1.A study on corneal morphometric parameters among Mongolian adults
Bayarmaa Kh ; Bayarmagnai L ; Bayasgalan P ; Uranchimeg D
Mongolian Journal of Health Sciences 2025;88(4):56-61
Background:
The corneal endothelium, the innermost layer of the cornea, is composed of hexagonal cells that maintain
corneal transparency and provide essential nutrients to the stroma. These cells play a critical role in preserving visual acuity. Previous studies have demonstrated that endothelial cells do not regenerate, and their density progressively declines
with age, accompanied by morphological alterations. Given the individual variability in corneal thickness and endothelial
morphology, establishing normative reference values is crucial for diagnosing corneal diseases, planning corneal transplantation, and optimizing surgical strategies for cataract surgery. However, there is a scarcity of data regarding central
corneal thickness, endothelial cell density, and cell morphology among Mongolian adults. This knowledge gap provided
the rationale for the present study.
Aim:
To study the central corneal thickness and endothelial cell morphology in Mongolian adults.
Materials and Methods:
This study was conducted using an analytical cross-sectional design. A total of 198 individuals
aged 20 to 79 years were randomly selected, and comprehensive ophthalmic examinations were performed. Corneal parameters—including central corneal thickness, endothelial cell density, mean cell area, coefficient of variation of cell size,
and the percentage of hexagonal cells—were quantitatively assessed using a non-contact specular microscope. Ethical
approval was obtained from the Research Ethics Committee of the Mongolian National University of Medical Sciences
(Approval No. 2024/3-06), and written informed consent was obtained from all participants prior to enrollment.
Results:
The mean age of the study participants was 48.4±14.5 years, with 48.9% (n=97) being male and 51.1% (n=101)
female. In the central cornea, the mean endothelial cell density (ECD) was 2857.14±291.49 cells/mm², the mean central
corneal thickness (CCT) was 526.25±33.67 µm, the mean cell area was 335.11±37.82 µm², the percentage of hexagonal
cells was 64.81±3.94%, and the coefficient of variation (CV) in cell size was 0.31±0.04. With increasing age, both ECD
and the percentage of hexagonal cells showed a statistically significant decline, while the mean cell area and CV demon
strated a significant inverse correlation (P=0.0001). No statistically significant differences were observed in corneal thickness or endothelial morphometric parameters between the right and left eyes or between sexes. Among the Mongolian
adults, the endothelial cell density decreases by approximately 0.3% annually (r=0.2107, p<0.0001).
Conclusion
1. The mean central corneal thickness (CCT) in adult Mongolian individuals was 526.25±33.67 μm, which is comparable to reported averages from other populations. However, the mean endothelial cell density (ECD) was relatively
higher, measured at 2857.14±291.49 cells/mm².
2. With advancing age, a progressive decline in central endothelial cell density and the proportion of hexagonal cells
was observed, whereas the coefficient of variation (CV) in cell size and the mean cell area showed a corresponding
increase
2.Determination sugar and brix content in Mongolian sugar-sweetened beverages
Nyamsuren A ; Khaliun B ; Uranchimeg L ; Nandin-Erdene O ; Gantuya D
Mongolian Journal of Health Sciences 2025;85(1):30-34
Background:
The main risk factors for childhood overweight and obesity include the consumption of sugar-sweetened
beverages and other sweetened foods. The sugar content of sugar-sweetened beverages was different from the nutritional
information on the packaging.
Aim:
To determine sugar and brix content in domestic manufactured sugar-sweetened beverages, and compare information on the packaging and regulatory standards.
Materials and Methods:
The sugar and brix content in sugar-sweetened beverages was determined by laboratory anal
ysis, including 150 domestically manufactured sugar-sweetened beverages. Laboratory analysis carried out in the Chemical toxicology laboratory of the National Reference Laboratory for Food Safety, MASM, determined sugar using a
saccharometer and brix using refractometry.
:
Results: The study included 150 Mongolian sugar-sweetened beverages, including 20.7% (n=31) carbonated drinks,
47.3% (n=71) fruit drinks, 16.0% (n=24) tea drinks, 1.3% (n=2) energy drinks, 14.7% (n=22) flavored water. Sugar content 0.0–15.6% in sugar-sweetened beverages. The laboratory analysis results compared with information on the packaging 72.0% (n=108) difference between 0.1–11.3%, 10.7% (n=16) same, do not have sugar content in the nutritional information on the packaging 17.3% (n=26). Brix contained 0.2–13.0% carbonated drinks, 4.9–15.7% fruit drinks, 0.6–9.8%
tea drinks, 7.7–16.0% energy drinks, and 0.1–9.7% flavored water.
