Background: Tick-borne encephalitis is human viral infection involving the nervous system and transmitted by the bite of infected tick. The TBE Virus is distributed in different geographical areas by three widespread subtypes of the virus: The Far East, Europe, and Siberia. The Far East type has a mortality rate was 30-35%, the European type has a mortality rate of 2.2%, and the Siberian type has a mortality rate of 6-8% (A.G. Pletnev, 1998) [2].
In recent years, human cases of tick-borne infections have been reported in 19 European countries and four Asian countries (Mongolia, China, Japan, and South Korea) [3].
Human cases of tick-borne encephalitis, tick-borne rickettsiosis, and tick-borne borreliosis have been registered in Mongolia since 2005. Deaths have been reported year by year [5].
During 2005 to 2021, tick-borne rickettsiosis (71.6%), tick-borne encephalitis (17.3%) and tick-borne borreliosis (52.9%) were confirmed by epidemiological, clinical and laboratory tests at the NCZD.
Tick-borne encephalitis was registered in 63 soums of 15 provinces and 9 districts of the capital city, of which 90% were infected with tick bites in Selenge and Bulgan provinces. The average mortality rate is 4.9% (14), of which 28.6% in Bulgan province and 2.7% in Selenge province.
Tick-borne encephalitis is the leading cause of death in Bugat soum of Bulgan province and more infected men about 40 years of age [7]. Purpose : Collect ticks from selected soums of the provinces, identify tick species, species composition, distribution, tick densities, pathogens of tick-borne diseases, conduct population surveys to assess the risk of tick-borne infections, and identify tick-borne infections. Material and Method: Ticks were collected by flag from birch trees in birch forests and meadows with biotope and overgrown berries, determined morphological analyze and molecular biological investigation for detecting tickborne pathogens.
Questionnaires were collected from selected soum residents according to a specially designed randomized epidemiological and clinical survey card, collected information and forms were submitted to soum hospitals with a history of tick bites (according to clinical criteria). Serological tests were performed to detect IgG-specific antibodies to the collected serum mites. Result and conclusion Collected 121 ticks (120 I. persulcatus and 1 D. nuttalli) and not wound egg, larvae, nymphs. By molecular biological investigation detected 3.5% of I.persulcatus from Khutag-Undur soum of Bulgan province, 3.5% of anaplasmosis, and 14.1% of I.persulcatus mites from Bugat soum. 1.5% borreliosis, 3.1% anaplasmosis.
Detected DNA of 100% tick-borne rickettsiosis from D.nutalli ticks and determined circulation of infection among tick in Bugat and Khutag-Undur soums of Bulgan province.
247 people were surveyed, 56 blood serum from cases. Detected Q fever, erysipelas, and anaplasmosis, tick-borne borreliosis 3 (5.4%), tick-borne rickettsiosis 26 (46.4%), Japanese encephalitis 3 (5.4%), tick-borne encephalitis tick-borne rickettsiosis 6 (13.0%), tick-borne rickettsiosis tick-borne borreliosis 1 (1.8%), tick’s rickettsiosis Japanese encephalitis 1 (1.8%), tick-borne encephalitis tick-borne borreliosis 1 (1.8%).
By investigation, vaccination (88%) and wearing long-sleeved shirts and pants (81%) were the most effective ways to prevent tick bites (81%) [15]. According to our research, the percent of population knowledge in Bulgan province was insufficient (40.9%) which there is a lack of information, training and advertisement among the population in the province.

