Background: According to the World Health Organization (WHO), 99 percent of the world’s population is exposed to air that exceeds WHO recommendations, with low- and middle-income countries being the most affected. The main causes of indoor air pollution include human activities such as fuel burning, cooking, cleaning, and smoking; housing characteristics such as walls, floors, ceilings, and furniture; ventilation; and outdoor air pollution. Aim : To assess PM1 and PM10 concentrations in 120 selected households in Ulaanbaatar. Materials and Methods : Indoor PM1 and PM10 concentrations were measured using Purple Air real-time sensors in randomly selected Ulaanbaatar households between October 2023 and January 2024. Supplementary data on factors affecting the PM2.5 concentration were collected via questionnaires. Each measurement was taken in 10-minute intervals, yielding 51,309 data for analysis. Results : PM1 concentrations were measured at 55.5±53.2 μg/m³ in gers, 54.9 ± 46.7 μg/m³ in houses, and 31.6±40.1 μg//m³ in apartments (p<0.001) and measuring PM10 concentrations were 110.6±108.6 μg/m³ in gers, 110.6±96.7 μg/m³ in houses, and 62.2±83.0 μg/m³ in apartments (p<0.001) When considering the concentration of PM1, PM10 by heating type, PM1 was 55.3±50.1 μg/m³ and PM10 was 110.6±103.0 μg/m³ in households with stoves and furnaces, and PM1 was 31.6±40.1 μg/m³ and PM10 was 62.2±83.0 μg/m³ in households connected to the central heating system (p<0.001). Regarding the months of measurement, the highest concentration was observed in December 2023, at 77.1±94.1 μg/m³. The highest concentrations for both PM₁ and PM₁₀ were recorded in January 2024, at PM₁: 64.8±55.1 μg/m³, PM₁₀: 131.4±116.0 μg/m³. Conclusion 1. Indoor PM10 concentrations in residential environments in Ulaanbaatar city were within the MNS4585:2016 Air Quality Standard, however, it was exceeded the WHO air quality guidelines, indicating an excessive risk of increasing morbidity and mortality among the population. 2. Indoor PM1 and PM10 concentrations in residential environments in Ulaanbaatar varies depending on location, type of housing, type of heating, and month of measurement.

Background: Obesity, especially central obesity, is a risk factor for non-communicable chronic diseases such as dyslipidemia, type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and metabolic syndrome (MetS). Aim: Study the association between the subcutaneous fat area (SFA) and visceral fat area (VFA) with lipid metabolism parameters in adults with MetS. Materials and Methods: Data from 1511 participants who visited the ‘NURA Mongolia’ Ai Health screening center between September 2023 and February 2024, including general information, DEXA (Dual X-ray Absorptiometry), and biochemical analysis results, were used. Metabolic syndrome (MeS) was assessed based on the harmonizing criteria 2009 (≥3 criteria). VFA and SFA were categorized into four groups using quartiles (Q1-Q4). Statistical analysis was performed using SPSS v26, including T-tests, multiple logistic regression (OR, 95% CI), and ROC (AUC) analysis. Results: The average age of the participants was 30.5±3.9 years, with a BMI of 25.1 kg/m², and 49.5% were male. The group with MetS (n=531) had significantly higher levels of VFA and SFA compared to the group that rated their health as relatively healthy and had no clinical diagnosis (n=979) (control group) (p<0.0001), with males showing higher VFA and females showing higher SFA (p<0.0001). The Q4 group for VFA had a significant association with MetS in males (4.611, 95% CI=2.394–9.591) and females (2.253, 95% CI=1.097-3.912) (p<0.001). Logistic regression analysis showed that increased VFA was more strongly associated with MetS in males (β=0.325, p<0.0001) and females (β=0.338, p<0.003) than BMI. The AUC for predicting MetS was 0.790 (95% CI=0.750-0.831) for VFA and 0.401 (95% CI=0.351-0.451) for SFA, with all results being statistically significant (p<0.001). VFA had a higher predictive value compared to other markers. Conclusion In healthy men with metabolic syndrome, VFA is more prominently defined, while SFA is higher in healthy women. Since VFA is a better predictor of metabolic syndrome than SFA, it increases the risk of diseases such as cardiovascular diseases and type 2 diabetes in men, whereas SFA in women serves as a protective factor.

