1.Community knowledge, attitude and practice on preventive service and attitude of primary health care providers
Dulamsuren S ; Enkhmaa U ; Shirnen L ; Suvd B ; Ariunbileg Z
Mongolian Medical Sciences 2013;163(1):42-47
Aim and objectivesTo assess the community health seeking behavior, knowledge, attitude, practice and the attitude ofprimary health care providers and to determine methodologies for developing of voluntary attendanceof preventive screening services. This included:• Assessment of community knowledge, attitude and practice related with preventive healthservices and health seeking behavior;• Assessment of the attitude of primary health care providers on preventive healthservices;• Identify methodologies to establish a practice of voluntary attendance of preventivescreening services;Materials and MethodsIn this survey both quantitative and qualitative research methods were used. 846 individuals wereinvolved in the quantitative survey and 112 family doctors, nurses, social workers of the selectedaimags and districts participated in the qualitative surveys.ResultsThough the participants demonstrate knowledge that the primary health care facilities should beapproached on the initiative of the patients themselves (85%), while healthy (50%) and for earlydetection of a disease (70%), this knowledge on preventive care is not evolving into actual practiceas most of them visit the primary care facilities only as they become sick (70%). The communityparticipants demonstrate incorrect attitude that preventive services do not require personal initiativesand engagement of patients (42%), primary care facilities are visited in order to obtain a referral tothe next level of care (46%), primary care facilities should be visited only when there are symptoms ofdiseases (32%) and only when the patient has free time. The participants of the survey also noted theinsufficient attitude and communication manners of the doctors and health professionals (31%), thatpatients are not received with smile when they visit for preventive screening (60%), dissatisfaction withthe services of primary care facilities (28%).ConclusionsThe majority of the respondents know that visit to primary health care clinic for health check-up isrequired. Although most of the participants demonstrate knowledge that primary health care unitsshould be visited voluntarily for preventive screening services, most do not practice this knowledge.The attitude of most of the participants was that the benefit of visiting a primary care facility is obtaininga referral to the specialist doctor. One out of three of the survey participants had an incorrect attitude asthey perceive that health check-up is only necessary if a patient is sick with one or more conditions.
2.STUDY OF LIVER FIBROSIS IN CHRONIC VIRAL HEPATITIS PATIENTS USING SHEAR WAVE ELASTOGRAPHY WITH ELASTOGRAPHY POINT QUANTIFICATION
Enkhmaa G ; Davaasuren B ; Anuzaya P ; Mend-Amar B ; Namjilmaa G
Innovation 2017;11(4):18-21
BACKGROUND: Chronic viral hepatitis is the most important public health problems and main cause of liver fibrosis. Progressive hepatic fibrosis will gradually lead to liver cirrhosis, hepato-cellular carcinoma and liver failure and deaths. Study of liver fibrosis is becomes an essential issue of prevention, prognosis and radical treatment plan. The evaluation of liver fibrosis using ultrasound based-electrographic shear wave elastography (SWE) with elastography point quantification (ElastPQ) is a modern non-invasive method. This study is aimed to evaluate diagnostic value of SWE with ElastPQ feature of liver fibrosis.
MATERIAL: A total of 110 patients with chronic viral (B, C and D) infection and 50 healthy controls were involved. Quantitative evaluation of LS was performed by Philips iU 22 ultrasound system with ElastPQ using convex transducer C5-1.
