Introduction:According to studies range by the World Health Organization in 2010, 278 million people are deaf or hearing impairment, out of which 24% use an hearing aid and one out of every 10 people has been treated with surgical method and 9 people’s hearing loss has been restored using acoustic treatment method.Purpose:Our purpose is to define noisy vowels of Mongolian word, which will be used for configuration of hearing aid, thereby improve hearing ability.The objectives1. Analyze spectrogram for noisy sound of Mongolian word and define frequency and level of noisy words.2. Define average difference of listening level of the noisy sounds of Mongolian language using “Listening field of Mongolian word”Materials and method:We did the spectrogram for noisy sounds of the Mongolian word using voices of 62 people including male and female children as well as adults. Also, we analyzed frequency energy of all vowels noted in the 60-65 dB computer, via the “PRAAT” software, which defines analysis of speech in phonetics and studied listening level of the strong vowels using listening sphere of word.Result:During our studies, we selected the vowels [a], [e], [u], [o] [a], [ʊ], [ɔ], [i] and defined spectrogram and energy concentration (formant) of each vowel to define the vowels with the highest energy, and further found out that distance difference of the spectrogram of each vowel and frequency between vowels as 300-780 Hz. On the other hand, difference between spectrogram of each strong sound such as [sh], [s], [v], [z], [dj], [kh] has been defines as 340-2800 dB.When we observed the words with strong sound in the listening field of Mongolian words, which were 3- 5 dB lower than the clearer words.Conclusion:1. According to spectrogram, noisy sound [sh], [s], [z], [dj] has frequency of 3300Hz-3500Hz, which is noisier and resulted in poor acoustic listening ability. Further, we found out that Distant difference of vowels of Mongolian language [a], [e], [o] and consonants [m], [n] is far, accordingly, acoustic listening ability has been good, on the other hand, distant difference of vowels of Mongolian word [ʊ], [ɔ], [u] is near or close, accordingly, acoustic listening ability has been not well.2. Level of distinquishment of the noisy sounds of Mongolian word has been lower by 3.6+ 0.8Db to 5.2+1.2Db at levels of clear sound to feedback.

INNOVATION DENT • VOL. 3 • No.1 • Mar 2017 35 Background Odontogenic infection is defined as most dangerous inflammatory diseases in dental practice, it is believed that the cause of tooth decay disease and its complications currently a major cause of oral infections, or bacterial infection of the main sources of these diseases. Methods Between 2010-2011, odontogenic cellulitis in 21 patients were studied for aerobic and anaerobic bacteria by the Clinic bacterial laboratory in NCCD. Results 21 patients participated, were 10 men and 11 women with odontogenic cellulitis. Aerobic bacteria only were recovered in 3 (14%), anaerobic bacteria were recovered 8 (38%), mixed aerobic and anaerobic bacteria were recovered in 10 (48%). Conclusion A certain percentage of aerobic and anaerobic bacteria in odontogenic cellulitis shows simple space infection caused by aerobic bacteria, other complication of odontogenic cellulitis and multiple spaces infection caused by anaerobic and mixed bacterial infection. During dontogenic cellulitis determined high percentage of anaerobic and mixed bacterial infection, thus is our study have shown detection of anaerobic bacterial infection is important clinical significance in dental practice.

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.

There are a lot of influencing factors of facial nerve palsy; experts believe that is most likely caused by a Virus (54%) and Bacterial infections. Noninfectious causes of facial nerve palsy induce tumors (28%) and less commonly influences head trauma (18%). The retrospective analysis of WHO, in 2012. There are some cases of postoperative complication in middle ear surgery is facial nerve palsy and the total recovery outcome of function was not good. From 2013 to 2016 in EMJJ hospital, Mongolia, we enrolled 16 cases with facial nerve damaged in intratympanic canal but we could not recruit some patients with facial palsy over 6 months. Each subject was tested with pure tone test, ABR, Tympanometry. These were performed for the detection of hearing loss after Temporal bone injury. Then we also investigated location of facial nerve damages of patients by MRI and CT before reconstructive surgery. After that surgery, all patients were given corticosteroid treatment (20mg/day) and physical therapy performed such as acupuncture for a week. Study results revealed that 6 cases after 18 days, 2 cases after 30 days, 1 patient after 45 days of reconstructive surgery regained good symmetry. Therefore, we considered that, postoperative treatments like physical therapy with B12, steroid had good benefits for operation result and to shorten the recovery time. There was a patient who had damaged facial nerve in the tympanic segment during Mastoidectomy. In that case, we performed cable nerve grafting using the r.auricularismagnium but we could not recover facial nerve function. Traumatic facial nerve paralysis is the second most common type. We discussed that performing reconstruction surgery within first 3 months after intratemporal facial nerve injury is extremely desirable and more effective. In our opinion, nerve recovery might be not successfully cause of injured myelin sheet of facial nerve during middle ear surgery.

