1.Association between serum cryoglobulinemia and clinical manifestation in chronic hepatitis C patients
Amin-Erdene G ; Gantogtokh D ; Yumchinsuren Ts ; Dolgion D ; Bolor U ; Otgongerel N ; Enkhmend Kh ; Ganchimeg D ; Tulgaa L ; Sarnai Ts ; Batbold B
Mongolian Journal of Health Sciences 2025;88(4):92-99
Background:
The most common clinical manifestation of HCV infection, which includes both hepatic and extrahepatic
manifestations, is mixed cryoglobulinemia, which is characterized by the precipitation of certain proteins in the blood at
temperatures below 37°C (in vitro), aggregation, and deposition in the walls of small and medium-sized vessels, causing
vasculitis, which is clinically manifested by a triad of joint pain, fatigue, and rash on the soles of the feet. Cryoglobulinemia is commonly diagnosed in people with HCV infection, with a prevalence ranging from 10% to 70%. Vasculitis that
occurs when cryoglobulinemia is detected mainly affects the small vessels of the skin, kidneys, and peripheral nerves,
causing complications in other organ systems.
Aim :
To determine the prevalence of cryoglobulinemia in people with HCV infection, study it in relation to the stage of
liver fibrosis, and determine its clinical relevance.
Materials and Methods :
200 chronic HCV infected individuals were included in the study according to the inclusion
and exclusion criteria. After obtaining informed consent from each participant, a questionnaire was used to collect information, perform physical measurements, and collect peripheral blood samples. Complete blood count and biochemical
tests (liver and kidney function) were performed. The degree of liver fibrosis was assessed non-invasively (APRI, FIB4). The glomerular filtration rate was calculated electronically using the MDRD GFR Equation. Skin examination was
performed to assess the presence of rash, ulcers, and scarring on the shins and ankles of cryoglobulinemia. To determine
cryoglobulinemia, 8 ml of blood was collected in a tube without anticoagulant, and the sample was kept motionless for
1 hour at room temperature until clotting was complete. After centrifugation, the samples were separated and stored in a
refrigerator at +4°C for 7 days, and then at room temperature for 30 minutes, the precipitate was detected.
Results :
A total of 200 people participated in the study, of which 71 were men (35.5%), the average age was 53.39±13.0.
Cryoglobulinemia protein precipitates were determined in a total of 148 people, of which 50 were men (33.8%), the
average age was 52.95±13.0. Cryoglobulinemia protein precipitates were detected in 89 people, or 60.1% of the study
participants. Of the total study participants, 176 (88.0%) had chronic hepatitis C (CHC). Of these, 57 people had CHC
with cryoglobulinemia. Comparing laboratory parameters, the mean GGT level in the cryoglobulinemia group was statistically significantly higher than in the non-cryoglobulinemia group (p=0.039). However, when laboratory parameters
were grouped by increasing or decreasing, AST and ALT levels were significantly higher in the cryoglobulinemia group,
indicating more hepatocellular damage (p<0.000). Increased creatinine levels may be associated with the risk of renal
dysfunction. The FIB-4 index and APRI index showed a more severe degree of fibrosis in the cryoglobulinemia group
(p<0.005; p<0.000). Univariate logistic regression analysis showed that age was associated with the occurrence of cryoglobulinemia (OR=2.48; 95% CI:1.31–4.70; p=0.005). Platelet count had a statistically significant positive effect in multivariate analysis (OR=14.38; 95% CI:1.26–163.89; p=0.032).
Conclusion
The prevalence of cryoglobulinemia among HCV-infected patients was 60.1%, and older age and decreased
platelet count among infected individuals were associated with the occurrence of cryoglobulinemia.
2.Evaluation of Bite Force in Teeth Restored with Zirconia and Porcelain-Fused-to-Metal Crowns
Batbold E ; Munkhjargal G ; Javkhlan P ; Batsukh Sh
Mongolian Journal of Health Sciences 2025;88(4):216-220
Background:
Mastication is a biomechanical process that involves the jaws and teeth working together to effectively
break down food through the contraction of masticatory muscles. The efficiency of this process is influenced by factors
such as bite force, the integrity of the dental arch, and individual characteristics, including age, gender, and body weight.
