IntroductionAvailability of antimicrobials for customers without prescription is anticipated as one of the factors to accelerate the emergence of drug-resistant pathogens. In countries under economic development, an improvement of socioeconomic status of the population improves consumption of medicines.ObjectiveThe objective of this study was to examine if there are socio-demographic gradients associated with purchasing antimicrobials without prescriptions at retail stores in Ulaanbaatar, Mongolia.Methods and MaterialsA survey was conducted in among medical doctors and the randomly selected 250 pharmacy stores in Ulaanbaatar city and provinces (aimags). Customers who left from the stores were interviewed outside of the pharmacy and the medicines they bought at the stores were examined. The use of prescriptions and advice in purchasing medicines, instructions given at pharmacy stores, were interviewed and the type of medicines and details of antimicrobials purchased were examined by pharmacists.ResultsWe found that, quite common consumption of antimicrobials drugs specially betta-lactamas antibiotics and were sold without prescription. There are several reason to purchase antibiotics without prescription were several brand name of drugs, takes a lot of time.ConclusionThe purchase of antimicrobials without prescriptions was common across socio-demographic strata in Ulaanbaatar. By considering the increase of retail pharmacies and followed sales of antimicrobials according to the economic development, measures to enforce regulations and promote education to general public and professionals are urgently required.

Objectives: The patterns of purchasing prescription antimicrobials with or without a prescription from retail pharmacies in Ulaanbaatar, Mongolia, were examined in relation to purchasers’ socioeconomic status and price of the product.
Methods: A survey was conducted at 250 randomly selected pharmacies in Ulaanbaatar. A total of 619 customers were interviewed, and the medicines they bought at the stores were examined by medical doctors. The use of prescriptions and advice in purchasing medicines and sociodemographic characteristics of the subjects were determined.
Results: Interviews were conducted with 297 customers who purchased prescription antimicrobials in front of the store in which they made their purchase. Among these 297 customers, only 19.5% (n=58) purchased medicine with a formal prescription, and 37.4% (n=111) purchased medicines on their own initiative and without the guidance of medical professionals. Purchase without a prescription was not associated with the subjects’ gender, age, educational status or area of residence. Lower-priced antimicrobials were purchased without prescriptions more frequently than those with a higher price (P<0.05).
Conclusion: The purchase of antimicrobials without prescriptions is common across all sociodemographic strata in Ulaanbaatar, Mongolia. Considering the increases in number of retail pharmacies and in sales of antimicrobials associated with economic development, measures to enforce regulations and to promote education among the general public and pharmacy professionals are required.

The Mongolian plants considered to possess medicinal properties may contain novel compounds since they are exposed to severe conditions; such plants could become good candidates for modern drug discovery programs. Daurian Thermopsis (Thermopsis lanceolata R.Br.= Th.dahurica Czefr.), Gobian Thyme (Thymus gobicus Tschern.) and Mogilev Mallow (Malva mohileviensis Downer) are separately used as mucolytic and anti-inflammatory treatment in non-conventional medicine. Therefore, weprepared extract of these herbals compound called as a Tetima and to evaluate it’s acute toxicity. It isimportant to produce mucolytic effective new pharmaceutical preparation used for upper and lowerrespiratory tract inflammatory disease.Tetima herbal compound extract was prepared in ethanol, the ratio of herbals to ethanol was 1:10. Healthy 25 white albino mice (male weighing between 17-30 gram) used in this study. They were kept in large airy cages in groups of 5 animals per cage with free access to food and water. Five doses (8-20 g/kg) were then chosen for the determination of intraperitoneal LD50 in mice and given to five groups of albino mice. The animals were observed for first 2 hours and then at 6th and 24th hour for any toxicsymptoms. After 24 hours, the number of deceased mice was counted in each group. The percentage of animals that died at each dose level was transformed and then LD50 determined by the methods of Karber and Pershin.G.N.The LD50 of Tetima herbal compound in mice was determined to be 14.3 g/kg after intraperitonealinjection. There was no difference occurred between Karber and Pershin methods to evaluate acute toxicity. In the animals receiving intraperitoneal injection, the abdominal muscle contractions and ataxia was observed, which persisted for few hours. At the 6th hour they were drowsy and less responsive. The severity of these effects was related to the level of dose. However, at 24th hour most of the survivors had recovered from these symptoms.Tetima herbal compound extract is a relatively safe, particularly when given intraperitoneal inject toexperimental animals.

