1.Results of using fecal calprotectin in the diagnosis of inflammatory bowel disease
Maral B ; Byambajav Ts ; ; Bira N ; ; Sugar B ; Zesemdorj O ; Khishgee D ; Gantuya B ; ; Tsevelnorov Kh ; ; Sainzaya B ; Munkh-Erdene Ts ; Saruuljavkhlan B ; ; Tuul B ; Pagamdulam L ; Sarantuya G ;
Mongolian Journal of Health Sciences 2026;95(5):77-81
Background:
Inflammatory bowel disease (IBD) is a chronic immune-related condition caused by interactions between genetics, immune dysfunction, gut microbiota changes, and environmental factors, often presenting as persistent or recurring diarrhea. Clinically, it commonly presents with chronic diarrhea and other gastrointestinal symptoms. The global prevalence of IBD is increasing, currently affecting approximately 0.5% of the population, with projections suggesting a rise to nearly 1% by 2030. Fecal calprotectin is a neutrophil-derived S100 calcium-binding protein that is elevated in intestinal mucosal inflammation and serves as a reliable noninvasive biomarker of inflammatory activity. Due to its high stability and close association with intestinal inflammatory activity, fecal calprotectin has been established as a dependable, non-invasive marker for identifying intestinal inflammation. In clinical practice, it is extensively used to distinguish IBD from functional gastrointestinal disorders, especially irritable bowel syndrome, among patients presenting with chronic diarrhea. However, its diagnostic utility in Mongolia remains underexplored, and this study aims to determine its sensitivity and specificity in inflammatory bowel disease and compare its diagnostic performance with other inflammatory markers.
Aim:
To determine the sensitivity and specificity of fecal calprotectin in inflammatory bowel disease and to compare it with other inflammatory markers.
Materials and Methods:
A total of 109 participants aged 18-87 years with chronic diarrhea, who attended the gastroenterology outpatient clinics of the Mongolia–Japan Hospital and Intermed Hospital between December 2024 and December 2025 and provided informed consent, were enrolled in this study. Data were collected using structured questionnaires, and laboratory investigations included complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and measurement of fecal calprotectin levels from stool samples. Based on fecal calprotectin results, selected participants underwent colonoscopic examination as clinically indicated.
Results:
Among the 109 participants included in the study, 17.4% were diagnosed with inflammatory bowel disease (IBD), with a mean age of 47.41±15.52 years. Fecal calprotectin levels were significantly higher in the IBD group compared to the control group (p<0.001). Fecal calprotectin demonstrated a weak positive correlation with C-reactive protein (CRP) and leukocyte count (p=0.042, p=0.06), while no significant correlation was observed with erythrocyte sedimentation rate (ESR). At a cutoff value of 250 µg/g, fecal calprotectin showed a sensitivity of 94.4%, specificity of 69.2%, positive predictive value (PPV) of 37.8%, and negative predictive value (NPV) of 98.4%. Receiver operating characteristic (ROC) curve analysis identified an optimal cutoff value of approximately 400 µg/g (AUC=0.919, Youden index=0.724), at which the sensitivity remained 94.4% and specificity increased to 78.0%. In contrast, CRP and ESR demonstrated comparatively lower diagnostic performance, with AUC values of 0.640 and 0.644, respectively.
Conclusion
This study demonstrates that fecal calprotectin has superior diagnostic performance compared to conventional inflammatory markers in differentiating inflammatory bowel disease (IBD). An optimal cutoff value of approximately 400 µg/g yielded the highest sensitivity and specificity. Therefore, fecal calprotectin may serve as a valuable tool in clinical practice for both screening and diagnostic confirmation.
2.Healthy live guidance based on human characteristic types by traditional Mongolian medicine
Tuul Kh ; Munkhdelger D ; Sosorbaram L ; Lkhagvasuren Ts
Mongolian Pharmacy and Pharmacology 2018;13(2):14-17
Introduction:
Traditional Mongolian medicine contents a whole idea of preventive medicine.
