Background: Numerous studies have shown that air pollution is a serious public health threat and risk worldwide. Mongolia is the world leader in outdoor and indoor air pollution, and the morbidity and mortality caused by it are increasing every year. People spend most of their lives indoors, and it is necessary to regularly assess and study indoor air pollution. Aim: To study the concentration of PM2.5 particles in the indoor air of households in Ulaanbaatar and Darkhan cities in relation to some symptoms of respiratory diseases. Materials and Methods: The study was conducted using an analytical cohort design from October 2023 to July 2025, and the 4 districts of the central Ulaanbaatar city and Darkhan cities were included in the study. A total of 240 households were included in the study, including 48 households living in ger and house, 24 households living in apartments, and 48 households living in ger and house, and 24 households living in apartments from Ulaanbaatar city. A direct measurement device (PurpleAir) was installed in the households for 3-4 weeks to measure PM2.5 particles in the indoor air for 24 hours. After measuring PM2.5 particles in the indoor air of the household, data were collected through questionnaires from the participants aged 18-60 who participated in the study and underwent health examinations. The results were processed using STATA-19.0 and R programs. Result: 213-239 households were selected for the study, including households living in 17-26 apartments, 42-58 houses, and 38-50 houses. The 24-hour average concentration of PM2.5 particles in the ambient air of households in Ulaanbaatar city was measured relatively higher in winter and summer than in households in Darkhan city. Among the districts of Ulaanbaatar city, the highest concentration of PM2.5 particles was measured in Songinokhairkhan district, and the lowest concentration was measured in Bayanzurkh district. Considering the cities by heating type, households with stoves are more polluted than households with centralized heating. In Darkhan city, the lowest concentration was measured in apartments (22.78-31.53 μg/m³), houses (44.53-68.17 μg/m³), and the highest concentration was measured in traditional felt houses (houses) (63.20-68.25 μg/m³). In Ulaanbaatar, PM2.5 concentrations were relatively high in all types of housing, including apartments (41.61-58.37 μg/m³), houses (79.22-92.50 μg/m³), and traditional felt dwellings (76.69-86.31 μg/m³). In the summer, PM2.5 concentrations in Darkhan were 3.10-10.03 μg/m³ in apartments, 7.67-14.37 μg/m³ in houses, and 7.98-17.90 μg/m³ in traditional felt dwellings (houses). The concentration of PM2.5 particles in the ambient air of the settlement is statistically significantly associated with shortness of breath, fatigue, weakness, muscle pain, nausea, palpitations, sneezing, runny nose, conjunctivitis, pain in the eye socket, tearing of the eyes, headache, fever, nasal congestion, cough, loss of appetite, sore throat, phlegm, wheezing, and chest pain. Conclusion The 24-hour average concentration of PM2.5 particles in indoor air in households in Ulaanbaatar and Darkhan cities is higher than the Mongolian standard during winter and is statistically significantly associated with some symptoms of respiratory diseases.

