1.The Contribution of Academician Byambajav Ragchaa to the Development of Internal Medicine Diagnostics and Hepatology
Dolgion D ; Tulgaa L ; Bira N ; Badamjav S ; Enkh-Amar A
Mongolian Journal of Health Sciences 2025;86(2):8-13
Background:
Academician Ragchaa B made a profound contribution to the foundation and development of internal
medicine in Mongolia. He was among the first graduates of the Faculty of Medicine at the National University of Mongolia,
becoming the country’s first internal medicine physician, educator, and researcher in the field of internal pathology.
Ragchaa B achieved numerous pioneering roles, including being, the first Mongolian head of the Department of Internal
Medicine, and the first professor in this specialty. His extensive contributions helped establish and advance internal medicine
and medical education in Mongolia.
Aim:
The aim of this study is to analyze the scholarly works of Academician Ragchaa Byambajav to explore and disseminate
his valuable contributions to the foundation and development of the science of “Internal Medicine Diagnostics” and
hepatology
Materials and Methods:
This study utilized a documentary research method to analyze the contributions of the distinguished
scholar, Academician Ragchaa B. The research involved a comprehensive review of his published books, textbooks,
scientific articles, presentations, and archival materials. Additionally, the study examined references to Ragchaa B
in books, newspapers, and collected written and oral recollections from his former students across different generations.
Through systematic analysis of these sources, the study aimed to provide an in-depth understanding of his academic and
professional legacy.
Results:
Academician Ragchaa B, during his teaching career, graduated approximately 4,000 medical professionals and
produced a total of 156 scholarly works. Drawing from his vast knowledge, skills, and experience, he became renowned
for writing the textbooks “Clinical Aspects of Botkin’s Disease” (1969) and “Diagnosis of Internal Diseases” (1970),
earning recognition as the first scholar to author a Mongolian medical textbook.
In 1977, Professor Ragchaa B consolidated his research on liver diseases and authored the monograph “Clinical Aspects
of Botkin’s Disease,” which led to him earning the Doctor of Medical Sciences (Sc.D.) degree.
Conclusion
1. Academician Ragchaa Byambajav was a distinguished scholar who made significant contributions to the science of
internal medicine diagnostics. He served as the first Mongolian head of the “Department of Internal Medicine Diagnostics”
in 1953, teaching for over 50 years and acting as a consultant in internal medicine for more than 40 years.
2. He directed research on viral hepatitis and authored the monograph “Clinical Aspects of Botkin’s Disease”, which
led to his achievement of a Doctor of Medical Sciences degree in 1977. This accomplishment established him as the
first specialized researcher and educator in hepatology in Mongolia.
2.Comparative study of subcutaneous fat area and visceral fat area among healthy and metabolic syndrome patients
Munkh-Erdene U ; Odmaa T ; Solongo Ts ; Ganchimeg S ; Egshiglen G ; Anir B ; Ariunaa A ; Navchaa G ; Tulgaa S ; Munkhtsetseg J
Mongolian Journal of Health Sciences 2025;86(2):36-41
Background:
Obesity, especially central obesity, is a risk factor for non-communicable chronic diseases such as dyslipidemia,
type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and metabolic syndrome (MetS).
Aim:
Study the association between the subcutaneous fat area (SFA) and visceral fat area (VFA) with lipid metabolism
parameters in adults with MetS.
Materials and Methods:
Data from 1511 participants who visited the ‘NURA Mongolia’ Ai Health screening center
between September 2023 and February 2024, including general information, DEXA (Dual X-ray Absorptiometry), and
biochemical analysis results, were used. Metabolic syndrome (MeS) was assessed based on the harmonizing criteria 2009
(≥3 criteria). VFA and SFA were categorized into four groups using quartiles (Q1-Q4). Statistical analysis was performed
using SPSS v26, including T-tests, multiple logistic regression (OR, 95% CI), and ROC (AUC) analysis.
