BACKGROUND: One of the confronted problems of health branch of Mongolia is to confirm pregnancy and delivery to health of mother and baby and to decrease early neonatal mortality and stillbirth. Rate of perinatal mortality becomes real index of health and quality of health care. In the world more than 6 million perinatal mortality and 2.6 million stillbirths occur in 1000 birth every year. In Mongolia last year’s birth increases and perinatal mortality hasn’t been decreased yet. By 2013 perinatal mortality of country and aimag 14.4 per 1000 birth, in eastern and khangai and central regions and Ulaanbaatar (UB) city it is fewer than the above mentioned average, but the western region it is 17.5 or 3.1 î/îî higher than average rate. GOAL: To study current situation of perinatal mortality in western region of Mongolia MATERIAL AND METHODS: On the base of statistical dates of perinatal mortality of Health indicators and dates of health authorities of western region of Mongolia in 2004-2013 we considered indications of stillbirth from 22 weeks of gestation and early neonatal mortality by trend criteria. RESULTS: In the period of last 10 years in the western region of Mongolia totally 94810 mothers gave a birth, perinatal mortality is 2347 or 24.7 per 1000 birth. 57.7% of total perinatal mortality is stillbirth and 42.3% is early neonatal mortality. Among 5 aimags of region in Bayn-Ulgii stillbirth is the highest (77.2%), in Gobi-Altai aimag early neonatal mortality is the highest (70.3%). Dates show that perinatal mortality rate is different among western region’s aimags. Trends of Mongolian western region’s perinatal mortality rate till 2016 years will increase in Zavkhan aimag by 8.6, and in Khovd aimag by 0.9; and in other aimags will decrease. CONCLUSION: Although perinatal mortality decreases in western region of Mongolia, it is always higher than average rate of country. Therefore it is necessary to improve quality of antenatal and prenatal care. By doing this trend of increasing and decreasing will become stable and further it will be decreased.

The pathogenesis of chronic obstructive pulmonary disease (COPD) encompasses a number of injurious processes, including an abnormal inflammatory response in the lungs to inhaled particles and gases. Other processes, such as failure to resolve inflammation, abnormal cell repair, apoptosis, abnormal cellular maintenance programs, extracellular matrix destruction (protease/antiprotease imbalance), and oxidative stress (oxidant/antioxidant imbalance) also have a role. The inflammatory responses to the inhalation of active and passive tobacco smoke and urban and rural air pollution are modified by genetic and epigenetic factors. The subsequent chronic inflammatory responses lead to mucus hypersecretion, airway remodeling, and alveolar destruction. This article provides an update on the cellular and molecular mechanisms of these processes in the pathogenesis of COPD. During the past decade a plethora of studies have unravelled the multiple roles of nitric oxide (NO) in airway physiology and pathophysiology. In the respiratory tract, NO is produced by a wide variety of cell types and is generated via oxidation ofL-arginine that is catalyzed by the enzyme NO synthase (NOS). NOS exist in three distinct are forms: neuronal NOS (nNOS), inducible NOS (iNOS), and endothelial NOS (eNOS). NO derived from the constitutive are forms of NOS (nNOS and eNOS) and other NO-adduct molecules (nitrosothiols) have been shown to be modulators of bronchomotor tone. On the other hand, NO derived from iNOS seems to be a proinflammatory mediator with immunomodulatory effects. Finally, the production of NO under oxidative stress conditions secondarily generates strong oxidizing agents (reactive nitrogen species) that may modulate the development of chronic inflammatory airway diseases and/or amplify the inflammatory response.

