1.Knowledge and attitude of women on cervical cancer risk factors, prevention and screening
Uranchimeg Ts ; Ganchimeg T ; Bayasgalan E ; Buyanjargal Ya ; Avirmed D
Mongolian Medical Sciences 2013;163(1):151-157
Introduction
Cervical cancer is one of the most common types of cancer in women worldwide. It can be prevented by identifying pre-cancer lesions at early stages using Pap smear screening and treating these lesions. Knowledge and attitude on cervical cancer and Pap smear tests are associated with actual participation in cervical cancer screening. Therefore, our study aimed to investigate cervical cancer and Pap smear knowledge and attitudes among Mongolian women.
Materials and Methods
A total of 671 women aged 30 to 60 years from urban and rural areas participated in the study. The multiple clusters sampling method was used. We examined the relations of socio-demographic characteristics with lack of knowledge and negative attitude towards Pap smear tests by using a multilogistic regression analysis.
Result
The response rate was 89% (671/750). 62% of the participants correctly answered less than 4 out of 8 questions about cervical cancer risk factors. Also 47,2% and 79,3% of the total number of the women had never heard of Pap Smear and HPV. Only 16,4% of the respondents have some knowledge about them. Almost all (93%) participants agreed that there is a defficiency of information about cancer and its screening.58% and 28% of respondents said that they would participate in Pap smear tests voluntarily and agree to vaccinate their daughters. Positive attitude on Pap smear tests was higher among women living in rural areas and those who have had a Pap smear test.
Conclusions
Cervical cancer and Pap smear knowledge and attitude among the women in Mongolia are low. Having higher education and higher income level did not ensure positive attitude to cervical cancer screening. Strategies for communicating accurate information about cervical cancer, prevention, and detection as well as risk and treatment of cervical cancer are needed.
2. Intravitreal bevacizumab and laser therapy in the management of diabetic macular edema
Anar T ; Uranchimeg D ; Baasankhuu J
Innovation 2015;9(Ophthalmology):42-45
Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 40 and 59 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significantpublic health issue. The Early Treatment Diabetic Retinopathy Study (ETDRS) showed the benefit of focal/grid laser for the management of DME, reducing the risk of moderate visual loss by approximately 50%, and since then,macular photocoagulation (MPC) has been the gold standard treatment. Vascular endothelial growth factor (VEGF) is an important mediator of blood-retinalbarrier breakdown, which leads to fluid leakage and the development of macular edema. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an optionthat must be considered for the treatment of DME. The aim of this study to evaluate intravitreal bevacizumab and modified Early Treatment Diabetic Retinopathy Study (ETDRS) macular laser therapy (MLT) in patients with clinically significant macular edema (CSME). Methods: In a1-year, single-center, randomized controlled trial, 70 patients with center-involving CSME were randomized to receive either bevacizumab or MLT. Result: The baseline mean ETDRS BCVA was 58.3±8.6 (range 38–71) in the bevacizumab group and 56.6±7.3 (range 37–69) in the laser group. The mean ETDRS BCVA at one year was 63.2±12.5 (range 41–80) in the bevacizumab group and53.0±8.3 (range 35–74) in the laser group (p=0.0004). At one year, central macular thickness decreased from 405±121 μm (range 275–715 μm) at baseline to 247±141 μm (range 178±541 μm) in the bevacizumab group and in the laser group from 392±137 μm (range 284–741 μm) to 318±129 μm (range 165–615 μm) (p=0.05). Conclusioni: The study provides evidence to support the use of bevacizumab in patients with center involving CSME without advanced macular ischemia.
3. Results of treatment for sight-threatening diabetic macular edema
Anaraa T ; Uranchimeg D ; Baasankhuu J ; Bulgan T ; Munkhzaya TS ; Munkhkhishig B ; Oyunzaya L ; Urangua J ; Munkhsaikhan M ; Unudeleg B ; Khuderchuluun N ; Chimedsuren O
Innovation 2016;10(1):24-29
To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p<0.0001). There were significant difference detected between the bevacizumab and bevacizumab combined with laser treatment groups (p=0.004). At month 12, greater proportion of patients gained ≥10 and ≥15 letters and with BCVA letter score >73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.
