1.Clinical and demographic factors of long-term physical disability in patients with demyelinating diseases
Urantugs G ; Khaliun B ; Tuvshinjargal D ; ; Gantuya D ; Natsagdorj L
Mongolian Journal of Health Sciences 2026;91(1):72-78
Background:
Aetiological mechanisms of demyelinating diseases underlie a very heterogeneous clinical course, ranging from relapsing to progressive, with a longer disease duration leading to physical and cognitive disability.
Aim:
To identify factors in the development of long-term disability in demyelinating diseases.
Materials and Methods:
A cross-sectional study was conducted among 64 patients with multiple sclerosis and 33 patients with NMO treated at the Third State Central Hospital. We assessed demographic and clinical data, including the Expanded Disability Status Scale (EDSS). Statistical analysis included descriptive statistics, t-tests, chi-square tests, analysis of variance, correlation, and regression.
Result:
In MS, relapses (≥1) within 1.0 years of MS onset (OR=5.5, 95% CI 1.11-26.69, p=0.037), optic neuritis (OR=4.3, 95% CI 1.02-21.67, p=0.014), relapse frequency (≥3) (OR=6.6, 95% CI 1.39-31.3, p=0.018), myelitis frequency (≥2) (OR=5.5, 95% CI 1.42-21.67, p=0.014), in NMOSD, time from disease onset to diagnosis (≥3 month) (OR=7.9, 95% CI 1.04-60.7, p=0.046), years of diagnosis (≥3 years) (OR=6.3, 95% CI 1.15-34.12, p=0.034) contributed to disabilty worsening outcomes.
Conclusion
Disability in demyelinating diseases is affected by many factors.
2.Quantitative assessments of brain in multiple sclerosis patients
Khaliun B ; ; Enkhtuya M ; Janar M ; Urantugs G ; Lkhamtsoo N ; Tuvshinjargal D ;
Mongolian Journal of Health Sciences 2026;96(6):133-138
Background:
Multiple sclerosis (MS) is an autoimmune inflammatory neurodegenerative disease of the central nervous system and a major cause of disability in young adults. MRI is essential for diagnosis and monitoring, while early evaluation of structural brain changes is important.
Aim:
To evaluate brain volumetric changes using automated MRI analysis in patients with MS.
Materials and Methods:
This case–control study included 50 MS case patients and 50 controls patients examined between 2020–2023 at the Third State Hospital. T1-MPRAGE images were analyzed using volBrain automated segmentation software.
Result:
The mean age of MS patients was 45.5±11.8 years. Compared with healthy controls, the MS group showed significantly lower total grey matter volume (p=0.002), cortical grey matter volume (p<0.001), subcortical grey matter volume (p=0.006), and cerebral volume (p=0.02). Significant volume reductions were also observed in the temporal (p=0.006) and occipital (p<0.001) lobes. Deep grey matter structures, including the thalamus (p=0.001), caudate nucleus (p=0.009), putamen (p=0.008), and nucleus accumbens (p<0.001), also showed significantly reduced volumes. Disease duration was negatively correlated with total grey matter volume (r=−0.30, p=0.02), thalamic volume (r=−0.28, p=0.04), and occipital lobe volume (r=−0.43, p=0.002). Disease duration was also significantly associated with spinal cord involvement (p=0.01) and grey matter volume (p=0.04). The number of relapses was negatively correlated with total brain volume (r=−0.28, p=0.046).
Conclusion
Patients with MS demonstrated decreased grey matter volume, particularly within deep grey matter structures, along with increased abnormal white matter volume, suggesting the coexistence of neurodegeneration and demyelination in MS. Brain volume loss in MS appeared to occur independently of aging. Automated quantitative MRI analysis may provide important diagnostic value in detecting structural brain changes associated with MS.
3.Investigating the effects of age, body composition, and breast morphology on mammographic imaging
Tugsjargal P ; Dariimaa G ; Erdembileg Ts ; Enebish S ; ; Tuvshinjargal D
Mongolian Journal of Health Sciences 2026;96(6):228-232
Background:
Although breast density is an important determinant of breast cancer risk and the likelihood of masking pathological lesions on mammography, it is insufficient to fully characterize the breast imaging phenotype on its own. Age, body mass index (BMI), total body fat percentage, breast size, compressed breast thickness, tissue distribution, and reproductive history influence not only the biological composition of the breast but also the technical conditions of mammographic imaging.
Aim:
To synthesize the evidence on how age, BMI, body composition, breast-specific anthropometric characteristics, reproductive factors, and population-specific characteristics influence mammographic imaging.