Traditional Mongolian medicine main theory is “Rlung-Mkhris-Badgan” which is composed human
body. These elements confirm human healthy during metabolite balance but when any of these
lacks or exists in an excessive amount, then there is an illness. Understanding on the theory “Rlung-Mkhris-Badgan” by modern medicine there are called cell universal regulation system.[1] A striking
feature of metabolism is the similarity of the basic metabolic pathways and components of “Rlung-Mkhris-Badgan” even vastly different metabolic pathways. Human has own Rlung-Mkhris Badgan`s
portion differently when they were born, during all life must obey their attribute manner. There are
seven individualities which expressed human characters.
Furthermore in traditional Mongolian medicine have richness experience of concerning with
three elements unbalanced time to come disease early diagnosis and remedy them effectively. Accordingly organic body must adaption four seasons` biological accommodation and follow up four
seasons` suitable food technology and climate condition.
Purpose:
1. To determine human characteristic types by traditional Mongolian medicine main theory.
2. To suggest healthy live advice for people who participate randomized in preventive medical examination by used modern and traditional medical diagnostic methods.
Method:
Biomedicine and Clinical Pharmacy Department doctor teachers were organized “Healthy
life starts every day right habit” topic preventive medical examination for all students of Mongolian
University of Pharmaceutical Sciences 09-29 days of September, 2016. Participant by diagnosed
medical basic physical examination methods and filled out questionnaire in human characteristics
based traditional Mongolian medicine main theory.
Results:
There had 513 participants, 29 of them were “rlung” characteristic personality, 26 of
“mkhris” characteristic personality, 22 of them “badgan” characteristic personality, 163 of them “rlung
and mkhris” combined characteristics, 118 of them “rlung and badgan” combined characteristics”, 68
of them “Badgan and Mkhris” combined characteristics, 87 of them were composite characteristic
personalities.
Conclusion
1. Determined 85% of participants are respectively combined and composed types of characteristic personalities, and these participants supposed to be better metabolism balance. Determined 15% of
participants are one element dominantly personalities.
2. We made a Healthy Life Guidance depending on human characteristics.
3.The research of logistic regression model and correlations between blood plasma melatonin (MLT) and epidermal growth factor (EGF) with index of skin type of the body, cardiovascular system, biological age and adaptive capacity assessment of relatively healthy people in Uvs province
Buyan-Orshikh S ; Tuya N ; Tsanjidmolom A ; Odgerel TS ; Amgalanbaatar D ; Lkhagva L ; Zevgee T ; Tuul M
Mongolian Medical Sciences 2016;178(4):12-18
BackgroundIn Mongolia scientists have been doing research about skin disease and process of aging. Howeverthere has not enough study material about skin aging process which is the key indicator of aging andhow that affect to Mongolian people.GoalMain purpose is to study correlations between main index of skin type of the body, cardiovascularsystem, biological age, epidermal growth factor and blood plasma melatonin, within the people of Uvsprovincial center as they are relatively healthy people.Material and MethodsResearch works were done using cross sectional study model in years 2015-2016, within randomlychosen 400 citizens of Ulaangom city, counted to be relatively healthy people. Research model includes41 questionnaires, examination and blood plasma samples.Basic indexes of the body, cardiovascular system and respiratory functions were chosen by biomarkers,biological age is determined by V.P.Voytenko’s 4th version method and adaptive capacity assessment isdetermined by R.M.Baevskii’s multi-repeating regression method.Main skin type parameters such as porosity, wrinkles, pigmentation, elastics and aging is determined bythe “BOOMTECH skin diagnosis” digital equipment made in the Republic of Korea.The blood plasma MLT and EGF were measured by the method of ELISA analysis ELISA made in thelaboratory of the “AVITSENNA Science and Technology center”.The study material analysis carried out an analysis using logistic regression analysis and Pearson’scorrelation coefficient with SPSS 23.0 software.ResultThere’s an inverse weak correlation between blood plasma MLT and EGF with body wealth characteristicsof Uvs province citizens. It shows that when the blood plasma MLT and EGF decreases the body weight,body height and body weight index increase tendency.In women the decrease of blood plasma MLT and EGF also decreases the body height and body weightindex.Research on correlation between cardiovascular system and blood plasma MLT and EGF shows thatdecrease of blood plasma MLT causes in increased arterial pressures in both sexual groups, decreasedEGF in women causes decreased arterial pressure.Correlation study between skin main characteristics and blood plasma MLT and EGF shows thatdecreased blood plasma EGF in men resulted in decreased skin wrinkles, porosity, elasticity and skin aging index, in