1.Evaluation of the vaginal microenvironment in women of menopausal age
Tsevelmaa E ; Buyan-Ulzii Ch ; Lkham-Erdene G ; Pagmadulam S ; Munkhzul N
Diagnosis 2025;112(1):90-94
Postmenopausal estrogen deficiency can lead to genitourinary syndrome of menopause (GSM), which manifests as vaginal dryness, dyspareunia, and sexual dysfunction, among other clinical symptoms. These complications often result in emotional distress and a decline in overall quality of life (7). Several studies estimate that 25–50% of postmenopausal women experience symptoms such as pain during
intercourse, burning, itching, and dysuria due to vaginal atrophy and inflammation (9). Menopause is commonly diagnosed based on the absence of menstruation and hormone levels (10), but one of the simplest diagnostic methods is the evaluation of the vaginal microenvironment. There is limited
data in Mongolia regarding the vaginal microenvironment of perimenopausal and postmenopausal women and the factors influencing its changes. This gap in knowledge formed the basis of our study.
The aim of this research was to assess the vaginal microenvironment in menopausal women and to analyze its relationship with various influencing factors. We conducted a cross-sectional observational study using a descriptive research design. A total of 110 women aged 45–55 years, presenting with menopausal symptoms at “Santmaral” Women’s Clinic and the Women’s Outpatient Department of Songinokhairkhan Health Center, were selected for the study. Both quantitative and qualitative
research methods were employed, including surveys and physical examinations. Participants completed a 10-minute questionnaire consisting of 8 open-ended and 12 closed-ended questions. The vaginal microenvironment was assessed using special pH test strips applied to vaginal secretions. Data were analyzed using Excel 21 and SPSS 23, comparing the vaginal microenvironment with various influencing factors. The results showed that the average vaginal microenvironment pH among menopausal women was 5.18 ± 0.45 (n=110). In married women, the average pH was 5.1 ± 0.45; among women with a history of pregnancy, it was 4.10 ± 1.58; and among those who had given birth,
it was 2.8 ± 0.98 — indicating an abnormal vaginal microenvironment. Women who were using hormone replacement therapy had an average pH of 5.05 ± 0.45, while those using non-hormonal contraceptive methods had an average pH of 5.3 ± 0.43. These findings were statistically significant
(p = 0.0001****)
2.Chronic kidney disease and serum NT-proBNP level
Sodgerel B ; Anudari I ; Buyandelger J ; Pilmaa Yo ; Gantogtokh D ; Yesukhei E ; Bilguun E ; Nyam-Erdene N ; Yundendash D ; Munkhbayar S ; Bolormaa Do ; Sarangerel Ga ; Munkhzul D ; Batbold B ; Sodnomtsogt L
Mongolian Medical Sciences 2024;210(4):9-17
Background:
Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular
dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD),
emphasizing the need for its early detection and prognosis.
Objective:
This study aimed to determine the serum NT-proBNP levels in participants with CKD and
establish a cut-off value for predicting heart failure.
Methods:
A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study
received approval from the Ethics Committee of the Institute of Medical Sciences (Approval
No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology
Department of the third state hospital were enrolled based on predefined inclusion and
exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound
test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence
quantitative analyzer. Data were analyzed with SPSS 26.0.
Results:
The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The
mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences
were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension
between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly
between heart failure and non-heart failure groups (p<0.05). Significant differences were
also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05).
NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted
between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value
for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%,
specificity: 55%).
Conclusion
Serum NT-proBNP levels are elevated in CKD patients regardless of heart
failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure
was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).
3.Study of exposure and vaccination coverage of the medical students
Yanjindulam B ; Naranzul B ; Ulziisuren B ; Byambasuren S ; Gantsetseg G ; Solongo G ; Narangerel P ; Nyammkhuu D ; Nyamsuren B ; Munkhzul D ; Batchimeg Ch ; Ganchimeg Ch ; Oyunbileg D ; Khosbayar T
Diagnosis 2023;106(3):109-117
Background:
To prevent and combat the spread of the COVID-19 pandemic, the Government of Mongolia has implemented measures such as movement and time restrictions, social distancing and isolation, closure of schools, kindergartens and public places, immunization, and others. It has caused adverse consequences for people, social relations, and the economy, causing health, social, economic, and humanitarian crises. Not only does this situation, medical students, as frontline healthcare workers, are more susceptible to virus infection. Vaccines against COVID-19 have been researched quickly due to the pandemic and are being used under emergency use authorization. In our country the approach of mixing vaccine doses from different manufacturers was used (fractional doses). Therefore, there is no study on the exposure of medical students to the COVID-19 infection and the adverse effects after receiving a dose of a heterologous vaccine. Objective: To study the exposure to the COVID-19 infection and vaccination status of medical students.
