Background: According to the 2023 report on global water sector development, water consumption has increased by approximately 1% annually over the past 40 years and is expected to rise further due to population growth, socio-economic development, and changes in consumption patterns. Both low- and middle-income countries face risks related to water quality. In many developing nations in Asia and Africa, natural water sources are of poor quality and lack purification infrastructure, with limited research and data available—often restricted to monitoring reports and basic statistics. Although the United Nations' Sustainable Development Goals (SDG-2030), adopted at the 70th UN General Assembly, aim to ensure access to safe drinking water and sanitation for all, around 26% of the global population—approximately 2 billion people—still lack access to safely managed drinking water services. In line with this, Mongolia’s long-term development policy “Vision-2050” sets a target to ensure 90% of the population has access to safe drinking water by 2030 through comprehensive measures. The World Health Organization (WHO) identified ten key chemical contaminants posing significant public health concerns in 2020, including arsenic, along with air pollution, asbestos, benzene, cadmium, dioxins, excessive fluoride, lead, mercury, and hazardous pesticides. Over 140 million people in more than 70 countries are consuming arsenic-contaminated water, exceeding the WHO guideline of 10 μg/L. While Mongolia has conducted studies on arsenic contamination in drinking water in 2004, 2013, and between 2019–2022, there is still a scarcity of research assessing the potential health risks associated with such contamination. Aim: To assess the health risk of arsenic exposure through drinking water. Materials and Methods: Using a document-based research design, we obtained official permission from the Health Statistics, Information and Research Department (Letter No. 01/290) and collected arsenic testing data and well information from 29 internal research reports. A database was created, and secondary data analysis was conducted. Based on the U.S. Environmental Protection Agency (EPA) methodology, the following were calculated: average daily dose (ADD), lifetime average daily dose (LADD), cancer risk (CR), and hazard quotient (HQ) for arsenic exposure through drinking water. Official statistics from 2023 released by international and national organizations such as the UN, WHO, NSO, MCHD, and NCCD were used for risk calculations. Results: Out of 3,575 drinking water samples collected from 1,315 wells in 329 soums across 21 provinces and 2,260 samples from 9 districts of Ulaanbaatar, 61% met the MNS 0900:2018 national drinking water standard for safety and quality. However, in samples from Dornogovi, Dundgovi, Sukhbaatar, Umnugovi provinces and Nalaikh district, arsenic concentrations exceeded the national and WHO recommended limit (10 μg/L) by 1 to 6 times. Health risk assessment showed hazard quotient values ranging between 0.12 and 1.15. Conclusions Arsenic contamination in drinking water is locally prevalent in the Gobi and Eastern regions of Mongolia (Dundgovi, Sukhbaatar, Dornod, Umnugovi, Dornogovi). The hazard quotient for arsenic exposure via drinking water ranges from 0.12 to 1.15, with 8 provinces showing values above 0.3—indicating potential health risks.

Background: Lish-6 has been used for treatment pharyngitis, flu and throat disease. Lish-6 is composed from Eugenia caryophylla. Thumb, Saussurea lappa C.B. Clark, Schizostachoum chinense. Rendle, Glycyrrhiza uralensis. Fisch, Gentiana algida Pall, Terminalia chebula. Retz. Anti-fever properties of these plants and their bio-active compounds have extensively been studied. Aim: To determine the anti-fever effects of Lish-6. Marerials and Methods: Fever was induced by intravenous administration of lipopolysaccharide (LPS) at concentration of 0.5 mg/kg. Lish-6 was given orally at concentration of 92 mg/kg, 1 and 6 hours after the LPS administration. Rectal temperature wa measured 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 hours after the LPS administration. Paracetamoli was given orally at concentration of 50 mg/kg. Blood levels of Prostaglandin E2 (PGE2) and interleukin-6 (IL-6) interleukin-1β (IL-1β) were determined by enzyme linked immune sorbent assay using rat kits. Lung tissue was examined by histopathological analysis. Results: The body temperature of rats in the normal group was 35.0±1.10С, while in the control group, periodic fever was caused by the effect of lipopolysaccharide (p=0.001). But in the Lish-6 drug group, rectal temperature decreased steadily (p=0.05). In addition, the IL-1β cytokine in the normal group was 3.24±0.31 ng/L and increased by 60.5% in the control, indicating the development of the pathological model, while this parameter decreased by 31% in the Lish-6 drug group (p=0.05). IL-6 cytokine in the normal animals was 21.1±0.2 pg/L and increased by 19.04% in the control, indicating the development of the pathological model, while this parameter decreased by 8.3% in the Lish-6 drug group (p =0.05). PGE2 in the normal group was 43.2±0.3 ng/L, and it increased by 62.7% in the control group, indicating the development of a pathological model, while this parameter decreased by 53.3% in the Lish-6 drug group (p=0.05). Conclusion Lish-6 traditional drug has the effect of reducing rectal temperature, IL-1β, PGE2 and IL-6 cytokines during lipopolysaccharide-induced febrile pathology model.

