1.Clinical case of treating skeletal Class II malocclusion with severe crowding without extraction
Tsendsuren Kh ; Undrakh N ; Molor-Od O ; Dolgor B
Mongolian Journal of Health Sciences 2026;93(3):217-220
Background:
In recent years, as the demand for orthodontic treatment has increased, the need to thoroughly investigate the causes of dental and skeletal malocclusions has become more important. In skeletal Class II malocclusion, mandibular deficiency prevalence for 70–80% of cases, maxillary excess for 10–20%, and a combination of both for approximately 15% (Figure 1). In cases associated with mandibular deficiency, clinical features include severe dental crowding, deep overbite, and reduced lower facial height. These conditions negatively affect facial profile, occlusion, masticatory function, and airway. Therefore, accurate diagnosis and appropriate treatment planning are essential.
Diagnosis:
Skeletal Class II malocclusion, deepbite, and severe crowding.
Treatment:
in August 2025, using self-ligating brackets with posterior bite up placed on the molars. After 4 months, a temporary anchorage device (TAD) was inserted, and anterior retraction was performed along with vertical elastics. Within 7 months, the overjet was decreased from 7 mm to 3 mm, and the overbite decreased from 7.5 mm to 4.5 mm. Midline deviation and arch form were corrected, and molar and canine relationships improved to Angle Class I. The facial profile also showed noticeable improvement.
Conclusion
Within a relatively short period after treatment initiation, severe crowding was resolved, and both sagittal and vertical relationships of the anterior teeth improved to normal values. Molar and canine relationships were significantly improved, along with facial esthetics. This case demonstrates that with proper planning, TAD-supported orthodontic treatment can be an effective non-extraction approach for certain cases of skeletal Class II malocclusion with severe crowding.
2.Splenic Predominant Diffuse Large B-Cell Lymphoma: A Rare Case Report
Enkhsaikhan S ; Erdenetuya J ; Demberelmaa B ; Erdenechimeg T ; Uugantuya P ; Tsendsuren B ; Batdelger B
Mongolian Journal of Health Sciences 2026;95(5):325-328
Background:
Diffuse large B-cell lymphoma (DLBCL) is a common subtype of non-Hodgkin lymphoma of B-lymphocyte origin, characterized by an aggressive clinical course. Clinically, it most often presents with lymphadenopathy and “B symptoms,” including fever, night sweats, and weight loss. However, in some cases, the disease predominantly involves extranodal organs, such as the spleen, and may present with nonspecific manifestations, thereby posing a diagnostic challenge.
Case presentation:
A 36-year-old male patient presented with high-grade fever of unknown origin, dyspnea, generalized weakness, sweating, and a 7–8 kg weight loss over one month. Clinical evaluation and laboratory investigations revealed massive splenomegaly measuring 15 × 20 × 20 cm, progressive thrombocytopenia, anemia, and elevated C-reactive protein and lactate dehydrogenase levels. Diagnostic workup for infection, tuberculosis, viral infection, and autoimmune disease did not reveal findings sufficient to establish an alternative diagnosis. Because focal splenic lesions and suspected splenic infarction were identified, splenectomy was performed. Histopathological and immunohistochemical examination of the splenic tissue demonstrated CD20+, CD79a+, BCL2+, CD3−, CD8−, CD30−, and ALK− expression, confirming the final diagnosis of diffuse large B-cell lymphoma. Although DLBCL itself is a common form of non-Hodgkin lymphoma, this case is clinically rare and diagnostically challenging because it presented with predominant splenic involvement, massive splenomegaly measuring 15×20×20 cm, treatment-resistant fever, progressive thrombocytopenia, and imaging findings mimicking splenic infarction.
Conclusion
In patients presenting with fever of unknown origin that is resistant to treatment, massive splenomegaly, thrombocytopenia, elevated LDH, and increased inflammatory markers, lymphoproliferative disorders should be considered early in the differential diagnosis in addition to infectious causes. Histopathological and immunohistochemical examination play a crucial role in confirming the diagnosis.