Materials and Methods:
In this review, we synthesized evidence from studies indexed in PubMed/MEDLINE, Scopus, Embase, and Web of Science from 2000 through August 2026, focusing on the associations of these factors with mammographic appearance, lesion conspicuity, BI-RADS classification, image quality, radiation dose, and screening performance.
Result:
Breast density generally decreases with advancing age and during the menopausal transition. Increasing BMI and adipose tissue volume are also associated with lower breast tissue density. Therefore, the absolute volume of fibroglandular and connective tissue should not be inferred directly from percent breast density alone. Breast-specific parameters, particularly compressed breast thickness and breast volume, are clinically important because they influence positioning, compression, exposure parameters, and mean glandular dose. Studies in Asian cohorts have demonstrated significant associations between age, body size, and mammographic characteristics, although substantial inter-population differences have been reported. Advances in digital breast tomosynthesis (DBT) and artificial intelligence (AI) are enabling a transition from single-category breast density assessment toward multidimensional breast phenotyping. Future research should integrate DICOM technical parameters, standardized anthropometric measurements, quantitative breast density measures, and externally validated AI-derived features to improve personalized screening and radiation dose optimization.
Conclusion
Breast imaging phenotype should be considered a multidimensional construct integrating breast density with age, body composition, breast spatial architecture, imaging parameters, and validated AI-derived features. This approach may improve biological interpretation, radiation dose estimation, and risk stratification while avoiding the oversimplification that a single breast-density percentage or BI-RADS density category can fully characterize the breast phenotype.
4.Comparative Study of Brain White Matter Hyperintensity Burden in Adults with Type 2 Diabetes
Tserensugir A ; ; Oyuntugs B ; Gonshigsuren D ; Tuvshinjargal D ; Tovuudorj A ; Mungunbagana G ; Munkhbaatar D ; Delgerdalai Kh
Mongolian Journal of Health Sciences 2026;95(5):253-256
Background:
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with cognitive impairment and structural brain alterations. White matter hyperintensities (WMH) detected on magnetic resonance imaging (MRI) serve as critical neuroimaging markers of cerebral small vessel disease. However, research evaluating the WMH burden in the Mongolian population with T2DM using AI-based automated quantitative methods and comparing these findings with a control group remains limited. This research gap provides the rationale and necessity for the current study.
Aim:
To evaluate and compare the burden of brain white matter hyperintensities (WMH) in adults with type 2 diabetes mellitus (T2DM) versus a control group.
Material and Methods:
This analytical cross-sectional, retrospective comparative study included participants aged 40 and older who underwent brain MRI at the Mongolia-Japan Hospital of MNUMS between 2019 and 2025. The T2DM group consisted of patients with a confirmed diagnosis, while the control group included individuals without diabetes or prediabetes. After excluding cases with major structural abnormalities, poor image quality, failed automated processing, or incomplete clinical data, 257 out of an initial 283 participants were included in the final analysis (T2DM: 71, Control: 186). 3D T1-weighted MPRAGE and T2-FLAIR MRI sequences were processed using Neurophet AQUA software (version 3.1) to assess total, deep, and periventricular Fazekas scores. Age- and sex-adjusted ordinal logistic regression analysis was performed using SPSS 25.0, with p<0.05 considered statistically significant.
Results:
A total of 257 participants (T2DM=71, Control=186) were analyzed. There were significant differences between groups in sex distribution (p=0.046) and age categories (p<0.001). The T2DM group exhibited significantly higher total and deep Fazekas scores compared to the control group (total Fazekas: aOR 10.81, 95% CI 5.20-22.49; deep Fazekas: aOR 8.21, 95% CI 4.32-15.60; both p<0.001). Increasing age was associated with higher total (aOR 1.07, 95% CI 1.03-1.11, p=0.001) and deep (aOR 1.04, 95% CI 1.00-1.08, p=0.037) Fazekas scores. Additionally, female sex was associated with higher total (aOR 1.95, 95% CI 1.04–3.63, p=0.036) and deep (aOR 1.95, 95% CI 1.08–3.51, p=0.026) Fazekas score categories.
Conclusion
Assessment of WMH burden using AI-based automated quantitative MRI processing revealed that T2DM is significantly associated with higher total and deep Fazekas scores. This association remained significant after adjusting for age and sex. These findings suggest that AI-based MRI processing is a suitable method for the objective, quantitative, and standardized assessment of brain WMH burden associated with T2DM.
