Oyuntsetseg, Khasag
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Oyuntsetseg, Khasag
Бүтэн нэр
Oyuntsetseg Khasag
Латин нэр
Oyuntsetseg Khasag
Албан тушаал
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Item type:Publication, Randomized Controlled Trial Comparing Standard Triple and Sequential Regimens for Helicobacter pylori Eradication(Mongolian National University of Medical Sciences, 2016-11-25); ; ; ; Objectives: The aim of this study was to compare effectiveness of sequential therapy to the standard triple therapy to eradicate Helicobacter pylori (H. pylori) in Mongolia. Methods: From September 2014 to February 2016, 140 patients with confirmed H. pylori infection (upper gastrointestinal tract (GI) endoscopy, rapid urease test, histology, H. pylori stool antigen test (HpStAg)) randomly received 10 days standard triple therapy (20 mg pantoprazole, 1 g amoxicillin, 500 mg clarithromycin, all twice daily for 10 days; STT group, n = 70), and sequential therapy (20 mg pantoprazole, 1 g amoxicillin twice daily for 5 days followed by 20 mg pantoprazole, 500 mg clarithromycin, 500 mg metronidazole twice daily for 5 days; SQT group, n = 70). Successful eradication therapy for H. pylori infection was defined as a negative HpStAg test 4 weeks after the end of eradication treatment. Results: The eradication rates by intention to treat (ITT) analysis were 71.4% (50/70) and 50% (35/70) in the STT and SQT groups, respectively (p = 0.033). The eradication rates by per-protocol (PP) analysis were 72.5% (50/69) and 51.5% (35/68) in the STT and SQT groups, respectively (p = 0.018). The adverse event rates were 7.6% (5/70) and 18.6% (13/70) in the STT and SQT groups, respectively (p = 0.043). Conclusion: The eradication rate was significantly higher in the STT group compared with the SQT group. But the eradication efficacies of both STT and SQT for H. pylori infection in Mongolia are unacceptable. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Initial Trials With Susceptibility-Based and Empiric Anti-H. pylori Therapies in Mongolia(Frontiers Media SA, 2019); ; ; ; Background: Mongolia has a high prevalence of Helicobacter pylori infection and gastric cancer. We conducted a prospective, randomized, single-blind study to evaluate the efficacy of common regimens in Mongolia and to obtain specimens for susceptibility testing. Methods: Empiric treatments: 270 patients with confirmed H. pylori infection were randomized to receive 10 days clarithromycin-triple therapy (Clari-TT) (n = 90), modified bismuth quadruple therapy (M-BQT) (n = 90), or sequential therapy (ST) (n = 90). A second group of 46 patients received susceptibility-based Clari-TT. H. pylori was cultured from 131 patients and susceptibility testing was performed. H. pylori eradication was confirmed by stool antigen 4 weeks after the therapy. Results: Intention-to-treat (ITT) analysis cure rates were 71.1% (95% CI = 61.7-80.5%) for Clari-TT, 87.8% (95% CI = 81-94.6%) for M-BQT, 67.8% (95% CI = 58.1-77.5%) for ST vs. 89.1% (95% CI = 86-98.2%) for susceptibility-based Clari-TT. Per-protocol (PP) analysis results for these therapies were 72.7% (63.4-82%), 89.8% (83.5-96.1%), 68.5% (58.8-78.2%), and 97.6% (89.5-99.8%), respectively. Among 131 cultured H. pylori, resistance rates to amoxicillin, clarithromycin, and metronidazole were 8.4, 37.4, and 74%, respectively. Conclusion: In Mongolia, the prevalence of H. pylori resistance is high requiring bismuth quadruple therapy or susceptibility-based therapy to obtain acceptable cure rates.Scopus© Citations 12 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Western-Type Helicobacter pylori CagA are the Most Frequent Type in Mongolian Patients(MDPI AG, 2019-05) ;Tserentogtokh, Tegshee; ;Subsomwong, Phawinee; Bolor, DashdorjHelicobacter pylori infection possessing East-Asian-type CagA is associated with carcinogenesis. Mongolia has the highest mortality rate from gastric cancer. Therefore, we evaluated the CagA status in the Mongolian population. High risk and gastric cancer patients were determined using endoscopy and histological examination. H. pylori strains were isolated from different locations in