Results:
The average age of the participants was 30.5±3.9 years, with a BMI of 25.1 kg/m², and 49.5% were male. The
group with MetS (n=531) had significantly higher levels of VFA and SFA compared to the group that rated their health as
relatively healthy and had no clinical diagnosis (n=979) (control group) (p<0.0001), with males showing higher VFA and
females showing higher SFA (p<0.0001). The Q4 group for VFA had a significant association with MetS in males (4.611,
95% CI=2.394–9.591) and females (2.253, 95% CI=1.097-3.912) (p<0.001). Logistic regression analysis showed that increased
VFA was more strongly associated with MetS in males (β=0.325, p<0.0001) and females (β=0.338, p<0.003) than
BMI. The AUC for predicting MetS was 0.790 (95% CI=0.750-0.831) for VFA and 0.401 (95% CI=0.351-0.451) for SFA,
with all results being statistically significant (p<0.001). VFA had a higher predictive value compared to other markers.
Conclusion
In healthy men with metabolic syndrome, VFA is more prominently defined, while SFA is higher in healthy
women. Since VFA is a better predictor of metabolic syndrome than SFA, it increases the risk of diseases such as cardiovascular
diseases and type 2 diabetes in men, whereas SFA in women serves as a protective factor.
3.Evaluation of changes in human salivary amylase enzyme activity
Sarangerel G ; Odmaa T ; Buyankhuu T ; Oyun-Erdene P ; Odgerel Ch ; Tulgaa S ; Otgonjargal Ch ; Munkhtsetseg J ; Nandin-Erdene M
Diagnosis 2025;114(3):104-111
Background:
Saliva as a non-invasive biological sample can be a game-changer in early disease detection and health risk assessment.
Objective:
To examine the association between participants' dietary patterns and the activity of salivary amylase, along with serum amylase levels in humans.
Materials and methods:
This study was conducted at the research laboratory of the Department of Biochemistry, School of Biomedicine, MNUMS. A total of 30 students aged 19–22 years participated in the study. Saliva samples were collected three times at one-week intervals, and one blood sample was collected from each participant, alongside a dietary questionnaire. The activity of the amylase enzyme in both saliva and serum samples was determined using the iodine-starch method.
Results:
When evaluating the amylase enzyme activity based on participants' carbohydrate intake, the result was p > 0.05, indicating no statistically significant difference. Similarly, statistical analysis of the use of mouthwash and vitamin supplements also showed p > 0.05, which means these variables had no statistically significant effect on amylase activity. The correlation between salivary and serum amylase activity was found to be r = 0.365, indicating a weak positive correlation, but the difference was not statistically significant.
Conclusion
The intake of carbohydrates, vitamins, and mouthwash does not significantly affect the activity level of the salivary amylase enzyme, according to research findings. However, external factors such as stress and air pollution have been shown to exert a measurable influence on its activity. A comparative analysis of enzyme levels in saliva and blood using amylase as a representative marker revealed similar activity levels in both fluids. This suggests that saliva may serve as a viable non invasive sample for detecting various biomarkers and diagnosing diseases. The results underscore the potential of salivary components, particularly amylase, as valuable indicators in diagnostic applications.
4.Impact of storage conditions on the antioxidant capacity of food plants
Munkhzul T ; Oyun-Erdene R ; Tulgaa S ; Nandin-Erdene M ; Buyankhuu T ; Munkhtsetseg J ; Odgerel Ch
Diagnosis 2025;114(3):112-118
Background:
Due to Mongolia’s harsh climate and seasonal limitations in fresh food supply, fruits, vegetables, and medicinal plants are often consumed in preserved forms. However, the preservation methods and storage conditions may significantly alter their antioxidant activity, which is crucial for mitigating oxidative stress and preventing chronic diseases.
Objective:
This study aimed to evaluate the antioxidant activity of 19 commonly consumed vegetables, berries, and dried medicinal plants under different storage conditions including fresh, cold storage (cellar), and frozen (-20°C).