5.Results of voxel-based morphometry of the brain in children aged 9–11 years: a comparison between children with maxillary hypoplasia and those under neurological follow-up
Tuvshinjargal D ; Purevsuren E ; Otgonjargal L ; Choinyam B ; Darambazar G ; Amgalan B ; Purevdolgor L ; Munkh-Soyol E ; Xiling Jiang ; Damdindorj B
Mongolian Journal of Health Sciences 2026;94(4):7-12
Background:
The human head is an integrated biological structure composed of the brain, cranial bones, facial structures, neuromuscular systems, and sensory organs, all interconnected through coordinated signaling. The relationship between brain development, function, and craniofacial growth is most evident after birth, during which the head increases approximately fourfold in size before adulthood. Brain morphology and volume are associated not only with neurological disorders but also with cognitive and behavioral characteristics. For example, children with holoprosencephaly often present with varying degrees of facial anomalies, while studies have shown that adolescents with malocclusion exhibit higher levels of anxiety, depression, and psychological stress. With the increasing availability of magnetic resonance imaging (MRI), it has become an essential diagnostic tool in clinical practice. MRI is particularly advantageous in pediatric populations due to the absence of ionizing radiation and its superior soft tissue contrast. Recent advances in image processing techniques have enabled comprehensive analysis of both brain structures and craniofacial morphology from a single MRI dataset, forming the basis of this study.
Aim:
To investigate the relationship between brain tissue volumes and maxillary hypoplasia using MRI-based voxelbased morphometry in children with neurological conditions.
Materials and Methods:
This study was conducted at the School of Biomedicine, Mongolian National University of Medical Sciences, in collaboration with Chifeng University, as part of the project titled “Investigation of the relationship between craniofacial anomalies and brain disorders using MRI”, funded by the Ministry of Education and Science. Voxel-based morphometry (VBM) analysis was performed on brain MRI scans of children aged 9–11 years.
Results:
Among the 25 children included in the study, 17 (68%) were male. The youngest average age was observed in the maxillary hypoplasia group (8.4±0.95 years). The signal-to-noise ratio (SNR) of MRI was lowest in the non-temporal epilepsy group (41.1±1.35) and higher in the maxillary hypoplasia group (49.6±8.22). Both epilepsy and maxillary hypoplasia groups demonstrated physiological asymmetry of the cerebral hemispheres, with left parietal lobe dominance (−0.1% and −0.3 cm, respectively). Right frontal lobe dominance (+1.1%) was observed only in the epilepsy group.
Conclusion
Children aged 9–11 years with maxillary hypoplasia showed a reduction in both gray and white matter volumes of the brain. These findings highlight the importance of early diagnosis of neurodevelopmental disorders affecting odontogenesis and emphasize the need for a multidisciplinary team-based management approach.
6.A rare presentation of multi-drug induced Long QT syndrome misdiagnosed as epilepsy
Urantugs G ; Tuvshinjargal B ; Bayarmaa D ; Tuvshinjargal D ; Saruul N ; Lkhamtsoo N
Mongolian Journal of Health Sciences 2025;90(6):244-249
Background:
Multidrug-induced long QT syndrome is a serious heart rhythm disorder where multiple medications prolong the QT interval on an electrocardiogram, increasing the risk of a potentially fatal arrhythmia. Long QT syndrome
is characterised by heart rate corrected QT interval prolongation and life-threatening arrhythmias, such as polymorphic
ventricular tachycardia, Torsades de pointes leading to syncope and sudden death.
Case:
21-year-old woman required resuscitation from an apparent cardiac arrest that had occurred after status epilepticus.
The woman was diagnosed with long QT syndrome, cardiac channelopathy. She had a long history of syncope, seizure
and palpitations. Family history was non-contributory. Home medications included levetiracetam 500 milligrams orally
twice and fluoxetine 20 milligrams orally once a day which the patient reported non-compliance with. Levetiracetam is
a widely used anti-epileptic medication secondary to its favorable safety profile. To our knowledge, there are few other
case reports documenting torsades de pointes after levetiracetam administration, and specifically our case report will be
the first documenting cardiac arrest after multidrug administration.
Long QT syndrome is not often included in the differential diagnosis of epileptic and non-epileptic seizures. Early recognition of the syndrome is very important because of prognostic and therapeutic consequences.
Conclusion
Although no hereditary cause was confirmed, this case represents Torsades de Pointes triggered by multiple
medications—including long-term low-dose carbamazepine, fluoxetine, diazepam, and high-dose levetiracetam—on a
background of probable Romano–Ward syndrome or predisposition to QT prolongation. The arrhythmia progressed to
cardiac arrest, requiring ICD implantation.
