1.A decision tree to predict the effects of insomnia
Bayarmaa Dorjdagva ; Khulan Gansukh ; Sumiyabazar Gansukh ; Khishigtogtokh Manlai ; Ganbat Tsend
Mongolian Pharmacy and Pharmacology 2025;26(1):40-43
		                        		
		                        			:
		                        			 Researchers and scientists are developing practical clinical recommendations for behavioral and 
psychological treatments of chronic insomnia in adults. This also aims to create one of these 
recommendations.
 To calculate the effects of insomnia, the research method used a decision tree based on the results 
of 10 questionnaires from 43 people suffering from insomnia who are patients at “Enerel” hospital in 
Bayanzurkh district. The study focused solely on individuals with insomnia, it serves as a decision 
tree to assist those experiencing insomnia-Indiviuals-Individual who do not have insomnia were 
excluded from the study.
		                        		
		                        			Method:
		                        			 We used a questionnaire method in this study. 
		                        		
		                        			Conclusion
		                        			 All questionnaires pertain to the effects of insomnia when constructing a decision tree 
to produce insomnia effects as training data from 43 data points with 10 characteristics. It can be 
concluded with an average of five questions. If the training data is enhanced, it will get closer to 
reality. The decision tree will assist doctors and nurses in estimating, advising, and preventing the 
consequences of insomnia. 
In the next phase, a survey will be conducted with individuals who have insomnia and those who 
have insomnia and those who do not, and an expanded decision tree will be developed. 
		                        		
		                        		
		                        		
		                        	
2.Efficacy of probiotic mouthwash in treatment of plaque-induced gingivitis
Khongorzul S ; Namuundari G ; Narantuul Ch ; Saranchimeg A ; Bolor N ; Khulan G ; Angar S ; Buyanbileg S ; Nyamsuren E ; Oyun-Enkh P ; Oyunkhishig Kh ; Bayarchimeg B
Mongolian Journal of Health Sciences 2025;88(4):112-116
		                        		
		                        			Background:
		                        			In the treatment of plaque-induced gingivitis, in addition to mechanical plaque control, the use of chemical 
plaque control such as mouth rinses for a certain period has shown a positive effect on treatment outcomes and prognosis.
 
		                        		
		                        			Aim:
		                        			To evaluate the efficacy of a probiotic mouthwash in the treatment of plaque-induced gingivitis.
		                        		
		                        			Materials and Methods:
		                        			A randomized controlled clinical trial was designed for a period of 2 weeks on 45 systemically 
healthy subjects between 20 and 25 years having plaque-induced gingivitis. The study population was divided into three 
groups. Group 1-15 subjects were advised experimental (probiotic) mouthwash. Group 2-15 subjects were advised positive control (chlorhexidine) mouthwash and Group 3-15 subjects into a negative control group. Oral prophylaxis was 
done for all groups at baseline. After the proper oral hygiene instructions, groups 1 and 2 were instructed to rinse their 
mouth with 15 ml of their respective mouthwashes, for 1 min twice daily, 30 min after brushing. Clinical parameters such 
as Full mouth plaque score (FMPS), Full mouth bleeding score (FMBS) were assessed at baseline, 2 weeks respectively.
		                        		
		                        			Results:
		                        			At baseline, there was no statistically significant difference between the groups in terms of FMBS and FMPS 
mean values (p=0.174, p=0.887). At day 14, the FMPS, FMBS mean values were significantly reduced by all treatment 
modalities ranking probiotic and chlorhexidine is greater than negative control group (p<0.001, p<0.001).
		                        		
		                        			Conclusion
		                        			The probiotic mouthwash was effectively used as an adjunct to mechanical plaque control in the treatment 
of plaque-induced gingivitis. 
		                        		
		                        		
		                        		
		                        	
3.A study on risk factors influencing the outcomes of In vitro fertilization (IVF)
Amarzaya L ; Khadbaatar R ; Erkhembaatar T ; Gunjinlkham S ; Khulan Ch ; Jargalsaikhan B
Mongolian Journal of Health Sciences 2025;87(3):21-28
		                        		
		                        			Background:
		                        			Infertility is defined as the inability of couples to conceive
despite engaging in regular, unprotected sexual intercourse for over a year.
Assisted reproductive technology (ART), particularly in vitro fertilization (IVF),
has emerged as the most widely utilized solution for infertility. The cause
of infertility, a woman's ovarian reserve, response, egg and sperm quality,
the number and quality of embryos, and various other factors influence the
outcome of IVF. Despite significant advancements in ART, predicting IVF
outcomes remains challenging, especially when tailoring treatment strategies
to individual patient factors.
		                        		