RESULTS: In HBV patients: no fibrosis F0 score 7, mean liver stiffness was 3.1±0.28 kPa, mild liver fibrosis F1 score 26, mean LS was 4.9±0.90 kPa, F2 score 4, mean LS was 8.0±0.56 kPa, F3 score 3, mean LS was 11.0±0.83 kPa, and F4 score or liver cirrhosis 2, mean LS was 17±4.3 kPa, respectively. In patients HCV; F0 score -5, mean LS was 3.2±0,08 kPa, F1-36, mean LS was 5.0±0.94 kPa, F2 score-10, mean LS was 8.1±0.90 kPa, F3-10, mean LS was 10.9±1.03kPa, and F4 score 5, mean LS 15.9±2.8kPa, respectively. In patients with HBV, HDV; F0 score-1, liver stiffness was 3.2kPa, F1-13, mean LS was 4.9±0.72 kPa, F2 score 2, mean LS was 8.0±0.56kPa, F3 score, LS was 10.8kPa, F4 score 1, LS was 20.1kPa, respectively.
CONCLUSIONS: Shear wave elastography with elastography point quantification technique is a reliable that can to detect of the earlier fibrosis stage in chronic viral hepatitis patients. ElastPQ SWE method is an optimal to monitor liver tissue stiffness in patients with chronic liver diseases.
3.Research of the chemical composition of Siberian larch bark (Larix sibirica Ldb)
Purev B ; Batnairamdal Ch ; Enkhsuren E ; Enkhmaa D
Mongolian Pharmacy and Pharmacology 2020;16(1):13-17
Abstract
Since ancient times, In traditional medicine has been widely used for Tan medicine, which make
to natural raw material. Nowadays, this practice has been renewed, and researches are being
conducted to determine their chemical component, mineral content and to explain their activating
mechanism. Compounds with antioxidant activity contained in the pharmaceutical raw materials
has very important benefits for metabolism, organ system function and to inhibit inflammation, oxidation reaction. In Mongolian traditional medical sources literature noted that bark (Larix sibirica
Ldb) has activity such as anticoagulant, anti-cancer, anti-flu and to decrease arterial hypertension
and also it was included to composition of "Tanchin-25" reception. Spectrometry and Rentgen fluorescence spectroscopy were used to identify chemical composition and content of mineral in the
sample of Larix bark (Larix sibirica Ldb). According to the exploration, content of total flavonoid
were determined 0.773%, and by mineral test, essential macro and micro elements that were obtained Ca (18.74%), Mg (8.31%), P (13.29%), K (2.49%), Na (0.675%), Cu-(375ppm), Zn(715ppm),
Cr (68ppm) and V (17ppm), Co (5ppm).
4.Review survey of Siberian Larch (Larix Sibirica Ledeb)
Purev B ; Batnairamdal Ch ; Enkhsuren E ; Enkhmaa D
Mongolian Pharmacy and Pharmacology 2021;18(1):24-30
Abstract:
Mongolian traditional medicine has history of 5000 years and has been used medicinal plants, medicinal animal products, and minerals for prevention, treatment, more energy or strength. The woody parts, resins-colophony, and bark of the Siberian larch, belonging to the genus Pinaceae, are used in traditional medicine as a medicinal raw material. This paper purposed to reviews the chemical composition and pharmacological research of Siberian larch, a natural medicinal raw material that occupies 60.4% of Mongolia’s natural forest area and 78.7% of its reserves, and its use in Western and Oriental medicine.
Method:
The study of the chemical composition of Siberian larch, pharmacological research, and its use in Western and Eastern medicine was judged on the basis of sources, scientific articles, and textbooks.
Result
Alkaloids, flavonoids, various essential oils, polysaccharides, sesquiterpenes in the upper part of the Siberian larch, flavonoids such as quercetin, taxifolin, kempferol in Siberian larch wood, abietic acid in the solid part of Siberian larch resin, Siberian larch bark contains tannins (10-15%), lignin (46-47%) and polyphenols (38-39%). The woody part of the Siberian larch tree has antiviral activity against Herpes Simplex, high antioxidant properties, and is used to prevent and treat allergic diseases. The flavonoids in larch resin reduce the risk of cardiovascular disease and cancer. Larch bark inhibits E.coli bacteria.
