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).

Background: Pressure ulcer is the worldwide problem which does not depend on age group and any patients could suffer from. Nursing human resource, working load, hospital equipment supply, well-organized training, lack of scientific study are influencing the prevention and nursing care for patients with pressure ulcer although the prevention of ulcer’s depends on continuous nursing care. Therefore, we aimed to improve participation of nurses and evaluate knowledge of nurses on pressure ulcer. Methods: Total of 249 nurses who are working in primary and referral level were chosen as study participants. We used cross-sectional study of analytic study and standard questionnaire with Likert scale. Furthermore, we operated evaluative standard questions of Pieper and Mott (PUKT; 1995), standard questions of pressure ulcer evaluation and nurse’s knowledge. All statistics analysis done by using SPSS 21.0 program. Results: 237 (95.2%) were females, 12 (4,8%) were males were participated in the study and 122 (49,0%) had received Diploma, 125 (50,2%) of them had received bachelor degree and 2 (0,8%) had master degrees. Furthermore, 175 of all participants were nurse practitioners and 74 of them were clinical nurse specialists. The knowledge regarding nursing care on pressure ulcer was evaluated as 2,41% were excellent, 20,88% were with average-knowledge and 76,71% were with poor-knowledge. Nurse’s knowledge regarding Evaluation of pressure ulcer were measured as 65,68% were with poor-knowledge, 33,33% were with average, and 0,8% were with excellent knowledge. Finally, knowledge about nursing care on pressure ulcer, 14,86% were evaluated as average, 85,14% were with poor-knowledge. Conclusion Most of nurse’s knowledge regarding prevention and nursing care for pressure ulcer is inadequate. Therefore, there is a need to improve nurse’s knowledge about prevention and nursing care on pressure ulcer.

BACKGROUND: In Ulaanbaatar, the first case of the pandemic influenza infection has been reported on 12 October 2010.By November 9, a total of 929 cases laboratory-confirmed had been reported to National Center for CommunicableDiseases (NCCD). Of these cases reported, 9 people died.METHODS: The objectives of the study were to describe patients who admitted and hospitalized at NCCD and to determineoverall attack rates among health workers, secondary attack rates among students of colleges and universities. Datawas analyzed using Epi-Info2000.RESULTS: Among 929 of laboratory-confirmed cases, 50.3% (95% CI 43.0-57.5) were males aged 23 (±14.9) in averagewith youngest – 7 months, oldest – 76 years old. Data analysis by districts among the hospitalized patients, showed32.8% (139) of total cases in Bayanzurkh district including the first case of the pandemic influenza infection. The majorityof patients who admitted and hospitalized to NCCD mostly experienced fever (288, 68.1%), dry cough (251, 59.3%),headache (203, 48.0%), sore throat (175, 41.6%). With 1020 physicians and health workers in total, 41.4% (422) ofthem work at NCCD, 35.4% (361) – at MCHRC. 11.1% of health workers out of total become ill with pandemic H1N12009 (overall attack rate 11.1%) with the most common symptom, 380C and higher fever (100.0%, 113), sore throat(83.2%, 94), cough (76.1%, 86) and runny nose (59.3%, 67). The higher attack rates of health workers by occupationwere doctor (18.0%) and auxiliary (13%). The secondary attack rates among university students for influenza-likeillness(ILI) were 12.9%. These secondary attack rates were higher among students of art’s college as compared withother universities (52.4%). For students, the main clinical symptoms were fever + sore throat (75.0%, 18), fever+ cough(70.8%, 17).DISCUSSION: In China, as of 27 September, 2009, from reported total 19981 cases infected with pandemic influenza,61.0% were males, mean age was 17, mainly affected with 83% school students that consistent with our study result.The similar results on clinical symptoms were obtained in Russia. Out of 130 patients, 28.6% had 380Ñ and higherfever, for 54.3% the body temperature reached 38.1-390Ñ where as 17.1% - higher 390Ñ and 96% had cough, 89%had muscle ache, 65% had headache, 14% had diarrhea.

