IntroductionPossessing thorough pulse feeling skill, the main diagnostic method of traditional medicine, makesa direct impact to treatment results. Unfortunately, there has not been much research done ondetermining the scientific nature of the pulse feeling diagnostic method in Mongolia. Therefore, thetopic was selected in order to clarify some issues of history and theory of the pulse feeling method andto prove the method with practical application.Goal and objectivesThe goal of the research is determining some theoretical issues of traditional medical diagnosticmethod, pulse feeling and proving the effectiveness of the method to determine pregnancy and genderof fetus by practical use. The following objectives are defined:1. Conduct research regarding the theoretical concept of pulse feeling and compare it with thesources in Eastern and Western books, literary works and scriptures;2. Determining pregnancies and feeling the pulses of pregnant women admitted to maternityhospital to identify the gender of fetusMaterials and Мethods50 women admitted to “City Palace of Maternity” hospital and 50 mothers who were hospitalized atpre-natal and post-natal division participated in the study.Used following methods:1. Comparison method2. Pulse feeling method for determining gender of a baby and pregnancyResultsWhen feeling the pulse, the index finger is pressed lightly to feel the skin, the middle finger is pressedwith medium pressure to feel the muscle tissue and the ring finger is pressed hard to feel the boneof the doctor is pressed lightly in order to distinguish the twisted blood flow changes overcoming theresistance of sequential pressure. We also identified that the pulse feeling is based on the natureand connection of the wind and blood and their actions in regard to traditional medicine, whereasby modern medical theory; it is based on functioning factors of vascular muscle layers, pulse rate,pressure to vascular wall and condition of vascular wall as well as thickness and thinness of bloodflow.In addition to the method being effective when detecting pregnancy and gender of fetus of patients atthe maternity hospital, it is definite that it can be basis of identifying the characteristic of pulse of warmand cold diseases.

Introduction: It is significant to translate medical texts having a beginning source of Ayurveda and identifyMongolian doctors, maaramba’s works and books on prescription as well as treatment methods that meetour culture, living condition and climate. Especially, we should clarify the new ideas includes innovatedtheories, which became paradigm not only Traditional Mongolian Medicine but also in Tibetan Medicine.Thus, it has become important to introduce and use in the training for students and practitioners the “FourAmbrosia Essences” and “Dictionary of Drug Identification” by Sumbe Khamba Ishbaljir (1704-1788).Goal: The aim of this study is to investigate “Four Ambrosia Essences” and “Dictionary of Drug Identificationby Sumbe Khamba Ishbaljir and to clarify the new idea of theory and treatment methods created by him.Materials and Method: “Source of Spring” (བདདུ ་ར་ིྩ ཆ་ུ རནུྱྒ ), “White Dew of Spring” (བདདུ ་ར་ིྩ ཟལི ་དཀར), “Drop of Spring”(བདདུ ་ར་ིྩ ཐགི ་པ), “Wedding of Spring” (བདདུ ་ར་ིྩ དགའ་སནོྟ ” by the Sumbe Khamba Ishbaljir were the main materials in thisstudy. In addition, we used to take some sort of sources and manuscripts that related to our studies andcomparative historical method, analysis and synthesis method were used in the studies.Results: According to resources we found, Sumbe khamba Ishbaljor detailed a number of new theoreticaland practical concepts which were never or seldom mentioned in The Four Medical Tantras, in his bookRashaany Dusal (“Drop of Spring”). He expanded the list of common diseases from three wind (khii), bile(shar), phlegm (badgan) to 6 (wind, bile, phlegm, blood, yellow fluid (shar us), nyan or khorkhoi (virus andbacteria) and prescribed treatments for each of them. In addition, he established a concept of 10 importantdiseases and gave them satiric names making them easy to read and understand as well as taught theways to treat them.Ishbaljir developed the traditional medicine and made a reform in it by the discovery of three more causesof diseases blood, bile us and bacteria in addition to the existing causes wind, bile and phlegm. His theorywas that disease causes are wind, bile, phlegm, blood, yellow fluid, and bacteria or virus individually and\or combined. Wind, bile, phlegm, blood, yellow fluid, and bacteria or virus called as diseases. Ishbaljir’sconcept of bacteria duplicates that of some Noble Prize laureates. At the beginning of the 20 century, anAustralian scholar Barry J. Marshall and J. Robin Warren won the Noble Prize for their discovery of the“Bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease” in 2005.Conclusions:1. Sumbe Khamba Ishbaljir expanded the list of common diseases from 3 wind (khii), bile (shar), phlegm(badgan) to 6 (wind, bile, phlegm, blood, yellow fluid (shar us), nyan or khorkhoi (virus and bacteria)and prescribed treatments for each of them.2. Sumbe Khamba Ishbaljir established a concept of 10 important diseases and gave them satiric namesmaking them easy to read and understand as well as taught the ways to treat them.3. The Four Medical Tantras did not mention stomach bacteria. It is pity that Sumbe Khamba Ishbaljirfound out the stomach bacteria disease in the 18th century.