		                        			Aim:
		                        			To investigate the clinical indicators, ovarian reserve markers, and
stimulation outcomes influencing the success of IVF treatment in Mongolian
women.
		                        		
		                        			Materials and Methods:
		                        			A prospective study was conducted at the Unimed
International Hospital IVF Center between October 2023 and August 2024.
Clinical and demographic factors, ovarian reserve markers (FSH, AMH, AFC),
and ovarian stimulation outcomes were analyzed in 242 women aged 25-44
years undergoing IVF. Logistic regression analysis was performed to identify
risk factors and predictors of clinical pregnancy, with a statistical significance
threshold set at p<0.05.
		                        		
		                        			Results:
		                        			Among 208 women who underwent embryo transfer, the clinical
pregnancy rate was 36.5%, and biochemical pregnancy was observed in
38.4%. Age was a significant predictor, with older age groups (35-39 years:
OR=7.11, p=0.004; 40-44 years: OR=12.65, p=0.004) associated with reduced
IVF success. Ovarian reserve markers, including AMH (OR=2.49, p<0.001)
and AFC (OR=1.56, p<0.001), were significantly correlated with pregnancy
outcomes, whereas FSH was not significant (p=0.518). Higher numbers of
pre-ovulatory follicles (POF) (OR=1.03, p=0.040) and high-grade embryos
(OR=1.26, p=0.045) increased the likelihood of clinical pregnancy. No
significant associations were observed between total gonadotrophin dosage,
ovarian sensitivity index, and fertilization rate with pregnancy outcomes.
		                        		
		                        			Conclusion
		                        			Age and ovarian reserve markers (AMH, AFC) are critical
predictors of IVF success, while pre-ovulatory follicle counts and number
of high-grade embryos significantly enhance pregnancy likelihood. These
findings emphasize the importance of personalized ART protocols tailored to
ovarian reserve and age-related factors to optimize IVF outcomes.
		                        		
		                        		
		                        		
		                        	
4.Case report: Kaposi's sarcoma of the larynx and pharynx
Nyamdulam L ; Tamir L ; Tsend-Ayuush A ; Dolgortseren P ; Purevdorj S ; Bilguntur Kh ; Jargalkhuu E ; Bazarmaa Ts ; Munkhbaatar P ; Sayamaa L ; Shijirtuya B ; Khulan Kh ; Amina G ; Bayarmaa T
Mongolian Journal of Health Sciences 2025;87(3):29-34
		                        		
		                        			Background:
		                        			A rare angioproliferative condition of the larynx, Kaposhi sarcoma
typically affects the skin. Immunosuppressive treatment following organ
transplantation and human immunodeficiency virus infection are the causes.
Every type of Kaposi sarcoma has human herpesvirus-8. Laryngeal kaposi
sarcoma is uncommon in immunocompromised patients; since its initial identification
in 1965, 18 cases have been documented globally. A CO2 laser-assisted
laryngeal microsurgery is performed through the mouth cavity to remove
tumor when kaposi sarcoma of the larynx obstructs the airway. Case report: A
77-year-old woman complained of hoarseness, dry mouth, odynophagia, and
dysphagia three months prior when she arrived at the Mongolian-Japan Hospital.
Two years ago, she acquired hard, sensitive lumps that were palpable
on her right arm, left ankle, and right thigh. At that time, she was diagnosed
with Kaposiform hemangiodermatitis and treated at the National Center for
Dermatology. HIV test results were negative. Immunohistochemistry: CD31
+/-, CD34 /+/. Using flexible nasopharyngeal endoscopy to get the diagnosis:
There was a mass that was about 1.5–2–5 cm in diameter, bluish in color,
smooth and movable, and spongy and vascular on the larynx, on the nasopharynx,
behind the palatine tonsills, and supraglottic. Surgery: Through the
use of Kleinsasser laryngoscopy and a 0-degree endoscope, pathological tissues
were extracted under general anesthesia using a laryngeal microsurgical
instrument and a laparoscopic bipolar coagulator. The tissues were then sent
for histological evaluation, which revealed Kaposi sarcoma, sarcoma grade 1.
		                        		
		                        			Results of treatment
		                        			Pain decreased and quality of life increased following
surgery. Upon nasopharyngeal endoscopy, the vocal cord mobility was normal
and the surgical incision was clean. Conclusion: Kaposi sarcoma is an
extremely uncommon illness. A lower quality of life and further issues can be
avoided with an early diagnosis and suitable therapy. It also needs to be continuously
monitored because it is a potentially repeatable disease.
		                        		