Methods:
The survey was conducted from November 2023 to December 2023 using a cross-sectional study design, and 170 students who study at ASUSU and live in the dormitory were included.
Results:
A total of 170 students participated in the study. 55.9% (n=95) of them were in the first year, 22.4% (n=38) were in the second year, 10% (n=17) were in the third year, 7.6% (n=13) were in the fourth year, 2.4% (n=4) were from the 5th year and 1.8% (n=3) were from the 6th year students. 88.2% (n=150) of students were female and 11.8% (n=20) were male. In this study, 37.1% of the students were infected by COVID-19 infection previously. Among them, 50% of the students were infected from family members, 16.7% from the school environment, and 15.2% did not know about the source of infection. 76.2% of the respondents were diagnosed with COVID-19 in a medical institution, and forty-one students answered that they were treated at the hospital. 83% of the cases were treated at home and were cured within 14 days. In contrast, 93.8% of the hospitalized students were treated within four months to 1 year. The current study demonstrates neurological, respiratory, sensory, cardiovascular, psychiatric, digestive, and dermatological symptoms were in 37.6%, 24.1%, 27.6%, 17.6%, 11.8%, 11.2%, and 10% of the students who participated in the study, respectively. For a year or more, symptoms of all organ systems were present, but neurological symptoms appeared to be the highest. 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine, 3.5% (n=6) did not receive the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects and 65% (n=106) had no side effects.
Conclusion
In this study, 37.1% of the students were infected by COVID-19 infection previously. According to the current study, symptoms related to the nervous system was the most prevalent and 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects.
4.RESULTS OF DIAGNOSTIC AND OPERATIVE HYSTEROSCOPY WHICH STUDIED IN FIRST MATERNITY HOSPITAL
Enkhbat Ts ; Myagmartseren B ; Batgerel G ; Batnyam B ; Oyungerel Kh ; Unurgargal D ; Munkhzul S
Innovation 2015;9(3):16-19
Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.
5. RESULTS OF DIAGNOSTIC AND OPERATIVE HYSTEROSCOPY WHICH STUDIED IN FIRST MATERNITY HOSPITAL
Enkhbat TS ; Myagmartseren B ; Batgerel G ; Batnyam B ; Oyungerel KH ; Unurgargal D ; Munkhzul S
Innovation 2015;9(3):16-19
Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.
6. STUDY OF URODYNAMIC TEST USED IN DIAGNOSIS AND ANALYSIS OF TREATMENT EFFECT IN URINE INCONTINENCE
Purevjargal J ; Munkhzul S ; Gantuya S ; Ulziisuren CH ; Sarangoo KH ; Munkhzul A
Innovation 2015;9(3):28-31
Urine-incontinence is most significant disease in general population its rate between 10-47%. One of the most widespreeding 10 disease’s one is incontinence in USA, In European population 17%, In Russian 16%. Stress incontinence prevalence in Mongolian women, 78.1% was urban population, 21.9% was rural. In already diagnosed population 30% of them were non-treatment group, 32.25% were underwent surgical treatment. Early diagnose, right treatment option choice, value of surgical treatment all of its result is valuable in practice. Urogynecology Division of First Maternity Hospital Of Mongolia patients who underwent urodynamic machine their economic background, etiological factors, symptoms, maternal status, gynecological check up result all of these factors were calculated by PAD- test. Positive patients diagnostic and treatment options were determined by machine. Prospective study were done within 43 women who diagnosed by urodynamic machine. We reassumed pre and post – treatment patient’s incontinence symptoms by machine. 79.3% percent of women diagnosed with stress incontinence had a history of coffee or tea usage. / p<0.01, QR=0.38/. Birth injury such as vaginal or perineal tear showed statistically significant impact on urine incontinency (82%) /p<0.04, QR=0.31/. Among the signs of urine incontinence, dribbling of urine during physical load was a statistically significant sign of stress incontinence. /p<0.04, QR=0.38/ The result of Pad test showed significantly low statistic importance compare to stress incontinence/p<0.01, QR=0.35/. The result of Pad test showed significantly low statistic importance compare to stress incontinence /p<0.01, QR=0.35/. 41/95%/ women showed normal bladder volume while 5% showed low bladder volume which is lower than 300 ml. Residual urine more than 100 ml showed statistically significant relation with stress incontinence /p<0.03, Q=0.32/. The main symptom of stress incontinence in women was urine leakage /p<0.01, Q=0.44/. Stress incontinence prevalence was 44.8% and overactive bladder was 25% in 36-55 age group. Children weight showed no impact on stress incontinence and overactive bladder. 83% of participants had birth number of ≥ 2 showing the statistical significant impact of birth number in urine incontinence (р>0.05, QR=0.8). From all participants, 60% had stress incontinence, 19% had no abnormality, 9% had overactive bladder, 7% had mixed urine incontinence, and 5% had other diseases (urethral atrophy and obstruction). From total 43 participants, 22(51%) had surgical treatment, 4(9%) had chemical treatment, 3(7%) had combined surgical and chemical treatment, and 14 (33%) had physical exercise. From 21 women who received surgical treatment, 16 had improvement and 5 had no improvement. Analyzing the treatment result of urine incontinence by questionnaire and urodynamic test showed improvement in 75 % of patients received surgical and combined surgical chemical treatment and 80% of improvement in patients received chemical and exercise treatment.High number of birth, high usage of coffee and tea, birth injury especially perineal tear are statistically significant factors of stress incontinence development.Pad test is effective test used in diagnosis, treatment planning and monitoring treatment results of urine incontinence.Urine leakage symptom occurs 44% more in women with stress incontinence. 24% of women with stress incontinence were diagnosed without abnormality by urodynamic test. Urodynamic test has a diagnostic importance in treatment planning, individual treatment choice and increase of treatment effect in urine incontinence patients.