5.The prevalence and severity of anemia among adults
Enkhmaa B ; Khulan P ; Oyunsuren E ; Odgerel TS ; Uranbaigali E
Mongolian Journal of Health Sciences 2025;86(2):97-101
Background:
Anemia is still being a population’s challenging issue regardless of high development of countries around
the world. According to a study regarding prevalence and etiology of anemia conducted in 187 countries around the
world, the anemia rate is 23 176 per 100 000 population. In accordance with the “5th National Nutrition Survey” study
conducted in our country in 2017, one of every five women (21.4%), aged 15-49 years, 16.2% of reproductive age women
and 3.0% of men are anemic. The current study was conducted due to it is still essential to study and identify the etiology
of anemia, determine its prevalence, plan appropriate intervention, and organize future preventive measures, depending
on the socio-economic conditions, location, diet, and customs of the Mongolians.
Aim:
To identify anemia among the adult population, determine the type and severity of anemia.
Materials and Methods:
The cross sectional study was conducted during between May 2022 and Sep 2023 and adults
aged above 18 years were included. Moreover, we identified anemia cases based on the laboratory test results and determined
the anemia severity grade. Statistical analysis was performed by using SPSS software.
Results:
Among the participants, 6.7% of them, 9.9% of females and 2.8% of males are anemic. Prevalence of mild,
moderate and severe anemia is 66.7%, 30% and 3.3%, respectively. While the prevalence of anemia among reproductive
age women is higher, the prevalence of anemia increases with age. The anemia prevalence in Ulaanbaatar region, Western
region, Khangai mountainous region, Central region and Eastern region is 583 (25.6%); 171 (7.5%); 343 (15.1%); 921
(40.4%); and 261 (11.4%), respectively. By regional location, the prevalence is high in the Central region, with varying
prevalence in other regions.
Conclusion
Anemia was detected in 6.7% of the total study population, 9.9% of females, and 2.8% of males were anemic.
Of those with anemia, 66.7% had mild anemia, 30% had moderate anemia, and 3.3% had severe anemia. Moderate
and severe anemia were more common in females than in males.
6. Result of antimicrobial activity of antibiotic encapsulated in liposomes
Enkhtaivan E ; Enkhmaa O ; Nyam-Ochir E ; Bayasgalan B ; Odonchimeg M ; Lodoidanzan A ; Unursaikhan S ; Enkhjargal D ; Baatarkhuu O ; Ariunsanaa B
Mongolian Medical Sciences 2023;205(4):3-8
Introduction:
The treatment of antibiotic-resistant bacterial infections has become a pressing problem for humanity
worldwide, and antibiotic-resistant bacterial infections are likely to be the leading cause of death
by 2050.Due to the mutation of infectious disease-causing bacteria and the emergence of bacterial
resistance due to the improper use of antibiotics, the time and cost of infectious disease treatment
increases, and in some cases, it leads to an increase in mortality, so it is the focus of the health sector
in every country, regardless of the income level of the population. In addition, bacterial resistance has
a negative impact on public health, food safety, the environment, and the economy.
As of 2015, Mongolia ranks among the countries with the highest consumption of antibiotics in the
world, with 64.41 units of antibiotics prescribed per 1,000 people per day. Bacteria resistant to broad
spectrum antibiotics have increased dramatically, and among Gram-positive bacteria, drug-resistant
Staphylococcus aureus (MRSA) has become one of the most common and dangerous cause
Purpose:
Determine the external structure of liposome-encapsulated antibiotics and evaluate their antibacterial
activity.
Materials and Methods:
We conducted this study using an experimental research design. Phospholipids were isolated by
intermittent evaporation, antibiotic encapsulation by freeze-thaw method, and antibiotic sensitivity was
determined using standard strains by disc diffusion andmicro dilution method.
Research ethics:
Permission to submit the survey was granted by the Ethics Review Committee of the MNUMS. The
survey was granted in accordance with the rules and regulations.
