1.Treatment of miniere’s disease (icd-10 h.81) using traditional medicine and therapeutic interventions: Case report
Undarmaa B ; Tserendulam G ; Oyun-Erdene U ; Oyunnyam Ch ; Nasankhishig D ; Khaliun E ; Tsegmed G ; Oyunbileg Yu ; Enkhtuya V
Mongolian Journal of Health Sciences 2025;87(3):72-74
Background:
Meniere's disease is a condition caused by disturbances in the
auditory and vestibular systems. It is characterized by symptoms such as dizziness,
nausea, vomiting, and tinnitus. In the United States, the prevalence of
Meniere's disease has been found to be 84 cases per 100,000 women and
56 cases per 100,000 men. Regionally, it is more common in less populated
areas, and research has confirmed that the prevalence increases with higher
household income.
Aim:
To evaluate the effectiveness of traditional medicine treatments and therapies
for Meniere's disease.
Results:
The patient is a 43-year-old male, with symptoms of dizziness, vomiting,
and tinnitus. Since 2023, he has sought care at the Central Hospital of
Mongolian Medicine, where he received traditional medicine treatments including
herbal therapy and other traditional therapies on three occasions. As a
result, the frequency of dizziness has decreased and other clinical symptoms
have improved.
Conclusion
Traditional medicine treatments have been shown to be effective
in managing Meniere's disease by extending the interval between relapses,
improving quality of life, and significantly reducing clinical symptoms.
2.Determining antibiotic susceptibility and multidrug resistance of the pathogens isolated from wound infection
Altantsetseg D ; Tserendulam B ; Nomiundari E ; Lkhagvadorj D ; Gerelmaa Ts ; Undarmaa S ; Dagvadorj Ts
Mongolian Medical Sciences 2024;210(4):3-8
Introduction:
Antimicrobial Resistance (AMR) has emerged as a significant public health and economic
issue worldwide, affecting both developed and developing countries. Our research has been
motivated by the increasing prevalence of carbapenem-resistant P. aeruginosa, A.baumannii,
and K. pneumonia in recent years.
Goal:
To determine antibiotic susceptibility of the pathogens isolated from wound infection and to
detect its multidrug resistance.
Material and Method:
Samples were collected from patients with wound infections. Pathogens were identified
by using the traditional culture methods and the API system with serotypes determined
phenotypically. Antibiotic susceptibility was assessed using the disk diffusion method and
the MIC to analyse antibiotic resistance.
Results:
In the study, among 11,221 recorded cases of wound infections in 2023, bacterial pathogens
were detected and identified at the species level in 10,339 cases (92.1%).
For identification results showed that A. baummannii were detected from 138 cases (1.3%),
216 cases (2.08%) of Ps. aeruginosa, 5 cases (0.04%) of B. cepacia, 1,383 cases (13.4%)
of Enterobacteriaceae, 205 cases (2.0%) of Enterococcus spp., 8,329 cases (80.5%) of
Staphylococcus spp., and 63 cases (0.6%) of Streptococcus spp.
Antibiotic susceptibility of these bacteria was assessed and determined multidrug
resistance. We found the followings: For A. baumannii were resistant with MDR in 68 cases
(49.3%), MRSA in 4,243 cases (51.1%), MDRSta. aureus in 1,805 cases (29.4%), VRE in
34 cases (16.5%), ESBL in 4.6%, KPC in 26 cases (11.1%), FRNF in 24 cases (11.6%), and
CRPA in 13 cases (6.3%).
Conclusion
1. Of all wound infections reported in 2023 in 92.1% there were detected pathogenic bacteria,
of which S.aureus were in 80.5% and E. coli was in 13.4%
2. 60.7% of the pathogenic bacteria detected in wound infections were multidrug-resistant,
with MRSA accounting for 51.1% and MDR A.baumannii accounting for 49.3%, indicating
high antimicrobial resistance(AMR).
3.Investigation of morphometric measurement of the eyelid and ocular axial position in Mongolian adults
Oyungerel B ; Lkhagvadulam Ts ; Sumyasuren U ; Misheel B ; Lkhagvadulam U ; Bundarkhi Kh ; Undarmaa Sh ; Uranchimeg G ; Sarantuya J
Innovation 2022;15(1-Ophthalmology):18-23
Background:
The shapes of the eye and upper eyelid are distinctive facial landmarks. The palpebral fissure is composed of the free edges of upper and lower eyelids the lateral and medial canthus. Many
researchers confirmed that the morphometric characteristics of the palpebral fissure, canthal distance
and exophthalmometirc value (EV) vary according to race, ethnicity, age and sex and normative values
which may serve as a reference in the index population. Knowledge of normal dimensions, the existence of asymmetry of the palpebral fissure is of value in several clinical specialties including ophthalmology, plastic and reconstructive surgery and traumatology, where it plays a part in the patient evaluation, management and outcomes.