7. RESULTS OF RESEARCH CONDUCTED ON CYTOLOGICAL CHANGES OF DISEASES MOSTLY OCCURRING AMONG WOMEN
Munkhzul S ; Yumchmaa N ; Enkhtuul CH ; Myagmartseren B ; Oyunchuluun B
Innovation 2015;9(3):76-77
First Maternity Hospital in Ulaanbaatar has provided 1890 women, 2508 women and 3728 women in 2012, 2013 and 2014, respectively, for diseases in women. Uterine myoma, ovarian cysts, dysfunctional uterine bleeding, ovariandysfunction and endometriosis are commonly among women. These need to be diagnosed at early stages of the diseases. Endometrial carcinoma is detected in 5% of women under 40 years of age with over amount of hormone estrogen on a base of endometrial hyperplasia.Women with endometrial hyperplasia have 5% possibility to have endometriosis, endometroidcysts, ovarian cancer or uterine myoma and 0.5% possibility to have higher complication of disease. Therefore, we aimed to introduce the practical treatment with cytological analysis as a medical treatment and diagnosis method. The purpose of the research is to highlight the diseases mostly occurring in women, determine cytological changes and differences and improve the differential diagnosis.The research work has been carried out based on reports of cytological analyses undertaken by the National Centre of Pathology for 1310 patients, who were all of patients treated at the Inpatient Care Department in FMH in 2014. This study included in the cytological analyses at the National Centre of Pathology, by using special questinnaries and did retrospective study. 67.7% /888/, 27.8% /365/ and 4.3% /57/ of the above mentioned women were tested with cytological analyses due to surgical diseases, endocrinology diseases and inflammatory diseases, respectively. The average age is 39±58. The uterine myoma, the ovarian cyst and dysfunctional uterine bleeding have been more commonly occurred among the 35 diseases in women as 38.9% /510/, 15.7% /206/ and 16.7%/219/ of the women, respectively. For endometriosis cases, the ovarian endometriosis occurred with 3.7%, the fallopian tube endometriosis occurred 2.4%, the adenomyosis occurred 4.7% and the combined endometriosis occurred 0.5%.Based on the reports of cytological analyses on endometrial hyperplasia, the details show that the simple hyperplasia is 52.4% /178/ and the complex hyperplasia is 47.6% /162/.Compared with women without the HPV, a cervical intraepithelial neoplasia occurs to women with the HPVmore than 20 times. /p<0.001, OR=20.81/. It is statistically important that 2nd stage of adenomyosiscauses atypic cellular changes for 3 times. /p<0.001, OR=3.09/. In women, the uterine myoma, dysfunctional uterine bleeding and ovarian cyst disorders are most common. Average age of women with disease in women is 39.58.Compared with women without the HPV, a cellular change occurs to women with the HPV more than 20 times. /p<0.001, OR=20.81/.The 2nd stage of adenomyosis causes atypic cellular changes for 3 times. /p<0.001, OR=3.09/
8.Some Results Of Pharmacological Researchof Traditional Drug Jonlon-5
Davaadulam P ; Uuganbayar B ; Oldokh S ; Munkhzul G
Journal of Oriental Medicine 2015;9(2):36-45
Traditional drug Jonlon-5 have been widely used in the clinical
practice for recent years in traditional medicine. The study was
conducted on the experimental animal wistar rats by the
carrageenan induced mice paw edema (Winter et al. 1962, Vogel,
2002) methods. We performed chemical and pharmacological
investigation was based and implemented scientific research
laboratory of Institute of Traditional Medicine and Technology. The
Jonlon-5 significantly (P<0.05) inhibited carrageenan induced rat
paw edema as compared to control group. TNF-α secretion was
magnified by carrageenan injec¬tion (387.2 pg/ml). TNF-α secretion
was reduced, com¬parable to carrageenan group, as a respond to
extract administration. Administration of Jonlon-5 significantly
reduced inflammatory mediator secretion TNF-α by 20.8%, IL-1 β –
41.7%, to be close to inhibition level of Indo¬methacin
administration. Jonlon-5 significantly decreased (P<0.05) of serum
malondialdehyde (MDA) 16.5% in animal model.
