1.Evaluation on implementation of preventive activities of non-communicable diseases
Enkhzul T ; Sugarmaa M ; Amarsaikhan D ; Delgermaa V
Mongolian Medical Sciences 2013;166(4):44-47
Background: Mongolia is one of the most influenced countries by non-communicable diseases among developing countries. Non-communicable diseases, including cardiovascular diseases, cancers, respiratory diseases, diabetes, and injuries have become the major causes of morbidity and mortality in Mongolia.Goal: To assess impact of preventive intervention activities of non-communicable diseases in framework of the Millennium challenge account (MCA) health projectMethods: We conducted 17 focus group discussions (FGD) from March to April 2013 in primary and secondary health care settings, of which six in urban and eleven in rural areas.We identified themes concerning the current situation of NCD related health services from the perspective of health professionals, and insights into institutional and professional experiences related to management, implementation and coordination of the newly implemented MCA-Mongolia NCD prevention and control project.Results: As a result of the health project, NCD related knowledge and skills of health professionals have improved through progressive training, and development of guidelines and manuals. During the project, availability of equipment supplies has improved. Accordingly, medical equipment and laboratory reagents needed for early detection of NCDs were provided to primary and secondary health care settings, despite some challenges in the implementation of the project. As result of theproject implementation, increased public awareness on NCDs, and attitude change were considered as the biggest changes.Conclusion: The health project was considered as successful to provide knowledge on the best practice in NCD prevention.
2.A study of factors affecting the implementation of the curriculum
Otgonbayar D ; Dashtseren B ; Lkhamdulam B ; Enkhzul T ; Baasanjav N
Mongolian Medical Sciences 2018;185(3):75-79
Introduction:
The curriculum development is important issue, especially stakeholder’s evaluations for the
implementation of the curriculum. Accordingly, this time we conducted this survey to determine the
level of satisfaction of teachers, which is a key factor in implementation of curriculum at the “Ach”
Medical University.
Goal:
To study curriculum implementation assessment by teachers at the Ach Medical University.
Materials and Methods:
Study was conducted descriptive study design using quantitative research methodology. The Likert
scale (1-5) used for the assessment of satisfaction score. Total 77 teachers were included in the
study. Study questionnaire included 7 groups with 53 questionnaires.
Results:
Total n=77 teachers included in the study. The satisfaction level of teachers for the implementation
of curriculum was 73% (n=56) satisfied with satisfaction, 22% moderate satisfaction (n=17), and
medium satisfaction teacher 5% (n=4).
The satisfaction level of teacher workload and job satisfaction is high enough to satisfy the workload
of the trainee, the time to prepare the lesson, and the opportunity to work with the students in the
classroom. 3.6-4.2, while the teacher’s work value or salary the level of satisfaction level is 3.11, the
minimum value is 2.75, the average.
Conclusion
The average satisfaction score was 4.11 above the average but the effectiveness of
the program, the effectiveness of the teacher’s work, study environment and textbooks were below
average.
3.Item analysis of the basic clinical skills assessment
Otgonbayar D ; Khaliun B ; Zol B ; Enkhzul T ; Baasanjav N
Mongolian Medical Sciences 2018;185(3):80-82
Introduction:
The clinical skills training at medical schools provides the opportunity for future medical doctors to
deal with the client with proper care, diagnosis of the disease, first aid, treatment, nursing, treatment,
counseling to address the complexity of the problem solving and the ethical attitude of the doctor.
To achieve this objective, it is necessary to assess the level of knowledge, skills and attitudes students
have acquired.
Goal:
To analyze assignment of basic clinical skills assessment and to identify the level of кknowledge and skills
students who have graduated second year medical program at “Ach” Medical University during 2016-
2017 academic year.
Materials and Methods:
The study was used as a descriptive model to measure the reliability of the assignment, the difficulty
factor of tasks, and the Hoffsten’s scores based on the tasks and performance of each station and
compared with the indicators.
Results:
Based on Hoffsten’s study on the success rate of examiners at the 5 stations, the Hoffsten’s score
level of clinical examination was 68 percent, the physical examination station was 64 percent, the
station’s diagnostic level was 71 percent, the laboratory was 70 percent and the nursing station was
70 percent.
