Introduction: Scutellaria baicalensis Georgi, which is used in traditional medicine, has the ability to remove blood-drying heat. Chiazospermum erectum Bernh. has the ability to relieve typhoid fever and poison fever. Carthamus tinctorius L. has antiseptic, analgesic and anti-toxic properties. Saussurea amara L. has bactericidal, anti-infective, and anti-inflammatory properties. Researchers found that the Hepaclin-4 recipe has antioxidant, membrane-strengthening, liver-protective, necrosis-preventing, detoxification, and peroxidation product accumulation-reducing properties. Therefore, extracting the granular medicine form from the concentrated extract containing the Hepaclin-4 formulation is the basis of our research work. Goal: To obtain the granular medicine form from the concentrated extract containing ingredients of the Hepaclin-4 recipe. Materials and Methods: The research was carried out with the support of the Institute of Pharmaceutical Research and the University of Pharmaceutical Sciences. The raw materials for the Hepaclin-4 formula were extracted by remaceration with water, 40% ethanol, and 70% ethanol (1:10 ratio). Six types of granules were extracted from the concentrated extract using several excipients by the wet granulation method, and the pouring weight and flowability were determined. Results: The quality index of the concentrated extract of the Hepaclin-4 recipe complies with the standards outlined in the 11th Pharmacopoeia of the National Pharmacopoeia of Mongolia. In qualitative analysis of total flavonoid, spots were detected at the same level as standard quercetin (Rf=0.88) and rutin (Rf=0.4), indicating the presence of flavonoids. According to the results of the above research, lactose was found to be the suitable filler for extracting granules, and starch at 8% was identified as the appropriate binding agent from the concentrated extract of the Hepaclin-4 formula. Conclusion It was found suitable to select 8% lactose as a filler and starch as a binding agent from the concentrated extract of the Hepaclin-4 formula and obtain a granule drug form using the wet granulation method.

Abstract: Demographical, social and cultural factors including population health, diagnoses, introduction of new treatment methods, capacity of the health organizations, enhancement of professional skills of medical practitioners, as well as drug efficacy affect the needs of drug. There are many methods used to estimate needs of drug. For example; Essential medicine list, medicines prescribed for specific illnesses and medicines consumed by norms. Moreover, there are two ways to estimate the demand of the essential medicines making basic comparisons of essential drug needs and morbidity indicators of the other countries in compliance with the recommendation of WHO.¹
Actual needs of the essential medicines for most common diseases and other medicines have determined by selecting from the records of inpatients by classification and amount as well as estimating the classification, amount and price of the medicines sold by pharmacy for the given period. This estimation reveals the temptation of the needs of the drug so that the amount of the supply will be determined by upcoming month, season and year. More importantly, It will not only benefit the classification, amount of the necessary medications but also it will estimate the budget for the certain period.
In the recent 9 years, the community acquired pneumonia cases among the 0 to 5 year old children admitted to the hospitals of Ulaanbaatar city have increased by 15.7%.
Therefore, we have studied the needs of drug in the treatment actual consumption of medicine the CAP in children among 0 to 5 year old.
The research was referenced by the method of determining drug needs by consumption and morbidity indicators, other methods developed by scientists such as Hogerzell H.V., Jonathan D.Quick., James R.Rakin., Richard O.Laing., Ronald W.O.Connor., Andrew, Kobzari L.V, Dryomovo N.B, Glembotskaya G. T, Mnushko Z.N. Numerical data has been determined by average and standard deviation as well as maximum or minimum value employing variation analysis method. Result of the study Having determined the average number of CAP in children cases, temp of annual growth, fluctuations, statistical report of the last decade based on the actual medicine consumption for the treatment of CAP in children of all the participants (96 inpatients aged from 0 to 5 year) and disease prognoses; as result, it has been estimated the necessary drug needs for 27591-33869 CAP in children cases which will be treated in the hospitals of Ulaanbaatar city from 2019-2013.
There’s a tendency that approximately 31509 patients aged from 0 to 5 year are going to be hospitalized for CAP in children so that it’s estimated to require 1156848.1 MNT for the treatment.