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: Ambient and household air pollution remain leading risk factors for global morbidity and mortality. Exposure to fine particulate matter (PM₂.₅) is associated with increased risks of cardiovascular and respiratory diseases, as well as lung cancer, metabolic and neurological disorders, and immune dysfunction. In urban areas of Mongolia, air pollution reaches critical levels during the winter season. Although improved solid fuels have been introduced in recent years, their impact on both outdoor and indoor air quality remains insufficiently characterized. Aim: To compare outdoor and household air pollution levels in Ulaanbaatar and Darkhan cities. Materials and Methods: Outdoor air pollution data for Ulaanbaatar were obtained from fixed monitoring stations of the National Agency for Meteorology and Environmental Monitoring for the period 2014–2026, with seasonal comparisons performed. For indoor air quality assessment, a longitudinal study was conducted among 240 households (apartments, houses, and traditional gers) in Ulaanbaatar and Darkhan from 2023 to 2026. PM₂.₅ concentrations were measured using real-time sensors (PurpleAir sensor), deployed for 14–21 days per season (winter and summer) in each household, recording data at 10-minute intervals over 24-hour periods. Result: Between 2014 and 2026, the 24-hour mean concentrations in Ulaanbaatar were 60.5 µg/m for PM₂.₅, 117.3 µg/m for PM₁₀, 37.3 µg/m for NO₂, 41.8 µg/m for SO₂, and 27.5 µg/m for O₃. While particulate matter levels showed a decreasing trend following the introduction of improved fuels, SO₂ concentrations increased, and overall pollution levels remained higher than those observed in Darkhan. Indoor PM₂.₅ concentrations were higher in Ulaanbaatar compared to Darkhan (60.7±86.1 vs 48.4±96.7 µg/m). Significant differences were observed by housing type (p<0.0001), with higher concentrations in households using solid fuels (houses and gers) and lower levels in apartments. These findings indicate substantial variability in indoor air pollution by city, housing type, and season, with persistently elevated exposure levels. Conclusion Outdoor air pollutant concentrations in Ulaanbaatar, including particulate matter, NO₂, and SO₂, exceed national standards and WHO guideline values by 1–4 times. Indoor PM₂.₅ pollution is higher in Ulaanbaatar than in Darkhan and varies significantly by housing type and season, indicating a high and heterogeneous exposure burden among urban populations.

Background: Respiratory and gastrointestinal infectious diseases are the leading causes of morbidity in children. Numerous international studies have demonstrated that handwashing with soap is one of the most effective and cost-efficient methods for preventing these diseases in children. A previous study conducted in Ulaanbaatar found that only 50.1% of general education school students practiced proper handwashing, which is considered insufficient even in areas with relatively adequate facilities. In Mongolia, 56.1% of the 865 schools lack handwashing facilities and soap, and 25% do not meet the WASH standards. Although knowledge about handwashing increased during the COVID-19 pandemic, sustained behavioral change remained limited, highlighting a gap between knowledge and practice and indicating the need for targeted educational interventions. Furthermore, there is limited research comparing the effectiveness of such interventions across different school environments and urban–rural settings, which provides the rationale for this study. Aim: To evaluate the effectiveness of a handwashing educational intervention among primary school students and determine differences in knowledge change across four schools in urban and rural areas. Materials and Methods: A quasi-experimental study design was used from December 2024 to June 2025. A total of 1,353 students from grades 3–5 in four general education schools (two in Ulaanbaatar and two in rural areas) were included in the study. Preand post-intervention handwashing knowledge scores were analyzed using paired t-tests and one-way ANOVA (α=0.05) with STATA 14.0. Ethical approval was obtained from the Ethics Committee of the Mongolian National University of Medical Sciences. Result: The mean handwashing knowledge score increased significantly from 9.68 (±2.64) before the intervention to 10.30 (±2.74) after the intervention, with a mean difference of +0.63 (p<0.001). The differences in improvement between schools were also statistically significant (ANOVA: F(3,1335)=5.90, p=0.0005). The highest improvement was observed in urban School A (+1.49), while the lowest was observed in School B (+0.16). Rural schools C and D showed moderate and relatively consistent improvements (+0.51 and +0.70, respectively). Conclusion School-based handwashing educational interventions effectively improve knowledge among primary school students. However, environmental factors, such as infrastructure and geographic location, significantly influence the effectiveness of the intervention. Therefore, educational interventions should be implemented alongside infrastructure improvements.