9.Аnti-inflammatory activities of traditional Mongolian drug garidi-5
Uuganbayar B ; Ariunaa Z ; Oldokh S ; Chimedragchaa CH ; Munkhzul G ; Sugarjav E ; Molor-Erdene P
Mongolian Medical Sciences 2013;165(3):61-65
Introduction. Garidi-5, a traditional medicine composed of 5 herbs including Terminalia chebula Retz., Aconitum Kusnezoffii Reichb., Acorus calamus L., Saussurea lappa L., and musk of Moschus moschiferus, has been used in traditional Mongolian medicine as an analgesic and antibacterial medicine. The present work was undertaken to evaluate the traditional drug Garidi-5 for its analgesic and anti-inflammatory activity.Materials and Methods. The method of Winter et al. was used to study acute inflammation. Rats in groups of five each were treated with vehicle, Garidi-5 (20, 80 and 200 mg/kg, p.o.) and Indometacin (10 mg/kg) one hour prior to Carrageenan injection. 0.1 ml of 1% Carrageenan was injected into the subplantar tissue of left hind paw of each rat. Swelling of carrageenan injected foot was measured at 0, 0.5, 2, 4 h using Plethysmometer (UGO Basile, Italy)). The right hind paw was injected with 0.1 ml of vehicle.Results. The Garidi-5 (20, 80 and 200 mg/kg) significantly (P<0.01) inhibited carrageenan induced rat paw edema as compared to control group. Maximum inhibition of paw edema was observed with Garidi- 5 (80 and 200 mg/kg) at 4 h when compared to the control group (Tab.1). In assay data, the TNF-α, IL-1β and IL-6 secretion in serum were highly elevated by carrageenan induction but administration of Garidi-5 signifi cantly reduced serum secretion of inflammatory mediatorsas compared to vehicle group (Tab. 2).Conclusion. In conclusion, Traditional drug Garidi-5 have anti-in flammatory properties. The potential efficacy of Garidi-5 to treat inflammation is based in a part on the hy pothesis that it will suppress the proinflammatory cytok ines resulting in less oedema.
10.Аnti-inflammatory activities of traditional mongolian drug garidi-5
Uuganbayar B ; Ariunaa Z ; Oldokh S ; Chimedragchaa CH ; Munkhzul G ; Sugarjav E ; Molor-Erdene P
Mongolian Medical Sciences 2013;166(4):52-56
Introduction. Garidi-5, a traditional medicine composed of 5 herbs including Terminalia chebula Retz. Aconitum Kusnezoffii Reichb., Acorus calamus L., Saussurea lappa L., and musk of Moschus moschiferus, has been used in traditional Mongolian medicine as an analgesic and antibacterial medicine. The present work was undertaken to evaluate the traditional drug Garidi-5 for its analgesic and anti-inflammatory activity.Materials and Methods. The method of Winter et al. was used to study acute inflammation. Rats in groups of five each were treated with vehicle, Garidi-5 (20, 80 and 200 mg/kg, p.o.) and Indometacin (10 mg/kg) one hour prior to Carrageenan injection. 0.1 ml of 1% Carrageenan was injected into the subplantar tissue of left hind paw of each rat. Swelling of carrageenan injected foot was measured at 0, 0.5, 2, 4 h using Plethysmometer (UGO Basile, Italy)). The right hind pawwas injected with 0.1 ml of vehicle.ResultsThe Garidi-5 (20, 80 and 200 mg/kg) significantly (P<0.01) inhibited carrageenan induced rat paw edema as compared to control group. Maximum inhibition of paw edema was observed with Garidi-5 (80 and 200 mg/kg) at 4 h when compared to the control group (Tab.1). In assay data, the TNF-α, IL-1β and IL-6 secretion in serum were highly elevated by carrageenan induction but administration of Garidi-5 signifi cantly reduced serum secretion of inflammatory mediators as compared to vehicle group (Tab. 2). ConclusionIn conclusion, Traditional drug Garidi-5 have anti-in flammatory properties. The potential efficacy of Garidi-5 to treat inflammation is based in a part on the hy pothesis that it will suppress the proinflammatory cytok ines resulting in less oedema.

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