Abstract: Respiratory diseases are the most common among the population of Mongolia, besides, the data regarding the pneumonia and chronic obstructive lung disease (COLD) among the community acquired pneumonia in children specially 0-5 year old has taken into much consideration when re- viewing the statistical report of 2010-2018 of Mongolia.¹
Looking at the details, as regards 2010-2011 there were 82 CAP case, which increased by 6.8%, but in 2011-2012, 48 cases were registered, which dropped into 3.7%. Again in 2012-2013, jumped by 2.6 % by reporting 33 cases. Then from 2013 to 2014, it has become 406 cases, increased by 31.8% whereas it added up to 848 cases registered in 2014-2015, which fell by 50.4%. 788 cases reported in 2015-2016 , rose by 94.7%. Then the figure decreased by 2.2%, only 36 reported cases in 2016-2017, again it soared up to 14.1% when 224 cases were registered in 2017-2018. In the last 9 years, the community acquired pneumonia among the 0 to 5 year olds in Ulaanbaatar city has increased by 10.4%.
Reviewing the Statistical Report of 2010-2018 of Mongolia, hospitalized cases of the children aged from 0-5 year old for CAP has gradually increased from 2010 to 2014; the total number of the above mentioned cases has become 8603 and the average increase was 13,1%.
In fact, the figure fell by 40% by reporting 8071 cases in 2014-2015 which whereas in 2015- 2016 there were 13073 cases, an increase of 108.3%. Then, in 2016-2017, the number has de- creased by 6.3% with 1604 reported cases. But in 2017-2018, registering 3260 cases, the rated jumped by 13.9%.²
In the recent 9 years, the pneumonia cases among the 0 to 5 year old children admitted to the hospitals of Ulaanbaatar city have increased by 15.7%. Therefore we have studied the actual medicine consumption in the treatment of the CAP among 0 to 5 year old.
The research data was processed by cross-sectional study by employing retrospective analysis is used to randomly select actual drug consumption from the records of the inpatients who diag- nosed as CAP. Result of the study In the last 9 years, the CAP among the 0 to 5 year old children hospitalized in Ulaanbaatar city has increased by 15.7%.
The number of the inpatients diagnosed as the CAP has reached 21535 cases, which is increased by 6.2% in 2014-2018. Furthermore, there is tendency to increase pneumonia cases by 31509; it’s possible to have approximately an increase of 5.1% in the 2019-2023.
We have revealed 30 different types of medicines have been used for the treatment of the CAP after examining prescribed drugs.

Introduction: Khuumii (throat singing) is a unique form of art derived from the nomadic population of Central Asia, producing two or more “simultaneous” sounds and melodies through the organ of speech. Material and Methods: The aim of the study is to identify the anatomical structures involved in the formation of khuumii and the features and patterns of their functions and compare each type of khuumii as performed by Mongolian people. A total of 60 participants aged 18-60 years (54 men and 6 women) were selected by non-random sampling method using cross-sectional study. Statistical analysis was performed using SPSS 23 software using questionnaires, X-ray, endoscopy, sound research method, and general blood tests. Results: 90.7% of the khuumii singers were male and 9.3% were female. The average height of the participants was 172.91±0.93 cm (arithmetic mean and mean error), average body weight was 77.53±2.46 kg, and body mass index was 25.93±5.31 respectively. Heart rate was 92.19±20.71 per minute prior to khuumii while 133.19±19.09 after performing khuumii and 85.81-98.56 at 95% confidence interval. In terms of ethnicity (ethnographically), the Khalkh were the largest ethnic group (72.1%), followed by Bayad, Buryatia, Darkhad, Torguud, and Oirat (2.3%), respectively. 60.5% of the participants were professional khuumii singers who graduated from relevant universities and colleges. The process of Khuumii was recorded by X-ray examination, and laryngeal endoscopy evaluated the movement of true and false vocal chords, interstitial volume, movements of epiglottis and arytenoid cartilage, and mucosa. Khuumii increases the workload of the cardiovascular system by 70-80%. Furthermore, the sound frequency is 2-4 times higher than that of normal speech, and sound volume is 0.5-1 times higher. 95.3% of throat singers did not have a sore throat, 88.4% did not experience heavy breathing, and 74.1% had no hoarseness. During the formation of khuumii sound, thoracic cavity, diaphragm, and lungs regulate the intensity of the air reaching the vocal folds, exert pressure on the airways and vibrate the sound waves through air flows passing through the larynx and vocal folds. Mouth-nose cavity as well as pharynx are responsible for echoing the sound. Conclusion It is appropriate to divide khuumii into two main types according to structural and functional changes in the organs involved; shakhaa and kharkhiraa. Khuumii, the “Human music” originating from the people of Altai Khangai basin by imitating the sounds of nature with their own voice in ancient times, spread all over the world from Mongolia and it is proposed to classify khuumii into two main types of shakhaa and kharkhiraa in terms of structural involvement and functionality.

