1.A systematic review: epidemiology, etiology and risk factors of stroke in young adults
Delgermaa Ts ; Juramt B ; Tsagaankhuu А
Mongolian Journal of Health Sciences 2025;88(4):6-14
Background:
The annual incidence of stroke in different regions of the world ranges from 100 to 336 per 100,000 pop
ulation, and mortality ranges from 36 to 136, and in Mongolia there are 220 new cases of stroke per 100,000 people and
113 deaths annually, making it one of the countries with the high stroke incidence rate.
Aim:
To conduct a systematic review of published sources on the epidemiology, causes, and risk factors of ischemic
stroke in young people.
Materials and Methods:
The research sources were searched using keywords such as “Stroke”, “Definition”, “Epidemi
ology”, “Etiology”, “Risk factors”, “Young Adult”, “Ischemia”, “Hemorrhage”, “Silent stroke” from the works published
in international platforms such as Cochrane Library, Datebase, Medline, PubMed, Google Scholar, and Web of Science,
and relevant information and data were selected from the collected sources and a review article was developed.
Results:
According to the WHO MONICA project report, stroke incidence was reported in 16 countries, with 101–285
men and 47–198 women per 100,000 people aged 35–64 years, while in the United States it was 113.8 per 100,000 peo
ple under 55 years, of which 73.1 were cerebral infarctions per 100,000 people, and more than 10 percent were under 55
years. A recent study in Mongolia found that 21–26% of stroke patients were young people (20-50 year old), compared
with 10–13% in Western countries. Among the traditional causes and risk factors for stroke in young people, arterial
hypertension accounts for 45-60%, smoking 40-60%, alcoholism 40-50%, heart disease 18-30%, dyslipidemia 30%,
diabetes 13%, obesity 7-36%; among the specific risk factors, migraine accounts for 10-35%, taking hormonal contra
ceptives 10-22%, vasculitis 6-10%, blood clotting disorders 2-10%, vascular dissection 6-40%. According to the TOAST
classification, large vessel disease accounts for 16-17%, small vessel occlusion 14-15%, cardiac embolism 19-20%, other
determined etiologies 22-23% and undetermined 26-27%.
Conclusion
Epidemiological indicators of stroke vary significantly depending on the level of development of the coun
try, geographical characteristics of the region, lifestyle, age, and gender (stroke incidence rate range: 100–336 per 100,000
population; mortality: 36–136 per 100,000 population). Mongolia is among the countries with high rates of stroke in
cidence and mortality (incidence rate 220 per 100 000, mortality 113 per 100 000 population). While stroke among
young people accounts for 10–13% of all cases in Western countries, this figure reaches 21–26% in Mongolia, which is
explained by a combination of traditional and specific risk factors. As stroke is becoming more common among younger
populations, it is essential to study its causes and risk factors in detail and to intensify efforts in diagnosis, treatment, and
prevention.
2.A study on risk factors of renal cell carcinoma
Ganbayar B ; ; Munkhtuya T ; ; Myagmarsuren P ; ; Bayan-Ondor D ; ; Amarsaihan S ; ; Shiirevnyamba A
Mongolian Journal of Health Sciences 2025;88(4):15-18
Background:
Studies from other countries have identified multiple contributing factors to renal cell carcinoma (RCC).
We conducted this study to investigate the relationship between RCC and certain risk factors among the Mongolian pop
ulation.
Aim:
To identify the risk factors for renal cell carcinoma in Mongolian individuals.
Material and Methods:
This case-control study included 88 patients diagnosed with RCC (confirmed by pathological
examination) in the case group. The control group consisted of 88 healthy individuals matched by age and gender. A
case-control study design was used. Binary logistic regression analysis was conducted on the questionnaire results from
both groups to identify risk factors for RCC through both univariate and multivariate regression analysis.
Results:
A total of 176 participants were included in the study-88 with RCC and 88 without cancer. Statistically signif
icant associations with RCC were found for hypertension, urinary tract diseases, alcohol consumption, and smoking.
Although weight gain appeared to increase the risk for RCC, this was not statistically significant.
Conclusion
Individuals with hypertension, a history of urinary tract diseases, smokers, and alcohol users are at a higher
risk of developing renal cell carcinoma.