Tea is a product which contains of natural antioxidants for relaxation, prevention and healing effects, biofl avonoids, isofl avonoids, organic acids, glycoside and other substances. In order to use this valuable natural commodity economically with keeping the ecologicalbalance and provide quality and safety, nowadays, fi ltered tea bags become popularfor producing. The international standards forinfusion substance portion, antioxidants content, and quality and safety specifi cations for this type of tea are the important measures for preventing of fake products. The sustainable quality study is one of the main parameters, indicating the drug quality, safety and effects. The validity and storageconditions of the drug and its active agents are determined by the study.Aim: To determine the validity /expirationperiod/ of liver protection effect “Tunamal” tea by studying the parameters of its sustainable qualityObjective: To defi ne the expiration time by analyzing annually the moisture, ash, infusion substance, essential oil, appearanceof dry substances, ascorbic acid, content ofthe fl avonoids, mixture of heavy metals and microbiological parametersMaterials and methodologyCommodity of the study, which are the creeping thyme and rosehips fruits, were collected from the territory of Erdene county of Central province and Eruu county of Selenge province respectively; and dried in accordance with the standards. The moisture, ash, infusion substance, essential oil, appearance of dry substance, ascorbic acid, content of all fl avonoids wereanalyzed by methods set by Mongolian national pharmacopoeia, radioactive contamination and presence of heavy metals – by atomic absorption spectrometric method, afl atoxin B1 and pesticide residues – by thin-layer chromatography respectively,; and microbial contamination was analyses in the Steward geological laboratory in the culture medium as well as in the drug inspection laboratory of the State professional inspection authority.

Background: The main principles of pharmacotherapy are to provide pharmaceutical care with right medicine, right doses, in right time. If the treatment plan can be evidence based, it will improve treatment efficacy andsafety, can prevent from drug related adverse event and reduce the health care costs. Assessing the drug related problems in elderly patients is a main health care and safety issue for the health care system. Ischemic heart disease (IHD) is one of major cause of mortality and one of the main diseases of morbidity in Mongolia and in the Worldwide.Objective: Aim of this study was to conduct aretrospective study on inappropriate prescribingpattern among elderly patients with Ischemic heart disease who were treated in tertiary level hospitals ofUlaanbaatar.Methods: Total of 438 patient’s records who were treated with diagnosis of IHD during the 2011 –2012, was collected randomly from main three state hospitals of Ulaanbaatar. A retrospective analysis of inappropriate drug prescription was used Beers criteria (2012).Variables of study were patient’s diagnosis, age, sex,names, doses and route of medications.Results: The mean age of the participants was67.38±0.24 and 54.6% of participants were male and 44.4% were female. The trends of rational use of drug and number of drug and drug cost per patients were different in each tertiary level hospitals of Ulaanbaatar. In I state hospital, number and cost of drug per patients werehigher than second and third state hospitals. The result were shown that in all three hospitals, more than 50 percent of total drugs per patients were injection, less than 50 percent of total used drug per patients were from standard therapeutic guideline. The most common inappropriately used drugs were as follows: amiodarone (16% at the I state hospital; 10% at the II state hospital; 3% at the III state hospital),dipyridamole (51% at the I state hospital; 3% at the II state hospital), amitriptyline (29% at the I state hospital; 20% at the III state hospital), nifedipine (33% at the II state hospital).The use of that are inappropriate with certain medicalconditions were common in case of IHD patients with peptic ulcer comorbidity. Non-steroid anti-inflammatory drug + acetyl salicylic acid combination were used in 3% of patients at the I state hospital, in 4% of patients at the II state hospital and 1% of patients at the III state hospital.Conclusion: Among the medications used for elderly patients with IHD, 15 medications were listed in potentially inappropriate medication in elderly (Beers criteria) independent of diagnosis. In I and II state hospitals, usage of potentially inappropriate medication were greater than III state hospital.Key words: inappropriate drug, Beers criteria,ischemic heart disease, treatment guideline

