Background: Traditional medicine has long utilized herbal and animal-derived materials worldwide, and traditional formulations for the management of male sexual dysfunction continue to be actively investigated. This study aimed to investigate the chemical composition and antioxidant effects of Anti-Impotence-4, an herbal–animal formulation, in an experimental model of chronic stress-induced erectile dysfunction (ED). Aim: To investigate the bioactive compounds present in the plant- and animal-derived formulation Anti-Impotence-4 and its effects against oxidative stress. Materials and Methods: Fifty-eight male Wistar rats were randomly divided into six groups, including healthy control, disease control, reference, and treatment groups. Chronic stress was induced once daily for 56 days using a random stress protocol, as described by Peng Zou (2019). Oxidative stress parameters were determined using ELISA. The chemical constituents of the methanolic extract of Anti-Impotence-4 were analyzed using ultra-performance liquid chromatogra phy–mass spectrometry (UPLC–MS) in both positive and negative ionization modes. Results: In an experimental model of erectile dysfunction induced by chronic stress, treatment with Anti-Impotence-4 led to a dose-dependent attenuation of oxidative damage. Specifically, levels of the DNA oxidation marker 8-hydroxy-2′-de oxyguanosine (8-OHdG) were reduced by 13.3–32.5% following administration of Anti-Impotence-4 at doses of 42, 84, and 210 mg/kg. Likewise, malondialdehyde (MDA) concentrations decreased by 7.9–23.7% at therapeutic doses (p<0.05). In contrast, antioxidant defense mechanisms were markedly enhanced, as evidenced by significant increases in superoxide dismutase (SOD) activity (34.1%, 38.1%, and 44.6%, respectively; p<0.05) and glutathione (GSH) levels, which rose by 37.0–55.4%. Biological substances identified a total of 10 compounds, including six amino acids, flavo noids, and iridoids, in the positive ion mode. In negative-ion mode, 18 bioactive compounds were detected, including amino acids, carbohydrates, organic acids, fatty acids, flavonoids, and phenolic compounds. Conclusion Phytochemical analysis of the methanolic extract of the Anti-Impotence-4 formulation demonstrated the presence of diverse bioactive constituents, including amino acids, purine derivatives, nucleosides, carbohydrates, organic and fatty acids, flavonoids, phenolic compounds, and iridoids. In a chronic stress-induced erectile dysfunction model, treatment with Anti-Impotence-4 significantly enhanced antioxidant defense by increasing superoxide dismutase and glutathione levels, while markedly reducing oxidative stress markers such as 8-hydroxy-2′-deoxyguanosine and malond ialdehe indicating significant antioxidant and protective effects.

Background: According to classical sources of Traditional Mongolian Medicine, the Mana-4 decoction clears internal heat and fever, alleviates febrile and infectious diseases, resolves pale-brown Badgan disorders, and alleviates severe pneumonia. Chimedragchaa.Ch. et al. (2002) demonstrated that Mana-4 possesses heat-clearing, anti-inflammatory, and immunomodulatory effects. Chronic Fatigue Syndrome (CFS) is a disorder characterized by clinical manifestations including physical exhaustion, low-grade fever, headache, mood fluctuations, cognitive impairment, and sleep disturbances. In recent years, as the pace of modern life and workload have increased, physical, psychological, and mental stress have intensified, leading to dysregulation of the nervous and endocrine systems, impaired immune function, and a rising global prevalence of CFS—a trend that has attracted increasing attention from researchers worldwide. However, the etiology and pathogenesis of CFS remain incompletely understood, and effective, evidence-based treatments continue to be sought. Therefore, we developed Immunoflu soluble granules, derived from the constituents of Mana-4, and this study aimed to investigate its anti-fatigue effects, as no such investigation had previously been conducted. Aim: To evaluate the anti-fatigue effect of Immunoflu, a formulation derived from the traditional Mana-4 decoction widely used in Traditional Mongolian Medicine. Materials and Methods: A chronic-fatigue rat model was established by forced-swimming induction, following the method of Jia Wang et al. (2013). The behavioral effects of Immunoflu were assessed using the open-field test (locomotor activity) and the elevated plus-maze test (anxiety-related behavior). Result: Immunoflu was administered at 100, 200, and 400 mg/kg to evaluate its effects in a chronic-fatigue model. In the open-field test, no significant difference (p>0.05) in central-zone entries was observed between Immunoflu and the model control. However, vertical locomotor activity increased significantly: Immunal 50 mg/kg +80.4% (p=0.024), Immunoflu 100 mg/kg +82.6% (p=0.003), and 200 mg/kg +77.4% (p=0.035). From these findings, Immunoflu at 100 and 200 mg/kg clearly enhanced locomotor activity in rats with chronic fatigue. In the elevated plus-maze test, Immunal 50 mg/kg increased the time spent in the central zone (10×10cm) by 53.3% (p=0.021) and in open arms by 61.4% (p=0.032) compared with the model control. Although Immunoflu produced no significant changes (p>0.05) in central-zone entries or time spent in the central zone, the time spent in the open arms increased by 60.6% at 200 mg/kg (p=0.026), indicating a reduction in anxiety and improved behavioral response to stress. Conclusion In a forced-swimming–induced chronic-fatigue model, Immunoflu increased locomotor activity by 77.4–82.6% at 100 and 200 mg/kg, reduced anxiety by 60.6% at 200 mg/kg, and reduced behavioral despair and fatigue by 35.3% at 100 mg/kg.

