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: 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.

Introduction: Factors such as social and economic conditions, technological development, modern urbanization, lifestyle, physical activity, nutrition, and air pollution affect physical growth and development. Aim: To study the physical development of Mongolian children. Objectives: 1. To measure the physical indices (weight, height) of children aged 6-17 years old with some influencing factors. Material and method: Using a random sampling method, children's body height and weight were examined at a particular point in time using widely accepted methods. Statistical analysis was performed using the "SPSS ver.25" program. Result: The growth of children's height and weight is progressing according to general patterns of age and gender. Girls grow rapidly between the ages of 10-13 and stabilize after wards, while boys a sharp growth spurt between the ages of 13-17, with the average height of 17-year-old boys being 171.44 cm and 160.25 cm for girls, which is slightly higher than previous studies (Otgon G, 2006, Munkhzaya M, 2020). The trend of weight growth is more prominent in boys. However, compared to international standards (Russia, WHO, CDC), our children's height and weight are lower. The statistics show that parental education, income, exercise, and living environment positively influence growth and development, whereas excessive television watching and air pollution negatively affect it (p< 0.05). Conclusion 1. Children's growth is normal, but observed increase of the body weight of boys. Having healthy and well educated parents, as well as engaging in physical activity positively influences children's height. A lack of physical activity negatively affects height and increases weight. Mongolian children are shorter and lighter compared to foreign children (from Russia and America - CDC).

Introduction: The average age of the population varies in every country of the world, which depends on the changes that occur in the body during aging and many external and internal factors that affect it. Thyroid hormones play an important role in ensuring and maintaining normal metabolic function throughout life. Our country is located in a mountainous region of the mainland, the amount of iodine in drinking water is low, and the amount of iodine taken from food is low, which creates the risk of iodine deficiency disorders. Therefore, we aimed to study how the thyroid function changes with age in Mongolian people. Goal: A comparative study of thyroid hormone secretion levels in adult women. Material and Method: In our study, 83 women over the age of 20 were selected based on the “Yu Bi Lab” diagnostic center. Triiodothyronine (T3), thyroxine (T4), and thyrotropin (TSH) of the women participating in the study were determined using the FHU method using the Magiwel ELISA diagnostic kit manufactured by United Biotech. Results: 81 women over 20 years of age participated in our study, the average age was 44.45±14.17, and the participants were divided into 5 groups with 10 age intervals. 20-29 years 18% (n=15) average age 24.6±2.64, 30-39 years 22% (n=18) average age 33.6± 3.12, 40-49 years 16% (n=13) average age 45.15±1.67, 50-59 years 25% (n=20) average age 54.15±2.99, 60-69 years 19% (n=15) average age 63.73± 3.05, were. Conclusion
1. When comparing T3 and T4 hormones by age group, T3 hormone is higher in the 30-39 age group at 5.05 ng/ml. The T4 hormone gradually decreases with age.
2. Thyroiodin hormone increased with age. The relationship between the age of the participants and TSH hormone was directly related to statistical age when calculated by Pearson’s correlation coefficient (p=0.01).

Emergency cesarean section risk factors of Robson 1, 2A, 3, 4A Introduction: Cesarean section rates in Mongolia exceed WHO recommendations of 5–15%, reaching 27.6% nationally and 34.1% at the First Maternity Hospital between 2019–2023. C-sections, while life-saving, increase risks of hemorrhage, infection, uterine complications, and reduced maternal quality of life. This study aimed to analyze emergency C-sections by Robson classification and identify associated risk factors in groups 1, 2a, 3, and 4a. Material and methods: A retrospective case-control study was conducted using 886 medical records (443 emergency C-sections and 443 vaginal deliveries) from 2021–2023. Data were analyzed with IBM SPSS 24.0, and binary logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: Robson 2a was the most frequent category (43.8%), followed by 4a (25.7%), 1 (20.1%), and 3 (10.4%). Significant risk factors for emergency C-section included maternal age (p<0.001), early cervical dilation (<5 cm) at labor diagnosis (OR 3.54), abnormal CTG, pre-eclampsia, PROM, amniotomy, infertility, and malposition. Multivariate analysis showed PROM (aOR 14.66), amniotomy (aOR 6.85), fetal weight ≥4000 g (aOR 4.07), and maternal age (aOR 1.48) as key predictors. Conclusions: Emergency C-sections were most common in Robson group 2a. Major contributing factors included PROM, amniotomy, maternal age, macrosomia, and abnormal labor patterns. Targeted interventions to manage these risk factors could reduce unnecessary emergency C-sections.

Introduction: In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM. Methods: A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test. Results: The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003). Conclusion The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.

