Trifocal intraocular lens implantation to treat visual demands in Mongolian patients / Монголын Анагаах Ухаан

Introduction@#Intraocular lens (IOL) implants are monofocal and trifocal lenses which helps to clear up the vision after cataract surgery.@*Goal@#In this work, we aimed to compare the monofocal and trifocal IOL implantation during phacoemulsification surgery.@*Materials and Methods@#This study was conducted on 133 participants. Females comprised n=81, mean n=52 into equal groups. Preoperative and Postoperative cataract surgery UCVA and BCVA were measured and compared during the after 1 day, week 1, 2 weeks and month1. @*Statistical analysis@#The results of the study were processed using the SPSS 25.0 program after coding the data and checking for typographical errors. The normality of the data distribution was tested by inspecting a histogram. Categorical variables were compared using the chi-square test or Fisher's test. Statistical significance was determined at a p-value lower than 0.05@*Ethical statement@#The study was approved by the Research Ethics Committee of the Mongolian National University of Medical Sciences (No.2021/05/21). All patients provided written informed consent before participating in this study.@*Results@#The mean preoperative UCVA was 1.09±0.45D in monofocal IOL group, 0.99±0.49D in trifocal IOL group. At the first week: The mean postoperative UCVA at one week was 0.34±0.29D and 0.27±0.17D, in each group respectively. The mean postoperative BCVA in the first week was 0.28±0.27D and 0.20±0.15D in each group respectively. The mean postoperative UCVA at 1 month was 0.27±0.24D and 0.15±0.16D in each group, while BCVA was 0.26±24.94D and 0.06±0.63D.There was a highly significant statistical difference between the result of UCVA preoperative and the results of UCVA at the early and last postoperative follow up. @*Conclusion@#From our results, the best corrected visual acuity and was better for Trifocal group than Monofocal group. It is evident that post-operative near UCVA and BCVA was statistically significant at monofocal and trifocal groups.

Clinical features of ophthalmology in thyroid disease / Шинэ санаа Шинэ нээлт

Background@#TED (thyroid eye disease) is an inflammatory disease of the orbit caused by autoimmune diseases of the thyroid, which adversely affect the vision, appearance, and quality of life. Exophthalmos and eyelid retraction are the main features of TED, which can lead to ocular motility, diplopia, optic neuropathy, and permanent vision loss. The study aims to determine the most common clinical signs of TED in Mongolians and define whether there is a correlation with the levels of thyroid autoantibodies.@*Methods@#The study involved 102 patients with TED and 81 patients with Graves’ ophthalmopathy. The clinical features of TED were identified and evaluated by activity score (CAS) and severity of GO using the European Group of Graves’ Orbitopathy (EUGOGO).@*Results@#The mean age of TED patients was 42.6±11.2, which was younger than GD patients (P=0.012). The current smoker was 24 patients (23.5%) with TED, which is relatively higher than GD (P=0.0001). The most common ocular signs were eyelid retraction 80 (78.4%), proptosis 77 (75.5%), diplopia 14 (13.7%) and 4% vision loss. There were no differences in proptosis between the right (18 mm, median) and left eye (17.8 mm, median) (P>0.05). The mean CAS score was 3.09±1.72 and varied depending on gender and smoking. According to EUGOGO, 62.7% of the patients were moderately severe. Only 7 % of the patients were in the sight-threatening stage, presenting optic neuropathy and corneal breakdown. The mean TSI level in patients with TED was 37.95 ± 35.41 IU / ml, which was 2.7 times higher than the mean in patients with GD.@*Conclusions@#Eyelid retraction and exophthalmos are the most common clinical signs of TED. Early diagnosis of these features can prevent complications of the disease. Determining serum TSI levels will help in the treatment and monitoring of TED.

