Introduction: 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 determine the prevalence, red blood cell morphology, and severity of anemia among adults. Method: 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. Result: Overall, (6.7%) of participants were anemic: (9.9%) of women and (2.8%) of men. The distribution by severity was: mild anemia (66.7%), moderate anemia (30%), and severe anemia (3.3%). Among women of reproductive age, prevalence was higher, whereas in men, anemia prevalence increased with age. Regionally, the Central region showed the highest prevalence, while other regions varied. Analysis of anemia by red blood cell morphology showed that normocytic anemia accounted for (51.6%), hypochromic anemia 66%, and mean hemoglobin concentration hypochromic (53.6%). Moderate and severe anemia was more common in women than men. 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.

Background: Spinal muscular atrophy (SMA) is a degenerative neuromuscular disease that causes progressive muscle weakness and atrophy due to the loss of the motor neurons. Approximately 95% of patients with SMA are homozygous for the deletion of SMN1 exon 7. With an incidence of 1/10.000 and a carrier frequency of 1/40 to 1/50, SMA is the most common genetic cause of death in infants. Purpose: To detect homozygous deletion of SMN1 exon 7 and to analyse the SMN1 copy number by molecular genetic analysis. Materials and Methods: In this study, 3 SMA patients with SMN1 gene homozygous deletion and 17 people of their relatives were included. Molecular genetic analysis was performed in the Central Scientific Research Laboratory of the Institute of Medical Sciences. DNA was extracted from peripheral blood, and its purity was assessed by spectrophotometer. Homozygous deletion of SMN1 gene was analyzed with allele-specific PCR, and the SMN1 gene copy number was evaluated by real-time PCR. Results: Among the five participants diagnosed with SMA by clinical symptom and electromyographic test, three cases were found to have homozygous deletion of exon 7 of the SMN1 gene, while two cases did not exhibit such mutation by the allele specific PCR analysis.
The mean age of study participants was 27.76±16.07 (ranging from 8 months to 52 years). Six of the 7 relatives of the first proband had 1 copy number of SMN1 (0.75±0.29) or were carriers of SMA, while one had 3 copy numbers (2.99) or no deletion of SMN1 gene. Additionally, 6 of the 7 individuals of the second proband had 1 copy number of the SMN1 gene (0.72±0.14), and 1 person had 2 copy numbers. All 3 relatives of the third proband had 1 copy number of SMN1 gene (0.96±0.37). Conclusion We consider that determination of SMN1 gene homozygous deletion and carrier testing can be performed by the PCR method locally. Further, it is necessary to implement the molecular genetic testing method into practice and to study the requirements and needs of early detection of SMA in the newborn screening program of Mongolia.

Background: Specifically, stomach cancer ranks as the fifth leading cause of cancer morbidity and mortality worldwide. Early-stage detection significantly improves survival rates, with over 90% of patients diagnosed at stages I and II living beyond five years. To improve the early detection of gastric cancer, it is necessary to complement the conventional method of endoscopic examination with biomarker analysis. We aimed to compare biomarkers such as pepsinogen C (PGC), matrix metalloproteinase 2 (MMP2), matrix metalloproteinase 9 (MMP9), and the cell proliferation marker Ki-67 with immunohistochemical analysis. Purpose: A comparative study and evaluation of biomarkers for the early detection of gastric cancer. Materials and Methods: The study was conducted using a retrospective cohort design. Research ethics issues were discussed at the meeting of the Medical Ethics Control Committee of the Ministry of Health on October 13, 2023, and permission to start the research was obtained (Resolution No. 23/051). The information was gathered based on the criteria for K29.3, K29.4, K31, and C1 diagnoses according to the international ICD 10 classification, and participants were selected accordingly. Proteins such as PGC, MMP2, MMP9, and Ki-67 were examined using a tissue microarray kit and evaluated through immunohistochemical analysis. Results: Negative gastric tumor markers PGC, Ki-67, MMP2 and MMP9 were evaluated by immunohistochemical analysis. The mean PGC protein staining values were 6.20±2.61 for chronic superficial gastritis, 5.45±2.47 for atrophic gastritis, 3.61±2.0 for metaplasia, and 3.31±1.75 for gastric cancer, with statistically significant differences between the groups (P<0.001). The mean Ki-67 protein staining values were 0.1 ± 0.4 for chronic superficial gastritis, 0.33 ± 0.55 for atrophic gastritis, 0.09 ± 0.39 for metaplasia, and 2.62 ± 0.78 for gastric cancer, also showing statistically significant differences (P<0.001). The mean MMP2 and MMP9 protein staining values were 0.2±0.76 and 1.2±2.04, respectively, for chronic superficial gastritis; 0.28±0.52 and 3.28±2.82 for atrophic gastritis; 0.35±1.04 and 1.12±1.45 for metaplasia; and 1.38±2.11 and 5.29±2.51 for gastric cancer, with all differences being statistically significant (P<0.001). Conclusion PGC protein, a negative tumor marker, decreases during the transition from a gastric cancer precursor to cancer. MMP2 protein, a marker of cell migration and metastasis, has little diagnostic value, while the expression of MMP9 and the Ki 67 are highly effective in gastric cancer. Immunohistochemical analysis of endoscopic biopsy tissue to detect the negative tumor marker PGC, the positive marker Ki-67, and MMP9 can be used for early detection of gastric cancer.