Background: Bioactive compounds derived from plants have been extensively studied and widely applied in cosmetic and dermatological fields. In particular, plant-derived polyphenols and anthraquinones are known for their antioxidant properties as well as their ability to inhibit elastase enzyme activity. Elastase is a key proteolytic enzyme responsible for degrading elastin, a structural protein essential for maintaining skin elasticity. Excessive elastase activity contributes to skin aging and wrinkle formation. Therefore, the identification of plant-derived compounds capable of interacting with elastase is of significant importance for improving the composition and efficacy of cosmetic products. Aim: To identify bioactive compounds in the extract of Rheum undulatum L. and to investigate their interaction with elastase enzyme activity. Materials and Methods: The root of Rheum undulatum L. was used as the study material. Sample preparation was performed by grinding the plant root followed by extraction using 50% ethanol assisted by an ultrasonic water bath. The obtained extract was evaporated to dryness using a vacuum centrifugation system to remove the solvent completely. A total of 10 mg of the dried extract was dissolved in 100 µL methanol and 900 µL water, then filtered through a 0.1 µm membrane filter. Subsequently, two sample sets were prepared: a control sample and an elastase-incubated sample at a 1:1 ratio. Both were analyzed using liquid chromatography–mass spectrometry (LC-MS). Data processing was performed using Agilent MassHunter Qualitative Analysis software (version 10.0). Results: LC-MS analysis revealed a total of 16 bioactive compounds in the root extract of Rheum undulatum L. Comparative analysis between the control and elastase-treated samples demonstrated a decrease in the peak areas of gluconic acid and citric acid, while an increase in the peak area of emodin was observed. These changes indicate compositional differences between the two sample conditions. Conclusion The LC-MS analysis of Rheum undulatum L. root extract identified multiple bioactive compounds belonging to anthraquinone, phenolic, and flavonoid classes. Variations in peak intensities between control and elastase-treated samples suggest potential interactions between certain compounds and the enzyme. These findings indicate that the root extract contains biologically active constituents capable of modulating elastase activity, supporting its potential application in anti-aging and cosmetic formulations.

Background: Hand hygiene is a fundamental component of infection prevention and control in healthcare facilities. Healthcare workers’ hands can transmit pathogens between patients, medical equipment, and environmental surfaces, contributing to healthcare-associated infections (HAIs). Objective: To synthesize evidence on hand hygiene conditions, soap and alcohol-based hand rub availability, compliance, public health importance, and economic benefits in healthcare facilities, with particular relevance to Mongolia. Material and Methods: A narrative review was conducted using published studies, international guidelines, WHO/UNICEF reports, and Mongolian regulatory documents addressing hand hygiene infrastructure, essential supplies, compliance, HAI prevention, and economic outcomes. Results: Hand hygiene compliance remains suboptimal in many healthcare settings and is frequently reported below 40%. Compliance is influenced not only by healthcare workers’ knowledge and attitudes but also by the availability of running water, functional sinks, liquid soap, alcohol-based hand rub, hand-drying facilities, training, workload, institutional leadership, monitoring, and feedback. HAIs are more common in low- and middle-income countries, where limitations in water, sanitation, hygiene, and infection prevention infrastructure increase risks for patients and healthcare workers. In Mongolia, basic hand hygiene service coverage has been reported at approximately 72%, indicating continuing gaps in essential facilities and supplies. Multimodal strategies that combine system improvement, education, reminders, monitoring, feedback, and institutional support are more likely to improve compliance and reduce infection risks. Economic evidence also indicates that hand hygiene is a high-value intervention: every US$1 invested in hand hygiene improvement may save up to US$16.50 in healthcare expenditure, while hygiene promotion including handwashing can avert one DALY at an estimated cost of US$3.35. Conclusion Strengthening hand hygiene in Mongolian healthcare facilities requires sustainable financing, reliable supply systems, adequate infrastructure, continuous training, and routine monitoring. Integrating these measures into IPC and WASH programmes can improve patient safety, reduce HAIs, and generate substantial public health and economic benefits.

