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Purpose@#Researchers suggest that the prevalence of infertility varies between developing and developed countries, with differences in infertility care, socioeconomic status, lifestyle, and reproductive disorders such as pelvic inflammatory disease and sexually transmitted infections being the main risk factors. The research project aims is to define risk factors for female fertility in the Mongolian population. @*Methods@#This study was conducted between 2016-2018 using a cross-sectional survey of analytical research. Participants were randomly selected from Ulaanbaatar and the Central, Western, Eastern, and Khangai provinces according to Mongolia’s regional geographic model. The contents of a questionnaire were comprised of 5 units with 95 questions including socio-economic, geographical, lifestyle, health education, reproductive health indicators, sexual behavior. General physical characteristics were measured according to the standard. @*Results@#The prevalence of the female fertility rate in the Mongolian population is 7.4%. Female participants were classified into 2 groups, namely infertile and fertile, and we developed a case-control study. Among the socio-economic factors influencing infertility, primary education aOR: 1.6 (95% CI 0.98-2.66), monthly household income lower than the average aOR: 1.1 (95% CI 0.77- 1.66), living in rural areas OR: 2.3 ( 95% CI 1.46-3.68) were crucial risk factors. As for reproductive and general health indicators, STIs aOR: 1.8 (95% CI 0.98-3.50), especially gonorrhea OR: 2.8 (95% CI 1.14-6.91), and thyroid disorders OR: 1.7 (95% CI 1.03). -2.97), grade 3 obesity OR: 3.8 (95% CI 1.05-13.95) are estimated risk factors for infertility.@*Conclusions@#Of all potential socio-economic factors, residence status, education and financial situation are significant for female infertility meanwhile reproductive health indicators include sexually transmitted infections, thyroid disease, and obesity.
ABSTRACT
@#Worldwide, an estimated two billion people have evidence of HBV infection, and approximately 240 million have CHB. In April 2017, EASL added a drug newly approved for treatment of CHB, tenofoviralafenamide (TAF) to their list of recommended first-line therapies. Treatment with these therapies can achieve sustained suppression of HBV DNA replication, decreases in inflammation, and histological activity that decrease the risk of cirrhosis and hepatocellular carcinoma in both cirrhotic and noncirrhotic patients and, ultimately, of CHB-associated mortality [1, 2]. However, recent advances in understanding the HBV life cycle have enabled multiple, novel therapeutic targets to be identified and new therapies of direct-acting antiviral (DAAs) and host-targeting agents (HTAs) are indevelopment.</br> In most clinical trials, TAF was non-inferior to TDF in achieving HBV DNA levels below 29 IU/ml.No amino-acid substitutions associated with viral breakthrough were detected by deep sequencing, and no resistance to TAF.With clear evidence from major studies showing that TAF is safe, tolerable, and non-inferior to TDF, its recommendation as a first-line therapy is appropriate.</br> Long-term safety is an important consideration in the therapeutic management of patients with CHB because treatment is often life-long.</br> The efficacy of TAF in patients with resistance mutations associated with older nucleos(t)ide analogues is unclear. Although no evidence of TAF or TDF resistance was detected in the phase III studies through 96 weeks of treatment, very small numbers of patients had baseline mutations indicating resistance to lamivudine, adefovir or entecavir and efficacy data specifically for this group is not available.
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Introduction@#Worldwide, an estimated two billion people have evidence of HBV infection, and approximately 240 million have CHB. In this study, a representative group of Mongolian adults was tested for hepatitis B virus (HBV) in 2017. The prevalence estimates of HBV the general Mongolian adult population were found to be 11.1%, respectively.</br> In April 2017, EASL added a drug newly approved for treatment of CHB, tenofovir alafenamide (TAF) to their list of recommended first-line therapies. The requirement for long-term therapy in chronic HBV highlights the importance of these efficacy and safety trends, however their true clinical relevance is yet to be established and further studies with long-term follow up and real-world clinical data are needed.@*Goal@#Evaluate for result of tenofovir alafenamide in the treatment of chronic hepatitis B infection.@*Materials and Methods@#The clinical trials have evaluated TAF in HBeAg-positive and HBeAg-negative chronic HBV patients. The trials have similar designs and are randomized, double blind, non-inferiority studies. The primary efficacy endpoint was the proportion of patients with HBV DNA<29 IU/ml at week 24 and 48. Other prespecified efficacy endpoints were the proportion of patients with HBsAg seroncoversion to anti-HBs at week 24 and 48. Key secondary safety end- points at week 24 and 48 included the percentage change in T-score, and Z-score bone mineral density (BMD), percentage change in BMD and change from baseline serum creatinine.@*Results@#The primary efficacy endpoint, an HBV DNA level <29 IU/ml at week 24, was achieved by 120 (59.1%) of 203 patients receiving TAF, which was non-inferior to the 63 (55.2%) of 114 patients receiving TDF who had an HBV DNA<29 IU/ml. After 24 weeks of treatment, patients receiving TAF had significantly smaller reductions in bone mineral density (BMD) compared with patients receiving TDF.@*Conclusion@#The development of TAF, specifically designed to deliver potent antiviral activity but with an improved safety profile compared with TDF, is therefore timely.