3. Establishment and evaluation of a lung metastasis model of colorectal cancer in experimental animals
Anujin D ; Manaljav B ; Barsbold M ; Altanchimeg Ch ; Otgonsuren B ; Khuselt-Od T ; Suvd-Erdene U ; Enkhsaikhan L ; Gansukh Ch ; Juramt B
Mongolian Journal of Health Sciences 2025;88(4):19-23
Background:
Currently, colorectal cancer (CRC) ranks as the third most common cancer and the second leading cause
of cancer-related mortality worldwide. CRC frequently metastasizes to the liver (50%), lungs (10–15%), peritoneum
(4%), bones (10.7%–23.7%), brain (0.3%–6%), and spinal cord. Approximately 35% of CRC cases are diagnosed before
distant metastasis, 36% upon lymph node involvement, and 23% after distant organ metastasis. Although several studies
have established primary tumor models in mice in our country, there are limited studies on experimental lung metastasis
models, prompting the need for this research.
Aim:
To establish and evaluate a lung metastasis model of colorectal cancer in C57BL/6J mice using the MC38 cell line.
Materials and Methods:
This study was conducted at the Institute of Biomedical Sciences, Mongolian National Uni
versity of Medical Sciences. Approval was obtained from the Ethics Review Board of the Mongolian National Univer
sity of Medical Sciences (2023/3-09) and all laboratory safety regulations and protocols were strictly followed. Male
C57BL/6J mice bred at the Experimental Animal Center of Mongolian National University of Medical Sciences were
used. MC38 murine colorectal carcinoma cells were cultured and injected intravenously (via the tail vein) at a concen
tration of 0.25×10⁶ cells per mouse (n=12) to induce lung metastasis. Histological analysis was subsequently performed.
Results:
Histological examination revealed significant alterations in lung tissue architecture, characterized by areas of
dense infiltration by pleomorphic, hyperchromatic cells, disrupting the normal alveolar structure. No histological abnor
malities were observed in other organs.
Conclusion
Intravenous injection of MC38 colorectal adenocarcinoma cells into the tail vein of C57BL/6J mice success
fully induced lung metastases, characterized by hyperchromatic, pleomorphic cell infiltrates forming glandular structures
within the lung parenchyma.
4. Study of age and gender characteristics of patients treated for kidney stones in relation to disease risk at The First State Central Hospital
Sodgerel B ; Oyuntugs B ; Shiirevnyamba A
Mongolian Journal of Health Sciences 2025;88(4):24-27
Background:
Studies on the risk of kidney stone disease by age and gender show that the prevalence varies by countries
and regions, particularly influenced by the conutry development, population diet, etc. In our country, research on kidney
stones has been scarce over the past two decades.
Aim:
To study the age and gender characteristics of patients undergoing surgical treatment for kidney stones.
Materials and Methods:
Data from a total of 551 individuals who underwent surgical treatment at the Urology
Department of the First State Central Hospital over a six-month period (01.01.2024-06.01.2024) were analyzed. The age
and gender characteristics of patients diagnosed with kidney stones were studied, and logistic regression was used to test
the true probabilities. Statistical analysis was performed using SPSS 27 software, with a significance level set at 0.05.
Results:
Kidney stones were present in 12.5% of surgical patients (n=69), while other urological diseases accounted for
87.5% (n=482). The mean age of patients with kidney stones was 46.46±12.6 years, which is relatively younger compared
to patients with other urological surgical conditions (mean age=55.77, SD=16.174). Regarding the prevalence of kidney
stones by gender, females accounted for 56.5% and males 43.5%. Considering the gender distribution of all patients
receiving urological surgical care, females constituted 19.9% compared to 8.5% for males, nearly double the incidence.
According to logistic regression analysis, women had a 1.5-fold higher risk of developing kidney stones compared to men
(OR=1.5, 95% CI: 1.5–4.2, p<0.01). The highest prevalence was observed in the 36–55-year age group, while individuals
aged over 55 years had a significantly lower risk (OR=0.19, 95% CI: 0.10–0.39, p<0.001).
Conclusion
Kidney stones
were identified in 12.5% of individuals who underwent urological surgery. The majority of hospitalized patients with
kidney stones were aged 36–55 years, and women comprised 56.5% of these cases.
5.Effects of flavanone on cancer cells viability
Jadamba Ch ; Erdenezaya O ; Iderjavkhlan S ; Burnee M ; Gurbadam A ; Temuulen D ; Darambazar G ; Oldokh O ; Enkhmaa D ; Giimaa N
Mongolian Journal of Health Sciences 2025;88(4):28-32
Background:
In recent years, scientists have found that certain natural compounds have significant potential in cancer
prevention and early-stage cancer treatment. Flavanones, a class of polyphenolic compounds found in plants, vegetables,
seeds, fruit peels, and flowers, have been identified to possess anticancer, antioxidant, anti- inflammatory, and antibac
terial bioactivities. Cancer has become a major global challenge in terms of both economic and public health concerns.