Background: Erkhem-8 medicine is a composed Crocus Sativus L, Lagotis integrifolia, Gentiana barbata froel etc, used for the treatment of respiratory diseases, specially pneumonia and fever or hot disease in Mongolian Traditional Medicine. Aim: The effects of Erkhem-8 medicine to determine the some sourcebook study results. Materials and Methods: An evaluation of its effects on wind, bile, and phlegm was conducted using Traditional Mongolian Medicine methods (Dagvatseren B, 1996). In order to clarify the structure and composition of Erkhem-8 traditional medicines, and the treatment of lung fever from traditional medical sources. Text and source-study and comparison method were used in the study. Results: The study found that Erkhem-8 medicine demonstrated a varying capacity to suppress wind, bile, and phlegm, with bile suppression being the most significant at 0.68, followed by wind suppression at 0.58, and phlegm suppression at 0.16. Erkhem-8 is composed of 8 ingredients, which are safflower Carthamus tinctorius L, gmeline Bostaurus domesticus, Schizostachoum chinense Rendle, wood Santalum album L, Odontitis rubra Baung.Opiz, flora Gentiana decumbens L, herba Lagoti sintegrifolia Schischk, flora Aconitum Kusnezoffii Reichenb. These herbs themselves have a variety of biological activities, including reduce heat, pain relief, anti-oxidant and anti-tumor, anti-inflammation activity. Conclusions 1. The study found that Erkhem-8 exhibited the highest suppression of bile (0.68), followed by wind (0.58), and phlegm (0.16), indicating its effectiveness in modulating these elements. 2. Most of the raw materials included in the composition of Erkhem-8 medicine have a bitter and sweet taste and have the ability to remove heat, especially heat of the solid organs, i.e. heat of the lungs, liver, blood, specially pneumonia and fever or hot disease in Traditional Mongolian Medicine.

Background: Lish-6 has been used for treatment pharyngitis, flu and throat disease. Lish-6 is composed from Eugenia caryophylla Thumb, Saussurea lappa C.B.Clark, Schizostachoum chinense Rendle, Glycyrrhiza uralensis Fisch, Gentiana algida Pall, Terminalia chebula Retz. Anti-fever properties of these plants and their bio-active compounds have extensively been studied. Aim: To determine the pain relief and antibacterial effects of Lish-6. Materials and Methods: To conduct acute toxicity study using V.B. Prozorovsk method. Average lethal dose, lethal and maximum nonlethal doses were determined. Acetic acid (1%-0.1 ml) was injected into the rat abdominal cavity to induce pain. Wistar rat of either sex (n = 6) weighing 18–22g were used. All animals were withdrawn from food 2h before the start of experiment and were divided in five groups. Group I was injected with normal saline (10ml/kg) as control, Diclodenk was given orally at concentration of 25 mg/kg. Group II III, IV, V and VI were injected with Lish-6 was given orally at concentrations of 9.2, 18, 36, 92, 184 mg/kg injection of acetic acid. The number of abdominal constrictions (writhes) were counted of acetic acid injection for the period of 20 min. To determine the antibacterial effect by dilution method. Results: Average lethal dose of Lish-6 was found to be LD50=0.92 (0.6-1.04) g/kg suggesting that it is slightly toxic animals. Control group animals abdominal constrictions 72.4±8.8. Lish-6 concentrations of 9.2, 18, 36, 92, 184 mg/kg group animal reduced acitic acid induced pain by 41.9-78.7% suggesting that it is pain relief effect (p<0.001). 4 g of Lish-6 medicine is active against gram-positive bacteria (S.aureus, Streptococcus pneumonia). However, it is inactive against gram-negative bacteria. In other words, Lish-6 medicine inhibits the growth of methicillin-resistant and non-resistant S.aureus bacteria at a dose of 500 mg. It was also found to inhibit Streptococcus pneumonia at a dose of 250 mg. Conclusion Average lethal dose of Lish-6 was found to be LD50=0.92 (0.6-1.04) g/kg suggesting that it is slightly toxic animal. Lish-6 reduced acitic acid induced pain by 41.9-78.7% suggesting that it is pain relief effect. Lish-6 traditional drug has an antibacterial effect.

