Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.

Introduction: We began treatment of multi drug resistant tuberculosis first from 2003. At that time there was a 1960 cases and most of the cases were from Ulaanbaatar, Darkhan, Selenge, Tuv, Dornod provinces. From all the cases only 62% or 1058 cases were included in treatment. From that 336 patient or 19% deceased, 296 patient or 18% didn’t get a treatment. We did this study because there were never done any research or study of surgical treatment of multi drug resistant tuberculosis in Mongolia. Materials and Methods: We studied cases of patients who undergone lobectomy, since 2007. There were 48 cases of 46 patients, 2 patients surgery were done on both sides. Respondents aged between 14- 45, 25 male (52%), 23 female (48%), all patients got a first - line anti-tuberculosis treatment, such as cat-1, cat-1+cat-2 and 10 variants of these drugs. It was done based on sputum culture test results of NCCD TB surveillance and research department’s laboratory. Results: From the all patients only 77.08% had undergone surgery within the first 3 years. 92% patients were diagnosed with multi drug resistance TB only with the sputum and sputum culture test results, and the rest of the patients were diagnosed using a tissue analyses on the above tests. It was revealed that HR resistant -91.66%, HR+(Z,E,S) -3 drugs resistant -18.78%, HR+(ZSE)-4 or 5 drugs resistant. In the patients TB lesion locations was on the right upper lobe 54%, left upper lobe 31%, on a both upper lobes 85%, cavernous fibrosis tubercles 60%, combined TB lesions 77%, tubercles 21%.87.5% of total patients received a multi - drug resistant TB treatment between 7 - 24 months prior surgery. All 48 patients had a totally 69 surgeries. Surgeries included 9% pneumonectomy, 28% lobectomy, 30% Wedge resection, 23% pleurectomy decortication, 7% Wedge resection on both sides, one bilobectomy. There were no complications during the surgery but 5 of patients had an empyema after surgery. No fatal cases.Three patients out of 5 who had a surgery due to pulmonary hemorrhage developed an empyema after surgery. Drainage tubes were taken after the surgery within 2-3 months.Therewere no complication and escalations in the patients who received a surgical treatment, after the surgery from 6 months to 5 years. Conclusion: In study it shows that surgical treatment is effective to do after 6 months of anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows that combining of medical and surgical treatment is healing up to 98% in the patients who were rightly chosen according to surgical indications.This research result shows that in our country multi - drug resistant TB surgical treatment complication is only 10.41%, which is below in the other countries who have same anti-tuberculosis drug treatment.

Complete seizure control is the single most important determinant of good quality of life for patients with epilepsy and the chronic nature of the disorder requires that antiepileptic drugs (AEDs) be administered for many years, often for a lifetime. Therefore, long-term experience is of particular importance in evaluating the efficacy and safety of an AED. Valproic acid increases γ-aminobutyric acid (GABA) synthesis and release and potentiates GABAergic transmission in specific brain regions and it also has also been found to reduce the release of the excitatory amino acid β-hydroxybutyric acid and to attenuate neuronal excitation mediated by activation of N-methyl-D-aspartate (NMDA) glutamate receptors. In addition to these effects, valproic acid exerts direct actions on excitable membranes, including blockade of voltage-dependent sodium channels. Valproate is generally regarded as a first-choice agent for most forms of idiopathic and symptomatic generalised epilepsies. Many of these syndromes are associated with multiple seizure types, including tonic-clonic, myoclonic and absence seizures, and prescription of a broad-spectrum drug such as valproate has clear advantages in this situation. The elimination half-life is in the order of 9 to 18 hours, but shorter values (5 to 12 hours) are observed in patients comedicated with enzymeinducing agents such as phenytoin, carbamazepine and barbiturates. The most commonly reported adverse effects of valproate include gastrointestinal disturbances, tremor and bodyweight gain. Other notable adverse effects include encephalopathy symptoms (at times associated with hyperammonaemia), platelet disorders, pancreatitis, liver toxicity and teratogenicity. According to the some study results, endocrine manifestations of reproductive system disorders, including polycystic ovary syndrome, may be more common in women treated with valproate than in those treated with other AEDs.

Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.

