1.Mongolian translation and reliability assessment of the PedsQL™ gastrointestinal symptoms module standard form in pediatric patients with gastrointestinal disorders
Bulgantsetseg G ; Namuun G ; Enkhtuvshin N ; Enkhzul N ; Davaajav O ; Tserendavga D
Mongolian Journal of Health Sciences 2026;95(5):217-222
Background:
The Pediatric Quality of Life Inventory™ (PedsQL™) is a modular, multidimensional instrument designed to assess health-related quality of life (HRQoL) in children and adolescents aged 2 to 18 years. It encompasses both child self-report and parent proxy-report formats and includes generic as well as disease-specific modules, enabling comprehensive HRQoL assessment across healthy and clinical pediatric populations. In Mongolia, gastrointestinal (GI) disorders represent the second leading cause of morbidity among children aged 10 to 14 years. The assessment of HRQoL in children with GI disorders — particularly those with chronic conditions — is of considerable importance for clinicians and researchers in conducting epidemiological surveillance, monitoring treatment outcomes, and evaluating findings from clinical trials.
Aim:
To translate the Pediatric Quality of Life Inventory–Gastrointestinal Symptoms Module Standard Form (PedsQL™-GI version standard form) into Mongolian and to evaluate its internal consistency reliability.
Materials and Methods:
The PedsQL™-GI version standard form was selected for translation following written authorization from the original developers. The bilingual forward translation was conducted by a team comprising a professional linguist and a pediatrician with 15 years of clinical experience and academic proficiency in English, adhering to the developer-provided translation protocol. The preliminary Mongolian version was subsequently reviewed by a senior pediatrician with 25 years of professional experience and academic English, with particular attention to medical terminology accuracy and linguistic equivalence. A separate bilingual team — consisting of a second linguist and a pediatrician — then performed the backward translation into English. A small-group expert panel comprising the back-translation team and the research investigators convened to review discrepancies and finalize the English reconciled version, which was submitted to the original developers for approval before the official release of the Mongolian version. To evaluate the internal consistency reliability of the Mongolian version, the instrument was administered to 25 children aged 8–12 years and 25 adolescents aged 13 years and above, along with their respective caregivers. Data were analyzed using SPSS version 25.0, employing the Intraclass Correlation Coefficient (ICC) and Cronbach’s alpha coefficient.
Results:
The Cronbach’s alpha coefficient for the total instrument was α=0.96, indicating excellent internal consistency reliability. Test-retest reliability, assessed using the Intraclass Correlation Coefficient, yielded ICC=0.79, demonstrating satisfactory measurement stability over repeated administrations.
Conclusions
1. The overall semantic equivalence of the Mongolian version was 97.8%, and 96% of cognitive interview participants rated the questionnaire as “understandable” indicating that the clinical content and conceptual integrity of the original instrument were fully preserved throughout the translation process. 2. A total of 37 adaptation instances were identified during the translation process, encompassing six categories of linguistic and cross-cultural localization: age-appropriate modification, conversion of medical terminology into everyday language, linguistic and cultural adaptation, synonymous substitution, elaboration, and condensation. These adaptations collectively enhanced the content validity of the instrument. 3. The Mongolian version demonstrated excellent internal consistency reliability (Cronbach’s alpha α=0.96) and satisfactory test-retest reliability (Intraclass Correlation Coefficient ICC=0.79), both fully meeting international psychometric standards. These findings confirm that the instrument constitutes a reliable tool for assessing health-related quality of life in Mongolian children with chronic gastrointestinal disorders.
2.Total phenolic, total flavonoids content and antioxidant activity from the aerial parts of Thalictrum minus L.
