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.

Mongolia has a long history of traditional medicine and it is greatly related with the nomadic culture that has been developed along with lifestyle, diet, and animal-husbandry works. Traditional Mongolian Medicine (TMM) is based on Buddhist philosophy, cosmo-energical teachings in 5 elements. It belongs to the Eastern medicine which originated from Indian and Tibetan traditional medicine. There is wide range of theory and conception source in Mongolian traditional medicine, which needs scientific explanation. Important branches of scientific study might be divided into following topics: theory (to gather information from old literature and study fundamental principles of traditional medicine), phytochemistry (strives for obtaining active principles from natural medicinal materials and standardize new preparations), pharmacology (to study pharmacological activity and mechanisms), exploration and cultivation of medicinal plants. Drug technology research activities have been intended mainly to produce new medicaments based on traditional recipes. During redevelopment period of traditional Mongolian medicine 1 academician of Mongolian Academy of Science, 4 Doctors of Science, and 28 Philosophy Doctors and many researchers and traditional medical doctors were born. Within historical study was done the review of traditional medical ancient treasures (Ts.Khaidav, 1975) and was developed methodology aspects of Mongolian and Tibetan traditional medicine (B.Boldsaikhan) and historical background and Buddhist philosophical complex property (S.Seesregdorj, 2002). New concept of Membrane Structure of Three elements theory (M.Ambaga, 1990) and the foundation of the theory and methodology of Mongolian and Tibetan medicine (B.Dagvatseren, 1995) founded modern scientific interpretation of Traditional medicine. Beside of fundamental and historical research scientific explanations of diagnosis (N.Tumurbaatar, 1998, Sh.Bold, 1998), therapy (scientific explanations of blood letting treatment by Pr. D.Tserendagva, 2000) and prevention were done. Dr. B.Boldsaikhan developed a program supply of diagnostic expert system in 1996.

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.

In this study, the effects of traditional drugs such as Zachun-13 and Sampilnorov on serum levels of tumor necrosis factor (TNF) in mice model of arthritis induced by formalin were examined. Moreover, the effect of traditional external therapies including acupuncture, cauterization, pricking-cupping and massage on serum TNF levels in patients with spinal disk herniation and long-term back muscle injury. The study was done at the Research Center of Monos Medical University. Arthritis was induced by formalin (0.5 g/kg) injection into the phalangeal joints of mice. Sampilnorov and Zachun-13 were administered daily through oral tube at concentration of 42.5 mg/kg and 14 mg/kg respectively. Serum levels of TNF were determined 1, 3 and 7 days after initiating the treatment. Acupuncture, cauterization, pricking-cupping and massage were applied to patients once a day for 10 days. After 1 day of treatment, serum levels of TNF was increased 3.09 fold by formalin administration compare to control. This increase was reduced by Sampilnorov and Zachun-13 1.19 and 1.8 fold respectively. Serum levels of TNF were increased 3.0 fold in mice after 3 days of formalin administration. Sampilnorov and Zachun-13 reduced these increases 1.17 and 1.93 fold respectively. Serum levels of TNF increased 15.2 fold in patients with spinal disk herniation and long-term back muscle injury compare to normal range of TNF level. Acupuncture, cauterization, pricking-cupping and massage reduced increased serum levels of TNF in patients 1.3 fold. These results indicate that traditional drugs Zachun-13 and Sampilnorov and traditional external therapies including acupuncture, cauterization, pricking-cupping and massage can be effective for treatment of joint conditions by inhibiting TNF production.