Background: To investigate relapse rates after the successful treatment of patients with non-atypical endometrial hyperplasia (EH) either a levonorgestrel impregnated intrauterine system (LNG-IUS; MIRENA®) or two regimens of oral dydrogesterone (DGS) after primary histological response. Currently, the incidence of EH is indistinctly reported to be around 200,000 new EH cases per year in Western countries. Methods: Patients were at their choice assigned to one of the following three treatment arms: LNG-IUS; 10 mg of oral DGS administered for 10 days per cycle for 6 months; or 10 mg of oral DGS administered daily for 6 months. The women were followed for 6 months after ending therapy. [Figure2] Women aged 25-55 years with low or medium risk endometrial hyperplasia met the inclusion criteria, and 35 completed the therapy. Results: Histological relapse was observed in 55/ (41%) women who had an initial complete treatment response. The relapse rates were similar in the three therapy groups (P = 0.66). In our study involved 25-55 (mean 42.2±1.61) aged 35 women. Among them had reproductive aged 31.43% (n= 11) premenopausal women 42.86 % (n= 15) postmenopausal women 25.71% (n= 9). Their mean body mass index had 28.8±1.15 kg/m², and normal weight 34.29% (n=12), overweight 34.29% (n=12), obese 17.14% (n=6), extremely obese 14.29 % (n=5). [Figure3] Types of obesity had normal 37.14% (n=13), android 25.71% (n=9), gynecoid 37.14% (n=13). Mean parity had 1.8±0.19 to nulliparous 14.29% (n=5), primiparous 60% (n=21), multiparous 25.71% (n=9). Smoke 17.14% (n=6). Non combined disease had 65.7% (n=23), diabetes mellitus 17.14% (n=6), PCOS 14.29% (n=5), cardiovascular disease had 2.86% (n=1). [Table1] Mean endometrial thickness of TVUS had ( 16.0±0.91mm). Smoke (p=0.0391), types of obesity (p=0.0436) and myoma of the uterus (p=0.0187) seen affected the endometrial thickness. LNG-IUD group had after treatment’s menstrual period 11.11% heavy 80ml (n=1), 88.89% light 5ml (n=8). DGS (5-25 day) group had after treatment’s menstrual period 9.09% heavy =80ml (n=1), 90.91% light5ml (n=10), DGS (16-25 day) group after treatment menstrual period 40% heavy 80ml (n=6), 46.67% normal 5-80ml (n=7), 13.33% light 5ml (n=2) байв. Therefore between the three treatment groups had no differences. But treatment’s before and after result had statistics probability differences (P= 0.4064). [Figure4] Conclusions Finally, given the long natural history of menorrhagia, study outcomes need to be assessed over a period that is longer than 2 years. In conclusion, our study showed that both the LNG-IUD, oral progestin treatment reduced the adverse effect of menorrhagia on women’s lives over the course of two years. LNG-IUD was the more effective first choice, as assessed impact of bleeding on the women’s quality of life.

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.

Background: The Maternal and Child Health Handbook is a long-term health monitoring tool that records children’s health, immunization, and developmental stages from the prenatal period to age five. By using the MCH handbook together with parents and health workers, it is possible to increase health education for parents and prevent, and detect potential developmental delays in children at an early age. Aim: To detect the knowledge and attitudes toward family use of the MCH handbook Materials and Methods: The study was conducted using an analytical study using cross-sectional design and included a total of 373 parents and caregivers with children aged 1-4 in 4 districts of Ulaanbaatar city. When assessing knowledge, correct answers were scored and grouped. When assessing the attitude, the parents were scored based on whether they were recorded in the MCH handbook. To determine the relationship between influencing factors, a one-way logistic regression analysis was performed, which was considered statistically significant at a 95% confidence interval and p<0.05 and was performed using the SPSS 25 program. Results: The mean age of the study participants was 33.5±6.5. Reading and keeping a handbook completely (p=0.0001) was statistically significantly related to improving knowledge (p=0.0001). In studying the factors affecting handbook records, the following were statistically significant: gestational age (OR=0.956, 95% CI [0.923, 0.990]), number of births (OR=1.206, 95% CI [1.002, 1.452]). Factor influencing knowledge about the notebook is gestational age (OR=0.954, 95% CI [0.918, 0.992]). Conclusions The factor influencing knowledge about the health notebook of children under five years of age were gestational age (p=0.017). The factors influencing the maintenance of the notebook were gestational age (p=0.011), number of births (p=0.048), and whether the notebook was read completely (p=0.008).

