Background: Analyzing registered drug information and providing policymakers and decision-makers with evidence-based data is essential for future decision-making. Aim: To determine composition and patterns of change in registered medicines in Mongolia. Materials and Methods: In this study, an overview analysis of drug registration data from 2006 to 2025 was carried out using Microsoft Power BI. Result: During this period, a total of 7,528 drugs were registered, of which 77.3% were modern medicines, 15.1% were traditional medicines, 5.6% were herbal medicines, 1.4% were biopreparations, and 0.6% were vaccines. On average, overall drug registration increased annually by 2.2%, while imported drug registration grew by 1.9%. In contrast, domestic drug registration fell by 1.4%. Of all registered drugs, 79.7% were imported. Drugs from 64 countries were registered, with Mongolia contributing the largest share by registering 1,525 drugs, which accounts for 20.3% of the total. Among drugs registered by 33 countries with strict regulatory systems, 42.5% of total registrations and 53.3% of imported drugs originated from these countries. Of all registered medicines, 68.2% were prescription medicines, 28.3% were overthe-counter medicines, 1.2% were hospital-use medicines, 2.2% were narcotics, and 0.3% were psychotropic substances. In terms of routes of administration, 64.2% were oral medicines, 23.7% were injectable, 4.8% were ophthalmic, otic, or nasal preparations, 4.6% were topical medicines, 2% were administered via other routes, and 0.9% were inhaled. According to the ATC classification, the largest share was held by anti-infective medicines at 19.5%, while antiparasitic and insecticidal preparations had the smallest share at 0.76%. As of 4 April 2026, there were 477 antibiotics registered, of which 412 were other than suppositories, ointments, eye drops, and ear drops. According to the WHO AWaRe classification list for 2025, 49.03% (n=202) was “Access” group of antibiotics. Conclusion The findings of this study indicate that imported medicines account for a significant share of registered drugs in Mongolia, underscoring the need to expand domestic pharmaceutical production and strengthen the drug registration system.

Background: Organizational culture, reflected through institutional values, beliefs, behavioral norms, communication culture, and patterns of collaboration, plays an important role in organizational development. In educational institutions that train health professionals, organizational culture influences not only the internal environment but also the formation of future professionals’ ethics, attitudes, and communication culture. In Mongolia, there is limited research that comprehensively examines organizational culture, institutional values, behavioral norms, and their relationship with satisfaction in higher education institutions. This formed the rationale for the present study. Aim: This study aimed to comparatively assess the perceptions and attitudes of faculty, staff, and students toward organizational culture at the School of Pharmacy, Mongolian National University of Medical Sciences. Materials and Methods: A cross-sectional analytical study design was employed. Data were collected using a structured questionnaire from 194 participants, including faculty, staff, and students of the School of Pharmacy. The data were analyzed using SPSS version 26.0, and a p-value of <0.05 was considered statistically significant. Results: A total of 194 participants were included in the study; 87.6% were students and 12.4% were faculty members. Most participants were female (93.3%), while 6.7% were male. Regarding self-assessed knowledge of organizational culture policy, 47.9% reported having moderate knowledge, 19.6% good knowledge, and 4.6% very good knowledge, whereas 24.2% reported not knowing and 3.6% reported having no knowledge at all. When comparing groups, the mean satisfaction score was 3.73 among faculty and staff, 4.19 among graduate and postgraduate students, and 3.42 among undergraduate students, showing a statistically significant difference (p=0.003). Among undergraduate students, fifth-year students rated organizational culture the highest, with scores of 3.99 for values, 4.14 for behavioral norms, and 3.56 for satisfaction. In contrast, fourth-year students had the lowest scores for behavioral norms (2.88) and satisfaction (2.41), with statistically significant differences (p<0.05). In terms of satisfaction level, 41.2% of participants rated their satisfaction as “Good” and 29.4% as “Very good.” A statistically significant positive association was observed between knowledge of organizational culture policy and satisfaction (p=0.001). Satisfaction was also positively correlated with organizational culture indicators, with the strongest correlations observed for internal environmental culture and comfort (r=0.802), institutional image (r=0.787), and accessibility of information (r=0.760) (p<0.01). Conclusions 1. The perceptions and evaluations of organizational cultural values and behavioral norms among faculty, staff, and students of the School of Pharmacy differed according to their position and level of experience. 2. Participants who demonstrated a higher level of knowledge regarding the institution’s cultural policy reported greater satisfaction, whereas those with limited knowledge showed lower levels of satisfaction.