Previous research has investigated the bite force of natural teeth, comparing the differences between removable and fixed
denture teeth. For instance, Gibbs et al. estimated the bite force of Eskimo individuals to be 348 lbs (138 kg), while Al-Zarea et al. reported a bite force of 580.9 N for fixed partial dentures. Additionally, J. Urangua estimated the bite force of first
permanent molars to be 472 N. Although studies have explored the bite force of Mongolian individuals with removable
dentures, there has been no investigation into the bite force of fixed partial dentures, highlighting a significant gap in the
literature that the current study aims to address.
Aim:
This study aims to assess the bite force following the restoration of teeth with Zirconia and Porcelain-Fused-to-Metal crowns.
Materials and Methods:
The study involved 20 individuals aged 18 to 34 years, each of whom had their mandibular
molars restored with Zirconia and Porcelain-Fused-to-Metal (PFM) crowns on one side, while the other side retained
their natural teeth, which had not undergone root canal treatment and exhibited no significant alveolar bone loss. A single-instance design was employed to measure occlusal force using the Occlusal Force Meter GM10. Statistical analysis
was conducted using SPSS 26.0 software, with results considered statistically significant at a probability level of p < 0.05.
Results:
The cohort comprised 20 subjects aged 18 to 34 years, with 65% (13) male and 35% (7) female, yielding a mean
age of 28.2 ± 3.5 years. The mean bite force for teeth covered with crowns was (393.2±0.3 N), compared to (445.5±70
N) for natural teeth. Notably, the bite force of the Zirconia crown (407.0±0.7 N) was higher than that of the Porcelain-Fused-to-Metal (PFM) crown 367.7±0.9N. When analyzed by gender, the bite force of natural teeth in men averaged
484.1±46.2N, while that of crowns was 445.3±43.7N. In women, the bite force of natural teeth averaged 373.7±15.4N,
compared to 296.4±19.6 N for crowns.
Conclusion
1. The bite force of zirconia porcelain crowns was 407.0±76N, while the bite force of metal porcelain crowns was
367.7±97N.
2. When determining the bite force of crowns and natural teeth, the bite force of crowns and natural teeth was
296.4±19.6N, and the bite force of uncoated teeth was 445.5±70N, respectively.
3. When compared by gender, the bite force of uncoated teeth in men was 484.1±46.2N, the bite force of coated teeth
was 445.3±43.7N, and the bite force of uncoated teeth in women was 373.7±15.4N, and the bite force of coated teeth
was 296.4±19.6N, and the bite force was significantly related to gender (p<0.0001).
3.Analysis of Mandibular Fracture Cases Recorded in Mongolia
Gantsetseg G ; Ganbaatar Yu ; Batbold G ; Nyamtseren D ; Ochbayar N ; Davaakhuu Sh ; Enkh-Orchlon B
Mongolian Journal of Health Sciences 2025;86(2):77-83
Background:
The craniofacial region is one of the most frequently injured parts of the human body, with mandibular
fractures being the most common type of facial skeletal injury. The leading causes of mandibular fractures include traffic
accidents, falls, interpersonal violence, and sports-related injuries. In Mongolia, mandibular fractures are prevalent, with
a higher incidence among males. However, to date, no national-level analysis of mandibular fractures has been conducted.
This study aims to comprehensively examine mandibular fractures in Mongolia by identifying demographic factors and
causes of injury.
Aim:
To determine the incidence and causes of mandibular fractures recorded in Mongolia over the past ten years.
Materials and Methods:
This study collected data on mandibular fractures recorded in the Health Development Center
of Mongolia between 2014 and 2023. Cases were identified using the International Classification of Diseases (ICD-10)
code S02.6. Information on patient age, gender, and hospital diagnosis was collected, along with the cause of injury, classified
according to ICD-10 codes. Patient age was categorized based on the classification system of the National Statistics
Office. Statistical analysis was performed using SPSS 26.00 software, employing the chi-square test for data analysis.
Results:
During the study period, a total of 2,872 patients were diagnosed with mandibular fractures, with the highest
incidence occurring in the 20-40 age group. The average patient age was 31.1±12 years. Males were 5.6 times more likely
to sustain mandibular fractures compared to females. The primary causes of injury were interpersonal violence (42%),
mechanical trauma (17%), falls (16%), and traffic accidents (15%).