Background: To effectively deliver healthcare services, it is necessary to strengthen and expand the education system for qualified biomedical equipment technicians and engineers. This should be combined with measures such as providing modern equipment to health facilities and making spare parts available. Internationally, there is a reference of one engineer responsible for 100 pieces of equipment. Additionally, one engineer is responsible for each major piece of equipment such as MRI, CT, positron emission tomography (PET SCAN), and angiography equipment. However, in our country, the standard is independent of the number of medical equipment. Although 4 universities nationwide train medical equipment engineers and technicians, they are unable to meet the growing market needs. Aim: To assess human resource needs for biomedical equipment specialists. Materials and Methods: We conducted the study using an analytical survey design. In the study, data were collected from a total of 272 engineers and technicians using a self-administered questionnaire that included years of work experience, post-graduate training, qualification level, and workload. The data were processed using SPSS Statistics 26 software, and the results were presented in figures, tables, and sentences. Results: Of the professionals surveyed, 72.4% were male, 95.6% were full-time employees, and 68.8% had a bachelor’s degree. However, the majority (90.4%) of the professionals did not have a professional degree. When asked about the availability of on-the-job and other training among the professionals 73.5% had not received any training at all. The level of training received by professionals did not depend on the organization they worked for. However, there was a statistically significant difference between the level of training received from foreign and manufacturer-sponsored organizations. The professionals surveyed had relatively little training since they started working. As the number of years of experience in their profession increased, the number of times they participated in manufacturer-sponsored training increased. However, the number of times they participated in domestic, foreign, or postgraduate training was not related to the number of years of experience. Conclusion Medical equipment engineers and technicians are working harder than international professionals. The lack of post-graduate training for healthcare professionals is a concern for the industry.

Background: The assessment of patients’ quality of life has emerged as a critical metric in evaluating healthcare services. Internationally, numerous studies have been conducted to assess the QoL of individuals diagnosed with pulmonary embolism through the development of standardized questionnaires and their association with various clinical parameters. Aim: To adapt a standardized questionnaire for assessing the quality of life following a pulmonary embolism and to evaluate the quality of life of affected patients. Materials and Methods: A total of 33 patients diagnosed with pulmonary embolism and hospitalized in the Department of Pulmonology at the Third State Central Hospital in Mongolia between August 2022 and December 2023 were included in the study. An observational cross-sectional study design was used. Inclusion criteria encompassed all patients diagnosed with PE during the study period, while exclusion criteria included individuals with severe comorbidities, those aged over 85 years, and those who declined participation. QoL was assessed using the Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire, which consists of 39 questions categorized into six domains. Higher scores indicate poorer QoL. Data analysis was performed using SPSS version 16. Results: The average age of the participants was 61±15 years, and 18 (54.5%) were female. The median duration of anticoagulant therapy was 170 days (range: 27–2555 days), and the average monthly expenditure on medication was 80,000 MNT (range: 63,000–400,000 MNT). The overall mean QoL score was 69.7±23.2. The median scores for the six domains were as follows: frequency of complaints 1.6 (IQR 1.5-1.9; max 5 score), activities of daily living limitations 1.5 (1.3–1.8; max 3 score), work-related problems 1.7 (1.5–2.0; max 2 score), social limitations 2.0 (2.0–3.0; max 5 score), intensity of complaints 3.0 (3.0–4.0; max 6 score), emotional complaints 2.0 (1.5–2.4; max 6 score). The internal consistency reliability of the questionnaire was assessed, with the symptom frequency category scoring well (α=0.74), while the other categories had excellent reliability (α>0.85). A weak positive correlation was observed between overall QoL scores and age, while a weak negative correlation was identified with body mass index (r=0.14 & r= -0.13, P>0.05). Conclusion The study findings indicate a low QoL among PE patients, emphasizing the necessity for enhancements in post-diagnosis medical care and long-term management strategies to improve patient outcomes.

