1.Evaluation of the interactions between flavonoid molecules and the active site of the MRXA7 protein using molecular docking
Amarjargal Ts ; Ariunzaya D ; Nurdana B ; Densmaa L ; Bilguun B ; Uugantsetseg D ; Temuulen Ts ; Baasanjav B ; Munkhzul B ; Daariimaa Kh
Mongolian Journal of Health Sciences 2026;91(1):217-226
Background:
Skin wound healing, elasticity, and protective functions are closely associated with cellular regeneration and the remodeling of the extracellular matrix (ECM). MXRA7 (Matrix Remodeling Associated Protein 7) is a protein involved in ECM regulation, tissue regeneration, and inflammatory processes, and recent studies suggest that it may play a supportive role in skin wound healing. However, systematic investigations on natural small molecules capable of modulating MXRA7 activity remain limited. Flavonoids, on the other hand, have been reported to promote wound healing and ECM regulation through their antioxidant and anti-inflammatory properties. Therefore, it is hypothesized that flavonoid compounds may act as potential modulators of MXRA7 protein activity.
Aim:
The aim of this study was to evaluate the binding affinity, binding energy, and interaction characteristics of 14 naturally occurring flavonoid compounds with the active site of the MXRA7 protein using a molecular docking approach.
Materials and Methods:
The molecular structures of the flavonoids were obtained from the PubChem database, and their interactions with the MXRA7 protein were investigated using molecular docking with CB-Dock2 and SwissDock software. Docking results were visualized using PyMOL and evaluated based on root mean square deviation (RMSD), binding free energy (∆G), inhibition constant (Ki), pose ranking, and cluster analysis. An RMSD value of ≤ 2.0 Å was considered indicative of a stable binding pose.
Result:
The RMSD values of the MXRA7–flavonoid complexes ranged from 0.081 to 0.622 Å, indicating that all compounds stably occupied the binding cavity of the protein. Fisetin (0.081 Å), naringenin (0.107 Å), and hesperetin (0.107 Å) exhibited the lowest RMSD values, suggesting highly stable binding poses. The binding free energy (∆G) values ranged from −6.0 to −7.1 kcal/mol, with protopine showing the strongest binding affinity (∆G=−7.1 kcal/mol). Most flavonoids formed hydrogen bonds, hydrophobic interactions, and π–π interactions with key amino acid residues of MXRA7. Cluster analysis revealed that the majority of flavonoids shared a common binding mode, while fisetin, naringenin, and hesperetin formed a distinct subcluster with more stable binding poses. Ligand efficiency (LE) analysis indicated that chrysin, apigenin, and naringenin exhibited higher LE values, reflecting greater binding efficiency of smaller molecules.
Conclusion
This study demonstrates, through molecular docking analysis, that flavonoid compounds can stably interact with the active site of the MXRA7 protein. Protopine showed the strongest binding energy, whereas fisetin, naringenin, and hesperetin exhibited superior binding pose stability. These compounds may serve as potential bioactive molecules targeting MXRA7; however, further validation through molecular dynamics simulations and experimental studies is required.
2.A Preliminary Study on the Feasibility of Seed Propagation and Cultivation of Silybum marianum (L.) Gaertn. (under the conditions of the cultivation site of the school of pharmacy, MNUMS, Erdene soum)
Amarjargal Ts ; Khongorzul Ch ; Enkhtuul B ; Nomin B ; Buyanjargal B ; Norovnyam R ; Munkhzul B ; Daariimaa Kh ; Mandakhnaran P ; Davaadagva D
Mongolian Journal of Health Sciences 2026;96(6):217-222
Background:
Numerous experimental and clinical studies have investigated the therapeutic potential of Silybum marianum (L.) Gaertn., mainly attributing its biological activities to antioxidant, anti-inflammatory, antifibrotic, and hepatoprotective effects. In particular, silymarin has been reported to exert hepatoprotective effects by reducing oxidative stress, protecting cell membranes from certain toxic insults, and modulating protein synthesis. Therefore, cultivation of S. marianum and utilization of its seeds for industrial and research purposes are important for establishing a sustainable source of pharmacologically valuable bioactive compounds and increasing the availability of high-quality medicinal plant material.
