Background: Simulation-based education has become an effective and widely used modern teaching method in health professional education. This approach allows students to apply theoretical knowledge into practice and develop essential skills such as clinical assessment, clinical decision-making, and teamwork in a safe and controlled learning environment. In recent years, international studies have demonstrated that simulation-based training improves students’ clinical skills, confidence, communication abilities, and professional attitudes. However, evidence regarding the effectiveness of simulation-based training remains limited in certain educational settings, particularly in developing countries. Therefore, evaluating the effectiveness of simulation-based training within local educational contexts is necessary. Aim: To evaluate the effectiveness of simulation-based training on students’ knowledge, clinical skills, and professional attitudes. Materials and Methods: This study included 45 third-year medical students from four classes at the Mongolian National University of Medical Sciences using a random sampling method. Participants were divided into two groups according to the training modality: a simulation-based training group (n=20) and a traditional learning control group (n=25). Knowledge was assessed before and after training using an 18-item test covering asthma etiology, pathophysiology, clinical features, diagnosis, and treatment. After the training session, students’ knowledge, clinical skills, and professional attitudes were evaluated using a 21item Likert-scale questionnaire and small-group discussions to identify factors influencing learning outcomes. The reliability of the questionnaire was evaluated using Cronbach’s alpha, which demonstrated high internal consistency (α=0.90). Statistical analysis was performed using SPSS software. Paired samples t-tests were used to compare pre- and post-training knowledge within groups, while independent samples t-tests were used to compare post-training outcomes between groups. Result: After training, mean knowledge scores significantly improved among all participants (pre-training: 9.18±2.33; post-training: 10.47±2.31; p<0.001). In the simulation group, knowledge scores increased from 7.65±2.01 to 9.05±2.46, while in the control group, scores increased from 10.40±1.80 to 11.60±1.41 (p=0.007). Post-training comparisons showed that the simulation group demonstrated higher mean scores in knowledge (36.70±3.73 vs 34.44±4.77) and clinical skills (11.35±1.69 vs 10.92±1.75) than the control group; however, these differences were not statistically significant (p>0.05). Professional attitude scores were significantly higher in the simulation group compared with the control group (43.35±3.60 vs 40.64±4.51, p=0.034). Conclusion Simulation-based training demonstrated positive effects on students’ knowledge and clinical skills and significantly improved professional attitudes. Integrating simulation-based training with traditional teaching methods may serve as an effective educational strategy to enhance the quality of clinical education.

Background: Hepatocellular carcinoma (HCC) remains one of the leading causes of cancer-related mortality worldwide and in Mongolia. Alcohol-related liver disease (ALD) and metabolic dysfunction-associated steatohepatitis (MASH) are two major etiological factors contributing to the rising burden of HCC, each presenting distinct clinical and pathological characteristics. Aim: To compare the clinical, pathological, and survival characteristics of patients with ALD-related HCC and MASH-related HCC who underwent liver resection. Material and Methods: A retrospective cohort study was conducted using clinical and pathological data from 980 patients who underwent liver resection between 2010 and 2024. Among them, 191 were categorized into the ALD group and 789 into the MASH group. Clinical parameters, laboratory findings, tumor pathology (size, grade, fibrosis stage, vascular invasion), recurrence, and overall survival (OS) were analyzed. A simulated Kaplan–Meier survival curve was generated based on group-level survival estimates. Results: Patients with ALD were significantly younger and predominantly male compared with those in the MASH group (p=0.0014; p<0.0001). The MASH group demonstrated more aggressive pathological features, including larger tumors (>5 cm), poorer differentiation (G3–4), advanced T4 stage, and a higher rate of large-vessel invasion (all p<0.05). Despite these findings, the MASH group showed a longer mean overall survival (92.6 months) than the ALD group (82.0 months; p=0.0206). Conclusion Although MASH exhibits more aggressive pathological features compared with ALD, patients in the MASH group demonstrated better overall survival. These findings underscore the importance of incorporating etiological differences into the diagnostic, therapeutic, and postoperative management strategies for HCC.

Introduction: Since 1993, the Inula helenium L. plant has been planted in the production area (Bulgan Province, Dashinchilen Sum) of the Traditional Hatchery Science and Production Corporation’s medicinal plant introduction and cultivation experience. At the Drug Research Institute, there is also a botanical institute for medicinal plants where it is grown. In traditional Mongolian medicine, the roots and rhizomes of Inula helenium L. are used to reduce inflammation, boost immunity, enhance hunger, and improve intestinal motility. Inula helenium L. roots and rhizomes contain biologically active compounds such as monoterpenes, sesquiterpenes, phenols, flavonoids, and polysaccharides. Methods: The roots and rhizomes of Inula helenium L. were extracted with water and 70% ethanol at the following ratios 1:10 (2% of WAC), 1:8, and 1:6 by partial maceration at 700C for 2 hours each, extracted and concentrated. The dry extract was obtained by the spray drying procedure. High-performance liquid chromatography for determining the content of alantolactone, thin-layer chromatography for qualitative analysis. Spectrophotometer for determining the content of polyphenolic compounds, colored compounds with Folin-Ciocalteu reagent for qualitative analysis. Spectrophotometer for determining the content of inulin, and colored compounds with phenol and sulfuric acid solutions for qualitative analysis. Conclusion In determining the content of polyphenolic compounds, inulin, and alantolactone in the dry extract taken from the roots and rhizomes of cultivated Inula helenium L., the content of polyphenolic compound in dry extract A was 2.50±0.08%, and alantolactone was 1.39±0.11% in the raw material of the plant, while B dry the extract had a high concentration of inulin of 58.51±0.66%.