Methods:
Samples were extracted in 80% methanol and tested using the DPPH radical scavenging assay. Absorbance was measured at 517 nm using a UV-Vis spectrophotometer. IC⁻⁻ values were calculated to compare antioxidant potency. Statistical differences were assessed using paired and unpaired t-tests with SPSS v27 (p<0.05)
Results:
Cold storage significantly reduced antioxidant activity in root vegetables, with IC⁻⁻ values increasing by 2.4 to 13.5 times (p<0.01), indicating diminished radical scavenging potencial. In contrast, frozen samples showed minimal change (p>0.05). Dried medicinal plants such as Rosa canina and Thymus serpyllum maintained strong activity, with IC⁻⁻<50 μg/mL.
Conclusion
Cellar storage leads to a notable decline in antioxidant capacity of common vegetables, while freezing is a more effective method for preservation. Dried medicinal herbs remain potent sources of antioxidants and may be recommended for year-round use in Mongolian diets.
5.To synthesise dual-action nanoparticles (nps) by integrating zno with the extract of urtica dioica l. And to characterise
Odmaa T ; Buyankhuu T ; Oyun-Erdene R ; Odgerel Ch ; Tulgaa S ; Otgonjargal Ch ; Munkhtsetseg J ; Nandin-Erdene M
Diagnosis 2025;113(2):45-52
Background:
The synthesis of multifunctional nanoparticles by integrating the bioactive properties of the ethanol extract of Urtica dioica L. a medicinal plant widely distributed in Mongolia, with zinc oxide nanoparticles (ZnO-NP) serves as the foundation of the present study. The aim is to produce nanoparticles with synergistic antioxidant, anti-inflammatory, antibacterial, and anticancer activities.
Objective:
To synthesise dual-action nanoparticles (NPs) by integrating ZnO with the extract of Urtica dioica L. and to characterise their properties.
Materials and Methods:
The Control group, as ZnO-NPs, and the study group, as medicinal plant ethanol extraction loaded nanoparticles (UD-ZnO-NPs), were synthesised using green synthesis techniques. The morphology and particle size were characterised by Scanning Electron Microscopy (SEM), chemical bonding was analysed using Fourier Transform Infrared Spectroscopy (FTIR), and crystalline structure was examined by X-ray Diffraction (XRD). Hemolytic activity assays were conducted to assess cytotoxicity.
Results:
The Control and study group’s morphology and size distribution were uniform and spherical. The average particle size of the study group (UD-ZnO NPs) was 63 nm, while the control group (ZnO-NPs) was 77 nm. FTIR analysis showed that the basic chemical bonds in both types of nanoparticles were similar; however, additional peaks corresponding to the bioactive compounds from the Urtica dioica extract were detected in the UD ZnO-NPs. XRD analysis revealed that both types of ZnO-NPs investigated the same crystalline structure, consistent with the standard reference data (JCPDS No. 36 1451). Hemolysis assays showed that at concentrations ranging from 0.5 to 2.5 mg/ mL, the hemolytic activity was below 5%, indicating low cytotoxicity.
Conclusion
ZnO-NPs with and without Urtica dioica extract were successfully synthesized via a green method, yielding spherical, uniformly dispersed particles ranging from 63 to 77 nm in size. While the structural and crystalline characteristics of the NPs remained consistent, the presence of bioactive compounds was confirmed in the UD-ZnO-NPs. Hemolytic assays indicated dose-dependent cytotoxicity, highlighting the importance of concentration in biomedical applications.
6.Cystatin C levels in left ventricular hypertrophy and chronic kidney disease secondary to arterial hypertension
Khongorzul Ts ; Otgonjargal Ch ; Munkh-Erdene U ; Odgerel Ch ; Oyun-Erdene R ; Nandin-Erdene M ; Buyankhuu T ; Munkhtsetseg J ; Tulgaa S
Diagnosis 2025;113(2):63-68
Background:
Identifying reliable biomarkers for early detection, risk stratification, and prognosis of CVD in the context of CKD is, therefore, of critical importance. Cystatin C has emerged as a potential biomarker capable of reflecting both cardiac injury and renal impairment, particularly in patients with arterial hypertension. This study aimed to evaluate the association between serum cystatin C levels, left ventricular hypertrophy, and chronic kidney disease in individuals with hypertension.
Objective:
To assess serum cystatin C concentrations in patients with left ventricular hypertrophy and chronic kidney disease secondary to arterial hypertension.