Aim:
To evaluate the feasibility of cultivating S. marianum from seeds and to determine seed germination, seedling growth and development, survival after transplantation to open-field conditions, phenological stages, and seed yield characteristics.
Materials and Methods:
Seeds of S. marianum were germinated under indoor conditions, and normally developed seedlings were subsequently raised in a greenhouse and transplanted to a cultivation site near Tamgan Öndör, Erdene sum, Töv Province, Mongolia. Germination percentage (GP), mean germination time (MGT), seedling growth based on morphometric parameters, and survival rate after transplantation were evaluated. At harvest, the number and diameter of capitula, seed weight per plant, 1000-seed weight, and seed yield per unit area were determined. Data were expressed as mean±SD, and statistical significance was evaluated at p < 0.05.
Result:
Of the 1,000 seeds sown, 852 germinated, resulting in a germination percentage of 85.2% and a mean germination time of 11 days. Under greenhouse conditions, plant height increased from 1.0 to 3.0 cm, while rosette diameter increased from 1.2 to 7.0 cm. Of the 452 seedlings transplanted to the open field, 353 survived, corresponding to a survival rate of 78.1%. The first flowering was observed on June 12, full flowering on July 9, and full seed maturation on August 30, with 175 days from sowing to seed maturity. On average, each plant produced 18 branches and 20 capitula, with a capitulum diameter of 4.4 cm, seed weight per plant of 15.5 g, 1000-seed weight of 11.5 g, and seed yield of 195.325 kg/ha.
Conclusion
S. marianum was able to germinate, establish, complete its major growth, flowering, and seed maturation stages, and produce seeds under the cultivation conditions of the Tamgan Öndör area, Erdene sum, Töv Province. These findings indicate that S. marianum can potentially be cultivated in this specific area as a source of medicinal plant material.
3.Bioactive compound profiling of Rheum undulatum L. root extract and evaluation of its interaction with elastase enzyme
Buyanjargal E ; Otgonbaatar U ; Enkhtuul B ; Norovnyam R ; Enkhjargal D ; Munkhzul B ; Khuvitavilan B ; Amarjargal Ts ; Odtugs O ; Maralgua A ; Daariiimaa Kh
Mongolian Journal of Health Sciences 2026;95(5):82-88
Background:
Bioactive compounds derived from plants have been extensively studied and widely applied in cosmetic and dermatological fields. In particular, plant-derived polyphenols and anthraquinones are known for their antioxidant properties as well as their ability to inhibit elastase enzyme activity. Elastase is a key proteolytic enzyme responsible for degrading elastin, a structural protein essential for maintaining skin elasticity. Excessive elastase activity contributes to skin aging and wrinkle formation. Therefore, the identification of plant-derived compounds capable of interacting with elastase is of significant importance for improving the composition and efficacy of cosmetic products.
Aim:
To identify bioactive compounds in the extract of Rheum undulatum L. and to investigate their interaction with elastase enzyme activity.
Materials and Methods:
The root of Rheum undulatum L. was used as the study material. Sample preparation was performed by grinding the plant root followed by extraction using 50% ethanol assisted by an ultrasonic water bath. The obtained extract was evaporated to dryness using a vacuum centrifugation system to remove the solvent completely. A total of 10 mg of the dried extract was dissolved in 100 µL methanol and 900 µL water, then filtered through a 0.1 µm membrane filter. Subsequently, two sample sets were prepared: a control sample and an elastase-incubated sample at a 1:1 ratio. Both were analyzed using liquid chromatography–mass spectrometry (LC-MS). Data processing was performed using Agilent MassHunter Qualitative Analysis software (version 10.0).
Results:
LC-MS analysis revealed a total of 16 bioactive compounds in the root extract of Rheum undulatum L. Comparative analysis between the control and elastase-treated samples demonstrated a decrease in the peak areas of gluconic acid and citric acid, while an increase in the peak area of emodin was observed. These changes indicate compositional differences between the two sample conditions.