Background: From the perspective of Mongolian medicine, hemorrhagic disease is a symptom of bleeding from any part of the body. This disease was compared to the immune thrombocytopenia disease of modern medicine. The treatment of this disease using two medical methods and the prevention of complications and relapses are issues facing the healthcare sector. In this regard, we have chosen this topic to clarify and prove the mechanism of action of the Mongolian drug Gurgem-8, which is widely used to treat bleeding disorders. Aim: To evaluate the therapeutic efficacy of Gurgem-8, in haemostatic treatment. Materials and Methods: The study was conducted using a randomized, controlled (active), open label, single centered clinical trial method. The study was conducted in two phases. First, an acute toxicity study of the Gurgem-8, was conducted in accordance with OECD guideline 423 and evaluated according to GHS classification. A chronic toxicity study was also conducted on Wistar rats (n=20) given the Gurgem-8, at doses of 500 mg/kg, 100 mg/kg, and 150 mg/kg daily for 60 days. Second, a clinical study was conducted on a total of 74 patients, who were randomly divided into 2 groups. The treatment group was given 3 grams of the Gurgem-8, daily, and the comparison group was given 4 capsules of Sheng Xue Xiao Ban Jiao Nang 3 times a day. The results were determined by laboratory methods. The study was conducted with the approval of the Research Ethics Committee of Mongolian National University od Medical Sciences (2024.01.19 №2024/3-01). Results: In the acute toxicity study, Turmeric-8 was found to be of low toxicity according to the GHS classification. No mortality was observed in the chronic toxicity test. As a result of the clinical study, there were significant differences in the blood hemoglobin (χ2=73.923, P<0.001), platelet (χ2=62.465, P<0.001), erythrocyte (χ2=77.113, P<0.001) and leukocyte (χ2=14.771, P<0.001) cell counts between the Gurgem-8, drug group and the comparison group. It was also determined that the platelet (χ2=138.3, P<0.001), erythrocyte (χ2=85.405, P<0.001) and leukocyte (χ2=10.961, P=0.027) cell counts were directly related to the treatment period and the group. When determining the effect on immune cells, there was no significant difference in the lymphocyte cell content before and after treatment (CD4+: t=0.233, P=0.817; CD8+: t=-0.264, P=0.793; CD4/CD8:Z=-0.119, P=0.905). However, the CD4/CD8 ratio was statistically significantly increased in each of the Gurgem-8, drug group and the comparison group (P<0.001, P=0.001). Conclusion In immune thrombocytopenia diseases, the Gurgem-8, has the effect of reducing hemoglobin levels in the blood, increasing platelet counts, reducing CD4+ and CD8+ T cell counts, and increasing the CD4/CD8 ratio.

