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.Result of the treatment of certain eye diseases caused by adenovirus infection with normal immunoglobulin
Enhmaa Ts ; Tseveensuren Ts ; Sainjargal Z ; Sainchimeg B ; Oyunbileg J ; Uranchimeg D ; Lkhagvadolgor D
Mongolian Medical Sciences 2011;168(1):46-52
Background: In 1889, keratinocytes conjunctivitis with eruption in the form of Epidemic first was revealed by Fuchs and from 1995 it began to be diagnoses using the polymerase chain reaction. In our country annually about 11,850 patients visited the ophthalmology cabinet of the State Central Clinical Hospital, and from them 1290 cases or 10.89% were diagnosed to have viral infections, including 95% were sick of adenovirus infection, 3.7% had a herpes virus infection, 1,3% infection of other species respectively. At the international level of experience and research on the treatment of adenovirus conducted in a large circle, and immunoglobulin therapy has a high impact (P=0.0001, power 0.7599, ANOVA). In Mongolia, normal immunoglobulin is produced and widely uses to enhance immunity, but technological expertise and experiences on the use of immune globulin in ocular diseases caused by adenovirus infection had not been conducted yet.
Goal: To study the possibility to diagnose ocular diseases caused by adenovirus infection with laboratory method and use immunoglobulin in eye area.
Methods and materials: The investigation involved 50 patients aged 18-55 diagnosed with the infection of adenovirus. We took samples from eye conjunctiva, blood and stool of patients involved in the investigation and conducted a survey to identify adenovirus using the polymerase chain reaction. In this analysis it was used the diagnosing devise (Amply Sense Adenovirus – Eph) made in Russian Federation. Samples where the virus is detected were multiplied in Hep2 cell culture and viruses were abstracted. Linear cells Hep2 were made culture by methodology and recommendation from World Health Organization. Abstracted viruses were challenged in experimental rabbits by dropping it into their eyes or making injections. After rabbits became completely sick, they were divided into five groups and each had a different treatment. Statistical and analytical software used in the development of research. (SPSS,EPI-info8 STATA).
Results: Samples were taken from 50 people and made on them polymerase chain reaction analysis, at 43 (86%) of which were detected adenovirus: Viruses were found in 14(93%) of 15 samples taken from the eye, 12 (80%) of 15 samples taken from the blood, 17(85%) of 20 samples taken from the stool respectively. Sample with viruses was conducted the initial development and made culture in a linear cell Hep 2. Partial anesthesia were made on both eyes of 25 rabbits with use of Proparacaine Hydrochloride and infected them with adenovirus and after 7 days the following treatments were made dividing the rabbits in five groups so that each group has got five rabbits. (Treatment with interferon, ingavirin treatment against viruses, immunoglobulin drops, combined immunoglobulin drops jointly with ingavirin, immunoglobulin injection for combined with ingavirin). After infection eyes of rabbits with adenovirus and descending corneous phlegmon in their eyes, the symptom curing were observed on schedule at 2, 4, 6, 8, 10, 12, and 14th days of each separate treatment group and calculated the average. On the 8th day after starting the treatment combined ingavirin with lg eye drop and treatment lg catarrh injection with ingavirin conducted in related groups, and on the 12th day of treatment with ingavirin, all the symptoms of infections were completely cured. Treatability of group treated with interferon after 14 days was 71 percent.
On the basis of the above indicators, we compared the most effective method of treatment with interferon treatment, which is currently in use, then developed a method of statistical significance of the study with indicator ANOVA and proved that the significance of the treatment is of P<0.05. As in the 8th day of the treatment, the symptoms of viral infection is completely eliminated, and at the 10th day is not detected any viruses, we can prove that the treatment of immune globulin effectively prevents the virus and is capable of neutralizing the virus.
Conclusions:
1. The experiment shows that intravenous immunoglobulin therapy is an effective method against infection caused by adenovirus.
2. Since immunoglobulin counteracts the adenovirus, it has the opportunity to become a major application against inflammation caused by viruses and bacteria
3. Using of the drug against the virus with a combination of ingavirin has higher effectiveness than the use of only one immunoglobulin against adenovirus.