3.Current status of Atopic dermatitis in Mongolia: (2015-2025)
Oyuntsatsral B ; Dulguunkharaa B ; Anujin M ; Badamsuren G ; Narantuya B ; Tsendsuren S
Mongolian Journal of Health Sciences 2026;94(4):102-106
Background:
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by epidermal barrier dysfunction, immune dysregulation, and significant clinical burden. In Mongolia, research on AD has increased over the past decade; however, findings remain fragmented across various areas.
Aim:
To synthesize evidence from studies conducted in Mongolia over the last 10 years regarding the pathogenesis, clinical features, diagnosis, and treatment of atopic dermatitis.
Materials and Methods:
A narrative review was conducted, including original studies on Mongolian populations published within the last decade. Studies addressing skin barrier function, immunological mechanisms, genetic factors, environmental exposures, clinical severity, diagnostic tools, and treatment approaches were included.
Results:
The study findings show that genetic studies identified polymorphisms in the filaggrin gene and, more recently, mutations in the GCDH gene, suggesting these are linked to AD severity and allergen sensitization. Research on the immunopathogenesis of AD revealed that Th2-type cytokines, especially IL-3 and IL-4, are associated with pruritus and disease severity. Additionally, decreased skin hydration and increased transepidermal water loss in individuals with AD were linked to greater disease severity. Disease severity was evaluated using the SCORAD, EASI, and POEM tools, with most studies reporting that mild-to-moderate AD was most common. Clinically, symptoms like pruritus and sleep disturbances were evident. Additionally, clinical severity was associated with laboratory markers, particularly total IgE levels. The high rate of sensitization to inhalant and food allergens suggests that extrinsic atopic dermatitis (AD) may be common in the Mongolian population. In treatment studies using locally relevant natural products in Mongolia, such as seabuckthorn oil and Shargaljuut mineral spring spray, these products were associated with clinical improvement, suggesting they could serve as additional therapeutic options.
Conclusion
Research on atopic dermatitis in Mongolia has progressed in several areas; however, the current evidence remains limited and is mostly based on cross-sectional, small-sample, single-center, hospital-based studies. Therefore, there is a need for future comprehensive studies that are multicenter, long-term, and involve larger populations.
4.The identification of Unique Personal Characteristicsv and Body Constituition of Students Aged 18-25 Utilizing Information Technology
Delgerekhzaya E ; Lodoisambuu B ; Nyamsaikhan N ; Jargalmaa T ; Tserenvandan Kh ; Dorjbat S ; Tsendsuren S
Mongolian Journal of Health Sciences 2025;86(2):201-205
Background:
The physiology and intellectual traits of individuals are interrelated and should be studied comprehensively.
In traditional medicine, the teachings of wind (khi), bile (shar), and phlegm (badgan) are considered an integrated
system for maintaining health, preventing diseases, diagnosing, and treating illnesses.
Aim:
Our research is to study students’ physical indicators, body composition, innate characteristics and the relationship
between physique and psychological factors.
Materials and Methods:
The study was conducted on relatively healthy individuals, did clinical observations and used a
cross-sectional study design. (defined as those experiencing internal physiological changes that do not impair their work
capacity or active lifestyle)
Results:
Participants were aged 19-25 years, with an average age of 21.5. Heights ranged from 149 cm to 198 cm, with
an average of 165.7 cm. Weights ranged from 37 kg to 111 kg, with an average of 61.55 kg. The Body Mass Index (BMI)
varied between 15.3 and 36.3, with an average of 22.36. The majority of participants were female (76.4%), while male
participants accounted for 23.6%. Regarding individual constitutional types, the most common were: predominantly bile
with wind characteristics (21.2%), predominantly bile with phlegm characteristics (30.8%), predominantly wind with bile
characteristics (19.6%). Stress survey results ranged from a minimum score of 0 to a maximum of 50, with an average
score of 20.6, indicating slightly below-average psychological well-being. The correlation between physiological traits
and psychological survey scores was R=0.323** (p=0.001), showing a weak but positive correlation. This suggests that
below-average psychological well-being is only minimally influenced by physiological traits.
Conclusion
The stress survey results indicated an average score of 20.6, slightly below the normal psychological index.
The correlation between constitutional traits and psychological well-being was weak but positive (R=0.323**, p=0.001).