Methods:
This cross-sectional study was conducted in the Ophthalmological Department, Third State Central
Hospital between January 2022 and August 2022. We included participants who are above 18 years, no history of congenital or traumatic craniofacial deformities, any orbital fractures, tumors and surgeries. All measured values that represent eyelid shape and EV were calculated by mean and standard deviation for statistical analysis.
Results:
A total of 103 participants aged 19-86 were included in the study, of which 44 (42.7%) were male
and 59 (57.3%) were female. The distance between the lateral and medial canthus ranged from 20 to 35 mm, and the mean of the right and left side was 28.30+3.23 mm and 28.05+2.99 mm, respectively (p=0.561). The palpebral fissure height ranged from 5 to 13 mm, and the mean of the right and left side was 8.85+1.65 mm and 8.80+1.65 mm, respectively (p=0.816). The mean distance between the lateral canthi were 90.39+5.57 (range: 80-105 mm), whereas the mean distance between the medial canthi were 63.75+4.25 (range: 53-73 mm). The orbital height varied between 27-43 mm (33.73+3.72) and 26-44 mm (33.78+3.73) on the right and left sides, while the orbital width varied between 26-47 mm (36.75+4.53) and 27-45 mm (36.72+4.42) on the right and left sides, respectively. When measuring the exophthalmometric value (EV), the axial position of the eyeball, with the Hertel’s exophthalmometer, it ranged from 8 to 20 mm on both sides (mean value 13.68+3.01 and 13.71+3.00 on the right and left sides, respectively), and there was no statistically significant difference in symmetry (p=0.94).
Conclusion
The results are determined different from the findings of Chinese, Korean, Afro-American and
Caucasian population based studies. Thus further evaluation is required to represent the normative value of Mongolian index population, that is highly beneficial for clinical assessment, diagnosis and management.
4.The treatment outcome оf the patients with infectious keratitis
Undarmaa T ; Tumurbaatar B ; Burenjargal P ; Bayarmaa E ; Sayamaa L
Innovation 2021;14(1-Ophthalmology):26-31
Background:
Infectious keratitis is a disease caused by inflammation, infection, and other
ocular damage to the outer and other deep layers of corneal epithelium. It is a major cause of
monocular blindness and visual disability worldwide regardless of age and gender. Therefore, we
aimed to determine the clinical features and risk factors of infectious keratitis among Mongolians
and to identify the causative microorganism and compared them with the treatment results.
Methods:
We collected the data of 149 patients who diagnosed as infectious keratitis at the
Ophthalmology Department of the First State Central Hospital in 2017-2020 and using a case series
model of descriptive study. Statistical analysis was calculated using Stata14 software.
Results:
The majority of patients in our study were male, with a male-to-female ratio is 2.1:1. The
cause of infectious keratitis were categorized and eye injury-induced keratitis accounted for the
highest percentage of 38.3% (n=57), with the majority being men 73.7% (n=42) (p=0.028). As for the
type of treatment, antibacterial drugs 103 (69.1%) and evisceration 27(45%) predominate.
Conclusion
Our study shows that the majority of infectious keratitis in Mongolia is due to trauma
in male patients. Forty-five percent of all surgeries involve evisceration surgery, which reduces the
client's quality of life.
5.Interdependence of hepatitis B and C virus infection with M2BPGi marker
Battulga M ; Erdembayar O ; Munkhzaya D ; Bayanmunkh B ; Oyuntsetseg D ; Enkhjin B ; Undarmaa G ; Otgontungalag D ; Bolor A
Health Laboratory 2021;13(1):21-25
Introduction:
Over 800,000 people in the world contract HCC each year and approximately 700,000 die from the disease. HCC is the 6th most common cancer in the world. HCC is the 3rd leading cause of cancer deaths in the world. 2/3 of liver cancer deaths are caused by hepatitis. In the U.S, HCV infection is the more common cause of HCC, while in Asia and Africa, HBV is more common. Mongolia ranks first in the world in mortality from liver cancer, indicating the need for early detection and treatment of cirrhosis. Sysmex Corporation has introduced for HISCL series analyser, a new cirrhosis marker M2BPGi of non-invasive, blood-testing. In 2016, the test was introduced
at Medipas Hospital in Orkhon province. It is possible to study the advantages and significance of the marker for use in clinical practice.
Materials and methods:
From a total of 385 patients who underwent M2BPGi marker testing in 2016-2017Medipas hospital laboratory, data from a total of 283 patients tested for hepatitis B and C virus and M2BRGi markers were selected. A comparison of age, sex, and test parameters of a total of HCVab and HBsAg positive 172 patients tested for Total bilirubin, GPT, GOT, GGT, AFP and M2BPGi. HCV Ab, HBsAg, AFP, M2BPGi markers were analyzed by SysmexHISCL-5000 fully automated immunological analyzer, Liver function tests were performed with a fully automatic biochemical analyzer JEOL Biomajesty BM6010/C.