Background: Choriocarcinoma is an aggressive trophoblastic malignancy characterized by rapid progression and a strong tendency for early hematogenous metastasis. It may occur in gestational or nongestational forms. Nongestational choriocarcinoma is extremely rare and is most commonly reported in young women. The tumor frequently metastasizes early to organs such as the lungs, liver, and brain. Case presentation: We report the case of a 21-year-old woman who presented with dyspnea and hemoptysis and was initially treated for pneumonia. Further evaluation revealed nongestational choriocarcinoma with pulmonary and hepatic metastases. Diagnosis: Contrast-enhanced computed tomography of the chest initially suggested pulmonary artery thromboembolism; however, the diagnosis was ultimately confirmed by histopathological examination. Conclusion The distinctive feature of this case is that the disease presented with clinical and radiological findings mimicking pulmonary artery thromboembolism. This case highlights the importance of considering metastatic choriocarcinoma in young women presenting with unexplained respiratory symptoms, hemoptysis, and atypical pulmonary vascular findings.

Background: Among the total healthcare waste generated from health-related activities, 10–20% is considered haz ardous, posing significant threats to both the environment and human health. Approximately 3% of healthcare waste is pharmaceutical waste. In Ulaanbaatar city, an estimated 2.65 tons of healthcare waste is generated daily (0.78 tons of medical waste and 1.87 tons of general waste). With the continuous increase in pharmaceutical consumption, the improper disposal of pharmaceutical waste has emerged as a major environmental concern, adversely affecting nature, animals, and the food chain. Contamination from pharmaceutical waste, such as the development of antibiotic resistance, is closely linked to inadequate public awareness of waste management. Aim: This study aimed to assess the knowledge, skills, and attitudes of pharmacy technicians in community pharmacies regarding pharmaceutical waste management. Materials and Methods: A cross-sectional survey was conducted among pharmacy technicians across Mongolia. As of 2023, there are 4,959 licensed pharmacy professionals in the country. Using a representative sampling method, data were collected from 360 pharmacist and pharmacy technicians. Data were analyzed using MS Excel and SPSS version 26. Results: A total of 360 pharmacists from both urban and rural areas participated in the study. The assessment was based on a 5-point Likert scale, with scores of 1-2 considered negative and 3–5 considered positive. The average scores for knowledge, skills, and attitudes were 3.3, 3.06, and 3.25 respectively. While individual scores were satisfactory, the results of questions targeting social awareness were relatively low. Conclusion The knowledge, skills, and attitudes of pharmacy technicians regarding pharmaceutical waste management were found to be satisfactory. However, to further improve knowledge levels, it is recommended to implement additional training programs related to pharmaceutical waste management among pharmacy technicians.

Background: Community pharmacies are accessible healthcare institutions that offer services without the need for appointments or prepayment. In recent years, the scope of pharmacist responsibilities has expanded from merely dispensing medications and medical devices to providing patient-centered pharmaceutical care, health promotion, and disease prevention. As a result, pharmacists are increasingly confronted with ethical challenges in their daily practice. Aim: To identify the ethical issues faced by pharmacists working in community pharmacies in Ulaanbaatar, Mongolia. Materials and Methods: A cross-sectional survey was conducted between March and September 2024 among pharmacists working in community pharmacies in Ulaanbaatar. Participants included 374 pharmacists who had been working for at least three months, held valid professional licenses, and voluntarily agreed to participate. A structured questionnaire was used to collect data. Descriptive statistics were analyzed using SPSS version 25.0. Results: Among the respondents, 339 (90.4%) were female, 301 (80.48%) were pharmacists, and 230 (61.5%) were under 30 years old. Additionally, 214 (57.2%) had worked in a community pharmacy for less than five years. Open-ended responses were coded into three major categories and 15 subcategories: (1) pharmacy management and organization, (2) compliance with laws and regulations, and (3) professional communication with clients. The most frequently reported ethical issues were: Customers demanding prescription-only medications without a valid prescription (56.6%), Negative or inappropriate client behavior (27.5%), Attempts to use expired or invalid prescriptions (14%) Conclusion 1. A total of 56.1% of pharmacists demonstrated insufficient knowledge of the Code of Ethics for healthcare professionals, which is essential for their professional practice. 2. Among pharmacists, 54.5% showed a negative attitude, and 48.9% exhibited inappropriate practices when faced with certain ethical situations. 3. The most common ethical challenges faced by pharmacists include: Requests from clients to dispense prescription-only medicines without a valid prescription (56.6%), Unethical or inappropriate behavior from clients (27.5%), Attempts to obtain medicines using invalid prescriptions (14%).