Conclusion
Between 2014 and 2023, 2,872 cases of mandibular fractures were recorded in Mongolia, with the majority
occurring in individuals aged 20-40 years. The leading causes of mandibular fractures were interpersonal violence, mechanical
trauma, falls, and traffic accidents. Specialized trauma care services were accessed differently in urban and rural
areas.
4.Studying the relationship between Cryoglobulinemia and liver fibrosis in patients with chronic Hepatitis C virus infection
Amin-Erdene G ; Gantogtokh D ; Turmanduul Ch ; Yumchinsuren Ts ; Dolgion D ; Enkhmend Kh ; Bolor U ; Otgongerel N ; Ganchimeg D ; Tegshjargal B ; Tulgaa L ; Batbold B
Diagnosis 2024;111(4):10-19
Introduction:
Hepatitis C virus (HCV) infection has both hepatic and extrahepatic manifestations, and it is one of the leading cause of liver transplantation. There’s limited research on extrahepatic symptoms of chronic HCV in Mongolia, thus we aimed to investigate the relationship between cryoglobulinemia and it’s related factors.
Methods:
The study included 200 participants with active HCV, collecting blood samples for various tests (biochemical analysis, kidney function, and cryoglobulinemia detection). The degree of liver fibrosis was assessed using APRI and FIB4 scores, and the study evaluated other health conditions through a questionnaire. Statistical analysis was performed using SPSS-26.
Results:
Out of 200 participants, 148 checked for cryoglobulin precipitation and 89 (60.1%) were positive. There
was a statistically significant age difference between those with and without cryoglobulinemia (54.62 vs. 50.44 years). A higher percentage of participants with cryoglobulinemia had significant liver fibrosis (10.8% vs. 4.7% without). Liver fibrosis scores tended to increase with age, especially in men.
Conclusion
Liver fibrosis scores above 3.25 are associated with older age, lower platelet counts, elevated AST and ALT levels, and the presence of cryoglobulinemia. FIB4 scores were higher in men with active HCV and cryoglobulinemia.
5.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.
6.Correlation between interleukin-4 and advanced fibrosis in chronic hepatitis C patients
Serjbayar G ; Bolor U ; Chia-Yen D ; Batbold B
Mongolian Medical Sciences 2021;197(3):26-32
Background:
Various cytokine dynamics has been associated with chronic hepatitis C virus (HCV)
infection. We hypothesized that cytokines have an important role in fibrosis development in HCV
infection.
Methods:
All patients received liver biopsies to validate the severity of chronic hepatitis when enrolled
in this study. Fluorescent Bead immunoassay was used to measure the following serum cytokine
levels: Interferon γ, tumor necrosis factor α, interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and
IL-12. Various statistical analyses were used as appropriate.
Results:
From all the liver biopsy proven 92 HCV-infected patients, 49 (53.3%) were male, 23 (25%)
patients had advanced (fibrosis grades 3-4) fibrosis, and the mean age of the study population was
51.9 ± 9.4 years. Elevation of baseline IL-4 level (>490 pg/mL) was associated with liver fibrosis grade
by X2 test (odds ratio [OR] = 2.99; 95%, CI = 1.02-8.78; p = 0.042) and multivariate logistic regression
(OR = 4.26; 95% CI = 1.13-16.02; p = 0.032). Also, IL-4 had strong diagnostic value in advanced liver
fibrosis by using area under receiver operating characteristics curve analysis. Assessment of fibrosis
score was consequently developed from our findings and compared with other noninvasive serum
markers to assess liver fibrosis.
Conclusion
This study provides evidence that increased IL-4 expression predicted advanced liver
fibrosis in treatment of HCV-infected patients.
7.Knowledge and attitudes of Covid-19 vaccine in the target population vaccinated against coronavirus infection
Uugantuya L ; Azjargal G ; Batbold B
Mongolian Medical Sciences 2021;197(3):87-89
Introduction:
According to the World Health Organization, 251 vaccines against coronavirus
infection are under development. Although vaccination has been introduced nationwide to prevent
coronavirus infection, vaccine activity varies (50-95%), and the risk of infection and complications
may vary depending on the individual’s physical condition and immune activity. In addition, due to
the prevalence of variant of concern, which reduces the activity of some vaccines and increases
the risk of complications and mortality of COVID-19, each country and region needs to improve the
knowledge and attitudes of citizens about the vaccine. there is a need to study.