Background: Diabetes mellitus accounts for 42.9% of endocrine and nutritional metabolic diseases in Mongolia, with a prevalence of 111.4 cases per 10,000 population. This represents a 28.5% increase compared with the previous year (82.9 cases per 10,000 population in 2019), indicating a continuing upward trend in the prevalence of diabetes mellitus. In Mongolian traditional medicine, Sapparin tablets are used to treat blood disorders and liver diseases. The formulation contains four major herbal ingredients: C. jubata, C. sappan, Z. officinale, and H. rhamnoides. Aim: To study the effects of Sapparin in a high-fat diet and low-dose streptozotocin-induced diabetic model in experimental rats. Materials and Methods: We used 40 Wistar rats to establish a type 2 diabetes mellitus (T2DM) model according to the method described by Bailu Duan et al. (2017). The rats were fed a high-fat diet for 28 days, followed by an intraperitoneal injection of streptozotocin (STZ) at 35 mg/kg to induce T2DM. After STZ administration, Sapparin was orally administered to diabetic rats at 89 and 178 mg/kg for 21 days. At the end of the experimental period, insulin, GLUT4, superoxide dismutase (SOD), and glucagon-like peptide-1 (GLP-1) levels were determined using enzyme-linked immunosorbent assay (ELISA) according to the manufacturer’s instructions on days 14 and 21. Result: After 14 and 21 days of treatment, fasting blood glucose levels decreased by 33% and 22.5% in the Sapparin 89 mg/kg and 178 mg/kg groups, respectively, compared with the diabetic control group (p=0.05). In the glucose tolerance test, the 89 mg/kg Sapparin-treated group showed a 31% increase in glucose levels at the initial measurement compared with the diabetic control group, followed by decreases of 10% at 30 min and 30% at 120 min (p=0.04). Serum insulin levels in the 89 mg/kg Sapparin group decreased by 20% on day 14 and 19.8% on day 21 compared with the diabetic control group, while the 178 mg/kg group showed decreases of 15% and 20%, respectively, approaching the levels observed in the healthy control group (p=0.05). Furthermore, HOMA-IR decreased by 42–46% over time in both the 89 and 178 mg/ kg Sapparin-treated groups, with statistically significant differences observed (p=0.05). Conclusion In a rat model of type 2 diabetes mellitus, Sapparin reduced blood glucose levels, serum insulin levels, and insulin resistance (HOMA-IR), and may have a positive effect on lipid metabolism.