Background: In traditional medicine, the Shimshin-6 formulation, which consists of Rheum undulatum L., Hippophae rhamnoides L., Zingiber officinalie Roscoe, Saussurea Lappa C.B.Clark, Sal ammoniacum, Tronae veneni, is recommended for women experiencing menstrual retention disorders. In recent years, Shimshin-6 has been widely used to promote postpartum uterine involution for women and our study aimed to evaluate and determine the acute and chronic toxicity effects of Shimshin-6. Aim: To evaluate and substantiate the acute and chronic toxicity effects of Shimshin-6. Materials and Methods: The acute toxicity of Shimshin-6 was evaluated using the rapid method described by V.B. Prozorovsky (1978) by administering intraperitoneal injections of the medicinal extract in white mice to determine the lethal dose. The active dose was determined following the methodology of I.P. Zapadnyuk (1983). Chronic toxicity was evaluated in Wistar rats according to the OECD 407 (2008) guidelines. The test animals were administered Shimshin-6 in tablet form (90 mg/kg and 180 mg/kg) and decoction form (tang) (162 mg/kg) daily for 60 days. At the end of the experiment, biochemical and complete blood analyses were conducted, along with histopathological examination of major organs. The study was conducted with ethical approval granted by the Ethics Committee of the Mongolian National University of Medical Sciences (MNUMS) on October 25, 2024. Results: The LD50 for Shimshin-6 tablets was 4.47 (3.39–5.1) g/kg, indicating low acute toxicity based on the K.K. Sidorov classification. The LD50 for the decoction form was 8.1 (7.1–9.4) g/kg, suggesting it is non-toxic. Regarding chronic toxicity, platelet count was significantly reduced compared to the healthy control group: Shimshin-6 tablet group: 46% reduction at 90 mg/kg and 29.7% reduction at 180 mg/kg. Shimshin-6 decoction group: 60.5% reduction at 162 mg/ kg. Additionally, hemoglobin levels in the decoction group (162 mg/kg) decreased by 15.7% (p<0.05). Biochemical analysis showed a 36.3% reduction in total cholesterol (LDL-C) levels in the tablet group (180 mg/kg) and decoction group (162 mg/kg) compared to the control (p<0.05). Conclusion Shimshin-6 tablets showed low acute toxicity in experimental mice. However, long-term administration may lead to a reduction in platelet count.

Background: The Shimshin-6 formulation, composed of Rheum undulatum L., Hippophae rhamnoides L., Zingiber officinale Roscoe, Saussurea lappa C.B. Clarke, Sal ammoniacum, and Tronae veneni, has traditionally been used in the management of gynecological disorders such as amenorrhea, abnormal blood clot formation, and pelvic pain. It has also been widely applied in postpartum care to promote uterine contractility and to prevent complications, including hemorrhage and inflammation. However, its therapeutic potential in postpartum uterine involution has not been scientifically validated. Aim: To investigate the effects of the Shimshin-6 herbal formulation on postpartum uterine involution in rats Materials and Methods: This experimental study was conducted at the Research Center of the Institute of Traditional Medicine and Technology, following the methodology described by Zheng ZH et al. (2019). Postpartum rats were randomly assigned to four groups and received daily treatments for five consecutive days with either Shimshin-6 tablets at doses of 180 mg/kg and 90 mg/kg, Shimshin-6 decoction at 163 mg/kg, or physiological saline as a control. Serum concentrations of estrogen, progesterone, TNF-α, TGF-β1, and TGF-β3 were measured using commercially available ELISA kits (Shanghai MLBIO Biotechnology Co. Ltd, China). Following ethical euthanasia, uterine tissues were collected for histological examination, which included evaluation of uterine weight, endometrial thickness, myometrial structure, and glandular morphology. Results: Shimshin-6 treatment significantly reduced the uterine index and serum estrogen levels compared with the control group, while no significant difference was observed in progesterone concentration. The treatment also decreased tumor necrosis factor-α (TNF-α) levels and modulated growth factors in postpartum rats. Histological analysis further revealed that Shimshin-6 promoted uterine recovery, despite the presence of inflammatory cell infiltration and hemorrhagic changes in the uterine wall. Conclusion Shimshin-6 preparation exerts a promotive effect on postpartum uterine involution in rats.