Materials and Methods:
A case-control analytical study was conducted, enrolling 44 patients aged 45 years or older with both left ventricular hypertrophy and chronic kidney disease due to arterial hypertension alongside a control group of apparently healthy individuals. Serum cystatin C levels were measured using immunoturbidimetric assay. Statistical analysis was performed using SPSS version 25.0. Group comparisons were made using independent-sample t-tests, while multivariate regression and receiver operating characteristic (ROC) analyses were employed to explore associations and the predictive value of cystatin C.
Results:
The mean serum cystatin C concentration in the case group was 1.6±0.1 mg/L, significantly higher than in the control group (0.88±0.03 mg/L, p<0.05). Similarly, the estimated glomerular filtration rate (eGFR) was markedly reduced in the case group (44.88±6.8 mL/min/1.73 m²) compared to the controls (92.88±3.4 mL/ min/1.73 m², p<0.05). In the case group, a statistically significant inverse correlation was observed between serum cystatin C levels and glomerular filtration rate (GFR), with a regression coefficient of β=−0.028 (p<0.006).
Conclusion
The elevated serum cystatin C levels (1.6±0.1 mg/L) and decreased eGFR (38.99±12.7 mL/min/1.73 m²) observed in the case group suggest that cystatin C may serve as a potential biomarker for the early diagnosis of left ventricular hypertrophy due to arterial hypertension and chronic kidney disease, as well as for predicting related complications.
7.Result of assessment of lactate levels in high-end athletes
Oyundari A ; Bulgan M ; Ser-Od L ; Otgon-Erdene G ; Otgonjargal Ch ; Odgerel Ch ; Tulgaa S ; Nandin-Erdene M ; Buyankhuu T ; Munkhtsetseg J ; Oyun-Erdene R
Diagnosis 2025;113(2):81-88
Background:
Regularly participate international High-level in sports athletes national and competitions and engage in intense training, developing endurance and resilience. Measuring blood lactate levels is crucial for improving an athlete’s performance, assessing sports performance, and enhancing the effectiveness of future training.
Aim:
To study the relationship between lactate levels in the blood plasma and lactate dehydrogenase enzyme activity in Mongolian National Team athletes.
Materials and Methods:
The study involved 51 athletes from the Mongolian National Team. Anaerobic capacity was assessed using a Monark 894E Ergomedic Peak Bike, designed to apply exercise load. Blood serum lactate level and lactate dehydrogenase enzyme activity were determined using a Biobase BK-280 fully automated biochemical analyzer. Heart rate, peripheral blood oxygen levels, and oxygen saturation were measured using a pulse oximeter.
Results:
The average age of the participants was 24.04 ± 4.15 years, with an average height of 168 ± 8.78 cm and an average weight of 71.01 ± 7.69 kg. The average BMI was 24.82 ± 4.12 kg/m². Pre exercise lactate levels averaged 3.84 ± 0.75 mmol/L, while post-exercise lactate levels averaged 9.67±3.52 mmol/L. The average heart rate before exercise was 66.04±8.9 bpm, while post-exercise heart rate was 123.6±16.06 bpm. The average VO₂ max was 95.18±2.48.
Conclusion
The lactate levels before and after exercise among the athletes participating in the study showed significant differences in the age groups 20-29 (p<0.0001). When comparing lactate levels before and after exercise by sport, statistically significant increases were observed in freestyle wrestling and judo athletes (p<0.0001)
8.Metabolic changes of overweight and obese adults
Yumchinsuren Ts ; Dolgion D ; Ganchimeg D ; Enkhmend Kh ; Otgongerel N ; Gantogtokh D ; Amin-Erdene G ; Bolor U ; Tegshjargal S ; Batbold B ; Shiirevnyamba A ; Tulgaa L
Diagnosis 2024;111(4):97-104
Introduction:
The worldwide prevalence of obesity and its metabolic complications have increased substantially in recent decades. According to the World Health Organization (WHO) indicate that in 2016, over 1.9 billion
adults were overweight and, of these, over 650 million were obese. Obesity is a major risk factor for heart disease, type 2 diabetes, steatotic liver, chronic liver disease, stroke, and some cancers. The global prevalence of obesity and its associated comorbidities continue to increase on a pandemic scale.