Background: Polymyositis (PM) is a rare idiopathic inflammatory myopathy characterized by symmetric proximal muscle weakness, elevated muscle enzyme levels, dysphagia, and respiratory muscle weakness. Rhabdomyolysis is a potentially life-threatening condition caused by extensive skeletal muscle breakdown, resulting in myoglobinuria and an increased risk of acute kidney injury and multiorgan complications. The coexistence of rhabdomyolysis in patients with polymyositis is uncommon and may complicate both diagnosis and management. Case Presentation: A 65-year-old man was admitted with fever up to 39°C, generalized skin rash, dysphagia, progressive muscle weakness, dyspnea, decreased urine output, and dark tea-colored urine. Physical examination revealed symmetric proximal muscle weakness, with muscle strength graded 3/5 in both upper extremities and 4/5 in both lower extremities. Neck muscle strength was 4/5. Dysphagia and a generalized skin rash were also present. Laboratory investigations showed markedly elevated creatine kinase (CK) at 9,943.1 U/L, alanine aminotransferase (ALT) at 449.1 U/L, aspartate aminotransferase (AST) at 222.1 U/L, lactate dehydrogenase (LDH) at 1,342.9 U/L, and C-reactive protein (CRP) at 70.6 mg/L. Urinalysis showed blood 3+ and protein 2+, while no erythrocytes were detected on urine sediment microscopy. Electromyography demonstrated myopathic changes, and muscle biopsy revealed inflammatory infiltrates and necrotic muscle fibers. Conclusion Comprehensive assessment of clinical manifestations, laboratory findings, autoantibody testing, electrophysiological studies, and muscle biopsy is essential for the diagnosis of polymyositis complicated by rhabdomyolysis. An integrated diagnostic approach facilitates confirmation of the diagnosis, differentiation from clinically similar disorders, and appropriate treatment selection. Early recognition of rhabdomyolysis and other potentially life-threatening complications is crucial for preventing organ damage and improving patient outcomes.

Background: Respiratory diseases remain among the top five leading causes of morbidity, with an incidence rate of 788.4 cases per 10,000 population in 2021. Among these, acute bronchitis accounts for 9.3%. According to international clinical guidelines for the diagnosis and treatment of adult acute bronchitis, symptoms usually resolve spontaneously within 1–3 weeks, but they considerably reduce the patient’s quality of life. Therefore, Colsaurin syrup, a new natural formulation with analgesic and anti-inflammatory effects, was clinically investigated to assess its efficacy and safety. The introduction of this domestically produced herbal medicine into clinical practice is expected to have both medical and socioeconomic significance by expanding the range of national pharmaceutical products. Aim: To evaluate the effect of Colsaurin syrup on the quality of life in adults diagnosed with acute bronchitis. Materials and Methods: This study was a randomized, double-blind, placebo-controlled clinical trial conducted among inpatients at Songinokhairkhan District General Hospital, Ulaanbaatar. Adult patients diagnosed with acute bronchitis (J20) who met the inclusion criteria and provided informed consent were enrolled. Participants were randomly assigned to either the Colsaurin or placebo group. Result: In the Bronchitis Severity Score (BBS) assessment, baseline mean scores indicated severe disease: 10.88±2.47 in the Colsaurin group and 10.67±2.16 in the placebo group. After treatment, scores decreased significantly to 3.50±1.41 (p<0.001) in the Colsaurin group and 5.00±2.24 (p=0.006) in the placebo group, indicating greater improvement in the Colsaurin-treated patients. In the Visual Analog Scale (VAS) assessment, the mean pre-treatment score for both groups was 7, corresponding to frequent cough, which decreased to 2 after treatment (p<0.05), representing a 28% reduction in coughing discomfort. In the Cough and Sputum Assessment Questionnaire (CASA-Q), the Colsaurin group showed a 3.25-point reduction after treatment, indicating a significant decrease in cough frequency and triggering factors (p<0.05). Conclusion 1. In patients diagnosed with acute bronchitis (J20), treatment with Colsaurin syrup reduced disease severity by 30% and alleviated cough-related discomfort by 28% compared to baseline. 2. Moreover, patients reported improved sleep quality and work capacity, reflecting an overall enhancement in quality of life. 3. No adverse effects were observed in the Colsaurin treatment group.