JUSTIFICATION: According to the World Health Organization (WHO), 6.6 million children under the age of five died in 2012 - more than 750 every hour. Most of these children could survive and thrive with access to simple, affordable interventions. The loss of a child is a tragedy - families suffer and human potential is wasted. WHO is improving child health by helping countries deliver integrated, effective care in a continuum, starting with a healthy pregnancy for the mother, through birth and care up to five years of age. Investing in health systems is important to delivering this essential care [1, 2]. GOAL: To study perinatal mortality, this is the most important reason of infant mortality in Mongolia. MATERIALS AND METHODS: A retrospective cohort study was conducted reviewing data from 2007-2011 using the ICD code P00-P96 [4] listing “certain conditions originating in the perinatal period”. Data was analyzed using Epi-Info 2000 and GIS software. RESULTS: Data from 2007-2011 showed that 3091 neonates died from conditions originating in the perinatal period and of these 58.7% (1814) were males. Furthermore, the results of this study showed that the leading causes of death were “respiratory and cardiovascular disorders during the perinatal period” (ICD code P20-P29). More specifically, the causes were: - Birth asphyxia (P21) - Respiratory distress of newborn (P22) - Congenital pneumonia (P23) CONCLUSION: National average deaths per 1,000 live births in Mongolia are 9.5—with the highest rates reported in Dornogovi, Uvurkhangai, Bayankhongor, Gobi Altai, Uvs, Zavkhan and Khovsgol.

IntroductionDigestive system diseases are accounted in 4th place of the causes of mortality that are might caused by Mongolian climates and the features of food nutrition. It is a very important to obtain the natural herbal drug which has less side effect, use in medical practice for an appropriated disorder. Therefore we are put an aim of obtain a new drug from Sanguissorba officinalis L. for the treatment of diarrhea. This herbal plant grows in botanical and geographical provinces such as Khangai, Khentii, Khuvsgul, Mongol Daguur and widely distributed in Mongolia. Sanguissorba officinalis L. containes tannin substance up to 20%. Rhizome, herbs, flowers of Sanguissorba officinalis L. are widely used for the Mongolian, Tibetan, Russian, German, Korean, Poland, Hungarian traditional medicine to treat diarrhea, gastrointestinal disorders and haemostatic. This study and research work was done by Pharmaceutical Technology and Management Department of School of Pharmacy, HSUM.GoalThe aim of the study is to solve the problem of technology to obtain a tablet formulation from Sanguissorba officinalis L.Materials and MethodsWe collected and dried the flowers of Sanguissorba officinalis L. in Kherlen soum, Dornod province on August of 2010, 2011 and 2012. Choice of the optimal extragent, suitable extraction method was defined by I.A.Muraviev, U.G. Pshukov methods. The fraction of granules were determined using the method by Kozein, the bulk density of granules was determined method by Lusy Wan Cheng, to obtain tablets used by wet granulation method, to establish quality criteria of liquid extract and tablets by Mongolian National First Pharmacopeia, and the statistic analyses were done by SPSS-17 programme, using t-criteria of Student Fischer.ResultWe had extracted liquid extract from flowers of Sanguissorba officinalis L. and it has been extracted by repercolation method German pharmacopeia modification. The technological parameters of liquid extract are the main important index to calculate the extragent correctly, to establish the material balance exactly, to extract the process efficiently, to develop technological regimentation and to base account of economical benefit. We determined the technological parameters as the optimal extragent is 40% ethanol; the effective extracting method is repercolation method German Pharmacopeia modification. For the development of tablets by wet granulation method from liquid extract using various binders and choose the optimal bender was mix starch and methylcellulose past. Tablets from Sanguissorba officinalis L. was standardized by such criteria, as the amount of biologically active compound, appearance, hardness, friability, average weight, weight variation, disintegration, dissolution, amount of heavy metals and microbiological contamination by Mongolian National First Pharmacopeia.ConclusionThe result of the study was done the technological parameters of liquid extract of Sanguissorba officinalis L. such as the optimal extragent, the effective extracting method. As the result of determining these parameters, it has much practical significance for establishing the technological condition to extract the biological active compounds completely from flowers of Sanguissorba officinalis L. In the result of the study to obtain tablets from fluid extract of Sanguissorba officinalis L. has been developed and the quality criteria has been defined.