Abstract Mana-4, an herbal medicine, had been used to treat incomplete-mannered and infection-caused hot disease in Mongolian traditional medicine. It has already reported that Mana-4 acts as an anti-inflammation agent, an activator of T and B cells, an immune-modulator and an inducer of cellular proliferation. Moreover, it enhances the immune system and energy level of human body. It was confirmed that the main active compounds in Mana-4 are inulin and total flavonoids which are effective for many diseases. Drug formulation types are very important to delivery the drugs to the targeted tissues and organs without loss of active ingredients. Total flavonoids in the extract of Mana-4 and granulated Mana-4 was qualitatively evaluated by TLC and yellow-brown spots (Rf was 0.4) were found on TLC plates, indicating that the preparations contained flavonoids. Also, it confirmed that the appropriate extractor of total flavonoids from Mana-4 was 70% of ethanol. In conclusion, the tablet formulation from Mana-4 was successfully prepared and the quality requirements was allowable.

Introduction: Pharmacist and customer satisfaction is unique to other industries because it has a significant impact on patient outcomes and the quality of primary health care. In the framework of health sector reforms, improving the ethics and attitudes of medical professionals, the quality of care, internal environment and safety has become a priority issue for the development of the organization.
According to statistical data, in 2020, there are 2343 second-class pharmacies in Mongolia, 1254 in Ulaanbaatar, and 1249 pharmacies in Ulaanbaatar in 2021. As of 2020, there are 2639 pharmacists and 2009 drug directors working in the country, and in 2021, there are 2913 pharmacists and 2010 drug directors. Compared to the previous year, the number of pharmacists has increased by 0.8%, and the number of drug directors has increased by 13% has indicators. According to the above statistics, it is appropriate to study the satisfaction of specialists and clients in line with the increasing number of pharmacies and specialists.
As of the 1st quarter of 2023, pharmaceutical experts who play an important role in the quality and availability of pharmacy services and social economic development in the world (Pakistan, America, Canada. Great Britain, Spain, South Africa, etc.) Because it is important to study the satisfaction of pharmacists and the satisfaction of pharmacy users, we are conducting regular satisfaction surveys. Purpose and objectives: The purpose of the research is to evaluate the satisfaction of customers and pharmacists in the pharmacy of Ulaanbaatar. For this purpose, the following objectives were proposed. It includes:
1. Survey of pharmaceutical experts and pharmacy users determine the sample size
2. To evaluate the satisfaction of pharmacy users through a questionnaire
3. To evaluate the satisfaction of pharmacists by questionnaire
4. Compare the level of satisfaction by age group and perform statistical processing Materials and methods: A survey of pharmacy customers and pharmacist satisfaction was conducted using a Cross-sectional studies model. The Survey system calculator was used to calculate the sample size based on the representativeness of the sample to be studied. The survey was conducted between the 4th quarter of 2022 and the 2nd quarter of 2023. and the satisfaction of customers and pharmacists was obtained by random sampling by the UB City Hospitals and Health Deparments, and data was collected using 2 types of questionnaires to be evaluated on a 5-point Likert scale using the SERVQUAL model. The results were processed using Microsoft Excel and SPSS 23.0 software. The reliability of the survey questionnaire was calculated using the Cronbach alpha coefficient. Results: A total of 758 people participated in our study, and satisfaction was determined by including n=369 pharmacists and n=389 customers, respectively. A breakdown of the results:
369 pharmacists participated in the survey, and according to the total number of questions, 48.0% n=177 are satisfied, 37.7% n=139 are very satisfied. Considering the satisfied age group of pharmaceutical specialists, n=101 specialists in the age group of 26-35 years are the most satisfied.
52.85% n=195 satisfied. 25.20% n=93 Very satisfied, 20.87% n=77 Moderately satisfied, 0.54% n=2 Not at all satisfied, 0.54% n=2 He replied that he did not know. According to the results of the survey, pharmaceutical professionals are highly satisfied.
On the other hand, 389 customers participated in the satisfaction survey of pharmacy users, and according to the total results of the group questions, 67.4% n=262 customers were moderately satisfied with the organization's care and service culture and intimate environment outside the organization is satisfied. Looking at the satisfaction of pharmacy customers by age group, n=121 customers under 25 years of age have moderate satisfaction is satisfied.
49.61% n=193 not satisfied at all, 35.22% n=137 Moderately satisfied with the pharmacy services from the surveyed customers, degree, 9.55% n=37 Very satisfied, 5.66% n=22 answered that they do not know. Therefore, it shows the need to consider the quality of care. Conclusion 369 experts were included in the survey to evaluate the satisfaction of customers and pharmacists with the pharmacy, and 2 groups of evaluations were used in the survey. The reliability of the 22 questionnaires, calculated by Cronbach's alpha coefficient, is good between 0.9 a≥0.846. The majority of pharmaceutical professionals (n=316) surveyed are satisfied with their profession and workplace.
However, the reliability of the questionnaire used in the research to evaluate the satisfaction of customers in the pharmacy, when calculated by Cronbach's alpha coefficient, is acceptable between 0,8 a≥0.777. The n=262 customers surveyed are moderately satisfied with pharmacy services.
Depending on the age group of the people involved in the research, the location where they work and serve, the relationship attitude, understanding, and workload satisfaction level are different.

