Background Educating diabetic patients about their diseases encourages their families to learn as much as possible about the latest medical management and approaches, as well as informing healthy lifestyle choices, and supports their responsibility in improving their condition and quality of life through well-managed self-control. Goal To evaluate the outcomes of diabetes education in patients with T2DM. Materials and Methods The cohort survey was conducted at the Diabetes center of the State Central Clinical Hospital (SCCH) and District Health centers in Ulaanbaatar. Participants included 150 newly diagnosed patients with T2DM. Data collection was done by using internationally accepted questionnaire and anthropometric measurements and biomedical outcome measures such as Haemoglobin A1c levels, high density lipid (HDL), low density lipid (LDL), total cholesterol (TCh), triglyceride (TG), fasting blood glucose (FBG), blood pressure (BP), body weight (BW) at baseline and 3rd and 6th months of the follow ups. Statistical analyses were performed with the SPSS16 software. Results Diabetic patient’s knowledge (p=0.029) and self control of blood glucose (5.35±1.81 days in the last week) of newly diagnosed patients with T2DM improved statistically significantly (p=0.046) after 6 months diabetes education. Psychological problem areas in diabetes (PAID) score reduced in educated group 2.86% (95%CI 1.61 to 3.23) p=0.004 and points in illness perception questionnaire (IPQ) increased 8.95% (95%CI 5.31 to 10.1) p=0.001. After 6 months, the group of the newly diagnosed patients receiving diabetes education had decreased numbers in biomedical measurements: Systolic BP decreased 8mmHg (p=0.001), diastolic BP 2 mmHg (p=0.035), some anthropometric measurements including waist circumference (WC) decreased 2cm (p=0.014). Levels of HbA1C were 1.5% lower (p=0.001) in the diabetes educated group, LDL decreased 0.7 mmol/l (p=0.0001), and HDL increased 0.2% (p=0.036). Conclusion: 1. The data on the educated patients’ knowledge about diabetes, self control, psychosocial status, and illness perception are comparatively higher than those in the non-educated group. 2. The decrease in not only the levels of systolic and diastolic BP and WC of newly diagnosed patients with T2DM, but also levels of HbA1C and LDL together with the increase in levels of HDL indicates that the self control improves among educated patients.

Diabetes is known to be directly and indirectly associated with stress. Many researchers have reported that diabetes is actually induced by stress and several hormones includ¬ing cortisol are known to be involved.14 Though tight glycemic control is viewed as a primary indicator of favorable diabetes outcomes metabolic control , medication, and physical activity, contribute to a patient’s success in achieving desirable glycemic control. Our study aimed to evaluate improves depressive state in newly diagnosed patients with type 2 diabetes(T2DM) by education. The cohort survey was conducted in Ulaanbaatar. For the study we 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self-management control, beliefs about illness, depression. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software.The study involved newly diagnosed Type 2 diabetes 49,4±8,9 years men 65 (43,6%), women 85(56,7%) and 39,3% of the participants had a family history of diabetes. After 6 months self- control of blood glucose (p=0.046) significantly improved in educated newly diagnosed patients with T2DM. Problem areas in diabetes (PAID) score reduced in educated group -2.86 (95% CI -1.61 -3.23); (p=0.004) and illness perception questionnaire (IPQ) score increased 8.95 (95% CI 5.31-10.1); (p=0.001). Outcome shows positive improvements statistically increased diabetes self-management control IPQ score and decreased score PAID in the educated newly diagnosed patients T2DM.

DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p<0.003). There were statistically significant different between BMI, WC, BFP with normal (p<0.05). The weight, BFP were statistically significant different between gender BMI, WC, blood pressure were no significant between male and female (p>0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p<0.05), but there were no significant TG (p>0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.

Diabetes is known to be directly and indirectly associated with stress. Many researchers havereported that diabetes is actually induced by stress and several hormones includ¬ing cortisolare known to be involved.14 Though tight glycemic control is viewed as a primary indicator offavorable diabetes outcomes metabolic control , medication, and physical activity, contribute toa patient’s success in achieving desirable glycemic control. Our study aimed to evaluate improvesdepressive state in newly diagnosed patients with type 2 diabetes(T2DM) by education. The cohort survey was conducted in Ulaanbaatar. For the study we 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self-management control, beliefs about illness, depression. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software.The study involved newly diagnosed Type 2 diabetes 49,4±8,9 years men 65 (43,6%), women 85(56,7%) and 39,3% of the participants had a family history of diabetes. After 6 months self- control of blood glucose (p=0.046) significantly improved in educated newly diagnosed patients with T2DM. Problem areas in diabetes (PAID) score reduced in educated group -2.86 (95% CI-1.61 -3.23); (p=0.004) and illness perception questionnaire (IPQ) score increased 8.95 (95% CI 5.31-10.1); (p=0.001). Outcome shows positive improvements statistically increased diabetes self-management control IPQ score and decreased score PAID in the educated newly diagnosed patients T2DM.

DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p<0.003). There were statistically significant different between BMI, WC, BFP with normal (p<0.05). The weight, BFP were statistically significant different between gender BMI, WC, blood pressure were no significant between male and female (p>0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p<0.05), but there were no significant TG (p>0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.

