Background: Ear, nose, and throat (ENT) inflammatory diseases are common conditions that account for a high proportion of healthcare visits. These diseases negatively affect patient’s quality of life, reduce work and learning capacity, and increase healthcare costs. Antibiotics play a crucial role in treatment; however, inappropriate use contributes to the emergence and spread of antimicrobial resistance among pathogenic bacteria. In Mongolia, particularly in Darkhan-Uul Province, data on bacterial pathogens and their antimicrobial susceptibility patterns in ENT infections are limited. Therefore, evaluating the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and antimicrobial resistance is essential for guiding clinical practice and promoting rational antibiotic use. Aim: To assess the bacterial pathogens and their antimicrobial susceptibility patterns in inflammatory diseases of ear, nose and throat. Materials and Methods: The study was conducted at the School of Biomedicine, Mongolian National University of Medical Sciences, in collaboration with the Department of Pharmacology and the “Bid” Hospital of Darkhan-Uul Province. Data from ear, nose, and throat swab examinations of patients suspected of having ENT infections in the outpatient department between January 2024 and February 2025 were extracted from the hospital’s centralized database (n=185). Based on the inclusion and exclusion criteria, information from 145 patients was analyzed. The study was designed as a facility-based, retrospective, cross-sectional observational study and was carried out using SPSS - 26.0. Result: A total of 145 patients aged 1-73 years were included in the study, of whom 48.2% (n=70) were male and 51.7% (n=75) were female. Overall, 145 clinical specimens were collected, including nasal swabs 36 (24.8%), throat swabs 56 (38.6%), and ear swabs 53 (36.6%). Bacteriological examination revealed pathogenic microorganisms in 80.7% (n=117) of the specimens. S.aureus was isolated from 65.5% of nasal swabs, 53.6% of throat swabs, and 67.4% of ear swabs. Among S. aureus isolates from ear swabs, 27.6% (n=8) were identified as methicillin-resistant Staphylococcus aureus (MRSA). Antimicrobial susceptibility testing showed that S. aureus isolates from nasal swabs were resistant to amoxicillin (100%), ampicillin (90.0%), erythromycin (87.5%), and azithromycin (81.8%), while they were susceptible to cefazolin (72.7%), doxycycline (80.0%), and vancomycin (75.0%). S. aureus isolates from throat swabs demonstrated resistance to amoxicillin (100%), ampicillin (100%), chloramphenicol (87.5%), and azithromycin (75.0%), but were susceptible to ciprofloxacin (69.2%) and vancomycin (66.7%). S. aureus isolates from ear swabs were resistant to gentamicin (77.8%), clarithromycin (71.4%), azithromycin (66.7%), and penicillin G (66.7%), while higher susceptibility was observed to nitrofurantoin (87.5%), vancomycin (68.8%), and ciprofloxacin (64.7%). For Streptococcus spp, resistance was observed to erythromycin (84.6%), amoxicillin (76.9%), and chloramphenicol (71.4%), whereas susceptibility was noted to amoxiclav (54.6%), cefazolin (63.2%), and cefotaxime (50.0%). Conclusion 1. Staphylococcus aureus predominated in samples from ear, nose, and throat infections, confirming it as the main causative bacterium of these conditions. 2. The predominantly isolated Staphylococcus aureus showed high resistance to antibiotics from the penicillin, macrolide, and aminoglycoside groups.