Background: Medical experts in pharmacies are the most accessible health professionals and play a key role in primary health care. They must strike a balance between their autonomy, the objectives of the company, and professional standards, while facing a lot of ethical dilemmas. This phenomenon can impact the quality of pharmaceutical care, as highlighted in several studies. Numerous studies have been carried out internationally to explore the medical ethics knowledge of pharmacists working in community pharmacies, their attitudes towards emerging ethical issues, and identification of their common problems. However, research in this area is scarce in Mongolia, which serves as the basis for conducting this study. Aim: Assessing the knowledge, attitudes, and practices of pharmacists regarding professional ethics in community pharmacies in Ulaanbaatar city. Materials and Methods: This study was conducted using an analytical cross-sectional study design and included 374 pharmacists who had been working in community pharmacies in Ulaanbaatar for more than three months, had a valid professional license, and consented to participate in the study between March and September 2024 (ethical approval number 2024/3-01). To determine the degree of knowledge, attitude, and practice, a questionnaire including 39 closed questions and 4 groups was used to gather survey data. For statistical analysis, SPSS-25 software was utilized. Results: Of those who took part, 301 (80.48%) were pharmacists, 73 (19.52%) were pharmacy technicians, and 339 (90.4%) were women. Additionally, 259 (69.3%) work in secondary pharmacies, and 305 (81.6%) have received ethics training. The study shows that 56.1% of pharmacists had insufficient knowledge of professional ethics, 54.5% had poor attitudes towards ethical issues, and 48.9% had inappropriate practices. When analyzed in relation to their profession, the ethical knowledge of pharmacists did not differ by profession, age, years of experience in community pharmacies, professional degree, and university graduated, but it was statistically significantly correlated with the participants’ self-assessed ethical knowledge (CL 95%, p=0.0001). Conclusions 1. The knowledge of professional ethical principles and standards is insufficient among pharmacists. 2. While handling emerging ethical issues, they have a negative attitudes and inappropriate practices. Consequently, it is compulsory to intensify training on the ethical code of conduct for medical experts s based on the needs of pharmaceutical professionals.

Background: The COVID-19 pandemic has placed an extraordinary strain on healthcare systems worldwide, underscoring the need for evidence-based pharmacotherapy and rational use of medicines. Despite the availability of international and national treatment guidelines, notable variations in drug selection and utilization persist across healthcare institutions. Evaluating medication use according to clinical severity is vital for ensuring therapeutic rationality, improving patient outcomes, and optimizing pharmaceutical resource management. Aim: The aim of this study was to assess medication use and associated costs among inpatients diagnosed with COVID-19 at the Mongolia–Japan Hospital of MNUMS and the National Center for Communicable Diseases through ABC analysis Materials and Methods: : A retrospective, document-based study was conducted at the Mongolia-Japan Hospital (MJH) and the National Center for Communicable Diseases (NCCD) in Ulaanbaatar. Medical and pharmacy records of 1,012 inpatients diagnosed with COVID-19 between April 18 and December 31, 2021, were reviewed. Drug utilization was assessed using the ABC analysis method, classifying medicines based on their proportional contribution to total pharmaceutical expenditure. Comparative analyses were performed to identify differences in utilization patterns between hospitals and across clinical severity levels. Results: Of the total pharmaceutical expenditure for COVID-19 treatment, six medicines (4.5% of all drugs) were categorized as Class A, accounting for 69.7% of total costs. Class B included seven medicines (7.0%, 19.5% of total costs), while Class C comprised twenty-six medicines (88.6%, 10.6% of total costs). Remdesivir 100 mg injection, a Class A drug, represented 18.5% of total drug expenditure at MJH (used in 78 patients) and 36.2% at NCCD (used in 133 patients). Overall, approximately 70% of total expenditure was concentrated in a small number of high-cost medicines, indicating potential inefficiencies in pharmaceutical resource utilization. Conclusion This study demonstrates that a limited number of high-cost medicines, particularly Remdesivir, accounted for the majority of COVID-19 treatment expenditures. Strengthening evidence-based prescribing, rational selection, and monitoring of high-cost drugs is essential to enhance resource efficiency, ensure equitable access, and sustain hospital pharmaceutical care systems during pandemic response and beyond.

