Flavonoids isolated from the flowers of Pulsatilla flavescens and their anti-piroplasm activity

Journal of Natural Medicines - Pulsatilla species are known as “Yargui”, and their flowers are traditionally used in Mongolia as a tonic and for the treatment of inflammatory diseases....     

Structure of the <Emphasis Type="Italic">M. tuberculosis</Emphasis> population in Mongolia according to the results of genotyping of large-sequence polymorphisms

We performed genotyping of 112 tuberculosis agent isolates from patients suffering from lung tuberculosis in Mongolia using the RD9, RD7, TbD1, RD105, and RD750 loci. Genotypes of all the obtained isolates were characterized by preservation of the RD9, RD7, and RD750 loci and by a deletion in the locus TbD1. A deletion of RD105 was found in 65 (58%) isolates. The isolates were classified into two groups, East Asian and European-American ones, by the results of genotyping.     

Clinical information sources used by hospital doctors in Mongolia

BACKGROUND: Information technology presents new opportunities to facilitate clinicians' access to up-to-date clinical information. Developing countries have special needs in this area and the problems encountered in obtaining clinical information have not been well researched, particularly for hospital doctors. No previous study has examined which clinical information sources Mongolian hospital doctors' use and the problems they may encounter in obtaining information. This study addressed an important knowledge gap by examining clinical information-seeking practices of Mongolian hospital doctors. The objectives of the study were to ascertain: (a) which clinical information sources were used in clinical decision-making; (b) the level of confidence in these information sources, and (c) the impact these information sources had on clinical decision-making. Also investigated was proficiency in English language and computer skills, as these factors could influence ability to obtain clinical information electronically. METHODS: Self-administered questionnaires were given to 263 doctors from the two largest hospitals in Ulaanbaatar, the capital city of Mongolia. Respondents answered questions about 10 information sources: colleagues; local and foreign textbooks; local and foreign journals; personal notes; computer-aided literature searches; Mongolian clinical practice guidelines; and brief updates and health policies developed in Mongolia. Parameters of interest included: frequency of use; confidence in the sources; and perceived impact of the sources on clinical decision-making. RESULTS: The response rate was 87% (229). The respondents indicated that discussion with colleagues was the most frequently used information source, foreign medical textbooks most commonly inspired high confidence, and discussion with colleagues was the source most often perceived as having a high impact on clinical decision-making. For all sources, high confidence and high impact were strongly associated with each other. Only 26% of respondents understood English well, and only 41% had excellent/good computer skills. English language and computer skills were strongly associated with undertaking computer-aided literature searches and with age. Female respondents were less likely than males to have excellent/good computer skills and less likely to undertake computer-aided literature searches. CONCLUSIONS: Satisfying the clinical information needs of doctors in less developed countries is particularly challenging and even though improvements in information technology can facilitate access to knowledge, there still exist barriers. Health policies which promote computer skills and English language among doctors may contribute substantially to best medical practice in Mongolia.     

New payment model for rural health services in Mongolia

This article describes experiences in Mongolia in designing and implementing a new method of payment for rural health services. The new method involves using a formula that allocates 65% of available funding on the basis of risk-adjusted capitation, 20% on the basis of asset costs, 10% on the basis of variations in distance-related costs, and 5% on the basis of satisfactory attainment of quality of care targets. Rural populations have inferior health services in most countries, whether rich or poor. Their situation has deteriorated in most transition economies, including Mongolia since 1990. One factor has been the use of inappropriate methods of payment of care providers. Changes in payment methods have therefore been made in most transition economies with mixed success. One factor has been a tendency to over-simplify, for example, to introduce capitation without risk adjustment or to make per case payments that ignored casemix. In 2002, the Mongolian government decided that its crude funding formula for rural health services should be replaced. It had two main components. The first was payment of an annual grant by the local government from its general revenue on the basis of estimated service population, number of inpatient beds, and number of clinical staff. The second was an output-based payment per inpatient day from the National Health Insurance Fund. The model was administratively complicated, and widely believed to be unfair. The two funding agencies were giving conflicting types of financial incentives. Most important, the funding methods gave few incentives or rewards for service improvement. In some respects, the incentives were perverse (such as the encouragement of hospital admission by the National Health Insurance Fund). A new funding model was developed through statistical analysis of data from routine service reports and opinions questionnaires. As noted above, there are components relating to per capita needs for care, capital assets, distance, and quality of care. The risk-adjusted capitation component determines needs classes by use of age, gender, and family income. The model was accepted by all concerned parties, and steps are now being taken to implement it under transitional arrangements. Many of the data used to parameterize the model are inaccurate and will need to be updated in the near future. However, the model is inherently valid, and procedures have been set in place that will ensure accuracy is improved on a continuing basis. An important reason why the government strongly supported implementation was its commitment to implement output-based budgeting across all government sectors. The new model provided a convenient way of applying output-based budgeting to one major component of the health sector.     

Herbal nutraceutical treatment of chronic prostatitis–chronic pelvic pain syndrome: a literature review

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most frequent form of prostatitis, and has a serious impact on patients’ quality of life, and causes severe symptoms. The pain in the pelvic, perineal and penile areas, lower abdominal pain, and pain during urination or ejaculation are the main complaints of CP/CPPS. The underlying complex and unknown pathophysiology of this syndrome have made the management of CP/CPPS and the availability of monotherapy challenging. To identify an effective monotherapy, a plethora of clinical trials failed due to its puzzling etiology. Antibiotics, anti-inflammatory, and a-blockers have been commonly used for the treatment of CP/CPPS, but the desired and complete effects have not been gotten yet. The patients and clinicians are attracted to alternative therapies because of their multi-targeted effects. Attention toward natural compounds effectiveness and safety, supporting the development of a new nutraceutical science. In the alternative remedies for the treatment of prostatic diseases, medicinal herbs, in the form of herb parts or extracts, are getting attention due to their positive effects on prostatic diseases. At present, there is no available detailed literature review about the efficacy of medicinal herbs in the treatment of CP/CPPS. This review aimed to explore the useful medicinal herbs in the treatment of CP/CPPS from different perspectives and their possible mechanism of action in managing CP/CPPS.