Background: The aging of the world’s population will determine global health trends. According to the 2021 report of the Capital City Health Department, the average life expectancy of the Mongolian population is 71.3 years (male 67.3, female 76.7), the difference between male and female life expectancy is 9.4 years, and elderly people aged 60 and over account for 8.1% of the total population. The report also shows that 6.5% of all outpatient visits are for people aged 60-64, and 9% are for people aged 65 and over, which means that they do not receive adequate health care services. Therefore, it is important to increase the access to and quality of health care services provided to the elderly in order to improve their health and quality of life. Comorbidities that are common among the elderly are one of the pressing issues in the health sector. Aim: We aimed to study the prevalence and risk factors of multi-morbidities among older adults (aged sixty years and over) in urban and rural areas. Materials and Methods: To accomplish our aim, we conducted 156 lifestyle related questionnaires and 18 health related questionnaires among 720 older people in Ulaanbaatar city and rural areas, and created the database. Pearson correlation coefficient was used to determine the relationship between the quantitative influence of factors using single and multi-factor linear (β-coefficient) and binary logistic regression (odds ratio, CI 95%) methods, and p value less than 0.05 was considered statistically significant. The Apriori algorithm in SPSS was used to determine the relationship between multiple chronic diseases in the elderly people. Results: The prevalence of comorbidity was higher in urban areas (48.1%) and rural areas (51.9%), and ageing (urban areas OR: 2.45, 95% CI: 0.9-6.2; rural areas OR: 6.35, 95% CI: 1.47-27.4, P<0.01) was a risk factor of multi-morbidities. Multimorbidity is defined as the presence of 2 or more chronic conditions, and 3, 4, and 5 chronic conditions were co-occurred to older adults with chronic conditions, 28.7% (165). 11 common patterns of relationships in urban areas and 18 common patterns of relationships in rural areas (support (A→B)>3%, confidence (A→B)>30%, lift (A→B)>1) were determined. Conclusion Multimorbidity was different in urban and rural areas, 11 common patterns in urban areas and 18 common patterns in rural areas were determined. It has shown that the prevalence of multimorbidity was different in urban and rural areas.

Abstract: In the late 16^th century, Tibetan medical schools which were based on Indian Ayurvedic medicine were spread in Mongolia when Buddhism was revived the third time in Mongolia. This was a brand new page in the history of the Mongolian health system. Monasteries were set up in every corner and larger monasteries had doctor’s schools to train tens of doctors. At the end of the 17^th century, Mongolian doctors, scholars started translating and explaining the fundamentals of Indian Ayurveda and Tibetan medicine and even established new branches (schools) blending the Tibetan theory and treatment methods with their empirical knowledge. Conclusion At that time, in the 18^th century, complete bases were established for the start of the golden period of Mongolian medical development which was characterized by theoretical and practical compliance with the “Four Medical Tantras”. Tens of books of this time were written in the Mongolian and Tibetan languages by Mongolian doctors and scholars alike. A new paradigm containing progress, unique opinions can be seen on pages of “The Mongolian Four Medical Tantras” written by Sumbe khamba Ishbaljor, and “Satisfaction for the Readers” or Uzegsdiin Bayasgalan by Jigmeddanzan jamts and “Secrets of Prescription Recipes” or Uvidasyn Dalai by Mindol Jambal. These scholars reflected new concepts that were not specifically clear in the Four Fundamentals such as warm and cold diseases, which were the basis to categorize cold and common diseases and treat them differently, and the theoretical and practical understanding of the categorization of infectious diseases, in their book.