Background: Nicotine-containing vaporized liquids—composed of propylene glycol, glycerin, water, flavorings, and the thickening agent vitamin E acetate—have been implicated in the development of EVALI. Under conditions of low liquid levels and overheating, these substances release toxic carbonyl compounds (e.g., formaldehyde, acetaldehyde, acrolein). In a 2019 national survey, 3.5% of adolescents aged 13–15 reported cigarette use, and 10% used e-cigarettes. Aim: To study the changes in the behavior, lung, and hippocampal structures of rats due to the effects of electronic cigarettes and their vapor. Materials and Methods: In this study, nineteen 14-day-old SHR rats were exposed to 1 g/mg/day of nicotine and dry hit vapor (control, nicotine and dry hit groups) for four weeks. Behavioral assessments (Open Field Test, Elevated Plus Maze, Conditioned Place Preference), bronchoalveolar lavage (BAL), and histological analysis of lung and hippocampal tissue were conducted. Results: The dry hit vapor group showed significantly reduced body weight (p=0.034), increased anxiety (p=0.006, p=0.025), and avoidance of the smoky chamber. BAL revealed elevated total cells, neutrophils, and macrophages (p=0.01, p=0.04) in both nicotine and dry hit groups. Lung tissue exhibited alveolar septal thickening, inflammation, and emphysema- like changes. Extensive neuronal death was observed in the hippocampus. Conclusion Anxiety-like behavior was observed in both the burn and control groups. Analysis of BAL in the dry hit group revealed inflammation predominantly characterized by macrophage infiltration. Histological examination of lung tissue from both experimental groups demonstrated a reduction in the number of alveoli, accompanied by acute inflammation and thickening of the interalveolar septa. In the hippocampal region, neuronal loss and a reduction in neuronal density were also observed.

Background: We aimed to study the etiology and transmission route of diseases introducing the modern, rapid and high-sensitivity molecular genetic diagnostic methods for salmonellosis. Material and Method: In the study, we collected 680 stool samples and defined organisms of food intoxication by identification of bacteria, polymerase chain reaction (PCR) and determined serotype and antibiotic resistance. Result: Salmonella spp was detected from the stool of 25 (42.3%) patients out of 59 outpatient clinic and of 170 (27.4%) patients out of 621 inpatient clinic with diagnosis of food intoxication. In total there was detected 195 salmonella spp, and out of this isolated Sal. typhimurum in 193 (98.9%), and Sal. enteritidis was in 2 (1.1%) patients, respectively. We defined Sal. typhimurum in selected 32 cultures and did not detect resistant gene DT-104 ACS-SuT by PCR. Conclusion As resulted in the survey, we defined 195 (28,6) Salmonella typhimurum among the 680 patients who were suffered from food intoxication, and revealed fast foods, animal derived foods such as chicken, fish caused the food intoxication. Sal. typhimurium not resistance to antibiotics.

