Background: Healthcare works are high risk of infection through occupational exposure that contact with blood and other body fluids, including infected person, uses needles, syringes, equipment or exposures to sharp instruments. The World Health Organization (WHO) estimates, approximately 66,000 health workers are infected with the hepatitis B virus (HBV) and 200-5000 workers arc infected with human immunodeficiency virus (HIV) each year due to carelessness. HBV infection is a global health problem that remains to preventive. Hepatitis B can be prevented by vaccines that are safe, available and effective. In our country, which has a high prevalence of hepatitis B virus infection, it has been concluded that the coverage of hepatitis B vaccination and the level of immunity of health workers are insufficient. Aim: To evaluate post vaccination immunity against HBV in the staff of National center for transfusion medicine Methods: 63 workers with negative surface antigen of hepatitis B (HBsAg) and absent anamnesis of infection were selected for this study. In 2019 and 2020 all 63 workers were evaluated post vaccination immunity against HBV. Analysis done by Sysmex HSCL800 that is an automated immune assay system. Results and discussion: This center was begun to conduct the vaccination of workers from 2011. Among total 63 individuals involved in this study 53 (84.1%) were vaccinated against hepatitis B and 10 (15.9%) were not vaccinated. From the vaccinated 53 workers, 47 (88,7%) have immunized (anti-H Bs > 1 Ou/ml) but 6 (11.3%) of them were not immunized (anti-HBs <1 Ou/ml).
Therefore 1(1,9%) worker of them received just first dose, 14 (26.4%) workers were injected second dose, whereas 38 (71.7%) workers were vaccinated with third dose. The study shows that 12 (85.7%) workers after second dose and 34 (89.5%) workers after third dose were immunized. Conclutions As a result of hepatitis B vaccination, 88.7% of workers of the NCTM have had immunized against HBV. The final evaluation shows that 36 (57%) of workers had stable, 17 (27%) increased, and 10(16%) decreased level of immunization than the previous year.

Introduction: The Mongolian people have been using traditional medicine for hundreds of years. However, there is a need to produce traditional medicinal dosage forms such as capsules, tablets, decoctions easier to drink, store and transport, and to standardize not only finished product, but the raw materials used for traditional medicines in line with the current drug production, drug quality and safety requirements. Therefore, in this study, we aim to standardize five ingredients of a traditional powder medicine, which have been widely used for colds and flu in Mongolian, Chinese and Tibetan traditional medicine practice, and to convert the powder drug into tablet form using qualified raw materials. Materials and Methods: The study to convert multi-ingredient traditional powder into tablet was carried out at the Experimental production pharmaceutical technology unit and Pharmaceutical chemistry Laboratory of the Drug research institute, Monos Group, and the Quality control laboratory of medicine of Monos Pharm LLC. Result All raw materials were standardized and wet granulation method was used to prepare granules for the tableting with qualified raw materials. 4 different models of the tablet form was prepared and investigated. It was determined that model X-2 fully meets the general requirements for the tablet form.

Introduction: A joint research team of the Drug Research Institute аndMonos pharm Co.ltd is conducting an experiment to produce of “Darmon” tablets.Idridoids are one of the predominant biological active compound in “Darmon” tablets and will be an important indicator of the quality of the drug. Objectives: This is the first report on the determination of iridoids by spectrophotometric method in “Darmon” tablets. Methods: The amount of total iridoids of “Darmon” tablets was confirmed by spectrophotometry and the absorbance was measured at 238 nm. Geniposide (98%, Xilong Scientific Co., Ltd) was used as the standard substance. Results: The developed spectrophotometric method showed good linearity (R²=0.9989), high precision (RSD<2%) and a good recovery (96.01-104.48%). All the validation parameters of the spectrophotometric method were found to be within the permissible limits according to the ICH guidelines. Conclusions The method was robust, accurate and reliable for the quality control of “Darmon” tablets.

Introduction: Helianthus tuberosus L. is main source of inuline in pharmaceutical and food industry. Pharmacological studies of the plant have showed some important therapeutic properties such as anti-diabetic, anti-osteoporosis, anti-cancer and strengthening cardiovascular system, immune system. Material and method: Helianthus tuberosus L., which has been cultivated in Botanical Garden of Medicinal Plants of Drug Research Institute, Monos Group, was used as a research raw material. The aerial and below ground parts of the plants were harvested in September 2020. The content of inulin, the main active ingredient in the plant, was determined by spectrophotometry. Raw materials of the plant were processed in several ways and prepared for further use as a pharmaceutical raw material. Result: Inulin content in Sample 1 was 34.5 ± 0.76%, Sample 2 was 70.31 ± 1.25%, Sample 3 was 78.43 ± 0.44% and Sample 4 was 75.36 ± 1.42%. The inulin content and yield were the highest in samples prepared by heat and cold cutting methods. Conclusion According to the results of appearance, yield, inulin content and moisture contents during the different processings of plant materials, it can be considered that the most suitable method for preparing Helianthus tuberosus L. as a pharmaceutical raw material is the cutting followed by freeze-drying.