Background: Chronic Fatigue Syndrome (CFS) is a poorly understood disorder of unknown etiology, characterized by clinical manifestations including physical exhaustion, low-grade fever, myalgia, dizziness, mood fluctuations, cognitive impairment, and sleep disturbances. CFS is highly prevalent and frequently comorbid with psychiatric conditions, particularly depression and anxiety. Symptoms exacerbate during physical or mental exertion and do not completely resolve with rest. Currently, there is a lack of proven, effective pharmacological treatments for CFS. Therefore, this study aimed to investigate the anti-fatigue effects of Immunoflu. Aim: To evaluate the anti-fatigue effects of Immunoflu, a technologically modernized formulation derived from the traditional Mana-4 decoction. Materials and Methods: A chronic fatigue rat model was established using the forced-swim protocol described by Jia Wang and Chengxin Sun (2013). The pharmacological effects of Immunoflu were evaluated by quantifying serum levels of cytokines (IL-1β, IL-2, IL-5, IL-10, and IL-17a) by ELISA and assessing behavioral despair using the forced swim test (FST). Results: We evaluated how Immunoflu affects the chronic fatigue model at doses of 100, 200, and 400 mg/kg by measuring serum levels of IL-1β, IL-2, IL-5, IL-10, and IL-17a and assessing despair using the “Forced swim test”. In the forced-swimming-induced chronic fatigue model in rats, Immunoflu at a dose of 100 mg/kg increased the serum IL-2 indicator by 23.8%, and Immunal at a dose of 50 mg/kg increased it by 23.3% compared to the model control group, a statistically significant difference (p < 0.05). Furthermore, Immunoflu at 200 mg/kg reduced IL-17a cytokine levels by 23.7% compared with the model control group. When evaluating the swimming state of the animals with the Forced swim test, the group given Immunal 50 mg/kg (52.03±9.3 sec) decreased by 31.6% (*p=0.038), and the group given Immunoflu 100 mg/kg (49.19±8.54 sec) decreased by 35.3% (*p=0.01) respectively compared to the model control group, while no statistically significant difference was observed in other groups. Conclusions 1. Immunoflu at 100 mg/kg demonstrates immunostimulatory effects in a chronic fatigue model by increasing serum IL-2 levels by 23.8%. Additionally, at 200 mg/kg, it exhibits anti-inflammatory properties, reducing IL-17a levels by 23.7%. 2. In the forced-swimming model, Immunoflu at 100 mg/kg effectively reduced behavioral despair and physical fatigue by 35.3%.

Background: Onion peel is a raw material rich in biologically active compounds; however, within the framework of food waste management in Mongolia, detailed studies and safety evaluations of this material remain insufficient. Therefore, it is necessary to scientifically determine the properties of onion peel waste generated from the food production sector and explore its potential for reuse. Aim: To evaluate the safety parameters of red and white onion (Allium cepa L.) peels generated during food processing and to determine their bioactive compound content and antioxidant activity. Materials and Methods: Red and white onion peels were used in this study. Safety parameters were determined using atomic absorption spectrometry (for heavy metals) and GC-MS/MS and LC-MS/MS (for pesticide residues). The raw materials were extracted with 70% ethanol, and dry extracts were obtained using a vacuum evaporator and freeze dryer. Total phenolic content (TPC) and total flavonoid content (TFC) were measured by spectrophotometric methods, while antioxidant activity was evaluated using the DPPH radical scavenging assay. Results: The analysis showed that the levels of lead, cadmium, and 205 pesticide residues in onion peels did not exceed the permissible limits, indicating that the material is safe. Phytochemical analysis revealed the presence of quercetin and luteolin derivatives in the dry extracts. The TPC (27.40±1.64%) and TFC (17.95±1.47%) of red onion peel extract were significantly higher than those of white onion peel extract (20.34±0.34% and 12.69±1.44%, respectively). The IC₅₀ values were 17.58 μg·mL⁻¹ for red onion and 19.41 μg·mL⁻¹ for white onion, indicating strong antioxidant activity for natural composite extracts. Conclusion Onion peel waste meets safety requirements and exhibits strong antioxidant activity. These findings demonstrate its potential as a valuable raw material for the development of antioxidant preparations and functional food additives aimed at preventing oxidative stress.

