Introduction : In recent years, there has been a significant increase of cerebrovascular disease in Mongolia, which is the second leading cause of mortality. There are dozens of Mongolian traditional medicine which is good efficiency for cerebral ischemia that contains musk. Aim: Therefore, we aimed to investigate the effect of musk under the cerebral ischemia/reperfusion in rats. Materials and Methods: Cerebral middle cerebral artery occlusion was established in male rat (90-minute occlusion followed by 24-hour reperfusion). Rats were divided into following groups: control group, ischemia group (cerebral ischemia and reperfusion), nimodipine administrated group (cerebral ischemia and reperfusion + treated with nimodipine), musk administrated group (cerebral ischemia and reperfusion + musk 50 mg/kg and 100 mg/kg). The brain tissue levels of IL-1β, TNF-α, IL-6, IL-10 cytokines were measured using enzyme linked immunosorbent assay (ELISA) every 1, 3, 7th days. Results: Levels of cytokines (IL-1β, TNF-α and IL-6) were significantly lower in musk treated group compared to brain ischemia group (p<0.05). In contrast, treatment with musk was significantly improved neurological function with stimulation of M2 phenotype microglia cells and increased the anti-inflammatory cytokine level of IL-10 in the ischemic hemisphere of brain in rats Conclusion The mechanisms of musk are associated with increasing the brain tissue levels of IL-10, and reducing the levels of proinflammatory cytokines such as IL-1β, TNF-α, IL-6 subsequently stimulating neurogenesis and reduced ischemic zone. Musk may have neuroprotective effects against cerebral ischemia with stimulating M2 phenotype microglia cells in the brain. Regarding the ELISA, the effects of musk may be due to anti-inflammatory properties through inhibition of some of proinflammatory cytokines and stimulation of anti- inflammatory cytokines.

BACKGROUND. Congenital Cleft Lip and/or Palate (CL/P) is a common craniofacial birth defect and occurs 1 per 500-700 live births in average. Children with CL/P at a higher risk for speech/language problems due to the anatomical and structural differences in the oral and nasal cavities, Velopharyngeal Insufficiency causing speech disorders with articulation, phonation, and resonance, respectively. It leads to long-lasting adverse outcomes, influencing quality of life and causes obstacles in child’s socialization. Speech in 2007 Therapy team of School of Dentistry ( G. Ariuntuul , B. Bulgan, U. Azzaya, B. Batsukh, M. Bat-Erdene), Mongolian National University of Medical Sciences (MNUMS) (former Health Sciences University of Mongolia) established and successfully conducted a first clinical speech therapy sessions for children with clefts in Mongolia based on the Department of Oral and Maxillofacial Surgery (G. Ayanga et al.) of National Maternal and Children’s Health Center (NMCHC). Since 2012 the speech therapy team of School of Dentistry, officially transferred the equipped operating speech room to NMCHC and speech pathologist B. Bulgan, supervised and trained by Ariuntuul G. recruited by NMCHC for a full time position and working as a member of multidisciplinary team till present. OBJECTIVES. To assess and analyze registry data of children with clefts, visited speech therapy sessions of speech pathology team of School of Dentistry, MNUMS during 2007 through 2012. MATERIAL AND METHODS. Registry based retrospective study was conducted to obtain demographic and speech disorder related data of children with clefts, visited speech therapy sessions between 2012-2017 at the NMCHC. RESULTS. In total 203 participants are attended the speech therapy sessions: 103 male (51%), 100 female (49%). Out of total 203 children 144 (71%) had Cleft Lip and Palate (CLP), 44 had cleft palate only (22%), 15 had cleft lip (7%), respectively. Average age for primary cleft surgery was 1y13m, where as for secondary was 4y22m. CONCLUSION. For speech therapy session for children with clefts boys were dominant compared to girls (1:1.03). By the types of clefts children diagnosed with Cleft Lip and Palate was prevalent to attend treatment classes. There is a need in early CL/P diagnosis, using birth screening and furthermore, traning of speech therapists/pathologists are important for development of multidisciplinary team, surgery outcome and improvement of quality of life of children with clefts.