Abstract Bloodletting is a medical tradition that probably began in prehistoric times. Its rationale was based on the belief that removing blood eliminated “impure blood”. From antiquity until the beginning of the 20th century, bloodletting was considered a panacea, and it was the most common and versatile form of medical treatment. Not only was it believed to cure the sick, but also to promote vigor in the healthy. Some of the antient books of traditional medicine noted that the bloodletting tools is very importance when opening a vessel in order to bleed. Traditional medical bloodletting tools are one of the oldest archeological findings, and researchers have found many types of bloodletting tools in our country dated back thousands of years. Therefore, research on bloodletting tools an important component of bloodletting therapy, is of theoretical and practical importance. The location, indications, and tools of bloodletting therapy and bloodletting vessels are described in detail in the “Subsequent Tantra” of “Four Medical Tantras”, and its commentaries: Dar mo sman rams pa blo bzang chos grags “Dka’ phreng mun sel sgron”, Sde srid sangs rgyas rgya mtsho “Be edurya sngon po” and Luvsanchoinpil “Gces btus snying nor” so on. The first Mongolian surgical work is directly related to the historical tradition of bloodletting therapy. It is now known that the stone needles, which was discovered in the 3000th millennium BCE, may have originated from the Mongolia used to use in medicine as bloodletting tools. In the seventeenth and nineteenth centuries, Mongolian medical bloodletting tools were passed down through India and Tibet medical books, and later the science of surgery and bloodletting therapy became more sophisticated and comprehensive knowledge. At the same time, it is clear that there is every reason to say that it has been enriched by the medical knowledge of the neighboring countries and improved by their own experience.

PURPOSE: Neutrophils are considered key effector cells in the pathogenic mechanisms of airway inflammation in asthma. This study assessed the activation status of neutrophils in adult asthmatics, and the therapeutic potential of FTY720, a synthetic sphingosine-1-phosphate analog, on activated neutrophils using an in vitro stimulation model. METHODS: We isolated peripheral blood neutrophils (PBNs) from 59 asthmatic patients (including 20 aspirin-exacerbated respiratory disease [AERD] and 39 aspirin-tolerant asthma [ATA] groups). PBNs were stimulated with N-formyl-methionyl-leucyl-phenylalanine (fMLP) or lipopolysaccharide (LPS) and their activation status was determined based on reactive oxygen species (ROS) production, cell surface expression of CD11b, interleukin (IL)-8 and matrix metallopeptidase (MMP)-9 release. PBNs were primed with FTY720 to evaluate its anti-inflammatory action. RESULTS: In vitro PBN stimulation with fMLP or LPS induced a significant increase in ROS/CD11b/IL-8/MMP-9 levels (P < 0.05 for all). In asthmatics, fMLP-induced ROS level was significantly correlated with values of forced expiratory volume in 1 second/forced vital capacity (r = −0.278; P = 0.036), maximal mid-expiratory flow (r = −0.309; P = 0.019) and PC20 methacholine (r = −0.302; P = 0.029). In addition, ROS levels were significantly higher in patients with AERD and in those with severe asthma than in those with ATA or non-severe asthma (P < 0.05 for all). FTY720 treatment could suppress ROS/CD11b levels, and LPS-induced IL-8 and MMP-9 levels (P < 0.05 for all). Responders to FTY720 treatment had significantly higher neutrophil counts in sputum (P = 0.004). CONCLUSIONS: Our findings suggest a useful in vitro PBN stimulation model for evaluating the neutrophil functional status and the therapeutic potentials of neutrophil-targeting candidates in asthmatics.
Adult ; Asthma ; Fingolimod Hydrochloride ; Forced Expiratory Volume ; Humans ; In Vitro Techniques ; Inflammation ; Interleukin-8 ; Interleukins ; Methacholine Chloride ; N-Formylmethionine Leucyl-Phenylalanine ; Neutrophil Activation ; Neutrophils ; Phenotype ; Reactive Oxygen Species ; Sputum ; Vital Capacity

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.

Essential oils have evoked interest as sources of natural products, which their potential uses an alternative remedies for the treatment of many infectious disease and to restore healing mouth sores or kill oral bacteria. Gum disease is one of the major factor for systemic disease, which to recommend the latest study of world medical scientist. This study aimed to evaluate the anti-inflammatory activity and wound healing effect of the GINGITA® natural essential oils mouth wash in rats. Treatment was by topical application of the GINGITA® natural essential oils mouth wash onto wound surface for 21 days. Wistar rats divided into 2 groups of 15 animals each and anesthesia was administered. The dorsal area of skin of the each rats was shaved and clipped fully-thickness 10x10mm skin wound was made. The test group was treated with GINGITA® natural essential oils mouth wash, which control group untreated. A better healing pattern was observed in rats treated with GINGITA® natural essential oils mouth wash compared with the control group. There was a significant reduction in wound length and closure rats was faster treated by GINGITA® natural essential oils mouth wash compared with control group. Immunohistochemical analysis demonstrated that an increase of epithelial cells in wound lesions treated with GINGITA® natural essential oils mouth wash wish as compared untreated control group. Conclusions: The present study revealed that GINGITA® natural essential oils mouth wash may be effective in stimulating the enclosure of wounds in sort period time.