4.НУГАС-БУЛЧИНГийН ХАТАНГИРАЛ ӨВЧНИЙ ГЕНЕТИК ОНОШЛОГОО
Uranchimeg B ; Oyungerel Ts ; Jambaldorj J ; Munkhtuya T
Innovation 2017;11(2):62-65
BACKGROUND. Spinal muscular atrophy (SMA MIM#253300) is a heterogeneous group of neuromuscular disorders caused by degeneration of anterior horn cells. Spinal muscular atrophy is the second most common autosomal recessive disorder. The first substantive descriptions of SMA occurred at the end of the 19th century when Werdnig and Hoffman characterized the features of autosomal recessive SMA. SMA is broadly classified into four major categories characterized by the age of onset as well as severity of the disease. Clinically proximal weakness, predominantly athropy, upper muscle athropy and other muscle weakness including of facial, scapula and respiratory were reported. SMA is inherited by X chromosomal, autosomal recessive and dominant mode. In our study, we recruited an individual diagnosed with SMA, without SMN1 gene mutation to investigate BICD2 mutation. Peripherial blood from the patient and his family members were taken to extract genomic DNA according to commercial protocol. Amplification of target gene was done by special primers. DNA sequencing was done to detect a mutation. As a result, we identified a mutation in location c.484 C>T of third exon of BICD2 gene. This mutation is was a heterozygous in mother’ and child’ DNA, SIFT and Polyphen program was used to detect its pathogenic effect. We also checked by Grantham matrix score is 180.0 representing it,s changing acid and alkaline feature in this amino acid. We diagnoses a suspected case with SMA by his clinical symptoms as a SMA type III, Kugelberg-Belander desease. We detected a mutation of BICD2 gene in a patient with SMA. This mutation altered acid and alkaline checked by Grantham matrix. This mutation has never reported before, showing 100% pathogenic effect on protein function, but because of highly penetrate feature of this disease makes its inheritance mode of autosomal dominant pattern.
5.Findings of the assessment on social and the environmental accessibility for people with vision and hearing impairment
Batdulam T ; Chimedsuren O ; Uranchimeg D
Innovation 2021;14(1-Ophthalmology):32-35
Background:
According to the WHO, WB estimation, there are over 1 billion people living with some form of
disability in the world.2 Out of which, 284 million people have vision impairment, 360 million people have hearing and speech impairment, ten percent of them living in developing countries.3 According to the National Statistical Office’s 2018 data there are 105,730 people with disabilities in the country which is 3.2% of the total population.4 In Mongolia, 28% of the disabled population in the working age are employed while 43% of the population aged 6-18 are illiterate. People with vision, hearing and intellectual disabilities have the same right to access health, education, employment, social welfare and protection services as others, but due to the lack of access to facilities and public transport, they cannot fully access social services. Also, the legal framework that provides equal opportunities for social contacts is not enough. There is virtually no comprehensive study on access of social service and environmental accessibility for the disabled people in the country. Therefore, there is a need to study in detail of social services and environmental accessibility of the people with visual and hearing impairment and adapt their demands into policy and develop policy recommendations and to further improve legal regulations.
Purpose:
Main objective of the study is to assess social service delivery and environmental accessability of the
people with visual and hearing impairment
Methods:
The direct-observation, household based survey and document review, methods have been used
for this study. Direct observation method has been applied for 100 public constructions. Total of 100 disabled people, out of 50 people with visual impairment and 50 people with hearing impairment has been covered for the public transportation accessibility assessment questionnaire survey. Information and communication accessibility studies carried out among 100 organizational websites and 31 broadcasting internet television including Univision and Sky media.
Household survey covered 148 people with visual and hearing impairments to assess social service accessibility.
Results:
The public construction’s environmental accessibility for the people with vision impairment was
assessed at 48.8 percent: 36.8% for the people with poor vision impairment and very bad for blind people at only 16.5%. The public transportation accessibility assessed as not accessible (3.43 odds) for people with vision impairment and as moderate accepable for blind people (2.87 odds). Information and communication accessibility through website assessed at 25% for people with vision impairment which shows not sufficiently accessible for blind people (32%). Total accessibility of information regarding to the organizational website assessed at 34.8% which shows moderately accessible. Services of the Univision, Sky media internet TV (IPTV) wasn’t accessible for people with vision impairment. Regarding to the people with hearing impairment, public construction environmental accessibility assessed at 31.7%, 48.5% for people with moderate hearing impairment which is average accessibility and 21% people with severe hearing problem. The public transport accessibility assessed in high discrepancy (3.51 odds ratio) which means there is an in-sufficient access. Information and communication accessibility for people with hearing impairment assessed at 5% which shows very bad accessibility.