Introduction: Sea buckthorn (Hippophae rhamnoides L.) is a hardy deciduous shrub of family Elaeagnaceae. In traditional medicine, “Sea buckthorn-5” powder medicine and sea buckthorn extract for the treatment of lung diseases,“Sea buckthorn-11” and “Sea buckthorn-17”prsecriptions are used to treat gynecological diseases. Sea buckthorn fruit takes a lot of time to dry and prepare in the traditional way, and a small amount of raw material is obtained. Therefore, there is an urgent need to improve and standardize technology. Material and method: The study used “Sea buckthorn fruit” raw material harvested in September 2020 from the Botanical garden of medicinal plants of the Drug research institute and sea buckthorn dry extract purchased from China.Four types of samples were used as Dry fruit of sea buck- thorn (Sample 1), Sea buckthorn seeds (Sample 2), Natural dried sea buckthorn fruit (Sample 3), and sea buckthorn dry extract purchased from China (Sample 4).In each of these four samples, the total carotenoid was measured at 450 nm, the flavonoid at 500 nm, and the phenolic compound at 750 nm using a spectrophotometer. Result: The results show that Sample 1 contains the highest amount of carotenoids 56.29 ± 0.05%, Sample 2 contains the highest amount of flavonoids 32.19 ± 0.05%, and total phenolic compounds 41.67 ± 0.02%. Conclusion Dry fruit of sea buckthorn (Sample 1) has the highest content of carotenoids, sea buckthorn seeds (Sample 2)have the highest total flavonoids and total phenolic compounds, which is approximately to the content of natural sea buckthorn fruit.

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.

Introduction: Gastric cancer is still one of the most leading causes of mortality in the world. The highest mortality rate of gastric cancer is estimated in Mongolia. South Korea and Japan, where leading the incidence of gastric cancer, mortality rates are observed in 51th and 31nd rank respectively. In Mongolia, gastric cancer is the second leading site, after liver cancer. Goal: We aimed to determine the cause of late diagnosis of gastric cancer and to evaluate supply of upper endoscopy devices and human resource for gastric cancer in the general hospital of provinces and districts. Materials and Methods: In this study, 84 patients suffering from gastric cancer (42 patients in III, IV TNM stage; 42 patients in I, II TNM stage)were investigated in National Cancer Center, Mongolia. A survey questionnaire which included age, gender, education, income, risk factors and clinical questions was detected from all patients. And we conducted study of supply of upper endoscopy devices and human resource for gastric cancer in general hospitals of from 21 provinces and general hospitals of 6 districts by questionnaire. Results: Seventy three(86.9%) patients were over 50 years old and the highest rates of gastric cancer were in group of 61-70 years (40.5%). From the results, the reason to visiting hospital was significantly different between two groups. 55.1% of patients suffering from early-stage gastric cancer were voluntarily diagnosed by upper endoscopy. In contrary, 55.8% of patients suffering from late-stage gastric cancer have visited the hospital due to worsening symptoms or dysphagia and vomiting. Factors such as age, gender, education, employment status and income had no significant effect on late diagnosis of gastric cancer. In totally 24(89%)general hospitals out of 27 had upper endoscopy devices and 22 (81.5%) hospitals had endoscopist. Although 75% of total general hospitals conduct annual cancer screening, 64% of them do not perform the endoscopy in annual screening. Conclusion In our country, late diagnosis of gastric cancer is related to the attitudes of patients for preventing and screening disease. Therefore, it is important to improve the health education of the population and to develop healthy, right attitudes and practices. And the study revealed that general hospitals have insufficient for upper endoscopy devices and human resource.

