Outcomes of the retinopathy of prematurity screening and treatment in Mongolia Background: Retinopathy of prematurity (ROP) is a disease characterized by abnormal retinal vasculature that can have devastating visual consequences. Despite evidence that early detection and treatment can prevent blindness, ROP remains a leading cause of pediatric blindness worldwide. We aimed at investigating the outcomes of ROP screening, intravitreal anti–vascular endothelial growth factor (VEGF) and laser surgery in the treatment ROP and describe an evidence-based and specific process for identifying birth weight and gestational age screening guidelines in Mongolia utilizing telemedicine. Materials and methods: This was a retrospective of prematurity infants screened ROP from 2012 September to July 2020 and prospective cohort study of premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery and combined therapy from 2015 December 01 to January 31, 2017. Demographic factors, diagnosis and clinical course were recorded in a de-identified manner using REDCap, a secure, web-based platform to collect image and demographic data. The IRB approved the study protocol not requiring parental consent due to the de-identified nature of the data which was used for program monitoring purposes. Indirect ophthalmoscopy and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and images were uploaded to the web-based platform which could be accessed by the Mongolian ophthalmologist for reference. Each eye was evaluated by the local Mongolian ophthalmologist for the presence or absence of ROP, zone of vascularization, stage, plus disease, and aggressive posterior ROP (AP-ROP). The diagnosis and classification of ROP for this current study were determined by examination using indirect ophthalmoscopy, and treatment plans were determined according to the International Classification for ROP and the Early Treatment for ROP Study (ET-ROP).2,13 Regression analysis to determine association between BW and GA and the development of ROP. Results: A total of 9126 premature infants with BW ≤ 2500 g and/or GA ≤ 36 weeks were screened for ROP during the study period. 327 (3.5%) of the 9126 infants screened required treatment. The193 infants who received ROP screening had a mean GA of 30.09 ± 1.7 weeks, and mean BW of 1500.3 ± 125.42g. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. There were 96 boys (49.7%) and 97 girls (50.3%). Among infants receiving treatment, the highest BW was 2000g (born at 31 weeks GA), and the oldest was 34 weeks (with a BW of 1300g). The distribution of birth weight and gestational age in Mongolia was similar to other low-middle income countries, with higher birth weight and older gestational age. As birth weight and gestational age decreased, relative risk of developing ROP increased. Conclusions: After treatment, resolution of ROP was noted in approximately 90 % of the patients who had treatment-requiring ROP. 10 % of patients treated with IVB, IVR, Laser surgery and combined therapy however, did not respond and progressed to retinal detachment. This prospective study provides information about the development of ROP in preterm infants in the capital city of Mongolia. The distributions of BW and GA among infants developing ROP in Mongolia differ from those found in higher-income countries, and are comparable to other low and middle-income countries. We used a secure, web-based data collection and retrieval system that could be extended to multiple countries, which is now equipped with a telemedicine platform enabling remote grading of fundus images.

BACKGROUND Bovine colostrums is the milk secreted by cows during the first few days after parturition. It contains many essential nutrients and bioactive components, including growth factors, immunoglobulins, lactoperoxidase, lactoferrin and cytokines ets. Lactoferrin has been reported for its multifunctional properties such as antifungal, antibacterial, antiviral antioxidant and anticancer activities. The aims of this study focused on the isolation and purification of lactoferrin from Mongolian bovine colostrums. Lactoferrin purified using HiTrap DEAE an ion exchange chromatography. Lactoferrin purification efficiency was about 60.5%. The single band of purified lactoferrin has been observed in SDS-PAGE electrophoresis. METHODS Bovine colostrum was collected at a cow farm in the Darkhan province of Mongolia. At first the cream was separated by centrifugation (10000 xg 20 min at 4oC). In order to separate the whey, the samples were precipitated with 1mol/l to pH 4.6 and centrifuged at 10000 g 20 min again. The samples of whey were stored at -18oC to the analysis. Lactoferrin was purified by HiTrap DEAE an ion exchange chromatography using 0.005 M phosphate buffer (pH 7.7) and linear gradient NaCl from 0.25M, 0.5M, 1M. During chromatography, protein in the eluents was monitored by ultraviolet absorbation at 280 nm with the instrument. Purity test done by using polyacrylamide gel electrophoresis under denaturated condition (SDS-PAGE) method by Laemmli (1970). For HPLC determination of the lactoferrin by Shimadzu Nexera X2 HPLC system with UV/ VIS detector were used. Detection was carried out at the wavelength 280 nm. Separation was performed on a chromatographic column Protein R C18 ,2.2 x 150 mm, 5 μm particle size. Linear gradient and flow rate 0.2 ml/min were used. Mobile phase a consisted of water / acetonitrile/ trifluoroacetic acid ( 95:5:0.1). The column temperature was set at 40oC and injection volume was 10 μl. Data were collected and evaluated by software Lab Solution. An external standard method for quantification analytes was used. RESULTS Purified lactoferrin in the present study had a good concentration and purification efficiency was about 60.5 %. Protein fraction from 1M NaCl gradient delivers sharp and clean peak to HPLC chromatogram that fits intensity and retention time of standard bovine lactoferrin. Ammount of lactoferrin in bovine colostrums was 0.6 mg/ml and it`s molecular weight 80 kDa as a standard sample. The retention time of lactoferrin fraction which is purified by SDS-PAGE gel electrophoresis. The peak of fraction same compared to the standard lactoferrin 5.8 minutes by HPLC analysis. CONCLUSION Ion exchange chromatography shows reliable and easy isolation of lactoferrin from Mongol bovine colostrum.