Health service coverage is 64% for the people with vision impairment while 36% for the people of hearing impairment. Education service coverage for vision impairment people is 36% and 18% to people with hearing impairment. Regarding to the accessibility to social service, the coverage is 33% for people with vision impairment and 31% for the people with hearing impairment. Employment rate among people with vision disability resulted in 19% and 24 % for the people with hearing imapirment.
Conclusion
The public constructions accessibility for people with vision and hearing impairment (37.7%),
public transport accessibility (2.90 odds ratio), information accessibility (34.8%) assessed at “moderately
accessible”. Assessment result of below 50% considered as “insufficient” for education service -27%, employment service-21.5%, social welfare services -32%. There is a need for special laws and regulations concerning to social services and environment accessibility.
6.Evaluation and internal analysis of study program: Pharmacology
Uranchimeg T ; Purev B ; Munkhdelger B ; Lhagvasuren Ts ; Zultsetseg N
Mongolian Pharmacy and Pharmacology 2023;22(1):13-21
Abstract
In this article, the self-evaluation and internal analysis of the “Pharmacology” course program at the Mongolian University of Pharmaceutical Sciences (MUPS) are described. The “Pharmacology” curriculum is included in the professional course category in the curriculum of school’s Pharmacy program and includes 48 hours of lectures and 96 hours of seminar content. A total of 1,997 pharmacists have been trained by this curriculum since 2005. The pharmacy program was accredited by the National Council for Educational Accreditation with a rating of 94 percent in 2014 and 100 percent in 2021. This time, the teachers who mainly teach in the program, together with the evaluation specialist, have collected the experience and evaluation results of the “Pharmacology” curriculum in this article. Data was collected by google form and processed by the SURE online tool and used the structure-oriented evaluation (SURE) model.
7.VEGF-A and ARMS2 gene polymorphism on AMD susceptibility
Ariunzaya A ; Chimedlkhamsuren G ; Suvd T ; Sarantuya J ; Uranchimeg D ; Baasankhuu J
Innovation 2019;13(1-Ophthalmology):10-13
Background:
Age-related macular degeneration (AMD) is an eye condition, that occurs
people aged above 50, leads to gradual loss of the vision because of a damage in the macula,
which is located in the center of the retina. Several polymorphisms in different genes have been
proposed as factors that increase the disease susceptibility. Therefore, we investigated the
association between rs833061 polymorphism of VEGF-A gene and rs10490924 polymorphism of
ARMS2 gene and AMD in order to analyze with other similar studies by meta analysis.
Purpose:
To investigate the polymorphisms of VEGF-A gene and ARMS2 gene on AMD susceptibility
Methods:
is case-control study was conducted on 74 AMD patients and 32 unaffected age-and gender-matched control individuals. Genomic DNA was extracted from the peripheral
venous blood. The single nucleotide polymorphisms were identified by restriction fragment length
polymorphism (RFLP) method and results confirmed by gel electrophoresis. The REVIEW MANAGER
5.2 software and MetaXL was used for meta-analysis
Results:
We did not find statistically significant differences in С allele and СС genotype frequency
of rs833061 polymorphism of VEGF-A gene between patients and controls. However, analysis of
rs10490924 polymorphism of ARMS2 gene shows that T allele (OR=2.72, 95% CI, 1.47 – 5.02, p=0.001),
TT genotype (OR=4.54, 95% CI, 1.49 – 13.87,p=0.019) were significantly associated with AMD risk.
Haplotype analysis of these SNPs showed that C+T haplotype was statistically significantly different
(OR=5.23, 95% CI, 1.76-15.54, p=0.002) between patients and controls.
Conclusion
As shown by results, rs10490924 polymorphism of ARMS2 gene show that T allele,
TT genotype and C+T haplotype were significantly associated with AMD risk In meta-analysis, T
allele of rs10490924 polymorphism of ARMS2 gene was significantly associated with AMD risk in all
ethnicity that include Asian and Caucasian. However, T allele prevalence was higher in Asians.