Introduction: Sarcopenia is a prevalent condition characterized by decrease in muscle strength and loss of body function which result from the decrease of muscle mass in older age. In 2014, the Asian Working Group for Sarcopenia developed the diagnosis criterion for sarcopenia. The measurements were changed to accommodate for the physical characteristics of asians. The loss of muscle mass increases after age 40 and decreases by 8 percent every 10 years. After age 70 this number is increased to 15 percent every 10 years. Goal: Assess the prevalence of sarcopenia among men by comparing body height and mass Materials and Methods: The study included 196 older men aged 40 and above chosen by random sampling from the geriatric and rehabilitation cabinets of the Mongolian National Gerontology Center.
Sarcopenia diagnosis was made based on the criteria from the Asian Working Group for Sarcopenia using methods by Janssen I and others to compare body mass and height. Results: Comparing body muscle mass and height 11.7 percent of participant aged 40-86 had sarcopenia. When comparing body muscle mass and weigth 33.2 percent had sarcopenia. Conclusion Determining sarcopenia among Mongolian men by comparing muscle mass and body mass resulted in 33.2 percent sarcopenia. When compared with height, 11.7 percent had sarcopenia.

BackgroundChildren’s congenital hip dislocation is ranked first, accounting for 49,4% among other skeletal anomalieswhich cause to physical disability.There is a tendency that the number of newborn with the congenitalhip dislocation is going to be increased in recent years, 5000:1 were in 1976 and 1000:1,3% in 1998.Bilateral dysplasia accounts for 50-62% of the total incidences. In unilateral cases,left hip seems to beinvolved 2 times more than the right,and the sex ratio is 2,5:1. Some cultures who swaddle their infantstightly with their legs straightened have a far greater incidence of developmental dysplasia of the hip. Aresearch indicated that discouraging this traditional swaddling method has reduced the prevalence ofdevelopmental dysplasia of the hip and congenital hip dislocationby 6 times in America. It is noted thatthis methodhas also been implemented in Japan and Turkey.Aim.This research aimed to study about the prevalence of congenital hip dislocation, developmental dysplasiaof the hip and other anomalies among the children who were underwent treatment at Pediatric Traumaand Orthopedic Department of National Trauma and OrthopedicResearch Centre of Mongolia in 2013-2015 and children served by outpatient visit in the clinics in 2011-2015.The following objectives were defined in the scope of the research. Herein:1. Evaluate and determine the percentage and prevalence of congenital hip dislocation anddevelopmental dysplasia of the hip among the children who undergo treatment in Pediatric Traumaand Orthopedic Departmentof National Trauma Orthopedic Research Center of Mongolia.2. Evaluate and determine the percentage and prevalence of congenital hip dislocation, developmentaldysplasia of the hip and other anomalies among children who are being served by outpatient visit inClinics of National Trauma and Orthopedic Research Center of Mongolia.Materialis and MethodThis research were studied the prevalence of congenital hip dislocation, developmental dysplasia of thehip and other anomalies among the children who were underwent treatment at Pediatric Trauma andOrthopedic Department of National Trauma and OrthopedicResearch Centre of Mongolia in 2013-2015and children served by outpatient visit in the clinics in 2011-2015.ResultTotal of 40559 inpatients underwent treatment in National Trauma andOrthopedic Research of Mongolia;of which 12217 were inpatient in Pediatric Trauma and Orthopedic Department, aged 0-19;of which1351 has been registered with birth defects of hip; of which 248 has been diagnosed with developmentaldysplasia hip, 869 with congenital hip dislocation. Sex ratio of cases of congenital hip dislocationinmales to female is around 1:4.Total of 633 (13,8%) examinations were performed in the clinics in 2011;704 (15,3%) in 2012;962 (20,9%)in 2013;1013 (22%) in 2014;1287 (28%) in 2015 respectively. It shows an increase in the number ofexaminations year by year.Total of 4142 (90,1%) cases were diagnosed with congenital hip dislocation and developmental dysplasiain both hips; left hip has been dislocated 2 times more than the right, 162 (3,5%) with congenitaldislocation of right hip; 292 (6.4%) with congenital dislocation of left hip.ConclusionTo conclude, the analysis above shows that the prevalence of developmental dysplasia of the hip andcongenital hip dislocation is still high in Mongolia. Therefore, number of diagnosis with congenital hipdislocation has rapidly increased in the recent 2 years.

Managchenmo is a traditional Mongolian medicine functional liquor comprising twelve crude drugs: Sus scrofa / cinis faecis /, Inula helenium L., Terminalia chebula Retz., Melia toosendan Sieb, Gardenia jasminoides Ellis, Lagotis integrifolia (Willd.)Schischk, Gentiana barbata Froel, Moschus moschiferus, Bezoar Bovis, Calcio sinteris, Carthamus tinctorius L,and Saccharum officinarum. Nowadays the Mongolian traditional herbs are more preferable than the chemical ones; for this reason studies on their use history and new technologies are conducted. Thus we study Managchinmo affects, herb for treatment of liver hot disorders, on trial rats (Handa.S.S, Sharma.A .1990 ) with hepatotoxicity. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkalinephosphatase (ALP) were determined through biochemical methods. The bile duct was cannulated with a tube to collect bile for two hours and bile flow was calculated by the weight of each specimen. Our results showed that Managchenmo (150 mg/kg) significantly prevented CCl4-induced changes in bile flow and serum levels of ALT, AST, and ALP. In conclusion, Managchenmo exerted a protective effect on CCl4-induced hepatotoxicity in rats.