: According to the elemental analysis survey, it is confirmed that the content of silicon (Si) and aluminium (Al) in coarse particles in the ambient air of Erdenet city is the highest (2457 ng/cm2, 1061.72 ng/cm2), and the content of black carbon (BC) is the highest (2699.9 ng/cm2) for the fine particles, respectively. In Orkhon Aimag, 221 new cancer cases were registered in 2023, 20.8 per 10,000 population, and 123 deaths were registered, which decreased by 20 cases from the previous year. Stomach, lung, and oesophageal cancers are the most common. Among the leading causes of diseases, diseases of the respiratory system are led by its prevalence rate of 1536 per 10,000 population, followed by the diseases of the digestive system prevalence rate of 821 per 10,000. Goal: To review the epidemiological tendency of diseases registered in Orkhon aimag between 2006 and 2022. Materials and Methods: The secondary data on outpatient 2006-2022 of Orkhon aimag was collected and analysed. All disease data followed the X International Classification of Diseases classification. The Ethical permission was obtained from the Ethical Committee at the Ach Medical University. All personnel information-related data was removed and no any name and location of personnel data was mentioned in the survey result. Results: In Orkhon Aimag, 524,927 cases of diseases were registered in 2006-2022. Respiratory system diseases were 29.82 percent of total diseases, digestive system diseases were 16.58 percent, genitourinary system diseases were 11.28 percent, cardiovascular system diseases were 10.45 percent, and skin and subcutaneous tissue diseases were 8.38 percent. Chronic heart diseases of rheumatic origin were registered for 11.59 percent of the population aged 50-54, hypertension diseases were registered 12.41 percent, and a steady increase was observed in the age of 20-54. Conclusions
1. When studying the structure of diseases among the population of Orkhon aimag, the respiratory, digestive, and genitourinary system, circulatory system and diseases of the skin and subcutaneous tissue are the first five leading causes of diseases and consisted 76.95% of the total number of diseases. In the study of analyzing the diseases of the circulatory system by age group and diagnosis, cases of ischemic heart disease and high blood pressure are found among children aged 15-19 years. CVD are more common among the population aged 40-54.
2. There is a tendency that skin and subcutaneous tissue diseases to be on the rise among the population.

Background: The relationship between alcohol consumption and sleep disorders is a complex issue. Although alcohol has a sedative effect in small doses, this effect diminishes when alcohol consumption exceeds an average of 7 grams per hour. Aim: To assess the sleep quality of individuals dependent on alcohol. Materials and Methods: A quantitative study was conducted using a survey-based research design. A total of 120 men participated in the study, including 60 alcohol-dependent individuals and 60 in the control group without alcohol dependence. The study utilized demographic questionnaires, the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, and the Alcohol Use Disorders Identification Test (AUDIT) to determine the level of alcohol dependence. Results: The average age of alcohol-dependent participants was 45.3±42.4 years, while the control group had an average age of 42.4±5.1 years. The AUDIT score for the alcohol-dependent group was 25.6±9.8, indicating a high level of dependence, whereas the control group scored 7.2±3.2, suggesting low consumption levels. This difference was statistically significant (t=3.98, p=0.001). In the alcohol-dependent group, sleep latency was prolonged (p=0.042), sleep efficiency scores were lower (p=0.012), and sleep disturbances were more frequent (p=0.039) compared to the control group. The overall PSQI score was 9.82±2.8 for the alcohol-dependent group, whereas it was 4.1±1.2 for the control group. A correlation analysis revealed that poor subjective sleep quality (p=0.023), sleep latency of more than 30 minutes (p=0.012), sleep efficiency below 75% (p=0.021), and sleep disturbances (p=0.019) were significantly associated with higher AUDIT scores. Conclusion Alcohol dependence negatively affects sleep quality, particularly in terms of subjective sleep perception, sleep latency, and sleep efficiency, leading to sleep disorders.

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder characterized by degeneration of upper and lower motor neurons, leading to muscle weakness, spasticity, dysarthria, and dysphagia. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune-mediated neuropathy that primarily affects nerve fibers specifically myelin sheets. Clinically, CIDP presents with distal muscle weakness, prominent sensory disturbances, and diminished or absent deep tendon reflexes. The co-occurrence of ALS and CIDP is exceptionally rare and poses significant diagnostic and therapeutic challenges due to overlapping and distinct clinical features. A Case: A 44-year-old male presented to the Department of Neurology at the Mongolia-Japan Hospital, Mongolian National University of Medical Sciences, with progressive muscle weakness in both upper and lower extremities, along with dysphagia, especially for solids with frequent choking episodes. The initial symptoms began in May 2023 with muscle fasciculations, followed by progressive weakness, initially in the right upper limb and gradually progressing to the left. By August 2023, the patient developed bilateral arm weakness, dysarthria, and worsening dysphagia. From August 2024, episodes of head drop were noted. A progressive weight loss of 11 kg was recorded since January 2024. Comprehensive neurological evaluation, including antibody profiling, electromyography (EMG), and nerve conduction studies (NCS), supported a diagnosis of amyotrophic lateral sclerosis with chronic inflammatory demyelinating polyradiculoneuropathy-like neuropathy. Outcome: One month after hospital discharge, the patient demonstrated improvement in self-care abilities and increased muscle strength in both proximal and distal upper limb muscles. Notably, there was marked improvement in overall clinical status. Conclusion To our knowledge, this is the first reported case in Mongolia documenting the simultaneous presentation of ALS and CIDP-like neuropathy. Globally, such cases are exceedingly rare. Timely and accurate diagnosis, along with appropriate treatment, contributed to improved clinical outcomes and a deceleration of disease progression in this patient.

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.