Background: The Maternal and Child Health Handbook is a long-term health monitoring tool that records children’s health, immunization, and developmental stages from the prenatal period to age five. By using the MCH handbook together with parents and health workers, it is possible to increase health education for parents and prevent, and detect potential developmental delays in children at an early age. Aim: To detect the knowledge and attitudes toward family use of the MCH handbook Materials and Methods: The study was conducted using an analytical study using cross-sectional design and included a total of 373 parents and caregivers with children aged 1-4 in 4 districts of Ulaanbaatar city. When assessing knowledge, correct answers were scored and grouped. When assessing the attitude, the parents were scored based on whether they were recorded in the MCH handbook. To determine the relationship between influencing factors, a one-way logistic regression analysis was performed, which was considered statistically significant at a 95% confidence interval and p<0.05 and was performed using the SPSS 25 program. Results: The mean age of the study participants was 33.5±6.5. Reading and keeping a handbook completely (p=0.0001) was statistically significantly related to improving knowledge (p=0.0001). In studying the factors affecting handbook records, the following were statistically significant: gestational age (OR=0.956, 95% CI [0.923, 0.990]), number of births (OR=1.206, 95% CI [1.002, 1.452]). Factor influencing knowledge about the notebook is gestational age (OR=0.954, 95% CI [0.918, 0.992]). Conclusions The factor influencing knowledge about the health notebook of children under five years of age were gestational age (p=0.017). The factors influencing the maintenance of the notebook were gestational age (p=0.011), number of births (p=0.048), and whether the notebook was read completely (p=0.008).

Background: Meniere's disease is a condition caused by disturbances in the auditory and vestibular systems. It is characterized by symptoms such as dizziness, nausea, vomiting, and tinnitus. In the United States, the prevalence of Meniere's disease has been found to be 84 cases per 100,000 women and 56 cases per 100,000 men. Regionally, it is more common in less populated areas, and research has confirmed that the prevalence increases with higher household income. Aim: To evaluate the effectiveness of traditional medicine treatments and therapies for Meniere's disease. Results: The patient is a 43-year-old male, with symptoms of dizziness, vomiting, and tinnitus. Since 2023, he has sought care at the Central Hospital of Mongolian Medicine, where he received traditional medicine treatments including herbal therapy and other traditional therapies on three occasions. As a result, the frequency of dizziness has decreased and other clinical symptoms have improved. Conclusion Traditional medicine treatments have been shown to be effective in managing Meniere's disease by extending the interval between relapses, improving quality of life, and significantly reducing clinical symptoms.

Background: Vitamin E is an oil-soluble compound with antioxidant properties against free radicals. It has been used in cosmetic practice since long time ago. However, it is unstable to light and heat, and even when formulated into pharmaceuticals, it has poor skin penetration, which can reduce the effectiveness of the treatment. Therefore, by encapsulating Vitamin E in liposomes and forming a gel, it is possible to produce a highly therapeutically effective drug form that supports skin homeostasis and provides moisturizing benefits. To this reason, it is necessary to determine the appropriate methods and conditions for encapsulation in liposomes, which is the basis for conducting this study. Aim: The goal of the research is to develop a technology for preparing vitamin E-loaded liposomes and incorporating them into a gel formulation. Materials and Methods: Liposomes were formed using thin film hydration, ethanol injection, and heating methods, each with 5 different concentrations, and liposome formation was determined spectrophotometrically for each sample. The size of the formed liposomes was determined using a Nanophox instrument. Six gel models were prepared and compared for quality parameters. Results: The highest yield was obtained when 75 mg of phospholipids were used in the thin film hydration method, which is 82.3%; the highest yield was obtained when 50 mg of phospholipids were used in the ethanol injection method, which is 86.75%; and the highest yield was obtained when 50 mg of phospholipids were used in the heating method, which is 58.8%. The average size of liposomes prepared by ethanol injection and dissolved in distilled water was 106 nm. The gel bases were prepared using models F1-F6, and the pH values of models F4 and F5 were suitable. Conclusions 1. Among the three methods for liposome formation, the ethanol injection method had the highest yield. 2. The ethanol injection method had the highest encapsulation when prepared with a phospholipid:vitamin E ratio of (1:10). 3. For gel base model F5 was suitable which is carbomer 1.0%, preservative propylparaben 0.02%, pH adjuster sodium hydroxide, and permeability enhancer propylene glycol 10%.