Urangoo E ; Uranbileg B ; ; Altantogos M ; Enkhzul O ; Altansukh Ts ; Enkhmaa D ; ; Oldokh O
Mongolian Journal of Health Sciences 2026;97(7):24-29
Background:
The genus Thalictrum belongs to the family Ranunculaceae Juss. and comprises approximately 200 species distributed worldwide. Most species occur in temperate regions, although a few are also found in lowland areas. Approximately 43 species of Thalictrum have traditionally been used as medicinal raw materials due to their notable therapeutic properties and reported efficacy. These plants have traditionally been used to treat a wide range of conditions, including infectious diseases, nervous system disorders, joint diseases, intestinal inflammation, gingivitis, tumors, jaundice, pneumonia, and other pulmonary inflammatory conditions. They have also been used for wound healing, reducing fever, treating gastric and duodenal ulcers, managing eye disorders and headaches, restoring physical strength, promoting diuresis, alleviating digestive disturbances, stimulating intestinal peristalsis to facilitate bowel movements, supporting recovery after illness, and treating snakebites. Phytochemical investigations have revealed that Thalictrum species contain diverse bioactive constituents, including alkaloids, flavonoids, glycosides, terpenoids, fatty acids, and phenolic compounds. These compounds have been associated with various pharmacological properties, particularly antioxidant, anti-inflammatory, antimicrobial, cytotoxic, and antitumor activities. Therefore, Thalictrum minus, a species that is widely distributed in Mongolia but whose chemical composition and biological activities have not yet been comprehensively investigated, was selected for the present study.
Aim:
To determine total phenolic and flavonoid content of crude extracts of this plant. To investigate the antioxidant activity.
Materials and Methods:
Total phenolic compounds, total flavonoids and antioxidant activity were determined using spectrophotometer methods using extracts from the aerial parts of T. minus. Dried flowering plant material of Thalictrum minus, taxonomically identified by the Botanical Garden of the Mongolian Academy of Sciences, was obtained from the Department of Pharmaceutical Technology, Mongolian University of Pharmaceutical Sciences. Total phenolic content (TPC) was determined using the Folin–Ciocalteu method, with gallic acid as the reference standard, and absorbance was measured at 760 nm. Total flavonoid content (TFC) was determined using an aluminum chloride colorimetric assay, with rutin as the reference standard, and absorbance was measured at 500 nm. Antioxidant activity was evaluated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical-scavenging assay. Plant extracts at different concentrations were mixed with DPPH solution and incubated in the dark for 30 min. Absorbance was measured at 517 nm using an Agilent BioTek Epoch 2 microplate reader, with quercetin as the positive control. Radical-scavenging activity was calculated as a percentage, and IC₅₀ values were determined from concentration–response curves. All measurements were performed in triplicate or quadruplicate, and results were expressed as IC₅₀±standard deviation (SD).
Results:
The total phenolic, total flavonoid content and antioxidant activity of the aerial parts of T. minus, a plant species growing in Mongolia, were evaluated using spectrophotometric methods. The total phenolic content of the aerial parts of Thalictrum minus L. was determined using gallic acid as the reference standard. The absorbance was measured at 500 nm, and the content was calculated using the calibration equation (y=0.6947x + 0.0046, R²=0.9997), yielding a total phenolic content of 5.38±0.09%. The total flavonoid content was determined using rutin as the reference standard and calculated using the calibration equation (y=0.3089x +0.0112, R²=0.9960), yielding a content of 2.04±0.16%. The antioxidant activity of the aerial-part extract was evaluated using the DPPH free-radical scavenging assay, which yielded an IC₅₀ value of 66.09 µg/mL.
Conclusion
The contents of selected bioactive secondary metabolites in the aerial parts of Thalictrum minus were determined. In addition, the antioxidant activity of the aerial-part extracts was evaluated in comparison with reference standards, demonstrating that the extracts possess antioxidant activity.
3.The result of pharmacological studies on traditional medicine Chun-7
Davaasambuu T ; Munkh-Erdene R ; Batchimeg B ; Enkhzul T ; Tsedensodnom Ch ; Bayanmunkh A ; Khandmaa D ; Choijamts G ; Tsetsegmaa S ; Lkhagva L ; Khurelbaatar L
Mongolian Pharmacy and Pharmacology 2022;21(2):35-40
Abstract:
CHUN-7 a Mongolian traditional recipe consisting of 7 medicinal plants is described in the scripture named “༆༆ །།གཡུ་ཐོག་པའི་མཛད་པའི་རིམས སྲུང་ཁྱུ་ལྔ་རྒྱམ་ཏོན་གསལ་བ །།”. The ingredients including Caowu (Radix
Aconiti kusnezoffii, CW) and Glehniae Radix (GR) have the effects of suppressing pneumonia, viral pneumonia, relieving pain, stimulating the immune system and reducing fever. The present study was aimed to determine acute and chronic toxicity properties of traditional drug.
