1.Case report: Kaposi's sarcoma of the larynx and pharynx
Nyamdulam L ; Tamir L ; Tsend-Ayuush A ; Dolgortseren P ; Purevdorj S ; Bilguntur Kh ; Jargalkhuu E ; Bazarmaa Ts ; Munkhbaatar P ; Sayamaa L ; Shijirtuya B ; Khulan Kh ; Amina G ; Bayarmaa T
Mongolian Journal of Health Sciences 2025;87(3):29-34
Background:
A rare angioproliferative condition of the larynx, Kaposhi sarcoma
typically affects the skin. Immunosuppressive treatment following organ
transplantation and human immunodeficiency virus infection are the causes.
Every type of Kaposi sarcoma has human herpesvirus-8. Laryngeal kaposi
sarcoma is uncommon in immunocompromised patients; since its initial identification
in 1965, 18 cases have been documented globally. A CO2 laser-assisted
laryngeal microsurgery is performed through the mouth cavity to remove
tumor when kaposi sarcoma of the larynx obstructs the airway. Case report: A
77-year-old woman complained of hoarseness, dry mouth, odynophagia, and
dysphagia three months prior when she arrived at the Mongolian-Japan Hospital.
Two years ago, she acquired hard, sensitive lumps that were palpable
on her right arm, left ankle, and right thigh. At that time, she was diagnosed
with Kaposiform hemangiodermatitis and treated at the National Center for
Dermatology. HIV test results were negative. Immunohistochemistry: CD31
+/-, CD34 /+/. Using flexible nasopharyngeal endoscopy to get the diagnosis:
There was a mass that was about 1.5–2–5 cm in diameter, bluish in color,
smooth and movable, and spongy and vascular on the larynx, on the nasopharynx,
behind the palatine tonsills, and supraglottic. Surgery: Through the
use of Kleinsasser laryngoscopy and a 0-degree endoscope, pathological tissues
were extracted under general anesthesia using a laryngeal microsurgical
instrument and a laparoscopic bipolar coagulator. The tissues were then sent
for histological evaluation, which revealed Kaposi sarcoma, sarcoma grade 1.
Results of treatment
Pain decreased and quality of life increased following
surgery. Upon nasopharyngeal endoscopy, the vocal cord mobility was normal
and the surgical incision was clean. Conclusion: Kaposi sarcoma is an
extremely uncommon illness. A lower quality of life and further issues can be
avoided with an early diagnosis and suitable therapy. It also needs to be continuously
monitored because it is a potentially repeatable disease.
2.Study of EGFR Gene Mutation Detection in Non-Small Cell Lung Cancer
Mergen D ; ; Tamir B ; Dolgorsuren P ; Ganzorig B ; Undarmaa T ; Enkhjargal B ; Adilsaikhan M
Mongolian Journal of Health Sciences 2025;90(6):105-111
Background:
Lung cancer remains the leading cause of cancer-related mortality worldwide, accounting for approximately
1.8 million deaths annually and representing 18% of all cancer deaths¹. According to the GLOBOCAN 2024 report, 2.4
million new cases were registered globally, ranking second after breast cancer². Non-small cell lung cancer (NSCLC) constitutes
85% of lung cancer cases, with adenocarcinoma being the most common subtype³. The objective of this study is
to map the prevalence of HER2 activation and mutations in EGFR, EML4-ALK, ROS1, BRAF, and KRAS genes among
lung cancer patients in Mongolia, and to evaluate their correlations with clinical and morphological parameters (age, sex,
smoking status, stage, and morphology).
Aim:
To determine the distribution pattern of HER2 activation and EGFR, EML-ALK, ROS1, BRAF, KRAS gene mutations
among patients with lung cancer in Mongolia, and to evaluate their associations with clinical and morphological
characteristics.
Materials and Methods:
A retrospective study was conducted using archived materials from lung cancer patients at the
Clinical Pathology, Molecular Genetics, and Pathology Laboratories of the National Cancer Center of Mongolia, covering
the period from 2019 to June 2025.