Introduction: We began treatment ofmulti drug resistant tuberculosis first from2003. At that time there was a 1960 cases andmost of the cases were from Ulaanbaatar,Darkhan, Selenge, Tuv, Dornod provinces.From all the cases only 62% or 1058 caseswere included in treatment. From that 336patient or 19% deceased, 296 patient or 18%didn’t get a treatment. We did this studybecause there were never done any researchor study of surgical treatment of multi drugresistant tuberculosis in Mongolia.Materials and Methods: We studiedcases of patients who undergone lobectomy,since 2007. There were 48 cases of 46patients, 2 patients surgery were done onboth sides. Respondents aged between 14-45, 25 male (52%), 23 female (48%), allpatients got a first - line anti-tuberculosistreatment, such as cat-1, cat-1+cat-2 and 10variants of these drugs. It was done basedon sputum culture test results of NCCDTB surveillance and research department’slaboratory.Results: From the all patients only77.08% had undergone surgery within thefirst 3 years. 92% patients were diagnosedwith multi drug resistance TB only with thesputum and sputum culture test results, andthe rest of the patients were diagnosedusing a tissue analyses on the above tests.It was revealed that HR resistant -91.66%,HR+(Z,E,S) -3 drugs resistant -18.78%,HR+(ZSE)-4 or 5 drugs resistant. In thepatients TB lesion locations was on the rightupper lobe 54%, left upper lobe 31%, ona both upper lobes 85%, cavernous fibrosistubercles 60%, combined TB lesions 77%,tubercles 21%.87.5% of total patientsreceived a multi - drug resistant TB treatmentbetween 7 - 24 months prior surgery.All 48 patients had a totally 69 surgeries.Surgeries included 9% pneumonectomy,28% lobectomy, 30% Wedge resection,23% pleurectomy decortication, 7% Wedgeresection on both sides, one bilobectomy.There were no complications during thesurgery but 5 of patients had an empyemaafter surgery. No fatal cases.Three patientsout of 5 who had a surgery due to pulmonaryhemorrhage developed an empyema aftersurgery. Drainage tubes were taken afterthe surgery within 2-3 months.Therewere nocomplication and escalations in the patientswho received a surgical treatment, after thesurgery from 6 months to 5 years.Conclusion: In study it shows that surgicaltreatment is effective to do after 6 monthsof anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows thatcombining of medical and surgical treatmentis healing up to 98% in the patients whowere rightly chosen according to surgicalindications.This research result shows that inour country multi - drug resistant TB surgicaltreatment complication is only 10.41%,which is below in the other countries whohave same anti-tuberculosis drug treatment.