Findings of the assessment on social and the environmental accessibility for people with vision and hearing impairment / Шинэ санаа Шинэ нээлт

Background@#According to the WHO, WB estimation, there are over 1 billion people living with some form of disability in the world.² Out of which, 284 million people have vision impairment, 360 million people have hearing and speech impairment, ten percent of them living in developing countries.³ According to the National Statistical Office’s 2018 data there are 105,730 people with disabilities in the country which is 3.2% of the total population.⁴ In Mongolia, 28% of the disabled population in the working age are employed while 43% of the population aged 6-18 are illiterate. People with vision, hearing and intellectual disabilities have the same right to access health, education, employment, social welfare and protection services as others, but due to the lack of access to facilities and public transport, they cannot fully access social services. Also, the legal framework that provides equal opportunities for social contacts is not enough. There is virtually no comprehensive study on access of social service and environmental accessibility for the disabled people in the country. Therefore, there is a need to study in detail of social services and environmental accessibility of the people with visual and hearing impairment and adapt their demands into policy and develop policy recommendations and to further improve legal regulations.@*Purpose@#Main objective of the study is to assess social service delivery and environmental accessability of the people with visual and hearing impairment@*Methods@#The direct-observation, household based survey and document review, methods have been used for this study. Direct observation method has been applied for 100 public constructions. Total of 100 disabled people, out of 50 people with visual impairment and 50 people with hearing impairment has been covered for the public transportation accessibility assessment questionnaire survey. Information and communication accessibility studies carried out among 100 organizational websites and 31 broadcasting internet television including Univision and Sky media. </br> Household survey covered 148 people with visual and hearing impairments to assess social service accessibility.@*Results@#The public construction’s environmental accessibility for the people with vision impairment was assessed at 48.8 percent: 36.8% for the people with poor vision impairment and very bad for blind people at only 16.5%. The public transportation accessibility assessed as not accessible (3.43 odds) for people with vision impairment and as moderate accepable for blind people (2.87 odds). Information and communication accessibility through website assessed at 25% for people with vision impairment which shows not sufficiently accessible for blind people (32%). Total accessibility of information regarding to the organizational website assessed at 34.8% which shows moderately accessible. Services of the Univision, Sky media internet TV (IPTV) wasn’t accessible for people with vision impairment. Regarding to the people with hearing impairment, public construction environmental accessibility assessed at 31.7%, 48.5% for people with moderate hearing impairment which is average accessibility and 21% people with severe hearing problem. The public transport accessibility assessed in high discrepancy (3.51 odds ratio) which means there is an in-sufficient access. Information and communication accessibility for people with hearing impairment assessed at 5% which shows very bad accessibility. </br> Health service coverage is 64% for the people with vision impairment while 36% for the people of hearing impairment. Education service coverage for vision impairment people is 36% and 18% to people with hearing impairment. Regarding to the accessibility to social service, the coverage is 33% for people with vision impairment and 31% for the people with hearing impairment. Employment rate among people with vision disability resulted in 19% and 24 % for the people with hearing imapirment.@*Conclusion@#The public constructions accessibility for people with vision and hearing impairment (37.7%), public transport accessibility (2.90 odds ratio), information accessibility (34.8%) assessed at “moderately accessible”. Assessment result of below 50% considered as “insufficient” for education service -27%, employment service-21.5%, social welfare services -32%. There is a need for special laws and regulations concerning to social services and environment accessibility.

The comparison of retinal findings in end stage of CKD and in diabetic renal failure / Шинэ санаа Шинэ нээлт

Background@#Retinal pathologic features are associated with inflammatory processes and endothelial dysfunction, leading to circulatory abnormalities and reduced vascular reactivity. Both retinopathy and nephropathy involve thickening of basement membrane and muscular layers and increased leakage. These pathologic and hemodynamic abnormalities may occur throughout the body and their effects on the retinal vasculature may be useful indicators of cumulative microvascular damage from hypertension, inflammation, diabetes mellitus, and other processes. Type 2 MPGN is an uncommon renal condition associated with electron dense deposits in the lamina densa of the glomerular basement membrane with C3 found in the capillary loops and mesangium. The deposits in the basement membrane can lead to a breakdown of the blood-retinal barrier by interfering with the RPE layer, and type 2 MPGN has been described in association with central serous retinopathy.@*Purpose@#To assess the retinal findings in end stage of Chronic kidney disease (CKD) and diabetic renal failure@*Methods@#Data of diabetic renal failure (n=20, mean age 56.8±11.6), and end stage of CKD(n=83, mean age 48.2± 11.6) were cross-sectional analyzed. Nonmydriatic fundus photographs of the disc and macula in both eyes were obtained in all the subjects. The photographs were assessed by ophthalmologist using the standard protocols. The following parameters were recorded: BCVA, IOP, BP GFR, serum Creatinine, ophthalmic and fundus examination.@*Results@#Greater severity of retinopathy was associated with DM. The presence of vascular abnormalities usually associated with Diabetes Mellitus ( DM) and was not associated with lower estimated glomerular filtration rate. All of patients with DM (n=20, 100%) ,they have Diabetic retinopathy. We found sight direct relationship between retinal posterior pole deposit with CKD patients. Some of patients who have end stage of CKD, (n=18, 11%) they have retinal deposit on their posterior pole.@*Conclusion@#Our findings show ,In participants with end stage of CKD, there was no significant severe retinopathy. In summary, our study demonstrates that DM, is one of the leading cause of irreversible vision loss. Every patients with DM need the ophthalmic follow up examination in every six months.