Introduction: Coronavirus infection 2019 (Ковид-19) is an infection caused by a novel virus and induces severe ARDS. КОВИД-19 pandemic has rapidly spreaded in 221 countries, 245,373,039 cases and 4,979,421 mortalities have been reported. Pulmonary and renal thrombotic angiopathy occur in patients with complications of ARDS, sepsis, and multi-organ failure. Elevated D-dimer in КОВИД-19 patients has been reported firstly by doctors in Wuhan, China. In addition, many studies have revealed that elevated D-dimer has been associated with the severity of the diseases, an increased rate of poor prognosis. Objective: We aim to determine D-dimer in КОВИД-19 patients, and patient condition a decrease of D-dimer level after administration of anticoagulant therapy. Case report: We introduce a rare case of КОВИД-19. Laboratory test results and the effect of anticoagulant therapy have been evaluated during the infection. 85 aged women were admitted with a diagnosis other than КОВИД-19. PCR for SARS-Cov-2 was negative on the previous day of admission, and Sars-Cov-2 Ag rapid test was also negative on the admission day. However, the D-dimer test result was much higher with 7120 ng/мл and X-ray and CT revealed a similar pattern to the КОВИД-19 patient. Then anti-Sars-Cov-2 test was positive with 4,08 COI. Based on laboratory test results of D-dimer, LDH, CRP, and CT pattern the patient was diagnosed with post-КОВИД-19 pneumonia, and anticoagulant therapy was initiated additionally to prevent hypercoagulation induced by КОВИД-19. D-dimer test taken before administration of anticoagulant therapy increased more to 10910 ng/мл. 3 days later D-dimer level decreased to 8180ng/мл and the patient’s condition was improved. Conclusion The evaluation of D-dimer of the patients with КОВИД-19 is highly significant. Anticoagulant therapy might be necessary for КОВИД-19 patients with high D-dimer level in serum. Further studies are needed to assess the long-term outcome of the illness and mortality.

Background and Aims: Hepatocellular carcinoma (HCC) is a common cause of cancer related death in Mongolia. Early diagnosis is the very important management to increase successful treatment and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC) tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic biomarker of HCC. Methods: We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP) levels were measured using commercially available enzyme-linked immunosorbent assay kits. The diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and estimated sensitivity and specificity of each biomarker. Results: sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999 (0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6 ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 % with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%). Conclusion Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC. Combination of two markers showed greatest diagnostic accuracy.

Introduction: There is an urgent need to study client satisfaction in assessing the quality and availability of health care. Compliance with the needs of consumers of any care, its accessibility, professional ethics, speed of work, determining customer satisfaction allows for evidence-based decision-making. Therefore, satisfaction surveys should be conducted at short intervals and the results used for decision making. One hundred and fifty million people on the planet pay for their health care every year and face financial hardship. Hundreds of millions of them are living in poverty, according to the World Health Organization’s 2010 year report. Governments must ensure that all people receive health care and are protected from health-related financial risks. We believe that the current state of quality and access to health care in our country does not fully meet the needs of the population. 62.4% of customer satisfaction surveys conducted in 2013 that health care was inadequate. However, customer satisfaction surveys on health insurance coverage are rare. The process of providing discounted medicines through health insurance varies depending on the health needs of consumers and their budgetary capacity. Therefore, it is necessary to take into account the factors that affect customer satisfaction. Methods: In our study, we looked by retrospective at health and health insurance reporting indicators, Satisfaction of customers who bought medicines at pharmacies with health insurance prescriptions was surveyed in a one-moment survey.
We collected information on the satisfaction status of 525 people who used health insurance prescriptions from 36 pharmacies from December 2018 to April 2019 and from January to February 2021 using preprocessed cards. Conclusion
1. The cost of diagnosis from the health insurance fund and the selection of drugs to be included in the list of drug price discounts are related to the prevalence of the disease in Mongolia.
2. Difficulties in accessing drug price reductions from the health insurance fund can lead to dissatisfaction with the approved budget and the availability of drugs on the list.
3. In the case of Ulaanbaatar pharmacies, the satisfaction rate of consumers who use the discounted price of medicines according to the health insurance prescription is 3.634 or 72.688% in the first stage survey and 3.912 ± 0.50 or 78.248% in the second stage survey.