaluate the
clinical significance of RDW in hepatocellular carcinoma.
Aim:
The aim is to study some blood test indicators and compare them with the MELD score and Child-Pugh score systems
in order to determine the prognosis of chronic liver diseases.
Materials and Methods:
A retrospective, single-center, cross-sectional study was conducted at Mongolia-Japan Hospital.
Among 322 patients diagnosed with HCC, 24 patients were selected for the case group, and 37 patients with liver cirrhosis
were included in the control group.
Results:
According to the research criteria, 61 patients were selected and divided into 3 groups, and statistical analysis
was performed. In the detailed blood test, platelet count and WBC count showed statistically significant differences
among the 3 groups (p< 0.024). In the biochemical tests, C-reactive protein (CRP) was p< 0.018, total bilirubin p< 0.001,
and the mean albumin level p< 0.015, all showing statistically significant differences among the 3 groups. A statistically
significant inverse correlation was observed between RDW-CV and the clinical MELD score (r=-0.356).
Conclusion
Platelet count, RDW, CRP, total bilirubin, and average albumin levels are significantly different across the
studied groups. RDW-CV shows a moderate inverse correlation with MELD scores, suggesting its potential as a prognostic
marker in chronic liver diseases. Further research with larger sample sizes is recommended to confirm these findings.
5.Effect of flavanone on the migration of lung cancer cells
Jadamba Ch ; ; Erdenezaya O ; Iderjavkhlan S ; Burnee M ; Gurbadam A ; Temuulen D ; Darambazar G ; Oldokh O ; Enkhmaa D ; Giimaa N
Mongolian Journal of Health Sciences 2025;89(5):129-132
Background:
In recent years, natural compounds have been shown to play an important role in cancer prevention and
early-stage therapy. Flavanones, a class of polyphenolic compounds present in plants, vegetables, seeds, fruit peels, and
flowers, have been identified to possess anticancer, antioxidant, anti-inflammatory, and antibacterial bioactivities. Cancer
has become a major global economic and public health challenge. According to international statistics, one in four individuals
(22.8%) die from non-communicable diseases, while one in six (16.8%) die from cancer.
Aim:
To investigate the effect of flavanone (5,2’,3’-trihydroxy-6,7-methylenedioxyflavanone) isolated from Iris tenuifolia
on the migration of lung cancer cells.
Materials and Methods:
The study was conducted at the Institute of Biomedicine, MNUMS. The effect of flavanone
(5,2’,3’-trihydroxy-6,7-methylenedioxyflavanone) on cancer cell migration was evaluated in vitro using the scratch assay.
Human lung cancer cells (A549) were revived and stabilized before experiments were performed.
Results:
We treated A549 cancer cells with different concentrations of flavanone (1.25 μg/ml, 2.5 μg/ml) for 24 hours
and analyzed them using the scratch assay. A cell-free gap of 0.9 mm in width was created, and after 24 hours, A549 cells
migrated and proliferated into the gap, reducing its width to 0.25 mm. Treatment with 2.5 μg/ml flavanone completely
inhibited cell migration.
Conclusion
Flavanone isolated from Iris tenuifolia inhibits lung cancer cell migration in a doseand
time-dependent manner.
6.Assessment of rational use of antibiotics among hospitalized pregnant women at the National Center for Maternal and Child Health
Oyungerel V ; ; Temuulen T ; Sosorbaram A ; Purevsuren S ; Tungalag B
Mongolian Journal of Health Sciences 2025;90(6):178-183
Background:
Pregnancy induces multiple physiological, metabolic, and immunological alterations that increase susceptibility to infections, often necessitating antibiotic therapy. Evaluating the rational use of antibiotics among pregnant
women is crucial for optimizing antimicrobial stewardship at the hospital level, improving clinical pharmacy services,
and reducing the risk of antimicrobial resistance.
Aim:
To assess the rational use of antibiotics, including indication, selection, dosage, and treatment duration—among
hospitalized pregnant women in the Department of High-Risk Pregnancy and the Department of Preterm Birth at the
National Center for Maternal and Child Health.
Materials and Methods:
A retrospective study was conducted using a specifically designed data collection form to assess
antibiotic use among inpatients at the National Center for Maternal and Child Health. Descriptive statistical analyses were
performed using SPSS version 29.0.
Results:
A total of 348 pregnant inpatients were included, with a mean age of 31.6 ± 6.9 years. The mean length of hospital stay was significantly longer in the Department of Preterm Birth (12.5 ± 5.0 days) compared to the Department of
High-Risk Pregnancy (5.9 ± 2.0 days; p < 0.001). The indications for antibiotic use were therapeutic in 39.1%, prophylactic in 33.0%, and unspecified in 21.3% of cases. The most frequently prescribed antibiotic regimen was a combination
of β-lactams and metronidazole (29%). While the dosing of cefazolin and cefotaxime was largely appropriate, notable
dosing discrepancies were observed in the dosing of ampicillin and azithromycin. Based on the U.S. FDA pregnancy risk
classification, among a total of 762 antibiotic prescriptions, 87.0% belonged to category B, 8.8% to category C, and 4.2%
to category D, with no significant variation across trimesters (p = 0.695).