Results:
In liposome-encapsulated antibiotic sensitivity assays, azithromycin and clarithromycin did not form
sacred circles, whereas doxycycline hyclate was sensitive by forming a 16 mm circle. Doxycycline
hyclate encapsulated in liposomes formed a 16 mm circle with sensitive results, whereas blank liposomes were inactive. When the rabbits were infected with a standard strain of methicillin-resistant
Staphylococcus aureus, the infected area was purulent 24 hours later. A cream containing antibiotics
was started at this time. A deep wound was recovered after 12 days after the pus was removed.
Nevertheless, after 24 days, the wound on the rabbit’s infected part healed and the hair on the scraped
part grew back.
Conclusion
According to the dilution method, liposome-encapsulated doxycycline hyclate inhibited bacterial
growth at 2-fold lower doses than pure doxycycline hyclate. In experimental animal models,
liposome-based antibiotic ointment has shown antibacterial activity.
7.Study on the anticancer effect of apigenin on leukemia cells
Erdenezaya O ; Enkhkhishig O ; Egshiglen A ; Ulziisaikhan B ; Nomiungerel R ; Enkhmaa D ; Uugangerel E
Mongolian Journal of Health Sciences 2025;88(4):52-55
Background:
The study of small-molecule compounds with antitumor activity involves several crucial steps. These
include determining their selective effects on cancer cells, understanding the type of cell death they induce, identifying
the activated signaling pathways, pinpointing the target molecules, and elucidating the mechanisms of action. Among the
plant-derived compounds with anticancer properties, flavonoids are notable for their ease of isolation and their abundance
in food. Apigetrin, a representative flavonoid, is a secondary metabolite found in plants, and our previous study indicated
that its anticancer selectivity index was 13.1. However, the specific mechanism by which apigetrin inhibits leukemia cell
growth remains unclear.
Aim:
To study of the inhibitory action of apigenin on leukemia cell culture
Materials and Methods:
In this study, we evaluated the apoptosis of cells using flow cytometry and investigated the in
volvement of the caspase pathway through the use of pancaspase inhibitors to explore the effects of apigetrin on leukemia
cell growth.
Results:
After incubating leukemia RAW264.7 cells with 30 μM apigetrin for 24 and 48 hours, we did not detect any apoptosis through Annexin V and PI staining by flow cytometry. We compared the number of viable cells using the MTT
assay after 24-hour treatment of apigetrin with or without pretreatment of Z-VAD, a pancaspase inhibitor, for 30 minutes. The results indicated that the pancaspase inhibitor did not reduce the inhibitory effect of apigetrin on the growth of
RAW264.7 cells. In contrast, the positive control group, treated with doxorubicin—which induces apoptosis—showed
not only significant apoptosis but also a reduction of the pancaspase inhibitor on the cell growth inhibition. Therefore,
these data suggested that apigetrin likely has a cytostatic effect or inhibits the cell cycle rather than being cytotoxic. Future
research should focus on determining which stage of the cell cycle RAW264.7 cells treated with apigetrin are in, as well
as studying the signaling pathways involved in the cell cycle.
Conclusions
Apigetrin inhibits the proliferation of RAW264.7 leukemia cells in a caspase-independent and non-apoptotic
manner.
8. Subchronic toxicity and sedative activity studies of herbal complex preparations
Maral-Erdene G ; Batdavaa B ; Chimgee Ts ; Yeruult Ch ; Enkhmaa G
Mongolian Journal of Health Sciences 2025;85(1):168-172
Background:
According to the World Health Organization (WHO), approximately 70-95% of developing countries rely
on traditional medicine, which includes around 365 plant, animal, and mineral-based preparations. Natural products consist of numerous biologically active compounds that exert effects against pathogens, making up about 25% of modern
pharmaceuticals derived from plants. Since plants are a combination of various metabolites, they can have therapeutic
effects, side effects, and toxicity in the human body. Based on the traditional use of medicinal herbs in Mongolian and
Tibetan medicine for their sedative properties, we selected the medicinal herbs Valeriana officinalis L. and Leonurus sibiricus L., The objective is to develop new medicinal preparations that can be utilized in modern medical practice to treat,
prevent, or supplement the treatment of depression and anxiety. Consequently, it is necessary to prepare a herbal complex
from these selected plants and conduct studies to investigate their subchronic toxicity and sedative activities.