Background: Headache is a common disorder among population. 47% of population of the world suffers from the primary headache. Due to the chronic lasting process of headaches, individuals lose productivity, get depression because of negative impact on people’s quality of life and economic status.
Headache disorders are amongst the top ten causes of disability in Europe [4]. Three of these (migraine, tension-type headache and medication-overuse headache) are important in primary care because they are common and responsible for almost all headache-related burden.
The burden is immense on workers, women and children in terms of missing work and school days. The personal and social burden of primary headache is high. Health, occupational, social, and psychological factors contributing to burden in people with disabling headache have not been fully unraveled. Headache disorders are not perceived by the public as serious since they are mostly episodic, do not cause death, and are not contagious. A large number of people with headache disorders are not diagnosed and treated: worldwide only 40% of those with migraine or tension-type headache (TTH) are professionally diagnosed and only 10% of those with medication-overuse headache (MOH).
There are no studies on the burden and disability assessment in patients with primary headache in our country, therefore a need for conducting this study. Goal: The burden and disability assessment in patients with primary headache in Mongolian adults. Methods and Materials: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old randomly were selected from four aimags of Mongolia and three districts of Ulaanbaatar city. They were visited by door to door calling and surveyed using the HARDSHIP and Migraine Disability Assessment (MIDAS) questionnaire. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program, and level of depression in headache present patients was determined by odds ratio (OR). Study methodology introduced at Ethical review Committee of “Ach” Medical University and approved in 2017 (№17/3/2). Results: There were 2043 participants 39.7% and 60.3% of them were men and women respectively. The mean age of them was 38.0±13.4 years. 57.4% (n=1173) of participants had headache, and 27.4%, 30.0%, 11.2% and 7.5% of them had migraine, tension-type headache, chronic headache and medication overuse headache respectively. 42% of participants with headache had the median duration of suffering 7 years (IQR=3-13 years). Out of 1173 participants with headache 20.7% had depression. 23% of participants with migraine had depression whereas 68.2 % and 47% of participants with chronic headache and medicine overuse headache had depression respectively. Participants with migraine were 1.85 (OR: 1.85, CI: 95%, 1.39-2.47) times, with chronic headache 3.40 (OR: 3.40, CI: 95%, 2.04-5.67) times and medicine overuse headache 3.31 (OR: 3.31, CI: 95%, 1,50-7.30) times more likely to suffer from depression compare to participants with no headache.
People with migraine loses their productivity 10.6 days/m, with chronic headache 19.7 days/m, with MOH 20.3 days/ m. According the MIDAS (migraine disability assessment) people with migraine has mild disability, while people with chronic headache and MOH had middle score of disability. Conclusion The prevalence of primary headaches is high among Mongolian adults. These headaches cause disability, impair work, study and daily activities, decrease life quality, and brings unrecognized socioeconomic burden.

The main goal of this study is to examine the development of auditory perception performances of a cochlear implanted child who receive auditory verbal therapy. Present study included a child with prelinguistic hearing loss who received cochlear implant at the Department of ENT, 1st State Central Hospital and enrolled in Auditory Verbal Therapy (AVT) in the Speech Therapy Unit of “ Aid” Clinic. This hearing impaired child participated in auditory verbal therapy with their mother and/or father for 5 months, and the family was given training programs to apply at home after each therapy session. The auditory perception performances of a child were evaluated before implantation and after: twice every week in total 32 Audio-Verval Therapy sessions were performed with the help of Medel LittlEars Auditory Questionnaire, LIP (Listening Process Profile), Ling’s Five Sound Test, the Multiple Frequency Animal Sound Test (mFAST) and MTP (Monosyllable and Polysyllable Test). The auditory perception performances of a child joining auditory verbal therapy programs increased after 5 months of implantation. According to the Ling’s test all 5 sounds are determined (20-60dB) in 1m distance, but discrimination is observed in frequency range between 40-60 dB for sounds “A”, “U” and “M”. Parents active participation as well as full attendance in the AVT treatment shows progress in auditory development of a child. Furthermore evaluation and data analysis is needed.

This study investigates cochlear implant surgical and Audio Verbal Therapy (AVT) practice patterns of patients with hearing loss (HL) based on data of “Aid” ENT Clinic and Speech Therapy Unit of School of Dentistry, Mongolian National University of Medical Sciences (MNUMS) between 2009-2018. Our aim was to describe and collect related data on surgical interventions, using cochlear implant for patients with severe hearing loss and their involvement in the AVT sessions. Hospital based registry data by audiologistwere retrospectively investigated. Descriptive statistics are used to describe the basic features of the data in the study. In total 78 patients had cochlear implantation surgery with chronological age between 2 months and 55 years. From total subjects 46 (54.59%) were male and 32 (33.41%) female. The distribution of etiology for the hearing loss showed that the majority of hearing loss 47 (60%) had due to infectious diseases, other diseases or injury, 25 (32%) congenital and 6 (8%) unknown causes. Documentation and proper registration is essential for better outcome of cochlear implantation surgery, especially teamwork of speech therapist doing AVT and audiologist in charge of fitting. Furthermore, epidemiological studies are important for evaluation and monitoring of interventions by every specialists included in the treatment team.