Aetiology of congenital pediatric cataract in Mongolia / Шинэ санаа Шинэ нээлт

Aim@#The aim was to determine etiology and clinical presentation of pediatric cataract during 1 year period@*Methods@#NCMCH is tertiary and referral center for all pediatric patients with cataracts in 21 provinces and UB. Database contains cases during 1 year period. We have recorded the following data from the medical histories of these patients: family history, current age, age at diagnosis, age at surgery either eye, morphology of cataracts, laterality, associated findings and other investigations which were performed as clinically indicated. We have operated 80 children in total during 1 year period, however the study included 68 patients (91), eyes excluding 12 patients.@*Results@#Of 68 children with cataract 76.% were non traumatic, 21,15% hereditary, 51,9% were congenital/infantile, 35.8% were unilateral, 44% were associated other ocular findings, 25% were associated systemic disease. 33.3% were diagnosed and operated 0-12 months. 73% of congenital/infantile cataract patients were nystagmus. Of traumatic cataract 76,5% due to penetrating trauma.@*Conclusions@#Patients of pediatric cataract 1/3 were usually diagnosed in 0-12 months. 1/3 of these patients were diagnosed congenital cataract whereas 1/4 were nystagmus. To add up associating congenital/infantile cataract with Down syndrome weren’t rare.

VEGF-A and ARMS2 gene polymorphism on AMD susceptibility / Шинэ санаа Шинэ нээлт

Background@#Age-related macular degeneration (AMD) is an eye condition, that occurs people aged above 50, leads to gradual loss of the vision because of a damage in the macula, which is located in the center of the retina. Several polymorphisms in different genes have been proposed as factors that increase the disease susceptibility. Therefore, we investigated the association between rs833061 polymorphism of VEGF-A gene and rs10490924 polymorphism of ARMS2 gene and AMD in order to analyze with other similar studies by meta analysis.@*Purpose@#To investigate the polymorphisms of VEGF-A gene and ARMS2 gene on AMD susceptibility@*Methods@#is case-control study was conducted on 74 AMD patients and 32 unaffected age-and gender-matched control individuals. Genomic DNA was extracted from the peripheral venous blood. The single nucleotide polymorphisms were identified by restriction fragment length polymorphism (RFLP) method and results confirmed by gel electrophoresis. The REVIEW MANAGER 5.2 software and MetaXL was used for meta-analysis@*Results@#We did not find statistically significant differences in С allele and СС genotype frequency of rs833061 polymorphism of VEGF-A gene between patients and controls. However, analysis of rs10490924 polymorphism of ARMS2 gene shows that T allele (OR=2.72, 95% CI, 1.47 – 5.02, p=0.001), TT genotype (OR=4.54, 95% CI, 1.49 – 13.87,p=0.019) were significantly associated with AMD risk. Haplotype analysis of these SNPs showed that C+T haplotype was statistically significantly different (OR=5.23, 95% CI, 1.76-15.54, p=0.002) between patients and controls.@*Conclusion@#As shown by results, rs10490924 polymorphism of ARMS2 gene show that T allele, TT genotype and C+T haplotype were significantly associated with AMD risk In meta-analysis, T allele of rs10490924 polymorphism of ARMS2 gene was significantly associated with AMD risk in all ethnicity that include Asian and Caucasian. However, T allele prevalence was higher in Asians.