Goal:
To study the knowledge and attitudes of people who have been vaccinated against COVID-19
among the target population of Uvs province.
Materials and methods:
The study was conducted using a descriptive method of observational
research. Quantitative and qualitative methods were used to collect the survey data, and the data
were collected in April 2021 through a questionnaire. A random sample of 4,212 people from 11
organizations involved in the Covid-19 vaccine was randomly selected from 24 organizations, and
a total of 264 people were surveyed using 12 types of Covid-19 vaccine and analyzed using SPSS
software.
Result:
According to the results of the survey, 4212 people from 11 organizations and 24 people
from each organization were randomly selected from a total of 264 people. Mostly female participants
(57.5%) have been included in this study. 67.4% of the respondents reported that they do not feel
fear associated with vaccination and it means that most of the participants did not show any signs
of panic. 91.2% participants did not have any symptoms after the vaccination. 30.4% from total
participants was used anti-inflammatory or pain relief pills after vaccination at home. 45.8% of the
respondents self reported that they have moderate knowledge about Covid-19 vaccine.
Conclusion
Overall knowledge of people from Uvs province was insufficient. However, attitude was
good enough.
8.Influence of rs16924159 polymorphism of IL-33 gene on asthma susceptibility
Chimedlkhamsuren G ; Uyangakhorol N ; Batbold O ; Ichinnorov D ; Sarantuya J
Innovation 2020;14(2):67-71
Background:
Interleukin-33 (IL-33) cytokine plays a crucial role in asthma pathogenesis. Recent
studies have established that IL-33 activity was increased in serum, airway smooth muscle and
epithelial cells from patients with asthma and this increase positively correlates with asthma
severity. We hypothesized that several genetic variations that contributing IL-33 expression
and activity, which may risk factor for susceptibility to asthma. In this study, we examined the
association between rs16924159 single nucleotide polymorphism (SNP) of IL-33 gene and asthma
susceptibility.
Methods:
51 asthma patients and 54 healthy volunteers were involved in this case-control
study. Blood sample was collected for genomic DNA extraction. rs16924159 SNP genotyping was
performed by the allele specific-polymerase chain reaction (AS-PCR) method. Statistical analysis
was performed using STATA 13.0 software.
Results:
The groups were matched for age, gender and body mass index (p>0.05). The distribution
of rs16924159 allele and genotypes among patients and controls was found in accordance with
those expected by the Hardy-Weinberg equilibrium (p=0.088). Adenine (A) allele frequency of
rs16924159 was significantly different between case and control groups (OR = 1.91, 95% CI = 1.04-
3.51, p = 0.037). Also, homozygote A/A (OR=6.53, 95% CI 0.68-62.38, p=0.104) and heterozygote
(OR=2.08, 95% CI 0.93-4.62, p=0.073) genotypes were more frequent among asthma patients than
in controls.
Conclusions
From these findings, we conclude the A allele of rs16924159 SNP in IL-33 gene
may be contributing to asthma susceptibility, increasing the carrier`s risk to the development of
asthma.
9.Study on the risk factors of gastric cancer
Tulgaa L ; Ganchimeg D ; Enkhmyagmar D ; Tegshjargal B ; Nasanjargal T ; Ulziisaikhan B ; Dashmaa A ; Bayar D ; Bolor-Erdene T ; Erkhembayar E ; Chinzorig M ; Serjbayar G ; Batbold B
Mongolian Medical Sciences 2020;192(2):37-44
Introduction:
In 2018, a total of 901 new cases of gastric cancer were recorded, of which 64.8% in males and
34.2% in females. The incidence rate of gastric cancer was 28.5 per 100 000 population, which 38.2
for males and 19.2 for females.
Goal:
We aimed to investigate the associations between some risk factors and gastric cancer among the
Mongolian population.