Introduction: Endometritis (EMM) is the most common maternal infectious complication of childbirth, occurring more commonly after low transverse cesarean section (LTCS) than vaginal delivery [1]. In a Cochrane review, the mean incidence of EMM following elective cesarean section was 7% and after non-elective or emergency operations was 30% [4]. A variety of independent risk factors for post-cesarean EMM have been identified in previous studies, including no prior cesarean section [5], low infant Apgar scores [6], trial of labor [7], premature rupture of membranes (PROM) >24 hours, young maternal age [8], preterm or post-term gestation [9], antepartum infections [10], pre-eclampsia, meconium [11], amnion infusion, postpartum anemia, multiple vaginal examinations [12], and manual removal of the placenta [13]. The time of ruptured membranes before delivery is examined via dichotomized time thresholds, the risks of chorioamnionitis and endomyometritis are significantly increased at 12 hours and 16 hours, respectively [16, 17]. A change in policy to administer prophylactic antibiotics before skin incision led to a significant decline in postcesarean delivery surgical-site infections [18, 19]. Objective: To determine independent risk factors for EMM following (LTCS). Material and Method: The study was case-control study, between 2022 to 2023 years at the “Urguu” specialized maternal hospital Ulaanbaatar, Mongolia. Case group has 101 women with EMM and the control group has 100 women with non EMM after LTCS. Results: The age of 2 study groups was 32.4 and 32.8, body mass index was 30 kg/m2 and 30.7 kg/ m2.Young maternal age <25 has a 22% (p=0.001, OR=4.5) influence on the occurrence of EMM. Other pregnancy related factors were not associated with the EMM after LTCS. (p>0.05). Delivery risk factors has increases the EMM by 15% (p=0.002), labor induction by 20% (p=0.001), duration of labor >12 hours by 40% (p=0.001), PROM increased by 15% (p=0.005), meconium by 15% (p=0.005), chorioamnionitis by 15% (p=0.001). Conclusion Our study, young maternal age <25 has influence on the occurrence of EMM. Other pregnancy related factors were not associated with the EMM after LTCS. Delivery associated risk factors are affected by the EMM after LTCS. The labor after LTCS, labor induction, PROM >12 hours, duration of labor, number of vaginal exams>4, meconium, chorioamnionitis increased by EMM. Young maternal age (<25) increased the risk of EMM attached with labor association risk factors.

Introduction: Stinging nettle (Urtica dioica L.) belongs to the family of Urticaceae. Three species of Urticaceae (Urtica cannabina, Urtica angustifolia, Urtica dioica L) was grown in Mongolia. U. dioica has recently been shown to have antibacterial, antioxidant, analgesic, anti-inflammatory, antiviral, anti-colitis, anticancer and antiAlzheimer activities. Flavonoids, tannins, scopoletin, sterols, fatty acids, polysaccharides, isolectins and sterols are phytochemicals which are reported from this plant. But effect of hair growth is unclear yet. Goal: We investigated the effect of Urtica dioica L extracts on hair growth by using in-vitro and ex-vivo study methods. Materials and Methods: Human single hair follicle and dermal papilla cells obtained from scalp skin samples of healthy volunteers. We evaluated the effect of Urtica Dioica L on hDPCs and on ex-vivo hair follicle organ culture. Hair follicle matrix cell’s proliferation marker Ki-67 identified by immunoflurescence staining. Result: Urtica Dioica L ethanol extracts promoted elongation of the hair shaft and reduced catagen transition of human hair follicles in organ culture model. E.extract of Urtica Dioica L increased Ki-67 positive matrix keratinocytes. Conclusion Urtica Dioica L ethanol extract enhanced human hair growth in ex-vivo organ culture model. Needed future study to investigate the related mechanism of hair growth.

Background: Liposomes have been widely studied in the field of medicine in recent years for they can reduce side effects and regulate drug release by delivering active ingredients to target tissues and cells through active or passive routes. There are many types of methods for formulating liposomes, and comparing those methods and choosing the most suitable one will allow the delivery of active ingredients and their incorporation into pharmaceutical forms, so this research was carried out. Aim: To compare liposome formation methods. Materials and Methods: The research work was carried out with the support of “Drug Design Laboratory” and “Pharmaceutical Analysis Laboratory” of the School of Pharmacy of MNUMS. To formulate liposomes, 5 different concentrations of samples were prepared using thin-film hydration, ethanol injection, and heating methods. Phospholipid concentration and light absorption were determined by spectrophotometer in each sample. The size of the resulting liposome was determined using a Nanophox. Results: Phosphatidilcholines were dissolved in distilled water at concentrations of 5, 10, 20, 30, 40, and 50 μg/ml and a standard curve was established by spectrophotometry to determine the concentration of phospholipids in liposome samples. The highest formulation was 76.98% when 75 mg of phospholipid was used in the preparation by thin film hydration method, when 50 mg of phospholipid was used in the preparation by ethanol injection method, the highest formulation was 85.17%, and for when 50 mg of phospholipid was used in the preparation by heating method, the highest formulation was 58.45%. The mean liposome size by ethanol injection method was 115 nm. Conclusions 1. Ethanol injection method for liposome formulation is more efficient compared to thin-film hydration method and heating method. 2. Liposome size was 115 nm when prepared by ethanol injection.