Global statistics indicate that 22.8% of deaths are attributed to non-communicable diseases, and 16.8% are caused by
cancer, accounting for one in four and one in six deaths, respectively.
Aim :
To investigate anticancer effects of Iris Tenuifolia-derived flavanone on cancer cell lines.
Materials and Methods :
The study was conducted at the Bio-Medical Research Institute of the Mongolian National Uni
versity of Medical Sciences, investigating the effect of flavanones on cancer cell viability under in vitro conditions using
the MTT assay. In the study, colon, liver, and lung cancer cells were cultured, stabilized, and used for the experiments.
Colorectal cancer cells (MC38), liver cancer cells (HepG2), and lung cancer cells (A549) were revived, cultured, and
stabilized for use in the experimental procedures. Statistical analysis of the results was performed using Microsoft Excel
2010, and graphs were generated using GraphPad Prism 8. Differences between groups were analyzed using Student’s
t-test, and a p-value of <0.05 was considered statistically significant.
Results :
We treated MC38, HepG2, and A549 cancer cells with different concentrations of flavanone (2.5 µM, 5 µM, and
10 µM) for 24 to 48 hours to evaluate cell viability. Flavanone inhibited A549 cell viability by 2.5 μM-10%, 5 μM-25%,
and 10 μM-38%, respectively. For HepG2 cells, flavanone treatment at concentrations of 5-10 µM reduced cell viability
by 28–58%. No statistically significant effect on the viability of MC38 cells was observed following treatment with fla
vanone at concentrations ranging from 2.5 to 10 µM. Additionally, although MC38 inhibited cell viability in a dose-de
pendent manner in cell cultures, it had a statistically significant effect at higher concentrations of 30-200 μM (p<0.01).
Conclusion
Flavanone inhibits the cancer cell viability in a dose and time dependent manner
6.Diabetic Ketoacidosis and Associated Laboratory Abnormalities in New-Onset Type 1 Diabetes Mellitus
Azjargal B ; Khishigjargal B ; Erdenetuya G
Mongolian Journal of Health Sciences 2025;88(4):33-37
Background :
Diabetic ketoacidosis, an early and common complication at the initial diagnosis of Type 1 Diabetes Mel
litus (T1DM), remains a significant clinical concern. The high prevalence of this complication in the pediatric population
provided the rationale for conducting the present study.
Aim:
Our study aims to compare the incidence, clinical features, and physical measurements associated with diabetic
ketoacidosis (DKA) at the time of initial diagnosis of Type 1 Diabetes Mellitus (T1DM), and to classify the severity of
DKA based on selected laboratory findings.
Materials and Methods:
We conducted a retrospective observational study of newly diagnosed T1DM with DKA in
children aged less than 18 years old at National Center for Maternal and Child Health during the period 2017-2022. The
study compared the analysis of medical and laboratory records from patients medical charts. The severity of diabetic ke
toacidosis (DKA) was classified based on laboratory criteria according to the 2022 guidelines of the International Society
for Pediatric and Adolescent Diabetes (ISPAD). The study data were analyzed using STATA-16.0.
Results:
During the period from 2017 to 2022, a total of 124 children under 18 years of age (mean age: 9.11±3.84 years)
were newly diagnosed with T1DM and included in the study, of whom 67.7% (n=84) presented with diabetic ketoacidosis
(DKA). Of the children with DKA, 57.2% (n=48) had severe, 17.8% (n=15) had moderate, and 25.0% (n=21) had mild
severity. Girls were more frequently affected (67.1%, n=47; p=0.871). Having a viral infection before the first diagnosis
of type 1 diabetes (51.2%, n=43, p=0.011) and having high blood glucose levels at that time (25.8±9.32 mmol/l, p=0.012)
were statistically significantly associated with diabetic ketoacidosis. The blood gas analysis of children with ketoacido
sis showed pH 7.05±0.15, HCO3 8.68±4.27 mEq/l, and the group with severe ketoacidosis had higher blood potassium
levels (4.08±0.8 mEq/l, 3.6±0.56 mEq/l, p=0.049) and blood glucose levels (28.37±9.23 mmol/L, 21.96±9.18 mmol/L,
p=0.012) compared to the group with mild ketoacidosis.
