1. STUDY RESULT OF DRUGS SUPPLY FOR PEPTIC ULCER
Ulambayar L ; Khurelbaatar L ; Munkhbat S ; Tserenlkhagva R ; Oyuntsetseg KH
Mongolian Pharmacy and Pharmacology 2013;2(1):15-
Introduction:Structure and Function of the digestive organ diseases in that commonly occurred Ulcer Disease (PUD) is becoming one of the major diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death.80% of the patients who has Gastric ulcer, 80 % of the patient who has PUD, has helicobacter pylori infections.Mongolian statistics data estimates that there are in total 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.Purpose of the study: Indicate the substantial supply of essential drugs of PUD in the stationary and ambulatory treatment.The study material and method:Diagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Department of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songini Khairkhan District and Nalaikh Districtbut also 107 ambulatory patient’s substantial supply of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card.WHO advised the drug supply “ Managing drug supply, the selection, the procurement, distribution and use of pharmaceuticals ” method by Jonathan D. Quick, Jamas R. Rakin, Richard O.Laing, Ronald W.O’Connor, Hans V.Hogerzell, M.N.G.Dukes, Andrew and Кобзарь л.в, дрёмова н.Б, глембоцкая г.т мнушко з.н. Statistic was developed and implemented excel, SPSS16.0 programme.Result of the study: In the study 500 people wereabove 20 and average age is 48.36±14.44.As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used.163380.15 tugrug (Mongolian currency) budget is required for Stationary treatment of Peptic Ulcer Disease (PUD) but 987540.95tugrug budget is required for ambulatory treatment.Conclusion:As a tertiary Level hospital 27, As a secondary Level hospital 18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD.22 kinds of tablets were used for Peptic Ulcer Disease in an ambulatoryAs the result of the study 163380.15 tugrug for PUD’s stationary treatment, 987540.95 are required for PUD’s ambulatory treatment.
2.Health insurance services of Ulaanbaatar citizens satisfaction survey
Mongolian Pharmacy and Pharmacology 2021;19(2):31-37
Introduction:
There is an urgent need to study client satisfaction in assessing the quality and availability of health care. Compliance with the needs of consumers of any care, its accessibility, professional ethics, speed of work, determining customer satisfaction allows for evidence-based decision-making. Therefore, satisfaction surveys should be conducted at short intervals and the results used for decision making. One hundred and fifty million people on the planet pay for their health care every year and face financial hardship. Hundreds of millions of them are living in poverty, according to the World Health Organization’s 2010 year report. Governments must ensure that all people receive health care and are protected from health-related financial risks. We believe that the current state of quality and access to health care in our country does not fully meet the needs of the population. 62.4% of customer satisfaction surveys conducted in 2013 that health care was inadequate. However, customer satisfaction surveys on health insurance coverage are rare. The process of providing discounted medicines through health insurance varies depending on the health needs of consumers and their budgetary capacity. Therefore, it is necessary to take into account the factors that affect customer satisfaction.
Methods:
In our study, we looked by retrospective at health and health insurance reporting indicators, Satisfaction of customers who bought medicines at pharmacies with health insurance prescriptions was surveyed in a one-moment survey.
We collected information on the satisfaction status of 525 people who used health insurance prescriptions from 36 pharmacies from December 2018 to April 2019 and from January to February 2021 using preprocessed cards.
Conclusion
1. The cost of diagnosis from the health insurance fund and the selection of drugs to be included in the list of drug price discounts are related to the prevalence of the disease in Mongolia.
2. Difficulties in accessing drug price reductions from the health insurance fund can lead to dissatisfaction with the approved budget and the availability of drugs on the list.
3. In the case of Ulaanbaatar pharmacies, the satisfaction rate of consumers who use the discounted price of medicines according to the health insurance prescription is 3.634 or 72.688% in the first stage survey and 3.912 ± 0.50 or 78.248% in the second stage survey.
