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@#BACKGROUND Helicobacter pylori (H.pylori), the main cause of gastric and duodenal ulcer, is considered as a type 1 carcinogen. The primary prevention of gastric cancer is eradicating chronic H.pylori infection. However, the antimicrobial eradication rates are decreasing as low as 80% in some countries, less than 70% in Europe and are inversely correlated with antibiotic resistance rates reported worldwide. The current international guidelines recommended several regimens with higher success rate including sequential, combined, bismuth-containing and resistance-guided treatment and states that the local susceptibility testing in H.pylori should be studied. The research data that is covering correlation between H.pylori associated gastric changes and precancerous diseases, evaluation of H.pylori eradication rate are sparse in Mongolia. METHODS Totally, 495 eligible candidates were enrolled into this study. 225 patients who visited to endoscopy unit, received gastroscopy with multiple biopsies for rapid urease test, histology and H.pylori culturing. Out of these, 131 (52.2%) patients were positive for H.pylori infection. These were further tested for antibiotic resistance. 76 patients were treated with targeted therapy based on antibiotic resistance testing. Another 270 eligible patients with confirmed H.pylori associated gastritis were randomized into the following 1st line therapy regimen groups clarithromycin-based triple therapy (CBTT, n=90); bismuth-based quadruple therapy (BBQT, n=90) and sequential therapy (ST, n=90). In 43 patients that were not responded to 1st line therapy, levofloxacin-based triple therapy (LBTT) was prescribed as a second line treatment. Eradication rates were assessed using H.pylori stool antigen test 28 days of therapy just subsequent to termination of treatment. RESULTS During the gastroscopy, presence of active gastritis, nodular change and atrophy were 32.9%, 12% and 52.9% respectively. Epigastric pain was reported in 73.3%, 62.2%, 60-80% and 41.3% of patients with normal mucosa, nodular change, stomach and duodenal ulcer and antral atrophy (p<0.05). Abdominal fullness was more common among patients with extensive gastric atrophy (69.2%, p<0.05). In <40 age group gastritis was predominantly in the prepylori, while in the >50 age group it was predominantly the corpus region. H.pylori resistance rates to amoxicillin, clarithromycin, metronidazole and more than 2 antibiotics were 8.4%, 37.4%, 74% and 30.5%. On ITT analysis, eradication rates of 1st line H.pylori targeted treatment, CBTT, BBQT and ST were 92.1%, 71.1%, 87.8% and 67.8% (p<0.0001); on PP analysis, that were 94.6%, 72.7%, 89.8% and 68.5% (p<0.0001) respectively. Eradication rates of 2nd line treatment LBTT were 55.8% and 60% by ITT and PP analysis. Higher side-effects were reported during the second line treatment. CONCLUSION H.pylori infection rate was high among the dyspeptic patients resulting chronic gastritis and atrophic change. H.pylori resistance rate to metronidazole and clarithromycin was high. Among 1st line therapies; the eradication rates of CBTT and ST were poor, while BBQT and Targeted therapy had a higher success rate. 2nd line therapy showed higher failure rate.
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BACKGROUNDGastroesophageal reflux disease (GERD) is one of the most common digestive disorder in the world. In this study, we chose Calcitum-6 for GERD treatment and assessed itsimpact on the disease using modern laboratory and imaging study. Out main purpose was to investigate the impact of Calcitum-6 for GERD treatment using gastroscopy.METHODSWe selected 34 patients who meet the criteria of GERD for the study. All participants signed a consent form. After 21 days of treatment with Calcitum-6 patients underwentgastroscopy in the Teaching hospital of MNUMS.RESULTSSymptoms of GERD including heartburn and bitter taste were significantly reduced within 4.7±0.8 days after treatment. Symptoms of bile reflux, increased gastric acid and painwere reduced by 73.6%, 55.2%, and 69.8% (р=0.05), respectively, after the completion of 21 days treatment. Changes in esophageal mucosa were recovered in 83.87% (26) and relapse of gastritis was reduced in 65.52% (19) of all patients.CONCLUSIONSBased on our results, we conclude that using Calcitum-6 for the treatment of GERD shows significant reduction in symptoms of the disease.
