Introduction: Nephrogenic syndrome of inappropriate antidiuresis (NSIAD) is an uncommon X-linked genetic condition marked by euvolemic hyponatremia, which arises from a gain-of-function mutation in the arginine vasopressin receptor type 2 (AVPR2) gene. In contrast to the classic syndrome of inappropriate antidiuretic hormone secretion (SIADH), NSIAD is characterized by urine that is inappropriately concentrated even when arginine vasopressin (AVP) levels are low or undetectable. Failure to recognize NSIAD may result in recurrent hyponatremia and neurological morbidity. Case: A 2-year-old male was referred to us after recurrent vomiting and subsequently developed generalized tonicclonic seizures due to hyponatremia (with a sodium level of 115 mmol/L). He needed sodium replacement through an intravenous drip of 3% saline and was stabilized with oral sodium chloride 20%. Urine osmolality was elevated, serum osmolality remained normal, and copeptin levels were low. He was discharged after a 10-day hospital stay. During follow-up, hyponatremia recurred despite his typical fluid intake of 1,200 mL/day. He was instructed to limit his fluid intake to 600–700 mL, which successfully normalized his serum sodium levels. Serum levels of adrenocorticotropic hormone, the aldosterone-to-renin ratio, thyroid function tests, and serum cortisol were all within normal ranges. Plasma AVP was unusually low (4.0 pmol/L). Whole exome sequencing (WES) confirmed a likely pathogenic hemizygous variant in AVPR2 gene located on chromosome Xq28, which was inherited from his mother. He is the only child, born from a non-consanguineous marriage, with no other significant family medical history. Conclusion Nephrogenic syndrome of inappropriate antidiuresis (NSIAD), is an uncommon, yet clinically significant condition. This case highlights the importance of considering a broad range of differential diagnoses when a patient presents with hyponatremic seizure. Furthermore, obtaining a detailed family history is essential to identify potential hereditary factors that could contribute to the condition and for genetic counseling.
Child ; Nephrogenic Syndrome of Inappropriate Antidiuresis

Introduction: Beckwith–Wiedemann syndrome (BWS) is a congenital overgrowth disorder associated with dysregulation of genes on chromosome 11p15.5. Infants with BWS can present with hyperinsulinemic hypoglycemia. There are also distinctive clinical features including macrosomia, macroglossia and visceromegaly that may raise suspicion of this diagnosis. Case: A preterm female infant of 30 weeks gestation with a birth weight of 1.87 kg (97th centile) had recurrent hypoglycemia in the neonatal period, requiring escalation to a maximum glucose infusion rate of 17.6 mg/kg/min. Hypoglycemia only resolved after starting intravenous glucagon infusion. Critical sampling during hypoglycemia revealed serum insulin 3.9 µU/mL (3–25 µU/mL), serum ketone 0.2 mmol/L, cortisol 3,053 nmol/L and growth hormone 16.2 ng/mL. These findings supported the diagnosis of non-ketotic hyperinsulinemic hypoglycemia. She was commenced on oral diazoxide with resolution of hypoglycemia and discontinuation of glucagon. Examination at birth revealed macroglossia, hepatomegaly and ballotable kidneys. An initial US abdomen at birth revealed bilateral enlarged kidneys but normal liver. An initial chromosomal study revealed karyotype 46, XX. Over time, additional clinical features became evident fulfilling the diagnostic criteria for BWS, that is, polyhydramnios, large for gestational age, transient hypoglycemia, hyperinsulinism, macroglossia, hemihypertrophy, facial nevi, bilateral ear creases, hepatomegaly and ballotable kidney. A repeat US abdomen surveillance at 4 months old revealed a heterogeneous liver mass with marked vascularity, prompting a diagnosis of hepatic hemangioma. She was commenced on oral propranolol, with reduction in the size and vascularity of the liver hemangioma and decline in alpha-fetoprotein levels. Conclusion The clinical features of BWS may not be recognizable in a preterm baby in early neonatal period. Careful clinical examination should be done in a baby with persistent hyperinsulinemic hypoglycemia for underlying syndromal causes. US surveillance should also be carried out due to increased risk of hepatoblastoma or liver hemangioma in BWS, as was seen in this case.
Infant, Newborn ; Infant ; Beckwith-Wiedemann Syndrome ; Infant, Premature ; Hypoglycemia

