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A systematic review: epidemiology, etiology and risk factors of stroke in young adults

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 people 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 contraceptives 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 country, 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 incidence 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.

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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 population. 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 significant 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.

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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 University of Medical Sciences. Approval was obtained from the Ethics Review Board of the Mongolian National University 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 concentration 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 abnormalities were observed in other organs. Conclusion Intravenous injection of MC38 colorectal adenocarcinoma cells into the tail vein of C57BL/6J mice successfully induced lung metastases, characterized by hyperchromatic, pleomorphic cell infiltrates forming glandular structures within the lung parenchyma.

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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.

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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 antibacterial 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 flavanone 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

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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 ketoacidosis (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 ketoacidosis 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.

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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 imbalances; Saussurea amara L. is used for its antibacterial, anti-infective, and anti-inflammatory properties; Carthamus tinctorius 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 indicators 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.

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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 conditions 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 (Visual 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 before 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

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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 temperament, 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.

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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.

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