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Introduction:Structure and Function of the digestive organ diseases in that commonly occurred Ulcer Disease (PUD) is becoming one of the major diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death.80% of the patients who has Gastric ulcer, 80 % of the patient who has PUD, has helicobacter pylori infections.Mongolian statistics data estimates that there are in total 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.Purpose of the study: Indicate the substantial supply of essential drugs of PUD in the stationary and ambulatory treatment.The study material and method:Diagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Department of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songini Khairkhan District and Nalaikh Districtbut also 107 ambulatory patient’s substantial supply of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card.WHO advised the drug supply “ Managing drug supply, the selection, the procurement, distribution and use of pharmaceuticals ” method by Jonathan D. Quick, Jamas R. Rakin, Richard O.Laing, Ronald W.O’Connor, Hans V.Hogerzell, M.N.G.Dukes, Andrew and Кобзарь л.в, дрёмова н.Б, глембоцкая г.т мнушко з.н. Statistic was developed and implemented excel, SPSS16.0 programme.Result of the study: In the study 500 people wereabove 20 and average age is 48.36±14.44.As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used.163380.15 tugrug (Mongolian currency) budget is required for Stationary treatment of Peptic Ulcer Disease (PUD) but 987540.95tugrug budget is required for ambulatory treatment.Conclusion:As a tertiary Level hospital 27, As a secondary Level hospital 18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD.22 kinds of tablets were used for Peptic Ulcer Disease in an ambulatoryAs the result of the study 163380.15 tugrug for PUD’s stationary treatment, 987540.95 are required for PUD’s ambulatory treatment.
ABSTRACT
IntroductionStructure and Function of the digestive organ diseases in that commonly occurred Peptic Ulcer Disease (PUD) is becoming one of the majority diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death. Mongolian statistics data estimates that there are totally 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.PurposeTo define the types and needs of drugs which are used in the stationary and ambulatory treatment of patients who are suffering from peptic ulcerMaterial and MethodDiagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Unit of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songino-Khairkhan District and Nalaikh District but also 107 ambulatory patient’s substantial usage of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card. “The consumption method and morbidity method” by Hogerzell H.V., Jonathan D.Quick., James R.Rakin,(2005) was used due to identify drug needs as WHO advised.ResultsIn the study 500 people were above 20 and average age is 48.36±14.44. As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used. Peptic ulcer disease stationary treatment drug needs are not enough.Conclusions:1. As a tertiary Level hospital27, As a secondary Level hospital18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD. 22 kinds of drugs were used for Peptic Ulcer Disease in an ambulatory2. Peptic ulcer disease stationary treatment drug needs are not enough.
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BACKGROUND The aim of the study is to detect and define the role of H. pylori virulence factors and host IL-1 polymorphisms to prevent from further gastric cancer. mwom 5ml of blood samples were collected from each of 42 patients who had abdominal complaint, after informed consent was obtained. All patients were Mongolian nationality. The biopsy specimens were stored in liquid nitrogen and homogenized before DNA isolation. After tissue lysation with proteinase K. DNA isolation was performed with "Promege" tissue kit. according to the manufacturer's instructions. PCR amplification of H. pylori gene loci was performed for the cagA gene and the vacAs mosaics vac As 1 and vacAs2. RESULTS Result of histological findings shows 84.7% from all patients were diagnosed with II. pylori infection 83% (35/42). Histologically LI'G 50% (42/21). Gastric atrophy 30% (42/13). Intestinal metaplasia 9% (42/4). Gastroduodcnal ulcer 4% (42/2), Dys¬plasia 11% (42/5), Adinocarcinoma 2% (42/1), 3 patients (42/3, 7%) were none patho¬logic change. 62% (26/42) patients infected with H. pylori, as determined by Urease test. H. pylori were investigated in all 42 patients and 83% (35/42) were infected with II. pylori, as determined by histology (haematoxylin- eosin and (iiemsa-stained). Strain characteristics of H. pylori were investigated in all 42 patients and 83% (35/42) were infected with //. pylori, as determined by UreC PCR. Result of histological findings revealed Bacilla form 48,5% (17/35), Coccoid form 28,5% (12/35), mixed form 14% (5/35) from all patients were found //. pylori. 76% (13/17) of all patients were revealed coccoid form of H. pylori were taken anti-//. pylori treatment. The vacAs 1 genotype was found in 38% (16/42) of all UreC+ patients, and cagA was found in 23% (10/42) of UreC+ patients. 16.9% of all patients were IL-RN*2 positive (7/42), (IL-1B 31C/51 IT).