Conclusion
The assessment of antibiotic use among hospitalized pregnant women at the National Center for Maternal
and Child Health revealed that 39.1% of the prescriptions were therapeutic, 33.0% were prophylactic, and 21.3% lacked
a clear indication for use. β-lactam antibiotics were the most commonly used agents, frequently combined with metronidazole. Based on the FDA classification system, 87% of the prescribed antibiotics belonged to category B, 8.8% to
category C, and 4.2% to category D. These findings indicate inappropriate antibiotic use and insufficient implementation
of antimicrobial susceptibility testing. Therefore, strict adherence to antibiotic stewardship programs and strengthening
of clinical pharmacy services are necessary to improve antibiotic use practices.
7.Delays in health seeking, diagnosis and treatment for tuberculosis patients in Mongolia: an analysis of surveillance data, 2018–2021
Larissa Otero ; Tsolmoo Boldoo ; Anuzaya Purevdagva ; Uranchimeg Borgil ; Temuulen Enebish ; Oyunchimeg Erdenee ; Tauhid Islam ; Fukushi Morishita
Western Pacific Surveillance and Response 2024;15(1):59-67
Early diagnosis and treatment of infectious tuberculosis (TB) is essential to the attainment of global targets specified in the End TB Strategy. Using case-based TB surveillance data, we analysed delays in health seeking, diagnosis and treatment among TB patients in Mongolia from 2018 to 2021. We calculated the median and interquartile range (IQR) for “diagnostic delay”, defined as the time from symptom onset to diagnosis, subdivided into “health-seeking delay” (time from symptom onset to first visit to a health facility) and “health facility diagnostic delay” (time from first health facility visit to diagnosis), and for “treatment delay”, defined as the time from diagnosis to start of treatment. We also calculated “total delay”, defined as the time from symptom onset to treatment start. Based on data for 13 968 registered TB patients, the median total delay was estimated to be 37 days (IQR, 19–76). This was mostly due to health-seeking delay (median, 23 days; IQR, 8–53); in contrast, health facility diagnostic delay and treatment delay were relatively short (median, 1 day; IQR, 0–7; median, 1 day; IQR, 0–7, respectively). In 2021, health-seeking delay did not differ significantly between men and women but was shorter in children than in adults and shorter in clinically diagnosed than in bacteriologically confirmed TB cases.
Health-seeking delay was longest in the East region (median, 44.5 days; IQR, 20–87) and shortest in Ulaanbaatar (median, 9; IQR, 14–64). TB treatment delay was similar across sexes, age groups and types of TB diagnosis but slightly longer among retreated cases and people living in Ulaanbaatar. Efforts to reduce TB transmission in Mongolia should prioritize decreasing delays in health seeking.
8.D-Galactose and Hypoxia Induce the Early Onset of Age-Related Hearing Loss Deterioration in a Mouse Model
Temuulen TEMUULEN ; Jin Sil CHOI ; Sun Mok HA ; Yeji AHN ; Young Joon SEO
Tissue Engineering and Regenerative Medicine 2023;20(5):779-787
BACKGROUND:
We previously showed that aging accelerates after 3 months of exposure to hypoxia and environmental change but not genetic modifications. Here, we aimed to simply induce early-onset age-related hearing loss within a short period based on our previous method.
METHODS:
We randomly divided 16 C57BL/6 mice into four groups that were maintained under conditions of normoxia and hypoxia with or without injected D-galactose for 2 months. Deteriorated hearing, the expression of age-related factors, and oxidative stress responses were detected using the click and tone burst auditory brainstem response test, reverse transcription-polymerase chain reaction, and by measuring superoxide dismutase (SOD).
RESULTS:
The group maintained under hypoxia combined with D-galactose lost hearing particularly at 24 Hz and 32 Hz at 6 weeks compared with the other groups. Aging-related factors were also significantly decreased in the hypoxia and D-galactose groups. However, SOD levels did not significantly differ among the groups.
CONCLUSION
Age-related hearing loss is an environmental disorder induced by chronic oxidative stress associated with genetic backgrounds. Our findings suggested that D-galactose and hypoxia can induce the phenotypes of age-related hearing loss and aging-associated molecules in a murine model within a short time with environmental stimulation alone.
