1.Quality Assurance of Gastrointestinal Endoscopy Unit - A Single Center Study
Sarantuya Ts ; Amarjargal B ; Tungalag B ; Khishgee D ; Amarmend T ; Delgertsog T ; Amarjargal E ; Sarantuya G ; Gan-Orshikh L ; Enkhjargal B ; Sarantsatsral D ; Burentungalag A ; Nandintsetseg B ; Tserendolgor Ts ; Sattgul Sh ; Javzanpagma E ; Suvdantsetseg B ; Khashchuluun O ; Ouynkhishig N ; Munkhtuya E ; Uranchimeg M ; Oyuntungalag L ; Myadagmaa B ; Bat-Erdene I ; Batgombo N ; Saranbaatar A
Mongolian Journal of Health Sciences 2025;86(2):165-170
Background:
Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety
and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement
system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional
and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators
specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services.
Aim:
To assess the quality indicators in gastrointestinal endoscopy unit.
Materials and Methods:
A retrospective single-center study was conducted by collecting data from the Intermed hospital’s
electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results
were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research
committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of
four quality indicators measured monthly; b) sample survey data from five categories of quality indicators.
Results :
Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning
score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased
during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was
5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation
quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma
detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes,
Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge
time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate
risk was 0.28% by the TROOPS evaluation during procedural sedation.
Conclusion
The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be
effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.
2.Study of the stomatal cell in certain saponin containing medicinal plants in mongolia
Nurdana B ; Khulangoо B ; Densmaa L ; Norovnyam R ; Enkhtuul B ; Khuvtavilan B ; Munkhzul B ; Buyanjargal E ; Daariimaa Kh ; Enkhjargal D ; Turtushikh D ; Amarjargal T
Mongolian Journal of Health Sciences 2025;89(5):33-38
Background:
Saponins are secondary metabolites in plants that play an important role in defense mechanisms and
physiological processes. Since stomatal cells are crucial for gas exchange and water balance in plant tissues, studying the
anatomical and biochemical features of stomatal cells in saponin-rich plant species provides insight into the interactions
between these compounds and cellular mechanisms. This serves as the basis of our study.
Aim:
To determine the structure, types, and functions of stomatal cells in saponin-containing medicinal plants
Materials and Methods:
During June–September 2024, nine species of saponin-containing medicinal plants were
collected from Bulgan, Tuv provinces, and “Gorkhi-Terelj National Park” in Mongolia. Prepared microscopic specimens
were examined using macroscopic and microscopic techniques to study the structure, position, number, and epidermal
features of stomatal cells.
Results:
The study revealed that Anemone crinita Juz. exhibited the highest stomatal density (107 stomata/mm²) and
epidermal cell density (229 cells/mm²), indicating strong adaptation and protective capacity in arid conditions. Vicia
baicalensis (Turcz.) B. Fedtsch. showed the highest stomatal index (39.6), highlighting its significant role in regulating
transpiration. Stomatal types varied among species:
• Anomocytic stomata were observed in Potentilla multifida and Vicia baicalensis.
• Anisocytic stomata were found in Delphinium grandiflorum and Ranunculus borealis.
• Paracytic stomata were present in Gentiana algida, Adenophora remotiflora, Helianthemum nummularium,
Anemone crinita, and Ranunculus acris.
Conclution
In the study of the structure, form, and number of stomatal cells in saponin-containing plants growing in
Mongolia, Anemone crinita Juz. was found to have the highest number of stomatal and epidermal cells, indicating its high
efficiency in gas exchange, water regulation, and protection against external stress. Furthermore, Vicia baicalensis (Turcz.)
B.Fedtsch. showed the highest stomatal index, confirming its strong capacity for active regulation of gas exchange.
The variation in stomatal cell types among plant species was identified as playing an important role in ecological and
biological adaptation as well as protective mechanisms.
3.Microscopic structure and histochemical study of Gentiana decumbens L.f.