Introduction: Over 800,000 people in the world contract HCC each year and approximately 700,000 die from the disease. HCC is the 6th most common cancer in the world. HCC is the 3rd leading cause of cancer deaths in the world. 2/3 of liver cancer deaths are caused by hepatitis. In the U.S, HCV infection is the more common cause of HCC, while in Asia and Africa, HBV is more common. Mongolia ranks first in the world in mortality from liver cancer, indicating the need for early detection and treatment of cirrhosis. Sysmex Corporation has introduced for HISCL series analyser, a new cirrhosis marker M2BPGi of non-invasive, blood-testing. In 2016, the test was introduced at Medipas Hospital in Orkhon province. It is possible to study the advantages and significance of the marker for use in clinical practice. Materials and methods: From a total of 385 patients who underwent M2BPGi marker testing in 2016-2017Medipas hospital laboratory, data from a total of 283 patients tested for hepatitis B and C virus and M2BRGi markers were selected. A comparison of age, sex, and test parameters of a total of HCVab and HBsAg positive 172 patients tested for Total bilirubin, GPT, GOT, GGT, AFP and M2BPGi. HCV Ab, HBsAg, AFP, M2BPGi markers were analyzed by SysmexHISCL-5000 fully automated immunological analyzer, Liver function tests were performed with a fully automatic biochemical analyzer JEOL Biomajesty BM6010/C. Results: Of the M2BPGi marker tested 283 patients 94 (33%) were infected with the C virus, 78 (28%) were with the B virus,11 (4%) were co-infected with B and C viruses, 100 (35%) no any viral infection. Of the 172 patients diagnosed with hepatitis B and C virus infection, 97 (56%) were male, 75 (44%) were female. In terms of age, 72% of the population is over 45 years old.
Of the 172 patients, 115 (67%) had M2BPGi marker abnormal or > 1.0 COI. Of the M2BPGi marker abnormal patients, 47 (41%) were infected with the B virus and 68 (59%) with the C virus. In terms of age, 27.7% of hepatitis B patients and 10.3% of hepatitis C patients were under 45 years of age, 72.3% of hepatitis B patients and 89.7% of hepatitis C virus patients were over 45 years of age.
Hepatitis B and C viruses are slightly more common in men than in women. The majority of patients infected with the hepatitis virus over the age of 45. The majority of patients with hepatitis virus have abnormal liver function. Increased M2BPGi markers in people under the age of 45 with hepatitis B virus infection are relatively higher for hepatitis B virus infection than for C virus infection. Conclusions The M2BPGi marker was abnormal in 67% of hepatitis virus infected patients. It has been observed that the probability of an increase in M2BPGi marker is slightly higher in hepatitis C virus infection than in hepatitis B virus infection.