Conclusion
The LC-MS analysis of Rheum undulatum L. root extract identified multiple bioactive compounds belonging to anthraquinone, phenolic, and flavonoid classes. Variations in peak intensities between control and elastase-treated samples suggest potential interactions between certain compounds and the enzyme. These findings indicate that the root extract contains biologically active constituents capable of modulating elastase activity, supporting its potential application in anti-aging and cosmetic formulations.
4.Study on the correlation between bone mineral density and physical characteristics among first-year nursing students
Nyam-Ochir G ; Altanzul G ; Erdenesaikhan T ; Ganbaatar B ; Bat-Erdene T ; Naranbat B ; Odbayar G ; Tserennadmid B ; Baigalmaa B ; Dashdulam Ts ; Enkhbileg ; Dolgorsuren S ; Ulziijargal G ; Saranzaya B ; Munkhzul D ; Sukhbat B ; Tsetsegsuren Kh ; Tsolmontsetseg G ; Banzragch G ; Nomundari B ; Enkhtuul B
Mongolian Journal of Health Sciences 2026;95(5):150-153
Background:
Bone mineral density (BMD) is a key indicator reflecting bone strength and resistance to fracture. It is influenced by multiple factors, including age, sex, genetic background, body composition, nutrition, and physical activity. During young adulthood, peak bone mass is actively formed; therefore, identifying early variations in this period is essential for predicting future skeletal health risks. Accordingly, assessing BMD and evaluating its relationship with physical characteristics among first-year nursing students provides a scientific rationale for this study.
Aim:
To examine the relationship between bone mineral density and selected physical parameters among students.
Materials and Methods:
A total of 297 first-year students aged 17-35 years from the School of Nursing, Mongolian National University of Medical Sciences were included. Bone mineral density was assessed by measuring the speed of sound through the radius using an ultrasound bone densitometry device. Handgrip strength was measured using an electronic dynamometer. Physical parameters including age, sex, height, and body weight were measured using standardized procedures, and statistical analysis was performed. The study was approved by the Research Ethics Committee of MNUMS on November 21, 2025 (No. 26/1) and March 28, 2026 (No. 26/03-B02), with no ethical violations identified.
Results:
According to T-scores, 37.1% (n=110) of participants had normal bone status and 62.9% (n=187) showed reduced bone density. Based on Z-scores, 52.5% (n=159) were normal, while 45.6% (n=138) had decreased values. T-score values were 1.87±0.69 (<20 years), 1.44±0.55 (20–30 years), and 1.10±0.31 (>30 years), while Z-score values were −0.73±1.38, −0.43±1.23, and −0.02±1.27, respectively. ANOVA analysis revealed statistically significant differences among age groups (p<0.01). A positive correlation was observed between T-score and age, whereas no significant correlations were found with other physical parameters. Z-score showed a positive correlation with handgrip strength.
Conclusions
1. A high prevalence of reduced bone mineral density was observed among the students, which may be associated with incomplete attainment of peak bone mass in adolescents and young adults. 2. A significant difference in bone mineral density was found between age groups (p<0.01), indicating that age is an important factor influencing bone mineral density.
5.Study of the stomatal cell in certain saponin containing medicinal plants in mongolia
Nurdana B ; Khulangoо B ; Densmaa L ; Norovnyam R ; Enkhtuul B ; Khuvtavilan B ; Munkhzul B ; Buyanjargal E ; Daariimaa Kh ; Enkhjargal D ; Turtushikh D ; Amarjargal T
Mongolian Journal of Health Sciences 2025;89(5):33-38
Background:
Saponins are secondary metabolites in plants that play an important role in defense mechanisms and
physiological processes. Since stomatal cells are crucial for gas exchange and water balance in plant tissues, studying the
anatomical and biochemical features of stomatal cells in saponin-rich plant species provides insight into the interactions
between these compounds and cellular mechanisms. This serves as the basis of our study.
