CORRELATION BETWEEN REPRODUCTIVE HORMONAL LEVEL AND OSTEOPOROSIS GENE POLYMORPHISMS AMONG POSTMENOPAUSAL WOMEN / Шинэ санаа Шинэ нээлт

Cervical cancer is commonly caused by infection with human papilloma virus(HPV) and some risk factors are involved in the etiology of it.1 All over the world 437000 people are diagnosed with cervical disorders and half of them die due to cervical cancer.2 Annually 12000 new cases of cervical cancer are detected and 5000 women die because of it. In Spain about 2000 women are determined in the 3rd and 4th stage of the disease per year.3 Over the period 2000-2008 cervical cancer rate is 8 %among all cancers in Mongolia. Approximately 16 % of women’s cancer is cervical cancer. 4 In developing nations prevalence rate of cervical cancer is higher because of malnutrition, quality and framework for early detection are not satisfying and some reproductive risk factors also influence on it. 5 Worldwide diagnosing early and rapid management of precancerous condition and cervical abnormalities turn into main issue. Therefore based on these detection of premalignant lesion of cervix by colposcopy the main objective of the study. The overall goal of the study is to detect the premalignant lesion of cervix by colposcopy and determine of some risk factors and study the results.A total of 71 women, who are treated in Women’s inflammatory disease unit, Infertility and Women’s endocrine disorder unit are recruited for the cross sectional study. The women, who conducted the study were selected by accidently and colposcopy was done. They also have completed special questionnaires. The data were analyzed using the SPSS 19.0, Windows Office. The average age of the women was 38±9.4. Colposcopy was done 90.1% (n=64) of women, 9.9% (n=7) of women had not colposcopy. Among the women who had colposcopy, biopsies were taken 56.3% (n=36). During colposcopy we analyzed condition of cervix then we took biopsy from suspected areas and sent it histology laboratory. We compared predictive diagnosis, histology results after colposcopy and 33.3% (n=12) were identified as normal, CIN I was 52.7%, (n=19), CIN II was 5.5% (n=2), CINIII was 2.7% (n=1), cervical cancer is confirmed in 5.5% (n=2). We studied risk factors that can influence the cervical disorders among the women recruited in the study and age of first sexual intercourse (r=0.356, p=0.033), number of abortion (r=0.412, p=0.029) were statistically significant. However age of the women, parity, usage of contraceptive pills, smoking, number of sexual partners were statistically not significant.(p>0.05) When women’s age of first sexual intercourse is younger, cervical cancer disorder occurs30% greater comparing to women having first sexual intercourse later, (p<0.05, R=0.3), when number of abortion increases cervical cancer disorder increases 40%(p<0.05, R=0.41). F-1 to recruit osteoprogenitor /mesenchymal stem cells in the bone regeneration process.

RESEARCH THE EXPRESSION OF HIGH RISK HUMAN PAPILLOMA VIRUS AND P16 PROTEIN IN CERVICAL INTRAEPITHELIAL LESION BY IMMUNOHISTOCHEMISTRY CH ABOUT LAPAROSCOPY ASSISTED VAGINAL HYSTERECTOMY / Шинэ санаа Шинэ нээлт

The persistent high-risk human papilloma virus(HPV) infection is a necessary cause for developing cervical carcinoma. Although carcinogenic HPV types are found in virtually all invasive cancer, with types 16 and 18 being found in approximately 70 percent of cases. High risk HPV types’ Е6 and Е7 oncogenes have a pivotal role in cervical carcinogenesis. The p16, the cyclin-dependent kinase inhibitor and p16 overexpression in cervical neoplasia is a surrogate marker of high risk HPV E7 mediated pRb catabolism reflecting disruption of mechanisms that control cell proliferation and indicating persistent infection with high risk of development of neoplasia.Thus in worldwide p16 had been identified as the novel biomarker in pre-invasive cervical lesions. Objective: For the purpose to detect for cervical cancer risks we examined HPV16/18 and cell cycle protein p16 expression in cervical lesions.A total of 96 specimens enrolled in this study and 50 were diagnosed as LSIL and 46 were diagnosed as a HSIL. To detect HPV16/18 and p16 in cervical lesions used immunohistochemistry. Statistical analysis was performed using SPSS 16.0. Descriptive analysis was performed by Chi- Square test and also determined sensitivity and specificity.Positive stainingfor p16 and HPV16/18 were observed whole cell, within both the nuclear and cytoplasmic subcellular regions by immunohistochemistry. 63% of specimens had only HPV16 infection and 22% of specimens had only HPV18 infection.Also 14% specimens had co-infection with two viral types and 28% specimens had not above two most HPV infection. There were a significant difference for HPV16 positivity (X2 = 4.93, P 0.05) in HSIL and LSIL groups. There were not a difference for p16 in HSIL and LSIL groups.(X2 = 0.23, P > 0.05), respectively.P16, yielding a diagnostic sensitivity for HPV 16/18 were 82% and 30%, specificity for HPV 16/18 were 40% and 80%, respectively. In conclusion it is possible to detect high risk HPV types and persistent infection by immunohistochemistry in cervical intraepithelial squamous cell lesions. There is still critical need to use HPV testing and other molecular surrogate markers of HPV such as p16 in primary screening program.