Materials and methods:
CHUN 7 traditional drug were prepared in the traditional medicine sector of the Drug research Institute of Monos group. All WISTAR rats were kept in the same feed, under 12 hours lighting and 12 hours darkness housing. The study of acute and chronic toxicity of CHUN-7 traditional drug was studied by using IP and oral administration were performed on ten WISTAR rats and continued for a total of 28 days with 102.9 mg / kg dose (calculated from human dose: 16.7 mg/kg) in accordance with the WHO General Guidelines for the Evaluation and Study of Traditional Medicine.
Results:
The result showed no structural changes in the internal organs according to tissue morphology when we administrated CHUN-7 traditional drug.
Conclusion
This study showed CHUN-7 traditional drug has no toxic effects to internal organs including liver, kidney, stomach, lungs and heart. Therefore, CHUN-7 traditional drug has potential to use orally without any toxicology.
4.Result of implantation of scleral-fixated posterior chamber intraocular lenses
Enkhzul D ; Enkhtuul S ; Burenjargal P ; Tuvshintugs B ; Bat-Erdebe B ; Byamvadorj D
Innovation 2021;14(1-Ophthalmology):36-41
Purpose:
The aim of this study was to determine the surgical and visual outcomes of scleral
fixated intraocular lens implantation in eyes with as subluxated and dislocated crystalline lens or
traumatic aphakic eyes.
Methods:
A retrospective and short-term prospective cohort study was carried out in 45 eyes
of 43 individuals who underwent SFIOL implantation surgery in First Central Hospital of Mongolia
between January 2017 and January 2020 and had a minimum follow-up of 3 months. Pre-operative
and post-operative best corrected visual acuity, postoperative outcomes and complications
were summarized. Patients after the implantation of a scleral fixated PCIOL were evaluated for
the disease etiology, pre- and post-operative best corrected visual acuity, and occurrence of
postoperative complications.
Results:
The analysis included 45 eyes from 43 patients. Thirty-two (74.4%) patients were men and
eleven (24.6%) were women . The mean age at implantation was 57.2 ± 20.0. Indications for the
IOL implantation included ocular trauma (48.9%), pseudoexfoliation syndrome (22.2%) and Marfan
syndrome (15.6%). Disease etiology and age group were compared and results were Marfan
syndrome is mostly diagnosed in 20-29 years of age, ocular trauma is usually diagnosed in 30-69
years of age and pseudoexfoliation syndrome is occurred in 70 and above of age. Post-operative
visual acuity was improved in all cases from which 35 of patients (77.77%) visual outcome was 6/12
and above.
The mean preoperative best corrected visual acuity (BCVA) was 0.083 ± 0.088, which improved to
0.569 ± 0.221 (p<0.001) third month postoperatively and these were statistically significant.
The most frequent complication was induced astigmatism, which occurred in 6 eyes which
successfully corrected with glasses. Suture erosion occurred in three eyes which successfully
relocate it. The most serious complications such as vitreous hemorrhage, retinal detachment,
suprachoroidal hemorrhage, endophthalmitis and suture degradation or breakage was not seen.
Conclusion
Ab externo SFIOL implantation is a reasonable technique for the management of
eyes with aphakia or absence of capsular support, with relatively high visual outcomes and few
serious complications.
The most frequent cause of aphakia and absence of capsular support was ocular trauma thus,
pseudoexfoliation and Marfan syndrome were the most common in elderly and in young age,
respectively.
5.PRIMARY PHACOEMULSIFICATION WITH INTRAOCULAR LENS IMPLANTATION FOR ACUTE PRIMARY ANGLE-CLOSURE GLAUCOMA
Enkhzul D ; Enkhtuul S ; Burenjargal P ; Tuvshuntugs B ; Gantsooj N ; Bolortungalag P ; Sainbileg D
Innovation 2018;12(3):6-10
BACKGROUND. Acute primary angle-closure glaucoma (PACG) is a severe disease requiring intensive and emergency treatment. Surgical peripheral iridectomy and laser peripheral iridectomy procedures are performed to decrease papillary block and create an opening for the aqueous humor to pass through the eye. However, the intraocular pressure (IOP) cannot be consistently controlled by peripheral iridectomy. Phacoemulsification can widen the anterior chamber angle, position the ciliary processes in eyes with PAC posteriorly and inhibit the acute angle closure. This procedure can control the intraocular pressure sustainably for a long period. The higher incidence of the acute angle closure glaucoma in Mongolia compared to other countries was the rationale of this study.