Aim:
To determine the structure, types, and functions of stomatal cells in saponin-containing medicinal plants
Materials and Methods:
During June–September 2024, nine species of saponin-containing medicinal plants were
collected from Bulgan, Tuv provinces, and “Gorkhi-Terelj National Park” in Mongolia. Prepared microscopic specimens
were examined using macroscopic and microscopic techniques to study the structure, position, number, and epidermal
features of stomatal cells.
Results:
The study revealed that Anemone crinita Juz. exhibited the highest stomatal density (107 stomata/mm²) and
epidermal cell density (229 cells/mm²), indicating strong adaptation and protective capacity in arid conditions. Vicia
baicalensis (Turcz.) B. Fedtsch. showed the highest stomatal index (39.6), highlighting its significant role in regulating
transpiration. Stomatal types varied among species:
• Anomocytic stomata were observed in Potentilla multifida and Vicia baicalensis.
• Anisocytic stomata were found in Delphinium grandiflorum and Ranunculus borealis.
• Paracytic stomata were present in Gentiana algida, Adenophora remotiflora, Helianthemum nummularium,
Anemone crinita, and Ranunculus acris.
Conclution
In the study of the structure, form, and number of stomatal cells in saponin-containing plants growing in
Mongolia, Anemone crinita Juz. was found to have the highest number of stomatal and epidermal cells, indicating its high
efficiency in gas exchange, water regulation, and protection against external stress. Furthermore, Vicia baicalensis (Turcz.)
B.Fedtsch. showed the highest stomatal index, confirming its strong capacity for active regulation of gas exchange.
The variation in stomatal cell types among plant species was identified as playing an important role in ecological and
biological adaptation as well as protective mechanisms.
6.Chronic kidney disease and serum NT-proBNP level
Sodgerel B ; Anudari I ; Buyandelger J ; Pilmaa Yo ; Gantogtokh D ; Yesukhei E ; Bilguun E ; Nyam-Erdene N ; Yundendash D ; Munkhbayar S ; Bolormaa Do ; Sarangerel Ga ; Munkhzul D ; Batbold B ; Sodnomtsogt L
Mongolian Medical Sciences 2024;210(4):9-17
Background:
Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular
dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD),
emphasizing the need for its early detection and prognosis.
Objective:
This study aimed to determine the serum NT-proBNP levels in participants with CKD and
establish a cut-off value for predicting heart failure.
Methods:
A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study
received approval from the Ethics Committee of the Institute of Medical Sciences (Approval
No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology
Department of the third state hospital were enrolled based on predefined inclusion and
exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound
test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence
quantitative analyzer. Data were analyzed with SPSS 26.0.
Results:
The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The
mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences
were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension
between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly
between heart failure and non-heart failure groups (p<0.05). Significant differences were
also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05).
NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted
between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value
for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%,
specificity: 55%).
Conclusion
Serum NT-proBNP levels are elevated in CKD patients regardless of heart
failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure
was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).
7.Clinical Significance of BNP and NT-proBNP in Chronic Kidney Disease
Anudari I ; Buyandelger J ; Munkhzul D ; Sodgerel B
Mongolian Medical Sciences 2024;210(4):53-60
Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney
function over time. As the disease progresses, it leads to an increased risk of cardiovascular
complications, which are the leading cause of morbidity and mortality in CKD patients.
B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic
peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart
failure. Their role in CKD, however, is complex due to the overlapping pathophysiological
mechanisms between cardiac and renal dysfunctions. This literature review aims to explore
the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting
their clinical relevance, the impact of renal function on their levels, and potential therapeutic
implications. The review focuses on studies published in the last decade, examining the
clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP
as biomarkers in CKD patients.