Background: To prevent and combat the spread of the COVID-19 pandemic, the Government of Mongolia has implemented measures such as movement and time restrictions, social distancing and isolation, closure of schools, kindergartens and public places, immunization, and others. It has caused adverse consequences for people, social relations, and the economy, causing health, social, economic, and humanitarian crises. Not only does this situation, medical students, as frontline healthcare workers, are more susceptible to virus infection. Vaccines against COVID-19 have been researched quickly due to the pandemic and are being used under emergency use authorization. In our country the approach of mixing vaccine doses from different manufacturers was used (fractional doses). Therefore, there is no study on the exposure of medical students to the COVID-19 infection and the adverse effects after receiving a dose of a heterologous vaccine. Objective: To study the exposure to the COVID-19 infection and vaccination status of medical students. Methods: The survey was conducted from November 2023 to December 2023 using a cross-sectional study design, and 170 students who study at ASUSU and live in the dormitory were included. Results: A total of 170 students participated in the study. 55.9% (n=95) of them were in the first year, 22.4% (n=38) were in the second year, 10% (n=17) were in the third year, 7.6% (n=13) were in the fourth year, 2.4% (n=4) were from the 5th year and 1.8% (n=3) were from the 6th year students. 88.2% (n=150) of students were female and 11.8% (n=20) were male. In this study, 37.1% of the students were infected by COVID-19 infection previously. Among them, 50% of the students were infected from family members, 16.7% from the school environment, and 15.2% did not know about the source of infection. 76.2% of the respondents were diagnosed with COVID-19 in a medical institution, and forty-one students answered that they were treated at the hospital. 83% of the cases were treated at home and were cured within 14 days. In contrast, 93.8% of the hospitalized students were treated within four months to 1 year. The current study demonstrates neurological, respiratory, sensory, cardiovascular, psychiatric, digestive, and dermatological symptoms were in 37.6%, 24.1%, 27.6%, 17.6%, 11.8%, 11.2%, and 10% of the students who participated in the study, respectively. For a year or more, symptoms of all organ systems were present, but neurological symptoms appeared to be the highest. 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine, 3.5% (n=6) did not receive the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects and 65% (n=106) had no side effects. Conclusion In this study, 37.1% of the students were infected by COVID-19 infection previously. According to the current study, symptoms related to the nervous system was the most prevalent and 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects.

Background: Spinal Muscular Atrophy (SMA), an autosomal recessive disorder characterized by lower motor neuron loss, leads to progressive muscle weakness and atrophy. With a neonatal incidence ranging from 1:6000 to 1:11000, individuals affected by SMA face challenges in locomotor function. The advent of newborn screening tests, early diagnostic techniques, and the introduction of gene therapy have, however, shown promise in enabling the acquisition of these motor skills. Objective: This review article seeks to shed a light on current understandings of the epidemiology, clinical presentations, diagnostic methods, and treatments for spinal muscular atrophy, highlighting cutting edge approaches within the discipline. Methods: A thorough search was conducted on PubMed, Cochrane, National Institutes of Health, and Web of Science databases for recent research articles concerning SMA’s incidence, prevalence, clinical manifestations, early detection, genetic testing and contemporary gene therapy. Results: The prevalence of SMA stands at 1-2 cases per 100,000 population, with an incidence of approximately 8 cases per 100,000 live births. Pre-1995 studies exhibited varying prevalence rates due to using non molecular-biological methods, small localized populations, diagnostic errors, and regional characteristics. Diagnosis involving Multiplex ligation-dependent probe amplification (MLPA), quantitative polymerase chain reaction (qPCR), or next-generation sequencing (NGS) analysis to confirm SMN1 and SMN2 gene status aids in identifying carriers and SMA subtypes. Countries implementing newborn screening programs have demonstrated early SMA detection in asymptomatic newborns, contributing to reduced mortality and disability rates. Currently, several types of gene therapy are being used in the treatment of SMA. Conclusion The epidemiology of SMA varies between countries and regions. It is fully possible to confirm the disease, identify carriers and subtypes. The inclusion of SMA in newborn early detection programs is crucial for reducing infant mortality and disability, and several gene therapies have received approval from relevant authorities for SMA treatment. In Mongolia, it is possible to introduce tests to confirm the disease and determine carriers and subtypes.

