BackgroundThe preparations of multi-component have been the subject of chemical study for a long time. Therefore, when compounding the preparations of multi-component in traditional medicine, their taste is cautiously relied on, as the power of the one medicine should not be subdued with the power of another. Additionally the properties of the components and their regulating effects on the body systems are also considered. Our research group has been carrying out tests for raw materials,which are contained in multi-component preparations. However, it is a necessity to conduct phytochemical study on multi-component preparations in order to isolate pure biological active compounds and to identify their structure as well as to quantify its amount by modern techniques of analysis.GoalThe aim of the present study was to isolate pure biological active substances from Mongolian traditional medicine Garidi-5 and to elucidate their structures, which was used in Mongolian traditional medicine for the treatment of inflammation and as a pain relieving remedy.Objectives:1. To isolate pure substances from Garidi-5 and carry out tests to identify and determine their structure2. To quantify the amount of biological active substances.Materials and MethodsMongolian traditional medicine Garidi-5 has been selected as a biological natural product for the study. Garidi-5 is a traditional Mongolian medicine consisting of 5 medicinal herbs, namely Terminalia chebula Retz., Aconitum Kusnezoffii Reichb., Acorus calamus L., Saussurea lappa L., and musk of Moschus moschiferus and manufactured in the Drug factory of Traditional Medical Science Technology and Production Corporation of Mongolia. In this research, in order to determine the total content of phenolic compound was used the Folin–Ciocalteu method, which based on performing dark blue color complex compound. Isolated substance identification was determined by the TLC, UV and IR spectrophotometric methods. Inaddition it was checked melting point of the isolated substance. Determination of Gallic acid30g Garidi-5 was macerated in 60ml 80% methanol at room temperature for 24 h. After extraction, the extract was concentrated and vacuum evaporated. Different solvents from hexane, chloroform, ethyl acetate and n-butanol were used for theexperiment. All the extracts collected, evaporated and chromatographed on Silica gel column. Future purification of active fractions on Silica gel with methanol yielded the compound G1 which was further characterized as Gallic acid. Total phenolic content was determined spectrophotometrically according to the Folin–Ciocalteu’s method with slight modification. Gallic acid was used as a standard phenolic compound. Briefly, 1 ml of extract solution contains 1 mg extracts, in a volumetric flask diluted with distilled water (46 ml). One ml of Folin-Ciocalteu reagent was added and the content of the flask mixed thoroughly. After 3 min, 3 ml of Na2CO3 (2%) was added and then the mixture was allowed to stand for 2 h with intermittent shaking. The absorbance was measured at 760 nm in a spectrophotometer. All measurements were performed in triplicate.ResultsIn this research, TLC method on silica gel plates was used in order to identify the biological active pure substances from Garidi-5. Preliminary TLC experiments indicated the presence of Gallic acid in Garidi-5, which was isolated by column chromatography by comparing with reference standard substance (Gallic acid). Gallic acid was determined in the solvent system benzole-ethyl acetateformic acid- acetone (5:5:2:0.5) in isolated substance (G1). It showed blue color, Rf =0.65, on TLC plate. [1] For the characterization of two samples it was carried out IR analysis for each. In the IR spectra of G1 and standard substance can be recognized by the following absorption frequency regions: 700-900 cm-1 for Car-H; 1000-1300 cm-1 for vibration of bonds in various oxygen containing groups, 1350-1470 cm-1 for vibrations of –CH, -CH2 and –CH3 groups; 1500-1630 cm-1 for skeletal vibrations of aromatic rings, >C=O bonds; 2800-2950 cm-1 for stretching vibrations of –CH, -CH2 and -CH3 groups in saturated aliphatic structures; and 3030-3350 cm-1 for stretching associated vibrations of -OH groups in aromatic rings and aliphatic structures. As a result it was revealed that both IR spectra of G1 and standard substances were similar. [3]Further for the characterization of two samples it was carried out UV analysis of each. In the UV spectra of G1 and standard substance can be recognized by the following absorption frequency regions: 260-280nm for benzole groups; 200-225nm for carbonic acids; 400-770nm >C=O bonds, which reveal the presence of Gallic acid. In addition, melting point of isolated substance G1 was analyzed and detected at 2410C, which was similar to the standard substance’s melting point. [4]Moreover, Mongolian traditional medicine Garidi-5 contains 24% of the biological active substance (total phenolic compounds). [2]Conclusions:As a result of current study on Mongolian medicine Garidi-5, it was isolated one essential substance from ethyl acetate fraction. The phytochemical analysis reveals the presence of Gallic acid in Garidi- 5, which was determined by thin layer chromatography, UV and IR spectrophotometric methods. Mongolian traditional medicine Garidi-5 contains 24% of the biological active substance. Thus, the isolation of Gallic acid from multi-component preparations and identification of its structure was first phytochemical study conducted in our laboratory.