Abstract: In Mongolia, flu and flu-like diseases affect many people, and pneumonia is a public health concern. Therefore, we have an urgent need to research and develop a new medicinal syrup to replace imported products using raw materials grown in Mongolia and to compare it with similar products. There are imported cough syrup products on the pharmaceutical market of Mongolia, but there are domestic pharmaceutical products. Moreover, there is limited research data on cough relief. The main goal of the research team is to compare the experimentally obtained syrup containing Plantago asiatica L, Malva Sylvestris L. and syrup containing Plantago major L. Juice, honey that produced by Monos Pharm LLC whish the cough relieving drug Gerbion syrup. Material and methods: The vivarium of the pharmacology laboratory, Drug research institute, TPC7062Ti mark IVC system (Shanghai Pretty Industries Co.,Ltd, China) in a special environment with one care and one feeding regimen (Lab Mice Diet, Constant Formula Balanced Nutrition, Jiangsu Xietong Pharmaceutical Bio- Engineering Co., LTD, China, www.jsxtsw.com ) used 64 non-WISTAR white rats weighing 180-218 g. Experimental rats were smoked with an aerosol of 17% citric acid aqueous solution for 5 minutes. The statistical processing of the research results was done using the One-Way ANOVA/Multiple comparisons data of the GraphPad Prism 8 program. Results and conclusion Expressing the number of coughs produced in the experimental rats as a percentage (%), the control group showed 3.95% cough relief, and the experimental group-1 by 48.4%, experimental group-2 by 71.1%, comparison group by 74.6%, respectively has reduced. Experimental group -2 and comparison group for dry cough caused by citric acid 17%, it affects the cough receptors in the mucous membrane of the respiratory tract and relaxes the bronchial muscles (A and C fiber).

Abstract: Burn injury causes considerable incidence of disability, increase of hospitalization and rehabilitation. It is a crucial factor of morbidity and mortality, throughout the world, especially in the developing countries. Burn wound healing is a complex process including inflammation, granulation, and regeneration of the skin tissue. There are many animal and mineral derived agents applied for burn wounds treatment. For example, minerals and animal yellow marrow are applied as standard topical therapy in healing of burn wounds in the history. Specially, Mongolian camel’s (Camelus Bactrianus) yellow marrow and cinders have been used the healing effect standard topical antimicrobial for burn wounds for several centuries. The present study aimed to determine the healing effect of “CIBO” ointment with animal and mineral raw materials on third -degree burn wound in rats. Introduction: In our study, we selected an ointment containing a combination of yellow marrow and cinder. In ancient times, Mongolians used camel yellow marrow to relieve joint pain, spread people who had been bedridden for a long time due to the disease, and to prevent caries, and to use it on open wounds. In traditional medicine, cinder has been used as a mineral raw material and has been used to treat frostbite and burns. Material and methods: In the Vivar Department of the Pharmacology Sector of the Drug research institute, 18 Wistar white rats weighing 182-220 g fed in one environment for (12 hours a day/12 hour a night) were randomly selected and divided into the following groups. These are: negative control, Group 1 “Yellow marrow + Uvs black cinder”, Group 2 “Yellow marrow + Uvs brown red cinder”, Group 3 “Yellow marrow + Chinese red cinder”, Group 4 “Yellow marrow + Chinese white cinder”, Standard “Mebo” wound ointment. The wound area was prepared by scraping the hair 5 cm from the back of the test animal’s skull. The prepared area was sterilized with 70% ethanol and 10% iodine solution, resulting in a third-degree burn wound of 2.4 cm2. Wound experiential’s ointments were applied once daily for a total of 28 days, and wound healing was evaluated at 0, 3, 7, 14, 21, and 28 days after pathogenesis, with 16.1-pixel accuracy. Photo confirmed using a SONY brand camera. Result: “CIBO” ointment contains four deferent cinders which are from collected from deferent area and that have been shown to good affect burn wounds, and is more compatible with yellow marrow than Group 4 (Yellow marrow+Chinese white cinder).
Wound healing variables of control group compared with group 4 (Yellow marrow + Chinese white cinder) increased by 11.1% on the 3th day, 4% on the 7th day, 44.8% on the 14th day, and 54.5% on the 21st day. On the 28th day, healing and regeneration were accelerated by 50%. Conclusion The group 4 (Yellow marrow + Chinese white cinder) has been shown to have a pharmacological action of rapid healing and regeneration of burn wounds caused by experimental rats. It has also been shown to have pharmacological action to regenerate skin tissue and suppress inflammation caused by burns. Inclusion of Chinese white cinder in “CIBO” ointment promotes regeneration and healing of “CIBO” ointment.