BACKGROUND: Assessing the customer’s satisfaction of the health care services, professional organizations suggest the special methods to study what they want and don’t want and how much can pay for the service. For this purpose, we conducted the study to determine the satisfaction of the customers of Darkhan-Uul province health care organizations in 2016, according to the international experience. The survey was conducted in the Darkhan-Uul province Health Department, in general hospitals, public and private medical institutions in 2015 and 2016 respectively. On the basis of a unified methodology according to the order of the Ministry of Health No. 13 of 2014, the survey was conducted on the basis of a special questionnaire prepared in accordance with articles 22 and 23 of the Minister of Health No. 448. The results of the consumer survey, customer satisfaction in Darhan-Uul province by 2016 were higher than in 2015, a good estimate of 1.4%, an average rating of 10.4% and below was a poor estimate of 11.8%. The survey shows the need to consider the issue of equality, which is a key issue in the field of human rights, the formulation of political environments and the regulation of their situation.

Introduction: We began treatment of multi drug resistant tuberculosis first from 2003. At that time there was a 1960 cases and most of the cases were from Ulaanbaatar, Darkhan, Selenge, Tuv, Dornod provinces. From all the cases only 62% or 1058 cases were included in treatment. From that 336 patient or 19% deceased, 296 patient or 18% didn’t get a treatment. We did this study because there were never done any research or study of surgical treatment of multi drug resistant tuberculosis in Mongolia. Materials and Methods: We studied cases of patients who undergone lobectomy, since 2007. There were 48 cases of 46 patients, 2 patients surgery were done on both sides. Respondents aged between 14- 45, 25 male (52%), 23 female (48%), all patients got a first - line anti-tuberculosis treatment, such as cat-1, cat-1+cat-2 and 10 variants of these drugs. It was done based on sputum culture test results of NCCD TB surveillance and research department’s laboratory. Results: From the all patients only 77.08% had undergone surgery within the first 3 years. 92% patients were diagnosed with multi drug resistance TB only with the sputum and sputum culture test results, and the rest of the patients were diagnosed using a tissue analyses on the above tests. It was revealed that HR resistant -91.66%, HR+(Z,E,S) -3 drugs resistant -18.78%, HR+(ZSE)-4 or 5 drugs resistant. In the patients TB lesion locations was on the right upper lobe 54%, left upper lobe 31%, on a both upper lobes 85%, cavernous fibrosis tubercles 60%, combined TB lesions 77%, tubercles 21%.87.5% of total patients received a multi - drug resistant TB treatment between 7 - 24 months prior surgery. All 48 patients had a totally 69 surgeries. Surgeries included 9% pneumonectomy, 28% lobectomy, 30% Wedge resection, 23% pleurectomy decortication, 7% Wedge resection on both sides, one bilobectomy. There were no complications during the surgery but 5 of patients had an empyema after surgery. No fatal cases.Three patients out of 5 who had a surgery due to pulmonary hemorrhage developed an empyema after surgery. Drainage tubes were taken after the surgery within 2-3 months.Therewere no complication and escalations in the patients who received a surgical treatment, after the surgery from 6 months to 5 years. Conclusion: In study it shows that surgical treatment is effective to do after 6 months of anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows that combining of medical and surgical treatment is healing up to 98% in the patients who were rightly chosen according to surgical indications.This research result shows that in our country multi - drug resistant TB surgical treatment complication is only 10.41%, which is below in the other countries who have same anti-tuberculosis drug treatment.

