Palliative medicine deserved to improve quality of life of patients with advanced, incurable diseases. During last 13 years palliative care workers tried to palliate the pain, physical, psychological, spiritual symptoms of suffering, but they never measured the quality of life of palliative care patients. The term quality of life is used to evaluate the general well-being of individuals and societies. 111 countries of the World established Country QOL Index. Quality of life should not be confused with the concept of standard of living, which is based primarily on income, should not be confused with quality of health services, which is based on medical supplies, equipment, quality of medicine, education level of health workers. Health related quality of life (HRQOL) is “The degree to which a person enjoys the important possibilities of his or her life”. Health related quality of life index not established for all medical specialties. Some tools for measuring quality of life established for diabetic patients (DQOL), cancer patients (Ca QOL), HIV patients (HIVQOL), and palliative care patients (Pa QOL). In Mongolia since 2000 started to talk about quality of services and in 2008 started program on quality of health services, but never provided study of health related quality of life of any patientTo provide the study of quality of life index within palliative care patients and compare quality of life index with pain score and score of other physical, psychological, spiritual suffering of palliative care patientsWe provided study of quality of life index within 60 palliative care patients by MISSOULA-VITAS®- 15 quality of life index, pain score by Wong Baker scale, symptoms of suffering by Anderson method, functional activities by Karnofsky performance scale, psychological problems by hospital anxiety scale23.3% of patients were up to 45 years old, 76.6 % were older 45. 70% of palliative care patients in our study were patients with cancer, 30% were palliative care patients with non cancer pathology. The mean Quality of life Index of total palliative care patients was 37.7. They had more common symptoms of suffering, like pain (90%), fatigue (83.3%), weight loss (83.3%), poor appetite (66.6%), thirst (66.6%), nausea (53.3%), constipation (60%)., depression (66.7%) and anxiety (70%). 56.6% of palliative care patients had spiritual suffering because of false hope, lost of meaning, relationship problems, and forgiveness. Increasing the score of symptoms of physical, psychological, spiritual and social suffering correlated to decreasing the quality of life index.We need to develop comprehensive palliative care to improve quality of life palliative care patients.

To study the correlation within psychological and social suffering in palliative care cancer patientsWe provide study within 100 palliative care patients with cancer stage 3-4. Depression was evaluated by San Diego hospice screening method with 3 questions. Anxiety was assessed by Spielberg -Hanin anxiety scale. Spiritual pain was assessed by San Diego hospice questionnaire, which includes main 4 factors of spiritual suffering, like cooperation, meaning of life, hope, forgiveness. Results of study was statistically evaluated by SPSS20 program.19% of patients had depression, 40% had anxiety, 46% patients had insomnia. 18% of patients with depression had spiritual suffering. 33% of patients with anxiety had spiritual pain. 31% of patients with insomnia had spiritual pain. Depression and spiritual suffering had mild correlation (R-0.318), anxiety and spiritual suffering had mild correlation (R-0.330), insomnia and spiritual suffering had very strong correlation (R-0.84). Psychological suffering of palliative care cancer patients increased with spiritual suffering and correlated with spiritual suffering. Especially insomnia had very strong correlation with spiritual suffering (R-0.84).