Conclusions
1. Diabetic ketoacidosis (DKA) was identified in 67.7% (n=84) of the children included in the study.
2. At the initial diagnosis of Type 1 Diabetes Mellitus (T1DM), vomiting and fatigue were the predominant clinical manifestations of DKA.
3. Severe DKA was observed in 57.1% (n=48) of the participants, with elevated serum potassium and glucose levels
noted as contributing factors to the severity of ketoacidosis.
7.Technologycal study of preparing tablet formulations from hepaclin-4 prescription
Otgontsetseg B ; Khuslen M ; Byambasuren G ; Tserendolgor B
Mongolian Journal of Health Sciences 2025;88(4):38-41
Background:
As of 2024, digestive system diseases rank fourth among the causes of mortality in Mongolia. Among
these, hepatocellular carcinoma (liver cancer) accounted for 20,501 deaths, leading in total mortality rates. In Traditional
Mongolian Medicine, Scutellaria baicalensis Georgi is used to cool blood heat, clear internal heat, and regulate imbal
ances; Saussurea amara L. is used for its antibacterial, anti-infective, and anti-inflammatory properties; Carthamus tinc
torius L. serves for disinfection, pain relief, fever reduction, and detoxification; and Chiazospermum erectum L. is used to
eliminate toxic heat and febrile conditions. Studies have confirmed that the Hepaclin-4 formulation exhibits antioxidant,
membrane-stabilizing, hepatoprotective, anti-necrotic, detoxifying activities, and reduces the accumulation of harmful
byproducts from excessive peroxidation. Therefore, developing a solid dosage form from the raw herbal materials of
Scutellaria baicalensis Georgi, Saussurea amara L., Carthamus tinctorius L., and Chiazospermum erectum L.in the He
paclin-4 formula forms the basis of our research.
Aim:
To formulate and develop a tablet dosage form based on the compound prescription of Hepaclin-4
Materials and Methods:
The raw materials of Scutellaria baicalensis Georgi, Saussurea amara L., Carthamus tinctorius
L., and Chiazospermum erectum L.were weighed at a 1:1:1:1 ratio and extracted with 40% ethanol at a 1:10 ratio using
the remaceration method. Ethanol was evaporated using a vacuum evaporator to obtain a thick extract, and quality indi
cators were determined. From the obtained thick extract, granules were prepared using two types of excipients through
the wet granulation method, and their quality characteristics were studied. Based on the most suitable granules, tablet
and capsule dosage forms were prepared and standardized according to the methods outlined in the Mongolian National
Pharmacopoeia.
Results:
The Hepaclin-4 tablets were found to be round, well-formed, smooth, with intact edges, a slight characteristic
odor, no unpleasant taste, and light yellow in color. The friability resistance of the 0.5 g tablet was 99.6±0.08%, hardness
was 1.07±0.12 MPa, weight variation ranged from -2.6% to +3.9%, all within the acceptable 5% limit. The disintegration
time was 4.23±0.05 minutes, and dissolution was 95.4±0.47%, meeting the permissible standards. When flavonoids in the
tablets were detected by Thin Layer Chromatography (TLC), brownish-yellow spots appeared at Rf values identical to
standard quercetin (Rf=0.94) and rutin (Rf=0.48). The total flavonoid content, determined by Spectrophotometric Method
(SPM), was 0.165±0.01%.
Conclusion
Tablets were successfully developed from the thick extract of the Hepaclin-4 herbal compound. Upon eval
uation, the tablets met all the required technical specifications.
8.Results of Using Mineral Spray in children 2-16 years of age with Atopic Dermatitis
Minjinsuvd B ; Enkhtur Ya ; Dugarmaa U
Mongolian Journal of Health Sciences 2025;88(4):42-46
Background:
Atopic dermatitis (AD) is a common chronic and relapsing inflammatory skin disease in young children,
clinically characterized by pruritus and skin rashes. Epidemiological studies have reported that AD affects 5–30% of
children and 1-10% of adults worldwide. In recent years, the use of mineral waters for the treatment of chronic skin con
ditions has become increasingly popular globally. Although mineral waters, particularly from Shargaljuut springs, have
been traditionally used in Mongolia for various dermatological conditions, no studies have been conducted on their use in
atopic dermatitis, providing the rationale for this study
Aim:
To evaluate the result of Shargaljuut mineral spray on disease severity, pruritus intensity, and selected physiological
parameters of the skin in children with atopic dermatitis.