Aim:
To determine metabolic changes in overweight and obese adults and their related diseases based on some parameters of anthropometric and laboratory tests.
Materials and Methods:
This study was conducted with a case-control design in 2023–2024. There were 150 participants in
the study, 50 in the control group with normal weight, 50 in the overweight (BMI<29.9kg/m2)
case group, and 50 in the obesity (BMI>30kg/m2) case group. Subjects of three groups were matched by age (±1) and sex. We estimated anthropometric parameters and biochemical
laboratory analysis including glucose, lipid, ferrum, and liver parameters. CBC All statistical analysis was performed using SPSS 23 software. Categorical variables were described by numbers and percentages, and the numerical variables were characterized by the median (min and max) for the normal distribution, and mean± standard deviation for the non-normal distribution. The statistical
tests utilized were the Chi-square, Fisher’s exact, student t-test, and Mann–Whitney tests. Ethical approval for the survey was obtained from the Medical Ethics Committee under the Ministry of Health Of Mongolia in January 2023.
Results:
The participants' average age was 46.73±11.45, with 60% being women (90) and 40% being men (60). The prevalence of central obesity and fat % were 52.3% and 37.2%, respectively. Between study
groups, there were significant differences in fat% (p=0.004), central obesity (p<0.001), FBG (p=0.024), cholesterin (p=0.017), LDL (p=0.018), HDL (p=0.003), ferrum (p=0.010), АЛАТ (p=0.020), and GGT (p<0.001).
Conclusion
In overweight and obesity groups, the body fat, fasting blood glucose, cholesterol, LDL, and ALT levels are
increased. These changes often lead to conditions like type 2 diabetes, arterial hypertension, steatotic liver disease, and liver fibrosis. Therefore, it is important to develop plans for prevention, early detection,
public awareness, and intervention programs targeting obesity in the general population.
9.A study of tissue biomarkers in gastric cancer and its precursors
Nyam-Erdene N ; Tsogzolmaa Sh ; Batchimeg B ; Nomin-Erdene D ; Tuul B ; Оyunbileg N ; Zorigoo Sh ; Ganchimeg D ; Munkhbayar S ; Baasanjav N ; Tulgaa L
Mongolian Medical Sciences 2024;209(3):21-28
Background:
Specifically, stomach cancer ranks as the fifth leading cause of cancer morbidity
and mortality worldwide. Early-stage detection significantly improves survival rates,
with over 90% of patients diagnosed at stages I and II living beyond five years. To
improve the early detection of gastric cancer, it is necessary to complement the
conventional method of endoscopic examination with biomarker analysis. We aimed
to compare biomarkers such as pepsinogen C (PGC), matrix metalloproteinase 2
(MMP2), matrix metalloproteinase 9 (MMP9), and the cell proliferation marker Ki-67
with immunohistochemical analysis.
Purpose:
A comparative study and evaluation of biomarkers for the early detection of gastric
cancer.
Materials and Methods:
The study was conducted using a retrospective cohort design. Research ethics
issues were discussed at the meeting of the Medical Ethics Control Committee of
the Ministry of Health on October 13, 2023, and permission to start the research
was obtained (Resolution No. 23/051). The information was gathered based on the
criteria for K29.3, K29.4, K31, and C1 diagnoses according to the international ICD
10 classification, and participants were selected accordingly. Proteins such as PGC,
MMP2, MMP9, and Ki-67 were examined using a tissue microarray kit and evaluated
through immunohistochemical analysis.