Background: The main risk factors for childhood overweight and obesity include the consumption of sugar-sweetened beverages and other sweetened foods. The sugar content of sugar-sweetened beverages was different from the nutritional information on the packaging. Aim: To determine sugar and brix content in domestic manufactured sugar-sweetened beverages, and compare information on the packaging and regulatory standards. Materials and Methods: The sugar and brix content in sugar-sweetened beverages was determined by laboratory anal ysis, including 150 domestically manufactured sugar-sweetened beverages. Laboratory analysis carried out in the Chemical toxicology laboratory of the National Reference Laboratory for Food Safety, MASM, determined sugar using a saccharometer and brix using refractometry. : Results: The study included 150 Mongolian sugar-sweetened beverages, including 20.7% (n=31) carbonated drinks, 47.3% (n=71) fruit drinks, 16.0% (n=24) tea drinks, 1.3% (n=2) energy drinks, 14.7% (n=22) flavored water. Sugar content 0.0–15.6% in sugar-sweetened beverages. The laboratory analysis results compared with information on the packaging 72.0% (n=108) difference between 0.1–11.3%, 10.7% (n=16) same, do not have sugar content in the nutritional information on the packaging 17.3% (n=26). Brix contained 0.2–13.0% carbonated drinks, 4.9–15.7% fruit drinks, 0.6–9.8% tea drinks, 7.7–16.0% energy drinks, and 0.1–9.7% flavored water. Conclusions 1. Sugar content 0.0–15.6%, brix 0.0–16.0% in Mongolian sugar-sweetened beverages. 2. The laboratory analysis results compared with nutritional information on the packaging 72.0% (n=108) difference between 0.1–11.3%, 10.7% (n=16) same nutritional information on the packaging, do not have sugar content in the nutritional information on the packaging 17.3% (n=26). 3. 37.3% of Mongolian sugar-sweetened beverages are unsatisfied with regulatory standards.

Background: Liposomes have been widely studied in the field of medicine in recent years for they can reduce side effects and regulate drug release by delivering active ingredients to target tissues and cells through active or passive routes. There are many types of methods for formulating liposomes, and comparing those methods and choosing the most suitable one will allow the delivery of active ingredients and their incorporation into pharmaceutical forms, so this research was carried out. Aim: To compare liposome formation methods. Materials and Methods: The research work was carried out with the support of “Drug Design Laboratory” and “Pharmaceutical Analysis Laboratory” of the School of Pharmacy of MNUMS. To formulate liposomes, 5 different concentrations of samples were prepared using thin-film hydration, ethanol injection, and heating methods. Phospholipid concentration and light absorption were determined by spectrophotometer in each sample. The size of the resulting liposome was determined using a Nanophox. Results: Phosphatidilcholines were dissolved in distilled water at concentrations of 5, 10, 20, 30, 40, and 50 μg/ml and a standard curve was established by spectrophotometry to determine the concentration of phospholipids in liposome samples. The highest formulation was 76.98% when 75 mg of phospholipid was used in the preparation by thin film hydration method, when 50 mg of phospholipid was used in the preparation by ethanol injection method, the highest formulation was 85.17%, and for when 50 mg of phospholipid was used in the preparation by heating method, the highest formulation was 58.45%. The mean liposome size by ethanol injection method was 115 nm. Conclusions 1. Ethanol injection method for liposome formulation is more efficient compared to thin-film hydration method and heating method. 2. Liposome size was 115 nm when prepared by ethanol injection.