7.Characteristics of cerebral Infarction in young and old patients
Delgermaa Ts ; Tsagaankhuu G ; Tuvshinjargal D ; Baigalmaa G ; Tovuudorj A
Mongolian Medical Sciences 2016;177(3):10-19
Background
Ischemic stroke or cerebral infarction in young adults (20-50 years) is relatively frequent, accounting for
more than 10%-26% of all first strokes and its incidence rises steeply with age. Causes of “Young stroke”
are heterogeneous and while it generally has a good prognosis, it has a significant socioeconomic
impact, including functional deficits and financial costs. The most frequent causes of cerebral infarction
in young adults are cardio-embolism, hypertension, premature atherosclerosis, migraine, smoking and
hypercoagulable states.
Objective
The aim of this study was to compare characteristics of cerebral infarction between young (20-49 years)
and old (50-89 years) patients undergoing investigations and treatment according to one common
protocol in the tertiary hospital.
Methods
This Descriptive case series study was conducted in Department of Neurology of First State Central
Hospital from October 2014 to July 2016. During this study, we observed 220 patients with first-onset
of cerebral infarction from which 90 young patients (under 50 years) and 130 old one (above 50
years), based on prospective study. Data regarding the etiology and risk factors of the stroke, clinical
manifestations, and diagnostic test results of patients were examined during their hospital treatment as
well as a NIHSS, modified Rankin Scale scores, and Barthel Index at admission and discharge, also
at 21 day. Stroke subtyping was conducted in accordance with the Trial of Org 10172 in Acute Stroke
Treatment (TOAST) criteria.
Results
In total, 220 patients with cerebral infarction were included, from which 90 (40.9%) were 20-50 years
and 130 (59.1%) were 50-89 years. The proportion of males was higher among both groups: 61.1% vs.
70.0%. Common causes for cerebral infarction in the young patients were current smoking (53.3.1% vs.
37.8%), long-term alcohol consumption (51.1 vs. 12.3), cardiac embolism (36.0% vs. 16.2%), migraine
with aura (25.5% vs. 12.2%), infective diseases (15.6% vs. 0.8%), and oral contraceptive use (14.4
vs. 0%). Leading causes for ischemic stroke in old patients were the conventional risk factors such as
hypertension (75.4% vs. 38.9%), atherosclerosis (66.9% vs. 31.1), coronary artery disease (24.3% vs.
12%), and diabetes mellitus (26.9% vs. 6.7%). Most of the young stroke patients demonstrated good
functional outcomes, at the time of discharge (71.1% vs. 60%) and three weeks (86.6% vs. 66.2%)
patients had Rankin Scale scores in the range of 0-2.
Conclusions
There are significant differences between young and old patients with cerebral infarction regarding to risk
factors, etiological subtypes and improvement of functional deficits associated with the stroke. However,
severity of stroke on admittance is similar but three weeks outcome is different among young and old
patients with relatively rapid improvement of functional deficit in young stroke patients than old one.
8. Study of Salmonella cell lysis activity by bacteriophage
Ulziijargal E ; Oyunbileg J ; Tumenjargal D ; Tuvshinjargal G
Health Laboratory 2016;5(1):27-31
Background:Bacteriophages act only host bacterial pathogen selectively not affecting the normal microflora of the human digestive tract, not causing allergies. Also found that the bacteriophage preparations don’t have taste, smell and preparation technology doesn’t affect the structure of bacteriophage. Using of bacteriophages for treatment is safe and has established that they are very effective against multi-drug resistant bacteria according to conducted clinical studies. In our country is using the Bacteriophage preparate which is based on local strain of Salmonella Typhi. Nowadays there is no research data whether environmental physical and chemical factors can affect the Bacteriophage activity.Aim:To study whether the environment physical and chemical factors might influence on Bacteriophage of Salmonella Typhi.Materials and Methods:In this study, were used the test strains of the Salmonellatyphimurium, Salmonella typhi and Bacteriophage of Salmonella Typhi. All procedures are performed according to Mongolian National Standard MNS ISO 2416-94, 3317-94 and Bacteriophage of Salmonella Typhi.Our study was established that physical and chemical factors: temperature of water bath, chloroform action time interval, procedure to kept biopreparates all can affect bacteriophage lysis activity.Conclusions:Any use of bacteriophages did not reveal any adverse effects. From the Bacteriophage of Salmonella Typhi preparations kept up to 3 years can be isolated bacteriophage strains by our improved method.