Conclusions
1. Sugar content 0.0–15.6%, brix 0.0–16.0% in Mongolian sugar-sweetened beverages.
2. The laboratory analysis results compared with nutritional information on the packaging 72.0% (n=108) difference
between 0.1–11.3%, 10.7% (n=16) same nutritional information on the packaging, do not have sugar content in the
nutritional information on the packaging 17.3% (n=26).
3. 37.3% of Mongolian sugar-sweetened beverages are unsatisfied with regulatory standards.
3.Quality Assurance of Gastrointestinal Endoscopy Unit - A Single Center Study
Sarantuya Ts ; Amarjargal B ; Tungalag B ; Khishgee D ; Amarmend T ; Delgertsog T ; Amarjargal E ; Sarantuya G ; Gan-Orshikh L ; Enkhjargal B ; Sarantsatsral D ; Burentungalag A ; Nandintsetseg B ; Tserendolgor Ts ; Sattgul Sh ; Javzanpagma E ; Suvdantsetseg B ; Khashchuluun O ; Ouynkhishig N ; Munkhtuya E ; Uranchimeg M ; Oyuntungalag L ; Myadagmaa B ; Bat-Erdene I ; Batgombo N ; Saranbaatar A
Mongolian Journal of Health Sciences 2025;86(2):165-170
Background:
Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety
and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement
system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional
and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators
specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services.
Aim:
To assess the quality indicators in gastrointestinal endoscopy unit.
Materials and Methods:
A retrospective single-center study was conducted by collecting data from the Intermed hospital’s
electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results
were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research
committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of
four quality indicators measured monthly; b) sample survey data from five categories of quality indicators.
Results :
Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning
score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased
during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was
5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation
quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma
detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes,
Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge
time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate
risk was 0.28% by the TROOPS evaluation during procedural sedation.
Conclusion
The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be
effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.
4.Risk factors for common mental disorders in hospitalized patients during the covid-19 pandemic
Enkhtuvshin R ; Yerkyebulan M ; Munkh-Uchral D ; Enkhnaran T ; Mongoljin A ; Munkh E ; Uranchimeg M ; Maidar E ; Amarsaikhan A ; Amirlan B ; Otgonbayar R ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):32-38
Background:
The COVID-19 pandemic has profoundly impacted mental health, particularly exacerbating conditions
such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD), and emotional disorders among hospitalized
patients. This study examined the prevalence of COVID-19-related mental health issues and risk factors in hospitalized
patients affiliated with MNUMS, compared to a control group.
Aim:
To assess the prevalence of mental health disorders such as depression, anxiety, insomnia, and post-traumatic stress
disorder (PTSD), and to identify their associated risk factors.
Materials and Methods:
The study was conducted at hospitals under MNUMS, including the Mongolian-Japanese Hospital,
Central Hospital, and the National Center for Maternal and Child Health. A total of 552 participants (399 case
group, 153 control group) who were hospitalized were included. Depression (PHQ-9≥10), anxiety (GAD-7≥10), insomnia
(ISI≥15), and PTSD (PCL-5≥33) were assessed using standardized scales. Analysis was performed using chi-square tests
and binary logistic regression (crude odds ratio [cOR]/adjusted odds ratio [aOR], 95% confidence interval [CI]), adjusted
for group, age, and sex.
Results:
In the case group, depression (23.1% vs. 13.7%, p=0.015, cOR=1.884 [1.124-3.156]), anxiety (16.8% vs. 11.1%,
p=0.096), and any mental disorder (18.0% vs. 13.7%, p=0.225) were higher, while insomnia was lower (19.5% vs. 30.1%,
p=0.008). PTSD was low overall (1.8% vs. 0.7%, p=0.333). Risk factors included female sex (p<0.001, cOR=0.362 for
depression in males), younger age (p=0.004), unemployment (p=0.017), and prior trauma (p<0.001). COVID-19 symptoms
(difficulty breathing) increased the risk of depression (p<0.001, cOR=2.828 [1.708-4.682]).