Introduction: In Mongolia, there is opportunity to replace importing products by using raw materials based on the animal and minerals. Those products can be used for medical purposes.
In traditional medicine, yellow marrow has been widely used to treat burns and mechanical wounds, as well as frozen and open wounds. The purpose of this study was to determine the pharmacological action of “CIBO” ointment. We created a model of mechanical wound to evaluate the healing of wounds and its index after applying the ointment contains the above mentioned raw materials. Material and methods: Four different groups of “CIBO” ointment was prepared in the technology sector of the Drug Research Institute. Mebo wound ointment was used for comparison as control. The study was con- ducted in the Pharmacology Sector of the Drug Research Institute on white rats of the WISTAR breed under one feeding regime and one condition (12h / 12h). Mechanical wound injury and exposure to open wounds in experimental rats and its size were measured on the 3^rd, 7^th, 14^th, 21^st, and 28^th days of treatment. Wound healing, morphology, structure, size, and its index was quan- tified based on the defects. The ointment were applied once a day during the treatment period of 28 days to cover the wound. Result: Mechanical wound showed that study treatment group healed 0-6.2% on the 3^rd day, 21.4-35.7% on the 7^th day, 50-60% on the 14^th day, and 33.3-50% on the 21^st day separately compared with the untreated group. On the 28^th day, all the groups were decreased by 66.6%. The wound index was between from 0.002 to 0.0005 in the all experimental groups. Among experimented groups, the group consists of yellow marrow and Chinese white cinder was showed better performance than other groups. Conclusion The study group 4 (Yellow marrow + Chinese white cinder) has been showed to have a pharmacological action of rapid healing and regeneration of burn wounds caused by experimental rats. It has also been shown to have pharmacological action to regenerate skin tissue and suppress caused by mechanicals. Inclusion of Chinese white cinder in “CIBO” ointment promotes regener ation and healing of “CIBO” ointment.

Abstract: CHUN-7 a Mongolian traditional recipe consisting of 7 medicinal plants is described in the scripture named “༆༆ །།གཡུ་ཐོག་པའི་མཛད་པའི་རིམས སྲུང་ཁྱུ་ལྔ་རྒྱམ་ཏོན་གསལ་བ །།”. The ingredients including Caowu (Radix Aconiti kusnezoffii, CW) and Glehniae Radix (GR) have the effects of suppressing pneumonia, viral pneumonia, relieving pain, stimulating the immune system and reducing fever. The present study was aimed to determine acute and chronic toxicity properties of traditional drug. Materials and methods: CHUN 7 traditional drug were prepared in the traditional medicine sector of the Drug research Institute of Monos group. All WISTAR rats were kept in the same feed, under 12 hours lighting and 12 hours darkness housing. The study of acute and chronic toxicity of CHUN-7 traditional drug was studied by using IP and oral administration were performed on ten WISTAR rats and continued for a total of 28 days with 102.9 mg / kg dose (calculated from human dose: 16.7 mg/kg) in accordance with the WHO General Guidelines for the Evaluation and Study of Traditional Medicine. Results: The result showed no structural changes in the internal organs according to tissue morphology when we administrated CHUN-7 traditional drug. Conclusion This study showed CHUN-7 traditional drug has no toxic effects to internal organs including liver, kidney, stomach, lungs and heart. Therefore, CHUN-7 traditional drug has potential to use orally without any toxicology.

Background: Healthcare organizations are successfully implementing quality management system by forming legal entity, administration’s structure, arrangement and developing healthcare organization’s structure, arrangement, functional standard, clinical guideline, rule and employee’s moral principles. Implementation of accreditation system into healthcare organizations is proof of accepted standard application. However, the results of healthcare paradigm shift outcome is insufficient. Also researchers, citizens and policy makers commented that quality and access of healthcare service began to worsen compared with previous degree of development. Management capability index presents management assessment by score, assesses outcome of organizational functions and give chance to measure capability of management. Methods: This study was performed at the Amgalan Maternity Hospital, Urguu Maternity Hospital and Khuree Maternity Hospital. The study involved 480 employees of above-mentioned hospitals. The study used 9 chapter and 90 criteria that was used in over 30 Mongolian Governmental Organizations for capability assessment to determine management capability index of Maternity Hospitals, using Cross-Sectional study method. In the study, a questionnaire with 90 questions including organization management capability 9 chapters which are organizational goal and task, leadership skill in organization, worthwhile structure and arrangement, organization’s motivation and leverage, organization’s relationship and collaboration, organizational culture, resource utilization, knowledge and innovation, organizational productivity, quality and performance was used. Organizations capability index was estimated by assessment of each questions in scores 1 to 5. Results: Total 480 employees consisting of 220 employees working at Urguu Maternity Hospital, 125 employees of Khuree Maternity Hospital and 135 employees of Amgalan Maternity Hospital filled the questionnaire. 46 administration officials, 75 doctors, 208 nurses and obstetricians, 105 caregivers and service assistants and 46 economic employees involved it. Organizational management capability was 71.8, 73.6 and 93 respectively Urguu Maternity Hospital, Khuree Maternity Hospital and Amgalan Maternity Hospital. It is obvious that there has necessity to improve organizational knowledge, innovation, resource utilization, behavior, culture and activate their organization. In result of studying doctors, nurses, obstetricians and other employee’s work task management, there has relatively little difference of management capability index with 0-3.9% between Urguu Maternity Hospital and Khuree Maternity Hospital while management capability index of Amgalan Maternity Hospital had difference with 14.7-20.1%. In the work task questionnaire analysis, no difference was noted but administrative officials and service assistants gave high assessment for organizational management. Regression analysis was used to assess the relationship between management capability assessment of doctors, nurses, obstetricians and other employee of Maternity Hospitals and the result was p<0.001 and r=0.89. It represented the presence of strong association between those. Conclusions Management capabilities of Urguu and Khuree Maternity Hospitals which don’t implement the quality management system have difference from Amgalan Maternity Hospital’s management capability. All participants of Amgalan Maternity Hospital implementing quality management system gave same assessment for their organizational management capability index regarding of differences of work tasks.