Results:
Of the M2BPGi marker tested 283 patients 94 (33%) were infected with the C virus, 78 (28%) were with the B virus,11 (4%) were co-infected with B and C viruses, 100 (35%) no any viral infection. Of the 172 patients diagnosed with hepatitis B and C virus infection, 97 (56%) were male, 75 (44%) were female. In terms of age, 72% of the population is over 45 years old.
Of the 172 patients, 115 (67%) had M2BPGi marker abnormal or > 1.0 COI. Of the M2BPGi marker abnormal patients, 47 (41%) were infected with the B virus and 68 (59%) with the C virus. In terms of age, 27.7% of hepatitis B patients and 10.3% of hepatitis C patients were under 45 years of age, 72.3% of hepatitis B patients and 89.7% of hepatitis C virus patients were over 45 years of age.
Hepatitis B and C viruses are slightly more common in men than in women. The majority of patients infected with the hepatitis virus over the age of 45. The majority of patients with hepatitis virus have abnormal liver function. Increased M2BPGi markers in people under the age of 45 with hepatitis B virus infection are relatively higher for hepatitis B virus infection than for C virus infection.
Conclusions
The M2BPGi marker was abnormal in 67% of hepatitis virus infected patients. It has been observed that the probability of an increase in M2BPGi marker is slightly higher in hepatitis C virus infection than in hepatitis B virus infection.
6.OUTCOME OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Tuvshintugs B ; Gantsooj N ; Undarmaa T ; Bolortungalag P ; Sainbileg D ; Enkhtuul S ; Enkhzul D ; Burenjargal P
Innovation 2018;12(3):12-16
BACKGROUND: There are two general types of age-related macular degeneration: dry and wet. During wet or neovascular age-related macular degeneration new abnormal vessels grow and leak in the macula. As anti-vascular endothelial growth factor (anti-VEGF) was invented, it revolutionized the treatment of nAMD by inhibiting the progress of this disease. The incidence of AMD increases as life expectancy grows and there is a growing need to study this disease. We aimed to evaluate the outcome of anti-VEGF therapy for the treatment of nAMD and the incidence of ocular serious adverse events (SAE) after injections.. METHODS: In our retrospective, single-center study, medical records of patients receiving a single dose of anti-VEGF treatment (Bevacizumab) for nAMD between 17th of April, 2016 and October, 2017 were evaluated. Outcome measures were the change in the baseline visual acuity (VA) score at post-injective month one, incidence of ocular SAE and patients’ baseline characteristics affecting VA. Patients, whose treatment were started before April 2016 and had anti-VEGF treatment for the diseases other than nAMD, were excluded.. RESULTS: 15 eyes in 15 patients between 52 and 85 years of age received single dose of anti-VEGF (Bevacizumab/Avastin) injection. The mean baseline VA improved from pre-injective average of 0.21 to post-injective 1-month average of 0.37 by Snellen. Furthermore, there was no vision loss or other severe adverse effects, such as endophthalmitis, vitreous hemorrhage, retinal detachment, traumatic cataract after 4 weeks. CONCLUSION: Anti-vascular endothelial growth factor therapy has promising short-term outcomes on treating neovascular age-related macular degeneration.
7.RECURRENCE RATE WITH USE OF INTRAOPERATIVE MITOMYCIN C AND CONJUNCTIVAL AUTOGRAFT FOLLOWING PTERYGIUM EXCISION
Gantsooj N ; Undarmaa T ; Tuvshintugs B ; Tumur G ; Bolortungalag P ; Sainbileg D ; Enkhzul D ; Tumurbaatar B ; Burenjargal P ; Enkh-Oyun Ts
Innovation 2018;12(3):28-30
BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva
onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations
(UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in
developing pterygium among other environmental factors (hot, dry, windy, dusty and
smoky environments and hereditary factors. The main histopathological change in primary
pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include
foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and
cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing
the patient’s discomfort, but they do not cure the disease. After surgical removal there are
still many recurrences regardless of the method used. Autologous conjunctival grafting seems
to be the best method, given both the low recurrence rate and high safety. As described first
by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with
infrequent and relatively minor complications. The primary disadvantage of this technique
is the prolonged operative time required when compared to the bare sclera technique.
These disadvantages are outweighed by the lack of sight-threatening complications and the
relatively low recurrence rate, which made this procedure gain popularity in many centers.
The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing
the recurrence rate to a minimum.