Conclusion
Hospitalization for COVID-19 increases the risk of depression and anxiety, modulated by demographic,
clinical, and socioeconomic factors. Targeted interventions for vulnerable groups are essential.
5.Changes in mental health following COVID-19 infection: results of a prospective cohort study in mongolia
Enkhtuvshin R ; Mongoljin A ; Munkh.E ; Uranchimeg M ; Yerkyebulan A ; Munkh-Uchral D ; Enkhnaran T ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):39-44
Background:
COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the
WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first
case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus
affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways
(e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global
studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al.,
BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected
individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National
Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but
long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and
PTSD among COVID-19 patients over 12 months, compared to a control group.
Aim:
To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic
stress disorder (PTSD) among individuals who have had COVID-19
Materials and Methods:
In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited
from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021
and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12
months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases
were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and
multivariable logistic regression (p < 0.05).
Results:
Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12
months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p =
0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19
group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios
confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and
individuals aged 40–59 years were at elevated risk.
Conclusions
1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times
higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control
group.
2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected
after 12 months; this resolution is posited to be associated with the adaptive capacity of the population.
3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.
6.Histopathological and immunohistochemical characteristic for lung cancer among Mongolian patients
Tsend-Ayush B ; Anarkhuu B ; Nyamjargal B ; Uranchimeg B ; Bayarmaa E ; Saymaa L
Innovation 2021;15(1):4-11
Background:
Lung cancer is the leading cause of cancer death in both men and women.
In the past decade, histopathological classification of lung cancer has become increasingly
important in selecting the appropriate treatment.
Methods:
All cases of lung cancer diagnosed pathologically in the last 2.5-year period were
retrospectively identified at National Cancer Center and performed by descriptive case series
design.
Results:
The average age of our participants was 62, of which 82.2% were men. A total of 214
cases of lung cancer were reported, including 142 (66.4%) squamous cell carcinoma (SCC),
34 (16%) adenocarcinoma (AC), 4 (1.7%) NSCLC, 29 (13.6%) small cell carcinoma (SmCC) and
5 (2.3%) cases of other/unspecified type. Based on only morphology, initially 32 (17.7%) cases
of NSCLC were diagnosed, whereas after immunohistochemistry (TTF-1 or NAPA positive/p63
negative, and vice versa) staining, this category reduced to 2.2%.
Conclusions
Among both males and females, SCC which is highly related to smoking was
the most common histologic type of lung cancer. Our results showed that an approach of using
only a two-antibody panel (p63 and TTF-1) might help in the reduction of diagnostic category of
NSCLC-NOS significantly.
7.A comparative study on the fertility of uterine artery embolization and myomectomy for leiomyoma
Uranchimeg R ; Ganbaatar R ; Bayarmaa L ; Enkhtsetseg J ; Lkhagvasuren J
Mongolian Medical Sciences 2017;181(3):20-24
Objective:
To compare the nature of pregnancy and deliveryin women with leiomyoma who were treated with uterine
artery embolization to the outcomes in women who were treated with abdominal myomectomy.
Material and Methods:
A prospective, clinical study was conducted in 2010-2013 at “Urguu” Maternity Hospital, Ulaanbaatar. 94
women meeting the criteria were selected for the study. Post-treatment, the patients were reviewed for a
period of two years. Uterine artery embolization was performed using polyvinyl alcohol particles (300-500
µm in diameter).
Results:
The percentage of conception in UAE group was 25.5% and 31.9% in myomectomy group (p=0.494);
complication of pregnancy was 50.0% and 57.1% respectively (p=0.729); complication of delivery was
33.3% and 0.0% respectively (p=0.047). 88.9% and 90.0% (p=0.596) had Caesarean delivery. 16 (84.2%)
women had uncomplicated and 3 (15.8%) women had complicated delivery due to placenta praevia,
placenta acreta and uterine hypotonia. These cases all belonged to UAE group.
Conclusion
Pregnancy rates in women with leiomyoma who were treated by uterine artery embolization,
compared with pregnancies after abdominal myomectomy, were similar.(p=0.494) In this study, there
was the rate of Cesarean delivery above 80 percent in both group. There were no differences in newborn
weights and Apgar scores.