Environmental pollution, manufactured cities related to human activities such as soil contaminated by heavy metals pollution is one of the problems of the world’s major cities. Heavy metals are one of the main sources of pollution and the environment through biogeochemical cycles, and stored for a long time in the body of living organisms, poisoning is able to generate a negativeimpact on human health. Ulaanbaatar, 2010, along the main road in 11 point analysis of 22 soil samples from some of the heavy metal pollution in the soil lead levels were within normal limits,but the high concentration of topsoil is defined. A study conducted in 2011, but the average leadconcentration of 47.3 ppm healthy uncontaminated soil that is 3-4 times larger than defined.Heavy metals in the soil pollution, but pollution levels being conducted quarterly study and their sources of research have been identified. Heavy metal contamination of Ulaanbaatar soil andcalculation of the amount of heavy metals enter the body. Specialized inspection agency of Ulaanbaatar cities laboratory analysis conducted, the data used as descriptive research study design, participated in the study. Metropolitan areas in the 80 point balance divided analyzed by standard analysis of soil samples collected in spring and autumn, MNS5850:2008 was assessed by comparison with the standard.The average amount of lead in the soil of Ulaanbaatar 18.09 mg/kg (95%CI 13.7-22.4mg/kg), and cadmium concentration of 1.02 mg/kg (95%CI 0.7-1.3mg/kg), the mercury concentration of0.03 mg/kg (95%CI 0.006-0.05 mg/kg) that “The quality of the soil, and soil pollutants, maximum permissible elements” MNS5850:2008 standards, compared to less than the maximum allowed. Lead in the soil through the ingestion 11.75x10-3 mg/kg/day (95%CI 8.9-14.55x10-3 mg/kg/day) and cadmium 0.66x10-3 mg/kg/day (95%CI 0.45-0.84x10-3 mg/kg/day) of mercury 0.02x10-3 mg/kg/day (95%CI 0.0-0.03x10-3 mg/kg/day), and inhalation of lead 1.06x10-6 mg/m3 (95%CI 0.80-1.32x10-6 mg/m3) and cadmium 0.06x10-6 mg/m3 (95%CI 0.00-0.08x10-6 mg/m3), dermal adsorption lead 2.62x10-6 mg/kg/day (95%CI 1.98-3.24x10-6 mg/kg/day) and cadmium 0.15x10-6 mg/kg/day (95%CI 0.10-0.19x10-6 mg/kg/day) be digestible. Ulaanbaatar soil containing lead, cadmium, mercury, “The quality of the soil, and soil pollutants, maximum permissible elements” MNS5850:2008 compared to less than the maximum permitted levels. Three entry through access to the body of heavy metals in the soil to estimate the amount of mercury and cadmium lead digestive, respiratory and skin is a little more access.

Introduction: Oligophrenia makes 7.3% of all mental disorders in our country. It is known that almost 4% of all diagnosed cases of oligophrenia developed as a result of an inherited disturbance of amino acid metabolism. In most countries, the frequencies of inherited diseases of amino acid metabolism in the population are determined, and preventive screening programs of newborns are implemented. No study has been conducted so far into the issue of inherited diseases of amino acid metabolism in the Mongolian population. The goal of our survey was to detect inherited disorders of amino acid metabolism in the population at risk. Materials and Methods: The collection of samples and the laboratory analysis were carried out in the following two stages:
1. The screening analysis of 514 individuals diagnosed with mental retardation was performed by paper chromatography;
2. The positivecases detected by the screening were analyzed using high-performance liquid chromatography. Results: The screening testing detected twelve potential disturbances of amino acid metabolism. Out of the twelve positive cases four individuals refused to participate in the confirmatory stage of the survey. Among the remained eight individuals, cases of hypertyrosinemia, hypervalinemia, hyperglycinemia, hyperlysinemia and pyridoxine-dependent epilepsy were detected. Conclusions
1. The fact that cases of inherited disorders of amino acid metabolism were detected among mentally retarded individuals show that the disorder is one of causes of oligophrenia.
2. A screening program of newborns should be implemented for early detection of inherited disorders of amino acid metabolism.
3. A genetic counselling and testing centre could assist in reduction of number of individuals with inherited disorders.

Introduction: The treatment of antibiotic-resistant bacterial infections has become a pressing problem for humanity worldwide, and antibiotic-resistant bacterial infections are likely to be the leading cause of death by 2050.Due to the mutation of infectious disease-causing bacteria and the emergence of bacterial resistance due to the improper use of antibiotics, the time and cost of infectious disease treatment increases, and in some cases, it leads to an increase in mortality, so it is the focus of the health sector in every country, regardless of the income level of the population. In addition, bacterial resistance has a negative impact on public health, food safety, the environment, and the economy.
As of 2015, Mongolia ranks among the countries with the highest consumption of antibiotics in the world, with 64.41 units of antibiotics prescribed per 1,000 people per day. Bacteria resistant to broad spectrum antibiotics have increased dramatically, and among Gram-positive bacteria, drug-resistant Staphylococcus aureus (MRSA) has become one of the most common and dangerous cause Purpose: Determine the external structure of liposome-encapsulated antibiotics and evaluate their antibacterial activity. Materials and Methods: We conducted this study using an experimental research design. Phospholipids were isolated by intermittent evaporation, antibiotic encapsulation by freeze-thaw method, and antibiotic sensitivity was determined using standard strains by disc diffusion andmicro dilution method. Research ethics: Permission to submit the survey was granted by the Ethics Review Committee of the MNUMS. The survey was granted in accordance with the rules and regulations. Results: In liposome-encapsulated antibiotic sensitivity assays, azithromycin and clarithromycin did not form sacred circles, whereas doxycycline hyclate was sensitive by forming a 16 mm circle. Doxycycline hyclate encapsulated in liposomes formed a 16 mm circle with sensitive results, whereas blank liposomes were inactive. When the rabbits were infected with a standard strain of methicillin-resistant Staphylococcus aureus, the infected area was purulent 24 hours later. A cream containing antibiotics was started at this time. A deep wound was recovered after 12 days after the pus was removed. Nevertheless, after 24 days, the wound on the rabbit’s infected part healed and the hair on the scraped part grew back. Conclusion According to the dilution method, liposome-encapsulated doxycycline hyclate inhibited bacterial growth at 2-fold lower doses than pure doxycycline hyclate. In experimental animal models, liposome-based antibiotic ointment has shown antibacterial activity.