Nurdana B ; Densmaa L ; Enkhtuul B ; Khuvtavilan B ; Munkhzul B ; Buyanjargal E ; Daariimaa Kh ; Amarjargal Ts
Mongolian Journal of Health Sciences 2025;90(6):128-134
Background:
Plants of the family Gentianaceae in Mongolia are rich in bitter iridoid glycosides, flavonoids, and polyphenolic
compounds, and have been traditionally used in Mongolian medicine to promote digestion, protect the liver, and
reduce fever. However, standardized information on the micro-morphology and histochemical characteristics of the widely
distributed species Gentiana decumbens L.f. is scarce, limiting the assessment of its quality as a medicinal raw material.
Aim:
To identify the morphological and anatomical characteristics of the aerial and underground parts of Gentiana decumbens
and to localize the distribution of starch, polysaccharides, and phenolic compounds using histochemical methods.
Materials and Methods:
Plant materials were collected in July 2024 from Tsagaan-Uul soum, Khuvsgul province, andshade-dried. Samples were softened in a water–ethanol–glycerol solution (1:1:1) for 24 hours, and transverse and longitudinal
sections of stem, leaf, root, and floral parts (anther, petal, receptacle/bract) were prepared using a hand microtome.
Sections were cleared with 10% chloral hydrate. Histochemical reagents included potassium dichromate (K2Cr2O7), ferric
chloride (FeCl3), Lugol’s iodine (I₂+KI), thymol + concentrated H₂SO₄, and methylene blue. Slides were mounted in
glycerin and examined under an Olympus light microscope at 40× and 100× magnifications, and images were recorded
using a 12 MP digital camera.
Results:
Leaf: The leaf exhibits a dorsiventral structure with a dense palisade parenchyma on the adaxial side and a
loosely arranged spongy mesophyll on the abaxial side. Stomata are hypostomatic, and collenchyma is well developed
around the vascular bundles. Histochemical reactions were negative for starch and phenolic compounds. Stem: The stem
consists of an epidermis, a wide cortex, a continuous ring of sclerenchyma, 12–15 collateral vascular bundles, and a broad
central parenchyma. Histochemical tests showed a brownish-yellow coloration with potassium dichromate (K2Cr2O7),
indicating the presence of polyphenols and lignin, and a brown coloration with Lugol’s iodine, confirming the presence
of starch. Reactions with ferric chloride (FeCl₃), methylene blue, and thymol + H2SO4 were mostly negative in cross sections.
However, in longitudinal sections, Lugol’s and thymol + H2SO4 showed positive reactions, suggesting the presence
of starch and polysaccharides, respectively. Root: The root displays a primary structure with radial xylem and phloem,
a distinct endodermis with Casparian strips, and a pericycle layer. Positive reactions were observed with K2Cr2O7 and
FeCl₃, indicating phenolic compounds and lignin. Lugol’s iodine showed abundant starch granules in parenchyma cells.
Receptacle / Bract: The receptacle is covered by a thick cuticular epidermis with trichomes, and composed of outer and
central parenchyma layers containing numerous small closed (amphivasal-type) vascular bundles. Positive reactions were
detected with K2Cr2O7 and FeCl₃, indicating polyphenols, flavonoids, and tannins; Lugol’s iodine confirmed the presence
of starch; thymol + H2SO4 showed partial positivity for polysaccharides. Stamen (longitudinal section): The stamen structure
includes epidermis, endothecium, pollen sacs, and a distinct vascular bundle. Positive staining was observed with
K2Cr2O7, Lugol’s iodine, and FeCl3, confirming the presence of polyphenolic compounds, lignified elements, and starch.
Conclusion
The anatomical features of G. decumbens indicate adaptations to dry, high-light environments through
well-developed mechanical strengthening (sclerenchymatous ring), efficient photosynthetic structure (compact palisade
mesophyll), and nutrient storage (starch-rich pith and cortex). Histochemical analysis revealed the localization of polyphenolic
compounds and starch/polysaccharides mainly in the root, stem, and floral organs, while absent in the leaves,
demonstrating organ-specific accumulation patterns. These findings scientifically support the plant’s traditional medicinal
uses for digestive stimulation and hepatoprotection.