3. A SURVEY ON DIRECT COSTS FOR AN INDIVIDUAL’S HOSPITAL STAY PAID BY THEMSELVES
Ganshirmen G ; Munkhbat S ; Tserenlkhagva R
Innovation 2015;9(3):138-140
To study some direct fees paid by a household of a hospitalized patient during the treatment at secondary or tertiary care hospitals.The study was conducted using cross-sectional design. The data was collected from 6 specialized clinical centers, 7 hospitals of provincial and regional diagnostic and treatments centers, and 6 district hospitals using the data of 1335 in-patients hospitalized during 2012-2013. The in- patients’ medical histories were processed using descriptive research methods by using specially designed cards to register the costs for medications and medical equipment. In addition, the questionnaire was used to collect the data on direct and indirect costs associated with hospitalization paid by individuals. Statistical data was analyzed using SPSS 21.0 software. 96% (1282) of total hospitalized patients were covered by health insurance. However, 28.4% of them paid for their drug treatment out-of-pocket. 62% of in-patients who paid for their own medicines responded that the medicines were written in their medical history but the hospitals were out of stock and therefore did not provide them to the patients. 3% of in-patients who paid for their medicines were reimbursed the costs of medicines. When comparing the informal costs associated with a hospital stay to the total household income, 23% of respondents said that those expenditures were high. While 54% of total costs spent by hospitals on diagnosis and treatment of in-patients were used for medicines, the in-patients’ out-of-pocket expenditures were higher in secondary care hospitals.Due to drug supply in secondary and tertiary care hospitals is insufficient to meet the needs for drug treatment; in-patients are required to spend a part of their household income to pay for drug treatment during their hospital stay.
4.The study on drug needs of peptic ulcer disease
Ulambayar L ; Khurelbaatar L ; Munkhbat S ; Tserenlkhagva R ; Oyuntsetseg KH
Mongolian Medical Sciences 2013;164(2):76-81
IntroductionStructure and Function of the digestive organ diseases in that commonly occurred Peptic Ulcer Disease (PUD) is becoming one of the majority diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death. Mongolian statistics data estimates that there are totally 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.PurposeTo define the types and needs of drugs which are used in the stationary and ambulatory treatment of patients who are suffering from peptic ulcerMaterial and MethodDiagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Unit of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songino-Khairkhan District and Nalaikh District but also 107 ambulatory patient’s substantial usage of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card. “The consumption method and morbidity method” by Hogerzell H.V., Jonathan D.Quick., James R.Rakin,(2005) was used due to identify drug needs as WHO advised.ResultsIn the study 500 people were above 20 and average age is 48.36±14.44. As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used. Peptic ulcer disease stationary treatment drug needs are not enough.Conclusions:1. As a tertiary Level hospital27, As a secondary Level hospital18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD. 22 kinds of drugs were used for Peptic Ulcer Disease in an ambulatory2. Peptic ulcer disease stationary treatment drug needs are not enough.
5.Bladder cancer risk factors in Mongolians
Baasansuren S ; Shiirevnyamba A ; Myagmarsuren P ; Batmunkh G ; Amarsaikhan S ; Bayan-Undur D ; Munkhbat B
Mongolian Medical Sciences 2015;173(3):7-12
BACKGROUND: Bladder cancer is a cancer of significant morbidity and mortality in the worldwide. It is the second most common urological cancer in Mongolia. It is important to understand the risk factors of bladder cancer.We evaluated the association of smoking, alcohol intake, body mass index and other potential risk factors with bladder cancer incidence in Mongolians.MATERIALS AND METHODS: We analyzed data from a case-control study (116 histologically confirmed bladder cancer cases and 300 cancer-free healthy, age, gender-matched controls). All participants signed the consent form andfilled out the structured questionnaire including cigarette smoking, BMI, chronic urinary disease andalcohol drinking etc. Using logistic regression we estimated the covariate-adjusted odds ratio (OR) and95% confidence interval (CI) of the associations.RESULTS: Mean age of the patients with bladder cancer was 56±10.5 years and 79.3% male and 20.7% female.Cigarette smoking, history of urinary tract diseases and body mass index were associated with an increased risk of bladder cancer OR 6, 48 (95% CI 1, 61-1, 70), OR 80 (95% CI 1, 48-1, 93) and OR=9.8 (95% CI 2.32-2.91) respectively but not alcohol drinking OR 0, 26 (95% CI 1, 56-1, 66).CONCLUSIONS: The results suggest that cigarette smoking, history of urinary tract diseases and body mass indexincreased risk of bladder cancer in Mongolian patients.
