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.

Background: In Mongolia, 7,244 new cancer cases were registered in 2023, of which 5.9% (425 cases) were cervical cancer. The prevalence of cervical cancer is 14.5 per 10,000 populations. In Ömnögovi province, 597 cancer cases were recorded in 2023, and 18.5% of them were cervical cancer. The cervical cancer screening coverage in Ömnögovi province was 45.6% in 2023. Aim: To identify the types of human papillomavirus (HPV) among women aged 30 years and above in Dalanzadgad soum. Materials and Methods: A cross-sectional study design was used. We included 100 women aged 30 years and above in Dalanzadgad soum. HPV genotyping was performed using polymerase chain reaction (PCR) among women diagnosed with cervical erosion. A 44-item questionnaire was also administered to assess the risk factors for cervical cancer. Results: HPV was detected in 41% of participants, while 59% tested negative. Among the participants, 25 had one genotype, 13 had two genotypes, and 3 had three genotypes. Among the 41 women who tested positive, 49% had high-risk genotypes. A total of 20 HPV genotypes were identified, including 16 high-risk and 4 low-risk types. Of the HPV-positive women, 65.9% were married, and 58.5% had only one lifetime sexual partner. In addition, 78% of participants reported never having undergone cervical cytology screening prior to this study. Conclusion In Dalanzadgad soum, 2 out of every 5 women are at risk of HPV infection, and among those infected, 1 out of 2 carry a high-risk HPV genotype.

Abstract In this article, the self-evaluation and internal analysis of the “Pharmacology” course program at the Mongolian University of Pharmaceutical Sciences (MUPS) are described. The “Pharmacology” curriculum is included in the professional course category in the curriculum of school’s Pharmacy program and includes 48 hours of lectures and 96 hours of seminar content. A total of 1,997 pharmacists have been trained by this curriculum since 2005. The pharmacy program was accredited by the National Council for Educational Accreditation with a rating of 94 percent in 2014 and 100 percent in 2021. This time, the teachers who mainly teach in the program, together with the evaluation specialist, have collected the experience and evaluation results of the “Pharmacology” curriculum in this article. Data was collected by google form and processed by the SURE online tool and used the structure-oriented evaluation (SURE) model.

BACKGROUND OF STUDY: According to WHO report estimation, 76.3 million people have been diagnosed with disorder related to alcohol use which has been root cause for over 60 types of disease in the world.1 Smoking causes death to4 million people every year, 11 people every day and 6 every minute. This number is estimated to double reaching 10 million by 2030.2 The study conducted by the ‘World Vision Mongolia’ international organization and the Anti-alcoholism and Drug Association of the Ministry of Justice show 76% of all teenagers has drunk alcohol to some extent. AIMS: To determine alcohol, tobacco and psychoactive drug use by school teenagers of Sukhbaatar district in Ulaanbaatar MATERIAL AND METHODOLOGY: The survey on inquiry of alcohol, tobacco and psychoactive drug use (ASSIST) was conducted among a total of randomly selected 800 (374 boys, 426 girls) students of 8-12th grade from 7 secondary schools of Sukhbaatar district. Statistical data was put into Microsoft office applications (excel, word) and processed by SPSS application with 95% of probability of information and 5.0% of trust level. RESULT OF STUDY: Out of all respondents 32% (256) use tobacco, 43.8% (350)alcoholic drinks, 2.6% (21)cannabis,1.1% (9) cocaine, 1.5% (12) amphetamine, 3%(24)volatile substance, 4.3% (34)sedative and tranquilizer drug, 0.6% (5)hallucinogenic drug, 0.5% (4) opioid, and 0.1% (1) uses other types of drug. Among the survey participants, there are a total of 214 teenagers (in duplicated number) who need short-term action and 2 teenagers who are smoker and need intensive treatment. CONCLUSION: Among total teenagers, the survey participants, 1 in 3 used tobacco, 1 in 2 alcoholic drinks and 1 in 7 used psychoactive drug. Male students smoke twice more than female students and there is no difference in use of alcoholic drink in both sexes. The alcohol and tobacco use among teenagers at the age of 12-18 who participated in the survey showed that they use more when they grow older. 1 in 4 students of all participants belongs to a group with average risk and needs intensive treatment.

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.