Hepatitis B (HBV) and C (HCV) are viral infections which can cause acute and chronic hepatitis and are the leading causes for hepatic cirrhosis and cancer, thus creating a significant burden to healthcare systems due to the high morbidity/mortality and costs of treatment. The risk of HBV infection in an unvaccinated person from a single HBV-infected needle stick injury ranges from 6–30. The prevention of HBV infection among HCWs has become a crucial issue. HBV can effectively be prevented by vaccination. A safe and effective HBV vaccine has been available since the 1980s and can prevent acute and chronic infection with an estimated effectivity of 95%. In 2017, the São Paulo Declaration on Hepatitis was launched at the World Hepatitis Summit 2017, calling upon governments to include hepatitis B vaccines for HCWs in national immunization programs. The vaccine is 95% effective in preventing infection and its chronic consequences and has an outstanding record of safety and effectiveness. Data on current hepatitis B vaccine coverage among HCWs in Mongolia is scarce. According to Azzaya et al, the protection level of the subjects was 67.2% >100 mIU/ml, 18.8%, 11-100 mIU/mL and 14.1%, 0-10 mIU/mL based on antibody titer level respectively among the vaccinated HCWs at the 2nd Central hospital. Thus, the HBV vaccination among public and private sector HCWs in Mongolia to inform the health authorities about the HCWs HBV vaccination status along with associated problems and challenges for further improving vaccination strategy among HCWs.

Background: Since ancient times, humans have used medicinal plants for medicinal purposes, and they have been recognized as beneficial to health. The basis of the treatment of these plants is phytochemical substances and in modern times, with the development of science and technology, the substances contained in these plants are extracted and medicinal substances and drugs are produced to treat many diseases. There are more than 800 medicinal plants in Mongolia, and their chemical structure and properties are studied in detail, biological activity and main features are discovered, and new medicines are produced. From the Thalictrum squarrosum plant, 25 compounds have been identified, such as triterpenoids with 17 carbon atoms in the cycloartane type ring, saponins, oleic acid glycosides, phytosterols and their glycosides etc., and the structures of 7 new compounds have been determined and the research on phenolic compounds and antioxidant activity has been limited, which is the basis for this research. Aim: Determination of total phenolic content and antioxidant activity of Thalictrum squarrosum. Materials and Methods: Total phenolic compounds were determined spectrophotometrically using Folin-Chicolte color reagent in 1.0 raw material of the Thalictrum squarrosum. Antioxidant activity was determined by DPPH, FRAB and ABTS in sub-extracts of 4 groups. Results: The total phenolic compounds of Thalictrum squarrosum were determined to be 1.9±0.001%. In the study of biological activity of Thalictrum squarrosum plants, the antioxidant activity of 4 groups of sub-extracts was tested by DPPH method, and the IC50 of total alkaloids (pH 9-10) was 201.58±0.1 μg/ml, ethyl acetate sub-extract 94.34±0.66 μg/ml, aqueous extract 824.18±0.08 μg/ml, and butanol sub-extract 128.75±0.58 μg/ml. When tested by ABTS method, the IC50 of total alkaloids (pH 9-10) was 35.83±0.44 μg/ml, ethyl acetate sub-extract 90.45±0.62 μg/ml, aqueous extract 104.19±0.93 μg/ml, dichloromethane sub-extract 156.44±0.48 μg/ml, and butanol sub-extract 170.03±0.61 μg/ml. When tested for antioxidant activity at 800 μg/ml by the FRAB method, the ethyl acetate sub-extract was 8946.16±14.79 μg/ml, the dichloromethane sub-extract was 1670.12±39.28 μg/ml, the butanol sub-extract was 4863.97±25.98 μg/ml, and the total alkaloids (pH 9-10) were 4897.99±58.12 μg/ml. Conclusion The ethyl acetate extract of the plant Thalictrum squarrosum has been found to be highly antioxidant active and total phenolic compound was 1.9±0.001%.

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.