METHODS: This retrospective case series, single center study was conducted on 239
patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department
of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic
examination before the surgical intervention. Data were collected through a prepared
questionnaire. Postoperative follow-up examination sheets were evaluated. Data
for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17..
RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and
62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5
years old.
There is no statistical significance between the stages of the disease and its post-operative
outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative
pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred
pterygium had underwent pterygium excision without conjunctival autograft.
MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium
excision.
CONCLUSION: The relationship between pterygium stage and its post-operative recurrence
was not statistically significant (P=0.683).
The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001)
which showed significant statistically.
There was no recurrence after pterygium excision with MMC (P≤0.001).
The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our
outcome.
8.Associations of XRCC1 S326C (rs25487) gene Polymorphism in Myelodysplastic syndrome
Undarmaa O ; Narmandakh B ; Avirmed Kh ; Khosbayar T ; Odgerel Ts ; Batchimeg N
Health Laboratory 2017;7(2):21-25
Introduction:
Base excision repair (BER) is mainly responsible for the correction of small base changes of DNA damage. BER pathway involved many enzymes including OGG1 and XRCC1. The defective DNA repair is associated with an increased risk of various cancers including hematologic malignancies-leukemia and myelodysplastic syndrome (MDS). However, it is deniably these polymorphisms alter the susceptibility and clinical outcome of MDS patients.
The aim:
This study was to evaluate the impact of polymorphisms in gene encoding one protein of BER system: XRCC1 Arg399Gln in MDS and healthy population.
Methods:
In this study, we recruited 60 health control group [median 47.9 years, 9 MDS subjects [median 56.6 years] were included in this study. Genotyping was carried out by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Allele and genotype frequencies were calculated by direct counting.
Result:
The frequencies of genotypes of XRCC1 Arg399Gln were as follows: Arg /Arg 1 (11%), Arg/Gln 6 (66%), Gln/Gln 2 (22%) in MDS and Arg /Arg 18.4%, Arg/Gln40%, Gln/Gln41.6% in health control for XRCC1 Arg399Gln. The result revealed that genotypes Arg399Gln increased the risk of MDS
In conclusion
this study is the first to analyze XRCC1 SNPs and their associated risk of MDS in Mongolian samples. To fully understand the role of DNA damage and DNA repair in the MDS, prospective studies are needed and other genes (OGG1 Ser326Cys, MUTYH Gln324His, APE Asp148Glu) of base excision repair pathway should be analyzed.
9. Liver cirrhosis, liver cancer
Undarmaa D ; Myagmardulam B ; Buyankhishig S ; Naran G
Health Laboratory 2016;5(1):52-54
10.Detection of virulent of Klebsiella isolates from ñlinical samples
Undarmaa G ; Munkhdelger YA ; Bayarlakh B ; Oyunchimeg R ; Dolgorjav B ; Sarantuya J
Mongolian Medical Sciences 2016;175(1):21-25
IntroductionKlebsiella spp is a well-known opportunistic pathogen associated with nosocomial infections such asurinary tract, septicaemia and pneumonia number of multi-drug resistant strains and infections causedby Klebsiella has progressively increased, causing treatment limitations.GoalIdentify of phenotype of Klebseilla isolates from ñlinical samplesMaterials and MethodsA total of 112 Klebsiella strains were isolated from clinical samples in State Central First Hospital and StateCentral Third Hospital from July 2015 through December 2015. The bacterial isolates were identifi edaccording to cultural characteristics, biochemical test and API20E. The serum resistance, capsule andhypermucoviscosity, cell surface protein (curly), a-hemolysin and ability to form biofi lm were sought byphenotypic assays. Antimicrobial susceptibility was tested by diffusion method.ResultA total of 112 Klebsiella samples were collected. The bacterial isolates were identifi ed according tocultural characteristics, biochemical test and API20E, the results revealed that 16.1 percent isolateswere identifi ed as K.oxytoca all of them 83.9 percent isolates were belong to K.pneumonia. Therewere observed for ampicillin (99 percent), nitrofurantoin (53.6 percent), cepalotin (50.6 percent) and51 percent of isolates were considered as a multiple drug resistant. Serum resistance properties ofK.pneumoniae was resistance 89.4 percent, intermediately susceptible 4.3 percent, sensitive 6.4percent and for K.oxytoca resistance 88.9 percent, intermediately susceptible 5.6 percent, sensitive 5.6percent. The hemolysin àalpha was detected in 32.2 percent, and gamma, beta in 66.96 percent, 0.9percent respectively. The capsule was observed in 46.5 percent and hypermucoviscosity in 27.7 percentof isolates. The cell surface protein (curly) and biofi lm were detected in 100 percent.Conclusion:Both K.pneumoniae and K.oxytoca isolates from clinical samples have similar virulent properties, andthe a-hemolysin and hypermucoviscosity positive isolates were more resistance to antibiotics.
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