Background: Pregabalin significantly reduces pain intensity and improves sleep quality and health-related quality of life in patients with neuropathic pain. Since it remains uncertain whether the improvements in sleep quality and quality of life associated with Pregabalin are related to its analgesic properties. Therefore, this study aimed to evaluate whether these clinical outcomes are correlated. Aim: Assessing the Correlation Between patient’s analgesia and sleep quality, health-related quality of life outcomes after pregabalin treatment Materials and Methods: This study was conducted at the Geriatric Hospital of Bayangol District from February, 2026. Patients diagnosed seventy eight with neuropathic pain of any origin who attended the neurology outpatient clinic during the study period were enrolled. Pain intensity, sleep quality, and HRQoL outcomes were evaluated at baseline and at week 8 by means of an 11-point (0-10) numerical rating scale (NRS), the Pittsburgh Sleep Quality Index (PSQI), and the EuroQol EQ-5D-5L score, respectively. The study was designed as an uncontrolled observational analytic study, and statistical analyses were performed using SPSS version 27.0. Result: The mean age of the study participants was 59.5±15.7 years (n=78). Of the participants, 53.8% (n=42) were female and 46.2% (n=36) male. The relationships among pain intensity, sleep quality, and health related quality of life were evaluated using correlation analysis. A strong positive and statistically significant correlation was observed between sleep quality and quality of life (p<0.05), whereas no statistically significant associations were identified among the other variables. Conclusion It was observed that in patients with neuropathic pain, pregabalin reduced pain intensity and that a one-unit improvement in sleep quality was associated with a 0.7-unit increase in quality of life.

Background: Differentiating brain abscesses from necrotic cystic tumors is critical for clinical management but remains challenging due to overlapping features on conventional MRI. Aim: To evaluate the diagnostic performance of diffusion-weighted and morphological MRI biomarkers in differentiating brain abscesses from necrotic cystic brain tumors. Materials and Methods: This retrospective study included 54 patients with ring-enhancing brain lesions (brain abscess, n=13; metastasis, n=18; glioblastoma, n=23). MRI protocols (T1W, T2W, DWI, SWI, and T1+CE) were analyzed for lesion morphology, diffusion characteristics, capsule thickness, and the “dual rim sign.” Group comparisons were performed using ANOVA, chi-square, and Fisher’s exact tests. Diagnostic performance and optimal thresholds were determined using ROC curve analysis (p<0.05). Results: 1. Comparison of Diffusion Parameters: The core ADC ratio min was significantly lower in the brain abscess group than in the cystic-necrotic tumor group (0.812±0.228 vs 1.902±0.535 for glioblastoma, 1.590±0.394 for metastasis; p<0.001). The area under the curve (AUC) for core ADC ratio min was 0.977, indicating excellent diagnostic performance. 2. Capsule Characteristics: On SWI, the “dual rim sign” was detected in 92.3% of brain abscesses but was absent (0%) in all cystic-necrotic tumors (p<0.001). The abscess capsules were significantly thinner (mean 3.3 mm) and more uniform compared to the irregular, thicker walls of necrotic tumors. 3. Diagnostic Thresholds: The optimal cut-off value for the core ADC ratio min was 0.94 (sensitivity 92.3%, specificity 92.7%). For capsule thickness, the cut-off value was 3.3 mm with an AUC of 0.955. Conclusion Core ADC ratio and capsule thickness are reliable quantitative MRI biomarkers for differentiating brain abscesses from cystic-necrotic tumors. Integrating diffusion metrics with susceptibility-based and morphological features, such as the “dual rim sign,” significantly enhances diagnostic accuracy in clinical practice, facilitating non-invasive and timely diagnosis.

This clinical review provides a summary of information on antibiotic-food interactions. The effects of medications vary from person to person due to multiple interactions. These include drug-drug interactions and drug-food interactions, which are influenced by everything an individual consumes. While drug-drug interactions are relatively well studied and understood by healthcare professionals such as doctors, nurses, and pharmacists, drugfood interactions are often overlooked, even by medical professionals.
As a result, medications' effects may become stronger, weaker, or completely absent, and in some cases, this may lead to toxicity. Therefore, this review aims to enhance awareness of drug-food interactions among healthcare professionals and the general public to improve treatment outcomes. Food-drug interactions are more noteworthy compared to other interactions. This is because dietary habits are often not recorded in a patient’s medical history and are not always included in consultations with healthcare professionals. However, the risk of adverse effects is the same for both food and medication.
Particularly, solid dosage forms such as tablets, capsules, and pills should be taken with water. If taken with other beverages— such as milk, alcohol, coffee, or fruit juices— they can affect the drug's pharmacokinetics (absorption, metabolism, distribution, and excretion), potentially increasing side effects or suppressing the drug’s effectiveness. Spoiled food, food that has not been stored in a refrigerator, or aged, pickled, fermented, or smoked foods may contain tyramine. Therefore, special caution should be taken to avoid consuming these foods during medication treatment. Tyramine is also found in foods like bananas, avocados, raisins, raspberries, and soy sauce.
When Linezolid is taken with foods high in tyramine, it can cause a sudden and dangerous increase in blood pressure. Thus, it is important to check food labels and ingredients carefully.