Description: Asymptomatic bacteriuria is defined as the presence of 1x105 or more bacteria per milliliter of urine, although there are no signs of UTI [1]. Asymptomatic bacteriuria is quite common and occurs in 1-5% of healthy women before menopause. The incidence of asymptomatic bacteriuria increases in the elderly (men and women) to 4-19%. Asymptomatic bacteriuria is observed in 0.7% -27% of patients with diabetes mellitus, in 2-10% of pregnant women and in 23-89% of patients with spinal cord injury. Asymptomatic bacteriuria is rarely observed in young men and always requires differential diagnosis with chronic bacterial prostatitis[2].
Among the elderly, those in institutionalized settings such as long-term care facilities and hospitals have a higher prevalence of asymptomatic bacteriuria than those living in the community. Therefore, interest in asymptomatic bacteriuria has shifted from the general population to these groups of individuals. The prevalence varies from 2% to 10% in pregnancy and from 15% to 50% in the elderly in long-term care facilities.[3,4]
This study was undertaken to determine the prevalence of people asymptomatic bacteriuria in among hospitalized people. Purpose: Investigate cases of asymptomatic bacteriuria among hospitalized individuals and determine antibiotic susceptibility by type of pathogen detected in urine. Materials and methods: This cross-sectional study in the “I” Hospital of UB city, Mongolia. We conducted into the study 133 patients. After obtaining informed consent, a midstream clean-catch urine sample was collected in the same 24 hour time window and was evaluated for urinalysis using a dipstick test and routine culture. A positive urine culture was defined as a single urine sample with microbal growth of >10⁵ colony- forming units of a single organism. We use 5-10% Blood agar, UTI agar, Mackkong agar and Chroma agar for a bacterial growth. Then we did antibiotic susceptibility of the determined pathogen. Result: The average age of the respondents was 55.9±14.6, the youngest was 17 years old and the oldest was 91 years old (CI 95% 53.4-58.5). By age group, 4.5% (n = 6) of people aged 20-30, 21.1% (n = 28) of people aged 31-45, 37.5% (n = 50) of people aged 46-60, and people over 61 years of age 36.8% (n = 49) respectively.Of the respondents, more than 56 or 54.9% (n = 73) were elderly, of which 63.9% (n = 85) were women and 36.1% (n = 48) were men.
A total of 36 (27.1%) leukocytes were detected, and 25 (34.2%) more (P-0.05) were detected in people over 56 years of age. The protein detected in 24 (18.0%) people, all over 56 years of age and more defined in men (P-0.01).
80.5% (n = 107) of those surveyed were diagnosed with the pathogens, and 54.9% were elderly (P-0.031). 82.4% of women and 77.1% of men were diagnosed with urinary pathogens.
Streptococcus 26%, E.coli 19%, Saprophyticus 13%, Enterococcus 11% and Staphylococcus 11% were detected in the analysis, and Streptococcus and E.coli (19%) accounted for a slightly higher rate of infection.
A total of 13 types of pathogens were identified, of which 53.4% were susceptible, 21.7% were moderately sensitive, and 24.9% were non-susceptible. Discussion: According to a study conducted by researchers at the University of Taiwan, the prevalence of asymptomatic UTI-s in the general population is 57.8%. E.Coli was also the most common bacterium in the urine [6].
In our study, there are many cases of E. coli.
Study in the United States found that the prevalence of asymptomatic bacteriuria among inpatients was 8.5%, all of them women. The most common pathogens in this study are Enterococcus bacteria. This study found that 1 in 10 people admitted to the hospital may have asymptomatic bacteriuria. [1] Conclusion
1. Asymptomatic bacteriuria in 80.5% of those surveyed 54.9% were detected in people over 56 years of age.
2. Antibiotic susceptibility of the tested pathogens was determined as 53.4% sensitive, 21.7% moderately sensitive and 24.9% insensitive.

Extraintestinal pathogenic Escherichia coli (ExPEC), the specialized strains ofE.coli that cause most extraintestinal infections, represent a major but littleappreciated health threat. Phylogenetic analysis has shown that ExPEC is composedof four main phylogenetic groups (A,B1, B2, and D) and that virulent extraintestinalstrains mainly belong to groups B2 and D.In this study, we aimed to assess therelation between adherence virulence and phylogenetic groups of ExPEC.A total of 161 E.coli samples were collected. Out of these 17 (10.6%) werefrom pus, 66 (41 %) from urine, 78 (48.4%) from cervical swab. The phylogeneticgroups and 6 virulence genes (fimH, papC, papGII, papGIII, fa/draBC,andSfa/focDE) encoding adhesins were identified by triplex PCR. Phylogeneticgroups distribution was as follows: B1 10.5%, A 24.7%, B2 25.3%, and D 38.9%. Virulence genes prevalence was fimH 90.1%, papC 23%, papGII 16.8%, papGIII1.9%, Afa/draBC 11.8%, andSfa/focDE 5.6%. The cell surface protein (curli) wasdetected 50,3% by Congo red agar. In conclusion: The most isolated strainsbelonged to the phylogenetic group B2 and D. The phylogenetic groups weresignificantly associated with some genes encoding adhesins (fimH, papC) and cellsurface protein (curli).