Conclusion
At each clinical trial, the differential diagnosis of each individual clinical trial, clinical interview, nursing
station and visual diagnostic station (DF> 95), at the laboratory and at the physical examination
station, assess the student with a higher grade of difficulty factor (DF> 80) to the Hoffsten’s score of
the basic clinical skills exam is set to be 70 percent.
4.The result of pharmacological studies on traditional medicine Chun-7
Davaasambuu T ; Munkh-Erdene R ; Batchimeg B ; Enkhzul T ; Tsedensodnom Ch ; Bayanmunkh A ; Khandmaa D ; Choijamts G ; Tsetsegmaa S ; Lkhagva L ; Khurelbaatar L
Mongolian Pharmacy and Pharmacology 2022;21(2):35-40
Abstract:
CHUN-7 a Mongolian traditional recipe consisting of 7 medicinal plants is described in the scripture named “༆༆ །།གཡུ་ཐོག་པའི་མཛད་པའི་རིམས སྲུང་ཁྱུ་ལྔ་རྒྱམ་ཏོན་གསལ་བ །།”. The ingredients including Caowu (Radix
Aconiti kusnezoffii, CW) and Glehniae Radix (GR) have the effects of suppressing pneumonia, viral pneumonia, relieving pain, stimulating the immune system and reducing fever. The present study was aimed to determine acute and chronic toxicity properties of traditional drug.
Materials and methods:
CHUN 7 traditional drug were prepared in the traditional medicine sector of the Drug research Institute of Monos group. All WISTAR rats were kept in the same feed, under 12 hours lighting and 12 hours darkness housing. The study of acute and chronic toxicity of CHUN-7 traditional drug was studied by using IP and oral administration were performed on ten WISTAR rats and continued for a total of 28 days with 102.9 mg / kg dose (calculated from human dose: 16.7 mg/kg) in accordance with the WHO General Guidelines for the Evaluation and Study of Traditional Medicine.
Results:
The result showed no structural changes in the internal organs according to tissue morphology when we administrated CHUN-7 traditional drug.
Conclusion
This study showed CHUN-7 traditional drug has no toxic effects to internal organs including liver, kidney, stomach, lungs and heart. Therefore, CHUN-7 traditional drug has potential to use orally without any toxicology.
5.OUTCOME OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Tuvshintugs B ; Gantsooj N ; Undarmaa T ; Bolortungalag P ; Sainbileg D ; Enkhtuul S ; Enkhzul D ; Burenjargal P
Innovation 2018;12(3):12-16
BACKGROUND: There are two general types of age-related macular degeneration: dry and wet. During wet or neovascular age-related macular degeneration new abnormal vessels grow and leak in the macula. As anti-vascular endothelial growth factor (anti-VEGF) was invented, it revolutionized the treatment of nAMD by inhibiting the progress of this disease. The incidence of AMD increases as life expectancy grows and there is a growing need to study this disease. We aimed to evaluate the outcome of anti-VEGF therapy for the treatment of nAMD and the incidence of ocular serious adverse events (SAE) after injections.. METHODS: In our retrospective, single-center study, medical records of patients receiving a single dose of anti-VEGF treatment (Bevacizumab) for nAMD between 17th of April, 2016 and October, 2017 were evaluated. Outcome measures were the change in the baseline visual acuity (VA) score at post-injective month one, incidence of ocular SAE and patients’ baseline characteristics affecting VA. Patients, whose treatment were started before April 2016 and had anti-VEGF treatment for the diseases other than nAMD, were excluded.. RESULTS: 15 eyes in 15 patients between 52 and 85 years of age received single dose of anti-VEGF (Bevacizumab/Avastin) injection. The mean baseline VA improved from pre-injective average of 0.21 to post-injective 1-month average of 0.37 by Snellen. Furthermore, there was no vision loss or other severe adverse effects, such as endophthalmitis, vitreous hemorrhage, retinal detachment, traumatic cataract after 4 weeks. CONCLUSION: Anti-vascular endothelial growth factor therapy has promising short-term outcomes on treating neovascular age-related macular degeneration.
6.Item analysis on graduate exam performance
Otgonbayar D ; Soninbayar J ; Zol B ; Khaliun B ; Enkhzul T ; Baasanjav N
Mongolian Medical Sciences 2018;185(3):65-74
Introduction:
One of the quality assurance measurements for medical schools is the achievement of students who have graduated in the assessment of the knowledge, skills and attitudes they are trained in.