Gonadotropin hormone level of polycystic ovary syndrome / Монголын Анагаах Ухаан

BackgroundPolycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders affecting women of reproductive age, with a prevalence of about 5%–10% in the general population. PCOS is characterized by menstrual disturbances due to hirsutism, chronic anovulation or oligoovulation, and acne due to excessive androgen production (hyperandrogenemia). The pathogenesis of PCOS is still unexplained. Following the main criteria of diagnosis (Rotterdam Consensus 2003), Dewailly, Welt and Pehlivanov divided the patients with PCOS into 4 phenotype groups: Oligo + HA + PCO, Oligo + HA, HA + PCO, Oligo + PCO. ObjectiveThis aim of the study was to compare gonadotropin levels in serum of reproduction age for comparative healthy women and polycystic ovary syndrome (PCOS).MethodsA cross-sectional study was performed comprising 425 comparative healthy women of reproductive age group 18-35 (<20 n=76, 21-25 n=131, 26-30 n=92, 31-35 n=126). To collect blood sample 4 times of healthy, normal menstrual cycle and body mass index (BMI) of women. To determine FSH, LH hormone in serum by ELISA (Eucardio lab kit used). To evaluate FSH, LH, LH/FSH normal menstrual phase (early follicular phase,late follicular phase, ovulation and mid-luteal phase). PCOS patients divided 2 type (oligo+ha, ha+pco).ResultsThe mean age was group A 26.33±5.28, group B 24.9±4.93, and group C 29.75±4.12, BMI a; 22.35±2.95, b; 28.88±3.85, c; 28.0±3.19. The mean level was FSH a; 4.64±1.65 mIU/ml, b; 12.07±3.85 mIU/ml, c; 5.35±7.20 mIU/ml, LH a; 6.42±3.3 mIU/ml, b; 39.43±15.89 mIU/ml, c; 10.89±2.53 mIU/ml of PCOS. To correlate FSH, LH, LH/FSH level was women was significantly (p<0.05).Conclusion: The increased level of LH, LH/FSH strongly correlates with the clinical degree of amenorrhea and hyperandrogenism.It seems that LH, LH/FSH could be a crucial diagnostic and predictive factor among women with menstrual disorders or presence of polycystic ovaries.

Osteoporosis - socioeconomic aspects / Монголын Анагаах Ухаан

Osteoporosis and the fractures associated with it constitute a major public health concern. Osteoporosis is a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility. A WHO Scientific Group on April 2000 estimated osteoporosis is well-defined disease that affects more than 75 million people in Europe, Japan and the USA, and causes more than 2.3 million fractures annually in Europe and the USA.In Europe, for example, the number of women over 50 years of age is projected to increase by 30%-40% between 1990 and 2025.Most studies suggest the required daily intake is between 1000 mg and 1500 mg in postmenopausal women not taking estrogen replacement therapy. This can be obtained from about three serves of dairy products per day. For example, one glass (250 mL) of milk, two slices (40 g) of Cheddar cheese, or one tub (200 g) of yoghurt each contains about 300 mg of calcium. In one French study involving vitamin D deficient institutionalized elderly patients, simple vitamin D3 (800 IU) and calcium (1200 mg/day) reduced hip fractures by 43%.The management of postmenopausal osteoporosis should be based on an individual risk/benefit analysis, time since menopause, presence or absence of estrogen with drawal symptoms, history of atraumatic fractures, and other medical conditions. Socioeconomic evaluation of osteoporosis can be undertaken to estimate the cost of disease, the effectiveness of treatments, and the effects of strategies to identify patients at high risk such as screening and case-finding, or to assess global strategies. Global strategies aimed at increasing the BMD of the general population have not been adequately tested, but general advice on lifestyle is an important component of patient care.