women decreased skin pigmentation and elasticity, and increased skin wrinkles, porosity and aging index in women.Research study of correlation between biological age and adaptive capacity assessment with the blood plasma MLT and EGF shows that decreased MLT and EGF in men results in increased biological age characteristics. In other words, the early aging is caused.The logistical regression analyses made using blood plasma melatonin, skin porosity, biological age,body height and sex as the risk parameters of Pearson coefficient and chi-squared parameter. Above model resulted in skin porosity and blood plasma MLT’s are becoming independent variable assessing the skin aging.Conclusions:1. The decreased MLT and EGF’s are resulted in increased body weight, body height and body weight index in men and decreased body height, body weight index in women.2. Decreased blood plasma MLT resulted in increased arterial pressure in both sexual groups and decreased EGF resulted in decreased arterial pressure in women.3. The decreased blood plasma MLT and EGF results in decreased skin wrinkles, porosity, elasticityand skin aging parameter with the increased skin pigmentation in men, as it results in decreasedskin pigmentation, elasticity and skin porosity parameters with the increased skin aging degree in women.4. When epidermal growth factor and blood plasma melatonin is decreased in men it results in increased biological age, but depends directly to the adaptive capacity assessment.5. Skin porosity and blood plasma melatonin were becoming independent variable to assess skin aging.
4.Immunohistochemical diagnostics in stomach cancer
Gerelee Kh ; Avirmed D ; Tuul M ; Batbold Ts
Mongolian Medical Sciences 2014;169(3):73-80
Although stomach cancer immunohistochemistry is similar tothe immunohistochemistry of other organ, it
has great impact on diagnosis and treatment, such as its ability to reveal whether the cancer is primary
or metastatic and which treatment model would be more effective in individual case.
Lately, CK7, CK20 and CDX-2 immunohistochemical markers are commonly used in stomach cancers.
Stomach cancer prognosis is different in each patient, depending on several factors, patients’ health
status, cancer cell differentiation, and cancer cell growth. To evaluate these factors,immunohistochemic
al analysis is more effective and for this purpose they use Ki-67, CD 34, BCL-2, p53, Cyclin D1, andHer-
2 markers.The evaluation of HER-2 expression should be carefully carried out, as following:
1. HER-2 expression should be evaluated on minimum 5 positive stained cells. The evaluation criteria
aremicroscopic magnification and cytoplasmic membrane-stained pattern.
2. Other than the membrane-stained pattern must be excluded. HER2 gene evaluation (FISH) can
confirm the HER2 IHCexpression.
3. Usage of FDA approved antibody (4B5) has the advantageof increased sensitivity.
4. The algorithm for the evaluation of HER-2 expression used for breast cancer has 50% possibility of
false negativity if it is used for stomach cancer. Therefore, it is needed to beevaluated with another
specific algorithm. Because HER-2 2+ and 3+ cases can improve outcome with usingTrastizumab
treatment.
5.Diagnosis of intraoperative squash cytology in brain tumors
Enkhee O ; Tsetsegdelger M ; Bolortuya B ; Enkhbat TS ; Khusyan KH ; Tuul B ; Bayarmaa E
Mongolian Medical Sciences 2014;170(4):14-18
Background: The intraoperative smear cytology (squash preparation) is fairly accurate, simple, reliabletool for rapid intraoperative diagnosis of neurosurgical biopsies [1]. In the early 1930s, Dr Eisenhardtand Cushing introduced intraoperative cytological investigations for rapid examination of neurosurgicalspecimens and guidance of surgical treatment [2]. Besides rapid decision making during neurosurgicalprocedures, it is also to be ensured that minimum injury is caused to the normal brain structuressurrounding the intracranial neoplasm. It has become necessary for pathologists to train themselves inthe interpretation of cytomorphological features of various central nervous system lesion and used inmany neurosurgical units of all over the world [3]. Thus, to begin doing intraoperative squash cytology inour practice is the aim of this study.Aim: To study the diagnostic accuracy of squash cytology in the intraoperative diagnosis of centralnervous system tumorsMaterials and Methods: The material for this study was obtained from 30 cases of nervous systemneoplasms sent for intraoperative consultation from State Third Central Hospital, Shashtin to the thirdsection of National Center for Pathology between 7th of November 2013 to 28th of March 2014. Squashpreparation was performed on all cases and stained with hematoxylin and eosin. The diagnosis given onsquash cytology was then compared with final diagnosis given on paraffin-embedded sections.Results: Of total 30 cases of primary central nervous system tumors, neuroepithelial tumors are thelargest category of tumors (50%). The accuracy of squash cytology was 82.1%.Conclusion: This is the first study in our country where intra-operative squash cytology in brain tumorwas done and diagnostic accuracy was 82.1% as very good category. There were 4 cases had diagnosticdiscrepancy.