9.Epidemiology of tuberculosis in Mongolia: analysis of surveillance data, 2015–2019
Tsolmon Boldoo ; Larissa Otero ; Borgil Uranchimeg ; Anuzaya Purevdagva ; Temuulen Enebish ; Oyunchimeg Erdenee ; Tauhid Islam ; Fukushi Morishita
Western Pacific Surveillance and Response 2023;14(1):40-51
Mongolia has a high tuberculosis (TB) burden. Data from routine paper-based surveillance were used to describe the epidemiology of TB in Mongolia; the data included testing presumptive TB cases, TB notifications, drug-resistant cases, treatment outcomes and notifications in prisoners. The proportion of the population tested for TB increased between 2015 and 2019. The number and rate per 100 000 population of TB notifications decreased between 2015 and 2018 and then increased in 2019. Most TB notifications in 2019 were in the capital, Ulaanbaatar (59.3%), followed by the central (16.8%), Khangai (10.4%), east (8.5%) and west (5.0%) regions. About half of TB notifications nationally were bacteriologically confirmed (45.4% in 2015, 48.1% in 2019), with the proportion of bacteriologically confirmed TB per province or district varying from 0% to 66%. High TB notification rates were observed in 2019 for males aged 15–54 years (202 per 100 000 population) and females aged 15–34 years (190 per 100 000 population). Treatment success for all forms of TB was 90% in 2019 but was below the 90% target for bacteriologically confirmed cases. Between 2015 and 2019, the number of RR/MDR-TB notifications ranged from 265 to 211. The Mongolian National Tuberculosis Programme needs to continue its efforts in TB control, to further increase the programmatic impact and reduce the TB burden. It is recommended that Mongolia continue to increase TB screening, the use of Xpert testing, contact investigations and preventive treatments, and targeting interventions to the high-burden areas identified in this subnational analysis.
10.ADULT ORTHODONTICS WITH DAHL TECHNIQUE FOR BETTERFUNCTION AND AESTHETICS
Bilgee J ; Gantsetseg L ; Enkhjargal N ; Khorolbayar Sh ; Temuulen B ; Orkhon B ; Urjinlkham J
Innovation 2018;12(4):40-44
BACKGROUND. The Dahl Concept refers to the relative axial tooth movement that is observed when a localized restorations are placed in supra-occlusion in dental hard tissue worn anterior area and posterior full arch occlusal contacts re-establishes over a period of time irrespective of age and gender. The literature reports that the objectives of the Dahl concept are achieved in the majority of cases (94%-100%). Some minor and transient adverse events, such as initial difficulty with mastication could develop. If dental arch is crowded and some of the teeth are pushed away, they tends to be pushed more even they were visually aligned by a heavy preparation under the ceramic restorations such as crowns and veneers. To avoid these costly and teeth-harmful treatment options for patients with anterior crowding and who wants straighter and beautiful looking teeth, we use a conservative approach of Align+Bleach+Bonding technique.
MATEREALS AND METHOD. For tooth alignment we used Inman Aligner, Clear Aligner and Clear Smile Braces (fixed ceramic braces with super elastic Ni-Ti wires) or their combination. After short orthodontics a Dahl concept was applied to improve patients’ functional occlusion and anterior guidance. A “free-hand” and “no-any-drill” composite restoration technique was used to restore worn anterior teeth. For proper orthodontic diagnosis, assessment and treatment planning Spacewise analysis and Digital Caliper measurement were performed using models, their digital scans and intra/extraoral photos. We use Inman Orthodontic Lab in Florida for Inman Aligner fabrication and IAS Laboratory in London for Clear smile braces set up. Clear aligners (Scheu Dental, Germany) are planned and fabricated at the Digital Dental Office’s Clear Aligner certified laboratory. All treatments are start only after thorough diagnostic analysis, case discussion and acceptance from technical experts and orthodontists from UK, USA and Germany and acceptance of planned results from the patients. A course of home bleaching was then performed followed by resin bonding of anterior teeth edges to stabilize anterior guidance.
RESULTS. More than 200 cases of upper and lower anterior crowding have been treated in comparably short period of time. From those we are introducing 3 different cases which were treated using above mentioned three appliances as an example. Average orthodontic treatment lasted 8-16 weeks depending on degree of crowding and type of appliances used. The arch crowding were less than 4 mm in all of them. No any teeth were extracted. After orthodontic treatment patients had double retentions (fixed+clear retainers). Dahl concept was performed in patients with anterior attrition and few patients experienced minor difficulty with chewing for their first week only. To control results of molar extrusion we measured space between occlusal surfaces of opposing molars in the SAM 3 articulator positioned in the centric relation.
CONCLUSION. In order to get a long term proper stability of dento-facial function with a bonus of beautiful smile the concept of keeping own teeth and its structure became essential in cosmetic and restorative dentistry. The good thing of Dahl technique is its simplicity if it is done properly and its cost effectiveness. And as it was described the edge bonding itself could be a permanent retainer which prevents a future relapse in ortho-aligned teeth. Moreover patients were highly satisfied due to fast alignment, opportunity of keeping their teeth untouched and getting aesthetically pleasant result with a stable function.


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