AimThe aim was to study retrospectively the possible changes in practice patterns in the managementof patients with acute myocardial infarction who were admitted to the State Second Central Hospitalduring the last 5 years.Material and MethodThis study conducted at the State Second Central Hospital in September 2014.Patients with acute myocardial infarction were divided into 2 groups: main and control. Main groupincluded 95 patients with myocardial infarction who were treated from 2010 to July 2014. Controlgroup included 102 patients with myocardial infarction who were treated from 2005 to 2009.From 2005 to 2012 patients fulfilled the diagnostic criteria of myocardial infarction based on WHOcriteria. From 2013 to 2014 patients fulfilled the diagnostic criteria of myocardial infarction based onnational guideline’s criteria. Differences in proportions in the groups were tested with the chi squaretest. P value of <0.05 was considered significant.ResultsA total 197 patients (mean age 71.2±6.1, 62% man, and 38% women) with acute myocardial infarctionwere enrolled. More than half had a history of arterial hypertension. Atypical forms of myocardialinfarction increased from 25.8% in 2005-2009 to 40.4% in 2010-2014. ST elevation myocardialinfarction and non ST elevation myocardial infarction were detected in 61% and 39% of patientstreated in 2010-2014. Diagnostic use of troponin was increased significantly in last 5 year (44.2% vs.88.6%, p<0.05).The study revealed only 17.2% of patients with acute myocardial infarction met the national guidelinesgoal of pre-hospital time <12 hours. Eighty four (88.3%) patients of the main group received medicaltherapy and 11(11.7%) treated with percutaneous coronary intervention. Aspirin was prescribed in80.7% of main group, heparin in 97.9%, ACE inhibitors in 47.9%, Beta blocker in 14.9% within 24hours of acute myocardial infarction.ConclusionsCompared with control group use of troponin and invasive treatment strategy has increased since2010 in the management of patients with acute myocardial infarction. Delay of pre-hospital timeremains an actual problem in the management of acute myocardial infarction.

Mental health team includes a psychiatrist, a psychiatric nurse, psychologist and social workers. Mental health workers are more stressful than other sector’s workers. Mental workers are working with mental patients, who have chronic,severe and poor prognosis disorders for long time, and may have Work Burnout Syndrome (WBS). Worldwide, many researches are used Maslach Burnout Inventory (MBI) for assessing WBS. Our goal was to detect risk factors of WBS among mental health workers. We conducted the survey among workers mental (doctors, nurses and assistant nurses) and study design was a descriptive cross-sectional. We are used a questionnaire, is including MBI. Our subjects were 103 workers, who were 27 (26,2%) doctors, 32 (31,1%) nursesand 44 (42,75) nurse- assistant. They were 15 (14,6%) male and 88 (85,4%) female and average age was 38.21 (SD = 8.92). The worker’s average professional working year was 13.09 (SD = 9.76). Most of subjects (n=63 61.2%) were shift-workers and they (n=99 96.1%) have high workload. We determined 3 groups by level of MBS among mental workers, such as the group with EE’s high scale (n = 27; 27%), thegroup with DP’s high scale (n = 23; 22.8%) and the group with PA’s high scale (n = 50; 50.5%).MBS was high among NMHC’s workers. However their work time is low, but theyhave risk factors for MBI such as high workloads, shift work, number of patients. Workers of emergency department had termination burnout syndrome more than other acute departments. This was associated with working condition.