Results:
Negative gastric tumor markers PGC, Ki-67, MMP2 and MMP9 were evaluated
by immunohistochemical analysis. The mean PGC protein staining values were
6.20±2.61 for chronic superficial gastritis, 5.45±2.47 for atrophic gastritis, 3.61±2.0 for
metaplasia, and 3.31±1.75 for gastric cancer, with statistically significant differences
between the groups (P<0.001). The mean Ki-67 protein staining values were 0.1 ±
0.4 for chronic superficial gastritis, 0.33 ± 0.55 for atrophic gastritis, 0.09 ± 0.39 for
metaplasia, and 2.62 ± 0.78 for gastric cancer, also showing statistically significant
differences (P<0.001). The mean MMP2 and MMP9 protein staining values were
0.2±0.76 and 1.2±2.04, respectively, for chronic superficial gastritis; 0.28±0.52
and 3.28±2.82 for atrophic gastritis; 0.35±1.04 and 1.12±1.45 for metaplasia; and
1.38±2.11 and 5.29±2.51 for gastric cancer, with all differences being statistically
significant (P<0.001).
Conclusion
PGC protein, a negative tumor marker, decreases during the transition
from a gastric cancer precursor to cancer. MMP2 protein, a marker of cell migration
and metastasis, has little diagnostic value, while the expression of MMP9 and the Ki
67 are highly effective in gastric cancer. Immunohistochemical analysis of endoscopic
biopsy tissue to detect the negative tumor marker PGC, the positive marker Ki-67,
and MMP9 can be used for early detection of gastric cancer.
10.The incidence of stomach and esophageal cancer in Mongolia: a data from 2009-2018
Tulgaa L ; Nasanjargal T ; Ulziisaikhan B ; Ganchimeg D ; Tegshjargal B ; Tsegmed S ; Batbold B
Mongolian Medical Sciences 2020;192(2):27-36
Introduction:
Cancer is a major public health issue both in Asia and in Mongolia. The most prevalent cancer related
deaths in Mongolia are registered for the stomach, esophagus and liver.
Purpose:
We aimed to investigate the incidence of stomach and esophageal cancer in Mongolian population.
Materials and Methods:
Epidemiologic data were collected from 2009 to 2018 through the oncology cabinet of all hospitals and
medical centers from all provinces, soums (the smallest unit of provinces) and major districts of the
capital city. The incidence of stomach and esophageal cancer was calculated by appropriate methods
and it was presented by ArcGIS Pro 9.2 software. A P-value of less than 0.05 was considered to be
statistically significant and based on two side hypotheses. All calculations were performed in the IBM
SPSS Statistics software. The study design in concordance with ethical guidelines was approved
by the Ethics Committee of Ministry of Health Mongolia. All clinical investigations were conducted
according to the principles laid down in the Declaration of Helsinki.
Results:
The incidence of esophageal cancer in last ten years (2009-2018) was 10.09 in 100000 populations
and the highest incidence were registered in Uvs (38.13), Bayan-Ulgii (24.15) and Zavkhan (18.18)
provinces, respectively. The incidence of stomach cancer was 20.33 in 100000 populations and the
highest incidences were registered in Uvs (53.01), Khovd (46.02) and Darkhan-Uul (40.50) provinces,
respectively.
Conclusion
1. Incidence rates for esophageal and stomach cancer are high among the Mongolian population.
In the last decade, the incidence of esophageal cancer had not decreased significantly, but it’s
constant.
In our study, the esophageal cancer incidence was 10.09 per 100’000 people, which includes
one of the high incidence rate countries according to the WHO classification. More than 10
aimags incidence rate of esophageal cancer was higher than the National average. Most of them have occurred in the western region of the country. Most of the Western, some of Khangai and
Eastern soums have had the highest incidence of esophageal cancer what we have shown on
the mapping.
2. The incidence rates of stomach cancer were registered as 20.33 per 100’000 people in the last
10 years at the national level. It has shown that according to the WHO classification, our country
is also one of the countries with the highest incidence of stomach cancer. The stomach cancer
incidence trend was increased in the last 10 decades. Therefore, some of aimag’s soums has
included the highest rate classification. In addition, some soums in the Western, Khangai, and
Eastern aimags had have a very high incidence of stomach cancer.
According to results in the above, the nationwide targeted prevention program is needed
especially where the highest incidence rates. Also there is a lack of cooperation between national
organizations to accurate registration of gastrointestinal cancer and to fight against these harmful
cancers.
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