This implies that individual constitutional characteristics have a minimal effect on psychological well-being. In the study
of intrinsic unique characteristics, it has been found that certain physical constitution metrics of the participants demonstrate
both positive and negative correlations with the majority of body types, indicating that individuals exhibit varying
physical constitution characteristics. Additionally, there exists a positive but weak correlation between intrinsic unique
characteristics and stress levels, warranting further investigation.
5.Comparison study colonic polypectomy
Nyamsuren M ; Tsendsuren T ; Burmaajav B
Mongolian Medical Sciences 2023;204(2):14-26
Introduction:
Colorectal cancer remains one of the critical healthcare challenges nowadays. There are a lot of
studies done on colonic polypectomy around the world, and mostly diagnosis with dysplasia change,
so we consider to chose to study this topic.
Aim:
In this study, we aimed to compare the between cold snare polypectomy (CSP) and hot snare
polypectomy (HSP) of removing colon polyps. This method helped us to investigate which of the two
methods is most prevalent for polypectomy.
Materials and Method:
The research was carried out using a targeted sampling method from the cases where colonoscopy
was performed between 2022 and 2023, based on the Center for Imaging Diagnostics and Pathology
of Third General Hospital of Mongolia with a colon polyps less than 5mm in size should be removed
using the cold snare method according to the recommendation, and polyps between 5-10 mm should
be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions
using the Sydney classification.
Result:
The average age of the 81 cases included in the study was 57.9 years, and the male-female ratio was
1:1.2.149 cases (75.6%) of slightly elevated type 0-IIa according to the Paris classification, according
to the morphological structure revealed by endoscopy, while 79 cases (75.6%) were tubular adenoma
according to histological analysis. (38.9%), low grade dysplasia 52 (25.6%) and high grade dysplasia
3 (1.5%) cases are noteworthy. Average polyp was 5-9 mm. Most of polyps removed was left side of
colon especially in sigmoid colon. Bleeding rate was higher in hot snare method 11.5%. (1/149, 0.7%,
5/52, 9.6%; P = 0.6). There was no recurrent rate and no perforation in our study.
Conclusions
In our study, average size of 5-9 mm were removed and slightly elevated (0-IIa),
sessile (0-Is) type of polyps were commonly found in the sigmoid colon. There is a higher risk of
bleeding due to mucosal damage in hot snare polypectomy. A combination of hot and cold methods
is equally effective for resection of colon pollyps up to 1 cm in size.
6.A comparative study of the complications between hot snare and cold snare polypectomy
Nyamsuren M ; Tsendsuren T ; Burmaajav B
Mongolian Medical Sciences 2022;200(2):40-47
Colorectal cancer remains one of the critical healthcare challenges nowadays. Most patients’ disease, especially colorectal polyps develop via the adenoma carcinoma sequence; using colonoscopy with polypectomy reduces both mortality and incidence by removing precancerous adenomas, which are called polyps. In recent years, colorectal cancer tends to increase among Asian population. There are only limited studies that have been conducted in Mongolia regarding colorectal polypectomy and its complications. Both cold polypectomy and hot polypectomy are accepted methods. In this study, we aim to compare the complications (bleeding, perforation) between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of adenomas and hyperplastic polyps. After the procedure, repeated endoscopy will be performed to compare the incomplete resection rate (IRR) and complete resection rate (CRR) of mucosal residual and presence of recurrency. This will help us to investigate which of the two methods is most prevalent for polypectomy.
7.A comparative study of cold snare and hot snare resection of colon polyps
Nyamsuren M ; Tsendsuren T ; Burmaajav B
Mongolian Medical Sciences 2022;202(4):3-11
Introduction:
Colorectal cancer remains one of the critical healthcare challenges nowadays. Most patients’ disease, especially colorectal polyps develop via the adenoma carcinoma sequence; using colonoscopy with polypectomy reduces both mortality and incidence by removing precancerous adenomas, which are called polyps. In recent years, colorectal cancer tends to increase among Asian population. There are only limited studies that have been conducted in Mongolia regarding colorectal polypectomy and its complications. Both cold polypectomy and hot polypectomy are accepted methods. In this study, we aimed to compare the complications (bleeding, perforation) between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) of adenomas and hyperplastic polyps. After the procedure, repeated endoscopy was performed to compare the incomplete resection rate (IRR) and complete resection rate (CRR) of mucosal residual and presence of recurrency. This method helped us to investigate which of the two methods is most prevalent for polypectomy.