4.Prevalence of construction worker injuries in the last 5 years and influencing factors of some years
Mongolian Medical Sciences 2023;204(2):27-38
Background:
According to the International Labor Organization (ILO), 2.78 million workers are injured
and killed each year as a result of occupational diseases, while 374 million are injured. Furthermore,
work-related injuries cost the global economy 4% of its GDP. Construction workers are more likely than other workers to die and twice as likely to be injured. Construction accidents are
frequently caused by a lack of knowledge and training, negligence, and inadequate safety equipment. Workers account for 70% of the factors influencing accidents, 49% of workplace problems, 56% of
equipment shortages, 27% of material conditions, and 84% of risk management. Between 2009 and
2017, 3321 industrial accidents and acute poisoning cases were reported in Mongolia. 509 people
died as a result of industrial accidents, 761 people became disabled as a result of injuries, and 2051
people temporarily lost their ability to work. As a result, determining the distribution, causes, and
factors of accidents is reasonable.
Purpose:
To detect the prevalence and influencing factors of accidents in the construction industry in the last
5 years.
Material and Method:
Secondary data was collected using a quantitative research method based on a single-moment model
of observational research from the "General Directorate of Professional Supervision" quantitative
data on industrial accidents and acute poisoning by sampling 10 groups and 59 indicators of accident
cases in the construction industry.
Result:
The prevalence of accidents in the construction industry was calculated for 1000 workers in
Ulaanbaatar's 21 provinces and 9 districts using the ARC GS program. For the calculation of
influencing factors and injury causes at www.graphpad.com, P values less than 0.05 was considered
significant.
Between 2017 and 2021, 134 accidents and injuries were reported in Mongolia's construction industry.
All accidents were male in 123 cases (92%), and female in 11 cases (8%).
Accidents and injuries in the construction industry are distributed. In Mongolia, Ulaanbaatar had
66 cases, Umnugovi had 10, Orkhon had 10, and Khovd province had 12, all of which had more
accidents than other provinces. Calculating the distribution per 1000 workers, Sukhbaatar has 20,
Dornogovi has 15, Umnugovi has 12, and Khovd has 10.9.
The most important factors influencing construction accidents are the workplace environment and
human factors. In terms of accident causes, falling, tripping, or slipping caused 55 or 41% of all
accidents, falling objects caused 24 or 18%, being trapped by objects caused 19 or 14%, and 20 or 15% were remaining causes of injuries. In the last 5 years, 47 or 35.07% of all accidents were caused
by workplace environment, 45 or 33.5% by human factors, 23 or 17.1% by management system, and
19 or 14.1% by technical and technological factors.
Conclusions
1. In the last five years, the prevalence of accidents among construction workers is 16.3 per 1000.
The prevalence is 42.9% (66) highest in Ulaanbaatar City, 20.1% (27) in Khan-Uul district, and
8.9% (12) in Khovd province. The prevalence per 1000 workers is 20 in Sukhbaatar, 15.7 in
Dornogovi, 12 in Umnugovi, and 10.9 in Khovd, with a high prevalence of 1.07 in Ulaanbaatar.
2. Human factors, such as falling from a height due to noncompliance with safety rules, limited
space in the workplace and environment, and falling into pits, wells, ditches, and excavated pits,
are the leading causes of injuries and accidents. Closed fractures and head injuries are the most
common.
5.Assessing children with disabilities using who international classification of functioning (ICF)
Norovnyam P ; Tserendulam N ; Oyunkhand E ; Tuul O ; Amarjargal O ; Baljinnyam B ; Nasantogtokh E ; Altantuya Sh ; Enkhmaa D
Mongolian Journal of Obstetrics, Gynaecology and Pediatrics 2022;31(1):2265-2271
Assessing children with disabilities using who international classification of functioning (ICF)
Background: In 2021, according to the World Health Organization (WHO), over 1 billion people are estimated to experience disability. The number of children with disabilities globally is estimated at almost 240 million, according to a new UNICEF report. There are approximately 43 million children with disabilities in East Asia and the Pacific. In the 2020 population and housing census of Mongolia, a total of 106.4 thousand people with disabilities were counted, of which 7.6 percent or 8.1 thousand children aged 0-14 were counted. People with disabilities lose some of their ability to labor. WHO recommended that assessment of children with disabilities using both ICD and ICF. Thus, we aim to assess children with disabilities who have neurological disease using International Classification of Functioning and evaluate the validity of this classification.