Background: Plants of the genus Achillea are widely used in both traditional and modern medicine and are known to be rich in biologically active secondary metabolites. Numerous phytochemical and histochemical studies have been con ducted on Achillea millefolium L.; however, Achillea asiatica Serg., which is widely distributed in Mongolia, remains comparatively underexplored. Therefore, investigating the distribution of biologically active compounds, the content of polyphenolic compounds, and the optimal extraction conditions of this species is of significant scientific and practical importance. Aim: The aim of this study was to identify biologically active compounds in Achillea asiatica Serg. using histochemical methods, to determine the content of polyphenolic compounds and optimal extraction conditions, and to evaluate the total and internal absorption coefficients of the plant raw material. Materials and Methods: The aerial parts of Achillea asiatica Serg. were collected in August 2025 from Erdene soum, Tuv province, Mongolia. Histochemical analysis was performed on transverse stem sections and flower petals using potassium dichromate, ferric chloride (III), methylene blue, Lugol’s iodine, and Dragendorff’s reagent, followed by ob servation under a light microscope. The total polyphenolic content was determined using the Folin–Ciocalteu method and expressed as gallic acid equivalents. Extraction experiments were conducted using powdered plant material sieved to par ticle sizes of 1, 2, and 3 mm and extracted with 20–80% ethanol. In addition, the total and internal absorption coefficients of the plant material were determined according to standard procedures. Results: Histochemical analysis revealed the presence of essential oils, polyphenolic compounds (tannins and flavo noids), and starch, while alkaloids were not detected. Polyphenolic compounds were observed in both stems and flow ers, with more pronounced accumulation in the vascular tissues. The highest total polyphenolic content (0.421%) was obtained from the 1 mm particle-size fraction extracted with 70–80% ethanol. Using 60% ethanol, the total absorption coefficient of the plant material was determined to be 5.74, and the internal absorption coefficient was 1.885. Conclution Achillea asiatica Serg. is rich in polyphenolic compounds, and their anatomical distribution is closely as sociated with the plant’s protective and biological functions. The use of 1 mm particle-size material and 70–80% ethanol was identified as the most suitable condition for extracting polyphenolic compounds. These findings provide a scientific basis for the standardization of Achillea asiatica Serg. as a medicinal and phytopharmaceutical raw material and support its further pharmacognostic and phytochemical investigation.

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: In atopic dermatitis, impairment of the skin barrier function leads to increased susceptibility to environ mental particles and pollutants, thereby contributing to disease pathogenesis and complications, as well as to an increased risk of fungal skin infections. In children with atopic dermatitis, infections caused by Candida species exacerbate the dis ease and reduce the effectiveness of treatment. Candida species are common opportunistic pathogens colonizing the skin and mucosal surfaces, and more than 200 species have been described. Among these, Candida albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei are most frequently isolated from the skin, mucosa, and oral cavity. In Mongolia, studies culturing skin fungi and determining their metabolic activity and virulence factors are limited, which constituted the rationale for the present study. Aim: To determine virulence factors and selected biochemical activities of Candida species. Materials and Methods: In this study, Candida species strains cultured from clinical samples of children with atopic der matitis were used with research approval. The fungal strains preserved at –80°C were revived by culturing on Sabouraud Chloramphenicol Agar and evaluated microscopically after Gram staining. Biofilm-forming activity was determined us ing the microtiter plate method, in which cultures were grown in broth, optical density was measured using a microplate reader, and values were calculated using a standard formula. Phospholipase activity was assessed using egg yolk agar according to the method developed by Price et al. Results: Of the total cultured isolates, 54.1% (n=33) demonstrated weak biofilm-forming activity (≤ODc / ODc < ~ ≤2×ODc), while 32.79% (n=20) showed moderate biofilm-forming activity (2×ODc < ~ ≤4×ODc). Isolates exhibiting strong biofilm-forming activity (>4×ODc) accounted for 13.1% (n =8) Regarding phospholipase activity, 50% of the isolates showed strong activity, 30% showed moderate activity, 10% showed low activity, and 10% exhibited very weak activity. Conclusions 1. Virulent fungal strains capable of attaching to host cells are involved in the pathogenesis of atopic dermatitis. 2. Atopic dermatitis is shown to contain fungal strains that damage host cells and are involved in the process of inva sion.