6.The national occupational standarts of pharmacy technician
Mandakhnaran P ; Tugsbileg S ; Munkhbat S ; Purevsuren S
Mongolian Pharmacy and Pharmacology 2019;15(2):16-18
Abstract
National Occupational Standards specify standards of performance that people are
expected to achieve in their work, and the knowledge and skills they need to perform effectively. The
National occupational standards for supporting teaching and learning in schools were developed
to help improve the capacity and capability of the school workforce; they can make an important
contribution to raising standards in schools.
National Occupational Standards describe best practice by bringing together skills,
knowledge and values. They are valuable tools as benchmarks for qualifications as well as for
defining roles at work, staff recruitment, supervision and appraisal.
Globally the roles and scope of work for technicians and pharmacy support workforce cadres
vary greatly according to country and practice areas within that country. The School of Pharmacy
MNUMS and Mongolian Association of Clinical Pharmacist and Association of Pharmaceutical
Management has developed 4 phases National Occupational Standards.
7.STUDY OF “AKHIZUNBER” SOLUTION FOR THE TREATMENT OF INFLAMMATORY ORAL STOMATITIS
Urjinlkham J ; Batsuuri M ; Bulgan Ch ; Sapaar B ; Davaadagva D ; Munkhbat S ; Oyunbat B ; Choijamts G ; Bayarchimeg B ; Oyun-Enkh P ; Oyunkhishig Kh ; Nyamsuren E
Innovation 2018;12(4):8-11
ABSTRACT.
Recurrent aphthous stomatitis, or RAS, is common oral disorder of uncertain etiopathogenesis for which only symptomatic therapy is available. This article reviews the current clinical features of RAS among study patients and the result of therapeutic effects of the herbal preparation Akhizunber. Over the past four years we have treated 61 RAS patients with different clinical forms by herbal preparation Akhizunber or Alumekatin. The distribution of clinical forms RAS RAS among study patients were minor aphthae -75.4%, major aphthae -16.4% and herpetiform ulcers -8.2% respectively. The healing time of treated Akhizunber was in minor aphthae -9.28±4.82 days, major aphthae -14 days and herpetiform ulcers -12 days. Of the total study participants, the patients treated by Akhizunber reported a rapid and complete recovery from RAS during treatment compared with treated patients by Alumekatin. Treatment with herbal preparation Akhizunber can be effective for patients suffering from RAS in any clinic form, regardless of their ulcer number and size.
8.The key role of transcription factors on the innate immunity reaction
Ulziisaikhan J ; Gandolgor Ts ; Tsogtsaikhan S ; Yokochi T ; Enkhsaikhan L ; Jambaldorj J ; Munkhbayar S ; Munkhtuvshin N ; Munkhbat B ; Bilegtsaikhan Ts
Health Laboratory 2019;10(2):23-33
Background:
The effect of lipopolysaccharide (LPS) on valproic acid (VPA)-induced cell death was examined by using mouse RAW 264.7 macrophage cells.
Materials and methods, results:
LPS inhibited the activation of caspase 3 and poly (ADP-ribose) polymerase (PARP) and prevented VPA-induced apoptosis. LPS inhibited VPA-induced p53 activation and pifithrin-α as a p53 inhibitor as well as LPS prevented VPA-induced apoptosis. LPS abolished the increase of Bax/Bcl-2 ratio, which is a critical indicator of p53-mediated mitochondrial damage, in response to VPA. The nuclear factor (NF)-κB inhibitors, Bay 11-7082 and parthenolide, abolished the preventive action of LPS on VPA-induced apoptosis. A series of toll-like receptor (TLR) ligands, Pam3CSK4, poly I:C, and CpG DNA as well as LPS prevented VPA-induced apoptosis.