Materials and Methods:
A case-control study was conducted between November 2017 and September 2019. We selected
120 cases from National cancer center of Mongolia who newly diagnosed gastric cancer. And 120
controls were selected by matching by sex, age and the place of residence. Informed consents
were obtained from all subjects. All subjects were personally interviewed with researchers used by a
structured questionnaire consisting of 86 questions. The SPSS 21 (version 16.0, SPSS Inc., Chicago,
IL, USA) software was used for all analyses.
Results:
The mean age was 59.2±11.4 (26-85) years. Habits of having dinner after 6.00 pm (OR 1.42, 95%CI
1.11-1.83, p=0.008), having leftover meals (OR 2.22, 95%CI 1.27-3.86, p=0.008), daily consumption
of tea with salt (OR 1.97, 95%CI 1.18-3.30, p=0.01), smoking on an empty stomach (OR 2.44,
95%CI 1.11-5.37, p=0.033), weekly consumption of ham and smoked meat (OR 1.5, 95%CI 1.17-
2.13, p=0.02), and consumption of fat grease (OR 2.09, 95%CI .03-4.24, p=0.038) were significantly
increased gastric cancer risk. In contrast, habit of eating at regular times (OR 0.43, 95%CI 0.25-0.73,
p=0.002), chewing thoroughly (OR 0.39, 95%CI 0.23-0.67, p=0.001), cooking meat thoroughly until
it’s tender (OR 0.48, 95%CI 0.25-0.97, p=0.047), daily consumption of vegetables (OR 0.45, 95%CI
0.27-0.76, p=0.003), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p=0.026) were
significantly reduced gastric cancer risk. Furthermore, having first-degree relatives diagnosed with
gastric cancer had 2-3 fold higher increased risk of gastric cancer (parents OR 2.88, 95%CI 1.07-
7.78, p=0.038, sibling (OR 3.09, 95%CI 1.09-8.81, p=0.036). Also, previous records of the digestive
disease increased risk of gastric cancer (OR 3.65, 95%CI 2.10-6.35, p<0.0001).
Conclusion
Dietary habits, family history of gastric cancer and previous records of digestive disease were
associated with risk of gastric cancer. Thus, prevention effort could be focused on the population with
a family history of gastric cancer, changing bad dietary habit and screening precancerous disease of
gastric cancer.
10.Change of serum lipid profiles during antiviral therapy in chronic hepatitis C
Batbold B ; Gantsetseg G ; Tulgaa L ; Ganchimeg D ; Sodnomtsogt L ; Chia-Yen D
Mongolian Medical Sciences 2018;186(4):14-22
Background :
Low triglycerides and cholesterol was associated with hepatitis C virus (HCV) infection. Chronic HCV infection is the main cause of liver injury and it may influence to serum lipid levels. We aimed to evaluate the effect of antiviral treatment on the change of lipid profiles during interferon-based anti-HCV treatment.
Material and Methods :
Totally 863 patients who completed the interferon-based antiviral therapy in Kaohsiung Medical University Hospital were included in this present study. The lipid profile measured and assessed in the baseline of the treatment and after 6 months of completion of the treatment.
Results :
The most of the patients (81.2%) were achieved sustained virological response (SVR) by antiviral therapy. There was no significant difference between baseline triglycerides (TG) levels in the SVR group and non SVR groups. The TG levels at 6 months after completion of the treatment was significantly elevated in SVR group (102.9±57.0 mg/dL, p=0.0001) but did not elevated in non SVR group (94.5±45.6 mg/dL, p=0.690) compared with baseline TG levels.
After adjusting patients by four indexes for fibrosis (FIB4) in cut-off point 3.25, serum TG levels significantly increased in low FIB4 group (103.2±57.9 mg/dL, p=0.0001) but not in high FIB4 group (98.1±49.6 mg/dL, p=0.095) after 6 months end of the treatment. Serum TG level was increased greater in patients who had low FIB4 score and patients who achieved SVR (baseline 89.1±34.8 mg/dL; 6 months after treatment 104.3±59.3 mg/dL, paired T test p=0.0001).
Conclusion
The eradication of HCV is the main cause of the increase of lipids after Pegylated Interferon and Ribavirin treatment.
However advanced fibrosis also has an effect in increase of TG after the treatment.
Result Analysis
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