Introduction: Urinary tract infections (UTI) are at the second place in the frequency of all causes of infection after respiratory ones. The UTI requires appropriate antibiotic treatment. 85% of UTI predictive antibiotic treatment without confirmation by bacteriological analysis. This is one of the major causes of drug resistance, especially in K.coli. Urine bacteriological tests do not show bacterial culture in all cases where the number of bacteria in the urine exceeds the reference level. Therefore, there was a need to establish criteria for urine bacteriology test based on the results of urine sediment analysis.
In 20I7, a new fully automated Sysmex UF-5000 urine sediment analyzer was installed in the laboratory department of Medipas Hospital. The features of this analyzer include counting the number of bacteria in the urine, distinguishing between gram-positive and negative, homogeneous and mixed forms, and counting the formed elements in the urine. This feature made it possible to compare the number of bacteria and leukocytes in the urine with the results of urine bacteriology tests. Goal: Determine the relationship between the number of white blood cells and bacteria in the urine measured by the Sysmex UF-5000 urine sediment analyzer and the results of the urinary bacteriological test. Objectives: Compare the number of urine bacteriaand leukocyte measured by using the Sysmex UF-5000 urine sediment analyzer with the urine bacterial culture, and calculate the correlation. Materials and methods: The study is analytic cross-sectional study, analyzed the results of a total of 159 people who analyzed a urinalysis and urine bacteriological test at the Medipas Hospital Laboratory in 2017-2019 years.Urine samples were collected in a 100 ml, disposable sterile container in accordance with the instructions for taking urine midstream.Urine analysis was performed within 2 hours of sampling with a fully automatic urine sediment analyzer Sysmex UF-5000 Japan. Urine bacteriological analysis was performed on a lul sterile loop of urine specimens, inoculated into 5% blood agar from Hungary's BioLab, Sabouraud agar, and Chromogen agar from Biomerieux France, and incubated for 24 hours in an incubator at 37°C. Bacterial identification and antibiotic susceptibility tests were analyzed using the "Vitek-2" analyzer from the manufacturer Biomerieux France. Bacterial and leukocyte counts data measured by the Sysmex UF-5000 analyzer and urinary bacteriological analysis data were performed using SPSS23 software. Results: A total of 159 urine samples were tested for bacteriological analysis, of which 81 (50.9%) were bacteria over 105 CFU/ml or urine positive culture UTIs, 78 (49.1%) were nonsignificant bactcruria and urine negative culture.The average number of bacteria measured in the urine of 81 samples with urine positive culture above 105 CFU/ ml was 46491/ul (1168-100000 BACT/ul).
The average number of bacteria measured by the urine sediment analyzer of 78 samples with urine negative culture was 2645 BACT/ ul (2-57280 BACT/ul). To calculate more accurately estimate the average number of bacteria in 81 urine specimens with positive culture, the average number of bacteria in 17 (21%) samples was 4753 BACT/ul, measured in relatively low bacteria numbers of 1168-9450BACT/ul. The average leukocyte number in the urine of 81 samples with positive culture was 472.2 WBC/ul, and the average leukocyte number in the urine of 78 samples with negative culture was 87.7 WBC/ul.There is a strong correlation between the number of bacteria measured by the urine sediment analyzer and urine bacterial positive culture, which is 0.8 or statistically significant (p<0.001).The correlation coefficient of the number leukocytes measured by the urine sediment analyzer with in the urine positive cultureof bacteriological tests was 0.6 or moderately of statistically significant (p=0.005).There is a statistically significant relationship (p=0.001) between the number of bacteria in the bacterial positive culture population and the number of leukocytes. Discussion: Of the 81 cases of urine bacterial positive culture, 78 (96%) were female, indicating a high prevalence of UTI among women. According to the results of the Fabio Manon's study, the number of leukocytes in the urine is 160-340 WBC/uL and the number of bacteria is 15000-30000 BACT/u,L in the case of UTI, which is approximate results compared to the our study results.Based on the results of the urine sediment analysis, indications for a urine bacteriological test should be made.
Based on the results of urinary bacteriological tests, the choice of antibiotic treatment is the best treatment for urinary tract infections and a way to prevent of antibiotic resistance to UTI. Conclusions The number of bacteria measured by a Sysmex UF-5000 urine sediment analyzer is directly related to the bacterial culture urine bacteriological test. If the number of bacteria in the urine is measured above 4753 BACT/ul, it can be considered as an indication for urine bacteriological analysis. Although the number of leukocytes in the urine measured by the Sysmex UF-5000 urine analyzer is moderately correlated with bacterial culture in urine bactcriologucal tests, it is a key indicator of the degree of inflammation of the urinary tract.

BACKGROUND Mostly of liver cancer in the world is caused by hepatitis B and C virus. Liver cancer occurs within 10-29 years after the virus is infected. If have liver cirrhosis, you can develop cancer after 5-10 years. According to the study in Mongolia 2014, C virus infection is 9.5% and B virus infection is 10.6%, high prevalence of hepatitis B, C and liver cirrhosis. Designed by Sysmex Corporation of Japan, possible analyze from blood, non invasive, sensitive and specific, M2BPGi liver cirrhosis marker. It is necessary to investigate the relationship between hepatitis B and C viruses and M2BPGi liver cirrhosis marker. METHODS M2BPGi liver cirrhosis marker measured total patients number 283. Of this patients 172 cases infected hepatitis B and C viruses, 78 patients with hepatitis B virus infection and 94 patients hepatitis C virus infection. All tests performed by full automatic analyzers Sysmex HISCL-5000, JEOL BM-6010, in the Laboratory department, Medipas Hospital, Orkhon province. RESULT Of the 283 patients who received the M2BPGi screening, 33% had C virus, 28% B virus, 4% had B and C virus co-infected, and 35% had no virus. Of the 172 patients infected with hepatitis B and C virus, man 97 (56%), woman 75 (44%). The majority of patients (72%) have liver function abnormality. Of patients with B and C viruses 115 (67%) were positive for M2BPGi liver cirrhosis marker. M2BPGi positive patients with 68 (59%) had C virus, 47 (41%) had B viruses. CONCLUSION Men are more likely to be infected with hepatic viruses. 67% of patients with hepatitis B and C viruses have M2BPGi liver cirrhosis marker positive. The likelihood of a change M2BPGi liver cirrhosis marker, more likely associated hepatitis C virus infection, than B virus infection. The presence of liver cirrhosis in adults under 45 years of age B virus is relatively high compared to C virus infection.

To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p<0.0001). There were significant difference detected between the bevacizumab and bevacizumab combined with laser treatment groups (p=0.004). At month 12, greater proportion of patients gained ≥10 and ≥15 letters and with BCVA letter score >73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.