1.Current situation and future trend of antimicrobial drugs consumtion
Mongolian Medical Sciences 2012;162(4):118-124
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.
2.Purchase of Antimicrobials in Retail Pharmacies Whena Prescription is Not Required
Khaliun Nyambayar ; Keiko Nakamura ; Mayumi Ohnishi ; Rie Nakajima ; Vaanchig Urnaa ; Takehito Takano
Journal of Rural Medicine 2012;7(2):51-58
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.
3. Intraperitoneal acute toxicity study of Tetima herbal compound extract, in experimental animals
Anar E ; Yeruult CH ; Batkhuyag P ; Khaliun N ; Narantungalag D ; Tuvshinjargal TS
Innovation 2015;9(4):42-45
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.
4.Endometrial hyperplasia treatment with the levonorgestrel-impregnated intrauterine system or oral progestogens
Khaliun U ; Munkhtsetseg D ; Bolorchimeg B
Innovation 2021;15(1):24-27
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.
5.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.
6.Knowledge and attitudes towards family use of Maternal Child Health Handbook in Ulaanbaatar, Mongolia
Khaliun A ; Myagmartseren D ; Undram L
Mongolian Journal of Health Sciences 2025;88(4):200-203
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 togeth
er 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 re
gression 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 gesta
tional 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).
7.Urtica Dioica L. effect on hair growth
Khaliun M ; Enkhsaikhan L ; Munkhbayar S
Mongolian Medical Sciences 2018;186(4):52-56
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.
8.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.
9.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.
10.Treatment of miniere’s disease (icd-10 h.81) using traditional medicine and therapeutic interventions: Case report
Undarmaa B ; Tserendulam G ; Oyun-Erdene U ; Oyunnyam Ch ; Nasankhishig D ; Khaliun E ; Tsegmed G ; Oyunbileg Yu ; Enkhtuya V
Mongolian Journal of Health Sciences 2025;87(3):72-74
Background:
Meniere's disease is a condition caused by disturbances in the
auditory and vestibular systems. It is characterized by symptoms such as dizziness,
nausea, vomiting, and tinnitus. In the United States, the prevalence of
Meniere's disease has been found to be 84 cases per 100,000 women and
56 cases per 100,000 men. Regionally, it is more common in less populated
areas, and research has confirmed that the prevalence increases with higher
household income.
Aim:
To evaluate the effectiveness of traditional medicine treatments and therapies
for Meniere's disease.
Results:
The patient is a 43-year-old male, with symptoms of dizziness, vomiting,
and tinnitus. Since 2023, he has sought care at the Central Hospital of
Mongolian Medicine, where he received traditional medicine treatments including
herbal therapy and other traditional therapies on three occasions. As a
result, the frequency of dizziness has decreased and other clinical symptoms
have improved.
Conclusion
Traditional medicine treatments have been shown to be effective
in managing Meniere's disease by extending the interval between relapses,
improving quality of life, and significantly reducing clinical symptoms.