Goal:
To analyze assignment of theoretical and practical exam and to identify the level of кknowledge students who have graduate at “Ach” Medical University during 2015-2016 academic year.
Materials and Methods:
The study was conducted on a cross sectional and descriptive study through the based on the task of analyzing the 261 graduate students theoretical and practical exam performance of the bachelor degree in Medicine, Dentistry, Traditional Medicine and Nursing of Ach Medical University of Mongolia /AMU/ and was assessed and to identify a reliability coefficient, difficulty factor, discrimination index, Hoffsten’s score.
Results:
The reliabiliy coefficient of graduate exam meets requirement when it’s 0.94-0.96. According to the analysis of the 300 test of the each classroom of graduates was 70 percent (n=202) with weak dicrimination index, difficallty factor was more than 50 percent too easy, The Hoffsten’s score to which exam was passed of Medical graduates is 70 percent, traditional medicine is 87 percent, dentistry is 79 percent, the nursing is a Hoffsten’s score was 80 percent.
Conclusions
The reliability coefficient the theoretical exam of the graduates’ knowledge is convenient for all occupations, and whole field examines the weak difficulty index (DI≤0) for all field examinations. The Hoffsten’s score is 70% above the medical field. Graduate assignments can not discriminate graduates’ knowledge and skills levels and the difficulty factor graduate examination was very easy.
7.Student’s satisfaction level in curriculum implementation
Otgonbayar D ; Soninbayar J ; Zol B ; Khaliun B ; Lkhamdulam B ; Dashtseren B ; Batjargal B ; Enkhzul T ; Baasanjav N
Mongolian Medical Sciences 2018;185(3):83-87
Introduction:
The curriculum development is important issue, especially sudent’s evaluations for the implementation
of the curriculum. Accordingly this time we conducted this survey to determine the level of satisfaction
of students, which is a key factor in implementation of curriculum at the “Ach” Medical University.
Goal:
To determine student’s satisfaction level in the curriculum implementation of “Ach” Medical University
Materials and Methods:
Study was conducted descriptive study design using quantitative research methodology. The Likert
scale (1-5) used for the assessment of satisfaction score. Total 1105 students were included in the
study. Study questionnaire included 2 groups with 17questionnaires.
Results:
Students’ satisfaction level is 3.22 point on average and students gave lowest points 2.77 on the
quality of classroom, school environment, training equipment and books and course materials.
Conclusions
The average satisfaction score was 3.22 above the average but the some factors including classroom
capacity, study environment, training equipment and books and course materials, textbooks were
below average.
8.RECURRENCE RATE WITH USE OF INTRAOPERATIVE MITOMYCIN C AND CONJUNCTIVAL AUTOGRAFT FOLLOWING PTERYGIUM EXCISION
Gantsooj N ; Undarmaa T ; Tuvshintugs B ; Tumur G ; Bolortungalag P ; Sainbileg D ; Enkhzul D ; Tumurbaatar B ; Burenjargal P ; Enkh-Oyun Ts
Innovation 2018;12(3):28-30
BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva
onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations
(UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in
developing pterygium among other environmental factors (hot, dry, windy, dusty and
smoky environments and hereditary factors. The main histopathological change in primary
pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include
foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and
cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing
the patient’s discomfort, but they do not cure the disease. After surgical removal there are
still many recurrences regardless of the method used. Autologous conjunctival grafting seems
to be the best method, given both the low recurrence rate and high safety. As described first
by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with
infrequent and relatively minor complications. The primary disadvantage of this technique
is the prolonged operative time required when compared to the bare sclera technique.
These disadvantages are outweighed by the lack of sight-threatening complications and the
relatively low recurrence rate, which made this procedure gain popularity in many centers.
The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing
the recurrence rate to a minimum.
METHODS: This retrospective case series, single center study was conducted on 239
patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department
of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic
examination before the surgical intervention. Data were collected through a prepared
questionnaire. Postoperative follow-up examination sheets were evaluated. Data
for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17..
RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and
62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5
years old.
There is no statistical significance between the stages of the disease and its post-operative
outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative
pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred
pterygium had underwent pterygium excision without conjunctival autograft.
MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium
excision.
CONCLUSION: The relationship between pterygium stage and its post-operative recurrence
was not statistically significant (P=0.683).
The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001)
which showed significant statistically.
There was no recurrence after pterygium excision with MMC (P≤0.001).
The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our
outcome.