Abstract: Diabetes is describe as a disease of the thirst (undaasah) in the four foundations of traditional drug (Kh. Tumbaa, 1991).
There are drugs such as Jur Ur-4, Sopagi-14, Yunva-4 and Usu-3 used for thirst disease. One of the main medicines used in Mongolian traditional drug is “Usu-3”. This is drug with 3 ingredients (Coriandrum sativum L.), (Inula helenium L.), (Hippophae rhamnoides L.). Each of these ingredients were studied indivudually, but not studied in combination. Purpose: To study liver protection effects and toxicity of the “Usu-3” traditional drug in the pathological diabetic model. Methods: The experiment were performed using acute and chronic toxicity study by Organization economic cooperation development (OECD 423), effect of antihyperglycemic and antihyperlipidemic on the alloxan induced diabetic milletus. (Sheriff Modu*, A. Laila et al, 2011) and (Ju JB, Kim JS et al, 2008) method. Results:
1. The “Usu-3” traditional drug was tested in animals at a dose of 5 to 5000 mg/kg in accordance with OECD guideline 423 for acute toxicity study and was found to be harmless in the GHS category. Therefore showed no signs of chronic poisoning with the maximum dose determined for chronic toxicity studies oral administration by 5000mg/kg for 2 months.
2. The “Usu-3” traditional drug’s group has been shown to reducing the levels of Aspartate Aminotransferase and Alanine Aminotransferease comparison with other groups. Conclusion “Usu-3” traditional drug was found to be harmless in the GHS category, showed no signs of acute and chronic toxicity.
“Usu-3” traditional drug have a protection effect for liver at short and medium time in alloxan induced diabetic rats model.

Abstract: Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally and diabetes is one of the top 5 causes of these diseases.According to Mongolia's health statistics, diabetes accounted for 41.5% of all diseases of endocrine, nutritional and metabolic disorders and the morbidity rate was 82.9 per 10 000 population in 2018.
We chose to study the Usu-3 traditional medicine, which has been used in medicine for diabetes. Purpose: The study of effects for "Usu-3" traditional medicine in alloxan-induced diabetic model Methods: The experiment were performed using (Sheriff Modu*, A. Laila et al, 2011) and (Ju JB, Kim JSet al, 2008) method. Results: The "Usu-3" traditional drug has been shown to have a gradual effect on lowering serum glucose in short time and normal level in medium time. Therefore as well as normal levels of lipids in all groups. Conclusion "Usu-3" traditional drug has been shown to gradually lower blood serum glucose and when to study the antihyperglycaemic and antihyperlipidaemic effects of "Usu-3" traditional drug at in alloxan induced diabetic rats.

Background: In the network of health sector reform, improving the quality and safety of service, organizational development, and ethics and responsibility of doctors and health professionals is a priority issue. To bring this, the patient satisfaction is an important matter. Materials and methods: This study was carried out using a cross-sectional study design with quantitative and qualitative method. To collect data and materials of the study, we used questionnaires from Appendix No.2 of Order 13 of the Minister of Health dated 13 January, 2014. Results: 84 (61.8%) of inpatients evaluated hospital care as a good, while 117 of 197 outpatients (59.4%) evaluated hospital care as an average. The general satisfaction of patients is good for inpatients and average for outpatients. Discussion The patient satisfaction was different depending on the department, gender, age and age group for inpatients, while satisfaction was not dependent on age group for outpatients.

Background: In the network of health sector reform, improving the quality and safety of service, organizational development, and ethics and responsibility of doctors and health professionals is a priority issue. Therefore, it is important to study the satisfaction and needs of healthcare workers, who have essential role in the quality and accessibility of health care service, as well as in social and economic development. Materials and methods: This study was carried out using a cross-sectional study design with quantitative method. The questionnaires were conducted from 63 people who were working in the general hospital of Selenge province. To collect data and materials of the study, we used questionnaires from Appendix No.1 of Order 13 of the Minister of Health dated 13 January, 2014. Results: The Satisfaction score of doctors and healthcare workers which was evaluated by themselves was generally 1.74 ± 0.47 or average, meanwhile 1.62 ± 0.41 or good for each group. Conclusion The employee satisfaction with the General Hospital of Selenge aimag is good. The satisfaction of doctors and healthcare workers is not dependent on the age group, gender, position, and seniority.