Background: Skin wounds can occur for many reasons, including UV radiation, mechanical burns, trauma, and chronic inflammation caused by metabolic factors. In Mongolia, as of 2022, household burns were the top 5 causes of injuries, the leading cause of injuries in children aged 0-5, and accounted for 18.4% of all illnesses in children aged 0-5. Skin burns and wounds take a long time to heal, which causes emotional, aesthetic, and economic stress for doctors. Developing in novative, effective, and low-side effects therapeutic products to improve wound healing is of great clinical and economic importance. The lack of research on the effects of bacterial metabolites and aloe vera (Aloe barbadensis Miller) on burn wounds was the basis for our research. Aim: To determine the effects of a mixture of bacterial metabolites and aloe vera on burn wounds in experimental animals. Materials and Methods: Eight-week-old BALB/c mice were divided into three groups: control group, bacterial metabo lite group, and aloe vera group. The mice were anesthetized, and the dorsal hair was shaved over a 2×2 cm area using an electric clipper. A second-degree burn wound model was created by exposing the shaved dorsal skin to hot air at 200°C for 10 seconds. A total of 100 μL of a bacterial metabolite suspension mixed with aloe vera at a 1:1 ratio was applied evenly to the center of the wound. Wound images were captured daily, and wound areas were measured using ImageJ software. Healing was evaluated on days 7, 14, and 21 of treatment and compared with the control group. The initial wound size was defined as 100%, and wound closure percentages were calculated accordingly. Burn skin tissues from both experimen tal and control groups were subjected to immunofluorescence staining for the vascular marker α-SMA (Thermo Fisher Scientific). Statistical analysis: The differences between the control and experimental groups were analyzed using an independent t-test using GraphPad Prism 10 software, and the mean, standard deviation, and statistical correlation were calculated. Results: The effect of the mixture of bacterial metabolites and aloe vera (Aloe barbadensis Miller) on the healing of burn wounds in experimental mice was compared with the control group. The wound size at 7 days was 82.1% in the control group and 83.7% in the experimental group (p<0.197), at 14 days was 62.6% in the control group and 58.1% in the exper imental group (p<0.0001), at 21 days was 50.7% in the control group and 32.7% in the experimental group (p<0.0001). No statistically significant difference in wound healing was observed between the groups at day 7; however, significant differences were observed at days 14 and 21. Immunofluorescence analysis revealed uniform expression of α-SMA-pos itive cells in the experimental group at 7, 14, and 21 days of treatment, whereas α-SMA expression was not detected in the control group. Conclusion The combination of bacterial metabolites and aloe vera promotes wound healing in experimental mouse burn wounds.

Background: Saliva as a non-invasive biological sample can be a game-changer in early disease detection and health risk assessment. Objective: To examine the association between participants' dietary patterns and the activity of salivary amylase, along with serum amylase levels in humans. Materials and methods: This study was conducted at the research laboratory of the Department of Biochemistry, School of Biomedicine, MNUMS. A total of 30 students aged 19–22 years participated in the study. Saliva samples were collected three times at one-week intervals, and one blood sample was collected from each participant, alongside a dietary questionnaire. The activity of the amylase enzyme in both saliva and serum samples was determined using the iodine-starch method. Results: When evaluating the amylase enzyme activity based on participants' carbohydrate intake, the result was p > 0.05, indicating no statistically significant difference. Similarly, statistical analysis of the use of mouthwash and vitamin supplements also showed p > 0.05, which means these variables had no statistically significant effect on amylase activity. The correlation between salivary and serum amylase activity was found to be r = 0.365, indicating a weak positive correlation, but the difference was not statistically significant. Conclusion The intake of carbohydrates, vitamins, and mouthwash does not significantly affect the activity level of the salivary amylase enzyme, according to research findings. However, external factors such as stress and air pollution have been shown to exert a measurable influence on its activity. A comparative analysis of enzyme levels in saliva and blood using amylase as a representative marker revealed similar activity levels in both fluids. This suggests that saliva may serve as a viable non invasive sample for detecting various biomarkers and diagnosing diseases. The results underscore the potential of salivary components, particularly amylase, as valuable indicators in diagnostic applications.

Background: Due to Mongolia’s harsh climate and seasonal limitations in fresh food supply, fruits, vegetables, and medicinal plants are often consumed in preserved forms. However, the preservation methods and storage conditions may significantly alter their antioxidant activity, which is crucial for mitigating oxidative stress and preventing chronic diseases. Objective: This study aimed to evaluate the antioxidant activity of 19 commonly consumed vegetables, berries, and dried medicinal plants under different storage conditions including fresh, cold storage (cellar), and frozen (-20°C). Methods: Samples were extracted in 80% methanol and tested using the DPPH radical scavenging assay. Absorbance was measured at 517 nm using a UV-Vis spectrophotometer. IC⁻⁻ values were calculated to compare antioxidant potency. Statistical differences were assessed using paired and unpaired t-tests with SPSS v27 (p<0.05) Results: Cold storage significantly reduced antioxidant activity in root vegetables, with IC⁻⁻ values increasing by 2.4 to 13.5 times (p<0.01), indicating diminished radical scavenging potencial. In contrast, frozen samples showed minimal change (p>0.05). Dried medicinal plants such as Rosa canina and Thymus serpyllum maintained strong activity, with IC⁻⁻<50 μg/mL. Conclusion Cellar storage leads to a notable decline in antioxidant capacity of common vegetables, while freezing is a more effective method for preservation. Dried medicinal herbs remain potent sources of antioxidants and may be recommended for year-round use in Mongolian diets.