Background: Among the total healthcare waste generated from health-related activities, 10–20% is considered haz ardous, posing significant threats to both the environment and human health. Approximately 3% of healthcare waste is pharmaceutical waste. In Ulaanbaatar city, an estimated 2.65 tons of healthcare waste is generated daily (0.78 tons of medical waste and 1.87 tons of general waste). With the continuous increase in pharmaceutical consumption, the improper disposal of pharmaceutical waste has emerged as a major environmental concern, adversely affecting nature, animals, and the food chain. Contamination from pharmaceutical waste, such as the development of antibiotic resistance, is closely linked to inadequate public awareness of waste management. Aim: This study aimed to assess the knowledge, skills, and attitudes of pharmacy technicians in community pharmacies regarding pharmaceutical waste management. Materials and Methods: A cross-sectional survey was conducted among pharmacy technicians across Mongolia. As of 2023, there are 4,959 licensed pharmacy professionals in the country. Using a representative sampling method, data were collected from 360 pharmacist and pharmacy technicians. Data were analyzed using MS Excel and SPSS version 26. Results: A total of 360 pharmacists from both urban and rural areas participated in the study. The assessment was based on a 5-point Likert scale, with scores of 1-2 considered negative and 3–5 considered positive. The average scores for knowledge, skills, and attitudes were 3.3, 3.06, and 3.25 respectively. While individual scores were satisfactory, the results of questions targeting social awareness were relatively low. Conclusion The knowledge, skills, and attitudes of pharmacy technicians regarding pharmaceutical waste management were found to be satisfactory. However, to further improve knowledge levels, it is recommended to implement additional training programs related to pharmaceutical waste management among pharmacy technicians.

Background: Reconstruction of mandibular and maxillary defects resulting from malignant tumors has remained a complex challenge in recent years. Defects caused by tumors—as well as trauma, inflammatory diseases, and congenital anomalies—lead to impaired essential functions such as mastication, swallowing, and speech. Prior to the 1950s, reconstruction of maxillofacial hard tissue was not commonly performed. Instead, metal plates were used to reestablish bony continuity, and surrounding tissues were utilized to close soft tissue defects, without effectively restoring function. With modern advances in three-dimensional (3D) virtual planning, it is now possible to accurately plan free bone flaps for reconstructing jaw defects. During surgery, manually bending reconstruction plates to fit donor bone precisely is often not feasible. Preoperative 3D planning allows for precise fabrication of surgical guides and fixation plates, improving accuracy and significantly reducing operative time. Additionally, incorporating dental implant planning into the reconstruction process facilitates restoration of both structural and functional outcomes. Aim: To evaluate the outcomes of mandibular defect reconstruction using scapular free flaps in Mongolia and explore potential approaches to optimize the technique. Materials and Methods: This was a case study series. Data from reconstructive surgeries performed at the National Cancer Center of Mongolia, Central Dental Hospital, and the Mongolia-Japan Hospital were collected. Variables included patient age and sex, etiology of the mandibular defect, size of the scapular bone segment, operative time, ischemia time of the free flap, number of vascular anastomoses performed, and pedicle length. For 3D planning, CT scans of the patient's head and lower limb (slice thickness <1 cm) were used to generate 3D models via the 3D Slicer software. Cutting guides for the mandible and scapula (ASIGA), as well as the reconstruction models (AMS), were printed using a 3D printer. Results: A total of 400 free flap reconstructions were performed during the study period. Of these, 29 cases involved reconstruction of mandibular defects using scapular free flaps. The mean age of patients was 40.0 ± 18.3 years, with 52% (15 patients) being female. The etiologies of the defects included malignant tumors (13 cases, 45%), benign tumors (6 cases, 21%), and pre-existing defects (10 cases, 34%). In one case, tumor resection and mandibular reconstruction were performed using 3D planning. The total operative time was 9 hours and 30 minutes, and the ischemia time was 2 hours and 40 minutes. Conclusion Between 2012 and 2025, a total of 29 mandibular reconstructions using scapular free flaps were performed in Mongolia. Traditional reconstruction methods were associated with prolonged ischemia time. The use of 3D surgical planning has shown potential in significantly reducing ischemia time and improving surgical outcomes.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.