Hemangioma cases and treatment / Шинэ санаа Шинэ нээлт

Hemangiomas are common benign vascular tumors which about 70% to 80% of the lesions are found in the head and neck region. This study was conducted on 36 children with hemangioma who were referred to Orofacial Surgery Cabinet of Dental School of Health Sciences University of Mongolia and Orofacial Surgery Cabinet of National Center for Maternal and Child Health of Mongolia between 2013 and 2015.Of the 36 children referred for assessment, 72% were female, 55% were infants of 4 to 9 months old, and 83% of them were citizens. 58% of patients underwent cryotherapy,and 57% of patients underwent cryotherapy had 2 therapy sessions. 25% of patients receiver sclerotic therapy, and 67% of them had 2 therapy sessions. According to the locations of hemangiomas 30% of them were localized in infraorbital area. 72% of the participants are women and 55% are children age of 4-9 month which 83% of all participants were living in city. 58% of children with hemangioma are treated with cryotherapy which 57%of treatment finished by second visit. And 25% were treated by dehydration treatment which 67% were finished by second visit.

Results of treatment for sight-threatening diabetic macular edema / Шинэ санаа Шинэ нээлт

To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.

Prevalence and causes of the avoidable blindness and low vision in Mongolia / Монголын Анагаах Ухаан

The Rapid Assessment of Avoidable Blindness (RAAB) has been developed as a simple and rapidsurvey methodology that can provide data on the prevalence and main causes of blindness.AimTo assess the prevalence and main causes of avoidable blindness and visual impairment in peopleaged 50 and above in Mongolia.MethodsThe RAAB uses a standard methodology which is documented in the RAAB Instruction Manual (HansLimburg, International Centre for Eye Health, London School of Hygiene and Tropical Medicine).Assuming an estimated prevalence of blindness in persons aged 50+ of 2.14% and a non-complianceof 5%, with a variation to 25% around the estimate of 2.14% at 95% probability, the required samplesize was calculated at 4,040: 101 clusters of size 40. Visual acuity (VA) was measured with a Snellentumbling E chart, using optotype size 18 (60) on one side and size 60 (200) on the other side. Thelens status of all participants was assessed by both torch and distant direct ophthalmoscopy, by anophthalmologist in a shaded or dark environment. The data were analyzed using RAAB Version 4.02(ICEH, London) for pre-defined reports relating to both crude and age and gender adjusted results.ResultsThe survey included 4,040 people aged 50 years and older, of whom 4,029 were actually examined.The coverage was 99.7%. 7 persons (0.2%) were absent and 4 (0.1%) refused to participate in thestudy. The prevalence of bilateral blindness with available correction in the better eye is 2.2 % (95% CI,1.7 - 2.7%); 2.4% in males and 2.2% in females. The prevalence of bilateral severe visual impairment(SVI) is 2.1% and bilateral moderate visual impairment (MVI) is 10.8%. The prevalence of functionallow vision, requiring low vision services, is 4.5%. In people aged 50+, untreated cataract is the mostcommon cause of bilateral blindness with 38.9%, followed by glaucoma (20.0%), non-trachomatouscorneal opacity (13.3%), and other posterior segment disease (7.8%).Conclusion: Untreated cataract and uncorrected refractive errors are the major causes of avoidableblindness and low vision in Mongolia, respectively. Priority should be given to cataract surgery,followed by the development of optical services and PHC and PEC services, as these are the mostcost-effective interventions. These three interventions will address about three thirds (67.8%) of thecauses of blindness and have most impact.

Road traffic Injuries and deaths and their risk factors / Монголын Анагаах Ухаан

BACKGROUND: Worldwide, the number of people killed in road traffic accidents (RTA) each year is estimated at over 1.2 million, while the number f injuries reaches as high as 50 million. In Mongolia, the number of road accidents, crimes and road safety violations is on the increase, and it is forecasted that this trend will continue in the future The third leading cause of mortality in Mongolia is injury, and more injuries are caused by traffic accidents (18.9%) than any other cause. According to the National Statistics reports, health and demographic studies, it can be seen that there are a high number of road traffic accidents and injury cases in Mongolia.OBJECTIVE: The main objective was to identify the risk factors of road traffic injuries and deathsMETHOD: Primary data on Road Traffic Accidents (RTAs) of the Road Traffic Police was used. 4000 investigation forms were randomly selected and analyzed. Within the research objectives, necessary descriptive and analytical statistics were calculated and the results were illustrated by tables and charts.RESULT: The rate of road traffic accidents is high in urban areas from January till May while it is high in rural areas from February till October. The rate of road crashes caused by alcohol is significantly different in rural and urban areas (36% in rural and 16% in urban). The statistically significant risk factors for Road Traffic Injuries (RTIs) were the fault of pedestrians, drunk driving, failure to stop the vehicles, turning maneuver, inadequate estimation of the distance between cars and collation of lane and for Road Traffic Deaths (RTDs) the alcohol consumption, speeding, vehicle defects, driver’s negligence, cross the intersection, turning maneuver, failure to keep distance, fault of pedestrians and transportation people or goods.CONCLUSION: To decrease the risk factors of injuries and deaths of RTAs, specific actions are required to enhance the road traffic safety control and patrolling during certain months, weeks, days and times when accidents mostly happen in urban and rural areas.