This article provides an overview of the clinical evidence of interactions between herbal and conventional medicines. Herbs involved in drug interactions – or that have been evaluated in pharmacokinetic trials – are discussed in this review. While many of the interactions reported are of limited clinical significance and many herbal products (echinacea, valerian) seem to expose patients to minor risk under conventional pharmacotherapy, a few herbs, notably St. John’s wort, may provoke adverse events sufficiently serious about endangering the patient’s health. Healthcare professionals should remain vigilant for potential interactions between herbal medicines and prescribed drugs, especially when drugs with a narrow therapeutic index are used. Hypericum perforatum L. (St. John’s wort) extracts are widely used as a safe alternative to conventional antidepressant drugs for mild to moderate forms of depressive disorders. St. John’s wort represents the herbal product that is most involved in herb-to drug interactions. The aim of this article is to provide an overview of the clinical data regarding the E2 interactions between herbal remedies and prescribed drugs. For patients on prescription medications, the concomitant use of herbal medications can cause serious and adverse effects. It is the responsibility of health professionals to be well informed about the clinical evidence of herb-drug interactions.

Background: Induction of labor is a procedure performed to prevent maternal and perinatal morbidity and mortality. The effects of birth control pills on babies are still controversial. Therefore, we conducted this study to compare the effects of oxytocin and misoprostol on fetal blood gas parameters. Aim: To compare the effects of misoprostol and oxytocin used in labor induction on umbilical cord blood parameters Materials and methods: We conducted this study among mothers who gave birth in the NICU, according to the inclusion criteria, a control group (n=30), misoprostol alone vaginally (n=30) and oxytocin drip alone (n= 30) and oxytocin with misoprostol group (n=30) 4 groups used 100 mothers were selected respectively. Umbilical artery blood was sampled and umbilical artery blood pH, pCO2, pO2, HCO3, and VE (blood base excess) parameters were measured in the laboratory. The umbilical cord blood acid-alkaline parameters and lactate levels were analyzed and evaluated using COBAS C311 and COBAS B221 instruments. It was compared and determined using SPSS26 and EXCEL programs. Results: The average age of all mothers included in the study was 27.87±6.12, the average gestation period was 39.6±0.7 weeks, and the average weight of the newborn was 3466±323 gr. The average umbilical cord blood pH value was 7.34±0.04 in the control group, 7.25±0.07 in the oxytocin group, 7.27±0.04 in the misoprostol group, and 7.24±0.04 in the oxytocin and misoprostol group. And lactate valie was 5.8 in the control group, 7.5 in the oxytocin group, 9.87 in the misoprostol group, 8.7 in the combined group. Conclusions Compared to the group that did not use labor-inducing drugs, the mean pH of umbilical cord blood and lactate level were higher or statistically significant in the 3 groups that used labor-inducing drugs, indicating that birth-inducing drugs affect the umbilical cord blood parameters.