Background: Hand hygiene is a fundamental component of infection prevention and control in healthcare settings. Effective hand hygiene requires functional infrastructure and the consistent availability of essential supplies, including clean water, soap, hand disinfectants, and hand-drying materials. Assessing these conditions is essential for identifying gaps in service provision and informing targeted improvements in healthcare facilities. Aim: To assess hand hygiene conditions and the availability of essential handwashing supplies in selected healthcare facilities in Mongolia. Materials and Methods: An analytical cross-sectional study was conducted in 20 healthcare facilities located in urban and rural areas of Mongolia. Hand hygiene conditions and the availability of essential supplies were assessed at 186 handwashing stations using a structured observation checklist. Additionally, information on the budgeting and financial planning of handwashing supplies was collected from each participating healthcare facility using a structured questionnaire. Data were analyzed using IBM SPSS Statistics version 27.0. Ethical approval was obtained from the Research Ethics Committee of the Mongolian National University of Medical Sciences on April 17, 2026 (Approval No. 26/04-01). Results: Of the 186 observation points, 55.9% were located in urban areas and 44.1% in rural areas. Overall, 92.5% had functional handwashing sinks, 88.2% had access to clean water, 73.7% had liquid soap, 57.0% had disposable paper towels, and 52.2% had hand sanitizer available at the handwashing station. Accessible handwashing facilities for persons with disabilities were identified at 26.3% of observation points. The availability of liquid soap (82.7% vs 62.2%; p=0.002) and hand sanitizer (72.1% vs 26.8%; p<0.001) was significantly higher in urban than in rural areas. Among the 20 healthcare facilities, 80.0% allocated a budget for handwashing supplies, but only 5.0% based their budget planning on actual soap consumption reports. Conclusion Although basic handwashing infrastructure was generally available in the surveyed healthcare facilities, gaps persisted in the availability of essential hand hygiene supplies, particularly in rural areas. Limited accessibility for persons with disabilities and the infrequent use of consumption data in budget planning indicate areas requiring improvement. Strengthening the continuous provision of hand hygiene supplies, improving accessible infrastructure, and adopting consumption-based budgeting practices are essential priorities for improving hand hygiene conditions in healthcare facilities.

Introduction: Safe and accessible WASH services in healthcare facilities are crucial for maintaining high quality care, especially for maternal and newborn health. The WHO-UNICEF JMP on Water Supply, Sanitation, and Hygiene provides reports on progress in water supply, sanitation, and hygiene services at global, regional, and national levels, covering populations, schools, and healthcare facilities. This assessment was conducted to address the insufficient data on the level of hand hygiene services in healthcare facilities, following the methodology of the JMP. Materials and Methods: A cross-sectional study was conducted in 319 healthcare facilities. Availability of hand hygiene services in the study healthcare facilities was assessed using questionnaire of methodology of the JMP. Data were analyzed using SPSS 25.0 software. Relevant parametric and non parametric statistical analysis were conducted. Results: Overall, 72% and 28% of healthcare facilities had basic and limited hand hygiene service respectively. About 18% of private healthcare facilities had limited hand hygiene service compared to 34% of state healthcare facilities. While 20% of urban healthcare facilities had limited hand hygiene service, 56% of rural healthcare facilities do. When examining the level of hand hygiene services by type of medical care, specialty hospitals have 100% basic services. Among primary care facilities, 83% of family health centers provide basic services, while 41% of soum and village health centers meet these standards. Conclusion The basic hand hygiene services in urban healthcare facilities and specialty hospitals were generally sufficient. There need to enhance basic hand hygiene service at the soum and village level. Among the assessed facilities, 81.0% met four out of the five key hand hygiene requirements outlined in the national standard. However, additional budget allocation for maintenance and operational costs for keeping soap and sustaining water running remains crucial to ensure sustained compliance and quality.