Introduction: In order to Implement the Mongolian government's 2000 provisions for national health care, on May 28,2004, the Health Minister approved the "Home Care Nursing Service and Rules for Caring and Nursing" according to resolution # 136 and indicated that family clinic nurses should provide home care nursing services [6'71. Interestingly, it is noted that throughout the world, nursing home services have not been limited to family clinic nurses but are being delivered by nurses with diverse areas of specialization.Goal: Purpose of the study is to determine needs for making home nursing services to the population in some province and soum.Objectives:1. To comparatively search needs for providing home nursing services to citizens in the province and soum which were involved to the study.2. To determine nursing type which is required at home3. To develop needs of nurses who make home nursing servicesMaterials and Methods: Conducted studies among the 1109 people from the 520 families in 17 soums of five provinces such as Orkhon, Bulgan, Arkhangai, Khuvsgul and Selenge. We have chosen the clients with anamnesis who are repeatedly served and treated at the hospital for our study and had interviews with them. Questionnaire for citizens consists of 2 basic chapters including 17 questions which determine demographic information and needs of home nursing services. We asked and searched about needs of Home Care Nursing assistances under the 3 basic groups such as General nursing, Treatment nursing and Specialized nursing. After inserting study data into the SPSS-17 program, checked it by appropriate statistical methods (t, x2, fisher exact) and checked if difference between groups and relations has statistical truth.Results: 35.89 percent of clients who got involved to the study answered that they are interested in taking nursing and caring services at home. Also we consider needs for having home nursing at home according to numerical indexes in the provinces involved to the study, clients mostly want to be injected by intramuscular (25.88%), intravenous (31.02%) and IV fluid (30.57%). As we consider specialized nursing assistances at home under the types of needs, health education and assistance for people suffered with hemorrhage and injured people occupy major percent. Clients who got involved to the training, were asked question "With whom do you want to be made nursing assistance at home?" and 75.6% of them answered that they prefer nurses of family clinic.Conclusions:1. It was observed that 35.89% of clients who got involved to the survey, want to receive home nursing assistance and demands for home nursing is being increased with aging.2. Also we conclude that nursing after hemorrhage, nursing for injured patients and nursing for patients with cardiovascular disease occupies higher percent and it shows that percent of cardiovascular diseases and injuries is relatively high and clients' needs to receive nursing assistance at home are faced problems after they were discharged from hospital.3. 75.6% of people who got involved to the study are interested in taking home nursing assistance and we reached to conclusion that it is suitable to train nurses according to it.