Introduction Managers in the service sector are under increasing pressure to demonstrate that their services are customerfocused and that continuous performance improvement is being delivered. Given the financial and resource constraints under which service organizations must manage it is essential that customer expectations are properly understood and measured and that, from the customers ’perspective, any gaps in service quality are identified. Goal • SERVQUAL instrument in order to ascertain any actual or perceived gaps between customer expectations and perceptions of the service offered. • To point out how management of service improvement can become more logical and integrated with respect to the prioritized service quality dimensions and their affections on increasing/decreasing service quality gaps. Model of Service Quality Gaps There are seven major gaps in the service quality concept and three of them important gaps, which are more associated with the external customers are Gap1, Gap5 and Gap6. Gap1: Customers’ expectations versus management perceptions Gap2: Management perceptions versus service specifications Gap3: Service specifications versus service delivery Gap4: Service delivery versus external communication Gap5: The discrepancy between customer expectations and their perceptions of the service delivered Gap6: The discrepancy between customer expectations and employees’ perceptions Gap7: The discrepancy between employee’s perceptions and management perceptions According to this model, five dimensions are stated as follows 1) Tangibles. Physical facilities, equipments and appearance of personnel. 2) Reliability. Ability to perform the promised service dependably and accurately. 3) Responsiveness. Willingness to help customers and provide prompt service. 4) Assurance (including competence, courtesy, credibility and security). Knowledge and courtesy of employees and their ability to inspire trust and confidence. 5) Empathy (including access, communication, understanding the customer). Caring and individualized attention that the firm provides to its customers. The SERVQUAL approach contains a questionnaire that evaluates five generic service dimensions or factors through 27 questions, evaluating both expectation and performance using a seven point Likert scale. This approach evaluates service quality by calculating difference (gap) between customer expectations and perceptions (service quality= P – E). ‘P’ denotes customer perception of service or performance and ‘E’ denotes expectations before a service encounter deliver the actual. If the answer is negative, then dissatisfaction occurs. This equation is usually called gap analysis, but as it was emphasized, this approach only measures gap 5.

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.

Background: The medical works written by Darmo Maaramba Luvsanchoidog have been an important source for the theory, treatment, training and research of traditional Mongolian medicine. In recent years, number of his medical books written by dbu med (in English headless scriptures) have been found, but they are difficult to read or translate and have not been studied at all in Mongolia. Therefore, the study has been carried out to facilitate the use of handwriting medical scriptures by Darmo Maaramba Luvsanchoidog for research, teaching, and to explain complex words in his books. Purpose: Explain the difficult words related to precious medicines in the book called “legs bshad be ed’u dkar poi ‘phreng ba zhes bya ba bzhugs so” written by Darmo Maaramba Luvsanchoidog. Research methods: Methods of textual analysis for ancient books and analysis and synthesis were used in the study. Conclusion In the book “legs bshad be ed’u dkar poi ‘phreng ba zhes bya ba bzhugs so” written by Darmo Maaramba Luvsanchoidog clearly outlines the method of analyzing the sources of many precious medicines. Furthermore, the research identified that “legs bshad be ed’u dkar poi ‘phreng ba zhes bya ba bzhugs so” is a significant work to understand precious medicines in the main scriptures of medicine and thoroughly explained their content and terminology. In particular, ring srel (in English relic), which has long been forgotten in traditional medicine, has gained practical significance as it clearly explains its classification, nature, and use.

Background: Cancer incidence and mortality are steadily increasing both globally and in Mongolia. As these rates rise, traditional Mongolian medicine has long utilized herbal formulas for the treatment of gastric and esophageal cancers and precancerous conditions. One such formulation—Hot Natured 3 Herbs (HN3H)—comprises three species from the Ranunculaceae family: Atragene sibirica L., Ranunculus repens L., and Pulsatilla bungeana L.. However, scientific validation of its anti-tumor effects is essential. This study aimed to investigate the effect of HN3H in a tumor-induced animal model. Aim: To identify the biologically active compounds of HN3H and evaluate their effect in an experimentally induced tumor model in animals. Materials and Methods: The three herbs comprising HN3H—Atragene sibirica L., Ranunculus repens L., and Pulsatilla bungeana L.—were collected during their flowering stage (May–June) in Khishig-Undur, Bulgan province, and dried according to official procedures. Extraction was carried out by maceration in 96% ethanol at a 1:10 ratio. The concentrated extract was suspended in water (1:1) and successively fractionated with dichloromethane, ethyl acetate, butanol, chloroform, and n-hexane. The study was approved by the Research Ethics Committee of the Mongolian National University of Medical Sciences (Protocol №2020/03-04). A colorectal cancer model was established by subcutaneous injection of MC-38 cells (Kerafast, USA) into C57BL/6 mice. Immunohistochemistry was performed using CK20, CDX2, Ki67, and p53 antibodies at 1:100 and 1:200 dilutions. Results: The ethanol extract of HN3H contained 2.98±0.04% total phenolics and 2.16±0.05% total flavonoids. Body weight and tumor volume were measured daily with three repetitions. All groups showed a time-dependent increase in body weight. Mice in groups 1A and 1B received ethanol extract at 50 and 100 mg/kg doses; groups 2A and 2B received dichloromethane extract at the same doses. The negative control group was administered 0.5 mg/kg PBS orally, while the positive control group received intraperitoneal injections of 5-fluorouracil (5FU) at 10 mg/kg twice a week. Tumor growth increased in a time-dependent manner across groups. Compared to the negative control, tumor volumes in four treatment groups showed statistically significant reduction (p˂0.05), while no significant difference was observed when compared to the positive control (p=0.08). Histological analysis revealed necrosis in all groups, with variation in extent. Conclusion The ethanol extract of HN3H exhibited moderate levels of phenolic compounds and a high concentration of flavonoids. HN3H extract inhibited tumor progression and activated lymphocyte-predominant inflammation in tumor tissues, indicating potential anti-tumor activity (p˂0.05).