Background: An estimated 99% of the global population lives in environments where PM2.5 levels exceed the WHO air quality guideline of 15 μg/m³. In 2018, air pollution contributed to approximately 4.2 million deaths worldwide. In Mongolia, air pollution—particularly in urban centers like Ulaanbaatar, worsens significantly during the winter season, posing a serious public health and local concern. Therefore, it is compulsory to compare the outdoor air quality in Ulaanbaatar, the capital and Darkhan city. Aim: To assess and compare the outdoor PM2.5 concentrations in Ulaanbaatar and Darkhan during the winter season. Materials and Methods: This study was conducted in Ulaanbaatar and Darkhan from December 10, 2024, to February 19, 2025. A total of 60 PurpleAir Classic+ sensors (30 per city) were installed to assess PM2.5 concentrations at 2-minute intervals. We analyzed collected data using R software. The 24-hour average PM2.5 concentrations were compared with both the Mongolian National Air Quality Standard (MNS4585:2016) and the WHO air quality guidelines (2021). Results: The 24-hour average PM2.5 concentration in Ulaanbaatar was 112.3±62.2 μg/m³, which was significantly higher than that in Darkhan (79.2±25.6 μg/m³; p<0.05). In Ulaanbaatar, the monthly averages were 119.9±67.7 μg/m³ (Decem ber), 113.5±60.8 μg/m³ (January), and 95.0±51.9 μg/m³ (February) respectively (p<0.05). In contrast, Darkhan city’s monthly average PM2.5 remained relatively close across the months: 79.1±22.2 μg/m³ (December), 78.7±28.6 μg/m³ (January), and 84.6±30.0 μg/m³ (February), with no statistical significance (p>0.05). During the study period, the 24-hour average PM2.5 concentrations exceeded the MNS4585:2016 (50 μg/m³) in 69.8% of days in Ulaanbaatar and 64.6% in Darkhan. WHO’s guideline of 15 μg/m³ was exceeded 93.4% of the time in both cities. Conclusion Darkhan city has lower PM2.5 concentrations compared to Ulaanbaatar, both cities significantly exceeded MNS4585:2016 standard and the WHO air quality guidelines (2021) during the winter months.

Background: Vaginal candidiasis is a highly prevalent infectious disease among women caused by a wide range of pathogenic organisms. Although it can be treated with standard pharmacological methods, it has detrimental effects on women’s reproductive health. The absence of research to date on the anti-vaginal inflammatory effects of Jirug-6 suppositories - a traditional formulation derived from ancient medicinal recipes and long-used in traditional mongolian medicine has provided the rationale for conducting this study. Aim: Study of the effects of Jirug-6 suppositories on the vaginal inflammatory lesion model induced by Candida albicans. Materials and Methods: To establish the vaginal inflammatory lesion model in experimental animals, the inoculum was prepared according to the McFarland standard method, and 10 µL of the inoculum was intravaginally administered daily for 4 consecutive days. Fifty-six mice with induced vaginal candidiasis were divided into 7 groups. On treatment days 1, 3, 5, 7, and 10, the vaginal cavity of the mice was washed with 100 µL of phosphate buffer. From the lavage fluid, 20 µL was collected, mixed with 480 µL of phosphate buffer, and thoroughly homogenized. Using a 20 µL micropipette, three aliquots were inoculated onto Sabouraud Dextrose Agar (SDA) medium and incubated at 37°C for 48 hours. Colonies were counted, and at the end of the experiment, serum was isolated from blood samples, and IFN-γ and IL-10 levels in the samples were quantified using ELISA. Histopathological analysis was performed on vaginal tissues from the experimental animals. Results: In the experimental animals, Jirug-6 suppositories 0.4 mg/kg dose exhibited the mildest clinical signs of hyperemia, swelling, hemorrhage, infiltration, or fluid loss into soft tissues in the vaginal and cervical regions (p<0.01). For cervical inflammation, Jirug-6 suppositories 0.4 mg/kg demonstrated a strong anti-inflammatory effect with a score of 1.99±0.78, which was comparable to the positive control group (p<0.01). In serum, the concentrations of IFN-γ and IL-10 in Jirug-6 suppositories 0.4 mg/kg were determined to be 8.18±0.61 and 7.91±1.30, respectively, showing reduced levels similar to those of the positive control group (p<0.01). Conclusions 1. Jirug-6 suppositories reduce inflammatory symptoms and suppresses fungal dissemination during the vaginal lesion model induced by C. albicans. 2. At a Jirug-6 suppositories 0.4 mg/kg demonstrates anti-inflammatory effects by increasing IFN-γ concentration and decreasing IL-10 concentration in the C. albicans-induced vaginal lesion model. Furthermore, it enhances immunity and reduces swelling during inflammation, exhibiting positive therapeutic effects against clinical symptoms.