Background: In Mongolia, leading cause of morbidity prevalence is respiratory system disease by 2010. The prevalence is 1027,73 per 10000 people. Comparison to 2000, it has been increased by 1,5-2 times. Another word, it shown that respiratory diseases hadn’t been decreased, but progressively increased in the last 10 year.By WHO estimation in 2008, future trend of mortality rate of the respiratory system disease would taken 3rd place in the leading causes of the mortality by 2030. Most common symptoms of the respiratory diseases are cough and sputum.Aim of the study: Aim of this study is to investigate some effects Sorool-4 drug on some respiratory diseases.Method of study: Experimental research method was used in this study. 30 laboratory white mouse, each weigh is 18-22 grams and 40 Vistar species rats, each weigh is 180-220 g were used in the study in where Inner Mongolian National University of China.0.25% Ammonium hydrochloridium solvent was inhaled to each mices for 10 seconds. After 3 day inhalation procedure, Sorool-4 drug was injected 10 grams per kg to mices, and Libexin was administered 4.3mg/kg per one time in next 3 day. During these 3 days, we measured cough for 3 minutes to each mices by ZOLY- 3 devices in everyday.White mices were classified into 3 groups, and then0.1 ml/10gram phenol aldehyde solution 0.2-0.25 ml per each mice injected to abdominal cavity. After 3 day injection, sorool-4 was administered 10 gram per kg and bromhexine 0.12 mg per kg, 3 times a day, for 3 days.Bacterial colony: Coagulase positive S.aureus DU 5789 and coagulase negative mutant DU5843 species were used in this study. These bacterias has stored in-700C in brain and heart infusion, and 10% glycerol and 5% non-fat milk were feed until used.Culture: According to CASH method, some changes were made. S.aureus was cultured in the TSA, BBL agar in +370C for 24 hours and diluted with pure non- endotoxin saline and centrifuged at 3000rpm for 7 days, +40C, 10 min per day. And then again diluted with cold pure saline, and diluted to 2х109-4х109 CFU ml by turbid meter. Prepared suspension has warmed to 450C, and mixed 10 ml suspension with 4% 10ml melted NOBLE agar.Experimental model: 0.2-10ml/10ml/g agar wasinjected to every mice tail vein.To develop cough model, 0.25% ammonium hydrochloridium solution was inhaled 10 sec for 3 days in YLS-8A device. After 3 day, in three groups, mices of the each group coughed mean 25.6±3.6 amount. Sorool-4 drug and Libexin were administered 10mg/kg to treatment group 1 and 4.3 mg/kg to treatment group 2, each respectively. After administration these drugs, counted cough amount of each mice for 3 min in YLS- 8A device in 3 day.Conclusion: Because of amount of sputum of treatment group 1 and 2 is more than control group, Sorool-4 is not efficient as same as bromhexine, but this showed that it has mucus expectorant effect.As shown results, sorool-4 has anti-inflammatory effect. It would be more effective using sorool-4 with antibiotic.

Neonatal mortality is declining in our FIRST MATERNAL HOSPITAL last few years but the number of preterm babies are increasing. Globally, the main causes of neonatal deaths are preterm birth complications (35 per cent), intrapartum-related complications (complications during labor and delivery) (24 per cent), and sepsis (15 per cent). Together, these three causes account for almost three quarters of all neonatal deaths.We have analyzed 51 medical records who have died in neonatal intensive care unit of Urgoo maternal hospital. 23 questionnaries were analyzed.Premature infant deaths basis of the mother’s birth disorders and mother abnormality. Furthermore, abruption placenta 25.1%, caesarian section 57.1%, hypertonus–21.4%.Prevention of fetal lung under development treatment did not affect 67.8% mortality. Chronic hypoxia is 46.4%, not a day mortality 25.4%, treating was 1–3 days mortality rate is 57.1% is the ability to live shows children die. Compared treated for complications premature infant mortality is 14.2%, causes premature infant mortality is ischemia of brain.Based on the study of maternal hospital mortality in the treatment of premature infants most important thing is CPAP machine it is premature to reduce infant mortality 30.7per cent. Is necessary to use with respiratory distress syndrome infant most important thing is surfactant treatment.

BACKGROUND. One credit hour lecture is the most common type of learning method at the Mongolian National University of Medical Sciences. Long term lectures tend to be tedious and the students become passive receivers. Making the lectures more interesting is a solution to overcoming these problems. The study was done prerequisite for the necessity of comparative analysis of student satisfaction level, quality improvement and methodological innovation for traditional, interactive and online type of lecture evaluation. Study of the effects of lecture methods on student satisfaction level MATERIAL AND METHODS. The lecture satisfaction level was determined by 408 medical students of 3-5th years. The randomly pickedthird year students were given two types of lectures with different topics. This lecture lesson included 8 credit hour sessions; a 4 hour lecture was selected randomly and was given interactively. After that the students were asked to do a five section questionnaire inquiring their opinion. Statistical analysis was done with SPSS software version 20. RESULTS. According to the research result the student satisfaction level for lecture lessons scored 3.2. The fact that traditional lectures scored 3.74, interactive lectures scored 4.37 showed that use of innovative lecture methods had a direct effect on student satisfaction. (p<0.005)