Materials and Method:
The research was carried out using a targeted sampling method from the cases where colonoscopy was performed between 2020 and 2022, based on the Center for Imaging Diagnostics and Pathology of Third General Hospital of Mongolia with a colonoscopy with a high-performance Olympus EVIS EXERA III brand NBI from Japan. In this study, we selected only hyperplastic polyps and adenomas <10 mm in size. Polyps less than 5 mm in size should be removed using the cold snare method according to the recommendation, and polyps between 5-10 mm should be removed using the hot snare method. After polypectomy, we assessed deep mucosal lesions using the Sydney classification.
Result :
According to the results of the study, in terms of age, the percentage of people having a polyp removed was relatively low among 15-39 year olds compared to the other age groups, while it was higher in those aged >65 years. In terms of body mass index, 75% of the total number of people who had a tumor removed were overweight, indicating that overweight or obese people are at higher risk of developing a colorectal polyps.
In terms of gender, 63% of people who had a polyp removed were male, indicating a male predominance in polyp prevalence. The percentage of tumor questionnaires in the total study population was 0% or absent. Early detection of adenomas and hyperplastic polyps, which are precursors of tumor, is the main way to prevent the development of cancer. A slightly raised polyp was present in 53 or 79.1% of the polyps, while a broad-based polyp occurred in 13 or 19% of the polyps, indicating the predominance of the slightly raised polyp in the population.
In terms of location, polyps occurred more often in the descending colon and the sigmoid colon, and complications (perforation, bleeding) related to the anatomical structure and location are more likely to occur in these parts of the colon. However, the likelihood of relapse is very low. The procedure time was 17.6 minutes on average, and in 14 cases, hemostatic clamps were placed to prevent the risk of bleeding, and in 5 cases, epinephrine was injected for hemostasis. Early detection of colorectal diseases (endoscopy), changes in the lifestyle of clients, and regular preventive examinations are the main factors to reduce the risk of cancer development, and early start of treatment as well as complete removal of adenoma, an antecedent to cancer, will have a significant impact on cancer prevention and mortality reduction.
Conclusions
1. Left sided polyps were commonly diagnosed among study participants.
2. Correlation between the probability of recurrence and the anatomical location of the polyps was very low.
3. Our results suggest that HSP and CSP techniques can be effectively used for the complete removal of 4–10mm colorectal polyps. Moreover, there was no significant difference between CSP and HSP in terms of overall complications.
8. DETECTING FOR WORK BURNOUT SYNDROME AMONG WORKERS OF NCMH, USING MBI SCALE
Odonchimeg D ; Khishigsuren Z ; Khongorzul D ; Munkh E ; Bayarmaa B ; Enkhtaivan B ; Baatarjav O ; Tsendsuren Z ; Selenge E
Innovation 2015;9(1):20-23
Mental health team includes a psychiatrist, a psychiatric nurse, psychologist and social workers. Mental health workers are more stressful than other sector’s workers. Mental workers are working with mental patients, who have chronic,severe and poor prognosis disorders for long time, and may have Work Burnout Syndrome (WBS). Worldwide, many researches are used Maslach Burnout Inventory (MBI) for assessing WBS. Our goal was to detect risk factors of WBS among mental health workers. We conducted the survey among workers mental (doctors, nurses and assistant nurses) and study design was a descriptive cross-sectional. We are used a questionnaire, is including MBI. Our subjects were 103 workers, who were 27 (26,2%) doctors, 32 (31,1%) nursesand 44 (42,75) nurse- assistant. They were 15 (14,6%) male and 88 (85,4%) female and average age was 38.21 (SD = 8.92). The worker’s average professional working year was 13.09 (SD = 9.76). Most of subjects (n=63 61.2%) were shift-workers and they (n=99 96.1%) have high workload. We determined 3 groups by level of MBS among mental workers, such as the group with EE’s high scale (n = 27; 27%), thegroup with DP’s high scale (n = 23; 22.8%) and the group with PA’s high scale (n = 50; 50.5%).MBS was high among NMHC’s workers. However their work time is low, but theyhave risk factors for MBI such as high workloads, shift work, number of patients. Workers of emergency department had termination burnout syndrome more than other acute departments. This was associated with working condition.
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