6.Health status of khangai mountain regions’ population (30-69 years)
Enkhjargal М ; Tuul M ; Lkhagva L ; Odgerel TS ; Amgalanbaatar D ; Darjaa TS
Mongolian Medical Sciences 2013;166(4):9-14
Backround: Biological age score plays an essential role in the evalution of aging process and health status. The study was focused on clarifying relavance of health status scores of a population of Khangai mountain region with geographical and ecological specifics of the places they live. Goal: To determine the grades of aging (GA) and biological age score (BAS) among population (30-69 years) of Zavkhan aimags.Materials and Methods: We examined 1901 men and women aged 30-69 years old in Zavkhan aimags in 2012 and healthy subjects were assessed with physical, physiological variable. The BAS equation was employed to compute the individual BAScores for all subjects. Quantative data has been processed with the use of statistical data processing software SPSS-19. Results: Health scores of 92.1% of male in the age group of 30-39 years, 68.7% of male in the age group of 40-49 years had health problems (in level IV, V ). In all age groups 70.3% -98.6% had normal adaptation and adaptation functional tension. 54.2- 55.1% of both sex in the ages group 60-69 years had unsatisfactory adaptation.Conclusions: Aging process for women in age groups of 50-59, 60-69 years was significantly delayed or delayed. For men of 30-49 ages aging process was accelerated, for men of 50-69 years it was normal or delayed. Health scores of men in the age group of 30-39, 40-49 years is significantly at a lower level (IV,V) and health scores of women all age groups is significantly at a high level (IIII).
7.Хордлого Тайлах Эмчилгээ
Bodihuu Yo ; Suhbaatar O ; Tuul Ts
Journal of Oriental Medicine 2013;8(2):123-127
8.Health status scores of mountain regions’ population (30-69 years) of Mongolia
Enkhjargal М ; Tuul M ; Lkhagva L ; Odgerel TS ; Darjaa TS
Mongolian Medical Sciences 2012;162(4):7-13
BackroundTerritory of Mongolia is spread over seven natural ecological zones and it has harsh continental climate. Mongolia is one of the most sparsely populated country on the World. The study was done among residents of the Khovd province and its subprovinces as representations of Altai mountain region. The study was focused on clarifying relavance of health status scores of a population with geographical and ecologicalspecifics of the places they live.Goal:To determine BA, grades of aging and health status scores among population (30-69 years) of mountain regions.Materials and Methods:In total 1119 persons were chosen for the research study, which was conducted in 2011. Quantative data of the study has been processed with the use of statistical data processing software SPSS-19.Results14.4% - 94.1% of male in all age groups had health problems. In all age groups 55.9%-85.5% of male and 43.9%-78.4% of female had adaptation functional tension. Conclusions: Aging for women of all age groups was significantly slowed or slowed. Aging for men of 30-49 ages it was accelerated, for men of 50-69 years aging was normal or slightly slowed. The portion of people with adaptation functional tension was greater in all age groups. Most of the women in the age group of 60-69 years had unsatisfactory adaptation. Health status of male is significantly at a lower level compare to female.