Introduction: Khuumii (throat singing) is a unique form of art derived from the nomadic population of Central Asia, producing two or more “simultaneous” sounds and melodies through the organ of speech. Material and Methods: The aim of the study is to identify the anatomical structures involved in the formation of khuumii and the features and patterns of their functions and compare each type of khuumii as performed by Mongolian people. A total of 60 participants aged 18-60 years (54 men and 6 women) were selected by non-random sampling method using cross-sectional study. Statistical analysis was performed using SPSS 23 software using questionnaires, X-ray, endoscopy, sound research method, and general blood tests. Results: 90.7% of the khuumii singers were male and 9.3% were female. The average height of the participants was 172.91±0.93 cm (arithmetic mean and mean error), average body weight was 77.53±2.46 kg, and body mass index was 25.93±5.31 respectively. Heart rate was 92.19±20.71 per minute prior to khuumii while 133.19±19.09 after performing khuumii and 85.81-98.56 at 95% confidence interval. In terms of ethnicity (ethnographically), the Khalkh were the largest ethnic group (72.1%), followed by Bayad, Buryatia, Darkhad, Torguud, and Oirat (2.3%), respectively. 60.5% of the participants were professional khuumii singers who graduated from relevant universities and colleges. The process of Khuumii was recorded by X-ray examination, and laryngeal endoscopy evaluated the movement of true and false vocal chords, interstitial volume, movements of epiglottis and arytenoid cartilage, and mucosa. Khuumii increases the workload of the cardiovascular system by 70-80%. Furthermore, the sound frequency is 2-4 times higher than that of normal speech, and sound volume is 0.5-1 times higher. 95.3% of throat singers did not have a sore throat, 88.4% did not experience heavy breathing, and 74.1% had no hoarseness. During the formation of khuumii sound, thoracic cavity, diaphragm, and lungs regulate the intensity of the air reaching the vocal folds, exert pressure on the airways and vibrate the sound waves through air flows passing through the larynx and vocal folds. Mouth-nose cavity as well as pharynx are responsible for echoing the sound. Conclusion It is appropriate to divide khuumii into two main types according to structural and functional changes in the organs involved; shakhaa and kharkhiraa. Khuumii, the “Human music” originating from the people of Altai Khangai basin by imitating the sounds of nature with their own voice in ancient times, spread all over the world from Mongolia and it is proposed to classify khuumii into two main types of shakhaa and kharkhiraa in terms of structural involvement and functionality.

Introduction: Cancer is a major public health issue both in Asia and in Mongolia. The most prevalent cancer related deaths in Mongolia are registered for the stomach, esophagus and liver. Purpose: We aimed to investigate the incidence of stomach and esophageal cancer in Mongolian population. Materials and Methods: Epidemiologic data were collected from 2009 to 2018 through the oncology cabinet of all hospitals and medical centers from all provinces, soums (the smallest unit of provinces) and major districts of the capital city. The incidence of stomach and esophageal cancer was calculated by appropriate methods and it was presented by ArcGIS Pro 9.2 software. A P-value of less than 0.05 was considered to be statistically significant and based on two side hypotheses. All calculations were performed in the IBM SPSS Statistics software. The study design in concordance with ethical guidelines was approved by the Ethics Committee of Ministry of Health Mongolia. All clinical investigations were conducted according to the principles laid down in the Declaration of Helsinki. Results: The incidence of esophageal cancer in last ten years (2009-2018) was 10.09 in 100000 populations and the highest incidence were registered in Uvs (38.13), Bayan-Ulgii (24.15) and Zavkhan (18.18) provinces, respectively. The incidence of stomach cancer was 20.33 in 100000 populations and the highest incidences were registered in Uvs (53.01), Khovd (46.02) and Darkhan-Uul (40.50) provinces, respectively. Conclusion
1. Incidence rates for esophageal and stomach cancer are high among the Mongolian population. In the last decade, the incidence of esophageal cancer had not decreased significantly, but it’s constant.
In our study, the esophageal cancer incidence was 10.09 per 100’000 people, which includes one of the high incidence rate countries according to the WHO classification. More than 10 aimags incidence rate of esophageal cancer was higher than the National average. Most of them have occurred in the western region of the country. Most of the Western, some of Khangai and Eastern soums have had the highest incidence of esophageal cancer what we have shown on the mapping.
2. The incidence rates of stomach cancer were registered as 20.33 per 100’000 people in the last 10 years at the national level. It has shown that according to the WHO classification, our country is also one of the countries with the highest incidence of stomach cancer. The stomach cancer incidence trend was increased in the last 10 decades. Therefore, some of aimag’s soums has included the highest rate classification. In addition, some soums in the Western, Khangai, and Eastern aimags had have a very high incidence of stomach cancer.
According to results in the above, the nationwide targeted prevention program is needed especially where the highest incidence rates. Also there is a lack of cooperation between national organizations to accurate registration of gastrointestinal cancer and to fight against these harmful cancers.