INNOVATION DENT • VOL. 3 • No.1 • Mar 2017 35 Background Odontogenic infection is defined as most dangerous inflammatory diseases in dental practice, it is believed that the cause of tooth decay disease and its complications currently a major cause of oral infections, or bacterial infection of the main sources of these diseases. Methods Between 2010-2011, odontogenic cellulitis in 21 patients were studied for aerobic and anaerobic bacteria by the Clinic bacterial laboratory in NCCD. Results 21 patients participated, were 10 men and 11 women with odontogenic cellulitis. Aerobic bacteria only were recovered in 3 (14%), anaerobic bacteria were recovered 8 (38%), mixed aerobic and anaerobic bacteria were recovered in 10 (48%). Conclusion A certain percentage of aerobic and anaerobic bacteria in odontogenic cellulitis shows simple space infection caused by aerobic bacteria, other complication of odontogenic cellulitis and multiple spaces infection caused by anaerobic and mixed bacterial infection. During dontogenic cellulitis determined high percentage of anaerobic and mixed bacterial infection, thus is our study have shown detection of anaerobic bacterial infection is important clinical significance in dental practice.

Background: Retinal pathologic features are associated with inflammatory processes and endothelial dysfunction, leading to circulatory abnormalities and reduced vascular reactivity. Both retinopathy and nephropathy involve thickening of basement membrane and muscular layers and increased leakage. These pathologic and hemodynamic abnormalities may occur throughout the body and their effects on the retinal vasculature may be useful indicators of cumulative microvascular damage from hypertension, inflammation, diabetes mellitus, and other processes. Type 2 MPGN is an uncommon renal condition associated with electron dense deposits in the lamina densa of the glomerular basement membrane with C3 found in the capillary loops and mesangium. The deposits in the basement membrane can lead to a breakdown of the blood-retinal barrier by interfering with the RPE layer, and type 2 MPGN has been described in association with central serous retinopathy. Purpose: To assess the retinal findings in end stage of Chronic kidney disease (CKD) and diabetic renal failure Methods: Data of diabetic renal failure (n=20, mean age 56.8±11.6), and end stage of CKD(n=83, mean age 48.2± 11.6) were cross-sectional analyzed. Nonmydriatic fundus photographs of the disc and macula in both eyes were obtained in all the subjects. The photographs were assessed by ophthalmologist using the standard protocols. The following parameters were recorded: BCVA, IOP, BP GFR, serum Creatinine, ophthalmic and fundus examination. Results: Greater severity of retinopathy was associated with DM. The presence of vascular abnormalities usually associated with Diabetes Mellitus ( DM) and was not associated with lower estimated glomerular filtration rate. All of patients with DM (n=20, 100%) ,they have Diabetic retinopathy. We found sight direct relationship between retinal posterior pole deposit with CKD patients. Some of patients who have end stage of CKD, (n=18, 11%) they have retinal deposit on their posterior pole. Conclusion Our findings show ,In participants with end stage of CKD, there was no significant severe retinopathy. In summary, our study demonstrates that DM, is one of the leading cause of irreversible vision loss. Every patients with DM need the ophthalmic follow up examination in every six months.

Extraintestinal pathogenic Escherichia coli (ExPEC), the specialized strains ofE.coli that cause most extraintestinal infections, represent a major but littleappreciated health threat. Phylogenetic analysis has shown that ExPEC is composedof four main phylogenetic groups (A,B1, B2, and D) and that virulent extraintestinalstrains mainly belong to groups B2 and D.In this study, we aimed to assess therelation between adherence virulence and phylogenetic groups of ExPEC.A total of 161 E.coli samples were collected. Out of these 17 (10.6%) werefrom pus, 66 (41 %) from urine, 78 (48.4%) from cervical swab. The phylogeneticgroups and 6 virulence genes (fimH, papC, papGII, papGIII, fa/draBC,andSfa/focDE) encoding adhesins were identified by triplex PCR. Phylogeneticgroups distribution was as follows: B1 10.5%, A 24.7%, B2 25.3%, and D 38.9%. Virulence genes prevalence was fimH 90.1%, papC 23%, papGII 16.8%, papGIII1.9%, Afa/draBC 11.8%, andSfa/focDE 5.6%. The cell surface protein (curli) wasdetected 50,3% by Congo red agar. In conclusion: The most isolated strainsbelonged to the phylogenetic group B2 and D. The phylogenetic groups weresignificantly associated with some genes encodingadhesins (fimH, papC) and cellsurface protein (curli).