In the Traditional Medicine, traditional prescriptions and raw materials of animal, plant and mineral origins have been widely used in order to heal wounds, alleviate inflammation, kill bacteria, and accelerate the development of blood cells. These natural minerals or mountain butter /in the Russian Traditional Medicine, named as каменное масло, in Western Europe and the USA, named as Mountain Butter/ is the aluminum-potassic alum /Telyaiev.V.V, 1985/ including contamination of spunky saline originated in the mountain butter, widely occurred in the mountain zones of the world. The alum or mountain butter is widely overspread in Levitan, Leona, Alma in California province of the USA, mountain region in Peris of England, Plaka of Greece, Klara of Germany, Raphid Krik of Canada, mountain region in Sebiria of Russian, areas near Baikal lake, mountain regions in Khuvsgul and Bayan-Ulgii provinces, and mountain region of Khamar Davaa along to the boundary of Russia and Mongolia, consequently regional residents have been using it as a solution for scald and burned skin. However, the scientists have been entitling the mountain butter as tar of mineral origin, mountain butter and alum /A.Jusmin, V.Chulanov/ etc during hundreds of years because it is originated in rock chaps of mountain stony regions, other substances impacted it, mixed with spoils and animal litters, as a result of the spectrum analysis conducted in a chemical and physical laboratory of the Scientific Institute under Sankt Peterburg University of the Russian Federation, /Tabune E.V, Mikhailov. V.V 1999/ it was certified that the mountain butter is metallic pickering containing iron, magnesium, nickel, kali, aluminum, foil and copper or alum (Fe, Mg) x A12 (SO4)4 x 22H20). The scientist confirmed that the mountain butter or alum is the matted yellowish and alkaline organic compound including a variety of macro and micro elements and easily fades in water and it has function to improve renewability of blood cells /Shakirov A.,Uzbek, 1982/. As a result of our analysis, the mountain butter has non-toxic elements (As, Hg, Pb, Cd) for human body but there are a lot of positive elements for human body and improves the digestion and immunity. This is a pure natural product without any negative impact and hindrance (A.Jusman, V.Chulanov, Moskwa, 2009). However, the scald disease of fire, household, chemical and other origins are widely occurred among Mongolians, expensive oil polishes /oitment, Vishnevskii, selimazin and argosulphone etc/ are usually imported from foreign countries. In Mongolianmedicine, the gel drugs of natural origin, made in Mongolia, with active function for scald injuries, is rare, consequently we conducted present research paper. The preparation of gel from mountain butter Objectives: 1. Select the appropriate gel bases from mountain butter 2. To select pH neutralizer of gel spoiler condition and substance improving absorbable quality 3. Preparation of gel and determine the indicator of gel quality Results: In accordance with the requirement for determining the adequate correlation of substances to increase the infiltrating quality in pH adapting dermis of gel originating and stabilizing condition, the research paper was conducted by following way, in order to prepare gel from mountain butter. 1. For the purpose to select the gel originator substance, the clinging quality of the base containing 2% of carbomere was convenient as a result of analysis the bases by absorbing the 5% and 10% of carboxymethyl celluse and 1%,1.2%,1.4%,1.6%,1.8%, 2%, 2.2%, 2.4% of carbometer powder, and medical substance was completely absorbed and originated equable mass, consequently it’s determined to select 5% of carboxymethyl celluse and 2% of carbomere as the gel originator substance. 2. Although, carbomere originates acid reaction in water, base Ph was 2,56 or excessive acidity, thus the crystal unsmooth liquid mass was originated when blending it with main substance, consequently the research to select the adequate doze by choosing trietanolamin as the pH neutlalizer. In order to select the adequate doze of trietanlamin, trietanlamin was increased 0.5 gram to 0.25gram and 3 gram on the carbomere’s base, and it’s determined that 3.0 trietanolamin is required to disperify pH up to 5.75. When studying the substance to improve quality humectants of gel, 5%, 10% and 15% of glycerine was selected as the substance increasing the hatching quality, and variation of the mixing quality and gel’s spreading quality were studied in comparison, and as a result of it, it’s more proper to 15% of glycerine in order to improve the humectant quality of gel. 3. Conservant substances or 0.18 % of metilparaben and 0.02% of propilparaben were prepared, admixed and absorbed in distilled water previoursy heated, and added up carbomere and disperified it. To coordinate the condition, neutralize it with 3% of trietanolamin, the main reactor or 2% of mountain butter on 5-7 of pH was absorbed in distilled water, and added up it on base and originated the smooth gel, in order to increase the humectant quality, the quality requirement for gel pH, color, liquidity, mixing quality, sort, and humectant quality were provided. Discussions: Based on the main positive aspects of the gel drug, including on injured skin or surfaces of injuries effusive covering was originated and effectively stick, not slimmed and tanned, main medical substance is rapidly released, thin effusive covering can completely separate from outer condition, consequently we prepared the gel drug from mountain butter. Researchers, M. Balkkhaev, D. Jambaninj prepared the gel containing the galenical consistent infusion, and studied and compared its quality with рН, humectant quality, and spreading capability. In order to prepare the gel with galenical infusion, carbomere (934) as gel originator substance, trietanolamin as рН adapting substance, metilparaben and propilparaben as conservant substance, glycerine as substance to increase the hatching quality, were used separately and it рН was 7.02, and spreading quality was 21.54. These explorers used the main and accidental substances that are widely used to emulge the gel drug, in their research by the modern methodology of medical technology. We prepared the water emulsion of the mountain butter and in order to formulate the gel , 2% of carbomere as the originator substance, 3% of trietanolamin as рН adapting substance, 0.18% of metilparaben and 0.02% of propilpparaben as conservant substances, and 15% of glycerin as substance to increase the humectant quality, were prepared separately and obtained gel was agreeable with the result of other researchers’ paper and provided the criterions for standardization documents and gel’s quality pharmacopoeia.

Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney function over time. As the disease progresses, it leads to an increased risk of cardiovascular complications, which are the leading cause of morbidity and mortality in CKD patients. B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart failure. Their role in CKD, however, is complex due to the overlapping pathophysiological mechanisms between cardiac and renal dysfunctions. This literature review aims to explore the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting their clinical relevance, the impact of renal function on their levels, and potential therapeutic implications. The review focuses on studies published in the last decade, examining the clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP as biomarkers in CKD patients.