MATERIAL AND METHODS. Medical records of 9 patients (9 eyes) with acute PACG, who had received phacoemulsification with intraocular lens implantation as initial management for medically uncontrolled high IOP, were analyzed in a retrospective chart review. IOP, visual acuity, anterior chamber depth (ACD) and the number of anti-glaucoma medications used were evaluated.
RESULTS. The postoperative IOP was reduced in 9 eyes (100%). The mean preoperative IOP was 37.9 ± 13.0 mmHg, which decreased postoperatively to 11.0 ± 1.9 mmHg at day 1, 11.1 ± 2.1 mmHg at week 1, 11.1±2.0 mmHg at 2 weeks, 11.8 ± 1.9 mmHg at month 1, and 11.3 ± 1.4 mmHg at 3 months, which showed statistically significance (p < 0.001). The mean visual acuity improved from preoperative average of 0.04±0.03 to postoperative average of 0.17±0.24 at day 1, 0.45±0.26 at week 1, 0.54±0.31 at week 2, 0.56±0.34 at 1 month, and 0.57±0.33 (p = 0.001) at 3-months. There was functional success at month 3.
СONCLUSION. Our outcome indicates that primary phacoemulsification with intraocular lens implantation lowered IOP and improved visual acuity significantly in patients with acute PACG. This is a safe and effective method of IOP control and can be considered a first line treatment option in managing patients with acute PACG and coexisting cataract.
6.OUTCOME OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Tuvshintugs B ; Gantsooj N ; Undarmaa T ; Bolortungalag P ; Sainbileg D ; Enkhtuul S ; Enkhzul D ; Burenjargal P
Innovation 2018;12(3):12-16
BACKGROUND: There are two general types of age-related macular degeneration: dry and wet. During wet or neovascular age-related macular degeneration new abnormal vessels grow and leak in the macula. As anti-vascular endothelial growth factor (anti-VEGF) was invented, it revolutionized the treatment of nAMD by inhibiting the progress of this disease. The incidence of AMD increases as life expectancy grows and there is a growing need to study this disease. We aimed to evaluate the outcome of anti-VEGF therapy for the treatment of nAMD and the incidence of ocular serious adverse events (SAE) after injections.. METHODS: In our retrospective, single-center study, medical records of patients receiving a single dose of anti-VEGF treatment (Bevacizumab) for nAMD between 17th of April, 2016 and October, 2017 were evaluated. Outcome measures were the change in the baseline visual acuity (VA) score at post-injective month one, incidence of ocular SAE and patients’ baseline characteristics affecting VA. Patients, whose treatment were started before April 2016 and had anti-VEGF treatment for the diseases other than nAMD, were excluded.. RESULTS: 15 eyes in 15 patients between 52 and 85 years of age received single dose of anti-VEGF (Bevacizumab/Avastin) injection. The mean baseline VA improved from pre-injective average of 0.21 to post-injective 1-month average of 0.37 by Snellen. Furthermore, there was no vision loss or other severe adverse effects, such as endophthalmitis, vitreous hemorrhage, retinal detachment, traumatic cataract after 4 weeks. CONCLUSION: Anti-vascular endothelial growth factor therapy has promising short-term outcomes on treating neovascular age-related macular degeneration.
7.RECURRENCE RATE WITH USE OF INTRAOPERATIVE MITOMYCIN C AND CONJUNCTIVAL AUTOGRAFT FOLLOWING PTERYGIUM EXCISION
Gantsooj N ; Undarmaa T ; Tuvshintugs B ; Tumur G ; Bolortungalag P ; Sainbileg D ; Enkhzul D ; Tumurbaatar B ; Burenjargal P ; Enkh-Oyun Ts
Innovation 2018;12(3):28-30
BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva
onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations
(UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in
developing pterygium among other environmental factors (hot, dry, windy, dusty and
smoky environments and hereditary factors. The main histopathological change in primary
pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include
foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and
cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing
the patient’s discomfort, but they do not cure the disease. After surgical removal there are
still many recurrences regardless of the method used. Autologous conjunctival grafting seems
to be the best method, given both the low recurrence rate and high safety. As described first
by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with
infrequent and relatively minor complications. The primary disadvantage of this technique
is the prolonged operative time required when compared to the bare sclera technique.