Background: Headache disorders are most prevalent public-health problem. Worldwide, among the adults 46% suffer from primary headache, where the migraine presents 11% and tension type headache (TTH) presents 25%. Recently, one type of the primary headache, medication overuse headache tends to increase. Nowadays, there is no sufficient study about primary headache in Mongolia. So that, it is necessary to investigate prevalence, clinical type and risk factors of the primary headache. Purpose: To study prevalence and risk factors of primary headache in Mongolia. Materials and Methods: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old were randomly selected from four provinces and three districts of Ulaanbaatar city. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program. Results: A total of 2043 participants (812 men and 1231 women) were reviewed. The participant’s average age was 38.6±13.4years. 1350 (66.1%) participants reported recurrent headache within the last 1 year. Of the total study population, the prevalence rate of primary headache was 1305 (63.9%). Number of people who suffered from migraine was 494 (24.2%), significantly greater in female than male participants (p=0.0001), with most frequent attacks at age 26-45 years. The risk of migraine associated with sex, education and family history (p=0.001). 592 (29.0%) of participants had TTH, mean age of them was 37.7±5.24, significant high rate in female than men, risk of TTH depends on education and job. The medication overuse headache was diagnosed at 116 (5.7%), 29.4% in men and 70.5% in women with average of 45.6±11.4 and 43±12.7 respectively. Among the participants 38.6% used medications, 28% people had one drug, 8.5% two drugs and 2% used three or more drugs. Use of non-steroid anti-inflammatory drugs (NSAID) made up major percent in headache patients. Increased frequency of medication and multidrug affected to medication overuse headache (p=0.008). Conclusion More than half of studied population had primary headache. Migraine was in 24.2%, TTH in 29.0% of people, and associated with sex, education and family history. Use of non-steroid anti-inflammatory drugs made up major percent in headache patients.

Background: The primary headache disorders are one of the most common complaints among children and adolescents. Migraine and tension-type headache (TTH) are the most frequently types of primary headache, with prevalence of approximately 9.1% for migraine and 10–24% for TTH among children.
The aim of this study was to determine the 1-year prevalence and some risk factors of primary headache disorders in school-aged children. Material and Methods: A cross-sectional, school-based survey consisting of semi-structured questionnaires was administered to randomly select aged 6-11 years using stratified multistage cluster sampling during the period from April to June 2018. The questionnaire of primary headache was based on International Classification of Headache Disorders-III criteria. Statistical analysis was performed by using the SPSS, version 21. Student’s T-test, chi-square test and analysis of variance were used for comparisons when appropriate. The level of statistical significance was set at p<0.05. Results: We surveyed totally 635 participants; the one-year prevalence of all types of headache was 54.6%. Prevalence of migraine and tension-type headache was 3.0% and 5.4%, respectively. Elucidated biometric and socio-demographic risk factors showed statistically significant difference in prevalence of migraine: type of household, life situation and residential quarter. Conclusion Our study found that frequency of prevalence of primary headaches among the school-aged children is relatively high and comparable with other countries.

BACKGROUND Congenital and acquired hearing loss considered as the most common disability. According to the WHO report, 360 million people worldwide have disabling hearing loss, and 32 million of these are children. Severe to profound sensorineural hearing loss can be treated successfully with cochlear implants. Post implant Auditory Verbal Therapy/ Hearing Implant Rehabilitation is essential for the progress and better outcome. Multidisciplinary team approach, including ENT, audiologist, speech therapy, social worker, coordinator, caregiver /parent is required. The first clinical speech therapy department in Mongolia was established by the School of Dentistry, MNUMS based at the Maxillofacial Surgery Department of the MCNHC in 2006 (G. Ariuntuul, B. Bulgan, U. Azzaya). Where as the very first Cochlear Implanted child in Mongolia was received the surgery and audiology support by A. Ulziibayar, L. Byambasuren, B. Misheel, B. Narantya and the hearing implant rehabilitation treatment successfully conducted by the abovementioned speech team in 2009. Aim: To analyze current situation on speech therapy intervention for patients with hearing loss and deafness. METHODS Retrospective hospital data were collected based on the School of Dentistry, Speech therapy department between January, 2009- February, 2017. In total 70 patients’ information were retrieved for the study. Descriptive method is used for statistical analysis. RESULTS Out of 70 patients, attended speech therapy sessions 38 (54%) were males, 32 (46%) were females; where as 21 (30%) had congenital deafness and 28 (40%) acquired; 21 (30%) patients with hearing loss not known their causes of deafness. From the total of 28 (100%) cases with acquired hearing loss/deafness 11 (39%) patients cause of deafness is due to complication from infectios disease: meningitis.