1.A Rare Case of Nongestational Choriocarcinoma with Pulmonary and Hepatic Metastases Presenting as Pulmonary Artery Thromboembolism
Enkhsaikhan S ; Demberelmaa B ; Munkhbat O ; Byambadorj N ; Amgalandari B ; Javzan-Orlom D
Mongolian Journal of Health Sciences 2026;95(5):333-335
Background:
Choriocarcinoma is an aggressive trophoblastic malignancy characterized by rapid progression and a strong tendency for early hematogenous metastasis. It may occur in gestational or nongestational forms. Nongestational choriocarcinoma is extremely rare and is most commonly reported in young women. The tumor frequently metastasizes early to organs such as the lungs, liver, and brain.
Case presentation:
We report the case of a 21-year-old woman who presented with dyspnea and hemoptysis and was initially treated for pneumonia. Further evaluation revealed nongestational choriocarcinoma with pulmonary and hepatic metastases.
Diagnosis:
Contrast-enhanced computed tomography of the chest initially suggested pulmonary artery thromboembolism; however, the diagnosis was ultimately confirmed by histopathological examination.
Conclusion
The distinctive feature of this case is that the disease presented with clinical and radiological findings mimicking pulmonary artery thromboembolism. This case highlights the importance of considering metastatic choriocarcinoma in young women presenting with unexplained respiratory symptoms, hemoptysis, and atypical pulmonary vascular findings.
2.The study is aimed to investigate placental histopathological changes in pregnant women with pre-eclampsia
Erkhembayar B ; Orlom D ; Punsaldulam P ; Galtsog L
Mongolian Medical Sciences 2026;217(3):4-10
Introduction:
Preeclampsia disease represents a spectrum of hypertensive disease in pregnancy, beginning
with gestational hypertension and progressing to develop severe features, ultimately leading
to its more severe manifestations, such as eclampsia and HELLP syndrome. In Mongolia, the
incidence of preeclampsia was 26.3% in 2020. In our country, the International Amsterdam
Consensus Guidelines have been adopted since 2022, and the placenta has been evaluated
according to these guidelines.
Goal:
To evaluate the pathological changes in the placenta of pregnant women with
preeclampsia according to the Amsterdam guidelines and compare them with healthy
pregnant women.
Materials and method:
This study was conducted using a retrospective, case-control design. Based on clinical
data, 100 placentas from pregnant women with pre-eclampsia and 100 placentas from
healthy pregnant women were randomly selected from the 1046 placentas that arrived at
the Laboratory Department of the National Center for Mothers, Newborns and Women. The
study was conducted after obtaining approval from the research ethics committee of “Ach”
Medical University.
Statistical analysis of study results: Data collected during the study were analyzed using SPSS
software [Version 26.0, SPSS Inc., Chicago, IL, USA]. Study parameters were calculated
using descriptive statistics; the impact of factors influencing pre-eclampsia was assessed
via logistic regression analysis with 95% confidence intervals, and a P-value <0.05 was
considered statistically significant. Pearson’s Chi-square test was used to analyze placental
morphometric parameters, and Pearson’s correlation was used to assess the relationships
between various placental structural characteristics
Ethical approval:
The study was reviewed and approved by the Medical Ethics Committee
of "Ach" Medical University during its meeting on February 11, 2026, and was conducted
following the receipt of ethical approval.
Results:
Our study included placentas from 200 individuals aged 18-45 years. Placental weight was
statistically significantly lower in severe preeclampsia than in mild preeclampsia [390.8±66.4
g vs 489.7±52.0 g, t=8.32, p<0.001]. This indicates that as the severity of the disease
increases, the proliferation tends to be delayed. Multiple logistic regression analysis showed
that decidual arteriopathy was 70 times more likely to be associated with the predisposition to
preeclampsia [OR=69.7; 95% CI: 18.5–261.3; p<0.001], and Accelerated villous maturation
was 30 times more likely to be associated with the predisposition to preeclampsia [OR=24.9;
95% CI: 2.8–221.7; p=0.004].
Conclusion
1. When comparing the gross structure of the placenta in the two groups, in the preeclampsia,
the placental weight and length were reduced, while the rate of para-marginal placental
umbilical cord insertion site was statistically significantly increased.
2. When comparing the histological changes of the placenta in the pre-eclamptic and
healthy groups, the incidence of infarction, distal villous hypoplasia, accelerated villous
maturation, and decidual arteriopathy was statistically significantly higher in the pre
eclamptic group.