SCREENING THE NEWBORN FOR DYSPLASIA OF THE HIP / Шинэ санаа Шинэ нээлт

Developmental Dysplasia of the Hip (DDH) is a major health problem which can lead to lifelong handicapped condition of individuals if early diagnosis is missed. Cost for treatment, surgery and rehabilitation of these cases is much higher than that for prevention. According to Graf, hip ultrasound screening method is simple, reproducible, innocuous and can be performed by well- trained neonatologists. The purpose of this study is to determine prevalence and types of hip dysplasia by Graf standard screening method. A prospective study was carried out. Hip ultrasound screening using Graf method was performed by neonatologists at the Amgalan of maternity of the Capital city from January 2013 to March 2015.Totally 6154 neonates were eligible for the study and 50.9% of them were male, 93.27% term and 6.72% preterm, in 8.53% of babies, type IIa (physiological retardation of ossification)was found. Dysplasia or dislocation of hips (type III and IV) was found in 5 (0.08%) neonates. Babies diagnosed with type I on both hips were discharged. Type IIa cases were stopped being swaddled and reassessed after 4 weeks. Cases with type III and IV cases were all treated with abduction treatment or Tubinger. This study is an ongoing project. The implementation of the hip ultrasound screening according to Graf is feasible and can be performed by well-trained neonalogists in Amgalan of maternity of the Capital city.

Survey about correlation between senile cataracts types and some constituents of biochemistry / Шинэ санаа Шинэ нээлт

Cataract is the leading cause of low vision and blindness in the world. Most cataracts are related to aging because the life expectancy of population becomes increased in the world.However, the research ofthe types of cataracts has been studied in Mongolia, it is not investigating correlation between in the types of cataracts and the result of biochemistry, therefore it was the background of our research. To determine the correlation among the mongolians aged 50 and older for compare some biochemical results of blood and types of the senile cataract.Total 80 patients with cataract and aged over 50 were case-based selected for the study from November 2010 to November 2011 at the Department of Ophthalmology ofFirstCentral Hospital of Mongolia. There had been collected according to the questionnaire of risks, and records of biochemical examination. Eye examinations had been performed lenses evaluated with the biomicroscope and determined the lens opacities rightly to Lens Opacities Classification Systems-III (LOCS III, the international standard classification). And we used SPSS 16.0, The mean age of all participants was 70 (±9.36) years and 56.2% were female, 43.8% males. The study shows that cataract types: nuclear was 48.8%, cortical 10%, posterior subcapsular (PSC) 41.2%. The hypertriglyceridemia (≥2.26 mmol/L) was associated with PSC (p = 0.025). There was no statistically significant association between blood glucose and cholesterol level and senile cataract. Nuclear cataract was the most common type of senile cataracts in Mongolia. It was same that hypertriglyceridemia was related to PSC developing in comparison of some studies, which conducted in some nations.

Intravitreal bevacizumab and laser therapy in the management of diabetic macular edema / Шинэ санаа Шинэ нээлт

Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 40 and 59 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significantpublic health issue. The Early Treatment Diabetic Retinopathy Study (ETDRS) showed the benefit of focal/grid laser for the management of DME, reducing the risk of moderate visual loss by approximately 50%, and since then,macular photocoagulation (MPC) has been the gold standard treatment. Vascular endothelial growth factor (VEGF) is an important mediator of blood-retinalbarrier breakdown, which leads to fluid leakage and the development of macular edema. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an optionthat must be considered for the treatment of DME. The aim of this study to evaluate intravitreal bevacizumab and modified Early Treatment Diabetic Retinopathy Study (ETDRS) macular laser therapy (MLT) in patients with clinically significant macular edema (CSME). Methods: In a1-year, single-center, randomized controlled trial, 70 patients with center-involving CSME were randomized to receive either bevacizumab or MLT. Result: The baseline mean ETDRS BCVA was 58.3±8.6 (range 38–71) in the bevacizumab group and 56.6±7.3 (range 37–69) in the laser group. The mean ETDRS BCVA at one year was 63.2±12.5 (range 41–80) in the bevacizumab group and53.0±8.3 (range 35–74) in the laser group (p=0.0004). At one year, central macular thickness decreased from 405±121 μm (range 275–715 μm) at baseline to 247±141 μm (range 178±541 μm) in the bevacizumab group and in the laser group from 392±137 μm (range 284–741 μm) to 318±129 μm (range 165–615 μm) (p=0.05). Conclusioni: The study provides evidence to support the use of bevacizumab in patients with center involving CSME without advanced macular ischemia.

Outcome of laser surgery for mild myopia and myopic astigmatism / Шинэ санаа Шинэ нээлт

LASIK is the most popular treatment method for correction of the refractive errors of ophthalmology its development in 1990 and number of patients has continued to increase.The safety and efficacy of LASIK surgery have been reported several times by numerous researchers and doctors, but all studies have made abroad. This time we have summarized postoperative outcomes of LASIK surgery, which have performed in our country. Consequently 103 patients (206 eyes) who underwent LASIK surgery in “Bolor-Melmii” eye clinic between 2007 and 2011 were enrolled. The retrospective method of study was used to evaluate postoperative outcomes. Preoperative UCVA of 0.04-0.4 improved to 0.5-1.2(decimal) at 1 day after surgery and during 1 year after surgery revealed minimal but wasstable. Preoperative mean sphere equivalent of 2.2+/-0.72D improved at the 1 year by +/-0.5D in 161 eyes (78.15%), by +/-1.0D in 39 eyes (18.9%) and by +/-2.0D in 6 eyes (2.9%)after surgery. Mean sphere equivalent and astigmatism improved to -0.46 +/-0.4D and -0.43+/-0.34D respectively at 1 year after surgery. Improvement of the sphere equivalent and its stability during a year period of study proves that LASIK surgery is an effective with stable improvements and safe procedure for correcting myopia/myopic astigmatism. No severe complications occurred during and after surgery.

Human fetal eyeball layers’ structure, differentiation and vascularization / Шинэ санаа Шинэ нээлт

Studying formation and development of fetal organ system, it has reliable information in medical theory as well as practical importance for the medical diagnosis, treatment and prevention in certain country. Introducing the modern advanced methods of fetal study in our country, it willbe possible to get the necessary information of prenatal organ development, formation and differentiation. Currently, the research works of eyeball development, topography, structures have not been accomplished yet in the Mongolian human fetuses. Therefore, the aim of thiswork was to make an evaluation of the development of the human eye during the fetal life. In our study, the 66 eyeballs of 33 human fetuses were examined.It was observed that the axial length, corneal diameter and equatorial diameter of the eye were increased simultaneously in the early fetal period. In the late period the axial length was increased slightly and equatorial diameter was increased rapidly. In the histological observation, the thickness of the eyeball layers were increased regularly from the early fetal period until the late fetal period. Thickness of the choroid and retina were increasing irregularly. Anti VEGFantibody was high distinguished detected in the choroid and retina in the early fetal period but it was middle distinguished detected in the late fetal period by immunohistochemistry.

Some aspect of diagnosis and type of clinical management and risk factors of age-related macular degeneration / Шинэ санаа Шинэ нээлт

Age-related macular degeneration (AMD) is the leading cause of severe visual loss in people aged 50 years or older. It estimates that 25-35 million people lost vision due to AMD in the world. Rapid increase of aging population, 33.2 million people was affected by AMD in 1994and there is estimation the number will reach 80 million by 2050. Prevalence of disease is different in countries it relates due to aging population and the ratio is higher in developed countries. The risk factors of AMD; race, nationality, life style, cigarette smoking, alcoholconsumption, UV exposure, diet, vitamin or food supplements consumption, drugs and high blood pressure. This study was to evaluate risk factors in age related macular degeneration because cigarette smoking, alcohol consumption and high blood pressure are high among elder Mongolians. Introduction of Optical Coherent Tomography /OCT/ in ophthalmology enables us to early diagnose and prevention. It will be basic data for developing AMD prevention policy and improving methods of diagnosis and management.