Materials and methods: This was a cross sectional analytical study based on NCMCH. Study materials were collected from children and guardians through standard questionnaires. The questionnaire consisted of 2 groups: general information of the participant and indicators of the scope of the D code of the "ICF" to assess the childhood disability. According to the indicators of the D code range, activity limitations and participation restriction, disabilities were evaluated. Each question in the questionnaire was measured on a 5-point Likert scale from 0 to 4. The statistical analysis was performed using R 3.5.1 program. Validity was assessed using the Rasch model for each question. Questionnaire reliability was assessed by Cronbach's alpha test.
Results: The study included 32 children aged 2-15 years. Male children were 62.5% of participants, the mean age was 8±3.1 years. Correlation between questions was high (r = 0.79) and reliability was adequate (α=0.94). As a result of Rasch analysis, the mean and standard deviation of the 36 selected parameters were not significantly different from the standardized mean. 3 indicators that did not meet the analysis criteria were removed, and a total of 33 indicators were used to measure childhood disabilities. Mean infit MNSQ was 1.06, mean outfit MNSQ was 0.93. MNSQ of all participants were 1.0 – 2.0. As a result of Rasch analysis, the mean of 33 indicators of disability is -1.6, the standard deviation is 1.2, the upper limit of the mean is 3.6, and the lower limit is -3.4, and the indicator of D code was stable enough to measure disability. The mean code scores were 2.45±1.3. The mean score of disability level of children diagnosed with cerebral palsy was 2.9±1.09, and children hospitalized with seizures and meningitis was 0.5±0.3. Also, the total mean score was 2.61±1.2 in the group with disability and receiving care, and 1.8±0.21 in the group not receiving care, which was a statistically significant difference.
Conclusions: Inter-indicator correlation was good and reliability of the questionnaire was adequate in field use of the 38 indicators of the activity limitations and participation restriction of the International Classification of Functioning, Children's Version (ICF-CY) code range “D”. When evaluated by Rasch analysis, 33 questions were evaluated as structural and stable. The International Classification of Functioning can be used to assess children's disabilities.
Discussions: Niels Ove Illum et al. (2015) found that The World Health Organization International Classification of Functioning, Disability and Health child and youth version d code data can provide a coherent measure of severity of disability in children across various diagnoses, ages, and genders. Results were similar to our study.
6.Study of influencing factors of the maternal, infant and placenta weight
Jargalsaikhan B ; Otgonbayar L ; Gandolgor B ; Uurtiintuya B ; Oyunsuren E ; Otgontsetseg B ; Tsolmon G ; Amarjargal B ; Tegshjargal S
Mongolian Medical Sciences 2017;181(3):10-14
Introduction :
In the last years other country scientists told about not only determine infant weights, need to interest
correlation between maternal weight, height and infant weight. In our country few research articles posted
about anthropometry of obstetrics and gynecology. Our study aim is determine maternal weight, infant
weight, placenta weight and assess factors affecting roles on maternal story of “Amgalan” Maternity
Hospital in 2014-2015.
Goal:
The current study aimed at assessing maternal weight, infant weight, placenta weight and evaluating the
effect of factors leading to it.
Materials and Methods:
The data was already collected from “Amgalan” Maternity Hospital using maternal history and record and
it was collected measuring general physical characteristics such as body weight and height, infant weight,
placenta weight and body circumferences. We used retrospective method and collected statistical data
was analyzed using SPSS 21.0 software.
Results:
Of total 964 study participants aged 18-45. The average age of participants was 29.6 ± 5.8 years old and
49.7% (n=479) was working during pregnancy, 45.7% (n=441) hadn’t works, 4.6% (n=44) was student.
The average weight of mothers was 75.4±11.5, weight of infants was 3439.5±456, weight of placenta
was 685±129. The following factors affected maternal and infant weights: lower education, working, early
and late pregnancy complication. Maternal weight had a low direct correlation with infant weight (r=0.267,
p<0.01) and placenta weight (r=0.208, p<0.01). In our study maternal height had a low direct correlation
with infant weight(r=0.173, p<0.01) and infant weight had a moderate direct correlation with placenta
weight (r=0.376, p<0.01).
Conclusions
1. The average maternal weight was 75.4±11.5, infant weight was 3539.5±456, placenta weight was 685±129.
2. The following factors affected maternal and infant weights: lower education, working status, early and late pregnancy complications.
3. Maternal weight had a little direct correlation with infant weight (r=0.267, p<0.01) and placenta
weight (r=0.208, p<0.01).
Result Analysis
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