		                        		
		                        		
		                        	
5.A rare case of complete androgen insensitivity syndrome (cais) with serous cystadenoma
Amarzaya L ; Kherlen O ; Khadbaatar R ; Khulan Ch ; Lkhagva-Ochir M
Mongolian Journal of Health Sciences 2025;87(3):40-42
		                        		
		                        			
		                        			Complete androgen insensitivity syndrome (CAIS), also known as Morris
syndrome, is a rare X-linked recessive disorder characterized by a
46XY karyotype and a female external phenotype. We present the case
of a 32-year-old patient who presented to Unimed International Hospital
in 2024 with primary amenorrhea, infertility, and chronic pelvic pain.
Clinical examination, imaging, and laboratory investigations led to the
diagnosis of CAIS. Laparoscopic surgery was performed to remove bilateral
gonadal structures and a cystic mass on the left side. Histopathological
analysis revealed testicular tissue and a serous cystadenoma
originating from the left mesonephric remnant. Following gonadectomy,
hormone replacement therapy was initiated, resulting in stabilization of
hormone levels. This rare case highlights the possibility of mesonephric
remnant-derived cystadenoma in CAIS and underscores the diagnostic
value of cytogenetic and histological evaluations, especially in distinguishing
between ovarian and testicular tissue when imaging findings
are inconclusive.
		                        		
		                        		
		                        		
		                        	
6.Changes in rat behavior, lung, and hippocampal effects due to vaping exposure
Oyungerel S ; Tumenbayar B ; Javzandulam B ; Chimegsaikhan S ; Khulan B ; Altantsetseg B ; Mandakh-erdene B ; Munkhsoyol E
Mongolian Journal of Health Sciences 2025;87(3):141-146
		                        		
		                        			Background:
		                        			Nicotine-containing vaporized liquids—composed of
propylene glycol, glycerin, water, flavorings, and the thickening agent
vitamin E acetate—have been implicated in the development of EVALI.
Under conditions of low liquid levels and overheating, these substances
release toxic carbonyl compounds (e.g., formaldehyde, acetaldehyde,
acrolein). In a 2019 national survey, 3.5% of adolescents aged 13–15
reported cigarette use, and 10% used e-cigarettes.
		                        		
		                        			Aim:
		                        			To study the changes in the behavior, lung, and hippocampal
structures of rats due to the effects of electronic cigarettes and their
vapor.
		                        		
		                        			Materials and Methods:
		                        			In this study, nineteen 14-day-old SHR rats
were exposed to 1 g/mg/day of nicotine and dry hit vapor (control, nicotine
and dry hit groups) for four weeks. Behavioral assessments (Open
Field Test, Elevated Plus Maze, Conditioned Place Preference), bronchoalveolar
lavage (BAL), and histological analysis of lung and hippocampal
tissue were conducted.
		                        		
		                        			Results:
		                        			The dry hit vapor group showed significantly reduced body
weight (p=0.034), increased anxiety (p=0.006, p=0.025), and avoidance
of the smoky chamber. BAL revealed elevated total cells, neutrophils,
and macrophages (p=0.01, p=0.04) in both nicotine and dry hit groups.
Lung tissue exhibited alveolar septal thickening, inflammation, and emphysema-
like changes. Extensive neuronal death was observed in the
hippocampus.
		                        		
		                        			Conclusion
		                        			Anxiety-like behavior was observed in both the burn and
control groups. Analysis of BAL in the dry hit group revealed inflammation
predominantly characterized by macrophage infiltration. Histological
examination of lung tissue from both experimental groups
demonstrated a reduction in the number of alveoli, accompanied by
acute inflammation and thickening of the interalveolar septa. In the hippocampal
region, neuronal loss and a reduction in neuronal density
were also observed.
		                        		
		                        		
		                        		
		                        	
7.Outcomes of measures to prevent dose selection errors (2023-2024)
Nomin-Erdene Ts ; Tserennyam D ; Delgermaa Ts ; Orgilmaa Ts ; Mungunchimeg M ; Khulan M ; Khulan A ; Nina M ; Erdenetuya M
Mongolian Journal of Health Sciences 2025;87(3):154-160
		                        		
		                        			Background:
		                        			A drug related problem is defined by the Pharmaceutical Care
Network Europe Association as an an event or circumstance involving drug
therapy that actually or potentially interferes with desired health outcomes.
One critical aspect of preventing such errors is proper dose adjustment, which
plays a vital role in the diagnosis and treatment of disease. For instance, adjusting
the dose of warfarin based on the patient’s INR level is essential. In
a 1995 study conducted in England, clinical pharmacists recommended target
doses of angiotensin-converting enzyme (ACE) inhibitors for patients with
chronic heart failure. As a result, patients experienced a significant reduction
in pulmonary and peripheral edema, along with improved exercise test outcomes.
At the Mongolian-Japanese Hospital of the Mongolian Medical University
of Science and Technology, it is important to analyze dosage-related
issues identified by clinical pharmacists and inform healthcare professionals
about common dosage selection errors and associated risks.
		                        		