Conclusion
Taken together, LPS was suggested to prevent VPA-induced apoptosis via activation of anti-apoptotic NF-κB and inhibition of pro-apoptotic p53 activation.
9.Significance of evaluation of D-dimer in COVID-19 patient: Case report
Bayarjavkhlan Ch ; Battulga Ch ; Buyanjargal E ; Byambalkham B ; Jargal-Erdene B ; Naranmandakh D ; Munkhsaikhan B ; Munkhbat T ; Oyungerel S ; Enkhnomin O ; Gantuya L ; Ulziitsetseg Ts
Health Laboratory 2021;14(2):23-32
Introduction:
Coronavirus infection 2019 (Ковид-19) is an infection caused by a novel virus and induces severe ARDS. КОВИД-19 pandemic has rapidly spreaded in 221 countries, 245,373,039 cases and 4,979,421 mortalities have been reported. Pulmonary and renal thrombotic angiopathy occur in patients with complications of ARDS, sepsis, and multi-organ failure. Elevated D-dimer in КОВИД-19 patients has been reported firstly by doctors in Wuhan, China. In addition, many studies have revealed that elevated D-dimer has been associated with the severity of the diseases, an increased rate of poor prognosis.
Objective:
We aim to determine D-dimer in КОВИД-19 patients, and patient condition a decrease of D-dimer level after administration of anticoagulant therapy.
Case report:
We introduce a rare case of КОВИД-19. Laboratory test results and the effect of anticoagulant therapy have been evaluated during the infection. 85 aged women were admitted with a diagnosis other than КОВИД-19. PCR for SARS-Cov-2 was negative on the previous day of admission, and Sars-Cov-2 Ag rapid test was also negative on the admission day. However, the D-dimer test result was much higher with 7120 ng/мл and X-ray and CT revealed a similar pattern to the КОВИД-19 patient. Then anti-Sars-Cov-2 test was positive with 4,08 COI. Based on laboratory test results of D-dimer, LDH, CRP, and CT pattern the patient was diagnosed with post-КОВИД-19 pneumonia, and anticoagulant therapy was initiated additionally to prevent hypercoagulation induced by КОВИД-19. D-dimer test taken before administration of anticoagulant therapy increased more to 10910 ng/мл. 3 days later D-dimer level decreased to 8180ng/мл and the patient’s condition was improved.
Conclusion
The evaluation of D-dimer of the patients with КОВИД-19 is highly significant. Anticoagulant therapy might be necessary for КОВИД-19 patients with high D-dimer level in serum. Further studies are needed to assess the long-term outcome of the illness and mortality.
10.A new diagnostic biomarker in early detection of Hepatocellular Carcinoma
Batchimeg B ; Baljinnyam T ; Khulan U ; Khaliun M ; Bilguun E ; Munkhtsetseg B ; Terguunbileg B ; Chinzorig M ; Gan-Erdene B ; Bilegtsaikhan Ts ; Erkhembulgan P ; Batbold B ; Munkhbat B ; Munkhtuvshin N ; Munkhbayar S
Mongolian Medical Sciences 2021;197(3):10-16
Background and Aims:
Hepatocellular carcinoma (HCC) is a common cause of cancer related death
in Mongolia. Early diagnosis is the very important management to increase successful treatment
and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC)
tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a
diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic
value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic
biomarker of HCC.
Methods:
We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver
cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP)
levels were measured using commercially available enzyme-linked immunosorbent assay kits. The
diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and
estimated sensitivity and specificity of each biomarker.
Results:
sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and
healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity
was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999
(0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6
ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 %
with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%).
Conclusion
Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC.
Combination of two markers showed greatest diagnostic accuracy.