9.Study result of some treatment effects in collagen induced arthritis mouse model
Khongorzul B ; Bilguun E ; Undarmaa E ; Tuul B ; Gudegmaa TS ; Choijamts G ; Chimedtseren S
Mongolian Medical Sciences 2012;162(4):111-117
IntroductionRheumatoid Arthritis (RA) is chronic systemic inflammatory autoimmune disorder that still remains a disease of unknown etiology and complex disease without a single treatment that is dominated by serious and debilitating sequalae resulting from synovial membrane, cartilage and progressive joint destruction involvement. There is a one major obstacle in elucidating the early events in the pathogenesis of RA has been the lack of definition of the initial features of the disease. To overcome these difficulties, various animal models have been developed. But Collagen Induced Arthritis (CIA) mouse model is known to be the most valuable animal model to explore the pathogenic process, molecular and cellular mechanisms of joint destruction, to discover the immune system respond and activation and to develop new effective treatment methods and useful drugs [1].Materials and Methods:Within this study we have used 40 male mice at age 6-8 weeksfor 0-60 days and divided into following 4 groups which are:I group–CIA induced mouse group treated with Derveger Jirgeruu (Saposhnicovia divaricata) (n=12) II group–CIA induced mouse group treated with Natriisalicylas (10%) (n=12) III group–Healthy control mouse group (n=8) IV group–CIA inducedcontrol mouse group (n=8). To induce CIA model, we have used standard method of Murali /2005/’s design. Standard drug Natriisalicylas (10mg/ 20gr), one of the often used drug anti-inflammatory and Mongolian herbal plant Derveger jirgeruu (Saposhnicovia divaricate) (0.26mg/20gr) were daily administered by orally, starting on day 21 until day 60.To evaluate and compare 2 drug’s anti-inflammatory effect, we have done clinical score evaluation (Kim W.U, 2002), laboratory testing and histological examination of the joints using standard methods.ResultTo summarize the research result, both medications have proven to be as a medication which has anti-inflammatory effect that decreased the signs and symptoms of RA by it is histological and laboratory analysis.Conclusions:1. CIA model was effectively induced, which have proven by clinical signs, laboratory result and histological examination.2. Within this study it has proven that traditional herbal medicine Derveger Jirgeruu (Saposhnicovia divaricate) (0.26mg/20g) have anti-inflammatory effect on CIA induced mouse model of Rheumatoid Arthritis, which have had similar effect asstandard non-steroid medicine Natriisalicylas (10mg/20g).
10.The mortality and morbidity of cancer and other health events in Khongor soum, Darkhan-Uul, 2010
Suvd B ; Tuul TS ; Burmaajav B
Mongolian Medical Sciences 2011;168(1):71-82
Background: The Khongor soum has 253.3 thousand hectare square meter land which is 77 percent of Darkhan aimag from that 31.2 thousand hectare square meter land is used for plantation purpose. 12% of population is kazak. In April 2007, environment and drinking water resource of Khongor soum was polluted by dilution sewage water. Since after this incidence population were complaining about health status. Purpose of this survey was to determine cancer and general mortality of soum population. There 2 objectives: 1. To verify cancer mortality and morbidity in Khongor soum, Darkhan2. To assess excess mortality of cancer in the Khongor soumMethods: Health secondary data of 2006-2009 of Health department of Darkhan-Uul aimag was used for the assessment. The information about cause of death, number of death, population and so on were collected to caluculate crude mortality and cancer-specific mortality.Results: in 2007, the lowest or 4950 population was registered in Khongor soum and the highest number or 5628 of population was registered in 2002. The number of population gradually increased in 2009 by 5603. During 2006-2009 66 people were died in Khongor soum and this means 125.3 populations per 10000. According to the year trend mortality (66) rate was not fluctuated year by year. The leading ten causes of mortality of Khongor soum, at the first CVD (51.1 per 10000) and at the second cancer (37.8 per 10000) and it is similar with Mongolian mortality consistence. According to standardized mortality rate, mortality of Darkhan-Uul aimag was 8 per 10000 and the level of Khongor soum was 0.3 which means less than state average level. During 2006-2009 years, 24 people were died due to cancer and most of them were male (17, 70.8%). Every year of surveyed time, male mortality rate was high. The registered cancer (62.5 per 10000) of soum was similar with state average level and 1.5 times less then Darkhan- Uul aimag (92.5 per 1000) level.Conclusions: The last 5 years mortality rate of Khongor soum (124.9 per 10000) less 2.4 times from Mongolian state average level and 1.9 times less than Darkhan-uul aimag level. There are approved that cancer level of Khongor soum was not increased in last year. However, it is recommended to monitor Khongor soum’s morbidity and mortality to evaluate long-term effect of environmental pollution.

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