Background: In traditional medicine, Jur Ur-4 Tang, which is widely used for the treatment of diabetes, has been technologically processed and transformed into a modern pharmaceutical form as soluble granules. Therefore, it is essential to evaluate the pharmacological effects of the soluble granules derived from Jur Ur-4 Tang. Aim: To study the effect of granules extracted from Jur ur-4 Tang in a model of type 2 diabetes mellitus in experimental rats. : Materials and Methods : T2DM in rats was induced by a high-fat diet and a low-dose streptozotocin (STZ 35 mg/kg). Then, oral gavage administration of three different doses of Granule (450 mg/kg, 900 mg/kg) was given to T2DM rats. Experimental results showed that Granule dramatically reduced the levels of fasting blood glucose, fasting blood insulin, and GLUT4. Results:: In the glucose tolerance test, granules at doses of 450 and 900 mg/ kg significantly reduced blood glucose levels at 60 and 120 minutes (p < 0.01). Additionally, the soluble granules at all tested doses significantly decreased blood insulin levels and increased GLUT4 expression (p<0.01). Conclusion The granules lower blood glucose levels.

Background: Patients with rheumatoid arthritis are at increased risk of developing cardiovascular disease. In Mongolia, the registration of inflammatory diseases is increasing every year, and cardiovascular diseases are the leading cause of death. Aim: We aimed to determine the degree of cardiovascular risk and its correlation in people with rheumatoid arthritis. Materials and Methods: The study was conducted in a cross-sectional study design with 64 patients with rheumatoid arthritis between May and November 2024. Cardiovascular risk was assessed using mSCORE and the World Health Organization (WHO) cardiovascular Risk Table. We received ethical approval to begin the research at the MNUMS meeting on May 17, 2024 (No. 2024/3-05). Results: The average age of the participants was 55.2±9.7 years, and the average duration since being diagnosed with RA was 9.8±8.0 years. Among the participants, 82.8% (n=53) were female, and 17.2% (n=11) were male. The mean WHO risk index was 10.25±11, while the mean mSCORE risk index was 2.9±4 (p=0.001). There was a significant difference in mSCORE scores between the 40-55 and 56-65 age groups (p<0.001). In contrast, the mSCORE risk assessment showed that 15.6% (n=10) had high risk, and 6.3% (n=4) had very high risk. Among the parameters of inflammatory biomarkers, CRP (OR=0.05, r=0.35, 95% CI 0.9-3.2, p=0.004) has a statistically significant difference and positive correlation, and HDL-C (OR=2.3, r=-0.25, 95% CI 2.9- 10.0, p<0.0001) was significantly different and negatively correlated. Conclusion A total of 64 participants participated in our study, and according to the WHO assessment, 17.2% were at high or very high risk of developing cardiovascular disease in the next 10 years, and according to the mSCORE, 21.9% were at high or very high risk of developing cardiovascular disease. Although the degree of disease activity was not significantly associated with cardiovascular risk, the inflammatory biomarker C-reactive protein was statistically significantly different or positively associated with cardiovascular risk assessment.

Objective: Colony-stimulating factor 1 receptor-related leukoencephalopathy (CSF1R-L) is a rare adult-onset leukoencephalopathy. Reports of CSF1R-L patients from the Indian subcontinent remain limited. We aimed to report four patients with genetically confirmed CSF1R-L from four Asian Indian families and described their clinical, molecular, and radiological features. Methods: All patients underwent clinical examination, brain magnetic resonance imaging, and whole-exome sequencing to identify causative variants in the CSF1R gene. We also reviewed published reports of Indian patients with CSF1R-L. Results: The age at enrollment ranged from 34 to 40 years. The duration of symptoms ranged from 11 months to 2 years. The chief clinical phenotype in three patients was a rapidly evolving cognitive-behavioral syndrome combined with atypical parkinsonism, and asymmetrical spastic tetraparesis was observed in one patient. We identified four different variants (three missense variants and one in-frame deletion). Radiological findings revealed white matter involvement and diffusion restriction involving the subcortical white matter and pyramidal tracts. Conclusion We expand the literature on CSF1R-L patients from India by reporting four new cases.