Outcomes of the retinopathy of prematurity screening and treatment in Mongolia Background: Retinopathy of prematurity (ROP) is a disease characterized by abnormal retinal vasculature that can have devastating visual consequences. Despite evidence that early detection and treatment can prevent blindness, ROP remains a leading cause of pediatric blindness worldwide. We aimed at investigating the outcomes of ROP screening, intravitreal anti–vascular endothelial growth factor (VEGF) and laser surgery in the treatment ROP and describe an evidence-based and specific process for identifying birth weight and gestational age screening guidelines in Mongolia utilizing telemedicine. Materials and methods: This was a retrospective of prematurity infants screened ROP from 2012 September to July 2020 and prospective cohort study of premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery and combined therapy from 2015 December 01 to January 31, 2017. Demographic factors, diagnosis and clinical course were recorded in a de-identified manner using REDCap, a secure, web-based platform to collect image and demographic data. The IRB approved the study protocol not requiring parental consent due to the de-identified nature of the data which was used for program monitoring purposes. Indirect ophthalmoscopy and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and images were uploaded to the web-based platform which could be accessed by the Mongolian ophthalmologist for reference. Each eye was evaluated by the local Mongolian ophthalmologist for the presence or absence of ROP, zone of vascularization, stage, plus disease, and aggressive posterior ROP (AP-ROP). The diagnosis and classification of ROP for this current study were determined by examination using indirect ophthalmoscopy, and treatment plans were determined according to the International Classification for ROP and the Early Treatment for ROP Study (ET-ROP).2,13 Regression analysis to determine association between BW and GA and the development of ROP. Results: A total of 9126 premature infants with BW ≤ 2500 g and/or GA ≤ 36 weeks were screened for ROP during the study period. 327 (3.5%) of the 9126 infants screened required treatment. The193 infants who received ROP screening had a mean GA of 30.09 ± 1.7 weeks, and mean BW of 1500.3 ± 125.42g. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. There were 96 boys (49.7%) and 97 girls (50.3%). Among infants receiving treatment, the highest BW was 2000g (born at 31 weeks GA), and the oldest was 34 weeks (with a BW of 1300g). The distribution of birth weight and gestational age in Mongolia was similar to other low-middle income countries, with higher birth weight and older gestational age. As birth weight and gestational age decreased, relative risk of developing ROP increased. Conclusions: After treatment, resolution of ROP was noted in approximately 90 % of the patients who had treatment-requiring ROP. 10 % of patients treated with IVB, IVR, Laser surgery and combined therapy however, did not respond and progressed to retinal detachment. This prospective study provides information about the development of ROP in preterm infants in the capital city of Mongolia. The distributions of BW and GA among infants developing ROP in Mongolia differ from those found in higher-income countries, and are comparable to other low and middle-income countries. We used a secure, web-based data collection and retrieval system that could be extended to multiple countries, which is now equipped with a telemedicine platform enabling remote grading of fundus images.

Introduction: The aim of this research project is to elucidate the crosstalk of innate and adaptive immune reactions against the DNA containing bacteria. : This study held in the Core laboratory, Science Technology Center, Mongolian National University of Medical Sciences (MNUMS). Murine aortal endothelial cells, END-D cultured and the cell viability checked by MTT assay. In addition, the NO production, protein and gene expression studied by Griess Reagent assay, R.T-PCR and immunoblotting, respectively. Results: 0.1µM, 1µM and 10µM of TLR9 ligand exhibited no cytotoxic action against the cells by MTT assay. IFN-ү alone induced NO production in END-D cells. In the other hand, TLR9 ligand at 0.1µM, 1µM and 10µM up-regulated IFN-ү induced NO production in dose dependent manner. RTPCR results exhibit that TLR9 ligand up regulates iNOS mRNA. Immunoblotting analysis showed the enhanced iNOS protein expression and phosphorylation of STAT1 in cells pre-treated with TLR9 ligand. Discussion: We have demonstrated CpG DNA, TLR9 ligand, up-regulates IFN-ү induced NO via enhanced IFN-ү signaling. The result of Western Blotting and RT-PCR support the up-regulation of NO. CpG DNA can be used as agent against virus and bacteria. Further research need to be conducted. Conclusion TLR9 ligand, CpG DNA up-regulates IFN-ү induced NO production in time and dose dependent manner. TLR9 ligand augments the expression of iNOS mRNA and STAT1 phosphorylation in response to IFN-ү.

Abstract:The world population rising very fast and it has resulted in increasing the area of polluted soil, water and air. In order to cater to the demands of the people, the rapid expansion of industries, vehicles, etc. is necessary. But all of these developments make our world, especially urban area,heavily polluted. And many kind of contaminant substances showing bad effects to human health. Our research work aimed to evaluate Ulaanbaatar city soil contamination using sanitary microbiological and genetoxicological studies.The soils samples used in this study were collected from Ulaanbaatar city areas, from 5 points soil from the residential area of Ulaanbaatar; soil from city food market; soil from the area along the city highway; sludge of the city water treatment facilities; soil from the downtown. Genotoxicological effect of soil contaminant substances or ability to cause a mutation to living organisms was determined by Eims test and DNA damaging experiment on test strain Salmonella thyphimurium TA-100 (his G46, rfa B, bio pKm 101) and Escherichia coli (wp, uvr, pol). The result revealed that Ulaanbaatar city soil samples have inhibition effect to test strain growth rate.From our research work, we are making the following conclutions:1.Water and organic solvent solution of Ulaanbaatar soils have a high microbial growth inhibition rate. In particular, soil from the residential area has shown higher rate.2.Mutagenic activity of natural soil samples of Ulaanbaatar area was studied in bacterial test-systems. Soil samples revealed no mutagenic effect.