Background: The synthesis of multifunctional nanoparticles by integrating the bioactive properties of the ethanol extract of Urtica dioica L. a medicinal plant widely distributed in Mongolia, with zinc oxide nanoparticles (ZnO-NP) serves as the foundation of the present study. The aim is to produce nanoparticles with synergistic antioxidant, anti-inflammatory, antibacterial, and anticancer activities. Objective: To synthesise dual-action nanoparticles (NPs) by integrating ZnO with the extract of Urtica dioica L. and to characterise their properties. Materials and Methods: The Control group, as ZnO-NPs, and the study group, as medicinal plant ethanol extraction loaded nanoparticles (UD-ZnO-NPs), were synthesised using green synthesis techniques. The morphology and particle size were characterised by Scanning Electron Microscopy (SEM), chemical bonding was analysed using Fourier Transform Infrared Spectroscopy (FTIR), and crystalline structure was examined by X-ray Diffraction (XRD). Hemolytic activity assays were conducted to assess cytotoxicity. Results: The Control and study group’s morphology and size distribution were uniform and spherical. The average particle size of the study group (UD-ZnO NPs) was 63 nm, while the control group (ZnO-NPs) was 77 nm. FTIR analysis showed that the basic chemical bonds in both types of nanoparticles were similar; however, additional peaks corresponding to the bioactive compounds from the Urtica dioica extract were detected in the UD ZnO-NPs. XRD analysis revealed that both types of ZnO-NPs investigated the same crystalline structure, consistent with the standard reference data (JCPDS No. 36 1451). Hemolysis assays showed that at concentrations ranging from 0.5 to 2.5 mg/ mL, the hemolytic activity was below 5%, indicating low cytotoxicity. Conclusion ZnO-NPs with and without Urtica dioica extract were successfully synthesized via a green method, yielding spherical, uniformly dispersed particles ranging from 63 to 77 nm in size. While the structural and crystalline characteristics of the NPs remained consistent, the presence of bioactive compounds was confirmed in the UD-ZnO-NPs. Hemolytic assays indicated dose-dependent cytotoxicity, highlighting the importance of concentration in biomedical applications.

Background: Identifying reliable biomarkers for early detection, risk stratification, and prognosis of CVD in the context of CKD is, therefore, of critical importance. Cystatin C has emerged as a potential biomarker capable of reflecting both cardiac injury and renal impairment, particularly in patients with arterial hypertension. This study aimed to evaluate the association between serum cystatin C levels, left ventricular hypertrophy, and chronic kidney disease in individuals with hypertension. Objective: To assess serum cystatin C concentrations in patients with left ventricular hypertrophy and chronic kidney disease secondary to arterial hypertension. Materials and Methods: A case-control analytical study was conducted, enrolling 44 patients aged 45 years or older with both left ventricular hypertrophy and chronic kidney disease due to arterial hypertension alongside a control group of apparently healthy individuals. Serum cystatin C levels were measured using immunoturbidimetric assay. Statistical analysis was performed using SPSS version 25.0. Group comparisons were made using independent-sample t-tests, while multivariate regression and receiver operating characteristic (ROC) analyses were employed to explore associations and the predictive value of cystatin C. Results: The mean serum cystatin C concentration in the case group was 1.6±0.1 mg/L, significantly higher than in the control group (0.88±0.03 mg/L, p<0.05). Similarly, the estimated glomerular filtration rate (eGFR) was markedly reduced in the case group (44.88±6.8 mL/min/1.73 m²) compared to the controls (92.88±3.4 mL/ min/1.73 m², p<0.05). In the case group, a statistically significant inverse correlation was observed between serum cystatin C levels and glomerular filtration rate (GFR), with a regression coefficient of β=−0.028 (p<0.006). Conclusion The elevated serum cystatin C levels (1.6±0.1 mg/L) and decreased eGFR (38.99±12.7 mL/min/1.73 m²) observed in the case group suggest that cystatin C may serve as a potential biomarker for the early diagnosis of left ventricular hypertrophy due to arterial hypertension and chronic kidney disease, as well as for predicting related complications.