Mongolia. The CagA subtypes (East-Asian-type or Western-type, based on sequencing of Glu-Pro-Ile-Tyr-Ala (EPIYA) segments) and vacA genotypes (s and m regions) were determined using PCR-based sequencing and PCR, respectively. In total, 368 patients were examined (341 gastritis, 10 peptic ulcer, and 17 gastric cancer). Sixty-two (16.8%) strains were cagA-negative and 306 (83.1%) were cagA-positive (293 Western-type, 12 East-Asian-type, and one hybrid type). All cagA-negative strains were isolated from gastritis patients. In the gastritis group, 78.6% (268/341) had Western-type CagA, 2.9% (10/341) had East-Asian-type, and 18.2% (61/341) were cagA-negative. However, all H. pylori from gastric cancer patients possessed Western-type CagA. Histological analyses showed that East-Asian-type CagA was the most virulent strains, followed by Western-type and cagA-negative strains. This finding agreed with the current consensus. CagA-positive strains were the most virulent type. However, the fact that different CagA types can explain the high incidence of gastric cancer might be inapplicable in Mongolia.Scopus© Citations 21 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The prevalence of Helicobacter pylori infection and other risk factors among Mongolian dyspeptic patients who have a high incidence and mortality rate of gastric cancer(Springer Science and Business Media LLC, 2018); ; ; ; Dashdorj, AzzayaBACKGROUND: Mongolia has not only the second highest incidence rate but also the highest mortality rate for gastric cancer globally. In addition to gastric cancer, ulcerative disease complications are also life threatening; thus, investigating Helicobacter pylori infection and other risk factors is essential. RESULTS: H.pylori infection was high in tested dyspeptic patients from all parts of Mongolia, with an overall infection rate of 80.0%. Logistic regression analysis showed that H. pylori infection was associated with gastritis (odds ratio; 9.0 ([95% confidence interval 5.0-16.2]); p < 0.0001). H. pylori infection (3.3 [2.0-5.4]; p < 0.0001) and > 40 years old (1.5 [1.0-2.0]; p < 0.02) were both associated with atrophy. However, > 40 years old (3.8 [2.4-6.0]; p < 0.0001) and high salt intakes (1.6 [1.0-2.3]; p < 0.02), but not H. pylori infection, were associated with intestinal metaplasia. Excessive amount of salt usage was dramatically higher in northern and western parts of Mongolia, where precancerous diseases, such as erosive esophagitis (for cardia cancer), severe atrophy, and intestinal metaplasia (for non-cardia cancer), were highly prevalent. CONCLUSIONS: H. pylori infection was the major gastric health problem among the Mongolian population. In addition, environmental factors such as high salt intake worsened the clinical outcome. Therefore, a nationwide screening and eradication of H. pylori infection as well as salt-reducing measures should be implemented.Scopus© Citations 27 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, New observations regarding Helicobacter pylori and gastric cancer in Mongolia(Wiley, 2018-08); ;Bolor, Dashdorj; ;Erdene-Ochir, YansanBACKGROUND: The incidence and mortality of gastric cancer in Mongolia is among the highest in the world. METHODS: This was a case-control study in which upper gastrointestinal endoscopy, gastric histology, Helicobacter pylori testing, and risk factor questionnaires were obtained. Histologic subtypes were determined by Lauren's classification. RESULTS: We enrolled 45 gastric cancer and 108 non-gastric cancer patients. Gastric cancers were located in upper part of stomach in 53.3%, main gastric body in 37.8%, and lower part of stomach in 8.9%. The majority (60%) were diffuse type, followed by intestinal type (36.7%) and indeterminate type (3.3%). H. pylori infections were CagA positive in 100% with cancer vs 81% without cancer (P = .02). The majority of CagA was non-East Asian type (95% with cancer and 94.1% without cancer). Cancer patients had typically related with excessive use of salt, hot beverages, tobacco smoking, and low ingestion of fruits. CONCLUSION: The characteristic topography of gastric cancer in Mongolia being in the gastric