8.Study of exposure and vaccination coverage of the medical students
Yanjindulam B ; Naranzul B ; Ulziisuren B ; Byambasuren S ; Gantsetseg G ; Solongo G ; Narangerel P ; Nyammkhuu D ; Nyamsuren B ; Munkhzul D ; Batchimeg Ch ; Ganchimeg Ch ; Oyunbileg D ; Khosbayar T
Diagnosis 2023;106(3):109-117
Background:
To prevent and combat the spread of the COVID-19 pandemic, the Government of Mongolia has implemented measures such as movement and time restrictions, social distancing and isolation, closure of schools, kindergartens and public places, immunization, and others. It has caused adverse consequences for people, social relations, and the economy, causing health, social, economic, and humanitarian crises. Not only does this situation, medical students, as frontline healthcare workers, are more susceptible to virus infection. Vaccines against COVID-19 have been researched quickly due to the pandemic and are being used under emergency use authorization. In our country the approach of mixing vaccine doses from different manufacturers was used (fractional doses). Therefore, there is no study on the exposure of medical students to the COVID-19 infection and the adverse effects after receiving a dose of a heterologous vaccine. Objective: To study the exposure to the COVID-19 infection and vaccination status of medical students.
Methods:
The survey was conducted from November 2023 to December 2023 using a cross-sectional study design, and 170 students who study at ASUSU and live in the dormitory were included.
Results:
A total of 170 students participated in the study. 55.9% (n=95) of them were in the first year, 22.4% (n=38) were in the second year, 10% (n=17) were in the third year, 7.6% (n=13) were in the fourth year, 2.4% (n=4) were from the 5th year and 1.8% (n=3) were from the 6th year students. 88.2% (n=150) of students were female and 11.8% (n=20) were male. In this study, 37.1% of the students were infected by COVID-19 infection previously. Among them, 50% of the students were infected from family members, 16.7% from the school environment, and 15.2% did not know about the source of infection. 76.2% of the respondents were diagnosed with COVID-19 in a medical institution, and forty-one students answered that they were treated at the hospital. 83% of the cases were treated at home and were cured within 14 days. In contrast, 93.8% of the hospitalized students were treated within four months to 1 year. The current study demonstrates neurological, respiratory, sensory, cardiovascular, psychiatric, digestive, and dermatological symptoms were in 37.6%, 24.1%, 27.6%, 17.6%, 11.8%, 11.2%, and 10% of the students who participated in the study, respectively. For a year or more, symptoms of all organ systems were present, but neurological symptoms appeared to be the highest. 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine, 3.5% (n=6) did not receive the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects and 65% (n=106) had no side effects.
Conclusion
In this study, 37.1% of the students were infected by COVID-19 infection previously. According to the current study, symptoms related to the nervous system was the most prevalent and 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects.
9.MULTI DRUG RESISTANT TB PATIENTS SURGICAL TREATMENT
Rentsenmygmar Ts ; Sukhee E ; Munkhzul B ; Tsagaan B ; Batbayar D ; Javzandulam O ; Batzaya Ts ; Uuganbayar G
Journal of Surgery 2016;20(2):25-29
Introduction: We began treatment of
multi drug resistant tuberculosis first from
2003. At that time there was a 1960 cases and
most of the cases were from Ulaanbaatar,
Darkhan, Selenge, Tuv, Dornod provinces.
From all the cases only 62% or 1058 cases
were included in treatment. From that 336
patient or 19% deceased, 296 patient or 18%
didn’t get a treatment. We did this study
because there were never done any research
or study of surgical treatment of multi drug
resistant tuberculosis in Mongolia.
Materials and Methods: We studied
cases of patients who undergone lobectomy,
since 2007. There were 48 cases of 46
patients, 2 patients surgery were done on
both sides. Respondents aged between 14-
45, 25 male (52%), 23 female (48%), all
patients got a first - line anti-tuberculosis
treatment, such as cat-1, cat-1+cat-2 and 10
variants of these drugs. It was done based
on sputum culture test results of NCCD
TB surveillance and research department’s
laboratory.
Results: From the all patients only
77.08% had undergone surgery within the
first 3 years. 92% patients were diagnosed
with multi drug resistance TB only with the
sputum and sputum culture test results, and
the rest of the patients were diagnosed
using a tissue analyses on the above tests.
It was revealed that HR resistant -91.66%,
HR+(Z,E,S) -3 drugs resistant -18.78%,
HR+(ZSE)-4 or 5 drugs resistant. In the
patients TB lesion locations was on the right
upper lobe 54%, left upper lobe 31%, on
a both upper lobes 85%, cavernous fibrosis
tubercles 60%, combined TB lesions 77%,
tubercles 21%.87.5% of total patients
received a multi - drug resistant TB treatment
between 7 - 24 months prior surgery.