Background: Membranous nephropathy (MN) is among the most common causes of nephrotic syndrome in adults. MN is diagnosed in one third of cases of nephrotic syndrome on kidney biopsy. Kidney biopsy is the gold standard for diagnosing MN and plays an important role in determining the severity of the disease and in determining treatment decisions and regimens. Therefore, the lack of research on kidney biopsy in Mongolia is the reason for this study. Aim: The aim of this study was to investigate the pathological features in the kidney tissues of patients with primary membranous nephropathy diagnosed by kidney biopsy. Materials and Methods: A retrospective study was conducted on 51 cases of MN diagnosed in kidney biopsies performed at the First Central Hospital of Mongolia (FCHM) over a period of 12 years. Renal function was calculated using the CKD-EPI (2021) formula and classified into the stage of CKD by eGFR. Histopathological findings were examined using 4 light microscopy (LM) stains (Hematoxylin-Eosin, Masson-Trichrome, PAS, and Methenamine silver staining) and 8 immunofluorescence (IF) microscopy stains (IgG, A, M, complement C3, C4, C1q, and kappa, lambda). The study excluded secondary MN based on viral markers, tumor markers, and serological tests. Statistical analysis was performed using SPSS and STATA 15.0 software, using t-tests, Pearson’s chi-square tests, and multiple group comparisons were performed using ANOVA and Kruskal-Wallis methods. The study design was approved by the Ethics Committee of the MNUMS, Mongolia. (№ 2023/3-07) Results: A total of 305 kidney biopsies performed at the Kidney Center of the FCHM between 2011 and 2023 resulted in the diagnosis of 51 cases of primary MN. The mean age of patients with membranous nephropathy was 40.6±9.3 years, with the oldest age of 65 and the youngest of 22 years, and 36 (70.59%) were male and 15 (29.41%) were female. In the kidney biopsy, the average number of glomeruli was 16.51±7.82 (min-max, 3-54), and by LM, 33.3% showed global sclerosis of glomeruli by hematoxylin-eosin staining, 94.12% showed thickening of the glomerular basement membrane (GBM), 31.2% showed double counter staining of subepithelial immune complexes by methenamine-silver staining, 88.24% showed holes in the GBM, and 54.9% showed spike-like changes by Masson-Trichrome staining. IF showed IgG 3+ in 37.3%, 2+ in 39.2%, 1+ in 13.7%, and trace staining in 9.8%, while 74.5% of the cases were positive for C3, 93.1% for kappa, and 79.5% for lambda. LM showed thickening of the GBM (OR 23.5, 95% CI 0.093-0.53, p value= 0.007) and interstitial fibrosis (95% CI 6.98-31.07, p value= 0.003) contributing to the decrease in eGFR. The mean time from the onset of the first symptoms of kidney disease to the time of kidney biopsy was 35.35±61.54 months. Patients who underwent biopsy later (in months) after the diagnosis of the disease had a higher incidence of interstitial fibrosis (74.6 ± 98.43, 95% CI -90.52-20.68, p value = 0.002). Conclusion The histopathological features of MN confirmed by kidney biopsy showed thickening of the GBM in 94.12%, global sclerosis in 33.3%, and holes in 88.2%. Immunofluorescence microscopy showed 100% IgG staining, while C3, kappa, and lambda were positive in 74.5%, 93.1%, and 79.5%, respectively.