9. Preoperative local staging of colorectal carcinoma in Mongolian patients using computed tomography
Orkhon G ; Nergui B ; Narantsatsralt J ; Gonchigsuren D ; Tuvshinjargal D
Innovation 2015;9(4):34-37
In Europe, colorectal cancer (CRC) is the second most frequent malignancy and the second commonest cause of death from cancer. -The prognosis of CRC patients is dependent on the stage of disease at the time of diagnosis. Contrast-enhanced computed tomography (CT) examinations allows simultaneous assessment of tumor’s local staging, estimation of its possible invasion into neighboring organs, and detection of nodal and distant metastases; which is essential for appropriate treatment planning and estimation of its outcomes. The lack of reports on CT findings in CRC in Mongolia, increase in CRCmorbidity, and significant potential benefits of early detection served as background for this study.We investigated subjects with histologically proven adenocarcinoma who underwent CRC-related operative treatment either at National Cancer Center, First State Central Hospital, or Ulaanbaatar Songdo Hospital (UBSH) in 2009-2012. We retrospectively reviewed and analyzed from the UBSH’ database their preoperative CT, colonoscopy, surgical and pathohistologic reports using PACSPLUS,OCS operation systems. CECT examinations were performed at Siemens Somatom 64 multidetector scanner.Countrywide, 111 patients underwent surgery for colorectal cancer in 2009-2012. Totally, we involved86 subjects, whose age ranged from 25 to 87 years (mean 61.3years ±13.7SD). The F: M= 48 (55.8%) :38 (44.2%).The CECT determined T2 staging in 10/86 (11.6%),T3 in 61/86 (70.9%); T4 in 15/86 (17.4%);a significant difference in T-staging between CECT and histopathological examination (х2=41.28, p=0.00 (p<0.05)) was found. The CECT detected no peritumoral lymphadenopathy (N0) in 39/86 (45.3%), N1 in 18/86 (20.9%) and N2 in 29/86 (33.7%) patients; there was a significant difference in N-staging between CT and histopathological evaluation (х2=17.74, p=0.007(p<0.05)). For T-staging, CECT evaluation yielded sensitivity of 50% in T2 , 83.6% in T3, 71.4% in T4 staging; Diagnostic accuracy of CT for T2 staging was 89.7%, for T3- 78.2%, for T4- 88.7%. For N-staging, CECT had sensitivity of 88.2%, specificity of 64% and accuracy of 73.8%.Preoperative colorectal cancer patients in Mongolia receive initial MDCT in late stage. The similarsensitivity in staging of T-parameter to that of the international comparable studies. Nodal heterogeneity on CECT was more sensitive for nodal metastases than the size.
10. Intraperitoneal acute toxicity study of Tetima herbal compound extract, in experimental animals
Anar E ; Yeruult CH ; Batkhuyag P ; Khaliun N ; Narantungalag D ; Tuvshinjargal TS
Innovation 2015;9(4):42-45
The Mongolian plants considered to possess medicinal properties may contain novel compounds since they are exposed to severe conditions; such plants could become good candidates for modern drug discovery programs. Daurian Thermopsis (Thermopsis lanceolata R.Br.= Th.dahurica Czefr.), Gobian Thyme (Thymus gobicus Tschern.) and Mogilev Mallow (Malva mohileviensis Downer) are separately used as mucolytic and anti-inflammatory treatment in non-conventional medicine. Therefore, weprepared extract of these herbals compound called as a Tetima and to evaluate it’s acute toxicity. It isimportant to produce mucolytic effective new pharmaceutical preparation used for upper and lowerrespiratory tract inflammatory disease.Tetima herbal compound extract was prepared in ethanol, the ratio of herbals to ethanol was 1:10. Healthy 25 white albino mice (male weighing between 17-30 gram) used in this study. They were kept in large airy cages in groups of 5 animals per cage with free access to food and water. Five doses (8-20 g/kg) were then chosen for the determination of intraperitoneal LD50 in mice and given to five groups of albino mice. The animals were observed for first 2 hours and then at 6th and 24th hour for any toxicsymptoms. After 24 hours, the number of deceased mice was counted in each group. The percentage of animals that died at each dose level was transformed and then LD50 determined by the methods of Karber and Pershin.G.N.The LD50 of Tetima herbal compound in mice was determined to be 14.3 g/kg after intraperitonealinjection. There was no difference occurred between Karber and Pershin methods to evaluate acute toxicity. In the animals receiving intraperitoneal injection, the abdominal muscle contractions and ataxia was observed, which persisted for few hours. At the 6th hour they were drowsy and less responsive. The severity of these effects was related to the level of dose. However, at 24th hour most of the survivors had recovered from these symptoms.Tetima herbal compound extract is a relatively safe, particularly when given intraperitoneal inject toexperimental animals.
Result Analysis
Print
Save
E-mail