Health Science University of Mongolia has been using traditional teaching method which is originated from German Scandinavian learning and introduced by Russian to Mongolian medical science teaching. Generally, we have used traditional teaching method for long time but since 2000 multiple teaching methods are introduced. The purpose of this study was to compare Problem Based learning (PBL) and traditional teaching method for histology teaching class. The study involved 4groups’ students at their second semester of a laboratory based histology course at HSUM. There were 2 groups’ students in the Problem Based Learning group and same 2 groups’ students in the traditional group. Overall, results of this study suggest that Problem Based Learningapproach has positive influence on students’ achievement in masteringtheoretical knowledge about histology learning for these particular groups of students. Implication of the results suggests that traditional and Problem Based Learningmethod combination can be more effect

Introduction: Last Decades, Date by date medical developments providing friendly, high-efficiency treatment equipment and services in developed countries are working toward an advanced, as our country medical services are trying to that country’s technology has been introduced. In our country every day there is only surgical care necessary to endocrine gland disorders, including most common thyroid surgery. It is open and robotic assistant endoscopic surgery in the world. But robotic assistant endoscopic surgery is too expensive and impossible in our country. Thus we chose Thunderbeat for open thyroid surgery in especially huge enlarged goiter and vascularized goiter to try prevent bleeding, recurrent laryngeal nerve palsy and post operation hematoma and other complications Thunderbeat is new generation instrument combines an advanced bipolar clamp to the existing ultrasonic cutter. Materials and Methods: M 51-years-oldwoman was admitted to Mongol Hyundae hospital because of front of neck pain, multi nodular goiter, tachycardia, sweaty and not controlling emotion. Anamnesis: She diagnosed to Thyrotoxicosis in 2005 and she took medicine last ten years but not controlling that poisoning. Status locals: Huge enlarged goiter in front of her neck Treatment plan: 1. Preoperative Preparation 2. Operation: Open total thyroidectomy 3. Medicine 4. Wound dressing 5. Observation We did operation after day of admission day, Patient is placed in a Semi erect position with a folded sheet underneath the shoulders so that the head is sharply angulated backward on the multifunctional surgical table under general anesthesia. We used thunderbeat from muscular to all procedures, dissection both thyroid gland and isthmus after Kocher skin incision and sub skin tissue dissected. There is no complication while procedure and post operation days Result: Nodular hyperplasia of thyroid gland with focci of micro adenomatous change Conclusion: Thunderbeat in use open thyroid surgery first outcomes blood loss than 30ml, no injury of recurrent laryngeal nerve and no penetration ligament of Berry while procedure, second outcomes no hematoma, painless, wound healing process faster and short time hospitalization.

Liver disease accounts for approximately 2 million deaths per year worldwide and is responsible for 4% of all deaths. Acute hepatitis accounts for a smaller amount of mortality, with complications from cirrhosis and other chronic liver diseases being the main causes of death. It is mostly brought on by nonalcoholic liver disease, alcohol abuse, infections (chronic hepatitis B and C viruses), and air pollution.
In the last 10 years, the number of deaths caused by hepatocellular carcinoma has been continuously increasing in Mongolia, and it ranks first in the world in terms of deaths caused by hepatocellular carcinoma per 100,000 population, which is 8 times higher than the world average.
Mongolia is one of the most polluted countries in the world. Globally it is estimated that 9 out of 10 breathe polluted air and about 7 million deaths are attributed to air pollution. Studies on epidemiology have found an association between ambient air pollution and some liver diseases, including cirrhosis, liver cancer, and fatty liver disease related to metabolic disorders. This is an issue with global health.
Exposure to PM2.5 is linked to the development of inflammation, which may be a major risk factor in the advancement of non-alcoholic fatty liver disease. According to the literature review, exposure to PM is associated with systemic inflammation, a rise in plasma triglycerides, LDL and VLDL, pro inflammatory cytokines, and insulin resistance.
Many epidemiological and ecological studies were done in Mongolia on air pollution and health. However, it is still not clear how much ambient air pollution can cause cirrhosis and non-alcoholic fatty liver disease incidence in Mongolia.