Background: From the perspective of Mongolian medicine, hemorrhagic disease is a symptom of bleeding from any part of the body. This disease was compared to the immune thrombocytopenia disease of modern medicine. The treatment of this disease using two medical methods and the prevention of complications and relapses are issues facing the healthcare sector. In this regard, we have chosen this topic to clarify and prove the mechanism of action of the Mongolian drug Gurgem-8, which is widely used to treat bleeding disorders. Aim: To evaluate the therapeutic efficacy of Gurgem-8, in haemostatic treatment. Materials and Methods: The study was conducted using a randomized, controlled (active), open label, single centered clinical trial method. The study was conducted in two phases. First, an acute toxicity study of the Gurgem-8, was conducted in accordance with OECD guideline 423 and evaluated according to GHS classification. A chronic toxicity study was also conducted on Wistar rats (n=20) given the Gurgem-8, at doses of 500 mg/kg, 100 mg/kg, and 150 mg/kg daily for 60 days. Second, a clinical study was conducted on a total of 74 patients, who were randomly divided into 2 groups. The treatment group was given 3 grams of the Gurgem-8, daily, and the comparison group was given 4 capsules of Sheng Xue Xiao Ban Jiao Nang 3 times a day. The results were determined by laboratory methods. The study was conducted with the approval of the Research Ethics Committee of Mongolian National University od Medical Sciences (2024.01.19 №2024/3-01). Results: In the acute toxicity study, Turmeric-8 was found to be of low toxicity according to the GHS classification. No mortality was observed in the chronic toxicity test. As a result of the clinical study, there were significant differences in the blood hemoglobin (χ2=73.923, P<0.001), platelet (χ2=62.465, P<0.001), erythrocyte (χ2=77.113, P<0.001) and leukocyte (χ2=14.771, P<0.001) cell counts between the Gurgem-8, drug group and the comparison group. It was also determined that the platelet (χ2=138.3, P<0.001), erythrocyte (χ2=85.405, P<0.001) and leukocyte (χ2=10.961, P=0.027) cell counts were directly related to the treatment period and the group. When determining the effect on immune cells, there was no significant difference in the lymphocyte cell content before and after treatment (CD4+: t=0.233, P=0.817; CD8+: t=-0.264, P=0.793; CD4/CD8:Z=-0.119, P=0.905). However, the CD4/CD8 ratio was statistically significantly increased in each of the Gurgem-8, drug group and the comparison group (P<0.001, P=0.001). Conclusion In immune thrombocytopenia diseases, the Gurgem-8, has the effect of reducing hemoglobin levels in the blood, increasing platelet counts, reducing CD4+ and CD8+ T cell counts, and increasing the CD4/CD8 ratio.

: A study by Marsot and other investigators (2012) determined that the dose of vancomycin in adults is directly dependent on parameters such as creatinine clearance and body weight, as well as the need for dose correction. We used the MDRD equation to determine renal dysfunction in 113 inpatients and found grade I in 50.5%, grade II in 14.4%, grade III in 10.8%, grade IV in 6.3%, and grade V in 18%. There is a statistically significant difference (p=0.045) in renal dysfunction depending on the diagnosis. The average daily dose of vancomycin was 2.5 g, the total daily dose was 8.5 g, the total dose was 20.5 g. The daily dose and total dose of vancomycin were inversely proportional to age (g = -0.256), the daily dose was directly related to excess weight body (g=0.226), and days of vancomycin use are statistically significant (p=0.001) depending on the diagnosis. Conclusion Comprehensive programs are required to improve the vancomycin use in the hospitals. Vancomycin use should be monitored due to its large-scale empiric use. The rate of improper use of vancomycin in the infection and intensive care unit services may be high, and pharmacists must take appropriate action to optimize the use of the drug.

Introduction: Endometritis (EMM) is the most common maternal infectious complication of childbirth, occurring more commonly after low transverse cesarean section (LTCS) than vaginal delivery [1]. In a Cochrane review, the mean incidence of EMM following elective cesarean section was 7% and after non-elective or emergency operations was 30% [4]. A variety of independent risk factors for post-cesarean EMM have been identified in previous studies, including no prior cesarean section [5], low infant Apgar scores [6], trial of labor [7], premature rupture of membranes (PROM) >24 hours, young maternal age [8], preterm or post-term gestation [9], antepartum infections [10], pre-eclampsia, meconium [11], amnion infusion, postpartum anemia, multiple vaginal examinations [12], and manual removal of the placenta [13]. The time of ruptured membranes before delivery is examined via dichotomized time thresholds, the risks of chorioamnionitis and endomyometritis are significantly increased at 12 hours and 16 hours, respectively [16, 17]. A change in policy to administer prophylactic antibiotics before skin incision led to a significant decline in postcesarean delivery surgical-site infections [18, 19]. Objective: To determine independent risk factors for EMM following (LTCS). Material and Method: The study was case-control study, between 2022 to 2023 years at the “Urguu” specialized maternal hospital Ulaanbaatar, Mongolia. Case group has 101 women with EMM and the control group has 100 women with non EMM after LTCS. Results: The age of 2 study groups was 32.4 and 32.8, body mass index was 30 kg/m2 and 30.7 kg/ m2.Young maternal age <25 has a 22% (p=0.001, OR=4.5) influence on the occurrence of EMM. Other pregnancy related factors were not associated with the EMM after LTCS. (p>0.05). Delivery risk factors has increases the EMM by 15% (p=0.002), labor induction by 20% (p=0.001), duration of labor >12 hours by 40% (p=0.001), PROM increased by 15% (p=0.005), meconium by 15% (p=0.005), chorioamnionitis by 15% (p=0.001). Conclusion Our study, young maternal age <25 has influence on the occurrence of EMM. Other pregnancy related factors were not associated with the EMM after LTCS. Delivery associated risk factors are affected by the EMM after LTCS. The labor after LTCS, labor induction, PROM >12 hours, duration of labor, number of vaginal exams>4, meconium, chorioamnionitis increased by EMM. Young maternal age (<25) increased the risk of EMM attached with labor association risk factors.