		                        			Aim:
		                        			We analyzed issues related to medication dosage.
		                        		
		                        			Materials and Methods:
		                        			A retrospective study was conducted to examine
problem related to dosage detected through prescription monitoring at the
Mongolian Japanese Hospital of the Mongolian National University of Health
Sciences from 2023 to 2024.
		                        		
		                        			Results:
		                        			Out of a total of 2340 drug-related problem identified across five
inpatient wards during this period, 581 (100%) were related to dosage. Clinical
pharmacists performed prescription review on approximately 67% of all
inpatients, which was consistent between years. However, medication-related
problems tended to decrease from 41.1% (n=1499) in 2023 to 22.3% (n=841)
in 2024 (p=0.05). The majority of dose-related problems, 75.6% (n=440), were
overdoses. Medication-related problems were most common in the surgical
department, with 59.5% (n=346) (p=0.001). The most frequent dosage-related
errors involved exceeding the daily dose of diclofenac, administering higher-
than-recommended doses of ceftriaxone, failing to adjust cefotaxime for
renal function, and using inappropriate doses of metronidazole in patients with
impaired liver function. The leading cause of these errors was failure to adhere
to guideline-recommended dosing, which accounted for 71.3% (n=415)
of cases (p=0.001). When dosage-related recommendations were provided to
physicians before of treatment, acceptance rates increased by 14% (p=0.001).
These interventions resulted in an estimated cost saving of 1.267.219₮ and a
reduction of 363 injections.
		                        		
		                        			Conclusion
		                        			Therefore, clinical pharmacist-led prescription review can help
reduce the risk of dosage errors, lower associated healthcare costs, and alleviate
the burden on medical staff.
		                        		
		                        		
		                        		
		                        	
8.Relationship between the degree of adenoid hypertrophy and otitis media
Ninjmaa B ; Bayarmaa T ; Tsetsee B ; Enkhjin A ; Khulan B ; Bazarmaa Ts
Mongolian Journal of Health Sciences 2025;87(3):238-243
		                        		
		                        			Background:
		                        			Otitis media is an inflammatory disease involving the mucous
membrane of the middle ear, including the auditory tube, tympanic
cavity, mastoid antrum, and air cells¹. Multiple factors contribute to the
development of OM, one of which is adenoid hypertrophy5. However, to
date, no study has been conducted in Mongolia to assess the relationship
between the degree of adenoid hypertrophy and OM.
		                        		
		                        			Aim:
		                        			To analyze cases of children who underwent adenotonsillectomy.
		                        		
		                        			Materials and Methods:
		                        			The study was conducted using a cross-sectional
observational research design. Clinical data from a total of n=215
cases of children who were diagnosed with adenoid and palatine tonsil
hypertrophy and underwent surgical treatment at Gurvan Gal Hospital
between October 2023 and October 2024 were analyzed. Statistical
processing was performed using STATA 14.2, with statistical significance
considered at p < 0.05.
		                        		
		                        			Results:
		                        			Clinical data from 215 children were analyzed to evaluate the
relationship between the degree of adenoid hypertrophy (AH) and otitis
media. The children ranged in age from 2 to 17 years, with a mean
age of 7.23 ± 3.4 years. Among them, 128 (59.53%) were male (7.09
± 3.29 years) and 87 (40.46%) were female (7.45 ± 3.58 years). A statistically
significant moderate negative correlation was found between
age group and the degree of adenoid hypertrophy (rho = -0.3485, p <
0.001). A significant seasonal variation in otitis media was observed (p
= 0.0001). A statistically significant correlation was found between the
degree of adenoid hypertrophy and otitis media (p < 0.001). However,
no significant correlation was observed between the degree of palatine
tonsil hypertrophy and otitis media (p = 0.8762).
		                        		
		                        			Conclusion
		                        			The incidence of adenoid hypertrophy is highest among
children aged 6 to 9 years, and there is a moderate negative correlation
between age and the degree of adenoid hypertrophy. The occurrence
of otitis media varies by season, with the highest number of cases reported
during the winter months. As the grade of adenoid hypertrophy
increases, the number of otitis media cases also rises.
		                        		