corpus differed from East Asian countries and was more similar to western countries. The risk factors for gastric cancer in Mongolia were similar to other high-risk areas (ie, H. pylori infection, excessive use of salt, tobacco smoking, and low ingestion of fruits).Scopus© Citations 15 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of serum markers for gastric cancer and its precursor diseases among high incidence and mortality rate of gastric cancer area(Springer Science and Business Media LLC, 2019-01); ; ;Bolor, Dashdorj ;Erdene-Ochir, YansanBACKGROUND: Mongolia has the highest mortality rate of gastric cancer. The early detection of cancer and down-staging screening for high risk patients are essential. Therefore, we aimed to validate serum markers for stratifying patients for further management. METHODS: Endoscopy and histological examination were performed to determine high risk and gastric cancer patients. Rapid urease test, culture and histological tests were performed to diagnose Helicobacter pylori infection. Serum pepsinogen (PG) I and II and anti-H. pylori IgG were measured by ELISA. Receiver Operating Characteristic analysis was used to extract the best cut-off point. RESULTS: Totally 752 non-cancer and 50 consecutive gastric cancer patients were involved. The corpus chronic gastritis (72%: 36/50 vs. 56.4%: 427/752), corpus atrophy (42.0%: 21/50 vs. 18.2%: 137/752) and intestinal metaplasia (IM) (64.0%: 32/50 vs. 21.5%: 162/752) were significantly higher in gastric cancer than non-cancer patients, respectively. Therefore, corpus chronic gastritis, corpus atrophy and IM were considered as high risk disease. The best serum marker to predict the high risk status was PGI/II < 3.1 (sensitivity 67.2%, specificity 61%) and PGI/II further reduced to < 2.2 (sensitivity 66%, specificity 65.1%) together with PGI < 28 ng/mL (sensitivity 70%, specificity 70%) were the best prediction for gastric cancer. The best cut-off point to diagnose H. pylori infection was anti-H. pylori IgG > 8 U/mL. Multivariate analysis showed that anti-H. pylori IgG > 8 U/mL and PGI/II < 3.1 increased risk for high risk status and PGI/II < 3.1 remained to increase risk for gastric cancer. CONCLUSION: The serum diagnosis using PGI/II < 3.1 cut-off value is valuable marker to predict high risk patients for population based massive screening.Scopus© Citations 29 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gastric Microbiota in Helicobacter pylori-Negative and -Positive Gastritis Among High Incidence of Gastric Cancer Area(MDPI AG, 2019-04); ;El-Serag, Hashem B ;Matsumoto, Takashi ;Ajami, Nadim JHelicobacter pylori (H. pylori) related chronic gastritis is a well-known major etiological factor for gastric cancer development. However, H. pylori-negative gastritis (HpN) is not well described. We aimed to examine gastric mucosal microbiota in HpN compared to H. pylori-positive gastritis (HpP) and H. pylori-negative non-gastritis group (control). Here, we studied 11 subjects with HpN, 40 with HpP and 24 controls. We performed endoscopy with six gastric biopsies. Comparison groups were defined based on strict histological criteria for the disease and H. pylori diagnosis. We used 16S rRNA gene amplicon sequencing to profile the gastric microbiota according to comparison groups. These results demonstrate that the HpP group had significantly lower bacterial richness by the operational taxonomic unit (OTU) counts, and Shannon and Simpson indices as compared to HpN or controls. The linear discriminant analysis effect size analysis showed the enrichment of Firmicutes, Fusobacteria, Bacteroidetes and Actinobacteria at phylum level in the HpN group. In the age-adjusted multivariate analysis, Streptococcus sp. and Haemophilus parainfluenzae were at a significantly increased risk for HpN (odds ratio 18.9 and 12.3, respectively) based on abundance. Treponema sp. was uniquely found in HpN based on occurrence. In this paper, we conclude that Streptococcus sp., Haemophilus parainfluenzae and Treponema sp. are candidate pathogenic bacterial species for HpN. These results if confirmed may have important clinical implications.Scopus© Citations 74