Background: To investigate relapse rates after the successful treatment of patients with non-atypical endometrial hyperplasia (EH) either a levonorgestrel impregnated intrauterine system (LNG-IUS; MIRENA®) or two regimens of oral dydrogesterone (DGS) after primary histological response. Currently, the incidence of EH is indistinctly reported to be around 200,000 new EH cases per year in Western countries. Methods: Patients were at their choice assigned to one of the following three treatment arms: LNG-IUS; 10 mg of oral DGS administered for 10 days per cycle for 6 months; or 10 mg of oral DGS administered daily for 6 months. The women were followed for 6 months after ending therapy. [Figure2] Women aged 25-55 years with low or medium risk endometrial hyperplasia met the inclusion criteria, and 35 completed the therapy. Results: Histological relapse was observed in 55/ (41%) women who had an initial complete treatment response. The relapse rates were similar in the three therapy groups (P = 0.66). In our study involved 25-55 (mean 42.2±1.61) aged 35 women. Among them had reproductive aged 31.43% (n= 11) premenopausal women 42.86 % (n= 15) postmenopausal women 25.71% (n= 9). Their mean body mass index had 28.8±1.15 kg/m², and normal weight 34.29% (n=12), overweight 34.29% (n=12), obese 17.14% (n=6), extremely obese 14.29 % (n=5). [Figure3] Types of obesity had normal 37.14% (n=13), android 25.71% (n=9), gynecoid 37.14% (n=13). Mean parity had 1.8±0.19 to nulliparous 14.29% (n=5), primiparous 60% (n=21), multiparous 25.71% (n=9). Smoke 17.14% (n=6). Non combined disease had 65.7% (n=23), diabetes mellitus 17.14% (n=6), PCOS 14.29% (n=5), cardiovascular disease had 2.86% (n=1). [Table1] Mean endometrial thickness of TVUS had ( 16.0±0.91mm). Smoke (p=0.0391), types of obesity (p=0.0436) and myoma of the uterus (p=0.0187) seen affected the endometrial thickness. LNG-IUD group had after treatment’s menstrual period 11.11% heavy 80ml (n=1), 88.89% light 5ml (n=8). DGS (5-25 day) group had after treatment’s menstrual period 9.09% heavy =80ml (n=1), 90.91% light5ml (n=10), DGS (16-25 day) group after treatment menstrual period 40% heavy 80ml (n=6), 46.67% normal 5-80ml (n=7), 13.33% light 5ml (n=2) байв. Therefore between the three treatment groups had no differences. But treatment’s before and after result had statistics probability differences (P= 0.4064). [Figure4] Conclusions Finally, given the long natural history of menorrhagia, study outcomes need to be assessed over a period that is longer than 2 years. In conclusion, our study showed that both the LNG-IUD, oral progestin treatment reduced the adverse effect of menorrhagia on women’s lives over the course of two years. LNG-IUD was the more effective first choice, as assessed impact of bleeding on the women’s quality of life.