Abstract The aim of this study is to compare the effects of traditional and conventional treatment of chronic pyelonephritis. Total of 100 patients diagnosed with chronic pyelonephritis were enrolled in the study. Traditional medicines included following: Sugmel-10, Sarichun, Yuna-4, Sema-3, and Sojid-11. Conventional medicines included following: ciprofloxacin, cefasolin, and negram. After 10-14 days of treatment questionnaire, physical examinations, and laboratory tests were performed. In 90% of patient treated with traditional medicines, changes of smell and color of urine was disappeared. Back pain and dysuria was reduced in 89.7% and 75% of patients respectively. While in control or conventional treatment group, changes of smell and color of urine was completely disappeared and back pain and dysuria was reduced in 80% and 88% of patients respectively. Pasternatskii’s symptom and arterial hypertension was reduced in about 58% and 77% of patients respectively. Bacterial growth (Escherichia coli and Staphylococcus aureus) was ceased in 39.4% and reduced in 46.4% of patients treated with traditional medicines. It was ceased in 60% and reduced in 30% of control patients.Traditional medicines reduced signs and symptoms of chronic pyelonephritis. Bacterial growth was ceased or reduced by traditional treatment. Traditional medicines are effective as conventional medicines for treatment of chronic pyelonephritis.

Background: To prevent and combat the spread of the COVID-19 pandemic, the Government of Mongolia has implemented measures such as movement and time restrictions, social distancing and isolation, closure of schools, kindergartens and public places, immunization, and others. It has caused adverse consequences for people, social relations, and the economy, causing health, social, economic, and humanitarian crises. Not only does this situation, medical students, as frontline healthcare workers, are more susceptible to virus infection. Vaccines against COVID-19 have been researched quickly due to the pandemic and are being used under emergency use authorization. In our country the approach of mixing vaccine doses from different manufacturers was used (fractional doses). Therefore, there is no study on the exposure of medical students to the COVID-19 infection and the adverse effects after receiving a dose of a heterologous vaccine. Objective: To study the exposure to the COVID-19 infection and vaccination status of medical students. Methods: The survey was conducted from November 2023 to December 2023 using a cross-sectional study design, and 170 students who study at ASUSU and live in the dormitory were included. Results: A total of 170 students participated in the study. 55.9% (n=95) of them were in the first year, 22.4% (n=38) were in the second year, 10% (n=17) were in the third year, 7.6% (n=13) were in the fourth year, 2.4% (n=4) were from the 5th year and 1.8% (n=3) were from the 6th year students. 88.2% (n=150) of students were female and 11.8% (n=20) were male. In this study, 37.1% of the students were infected by COVID-19 infection previously. Among them, 50% of the students were infected from family members, 16.7% from the school environment, and 15.2% did not know about the source of infection. 76.2% of the respondents were diagnosed with COVID-19 in a medical institution, and forty-one students answered that they were treated at the hospital. 83% of the cases were treated at home and were cured within 14 days. In contrast, 93.8% of the hospitalized students were treated within four months to 1 year. The current study demonstrates neurological, respiratory, sensory, cardiovascular, psychiatric, digestive, and dermatological symptoms were in 37.6%, 24.1%, 27.6%, 17.6%, 11.8%, 11.2%, and 10% of the students who participated in the study, respectively. For a year or more, symptoms of all organ systems were present, but neurological symptoms appeared to be the highest. 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine, 3.5% (n=6) did not receive the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects and 65% (n=106) had no side effects. Conclusion In this study, 37.1% of the students were infected by COVID-19 infection previously. According to the current study, symptoms related to the nervous system was the most prevalent and 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects.

Background: Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD), emphasizing the need for its early detection and prognosis. Objective: This study aimed to determine the serum NT-proBNP levels in participants with CKD and establish a cut-off value for predicting heart failure. Methods: A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study received approval from the Ethics Committee of the Institute of Medical Sciences (Approval No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology Department of the third state hospital were enrolled based on predefined inclusion and exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence quantitative analyzer. Data were analyzed with SPSS 26.0. Results: The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly between heart failure and non-heart failure groups (p<0.05). Significant differences were also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05). NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%, specificity: 55%). Conclusion Serum NT-proBNP levels are elevated in CKD patients regardless of heart failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).