Introduction: During many decides, compounds derived from natural raw materials have demonstrated their effectiveness as therapeutic agents in different areas, such as metabolic disorder, immune system diseases and its regulations. Natural based products, like herbal medicines and minerals are implicated in the regulation of immune function. They control the immune system in a pleiotropic manner and participate in various processes of the adaptive/innate immunity. Therefore, natural raw material has great potential for targeted immune modulators, in the treatment of certain types of immunologic and inflammatory diseases, like rheumatoid arthritis, plaque psoriasis, ankylosing spondylitis and immune deficiency. The purpose of this survey was to study influence of “Shilajit +Golden Rosa” combined shot preparation named by Vitos on immune system in the experimental and preclinical circumstances. Goal: The purpose of this survey was to study influence of “Shilajit +Golden Rosa” Vitos shot preparation on immune system in the experimental and preclinical circumstances. Material and Methods: The immune deficiency was to created by Azathioprine through 5 days in the Balb/c mice after that control group, preparation of “Shilajit +Golden Rosa” Vitos shot were administrated appropriate doses by oral during 10 days. Then we collected blood and quantified amount of CD4+, CD8+, IgG and CD64 (Mouse Elisa Kit Assay: Catalog.No:WAM-568, Elisa Reader, 450 <b>нмb>, Melsin Medical Co.LTD, www. melsin.com) on the 5^th, 10^th days. Results: All statistical analyses were conducted with SPSS version 20.0 software (IBM, Armonk, NY). Oneway ANOVA was used to assess statistical significance between “Shilajit +Golden Rosa” Vitos shot group and days of observation. Mean values of CD4+, CD8+, CD4/CD8 ratio, IgG, CD64 levels determined in the control and sample group. CD4+, CD8+, CD4/CD8 ratio, IgG and CD64 levels were significantly increased in the “Shilajit +Golden Rosa” Vitos shot group compared with control group by 20.8-67.8 per cent (p<0.05, p<0.01). Conclusion It’s concluded that, “Shilajit +Golden Rosa” Vitos shot preparation shows immune-stimulator activity not only in the level of cellular (T cells:CD4+, CD8+) but also humoral immunity (B cells: IgG, CD64) in the previously using Azathioprine (75mg/kg) to provoke pathological model of immunosuppression

Abstract: Burn injury causes considerable incidence of disability, increase of hospitalization and rehabilitation. It is a crucial factor of morbidity and mortality, throughout the world, especially in the developing countries. Burn wound healing is a complex process including inflammation, granulation, and regeneration of the skin tissue. There are many animal and mineral derived agents applied for burn wounds treatment. For example, minerals and animal yellow marrow are applied as standard topical therapy in healing of burn wounds in the history. Specially, Mongolian camel’s (Camelus Bactrianus) yellow marrow and cinders have been used the healing effect standard topical antimicrobial for burn wounds for several centuries. The present study aimed to determine the healing effect of “CIBO” ointment with animal and mineral raw materials on third -degree burn wound in rats. Introduction: In our study, we selected an ointment containing a combination of yellow marrow and cinder. In ancient times, Mongolians used camel yellow marrow to relieve joint pain, spread people who had been bedridden for a long time due to the disease, and to prevent caries, and to use it on open wounds. In traditional medicine, cinder has been used as a mineral raw material and has been used to treat frostbite and burns. Material and methods: In the Vivar Department of the Pharmacology Sector of the Drug research institute, 18 Wistar white rats weighing 182-220 g fed in one environment for (12 hours a day/12 hour a night) were randomly selected and divided into the following groups. These are: negative control, Group 1 “Yellow marrow + Uvs black cinder”, Group 2 “Yellow marrow + Uvs brown red cinder”, Group 3 “Yellow marrow + Chinese red cinder”, Group 4 “Yellow marrow + Chinese white cinder”, Standard “Mebo” wound ointment. The wound area was prepared by scraping the hair 5 cm from the back of the test animal’s skull. The prepared area was sterilized with 70% ethanol and 10% iodine solution, resulting in a third-degree burn wound of 2.4 cm2. Wound experiential’s ointments were applied once daily for a total of 28 days, and wound healing was evaluated at 0, 3, 7, 14, 21, and 28 days after pathogenesis, with 16.1-pixel accuracy. Photo confirmed using a SONY brand camera. Result: “CIBO” ointment contains four deferent cinders which are from collected from deferent area and that have been shown to good affect burn wounds, and is more compatible with yellow marrow than Group 4 (Yellow marrow+Chinese white cinder).
Wound healing variables of control group compared with group 4 (Yellow marrow + Chinese white cinder) increased by 11.1% on the 3th day, 4% on the 7th day, 44.8% on the 14th day, and 54.5% on the 21st day. On the 28th day, healing and regeneration were accelerated by 50%. Conclusion The group 4 (Yellow marrow + Chinese white cinder) has been shown to have a pharmacological action of rapid healing and regeneration of burn wounds caused by experimental rats. It has also been shown to have pharmacological action to regenerate skin tissue and suppress inflammation caused by burns. Inclusion of Chinese white cinder in “CIBO” ointment promotes regeneration and healing of “CIBO” ointment.