Background: Headache disorders are most prevalent public-health problem. Worldwide, among the adults 46% suffer from primary headache, where the migraine presents 11% and tension type headache (TTH) presents 25%. Recently, one type of the primary headache, medication overuse headache tends to increase. Nowadays, there is no sufficient study about primary headache in Mongolia. So that, it is necessary to investigate prevalence, clinical type and risk factors of the primary headache. Purpose: To study prevalence and risk factors of primary headache in Mongolia. Materials and Methods: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old were randomly selected from four provinces and three districts of Ulaanbaatar city. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program. Results: A total of 2043 participants (812 men and 1231 women) were reviewed. The participant’s average age was 38.6±13.4years. 1350 (66.1%) participants reported recurrent headache within the last 1 year. Of the total study population, the prevalence rate of primary headache was 1305 (63.9%). Number of people who suffered from migraine was 494 (24.2%), significantly greater in female than male participants (p=0.0001), with most frequent attacks at age 26-45 years. The risk of migraine associated with sex, education and family history (p=0.001). 592 (29.0%) of participants had TTH, mean age of them was 37.7±5.24, significant high rate in female than men, risk of TTH depends on education and job. The medication overuse headache was diagnosed at 116 (5.7%), 29.4% in men and 70.5% in women with average of 45.6±11.4 and 43±12.7 respectively. Among the participants 38.6% used medications, 28% people had one drug, 8.5% two drugs and 2% used three or more drugs. Use of non-steroid anti-inflammatory drugs (NSAID) made up major percent in headache patients. Increased frequency of medication and multidrug affected to medication overuse headache (p=0.008). Conclusion More than half of studied population had primary headache. Migraine was in 24.2%, TTH in 29.0% of people, and associated with sex, education and family history. Use of non-steroid anti-inflammatory drugs made up major percent in headache patients.

BACKGROUND OF STUDY: For the past 10 years, accidents and trauma are ranking third in the cause of Mongolian population’s death. Russian scientists have defined that skull and brain trauma comprise of 40% of the total traumas and is one of the serious injuries that have damaging effect to the health. Defining its creation, injury period, death cause in the leading direction of science of forensic medicine in our country are still the urgent issues. Nowadays little research which studied case mortality due to accident and trauma has been studied, this became background of our research work. PURPOSE OF STUDY: To study cause and peculiarity of pathology of case mortality due to brain trauma, in the condition of our country and to consider the result. OBJECTIVE OF STUDY: To study the cause, some risks of head injury. To define pathology of case mortality due to head injury. MATERIAL AND METHODOLOGY: We did retrospective study in 555 case material of an autopsy of case mortality of head injury of forensic medicine and research department of national institute of forensic science. Statistical work out was done by Microsoft excel and extensive index. RESULT OF STUDY: 84.5% (n=459) is male and 15.5% (n=86) is female out of our 555 involved cases and the gender ratio is 5:1. The most or 81% of the research participants had head injuries due to hitting with firm and dull stuffs and 15.9% head injury as a result of traffic accident follows in the second place. To analyze from the characteristics of mortality, 93% is subarachnoid hemorrhage, subdural, epidural hematoma, 64% is brain tissue injury were detected. CONCLUSION: Young manhood men mortality that has head injury resulted from the firm and dull things occupies most of the percentage in our research. The head injury can lead to the mortality of his ordinary process.

Introduction: Determining stages of liver fibrosis in chronic liver disease is essential for clinical practice such as decision making on medical treatment, setting the interval of follow-up examination for its complication, screening intervals for hepatocellular carcinoma. Goal: We compared non-invasive fibrosis markers among the patients with chronic hepatitis Delta. Materials and Methods: Totally 70 patients with chronic hepatitis D enrolled into this study. The blood samples were examined for complete blood count, liver function test and serum M2BPGi level. Non-invasive markers such as AAR, APRI, Fib-4 scores were calculated. Those with AAR >1, APRI >0.7, FIB-4 >1.45 were considered with advanced fibrosis. All patients underwent liver stiffness measurement using FibroScan M2 probe. The cutoff values of FibroScan for advanced fibrosis were 9 kPa for patient with normal transaminase level and 11 kPa for patients with elevated transaminase. Results: Advanced fibrosis was observed in 25.7%, 38.6% and 38.6% by AAR, APRI and Fib-4 score, respectively. When cut-off levels of serum M2BPGi for advanced fibrosis was 2.2 COI, 35.7% had advanced fibrosis. FibroScan tests showed 34.4% had advanced fibrosis. The AUROC of M2BPGi were 0.894 and 0.827 for predicting advanced fibrosis and liver cirrhosis. Conclusion Serum M2BPGi and FibroScan would be reliable diagnostic tool for identifying liver fibrosis in Mongolian patients with chronic hepatitis D.