3. Placental weight loss was 2-fold, decidual arteriopathy was 70-fold, and accelerated
villous maturation was 30-fold which contributed to the predisposition to preeclampsia
pregnancy.
3.Assessing quality of life among patients with pulmonary embolism
Javzan-Orlom D ; Munkh-Erdene D ; Zolzaya B ; Solongo B ; Chuluunbileg B ; Altankhuyag N ; Badamsed Ts ; Tumur-Ochir Ts
Mongolian Journal of Health Sciences 2025;86(2):154-159
Background:
The assessment of patients’ quality of life has emerged as a critical metric in evaluating healthcare services.
Internationally, numerous studies have been conducted to assess the QoL of individuals diagnosed with pulmonary
embolism through the development of standardized questionnaires and their association with various clinical parameters.
Aim:
To adapt a standardized questionnaire for assessing the quality of life following a pulmonary embolism and to evaluate
the quality of life of affected patients.
Materials and Methods:
A total of 33 patients diagnosed with pulmonary embolism and hospitalized in the Department
of Pulmonology at the Third State Central Hospital in Mongolia between August 2022 and December 2023 were included
in the study. An observational cross-sectional study design was used. Inclusion criteria encompassed all patients diagnosed
with PE during the study period, while exclusion criteria included individuals with severe comorbidities, those aged
over 85 years, and those who declined participation. QoL was assessed using the Pulmonary Embolism Quality of Life
(PEmb-QoL) questionnaire, which consists of 39 questions categorized into six domains. Higher scores indicate poorer
QoL. Data analysis was performed using SPSS version 16.
Results:
The average age of the participants was 61±15 years, and 18 (54.5%) were female. The median duration of anticoagulant
therapy was 170 days (range: 27–2555 days), and the average monthly expenditure on medication was 80,000
MNT (range: 63,000–400,000 MNT). The overall mean QoL score was 69.7±23.2. The median scores for the six domains
were as follows: frequency of complaints 1.6 (IQR 1.5-1.9; max 5 score), activities of daily living limitations 1.5 (1.3–1.8;
max 3 score), work-related problems 1.7 (1.5–2.0; max 2 score), social limitations 2.0 (2.0–3.0; max 5 score), intensity
of complaints 3.0 (3.0–4.0; max 6 score), emotional complaints 2.0 (1.5–2.4; max 6 score). The internal consistency reliability
of the questionnaire was assessed, with the symptom frequency category scoring well (α=0.74), while the other
categories had excellent reliability (α>0.85). A weak positive correlation was observed between overall QoL scores and
age, while a weak negative correlation was identified with body mass index (r=0.14 & r= -0.13, P>0.05).
Conclusion
The study findings indicate a low QoL among PE patients, emphasizing the necessity for enhancements in
post-diagnosis medical care and long-term management strategies to improve patient outcomes.
4.Results of viral and bacterial pathogens detected in children hospitalized with pneumonia
Uugantsetseg E ; Miyesuren E ; Orlom D ; Tsevegmid U ; Oyungerel R ; Khosbayar T
Mongolian Journal of Health Sciences 2025;89(5):133-137
Background:
Respiratory viral and bacterial infections are one of the leading causes of hospitalization and death worldwide,
particularly affecting children, the elderly, and immune compromised individuals. The detection of causative pathogens
is crucial for understanding the epidemiology, prevention, management, and treatment of severe pneumonia. Molecular
diagnostic methods provide high sensitivity and speed, enabling the simultaneous detection of viral and bacterial
co-infections.
Aim:
Detection of single and combined viral and bacterial infections in hospitalized children with pneumonia using
multiplex PCR.
Materials and Methods:
We conducted a cross-sectional study design involving 100 hospitalized participants at the National
Center for Mothers, Newborns, and Women II. The study utilized questionnaires and laboratory analysis methods.
Nasopharyngeal swabs were collected from the participants using a sterile swab and transported in a UTM transport medium
(Jiangsu, China). After nucleic acid extraction using the STARMag 96 ProPrepC assay, the samples were analyzed
with the Seeprep 32 automated analyzer (Seegene Inc., Korea). Real-time polymerase chain reaction (PCR) analysis was
performed using the Allplex™ RV Master Assay and Allplex™ PneumoBacter Assay (Seegene Inc., Korea), with the
CFX-96 system (BioRad Inc., USA).