Introduction: In Mongolia, there is opportunity to replace importing products by using raw materials based on the animal and minerals. Those products can be used for medical purposes.
In traditional medicine, yellow marrow has been widely used to treat burns and mechanical wounds, as well as frozen and open wounds. The purpose of this study was to determine the pharmacological action of “CIBO” ointment. We created a model of mechanical wound to evaluate the healing of wounds and its index after applying the ointment contains the above mentioned raw materials. Material and methods: Four different groups of “CIBO” ointment was prepared in the technology sector of the Drug Research Institute. Mebo wound ointment was used for comparison as control. The study was con- ducted in the Pharmacology Sector of the Drug Research Institute on white rats of the WISTAR breed under one feeding regime and one condition (12h / 12h). Mechanical wound injury and exposure to open wounds in experimental rats and its size were measured on the 3^rd, 7^th, 14^th, 21^st, and 28^th days of treatment. Wound healing, morphology, structure, size, and its index was quan- tified based on the defects. The ointment were applied once a day during the treatment period of 28 days to cover the wound. Result: Mechanical wound showed that study treatment group healed 0-6.2% on the 3^rd day, 21.4-35.7% on the 7^th day, 50-60% on the 14^th day, and 33.3-50% on the 21^st day separately compared with the untreated group. On the 28^th day, all the groups were decreased by 66.6%. The wound index was between from 0.002 to 0.0005 in the all experimental groups. Among experimented groups, the group consists of yellow marrow and Chinese white cinder was showed better performance than other groups. Conclusion The study group 4 (Yellow marrow + Chinese white cinder) has been showed to have a pharmacological action of rapid healing and regeneration of burn wounds caused by experimental rats. It has also been shown to have pharmacological action to regenerate skin tissue and suppress caused by mechanicals. Inclusion of Chinese white cinder in “CIBO” ointment promotes regener ation and healing of “CIBO” ointment.

Abstract: CHUN-7 a Mongolian traditional recipe consisting of 7 medicinal plants is described in the scripture named “༆༆ །།གཡུ་ཐོག་པའི་མཛད་པའི་རིམས སྲུང་ཁྱུ་ལྔ་རྒྱམ་ཏོན་གསལ་བ །།”. The ingredients including Caowu (Radix Aconiti kusnezoffii, CW) and Glehniae Radix (GR) have the effects of suppressing pneumonia, viral pneumonia, relieving pain, stimulating the immune system and reducing fever. The present study was aimed to determine acute and chronic toxicity properties of traditional drug. Materials and methods: CHUN 7 traditional drug were prepared in the traditional medicine sector of the Drug research Institute of Monos group. All WISTAR rats were kept in the same feed, under 12 hours lighting and 12 hours darkness housing. The study of acute and chronic toxicity of CHUN-7 traditional drug was studied by using IP and oral administration were performed on ten WISTAR rats and continued for a total of 28 days with 102.9 mg / kg dose (calculated from human dose: 16.7 mg/kg) in accordance with the WHO General Guidelines for the Evaluation and Study of Traditional Medicine. Results: The result showed no structural changes in the internal organs according to tissue morphology when we administrated CHUN-7 traditional drug. Conclusion This study showed CHUN-7 traditional drug has no toxic effects to internal organs including liver, kidney, stomach, lungs and heart. Therefore, CHUN-7 traditional drug has potential to use orally without any toxicology.

Background and Aims: Hepatocellular carcinoma (HCC) is a common cause of cancer related death in Mongolia. Early diagnosis is the very important management to increase successful treatment and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC) tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic biomarker of HCC. Methods: We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP) levels were measured using commercially available enzyme-linked immunosorbent assay kits. The diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and estimated sensitivity and specificity of each biomarker. Results: sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999 (0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6 ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 % with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%). Conclusion Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC. Combination of two markers showed greatest diagnostic accuracy.