Some social and economic problems of mother’s who gave stillbirth / Монголын Анагаах Ухаан

Objective: To clear up of influence of society, economy family and mood of pregnant mother who gave stillbirth.Material and Methods: We chose 50 mother’s who gave stillbirth by case group, 50 mother’s who gave normal birth by control group by randomized method, research was conducted by specially prepared card and descriptive method, we compared placenta of mother’s who gave stillbirth and normal birth by pathologic analyse and working out was done by using SPSS 14.0 programme and difference between index was concluded by X 2 and F criteria.Results: Normal birth of mother’s who participated in the research is 19(16.7%) at the age 11(84.6%), at the age of 40-44 normal birth 1(50.0%), stillbirth 1(50.0%) stillbirth risk is increased under 19 and over 35, it has statistic probability (p=0.026). In 5(17.9%) of mother’s who gave normal birth, 23(82.1%) of mother’s who gave stillbirth. A member of her family smokes, in 45(62.5%) of mothers who gave normal birth, in 27(37.5%) of mothers who gave stillbirth a member of a family does not smoke .Seeing from this smoking of a family member affect to stillbirth and it has statistic probability (p=0.000).18(54.5%) of mothers who live in ger, 12( 35.3%) of mothers who live in a yard and a house, 20( 60.6) mothers who live in a flat gave normal birth. Seeing from this condition of living in a yard or in a house is worse that condition of living in a flat, it influence to stillbirth, it has probability for statistic (p=0.055). Conclusion: When women gives birth to a child under 19 and over 35 increases risk of stillbirth. It has statistic probability (p=0.026). Smoking of family member affects to stillbirth, it has statistic probability (p= 0.000). Condition of living in a yard and house is worse than living in a flat, it affect to stillbirth, it has probability for statistics (p=0.055).

Postpartum Endometritis in Ulaanbaatar City / Монголын Анагаах Ухаан

Endometritis is a common complication of the postpartum period. It is still a significant cause of maternal morbidity and, rarely, mortality. The term endometritis basically refers to infection of the endometrium or deciduas with extension into the myometrium. Other terms that have been used to define this infection include metritis, myometritis, endomyometritis, and puerperal sepsis. Involvement of the parametrial tissue is termed parametritis. By foreign researchers, the incidence of endometritis varies significantly depending on the population studied and, more importantly, on the method of delivery, i.e., vaginal vs. cesarean section. The risk of developing endometritis following vaginal delivery is estimated to be between 1 and 3%. But the after cesarean section it occurs about 10-20%. By Sebastian Faro (1990), the bacteria most commonly isolated from the inner uterine surface of patients with acute postpartum endometritis are Streptococcus agalactiae, Streptococcus faecalis, Escherichia coli, Bacteroides bivius and less frequently isolated bacteria are Citrobacter, Acinebacter, and pseudomonas. Objective: To indicate the incidence and cause of postpartum endometritis in Ulaanbaatar city. Design: Retrospective and prospective study. Methods. Collection of history data, abdominal and transvaginal ultrasound study using by Mochida ultrasound apparatus; microbiological study on collected materials from cervix of uterus. Settings. Covered 728 cases whose had diagnosed as postpartum endometritis, which treated in 1st Mternity hospital, 2st Mternity Hospital, 3st Mternity Hospital of Ulaanbaatar city and Mternity Hospital of MCMNC last 3 years (2005, 2006, 2007). Results. Last 3 years, incidence of postpartum endometritis was 1.19% in 1st Maternity Hospital 1.05% in 2st Mternity Hospital, 0.95% in 3st Maternity Hospital of Ulaanbaatar city, 1.51% in Maternity Hospital of MCMNC between all delivered mothers. Postpartum entometritis are obtained 43% between all of postpartum pathologyes. Enterobacter and Staphylococcus aureus are causes each by 13.4% of postpartum endometritis in studied biggest Maternity Hospitals of Ulaanbaatar city. Discussion. Average incidence of postpartum endometritis was 1.17% in Maternity Hospitals of Ulaanbaatar city, last 3 years. It is almost similarity by incidence to foreign researchers study, because this is the risk of developing endometritis following vaginal delivery by them is estimated to be between 3-8% [4]. But in our country the postpartum endometritis after cesarean section was higher than foreign researchers study. The commonly causative bacteria of postpartum endometritis is the E.coli, which causes 73.2% for this disease in studied Maternity Hospitals of Ulaanbaatar city. Conclusions: Last 3 years, by our study the incidence of postpartum endometritis after cesarean section was 29.1%. The Escherichia coli is dominantly inducing for postpartum endometritis with vaginal deliveried mothers, and also with mothers, whose had after cesarean section.