Aim:
To study subchronic and sedative activity of herbal complex preparations.
Materials and Methods:
The herbal complex preparation was prepared from the 70% ethanol extract of the roots of Valeriana officinalis L. and the aerial parts of Leonurus sibiricus L., and a compound preparation was made in a 30:70 ratio.
Subchronic toxicity study was conducted on Wistar rats weighing 180-250 g according to the OECD-407 guidelines. The
sedative activity of herbal complex preparation was studied on C57BL/6 and BALB/c mice using the dark/light transition
test according to Takao K., and the hole-board test according to Hiroshi Takeda.
Results:
In the sub-chronic toxicity study of the herbal complex preparation, biochemical analysis of the serum (including
ALT, AST, creatinine, and urea) and histopathological examination of the liver, kidney, and heart showed no statistically
significant changes when comparing the experimental groups to the control group. The herbal complex preparation at a
dose of 1000 mg/kg increased the time spent in the dark area, decreased the time spent in the light area, and the number
of transitions between the two areas of mice in the dark/light transition test, and reduced the number of head-dipping into
the holes of mice in the hole-board test.
Conclusion
The herbal complex preparation exhibited low toxicity at doses of 1000 mg/kg and 1500 mg/kg based on
biochemical and histopathological examinations in the subchronic toxicity study. Furthermore, the preparation demonstrated sedative effects at a dose of 1000 mg/kg.
9.Study of the subacute toxicity and antibacterial activity of Phythonephro-SAN Preparation
Batdavaa B ; Maral-Erdene G ; Chimgee Ts ; Enkhmaa G ; Yeruult Ch
Mongolian Journal of Health Sciences 2025;85(1):173-178
Background:
Urinary tract infections (UTIs) are common, affecting 150 million people worldwide annually. It is estimated that 1% of the population suffers from urinary tract infections. The most common infections in kidney and urinary tract
are Escherichia coli, Staphylococcus saprophyticus, Klebsiella, Enterobacter and Proteus which account 80%, 5-15%
and 5-10%, respectively. Oxidative stress, inflammation, and apoptosis are critical factors involved in the pathogenesis
of kidney disease. Oxidative stress, a pathological condition characterized by an imbalance between reactive oxygen species (ROS) and the body’s antioxidant defenses, leads to cellular damage and is directly implicated in the initiation and
progression of acute kidney injury. Antioxidants serve a protective role by mitigating the harmful effects of free radicals
and oxidative stress on cellular structures. Drawing upon the extensive resources of medicinal plants and the therapeutic
practices of traditional medicine, plants rich in antioxidant compounds, including Dasiphora fruticosa (L.), Cynara scolymus (L.), and Rosa acicularis (L.), were selected for the development of the Phytonephro-SAN preparation. The phytochemical profile and nephroprotective properties of these plants have been investigated and validated. Moving forward,
further studies are warranted to assess the safety profile of the formulation, including comprehensive toxicity evaluations.
Aim:
To investigate and establish the subacute toxicity and antibacterial activity of the Phytonephro-SAN preparation.
Materials and Methods:
The subacute toxicity assessment of the Phythonephro-SAN preparation was conducted on
Wistar rats following the OECD-407 guidelines. The study of the antibacterial activity of the preparation was determined
by the broth dilution method.