All 48 patients had a totally 69 surgeries.
Surgeries included 9% pneumonectomy,
28% lobectomy, 30% Wedge resection,
23% pleurectomy decortication, 7% Wedge
resection on both sides, one bilobectomy.
There were no complications during the
surgery but 5 of patients had an empyema
after surgery. No fatal cases.Three patients
out of 5 who had a surgery due to pulmonary
hemorrhage developed an empyema after
surgery. Drainage tubes were taken after
the surgery within 2-3 months.Therewere no
complication and escalations in the patients
who received a surgical treatment, after the
surgery from 6 months to 5 years.
Conclusion: In study it shows that surgical
treatment is effective to do after 6 months
of anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows that
combining of medical and surgical treatment
is healing up to 98% in the patients who
were rightly chosen according to surgical
indications.This research result shows that in
our country multi - drug resistant TB surgical
treatment complication is only 10.41%,
which is below in the other countries who
have same anti-tuberculosis drug treatment.
10. MULTI DRUG RESISTANT TB PATIENTS SURGICAL TREATMENT
Rentsenmygmar TS ; Sukhee E ; Munkhzul B ; Tsagaan B ; Batbayar D ; Javzandulam O ; Batzaya TS ; Uuganbayar G
Journal of Surgery 2016;20(2):25-29
Introduction: We began treatment ofmulti drug resistant tuberculosis first from2003. At that time there was a 1960 cases andmost of the cases were from Ulaanbaatar,Darkhan, Selenge, Tuv, Dornod provinces.From all the cases only 62% or 1058 caseswere included in treatment. From that 336patient or 19% deceased, 296 patient or 18%didn’t get a treatment. We did this studybecause there were never done any researchor study of surgical treatment of multi drugresistant tuberculosis in Mongolia.Materials and Methods: We studiedcases of patients who undergone lobectomy,since 2007. There were 48 cases of 46patients, 2 patients surgery were done onboth sides. Respondents aged between 14-45, 25 male (52%), 23 female (48%), allpatients got a first - line anti-tuberculosistreatment, such as cat-1, cat-1+cat-2 and 10variants of these drugs. It was done basedon sputum culture test results of NCCDTB surveillance and research department’slaboratory.Results: From the all patients only77.08% had undergone surgery within thefirst 3 years. 92% patients were diagnosedwith multi drug resistance TB only with thesputum and sputum culture test results, andthe rest of the patients were diagnosedusing a tissue analyses on the above tests.It was revealed that HR resistant -91.66%,HR+(Z,E,S) -3 drugs resistant -18.78%,HR+(ZSE)-4 or 5 drugs resistant. In thepatients TB lesion locations was on the rightupper lobe 54%, left upper lobe 31%, ona both upper lobes 85%, cavernous fibrosistubercles 60%, combined TB lesions 77%,tubercles 21%.87.5% of total patientsreceived a multi - drug resistant TB treatmentbetween 7 - 24 months prior surgery.All 48 patients had a totally 69 surgeries.Surgeries included 9% pneumonectomy,28% lobectomy, 30% Wedge resection,23% pleurectomy decortication, 7% Wedgeresection on both sides, one bilobectomy.There were no complications during thesurgery but 5 of patients had an empyemaafter surgery. No fatal cases.Three patientsout of 5 who had a surgery due to pulmonaryhemorrhage developed an empyema aftersurgery. Drainage tubes were taken afterthe surgery within 2-3 months.Therewere nocomplication and escalations in the patientswho received a surgical treatment, after thesurgery from 6 months to 5 years.Conclusion: In study it shows that surgicaltreatment is effective to do after 6 monthsof anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows thatcombining of medical and surgical treatmentis healing up to 98% in the patients whowere rightly chosen according to surgicalindications.This research result shows that inour country multi - drug resistant TB surgicaltreatment complication is only 10.41%,which is below in the other countries whohave same anti-tuberculosis drug treatment.
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