Results:
The prevalence of viral infections in the study population was as follows: influenza type A 3% (n=3), influenza
type B 3% (n=3), total influenza virus 14% (n=14), respiratory syncytial virus 18% (n=18), adenovirus 10% (n=10),
rhinovirus 20% (n=20), and SARS-CoV-2 5% (n=5). No bacterial infections, such as B.parapertussis or L.pneumophila,
were detected. However, bacterial infections identified included B.pertussis in 1% (n=1), C.pneumoniae in 2% (n=2),
H.influenzae in 43% (n=43), M.pneumoniae in 52% (n=52), and S.pneumoniae in 45% (n=45). Of the 100 children in the
study, 6% had influenza or influenza-like illness. Among these, 43% had the virus alone, and 14% had a viral co-infection.
Bacterial infections were detected individually in 40% of cases, with co-infections in 46% of bacterial cases.
Conclusion
Metapneumovirus, B.parapertussis, and Legionella pneumophila were not detected in the study participants
(0%). Among the viral infections, respiratory syncytial virus (18%, n=18) and rhinovirus (20%, n=20) had the highest
prevalence. For bacterial infections, H.influenzae (43%, n=43), M.pneumoniae (52%, n=52), and S.pneumoniae (45%,
n=45) were most commonly detected.
5.Risk Factors and Clinical Characteristics of Pulmonary Embolism Among Mongolian Patients
Javzan-Orlom D ; ; Chuluunbileg B ; Gantogtokh D ; Enkhtuguldur M ; Munkh-Erdene D ; Zolzaya B ; Enkh-Amgalan Ts ; Altankhuyag N ; Amgalandari B ; Badamsed Ts ; Tumur-Ochir Ts ; Solongo B
Mongolian Journal of Health Sciences 2025;90(6):55-62
Background:
The annual incidence of pulmonary thromboembolism is reported to be 39–115 cases per 100,000 population,
with rates of 60–120/100,000 in Western countries and 10–20/100,000 in Asian countries. In Mongolia, few studies
revealed the prevalence of risk factors and clinical manifestations of acute pulmonary embolism. Over the past 30 years,
the incidence of risk factors for non-communicable diseases, which are mainly triggered by lifestyle and social parameters,
has rose. Moreover, environmental conditions such as cold climate, hypoxia, and blood hyperviscosit may contribute
to higher incidences of acute pulmonary embolism in high-altitude regions. This condition is potentially fatal and can
become impair quality of life.
Aim:
We aimed to compare risk factors and clinical characteristics based on age and sex, and to evaluate laboratory findings
and diagnostic tests among Mongolian patients diagnosed with acute pulmonary embolism.
Materials and Methods:
This retrospective research included total 232 patients meeting inclusion criteria. The information
was collected from patient histories, including general demographics, risk factors, comorbidities, symptoms, and
physical examination findings. Laboratory analyses included complete blood count, coagulation profile, and immunological
markers (D-dimer, NT-proBNP, troponin, protein C, homocysteine, and C-reactive protein), as well as selected
imaging parameters. We used Wells and Geneva scoring systems to assess probability of acute pulmonary embolism and
Pulmonary Embolism Severity Index to determine disease severity. Differences by age and sex were analyzed using independent
t-tests for continuous variables and chi-square tests for categorical variables.
Results:
Among participants with acute pulmonary embolism, the prevalence of tobacco and alcohol use was significantly
higher among males (p<0.001). Among comorbidities, arterial hypertension and other pulmonary diseases were more
common in males, whereas cardiac diseases were more frequent in females (p=0.028). Participants aged 65 years and
older showed higher rates of comorbid conditions and regular medication use (p<0.001). The most common symptoms
were dyspnea (90.9%), chest pain (74.2%), cough (70.5%), leg pain (38.9%), hemoptysis (20.7%), and cyanosis (9.3%).
According to sPESI scoring, 69.8% (n=162) were at high risk of death within 30 days, with no significant difference by
sex. However, mortality risk within 30 days was significantly higher in participants aged 65 years and above (p<0.001).
As increasing age, the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were elevated, indicating an acute
inflammatory response (p=0.001). Contrast-enhanced CT scans revealed that 95 participants (44.2%) had main pulmonary
artery involvement, with no significant sex difference, though involvement of the main pulmonary artery was more
frequent in those aged 65 and older.
Conclusion
Dyspnea, chest pain, and cough were the most common symptoms among patients diagnosed with acute
pulmonary embolism. The 30-day mortality risk associated with it was higher among males and increased with advancing
age.
Result Analysis
Print
Save
E-mail