3.Prevalence and causes of the avoidable blindness and low vision in Mongolia
Uranchimeg D ; Munkhtsetseg TS ; Unudeleg B ; Dovchinjamts D ; Tamir A ; Baasankhuu J ; Hans LIMBURG
Mongolian Medical Sciences 2015;172(2):65-71
The Rapid Assessment of Avoidable Blindness (RAAB) has been developed as a simple and rapidsurvey methodology that can provide data on the prevalence and main causes of blindness.AimTo assess the prevalence and main causes of avoidable blindness and visual impairment in peopleaged 50 and above in Mongolia.MethodsThe RAAB uses a standard methodology which is documented in the RAAB Instruction Manual (HansLimburg, International Centre for Eye Health, London School of Hygiene and Tropical Medicine).Assuming an estimated prevalence of blindness in persons aged 50+ of 2.14% and a non-complianceof 5%, with a variation to 25% around the estimate of 2.14% at 95% probability, the required samplesize was calculated at 4,040: 101 clusters of size 40. Visual acuity (VA) was measured with a Snellentumbling E chart, using optotype size 18 (60) on one side and size 60 (200) on the other side. Thelens status of all participants was assessed by both torch and distant direct ophthalmoscopy, by anophthalmologist in a shaded or dark environment. The data were analyzed using RAAB Version 4.02(ICEH, London) for pre-defined reports relating to both crude and age and gender adjusted results.ResultsThe survey included 4,040 people aged 50 years and older, of whom 4,029 were actually examined.The coverage was 99.7%. 7 persons (0.2%) were absent and 4 (0.1%) refused to participate in thestudy. The prevalence of bilateral blindness with available correction in the better eye is 2.2 % (95% CI,1.7 - 2.7%); 2.4% in males and 2.2% in females. The prevalence of bilateral severe visual impairment(SVI) is 2.1% and bilateral moderate visual impairment (MVI) is 10.8%. The prevalence of functionallow vision, requiring low vision services, is 4.5%. In people aged 50+, untreated cataract is the mostcommon cause of bilateral blindness with 38.9%, followed by glaucoma (20.0%), non-trachomatouscorneal opacity (13.3%), and other posterior segment disease (7.8%).Conclusion: Untreated cataract and uncorrected refractive errors are the major causes of avoidableblindness and low vision in Mongolia, respectively. Priority should be given to cataract surgery,followed by the development of optical services and PHC and PEC services, as these are the mostcost-effective interventions. These three interventions will address about three thirds (67.8%) of thecauses of blindness and have most impact.
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. 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.
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.Investigation of morphometric measurement of the eyelid and ocular axial position in Mongolian adults
Oyungerel B ; Lkhagvadulam Ts ; Sumyasuren U ; Misheel B ; Lkhagvadulam U ; Bundarkhi Kh ; Undarmaa Sh ; Uranchimeg G ; Sarantuya J
Innovation 2022;15(1-Ophthalmology):18-23
Background:
The shapes of the eye and upper eyelid are distinctive facial landmarks. The palpebral fissure is composed of the free edges of upper and lower eyelids the lateral and medial canthus. Many
researchers confirmed that the morphometric characteristics of the palpebral fissure, canthal distance
and exophthalmometirc value (EV) vary according to race, ethnicity, age and sex and normative values
which may serve as a reference in the index population. Knowledge of normal dimensions, the existence of asymmetry of the palpebral fissure is of value in several clinical specialties including ophthalmology, plastic and reconstructive surgery and traumatology, where it plays a part in the patient evaluation, management and outcomes.
Methods:
This cross-sectional study was conducted in the Ophthalmological Department, Third State Central
Hospital between January 2022 and August 2022. We included participants who are above 18 years, no history of congenital or traumatic craniofacial deformities, any orbital fractures, tumors and surgeries. All measured values that represent eyelid shape and EV were calculated by mean and standard deviation for statistical analysis.
Results:
A total of 103 participants aged 19-86 were included in the study, of which 44 (42.7%) were male
and 59 (57.3%) were female. The distance between the lateral and medial canthus ranged from 20 to 35 mm, and the mean of the right and left side was 28.30+3.23 mm and 28.05+2.99 mm, respectively (p=0.561). The palpebral fissure height ranged from 5 to 13 mm, and the mean of the right and left side was 8.85+1.65 mm and 8.80+1.65 mm, respectively (p=0.816). The mean distance between the lateral canthi were 90.39+5.57 (range: 80-105 mm), whereas the mean distance between the medial canthi were 63.75+4.25 (range: 53-73 mm). The orbital height varied between 27-43 mm (33.73+3.72) and 26-44 mm (33.78+3.73) on the right and left sides, while the orbital width varied between 26-47 mm (36.75+4.53) and 27-45 mm (36.72+4.42) on the right and left sides, respectively. When measuring the exophthalmometric value (EV), the axial position of the eyeball, with the Hertel’s exophthalmometer, it ranged from 8 to 20 mm on both sides (mean value 13.68+3.01 and 13.71+3.00 on the right and left sides, respectively), and there was no statistically significant difference in symmetry (p=0.94).
Conclusion
The results are determined different from the findings of Chinese, Korean, Afro-American and
Caucasian population based studies. Thus further evaluation is required to represent the normative value of Mongolian index population, that is highly beneficial for clinical assessment, diagnosis and management.