DNA Extraction from Tumor Tissue: Formalin-fixed paraffin-embedded (FFPE) tissue blocks from patients diagnosed
with lung cancer, stored in the pathology department archives, were selected for the study. Sections of 5–10 μm thickness
were cut, mounted on glass slides, stained with hematoxylin and eosin (H&E), and reviewed by a pathologist. Areas containing
≥20–30% tumor cells were identified and macro-dissected for analysis.
Real-Time PCR Assay for Detection of EGFR/BRAF/KRAS/EML4-ALK/ROS1 Mutations: EGFR mutation detection
was performed using the PANAMutyper™ EGFR Mutation Detection Kit (Panagene, Daejeon, South Korea) according
to the manufacturer’s instructions. PCR reactions were carried out on a compatible instrument (Roche LightCycler 480,
Germany) as recommended by the manufacturer. Statistical analysis was performed using Prisma-10 software.
Results:
A total of 282 lung cancer cases were included in the study. EGFR mutations were detected in 44% of cases and
were absent in 56%. No significant age-related differences were observed (p=0.2636); however, EGFR mutations were
significantly more frequent in females (36.6% vs. 19.6%, p=0.0019). No statistically significant differences were found
across disease stage, T, N, or M classifications (p>0.05). No association was identified between smoking status and EGFR
mutations (p=0.4178). Morphologically, EGFR mutations were significantly more prevalent in adenocarcinoma (54.83%)
compared to squamous cell carcinoma (SCC) (31.8%; p=0.002).
Of the 282 cases, adenocarcinoma accounted for 155 (54.9%) and SCC for 116 (41.1%). Overall, EGFR mutations were
positive in 43.97% of cases, with a higher prevalence in adenocarcinoma (24.82%) than in SCC (13.1%). By exon:
- Exon 18 mutations were detected in 6% of cases, predominantly in adenocarcinoma (6%, 4.25%).
- Exon 19 mutations occurred in 8.15% and are associated with sensitivity to targeted therapy.
- Exon 20 mutations were found in 3.19%, with the T790M resistance variant in 1.77%.
- Exon 21 mutations were observed in 9.57%, more common in adenocarcinoma (9.57%) than in SCC (3.19%).
Survival analysis stratified by stage at diagnosis showed significantly longer median survival in early-stage patients (18.6
months). Kaplan-Meier curve comparison, log-rank test, and hazard ratio calculations confirmed statistically significant
differences (p < 0.05), indicating that disease stage is a key prognostic factor.
Conclusion
The study findings reveal a high prevalence of EGFR mutations among Mongolian patients with lung adenocarcinoma,
underscoring the need for widespread implementation of targeted therapy (EGFR-TKIs). In contrast, mutation
rates were lower in SCC and other morphological subtypes, highlighting the importance of investigating alternative
molecular markers in these subgroups.
3.Role for Social Media in Pediatric Liver Disease: Caregiver and Provider Perspectives
Douglas B. MOGUL ; Mary Grace BOWRING ; Jennifer LAU ; Erin BABIN ; John F.P. BRIDGES ; Sanjiv HARPAVAT ; Tamir MILOH
Pediatric Gastroenterology, Hepatology & Nutrition 2020;23(6):548-577
Purpose:
To better understand the benefits and harms of engagement with online pediatric liver disease communities within social media.
Methods:
We conducted a survey of caregivers of children with liver disease participating in online pediatric liver disease communities within social media, as well as a survey of healthcare providers (e.g., physicians, surgeons, nurse coordinators) from this field to better understand the perceived benefits and harms of participation.
Results:
Among 138 caregivers of children with liver disease that completed the survey, 97.8% agreed social media was a good place to learn about patient experiences and 88% agreed it was a good source of general information. Among caregivers, 84.8% agreed social media helps them to better advocate for their child. While 18% agreed that the information over social media was equal to the information from their healthcare team and 19% neither agreed/disagreed, only 3% indicated they would use this information to change care without telling their provider; in contrast, among 217 healthcare providers, 55% believed social media may lead caregivers to change management without telling their team.
Conclusion
Engagement with online disease-specific communities in social media yields several benefits for caregivers and, in contrast to healthcare providers' concerns, participation is unlikely to lead to problems including caregivers changing the treatment plan without first discussing these plans with their team. Openness between caregivers and medical teams about the role for social media can help to improve trust and maximize the potential benefits of engagement with these groups.
4.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.

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