Introduction: Antimicrobial Resistance (AMR) has emerged as a significant public health and economic issue worldwide, affecting both developed and developing countries. Our research has been motivated by the increasing prevalence of carbapenem-resistant P. aeruginosa, A.baumannii, and K. pneumonia in recent years. Goal: To determine antibiotic susceptibility of the pathogens isolated from wound infection and to detect its multidrug resistance. Material and Method: Samples were collected from patients with wound infections. Pathogens were identified by using the traditional culture methods and the API system with serotypes determined phenotypically. Antibiotic susceptibility was assessed using the disk diffusion method and the MIC to analyse antibiotic resistance. Results: In the study, among 11,221 recorded cases of wound infections in 2023, bacterial pathogens were detected and identified at the species level in 10,339 cases (92.1%).
For identification results showed that A. baummannii were detected from 138 cases (1.3%), 216 cases (2.08%) of Ps. aeruginosa, 5 cases (0.04%) of B. cepacia, 1,383 cases (13.4%) of Enterobacteriaceae, 205 cases (2.0%) of Enterococcus spp., 8,329 cases (80.5%) of Staphylococcus spp., and 63 cases (0.6%) of Streptococcus spp.
Antibiotic susceptibility of these bacteria was assessed and determined multidrug resistance. We found the followings: For A. baumannii were resistant with MDR in 68 cases (49.3%), MRSA in 4,243 cases (51.1%), MDRSta. aureus in 1,805 cases (29.4%), VRE in 34 cases (16.5%), ESBL in 4.6%, KPC in 26 cases (11.1%), FRNF in 24 cases (11.6%), and CRPA in 13 cases (6.3%). Conclusion
1. Of all wound infections reported in 2023 in 92.1% there were detected pathogenic bacteria, of which S.aureus were in 80.5% and E. coli was in 13.4%
2. 60.7% of the pathogenic bacteria detected in wound infections were multidrug-resistant, with MRSA accounting for 51.1% and MDR A.baumannii accounting for 49.3%, indicating high antimicrobial resistance(AMR).

Introduction: Major outbreaks of infectious diseases caused by enteroviruses (EV) have been reported in recent years. As of 2017, in Mongolia, hand, foot and mouth disease, or HFMD, accounts for 13.7% of all infectious diseases. The purpose of this study was to investigate the circulation of EV among healthy children, and clinical characteristics of infection. Materials and Methods : The analysis of EV circulation was conducted on Polio Laboratory data of 1172 specimens, collected in 2013-2018, from 9 districts of UB and 21 provinces of Mongolia. Also specimens of 239 patients, who underwent outpatient and inpatient treatment at the NCCD in 2014-2018, were randomly selected and stool samples were collected. Clinical symptoms of patients were analyzed and virus isolation analysis was performed in order to confirm the diagnosis. Results: Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months. The enterovirus rate among healthy children was 20.1%. Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July.
Out of selected patients 52.7% (n=126) were diagnosed with HFMD, rash infection occurred in 28.5% (n=68), acute flaccid paralysis-18.8% (n=45). EV was detected in 56.4% (n=135) of the collected stool samples.
Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months (95% CI:2.5 ±0.1). 49% (n=578) of participants were female, 50.7% (n=594) were male. The enterovirus rate among healthy children were 20.1% (n=236; 95% CI: 20.1 ± 0.55). Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. Although the enterovirus isolation rate was relatively high among children under 3, there was no statistically significant difference (p>0.05), as well as there was no difference in gender (p>0.05). As for the EV circulation by region, the highest prevalence rate is found in Central region (27.5%), while the lowest is in the Eastern region (12.7%) with no statistical significance by regions (p>0.05). Conclusions Among children, HFMD is a common disease, that caused by EV. Enterovirus infection can often cause fever, flu like symptoms as well as spotted, maculopapular rash. The EV isolation rate of 20.1% indicates that the incidence of enterovirus is characterized by symptoms of influenza-like illness or is asymptomatic.