Introduction: It is required to develop drug formulations and increase local preparations substituting the import preparations. The utilization of a new drug formulation of diclofenac gel is an example of a medicine which is encouraged to be prepared locally. Diclofenac gel is a cyclooxygenase inhibitor, which is a non-steroidal anti-inflammatory drug (NSAID) taken to reduce inflammation and as an analgesic reducing pain in certain conditions. It is important to develop technology and standard for diclofenac gel type of medicine in Mongolia.In 2010, domestic manufacturers produced about 30- 40 percentage of demand in Mongolia. However, there are many manufacturers that produce the same type of medicines. This shows that there is a need for local manufacturers to meet local demand. It is an indication of urgency in bringing in new technologies, new drug formulations, activating drug research and scientific work in domestic drug industry.Based on research, in 2011, non-steroidal anti- inflammatory drugs were the most sold drugs, which had a market share of 29.2%. Also in 2010, non- steroidal anti-inflammatory drugs of gel formulation had a market share of 130 million Tugriks.In 2011, there were nine different manufacturers of diclofenac gel have been registered to Mongolian Medicine Registrar/LICEMED/. They are:-Clafen 1%-20.0 produced in Antibiotice Ltd, Romania-Feloran 1%-60.0 produced in Bаlkanpharma Troyan AD, Poland-Almiral1%-10.0/25.0 produced in Medochemie Ltd, Cyprian-Olfen 1%-20.0 produced in Mepha Ltd, Switerland-Voltaren 1%-20.0/50.0 produced in Novartis pharma,Switzerland-Dicloran Plus 1%-30.0 produced in Unique pharmaceutical laboratories, India-DiclofenacAcri 1%-30.0 produced in Acrihin Ltd, Russia-Diclovit 1%-20.0 produced in Nijpharm, Russia-Diclomol 1%-20.0 produced in Win Medicare Ltd, India.These gels are packaged between 20-60 grams and the are price ranges from 2,700-12,000 Tugriks.In the world, nowadays diclofenac gel is most commonly produced.Diclofenac gel is colorless, and it penetrates the affected area quickly and effectively. The gel has an advantage of delivering full drug concentration to the affected area quickly, while it is convenient and pleasant to use.Purpose of study: The purpose of study’s to develop a Diclofenac gel technology for the first time in Mongolia. In order to reach my purpose, which owe as follows:• To determine convenient ingredients and gel baseof gel formulations• To develop a layout explaining gel manufacturingtechnology• To formulate raw ingredients based on the developed of the gel• To develop an evaluation and quality control systemfor producing gelMaterials and methods: Research work was done at the Monos School of Pharmacy and Drug Research Institute.Triethanolamin and Glycerin from Tsetsuuh LLC, Diclofenac sodium, hydroxypropylmethylcellulose, and menthol from Monos Pharm LLC, Carbomer 940, Ultrez-21 and Propylenglycol from Monos Cosmetic LLC were used for this research.To determine the drug ingredient: To determine gel formulations, primary and secondary ingredients were chosen carefully to maintain chemical compatibility and stability.Developed gel formulation was checked forquality control, which includes drug content, pH,appearance/Homogeneity/, and viscosity by Russian Pharmacopoeia XI and Mongolian Primary Pharmacopoeia. Permeability studies and skin irritation test was performed by USP.Result: First, carbopol concentrations of 0.5%, 1.0%, 1.5% and 1.2%, Ultrez-21 concentrations of 0.5%,0.8%, and 1%, and hydroxypropylmethylcelluloseconcentrations of 3%, 4%, 5% were prepared as gel formulations.Of those, carbopol concentrations of 1.2% and 1.5%, and Ultrez-21 concentrations of 0.8% and 1.0% were relatively better compared to other concentrations in terms of meeting drug content, appearance, pH level, and viscosity requirements. 0.2 gram of Menthol was added to provide comfort and pleasant odor when gel is applied as well as providing release of diclofenac sodiumFinal products were compared to similar diclofenac gels in the market in terms of pH level, drug content, skin irritation, and release of active substance. Of those final products, Ultrez-21 concentration of 1% resulted to be the most similar to the diflofenac gels in the market that satisfy the qualities mentioned above.Conclusion:1. The Ultrez-21 1% is determined to be the best gelling agent and 0.2 gram of Menthol is determined to be the best amount for increasing drug permeability.2. Developed technological procedure for preparingdiclofenac gel.3. To determine criteria for quality control, gel drug content, appearance, pH and viscosity were shown to be the most convenient measures.