Safety and effectiveness of COVID 19 vaccine among pregnant woman Introduction: Major International Organizations such as the World Health Organization (WHO), Centers for Disease and Prevention (CDC), American College of Obstetrics and Gynecology (ACOG) recommend that use of COVID 19 vaccine for people who are pregnant, breastfeeding and trying to get pregnant. Objective: To determine the safety and effectiveness of COVID 19 vaccine among pregnant woman. Materials and methods: In this prospective study, we collected data from pregnant woman who are receiving their antenatal care at the general hospitals of Ulaanbaatar city and National Center for Maternal and Child Health of Mongolia between July 1, 2021 and August 20, 2021. The survey data were collected four categories of questionnaires. An ultrasound scan performed to screening of fetal anomalies and to assess fetal growth at 12, 20, 28, 36 weeks of pregnancy. Results: Among the total of 420 pregnant woman, 193 (46.0%) have received COVID 19 vaccine and 227 (54.0%) were not. (1:1) The most commonly reported adverse events in pregnant participants were injection site pain (63.2%), myalgia (45.2%), headache (44.9%) and fatigue (40%). Furthermore, complications of pregnancy were 11.5% of vaccinated group and 7.8% of the other group and it has shown that pregnancy complications was not statistically significant in differentiating to the study groups (x^2 = 1.62, p = 0.205) Pregnant woman with COVID 19 infections were 73.6% (n=39) of unvaccinated group and 26.4% (n=14) of vaccinated group. Whether to relate between COVID 19 vaccination and COVID 19 infections were statistically significant in differentiating to the study groups. According to the result, COVID 19 vaccine has an effectiveness of 91% for the pregnant woman if they continue to administer the prevention method of COVID 19 infections (same as before the vaccination: wearing a mask, keep a safe distance). The risk of fetal anomalies at first trimester and 20 weeks gestation were not statistically significant in differentiating to the study groups. These results demonstrate that the COVID 19 vaccine does not affects fetus by now. Conclusions: In this study, COVID 19 vaccine does not increase a risk of pregnancy and medical complications. The prevalence of COVID 19 infection was statistically significant in differentiating to the both vaccinated and unvaccinated groups. It shows that COVID19 vaccines have became a crucial tools for reducing the incidence of COVID 19 infection in pregnancy.

Outcomes of the retinopathy of prematurity screening and treatment in Mongolia Background: Retinopathy of prematurity (ROP) is a disease characterized by abnormal retinal vasculature that can have devastating visual consequences. Despite evidence that early detection and treatment can prevent blindness, ROP remains a leading cause of pediatric blindness worldwide. We aimed at investigating the outcomes of ROP screening, intravitreal anti–vascular endothelial growth factor (VEGF) and laser surgery in the treatment ROP and describe an evidence-based and specific process for identifying birth weight and gestational age screening guidelines in Mongolia utilizing telemedicine. Materials and methods: This was a retrospective of prematurity infants screened ROP from 2012 September to July 2020 and prospective cohort study of premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery and combined therapy from 2015 December 01 to January 31, 2017. Demographic factors, diagnosis and clinical course were recorded in a de-identified manner using REDCap, a secure, web-based platform to collect image and demographic data. The IRB approved the study protocol not requiring parental consent due to the de-identified nature of the data which was used for program monitoring purposes. Indirect ophthalmoscopy and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and images were uploaded to the web-based platform which could be accessed by the Mongolian ophthalmologist for reference. Each eye was evaluated by the local Mongolian ophthalmologist for the presence or absence of ROP, zone of vascularization, stage, plus disease, and aggressive posterior ROP (AP-ROP). The diagnosis and classification of ROP for this current study were determined by examination using indirect ophthalmoscopy, and treatment plans were determined according to the International Classification for ROP and the Early Treatment for ROP Study (ET-ROP).2,13 Regression analysis to determine association between BW and GA and the development of ROP. Results: A total of 9126 premature infants with BW ≤ 2500 g and/or GA ≤ 36 weeks were screened for ROP during the study period. 327 (3.5%) of the 9126 infants screened required treatment. The193 infants who received ROP screening had a mean GA of 30.09 ± 1.7 weeks, and mean BW of 1500.3 ± 125.42g. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. There were 96 boys (49.7%) and 97 girls (50.3%). Among infants receiving treatment, the highest BW was 2000g (born at 31 weeks GA), and the oldest was 34 weeks (with a BW of 1300g). The distribution of birth weight and gestational age in Mongolia was similar to other low-middle income countries, with higher birth weight and older gestational age. As birth weight and gestational age decreased, relative risk of developing ROP increased. Conclusions: After treatment, resolution of ROP was noted in approximately 90 % of the patients who had treatment-requiring ROP. 10 % of patients treated with IVB, IVR, Laser surgery and combined therapy however, did not respond and progressed to retinal detachment. This prospective study provides information about the development of ROP in preterm infants in the capital city of Mongolia. The distributions of BW and GA among infants developing ROP in Mongolia differ from those found in higher-income countries, and are comparable to other low and middle-income countries. We used a secure, web-based data collection and retrieval system that could be extended to multiple countries, which is now equipped with a telemedicine platform enabling remote grading of fundus images.