Background. Cerebral palsy (CP), which is the most commonly encountered neuromuscular disorder of childhood, causes permanent physical deficits and sometimes intellectual deficits. Despite advances in the diagnosis and treatment of CP, the incidence of that disorder has not declined; it parallels the increased survival rates of premature infants. The children with CP may not have trunk control because they have spasticity and weakness in their trunk control. Goal. This study aimed to investigate the efficiency of functional electrical stimulation (FES) application on the abdomen-posterior back muscles in children with Cerebral palsy (CP). Materials and Methods. However 40 children with spastic CP, being treated in physical therapy, were selected by the way of random-sampling in the study, some of children were excluded by exclusion criteria and then 30 children have completed the study. The participants were randomly divided into two groups FES (n=15) and control groups (n=15). The control group received physical therapy 3 days a week in 45 minute for 6 weeks. The children in the FES group received physical therapy in addition to function electrical stimulation. FES was applied 5 days a week for 6 weeks to abdomen-posterior back muscles in 30 minute-long sessions. To evaluate the score of gross motor function measurement (GMFM) and to evaluate the trunk asymmetry in sitting, radiographic measurements were used. Result. The comparisons of the measurements of the two groups before and after the treatment showed that the GMFM standing score were statistical significantly (p<0.001) increased, and Cobb angles were decreased both groups, but the decrease in the control group was not statistically significant (p=0.128), and FES group was statistically significant (p=0.033). The comparison between groups GMFM standing score increased higher in the FES group than in the control group. Cobb angles after the treatment were statistically significant higher in the FES group than in the control group. Conclusion: To improve gross motor developing for children with CP, FES applied on abdomenposterior back muscles along with physical therapy is more effective than physical therapy alone.

BackgroundThese study made us to investigate the drug row material of Mongolian traditional medicine such us Tribulus terrestris, Malva neclecta Wall and Eriocheir sinensis compounded preparation named “Malbus”. Investigated us preparations steel using for treatment of kidney and urinetract deseases, it is one of effective in Mongolian traditional drug preparations.Material and MethodsThe experimental protocol was approved by the Ethics Review Committee at the Ministry Health of Mongolia. In research we used 20 healthy mice and 60 Wistar rats. Investigation was based and implemented at scientific research laboratory of Traditional Medical Science Technology and Producttion Corporation and pathological laboratory of Institute Veterinary medicine. Chemically acting substances is steroid saponin content in Malbus compound was detected by using thin layerchromatography (TLC) and its value was determined by UV-spectrophotometry. The acute oral toxicity study was according to the method Prozorovsky (1978). The toxic nephrosis was produced using Gentamicin (80 mg/kg) rats by using Neugarten’s method (1983).ResultsThe ethanolic extract results of the phytochemical investigations showed that conteined in the “Malbus” determined the presence of bioactive substances such as flavonoids, steroid saponins. The ethanolic extract of Malbus was found to be LD50 of 16.3 g/kg. Toxic nephrosis was induced in Wistar rats administered preparation Malbus dose 80 mg/kg, 160 mg/kg, and 240 mg/kg. Blood levels of creatinine, uric acid, and urea were siginificantly reduced by Malbus treatment compared tocontrol. Histological study revealed that Malbus was effective for treatment of nephritis in rats induced by gentamicin.Conclusions:1. The ethanolic extract of “Malbus” compound determined the presence of bioactive substances such as flavonoids, steroid saponins.2. LD50 of Malbus 16.3 g/kg, the preparation is has nephroprotective effect on experimental Gentamicine induced nephrosis in rats.

Introduction: According to World Health Organization, air pollution is a major environmental risk to health and is estimated to cause approximately 1.6 million premature deaths worldwide per year. The air pollution of Ulaanbaatar city is rising year after year.Goal: The aim of this study was to define the lung function of adults in Ulaanbaatar.Materials and Methods: 1196 adults were randomly chosen aged over 20 years of Ulaanbaatar city. Of them 238 subjects were excluded because they had at least one of the following: a history of lung diseases including asthma, COPD, pulmonary tuberculosis, lung fibrosis; symptoms of chronic cough, wheeze, or dyspnea; history of thoracic surgery; history of major acute illness in the past 3 months; or a history of respiratory tract infection in the past 4 weeks. Besides demographic data, information on smoking habits was collected. The lung ventilation function of subjects was checked using a spirometry EasyOne, calculating the indexes Forced expiratory volume 1sec (FEV1), forced vital capacity (FVC), FEV1/FVC ratio. Lung function measurements followed a standardized protocol and fulfilled the ATS criteria.Results: Of the respondents, 486 were males (50.7%) and 472 were females (49.3%). There was a negative correlation between each lung function and age (p<0.05). The lung function was significantly lower in female than in male, for FEV1, FVC (male - FEV1 3.66±0.659 L, FVC 4.467±0.716 L, female-FEV1 2.663+0.559 L, FVC 3.237+0.586 L). In overall, FVC, FEV1 was decreased by 34.5, 37.2 percent, respectively compared with European LLN value.Conclusion: The mean value for FEV1, FVC, FEV1/FVC ratio was 3.17±0.78 L, 3.86+0.89 L and 82.02±6.75 % in overall, respectively.