DEGREE OF CORONARY ATHEROSCLEROSIS IS ASSOCIATED WITH CHANGING CIRCULATING LEVELS OF ENDOTHELIN RECEPTOR TYPE A IN MONGOLIAN ADULTS / Шинэ санаа Шинэ нээлт

Background:The cardiovascular disease especially coronary artery disease is the leading cause of mortality in worldwide. There is lack of research study which evaluated stenosis of coronary atherosclerosis. It is known that coronary stenosis is highly connected to the levels of biomarkers. Coronary atherosclerosis correlated with endothelin receptor type A (EDNRA) levels in a group of patients suspected of having coronary artery disease.Objective:The goal of this study was to evaluate the relation between the coronary atherosclerosis and levels of EDNRAMethods:A total of 311 participants were involved in this study. A case-control study was used in the study. The baselines data were collected from the department of Angiography at the National Third Central Hospital and National lilood Transfusion and Research center. We have determined the degree of coronary atherosclerosis using the Angiography machine and Elisa were used for detecting the blood endothelin levels in all groups.Results:98 participants were diagnosed with stenosis and occlusion. The blood endothelin levels were estimated to 6.32±0.64 pg/ml which refer to () degree of coronary stenosis, the first degree of stenosis of coronary atherosclerosis is estimated to 5.56±0.22pg/ml, the second degree of stenosis of coronary atherosclerosis is estimated to 5.42J0.34 pg/ml, the third degree of stenosis of coronary atherosclerosis is estimated to 5.87 H). 13 pg/ml, the fourth degree of stenosis of coronary atherosclerosis is I'SlilllSltll lo 5.69±0.09 pg/ml, it was estimated to 5.88±0.13 pg/ml in control groups. Level of EDNRA (occupying one segment of coronary artery) was estimated to 5.77±0.08 pg/ml. two segment involvement was estimated to 5.72±0.16 pg/ml, three segment involvement 5.73±0.19 pg/ml. four segments involvement 5.50±0.25 pg/ml, respectively.Conclusion:The blood endothelin level and coronary artery stenosis were not correlated statistically significant in control group of the study. However, blood endothelin levels were increased in patients who tend to experience the coronary artery stenosis.

DEGREE OF CORONARY ATHEROSCLEROSIS IS ASSOCIATED WITH CHANGING CIRCULATING LEVELS OF ENDOTHELIN RECEPTOR TYPE A IN MONGOLIAN ADULTS / Шинэ санаа Шинэ нээлт

Background: The cardiovascular disease especially coronary artery disease is the leading cause of mortality in worldwide. There is lack of research study which evaluated stenosis of coronary atherosclerosis. It is known that coronary stenosis is highly connected to the levels of biomarkers. Coronary atherosclerosis correlated with endothelin receptor type A (EDNRA) levels in a group of patients suspected of having coronary artery disease. Objective: The goal of this study was to evaluate the relation between the coronary atherosclerosis and levels of EDNRA Methods: A total of 311 participants were involved in this study. A case-control study was used in the study. The baselines data were collected from the department of Angiography at the National Third Central Hospital and National lilood Transfusion and Research center. We have determined the degree of coronary atherosclerosis using the Angiography machine and Elisa were used for detecting the blood endothelin levels in all groups. Results: 98 participants were diagnosed with stenosis and occlusion. The blood endothelin levels were estimated to 6.32±0.64 pg/ml which refer to () degree of coronary stenosis, the first degree of stenosis of coronary atherosclerosis is estimated to 5.56±0.22pg/ml, the second degree of stenosis of coronary atherosclerosis is estimated to 5.42J0.34 pg/ml, the third degree of stenosis of coronary atherosclerosis is estimated to 5.87 H). 13 pg/ml, the fourth degree of stenosis of coronary atherosclerosis is I'SlilllSltll lo 5.69±0.09 pg/ml, it was estimated to 5.88±0.13 pg/ml in control groups. Level of EDNRA (occupying one segment of coronary artery) was estimated to 5.77±0.08 pg/ml. two segment involvement was estimated to 5.72±0.16 pg/ml, three segment involvement 5.73±0.19 pg/ml. four segments involvement 5.50±0.25 pg/ml, respectively. Conclusion: The blood endothelin level and coronary artery stenosis were not correlated statistically significant in control group of the study. However, blood endothelin levels were increased in patients who tend to experience the coronary artery stenosis.