These disadvantages are outweighed by the lack of sight-threatening complications and the
relatively low recurrence rate, which made this procedure gain popularity in many centers.
The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing
the recurrence rate to a minimum.
METHODS: This retrospective case series, single center study was conducted on 239
patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department
of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic
examination before the surgical intervention. Data were collected through a prepared
questionnaire. Postoperative follow-up examination sheets were evaluated. Data
for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17..
RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and
62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5
years old.
There is no statistical significance between the stages of the disease and its post-operative
outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative
pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred
pterygium had underwent pterygium excision without conjunctival autograft.
MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium
excision.
CONCLUSION: The relationship between pterygium stage and its post-operative recurrence
was not statistically significant (P=0.683).
The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001)
which showed significant statistically.
There was no recurrence after pterygium excision with MMC (P≤0.001).
The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our
outcome.
8.ДУА-ГИЙН ДАВХАРГА БУЮУ ДЕСЦЕМЕТИЙН ӨМНӨХ ДАВХАРГА: Түүний нээлт, эмнэлзүйн онцлог болон хэрэглээ
Undarmaa N ; Enkhzul D ; Enkhtuul S ; Sainbilig D ; Burenjargal P
Innovation 2018;12(3):42-49
Эвэрлэгийн цагаа, эвэрлэгийн бусад эмгэгийн үед төгс эмчилгээний арга нь эвэрлэг шилжүүлэн суулгах юм. Deep Anterior lamellar keratoplasty (DALK) мэс засал нь гэмтсэн эвэрлэгийн стромын давхарга болон эпителийг бүхэлд нь аван эрүүл эндотели болон десцемет давхаргыг нь үлдээн хийдэг хагалгаа юм. DALK мэс заслын үед Мухамед Анварын том бөмбөлгөн (“Big Bubble” technique) техникийг дэлхий дахинд өргөн ашигладаг ба үүнийг өөрөөр десцеметийн давхаргыг ил гаргах техник (Descemet’s baring technique) гэж нэрлэдэг. Энэ техникийн үед агаарыг эвэрлэгийн стромлуу шахаж өгдөг ба тухайн шахсан агаар нь стромыг десцеметийн давхаргаас салган гэмтсэн эдүүдийг эрүүл эдээс тусгаарлана. Сүүлийн хэдэн жил том бөмбөлгөн техникээр Deep Anterior lamellar keratoplasty (DALK) хагалгааг олон удаа хийх явцад Дуа-гийн давхаргыг олж нээсэн. Энэхүү судалгаанд Дуа-гийн давхаргын онцлог шинж чанар, анатомийн байрлал, түүний нотолгоо болон эмнэл зүйн ач холбогдол хэрэглээг судалсан.
9.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.
10.A study of factors affecting the implementation of the curriculum
Otgonbayar D ; Dashtseren B ; Lkhamdulam B ; Enkhzul T ; Baasanjav N
Mongolian Medical Sciences 2018;185(3):75-79
Introduction:
The curriculum development is important issue, especially stakeholder’s evaluations for the
implementation of the curriculum. Accordingly, this time we conducted this survey to determine the
level of satisfaction of teachers, which is a key factor in implementation of curriculum at the “Ach”
Medical University.
Goal:
To study curriculum implementation assessment by teachers at the 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 77 teachers were included in the
study. Study questionnaire included 7 groups with 53 questionnaires.
Results:
Total n=77 teachers included in the study. The satisfaction level of teachers for the implementation
of curriculum was 73% (n=56) satisfied with satisfaction, 22% moderate satisfaction (n=17), and
medium satisfaction teacher 5% (n=4).
The satisfaction level of teacher workload and job satisfaction is high enough to satisfy the workload
of the trainee, the time to prepare the lesson, and the opportunity to work with the students in the
classroom. 3.6-4.2, while the teacher’s work value or salary the level of satisfaction level is 3.11, the
minimum value is 2.75, the average.
Conclusion
The average satisfaction score was 4.11 above the average but the effectiveness of
the program, the effectiveness of the teacher’s work, study environment and textbooks were below
average.
Result Analysis
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