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.

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.

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.

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.

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.

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.

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.

Introduction: The clinical skills training at medical schools provides the opportunity for future medical doctors to deal with the client with proper care, diagnosis of the disease, first aid, treatment, nursing, treatment, counseling to address the complexity of the problem solving and the ethical attitude of the doctor. To achieve this objective, it is necessary to assess the level of knowledge, skills and attitudes students have acquired. Goal: To analyze assignment of basic clinical skills assessment and to identify the level of кknowledge and skills students who have graduated second year medical program at “Ach” Medical University during 2016- 2017 academic year. Materials and Methods: The study was used as a descriptive model to measure the reliability of the assignment, the difficulty factor of tasks, and the Hoffsten’s scores based on the tasks and performance of each station and compared with the indicators. Results: Based on Hoffsten’s study on the success rate of examiners at the 5 stations, the Hoffsten’s score level of clinical examination was 68 percent, the physical examination station was 64 percent, the station’s diagnostic level was 71 percent, the laboratory was 70 percent and the nursing station was 70 percent. Conclusion At each clinical trial, the differential diagnosis of each individual clinical trial, clinical interview, nursing station and visual diagnostic station (DF> 95), at the laboratory and at the physical examination station, assess the student with a higher grade of difficulty factor (DF> 80) to the Hoffsten’s score of the basic clinical skills exam is set to be 70 percent.

Introduction: The curriculum development is important issue, especially sudent’s evaluations for the implementation of the curriculum. Accordingly this time we conducted this survey to determine the level of satisfaction of students, which is a key factor in implementation of curriculum at the “Ach” Medical University. Goal: To determine student’s satisfaction level in the curriculum implementation of “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 1105 students were included in the study. Study questionnaire included 2 groups with 17questionnaires. Results: Students’ satisfaction level is 3.22 point on average and students gave lowest points 2.77 on the quality of classroom, school environment, training equipment and books and course materials. Conclusions The average satisfaction score was 3.22 above the average but the some factors including classroom capacity, study environment, training equipment and books and course materials, textbooks were below average.

Background: One of the confronted problems of doctors and medical personnels is sexually transmitted disease has not been decreased in our country up to now. By last 5 years propagation of trichomoniasis was 16.7-9.5% per 10000 population and infected T.vaginalis. In the practice of parasitology of our country metilen is revealed by gram method hasn’t been introduced which is used in up to date histological analyse. This became the background of our research work. Aim of our research is to diagnose trichomoniasis which infects sexually by cytological analyse and to define its specific and sensibility.Materials and Methods: A total 99 smears of 33 females aged 19-39, used cross sectional descriptive method. Finding T.vaginalis on specimens (1) Vaginal wet mount, (2) Gram staining and (3) Pap stain. Result: In our research T.vaginalis leaked out in wet mount smear was 33%, in Gram stain was (21.2%). The sensibility quality of T.vaginalis on Gram stain is 63%, specific quality is 90%, value of kappa coefficient (К=0.58 Р<0.002). In Pap stain T.vaginalis diagnosed 27,2% and sensibility quality of T.vaginalis is 81%, specific quality is 100%, value of kappa coefficient (К=0.87 Р<0.005). In the case when 3 analysis were positive case was 5 or 15.2%, in the case where 2 analysis were positive case was 6 or 18.2%. Conclusions: The Pap stain sensibility quality of T.vaginalis is 81%, specific quality is 100%, value of kappa coefficient (К=0.87 Р<0.005), that shows should be to give effect on diagnosing of sexually transmitted infectious disease.