Background: Early application of autologous skin may lead to the loss of split thickness skin graft due to unclarified wound bed. Allogeneic skin grafts are performed on patients with extensive burn injuries after escharotomy, tangential excisions and deep debridement for the purpose of stabilizing the general condition and reducing the scope of local complications. Objectives: The aim of this paper is to determine how the use of allografts improves the conditions for the intake of autografts in burns treatment, and how it accelerates wound healing in comparison to the autografts-only option. Material and Methods: In 2016-2017, allogeneic skin was grafted on 24 patients, and in 6 cases grafting was repeated several times. An autologous split-thickness skin graft was applied to 23 patients. The analysis included the relationship between the duration of hospitalization and the number of skin transplantations, the relationship between the time of admission to debridement of the necrotic tissues and the total duration of hospitalization. Results: The results suggest that multiple applications of autografts not only do not lead to quicker recovery, but even lengthen the hospitalization time. The dependency is visible also in the patients who underwent the skin grafting procedure in allogeneic and autologous systems twice or more. There was a statistical significant difference between the duration of hospitalization in groups of patients who underwent STSG preceded by allogeneic skin graft transplantation when compared to the group of patients who underwent allogeneic skin application (p < 0.05) and the group of patients who were grafted with autologous skin (p < 0.05). The procedure of early resection of necrotic tissue combined with autologous or allogeneic skin graft improved the survival outcomes of the patients. Conclusions Allogeneic skin grafts are a perfect dressing when wound vascularization is insufficient to take free split-thickness skin graft. In patients with comparable burn surface areas, multiple applications of free autologous split-thickness skin grafts (STSG) extend the hospitalization time in comparison to application of allogeneic skin dressing as the first-line therapy.

The Mongolian plants considered to possess medicinal properties may contain novel compounds since they are exposed to severe conditions; such plants could become good candidates for modern drug discovery programs. Daurian Thermopsis (Thermopsis lanceolata R.Br.= Th.dahurica Czefr.), Gobian Thyme (Thymus gobicus Tschern.) and Mogilev Mallow (Malva mohileviensis Downer) are separately used as mucolytic and anti-inflammatory treatment in non-conventional medicine. Therefore, weprepared extract of these herbals compound called as a Tetima and to evaluate it’s acute toxicity. It isimportant to produce mucolytic effective new pharmaceutical preparation used for upper and lowerrespiratory tract inflammatory disease.Tetima herbal compound extract was prepared in ethanol, the ratio of herbals to ethanol was 1:10. Healthy 25 white albino mice (male weighing between 17-30 gram) used in this study. They were kept in large airy cages in groups of 5 animals per cage with free access to food and water. Five doses (8-20 g/kg) were then chosen for the determination of intraperitoneal LD50 in mice and given to five groups of albino mice. The animals were observed for first 2 hours and then at 6th and 24th hour for any toxicsymptoms. After 24 hours, the number of deceased mice was counted in each group. The percentage of animals that died at each dose level was transformed and then LD50 determined by the methods of Karber and Pershin.G.N.The LD50 of Tetima herbal compound in mice was determined to be 14.3 g/kg after intraperitonealinjection. There was no difference occurred between Karber and Pershin methods to evaluate acute toxicity. In the animals receiving intraperitoneal injection, the abdominal muscle contractions and ataxia was observed, which persisted for few hours. At the 6th hour they were drowsy and less responsive. The severity of these effects was related to the level of dose. However, at 24th hour most of the survivors had recovered from these symptoms.Tetima herbal compound extract is a relatively safe, particularly when given intraperitoneal inject toexperimental animals.