8. Results of treatment for sight-threatening diabetic macular edema
Anaraa T ; Uranchimeg D ; Baasankhuu J ; Bulgan T ; Munkhzaya TS ; Munkhkhishig B ; Oyunzaya L ; Urangua J ; Munkhsaikhan M ; Unudeleg B ; Khuderchuluun N ; Chimedsuren O
Innovation 2016;10(1):24-29
To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p<0.0001). There were significant difference detected between the bevacizumab and bevacizumab combined with laser treatment groups (p=0.004). At month 12, greater proportion of patients gained ≥10 and ≥15 letters and with BCVA letter score >73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.
9. Hemangioma cases and treatment
Davaanyam L ; Ayanga G ; Erdenetsogt J ; Tserendulam D ; Bayasgalan R ; Batbayar B ; Uranchimeg D ; Bulgantamir E
Innovation 2016;2(1):18-20
Hemangiomas are common benign vascular tumors which about 70% to 80% of the lesions are found in the head and neck region. This study was conducted on 36 children with hemangioma who were referred to Orofacial Surgery Cabinet of Dental School of Health Sciences University of Mongolia and Orofacial Surgery Cabinet of National Center for Maternal and Child Health of Mongolia between 2013 and 2015.Of the 36 children referred for assessment, 72% were female, 55% were infants of 4 to 9 months old, and 83% of them were citizens. 58% of patients underwent cryotherapy,and 57% of patients underwent cryotherapy had 2 therapy sessions. 25% of patients receiver sclerotic therapy, and 67% of them had 2 therapy sessions. According to the locations of hemangiomas 30% of them were localized in infraorbital area. 72% of the participants are women and 55% are children age of 4-9 month which 83% of all participants were living in city. 58% of children with hemangioma are treated with cryotherapy which 57%of treatment finished by second visit. And 25% were treated by dehydration treatment which 67% were finished by second visit.
10. Clinical and pathological analysis of rejection cases after kidney transplantation
Enkhtamir E ; Galtsog L ; Ulzii-Orshikh N ; Bayambadash B ; Munkhjargal B ; Od-Erdene L ; Uranchimeg B ; Saruultuvshin A ; Chimidtseren S ; Tsogtsaikhan S ; Batbaatar G ; Munkhzol M
Innovation 2016;10(2):48-51
Kidney transplantation is the best alternative treatment for end-stage renal disease and health-related quality of life and survival of the patients are improved compared with dialysis. Worldwide, more than 1.4 million patients with CKD receive renal replacement therapy with incidence growing by approximately 8% annually.1 Unfortunately, despite significant improvement in graft function, kidney transplants can still fail due to acute rejection and chronic allograft nephropathy.2 Kidney biopsy after transplantation, which has evaluated by Banff 09 classification is usefull method for diagnose of transplanted kidney disease.3,4Kidney graft rejection was diagnosed in 10 renal allograft biopsy specimens (bs) obtained from transplant patients followed up at our institute between 2015 and 2016. All specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgA, IgM, IgG and complement component (C3, C4, C1q, C4d). All the renal biopsies were examined by the same pathologist.Out of 117 transplantations, 10 episodes of rejection selected. Among the 10 patients, 30% had an acute T cell rejection and 70% had a chronic allograft nephropathy. Interstitial inflammation (i1-7) was present in 7 bs (70%), tubulitis (t1-4,t2-2) in 6 bs (60%), transplant glomerulitis (g1-1, g2-2, g3-1) in 4 bs (40%), transplant interstitial fibrosis (ci1-2, ci2-2, ci3-2) in 6 bs (60%), tubular atrophy (ct1-6, ct2-2, ct3-1) in 9 bs (90%), mesangial matrix increase (mm1-5) in 5 bs (50%), vascular fibrosis intimal thickeness (cv1-3) in 3 bs (30%), arteriolar hyaline thickening (ah1-5) in 5 bs (50%), tubulitis (ti1-6, ti2-3, ti3-1) in 10 bs (100%) and peritubular capillaritis (ptc1-1, ptc2-2, ptc3-1) in 4 bs (40%). C4d deposition was present very mild in wall of the vessels and peritubular capillaries. Because of not good working Methenamin silver stain, we couldn’t demostrate glomerular basement membrane changes (cg) fully.We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis. C4d deposition in the wall of the vessels and peritubular capillaritis is not always present in biopsy specimens of transplant glomerulopathy.
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