Introduction: Studies in many countries have found that the satisfaction of medical workers is closely linked to the quality and efficiency of medical services, as well as the satisfaction of patients. Satisfied employees will bring about satisfied clients. The satisfaction of employees remains a key factor linking the internal management and external management of an organisation. The World Health Organization (WHO) Global strategy on human resources on health workforce 2030 sets out the policy agenda to ensure a workforce that is ft for purpose to attain the targets of the Sustainable Development Goals (SDGs). Motivation of health care workers can initiate them to exert and maintain an efort towards organizational goals. Motivation depends up on many factors, and job satisfaction is one of the most important factors. Healthcare is a service industry where the overall service experience is important for customer satisfaction and quality of care (even if in different extents according to the professional at stake) and that the literature has been bringing about the pertinence of such a holistic approach, this research was conducted within this perspective. Likewise, it is also known that there is close correlation between the job satisfaction of health care staff and the total quality of health services. Different groups have reported differences between the job satisfaction of doctors and that of other health providers. Various satisfaction levels of health care workers, including general practitioners, nurses and midwives, have been reported previously. Materials and Methods: This study was performed at the Amgalan Maternity Hospital, Urguu Maternity Hospital and Khuree Maternity Hospital The study involved 480 employees of above mentioned hospitals. The short form of the Minnesota Satisfaction Questionnaire, with 20 items, was used to examine satisfaction with professional life. The self-administered questionnaire was distributed to all people at their workplaces. Responses of 4 (satisfied) or 5 (very satisfied) were classified as ‘satisfied’, those of 1 (very dissatisfied) or 2 (dissatisfied) as ‘dissatisfied’. Results: The study recruited total 480 employees consisting of 220 employees working at Urguu Maternity Hospital, 125 employees of Khuree Maternity Hospital and 135 employees of Amgalan Maternity Hospital. 46 administration officials, 75 doctors, 208 nurses and obstetricians, 105 caregivers and service assistants and 46 economic employees involved it. In table, 87.1% of total employees of maternity hospitals were female and 12.9% were male. While there had significantly difference for gender, occupation type and worked year in this sector and workplace between 3 maternity hospitals (p<.001), age and education level had no significantly difference between these 3 groups. The proportion of health care staff satisfied with their work was 80.7%. The chance to tell people what to do’ and ‘Being able to do things that do not go against my conscience’, and mostly dissatisfied with ‘The working conditions’ and ‘My pay and the amount of work I do’. There was no significant difference between satisfaction scores of health care staff according to age, gender, marital status, and experience of profession. When the 20 items constituting job satisfaction were examined specifically, the satisfaction score showed a difference related to profession. The midwives’ satisfaction score was significantly lower than that of the others. In table 4, to assess employee’s satisfaction of each maternal hospital: While the minimum satisfaction was assessed by employees of Urguu maternity hospital whether salary is equal for work performance, the maximum satisfaction was assessed by employees of Amgalan maternity hospital under scope of consistent workplace at 93.9 percent. Conclusion Maternity satisfy external and internal factors of employees are influenced. Maternity is different, depending on the satisfaction of other working areas of employment.