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Introduction@#Worldwide, an estimated two billion people have evidence of HBV infection, and approximately 240 million have CHB. In this study, a representative group of Mongolian adults was tested for hepatitis B virus (HBV) in 2017. The latest data shows that 11,1% of Mongolian adult population are infected with HBV.@*Goal@#Evaluate the efficacy and safety of tenofovir alafenamide treatment in patients with chronic hepatitis B.@*Materials and Methods@#The clinical trials have evaluated TAF in HBeAg-positive and HBeAg-negative chronic HBV patients. The trials have similar design and randomized, single blind, non-inferiority studies. The primary efficacy endpoint was the proportion of patients with HBV-DNA<29IU/ml at weeks 24 and 48. Other prespecified efficacy endpoints were the proportion of patients with HBsAg seroconversion to antiHBs at weeks 24 and 48. Study protocol approved at Ethical review Committee of “Ach” Medical University in January 2019 (#19/01/06).@*Results@#The primary efficacy endpoint, an HBV-DNA<29IU/ml at weeks 48 and was achieved by 251 (79.9%) of 314 patients receiving TAF, which was non-inferior to the 113(74.8%) of 151 patients receiving TDF who had an HBV-DNA<29IU/ml. After 48 weeks of treatment, patients receiving TAF hed significantly smaller reductions in bone mineral density(BMD) compared with patients receiving TDF. At weeks 48, median changes in eGFR were signifi-cantly smaller in the TAF recipients compared with the TDF recipients.@*Conclusion@#TAF treatment has the same efficacy as TDF treatment. However, TAF treatment demonstrates more safety profile compared with TDF treatment. Patients receiving TAF had a significantly smaller median decrease in eGFR, by Cockcroft-Gault equation, than patients receiving TDF.
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@#BACKGROUND. According to the World Health Organization (WHO), 10-15% of couples of reproductive age have infertility. According to researcher D. Sukhe (1999), hormonal infertility in the reproductive age of women was 33.6%, which was a large part of the cause of infertility. In recent years, the number of cases of endocrine disorders, including malignancy and sexually transmitted infections, have been increasing year by year. According to WHO reports, thyroid disorders have a prevalence of 49.3% among active reproductive age (30-50) group. According to the report of the Health Development Center in 2016, since the thyroid disorders are the second most common disease in endocrine gland disease, our study has found that the infertility in reproductive age of women can be substantial due to the loss of thyroid gland. OBJECTIVE. To study the relationship between the thyroid gland antibodies and female infertility. MATERIAL AND METHODS. The study was carried out in 20-45 year old couples and was modeled as an analytical study model. The questionnaire was used for the couple’s interviews, antroplogical measurements, and serum was analysed. On the serum, anti-TPO and аnti-TG carbohydrates were identified by the Cobas e-411 analyzer under the manufacturer’s accompanying protocol. RESULTS. Prevalence of TAI, in 6.7% positive anti-Tg were found, and 14.3% had positive TPO. In 3.7% of cases, both types of autoantibodies were present. We analysed binary logistic regression for anti-TPO and anti-TG autoantibody in the positive and negative group in relation to the past obstetrics history. A=Accoding to the analysis, evidence of positive anti-TPO and anti-Tg increased the risk of miscarriage by 2.2 times (OR = 2.2, p <0.01). CONCLUSION: Women with infertility in our study have high percentage of subclinical hypothyroidism and have higher rate of thyroid autobodies in serum which could be a problem for women with infertility and pregnancy complications due to the loss of thyroid gland. Thus, there is a need to develop intervention guidelines for recovery and treatment of these types of infertility.
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@#BACKGROUND. According to the International osteoporosis foundation, the incidence of osteoporose in men is increasing rapidly. Some investigations mention the serum testosterone hormone decreases by aging and may cause of osteoporose. Our study was aimed to evaluate relation between serum total testosterone and bone mineral density in men. MATEREALS AND METHOD. Relatively healthy 624 men aged between 18-87 were randomly selected from Mongolian 4 provinces and Ulaanbaatar city. Specially designed questionnaire was used in the survey. And some of measurement, Weight, height and BMI, was measured. Bone mass density was diagnosed according to the WHO criteria by the T-score. Serum total testosterone level were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the laboratory of MHI.The statistical result was analyzed by SPSS 22 program. RESULTS. The subjects mean age was 48.56±16.63, with a range of 18-87. The mean SOS was -4055.23±228.89. And the osteoporse was 14.6% (n=91) in all of participants. 152 participants were randomly selected from all participants and classified 2 groups(case and control) according to WHO osteoporosis criteria and evaluated relation between serum total testosterone and bone mineral density. The mean of serum total testosterone level was significantly low (8.80±2.67) in case group than (9.33±2.44) control group (p<0.05). Our study showed that positive correlation between bone mass density values at testosterone hormone (r=0.17 p<0.034). CONCLUSION. Our study showed decreased serum total testosterone hormone affected to decrease of bone mineral density.