Introduction: We began treatment ofmulti drug resistant tuberculosis first from2003. At that time there was a 1960 cases andmost of the cases were from Ulaanbaatar,Darkhan, Selenge, Tuv, Dornod provinces.From all the cases only 62% or 1058 caseswere included in treatment. From that 336patient or 19% deceased, 296 patient or 18%didn’t get a treatment. We did this studybecause there were never done any researchor study of surgical treatment of multi drugresistant tuberculosis in Mongolia.Materials and Methods: We studiedcases of patients who undergone lobectomy,since 2007. There were 48 cases of 46patients, 2 patients surgery were done onboth sides. Respondents aged between 14-45, 25 male (52%), 23 female (48%), allpatients got a first - line anti-tuberculosistreatment, such as cat-1, cat-1+cat-2 and 10variants of these drugs. It was done basedon sputum culture test results of NCCDTB surveillance and research department’slaboratory.Results: From the all patients only77.08% had undergone surgery within thefirst 3 years. 92% patients were diagnosedwith multi drug resistance TB only with thesputum and sputum culture test results, andthe rest of the patients were diagnosedusing a tissue analyses on the above tests.It was revealed that HR resistant -91.66%,HR+(Z,E,S) -3 drugs resistant -18.78%,HR+(ZSE)-4 or 5 drugs resistant. In thepatients TB lesion locations was on the rightupper lobe 54%, left upper lobe 31%, ona both upper lobes 85%, cavernous fibrosistubercles 60%, combined TB lesions 77%,tubercles 21%.87.5% of total patientsreceived a multi - drug resistant TB treatmentbetween 7 - 24 months prior surgery.All 48 patients had a totally 69 surgeries.Surgeries included 9% pneumonectomy,28% lobectomy, 30% Wedge resection,23% pleurectomy decortication, 7% Wedgeresection on both sides, one bilobectomy.There were no complications during thesurgery but 5 of patients had an empyemaafter surgery. No fatal cases.Three patientsout of 5 who had a surgery due to pulmonaryhemorrhage developed an empyema aftersurgery. Drainage tubes were taken afterthe surgery within 2-3 months.Therewere nocomplication and escalations in the patientswho received a surgical treatment, after thesurgery from 6 months to 5 years.Conclusion: In study it shows that surgicaltreatment is effective to do after 6 monthsof anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows thatcombining of medical and surgical treatmentis healing up to 98% in the patients whowere rightly chosen according to surgicalindications.This research result shows that inour country multi - drug resistant TB surgicaltreatment complication is only 10.41%,which is below in the other countries whohave same anti-tuberculosis drug treatment.

Introduction The use of phytochemical preparations is being promoted an supported worldwide. In order to investigate and confirm the usage of phytochemical preparations that are widely used in the traditional medicine, there is an urgent need to complete a chemical, phytochemical and clinical study for those medicinal preparations. Goal To investigate the effects of “Antitoxic preparation” on the test animal with previously developed acute hepatotoxic infection by LPS. Materials and Methods A pathology model of the acute liver infection was developed on a total of 50 Vister rats, weighing between 200 and 250 gr. The test animals were categorized info five five further groups, e.g. healthy, control, comparison and administered with 50 mg/kg and 100 mg/kg of “Antitoxic preparation”. The preparation for each group was individually and orally administeredfor a period of ten days. On day 11, 2nd, 3rd, 4th and 5th groups were administered 5 μg of LPS and 300 mg/kg of GaIN calculated in 2 ml of physiogial solution was injected in the abdomed of the test animal. After 8 hours, AST, ALT, cholesterol, triglycerides, level of MDA, cytokine levels such as TNF-α, IL-1β, IL-6, IL-10 contained in the blood plasma of test animals were analysed. Results A comparison between measurement of “Antitoxic preparation” group and control group has indicated that the AST was 24.9-30.8%, ALT 23.8-27.6%, Poenzyme activation was reduced by 29.1-32.6%, of cholesterol by 13.2-19.9%, of tryglyceride 23.4-30.5%, MDA in plasma 8.8-20.9%, MDA in urine 11.3- 22.9%, also reduction of TNF-α in plasma by 17.5-27.3% and IL-1β17.7-19.8% respectively. Also, it was determined that the cytokines activating the acute liver infection (TNF-α, IL-1β, IL-10) were impacted after administering the preparation and infection process was suppressed. Conclusions: 1. The pathological model for chronic toxic liver infection developed on the test animal indicated that “Antitoxic preparation” had a reducing effect on cholesterol, tryglycerides, inhibitory effect on activation of fat oxidation, choleretic, antioxidant, reducing effect on ALT, AST activation, reducing the destruction of liver cells and followed by hepatoprotective action. 2. “Antitoxic preparation” was effective in impacting the cytokines (TNF-α, IL-1β, IL-10) that activate the acute liver infection and also suppressing effect on infection process.