Materials and Methods:
This clinical trial study with a placebo-controlled group included children aged 2-16 years with
AD. The participants were treated with Shargaljuut spray and the clinical assessment was conducted before and after the
treatment, evaluating severity using SCORAD (Severity Scoring of Atopic Dermatitis), itching intensity using VAS (Vi
sual Analog Scale), skin hydration (SCH) and transepidermal water loss (TEWL).
Results:
Among all participants, 81.7% (n=49) had mild atopic dermatitis based on SCORAD scores, and 18.3% (n=11)
had moderate severity. According to the VAS scores, 40% (n=24) of the participants reported mild pruritus. Skin hydration
was found to be severely decreased in 96.7% (n=58) of the cases, while TEWL values were within normal limits in 76.7%
(n=46). Statistically significant differences were observed between the experimental and control groups at day 30 in terms
of disease severity and pruritus intensity, as well as in certain skin physiological parameters (p=0.001, p=0.002). Within
the experimental group, statistically significant differences were also detected in disease severity (p=0.001), pruritus
intensity (p=0.002), skin hydration (p=0.002), and TEWL (p=0.001) between baseline, day 15, and day 30. A correlation
was found between transepidermal water loss (TEWL) and skin hydration (r=0.566, p=0.0001).
Conclusions
1. Among the children with atopic dermatitis (AD) included in the study, 81.7% (n=49) had a mild severity score
according to SCORAD, 40% (n=24) had mild itching intensity based on the VAS assessment, 96.7% (n=58) had
excessively dry skin, and 76.7% (n=46) showed good transepidermal water loss (TEWL) levels.
2. In the experimental group, comparisons of disease severity, itching intensity, skin hydration, and TEWL levels be
fore and after the use of the Shargaljuut spring water spray revealed that skin hydration increased, TEWL decreased,
and both disease severity and itching intensity were reduced following treatment
9. Impact of Individual Temperament on the Immune Response After COVID-19 Vaccination
Burenjargal B ; Dashpagam O ; Shatar Sh ; Khongorzul T ; Ariunzaya B ; Zolmunkh N ; Gansukh Ch ; Ulziisaikhan B ; Chimidtseren S ; Baasanjargal B ; Enkh-Amar B ; Nomin-Erdene Ts ; Davaalkham D ; Tsogtsaikhan S ; Batbaatar G
Mongolian Journal of Health Sciences 2025;88(4):47-51
Background:
The first confirmed case of COVID-19 in Mongolia was reported on November 11, 2020. In response, the
government imposed a nationwide lockdown, which significantly impacted the population’s mental health. Heightened
levels of stress, anxiety, loneliness, and depression during the pandemic altered individuals’ psychological stability and
behavior. Personality traits—defined as relatively stable patterns of emotion, cognition, and behavior—play a key role in
stress responses and emotional regulation under pressure. Emerging evidence suggests that these psychological factors
may influence the immune system’s responsiveness, including vaccine-induced antibody production.
Aim:
To evaluate the association between post-vaccination antibody responses and personality types following two doses
of COVID-19 vaccines.
Materials and Methods:
A total of 738 participants who received two doses of COVID-19 vaccines (AstraZeneca
ChAdOx1, n=29; Pfizer-BioNTech, n=119; Sinopharm BBIBP, n=590) and had no prior SARS-CoV-2 infection were
enrolled. Serum samples were collected 21–28 days after the second dose, and SARS-CoV-2 RBD (S) IgG antibodies
were measured using ELISA (Proteintech Inc., USA). Personality types were assessed using a 56-item temperament
questionnaire developed by A. Belov, categorizing individuals into classical temperament types (choleric, phlegmatic,
sanguine, melancholic). Logistic regression and ROC analysis were used to examine associations between personality
types and antibody response.
Results:
The presence of an antibody response was significantly higher among individuals with a melancholic tempera
ment, and significantly lower among those with a phlegmatic temperament. Furthermore, antibody titers were higher in
participants with melancholic and sanguine temperaments and lower in those with a phlegmatic type.
Conclusions
1. During the early period following the second dose of COVID-19 vaccination, the antibody response was higher
in individuals with a pure melancholic temperament, while it was lower in those with a phlegmatic temperament.
2. After the second dose of the Sinopharm BBIBP COVID-19 vaccine, antibody titers were higher in individuals with
pure melancholic and sanguine temperaments, and lower in those with a phlegmatic temperament.
10.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 min
utes. 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.