Result of the treatment of certain eye diseases caused by adenovirus infection with normal immunoglobulin / Монголын Анагаах Ухаан

Background: In 1889, keratinocytes conjunctivitis with eruption in the form of Epidemic first was revealed by Fuchs and from 1995 it began to be diagnoses using the polymerase chain reaction. In our country annually about 11,850 patients visited the ophthalmology cabinet of the State Central Clinical Hospital, and from them 1290 cases or 10.89% were diagnosed to have viral infections, including 95% were sick of adenovirus infection, 3.7% had a herpes virus infection, 1,3% infection of other species respectively. At the international level of experience and research on the treatment of adenovirus conducted in a large circle, and immunoglobulin therapy has a high impact (P=0.0001, power 0.7599, ANOVA). In Mongolia, normal immunoglobulin is produced and widely uses to enhance immunity, but technological expertise and experiences on the use of immune globulin in ocular diseases caused by adenovirus infection had not been conducted yet. Goal: To study the possibility to diagnose ocular diseases caused by adenovirus infection with laboratory method and use immunoglobulin in eye area. Methods and materials: The investigation involved 50 patients aged 18-55 diagnosed with the infection of adenovirus. We took samples from eye conjunctiva, blood and stool of patients involved in the investigation and conducted a survey to identify adenovirus using the polymerase chain reaction. In this analysis it was used the diagnosing devise (Amply Sense Adenovirus – Eph) made in Russian Federation. Samples where the virus is detected were multiplied in Hep2 cell culture and viruses were abstracted. Linear cells Hep2 were made culture by methodology and recommendation from World Health Organization. Abstracted viruses were challenged in experimental rabbits by dropping it into their eyes or making injections. After rabbits became completely sick, they were divided into five groups and each had a different treatment. Statistical and analytical software used in the development of research. (SPSS,EPI-info8 STATA). Results: Samples were taken from 50 people and made on them polymerase chain reaction analysis, at 43 (86%) of which were detected adenovirus: Viruses were found in 14(93%) of 15 samples taken from the eye, 12 (80%) of 15 samples taken from the blood, 17(85%) of 20 samples taken from the stool respectively. Sample with viruses was conducted the initial development and made culture in a linear cell Hep 2. Partial anesthesia were made on both eyes of 25 rabbits with use of Proparacaine Hydrochloride and infected them with adenovirus and after 7 days the following treatments were made dividing the rabbits in five groups so that each group has got five rabbits. (Treatment with interferon, ingavirin treatment against viruses, immunoglobulin drops, combined immunoglobulin drops jointly with ingavirin, immunoglobulin injection for combined with ingavirin). After infection eyes of rabbits with adenovirus and descending corneous phlegmon in their eyes, the symptom curing were observed on schedule at 2, 4, 6, 8, 10, 12, and 14th days of each separate treatment group and calculated the average. On the 8th day after starting the treatment combined ingavirin with lg eye drop and treatment lg catarrh injection with ingavirin conducted in related groups, and on the 12th day of treatment with ingavirin, all the symptoms of infections were completely cured. Treatability of group treated with interferon after 14 days was 71 percent. On the basis of the above indicators, we compared the most effective method of treatment with interferon treatment, which is currently in use, then developed a method of statistical significance of the study with indicator ANOVA and proved that the significance of the treatment is of P<0.05. As in the 8th day of the treatment, the symptoms of viral infection is completely eliminated, and at the 10th day is not detected any viruses, we can prove that the treatment of immune globulin effectively prevents the virus and is capable of neutralizing the virus. Conclusions: 1. The experiment shows that intravenous immunoglobulin therapy is an effective method against infection caused by adenovirus. 2. Since immunoglobulin counteracts the adenovirus, it has the opportunity to become a major application against inflammation caused by viruses and bacteria 3. Using of the drug against the virus with a combination of ingavirin has higher effectiveness than the use of only one immunoglobulin against adenovirus.