		                        		
		                        		
		                        	
9.The prevalence and severity of anemia among adults
Enkhmaa B ; Khulan P ; Oyunsuren E ; Odgerel TS ; Uranbaigali E
Mongolian Journal of Health Sciences 2025;86(2):97-101
		                        		
		                        			Background:
		                        			Anemia is still being a population’s challenging issue regardless of high development of countries around
the world. According to a study regarding prevalence and etiology of anemia conducted in 187 countries around the
world, the anemia rate is 23 176 per 100 000 population. In accordance with the “5th National Nutrition Survey” study
conducted in our country in 2017, one of every five women (21.4%), aged 15-49 years, 16.2% of reproductive age women
and 3.0% of men are anemic. The current study was conducted due to it is still essential to study and identify the etiology
of anemia, determine its prevalence, plan appropriate intervention, and organize future preventive measures, depending
on the socio-economic conditions, location, diet, and customs of the Mongolians.
		                        		
		                        			Aim:
		                        			To identify anemia among the adult population, determine the type and severity of anemia.
		                        		
		                        			Materials and Methods:
		                        			The cross sectional study was conducted during between May 2022 and Sep 2023 and adults
aged above 18 years were included. Moreover, we identified anemia cases based on the laboratory test results and determined
the anemia severity grade. Statistical analysis was performed by using SPSS software.
		                        		
		                        			Results:
		                        			Among the participants, 6.7% of them, 9.9% of females and 2.8% of males are anemic. Prevalence of mild,
moderate and severe anemia is 66.7%, 30% and 3.3%, respectively. While the prevalence of anemia among reproductive
age women is higher, the prevalence of anemia increases with age. The anemia prevalence in Ulaanbaatar region, Western
region, Khangai mountainous region, Central region and Eastern region is 583 (25.6%); 171 (7.5%); 343 (15.1%); 921
(40.4%); and 261 (11.4%), respectively. By regional location, the prevalence is high in the Central region, with varying
prevalence in other regions.
		                        		
		                        			Conclusion
		                        			Anemia was detected in 6.7% of the total study population, 9.9% of females, and 2.8% of males were anemic.
Of those with anemia, 66.7% had mild anemia, 30% had moderate anemia, and 3.3% had severe anemia. Moderate
and severe anemia were more common in females than in males.
		                        		
		                        		
		                        		
		                        	
10.Title: Effect of Cacalia hastate.L 60 mg/kg for 7 and 14 days in treatment on model of Gastric ulcer
Khulan B ; Ariunaa S ; Javzandulam E ; Chimegsaikhan S ; Jargalsaikhan B ; Mandakhaa B ; Tumenbayar B ; Oyungerel S ; Altantsetseg B
Diagnosis 2024;110(3):14-18
		                        		
		                        			
		                        			Introduction Gastric ulcer is one of the most common disorders considering the gastrointestinal tract, it affects 5% of the population around the world, so its prevention and management are considered very important challenges. Researchers have revealed several causes 
of gastric ulcer; these include an imbalance between aggressive and intrinsic defensive 
factors. Gastric ulcer is a very common gastrointestinal disease that may lead to 
dangerous complications and even death. 
The aggressive factors include non-steroidal anti- inflammatory drugs(NSAID),alcohol, 
psychological stress and Helicobacter pylori infection, cytoprotective intrinsic factors 
include mucosal blood flow, bicarbonate, mucus, cell renewal, growth factors, NO 
and prostaglandins, NSAID-induced gastric damage is known to be the most common 
and dangerous side-effect of these drugs and accounts for 25% of gastric ulcer cases. 
Indomethacin (INDO) is considered to be the most common NSAID known to induce experimental gastric ulcer and has been documented to have a higher potential to cause gastric injury than other commonly used NSAIDs.
Most of the drugs which are used for wound healing are imported in Mongolia. It is required to develop drug formulation and increase local productions used for the treatment of wound healing. For the 
purpose of solving the above problems, we aimed to prepare new drug formulation from Cacalia hastata L. for the treatment.
of wound healing. Cacalia hastata L. is 
a medicinal plant, member of the family 
Asteraceae. Cacalia hastata L. is widely 
used for the Mongolian traditional medicine 
to 
treat wound healing, gastric ulcer, 
poisoning fever, liver fever, bile fever, oral 
cavity, and gynecological diseases
		                        		
		                        		
		                        		
		                        	
            
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