Kidney transplantation is the best alternative treatment for end-stage renal disease and health-related quality of life and survival of the patients are improved compared with dialysis. Worldwide, more than 1.4 million patients with CKD receive renal replacement therapy with incidence growing by approximately 8% annually.1 Unfortunately, despite significant improvement in graft function, kidney transplants can still fail due to acute rejection and chronic allograft nephropathy.2 Kidney biopsy after transplantation, which has evaluated by Banff 09 classification is usefull method for diagnose of transplanted kidney disease.3,4Kidney graft rejection was diagnosed in 10 renal allograft biopsy specimens (bs) obtained from transplant patients followed up at our institute between 2015 and 2016. All specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgA, IgM, IgG and complement component (C3, C4, C1q, C4d). All the renal biopsies were examined by the same pathologist.Out of 117 transplantations, 10 episodes of rejection selected. Among the 10 patients, 30% had an acute T cell rejection and 70% had a chronic allograft nephropathy. Interstitial inflammation (i1-7) was present in 7 bs (70%), tubulitis (t1-4,t2-2) in 6 bs (60%), transplant glomerulitis (g1-1, g2-2, g3-1) in 4 bs (40%), transplant interstitial fibrosis (ci1-2, ci2-2, ci3-2) in 6 bs (60%), tubular atrophy (ct1-6, ct2-2, ct3-1) in 9 bs (90%), mesangial matrix increase (mm1-5) in 5 bs (50%), vascular fibrosis intimal thickeness (cv1-3) in 3 bs (30%), arteriolar hyaline thickening (ah1-5) in 5 bs (50%), tubulitis (ti1-6, ti2-3, ti3-1) in 10 bs (100%) and peritubular capillaritis (ptc1-1, ptc2-2, ptc3-1) in 4 bs (40%). C4d deposition was present very mild in wall of the vessels and peritubular capillaries. Because of not good working Methenamin silver stain, we couldn’t demostrate glomerular basement membrane changes (cg) fully.We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis. C4d deposition in the wall of the vessels and peritubular capillaritis is not always present in biopsy specimens of transplant glomerulopathy.

Background:The cardiovascular disease especially coronary artery disease is the leading cause of mortality in worldwide. There is lack of research study which evaluated stenosis of coronary atherosclerosis. It is known that coronary stenosis is highly connected to the levels of biomarkers. Coronary atherosclerosis correlated with endothelin receptor type A (EDNRA) levels in a group of patients suspected of having coronary artery disease.Objective:The goal of this study was to evaluate the relation between the coronary atherosclerosis and levels of EDNRAMethods:A total of 311 participants were involved in this study. A case-control study was used in the study. The baselines data were collected from the department of Angiography at the National Third Central Hospital and National lilood Transfusion and Research center. We have determined the degree of coronary atherosclerosis using the Angiography machine and Elisa were used for detecting the blood endothelin levels in all groups.Results:98 participants were diagnosed with stenosis and occlusion. The blood endothelin levels were estimated to 6.32±0.64 pg/ml which refer to () degree of coronary stenosis, the first degree of stenosis of coronary atherosclerosis is estimated to 5.56±0.22pg/ml, the second degree of stenosis of coronary atherosclerosis is estimated to 5.42J0.34 pg/ml, the third degree of stenosis of coronary atherosclerosis is estimated to 5.87 H). 13 pg/ml, the fourth degree of stenosis of coronary atherosclerosis is I'SlilllSltll lo 5.69±0.09 pg/ml, it was estimated to 5.88±0.13 pg/ml in control groups. Level of EDNRA (occupying one segment of coronary artery) was estimated to 5.77±0.08 pg/ml. two segment involvement was estimated to 5.72±0.16 pg/ml, three segment involvement 5.73±0.19 pg/ml. four segments involvement 5.50±0.25 pg/ml, respectively.Conclusion:The blood endothelin level and coronary artery stenosis were not correlated statistically significant in control group of the study. However, blood endothelin levels were increased in patients who tend to experience the coronary artery stenosis.

Purpose; To control acupuncture of essential hypertension. Method;The design of the SHARP trial balanced rigorous clinical trial methodology with principles of TCM. Eligible participants had systolic blood pressure 140-179 mm Hg and diastolic blood pressure 90-109 mm Hg in the absence of antihypertensive therapy. Acupuncture was delivered twice a week for 6 weeks.Follow –up visits were every 2 weeks. Result;At weeks 2, 4 and 6 ;both pre-acupuncture and post- acupuncture blood pressure were measured. Those time pre- acupuncture blood pressure decline than post –acupuncture(p<0.0001) . Conclusion;Acupuncture treatment had a significant negative influence reduction blood pressure.