Introduction: Last Decades, Date by datemedical developments providing friendly,high-efficiency treatment equipment andservices in developed countries are workingtoward an advanced, as our country medicalservices are trying to that country’s technologyhas been introduced. In our country everyday there is only surgical care necessary toendocrine gland disorders, including mostcommon thyroid surgery. It is open androbotic assistant endoscopic surgery in theworld. But robotic assistant endoscopicsurgery is too expensive and impossible inour country. Thus we chose Thunderbeatfor open thyroid surgery in especially hugeenlarged goiter and vascularized goiter to tryprevent bleeding, recurrent laryngeal nervepalsy and post operation hematoma andother complicationsThunderbeat is new generation instrumentcombines an advanced bipolar clamp to theexisting ultrasonic cutter.Materials and Methods: M 51-years-oldwomanwas admitted to Mongol Hyundaehospital because of front of neck pain, multinodular goiter, tachycardia, sweaty and notcontrolling emotion.Anamnesis: She diagnosed toThyrotoxicosis in 2005 and she tookmedicine last ten years but not controllingthat poisoning. Status locals: Huge enlargedgoiter in front of her neckTreatment plan:1. Preoperative Preparation2. Operation: Open total thyroidectomy3. Medicine4. Wound dressing5. ObservationWe did operation after day of admissionday, Patient is placed in a Semi erect positionwith a folded sheet underneath the shouldersso that the head is sharply angulated backwardon the multifunctional surgical table undergeneral anesthesia. We used thunderbeatfrom muscular to all procedures, dissectionboth thyroid gland and isthmus after Kocherskin incision and sub skin tissue dissected.There is no complication while procedureand post operation daysResult: Nodular hyperplasia of thyroidgland with focci of micro adenomatouschangeConclusion: Thunderbeat in use openthyroid surgery first outcomes blood lossthan 30ml, no injury of recurrent laryngealnerve and no penetration ligament of Berrywhile procedure, second outcomes nohematoma, painless, wound healing processfaster and short time hospitalization.

BackgroundIgA nephropathy and MPGN are common glomerulonephritis in the world that progresses slowly andrenal function can even remain unchanged for decades. Clinically, it presents by isolated hematuria,proteinuria. Histologically, IgA nephropathy presents with acute glomerular damage, mesangial cellproliferation, endocapillary leucocyte infiltration, and crescent formations, these lesions can undergoresolution with sclerotic healing. Since 2013, renal biopsy has been done at the First Central Hospitalof Mongolia a few times. However, the confirmative diagnosis of IgA nephropathy and MPGN remainunknown in Mongolia by renal biopsy. Therefore, we intended to test renal biopsy techniques andconfirm its diagnosis by renal biopsy at the Second Central Hospital of Mongolia.MethodsUltrasound guided renal biopsy had been done for four patients by nephrologist at the Departmentof Nephrology of the Second Central Hospital of Mongolia. All four specimens were evaluated assatisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissuewas divided into two tips: one piece for routine H&E stain and special stains, including Masson’strichrome, and PAS stain; another piece for immunofluorescence by frozen section, which werestained with IgG, IgM, IgA and complement component 3 (C3). Each case was screened by threepathologists.Results:The case which shows mesengial widening, mesengial hypercellularity under the light microscopyor mesangial granular deposition of IgA and C3 by immunofluorescence was diagnosed as IgAnephropathy. We obtained crescent formation with glomerular adhesion in most cases. In addition, weobserved secondary MPGN in one case, which is caused by hepatitis C virus infection.Conclusion: Probably, it is a new step for developing pathologic diagnosis for nephrology in Mongolia.We needs further study for improving renal biopsy technique and confirming the diagnosis of IgAnephropathy and MPGN using electron microscopy and pathological report by oxford classification forIgA nephropathy.