There are a lot of influencing factors of facial nerve palsy; experts believe that is most likely caused by a Virus (54%) and Bacterial infections. Noninfectious causes of facial nerve palsy induce tumors (28%) and less commonly influences head trauma (18%). The retrospective analysis of WHO, in 2012. There are some cases of postoperative complication in middle ear surgery is facial nerve palsy and the total recovery outcome of function was not good. From 2013 to 2016 in EMJJ hospital, Mongolia, we enrolled 16 cases with facial nerve damaged in intratympanic canal but we could not recruit some patients with facial palsy over 6 months. Each subject was tested with pure tone test, ABR, Tympanometry. These were performed for the detection of hearing loss after Temporal bone injury. Then we also investigated location of facial nerve damages of patients by MRI and CT before reconstructive surgery. After that surgery, all patients were given corticosteroid treatment (20mg/day) and physical therapy performed such as acupuncture for a week. Study results revealed that 6 cases after 18 days, 2 cases after 30 days, 1 patient after 45 days of reconstructive surgery regained good symmetry. Therefore, we considered that, postoperative treatments like physical therapy with B12, steroid had good benefits for operation result and to shorten the recovery time. There was a patient who had damaged facial nerve in the tympanic segment during Mastoidectomy. In that case, we performed cable nerve grafting using the r.auricularismagnium but we could not recover facial nerve function. Traumatic facial nerve paralysis is the second most common type. We discussed that performing reconstruction surgery within first 3 months after intratemporal facial nerve injury is extremely desirable and more effective. In our opinion, nerve recovery might be not successfully cause of injured myelin sheet of facial nerve during middle ear surgery.

Background: We aimed to study the etiology and transmission route of diseases introducing the modern, rapid and high-sensitivity molecular genetic diagnostic methods for salmonellosis. Material and Method: In the study, we collected 680 stool samples and defined organisms of food intoxication by identification of bacteria, polymerase chain reaction (PCR) and determined serotype and antibiotic resistance. Result: Salmonella spp was detected from the stool of 25 (42.3%) patients out of 59 outpatient clinic and of 170 (27.4%) patients out of 621 inpatient clinic with diagnosis of food intoxication. In total there was detected 195 salmonella spp, and out of this isolated Sal. typhimurum in 193 (98.9%), and Sal. enteritidis was in 2 (1.1%) patients, respectively. We defined Sal. typhimurum in selected 32 cultures and did not detect resistant gene DT-104 ACS-SuT by PCR. Conclusion As resulted in the survey, we defined 195 (28,6) Salmonella typhimurum among the 680 patients who were suffered from food intoxication, and revealed fast foods, animal derived foods such as chicken, fish caused the food intoxication. Sal. typhimurium not resistance to antibiotics.

Introduction: Major outbreaks of infectious diseases caused by enteroviruses (EV) have been reported in recent years. As of 2017, in Mongolia, hand, foot and mouth disease, or HFMD, accounts for 13.7% of all infectious diseases. The purpose of this study was to investigate the circulation of EV among healthy children, and clinical characteristics of infection. Materials and Methods : The analysis of EV circulation was conducted on Polio Laboratory data of 1172 specimens, collected in 2013-2018, from 9 districts of UB and 21 provinces of Mongolia. Also specimens of 239 patients, who underwent outpatient and inpatient treatment at the NCCD in 2014-2018, were randomly selected and stool samples were collected. Clinical symptoms of patients were analyzed and virus isolation analysis was performed in order to confirm the diagnosis. Results: Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months. The enterovirus rate among healthy children was 20.1%. Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July.
Out of selected patients 52.7% (n=126) were diagnosed with HFMD, rash infection occurred in 28.5% (n=68), acute flaccid paralysis-18.8% (n=45). EV was detected in 56.4% (n=135) of the collected stool samples.
Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months (95% CI:2.5 ±0.1). 49% (n=578) of participants were female, 50.7% (n=594) were male. The enterovirus rate among healthy children were 20.1% (n=236; 95% CI: 20.1 ± 0.55). Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. Although the enterovirus isolation rate was relatively high among children under 3, there was no statistically significant difference (p>0.05), as well as there was no difference in gender (p>0.05). As for the EV circulation by region, the highest prevalence rate is found in Central region (27.5%), while the lowest is in the Eastern region (12.7%) with no statistical significance by regions (p>0.05). Conclusions Among children, HFMD is a common disease, that caused by EV. Enterovirus infection can often cause fever, flu like symptoms as well as spotted, maculopapular rash. The EV isolation rate of 20.1% indicates that the incidence of enterovirus is characterized by symptoms of influenza-like illness or is asymptomatic.