Results:
The subacute toxicity assessment, evaluated through parameters such as body and organ weights and complete blood count (CBC), revealed no statistically significant differences between the groups administered the Phytonephro-SAN preparation at doses of 500 mg/kg and 1000 mg/kg, and the control group. According to the study of antibacterial activity, Phytonephro-SAN preparation has antibacterial activity at 90 mg/ml and 80 mg/ml doses.
Conclusion
The administration of the Phytonephro-SAN preparation to Wistar rats at doses of 500 mg/kg and 1000
mg/kg over 28 days did not result in mortality, and no significant changes were observed in body and organ weights or
CBC parameters. These findings support the conclusion that the preparation possesses minimal toxicity. Additionally, the
preparation demonstrated effective antibacterial activity against specific urinary tract pathogens at higher concentrations.
10.The Effect of “Hot Natured 3 Herbs” in a Tumor-Induced Model in C57BL/6 Mice
Narankhuu R ; Gansukh Ch ; Enkhsaikhan L ; Uranbileg B ; Enkhmaa D ; Odontuya G ; Chimgee Ts ; Ulziisaikhan B ; Enkhtushig G ; Sarantuya L ; Suvd O ; Amgalan B ; Sanjpurev D ; Tserendagva D ; Tsend-Ayush D ; Tserentsoo B
Mongolian Journal of Health Sciences 2025;87(3):44-53
Background:
Cancer incidence and mortality are steadily increasing both
globally and in Mongolia. As these rates rise, traditional Mongolian medicine
has long utilized herbal formulas for the treatment of gastric and esophageal
cancers and precancerous conditions. One such formulation—Hot Natured
3 Herbs (HN3H)—comprises three species from the Ranunculaceae family:
Atragene sibirica L., Ranunculus repens L., and Pulsatilla bungeana L.. However,
scientific validation of its anti-tumor effects is essential. This study aimed
to investigate the effect of HN3H in a tumor-induced animal model.
Aim:
To identify the biologically active compounds of HN3H and evaluate their
effect in an experimentally induced tumor model in animals.
Materials and Methods:
The three herbs comprising HN3H—Atragene sibirica
L., Ranunculus repens L., and Pulsatilla bungeana L.—were collected
during their flowering stage (May–June) in Khishig-Undur, Bulgan province,
and dried according to official procedures. Extraction was carried out by maceration
in 96% ethanol at a 1:10 ratio. The concentrated extract was suspended
in water (1:1) and successively fractionated with dichloromethane, ethyl
acetate, butanol, chloroform, and n-hexane. The study was approved by the
Research Ethics Committee of the Mongolian National University of Medical
Sciences (Protocol №2020/03-04). A colorectal cancer model was established
by subcutaneous injection of MC-38 cells (Kerafast, USA) into C57BL/6 mice.
Immunohistochemistry was performed using CK20, CDX2, Ki67, and p53 antibodies
at 1:100 and 1:200 dilutions.
Results:
The ethanol extract of HN3H contained 2.98±0.04% total phenolics
and 2.16±0.05% total flavonoids. Body weight and tumor volume were
measured daily with three repetitions. All groups showed a time-dependent
increase in body weight. Mice in groups 1A and 1B received ethanol extract at
50 and 100 mg/kg doses; groups 2A and 2B received dichloromethane extract
at the same doses. The negative control group was administered 0.5 mg/kg
PBS orally, while the positive control group received intraperitoneal injections
of 5-fluorouracil (5FU) at 10 mg/kg twice a week. Tumor growth increased in a
time-dependent manner across groups. Compared to the negative control, tumor
volumes in four treatment groups showed statistically significant reduction
(p˂0.05), while no significant difference was observed when compared to the
positive control (p=0.08). Histological analysis revealed necrosis in all groups,
with variation in extent.
Conclusion
The ethanol extract of HN3H exhibited moderate levels of phenolic
compounds and a high concentration of flavonoids. HN3H extract inhibited
tumor progression and activated lymphocyte-predominant inflammation in
tumor tissues, indicating potential anti-tumor activity (p˂0.05).