: The “Zidraga-6” prescription, which is widely used in traditional medicine, was selected and technologically developed, and formed into capsule medicine. Zidraga-6 capsule was prepared using six different herbal Capsicum annuum L. Holarrhena antidysenterica Wall ex, Atragene sibirica L, Embelia ribes Burm, Terminalia chebula Retz, and Kaempferia galanga L. Goal: This study was conducted to standardize and determine the safety and quality parameters of the Zidraga-6 capsule. Materials and Methods: Quality (moisture, total ash) and safety parameters were determined by Mongolian National First Pharmacopoeia methods. The content of the main biologically active compounds in the Zidraga-6 capsule was identified using TLC. In addition, the content of biologically active compounds is determined by UV spectrophotometer methods. The results were processed using basic biostatistical methods, calculating the arithmetic mean (M), standard deviation (δ), and standard error (m) using the SPSS 20.0 program. The ethical approval for the study was obtained by a decision of the Ministry of Health - Medical Ethics Review Committee on research on May 23, 2023 (23/029). Results: The presence of p-methoxycinnamate, gallic acid, oleanolic acid, and capsaicin in the Zidraga-6 capsule drug was detected by the TLC method, and their Rf values were 0.26, 0.24, 0.82, and 0.45, respectively. The average weight of Zidraga-6 capsules was 0.4±0.019 g, moisture was 9.63±0.09%, disintegration was 6.48±0.37 minutes, dissolution was 94.68±2.85%. The content of methods biologically active compounds in the Zidarga-6 capsule was determined total triterpene saponins as 1.89±0.19% by UV spectrophotometric methods. Conclusion We determined quality and safety parameters of the Zidraga-6 capsule were defined and the Mongolian National Pharmacopoeia monograph’s draft for the Zidraga-6 capsule was developed.

Introduction: One of the main ingredients of Anar-5 tablets is Piper longium L. Piperine alkaloids are the main active ingredients of the Piper longum and have anti-inflammatory, antioxidant and gastric protection properties.In the framework of the standardization study of Anar-5 tablets, a method was developed to determine the content of piperine in highly perpormance liquid chromatography, and then it was sought to include it in the method of analysis of Anar-5 drugs. Goal: Quantitative determination of piperine in Anar-5 tablets and validate the method Material and Methods: The research was conducted in the Chemistry and Chemical Technology Laboratory of the Research Center of the Institute of Traditional Medicine and Technology. And Anar-5 tablets (serial number 04012020) that are produced for experimental were used in the research. The standard substance, piperine alkaloids, was purchased from Green Chemistry.Purification of HPLC (organic solvent methanol, 99.9%, distilled water) was used. The EX 1600 HP/ PUMP high-performance liquid chromatography instrument (column Arcus EP+-C18, 5µm, 4.6x250 mm) and the organic solvent filter 0.45 μm syringe filter were used. The methodology related to this research was discussed and approved at the online meeting of the Ethics Committee of the Academy of Sciences on January 26, 2021. SPSS 16 software was used to statistically program the survey results. Results : According to the above method, the retention time of the standard piperine is 10.38± 0.02 minutes, and the retention time of the piperine in Anar-5 tablets is 10.42±0.033 minutes. Relative velocity deviation RSD 1.077%, accuracy 0.65446±0.0068mg, stability 0.61298±0.013mg, capture time 10.42±0.033 minutes, relative standard deviation RSD≤2%, specificity 10.35 minutes, The equation of a line constructed with a standard curve is y=43360x-33587 and the correlation coefficient R2=0.9989. The piperine content of Anar-5 tablets was determined to be 0.61298±0.013 mg. The LOD and LOQ for piperine were in 2.268 μg/ml and 6.873 μg/ml, respectively. Conclusion The content of piperine in Anar-5 tablets can be determined by the HPLC method, and the appropriate conditions for this method have been established. The HPLC method is unique, accurate, linear, and stable, and meets ICH Q2 (R1) guideline criteria.

Background: A water supply sufficiency and quality standard has been still important object of the priority issues of countries, regions as well as the Worldwide. In December, 2003, the General Assembly of the UN announced to worldwide a decade named as "Water for life" with duration of 2005 - 2015. Public Health Institute of Mongolia,2 Health Sciences University of Mongolia Background: A water supply sufficiency and quality standard has been still important object of the priority issues of countries, regions as well as the Worldwide. In December, 2003, the General Assembly of the UN announced to worldwide a decade named as "Water for life" with duration of 2005 - 2015. Ensure environmental sustainability objective 6.16 within MDGs of Mongolia proposed to decrease a share of inhabitants without safe drinking water, and a share of inhabitants not provided by an improved sanitation infrastructure, respectively. After Mongolia shifted to a market economy system, production rapidly developed, and rapid increasing of mining, population centralization in urban areas and use of the chemical elements were basic and necessary conditions to study an arsenic content in drinking water of Gobi provinces. Goal: To determine arsenic content in drinking water of Gobi provinces and provide a hygienic assessment. Materials and Methods: Research study designed by cross-section methods and analyzed one action data. In total of 62 soumsfrom five Gobi provinces (namely Gobi-Altai, Gobisumber, Dornogobi, Dundgobi, and Umnugobi) were selected as a research sites. Samples are taken according to the standard MNS ISO 5667-2:2001 from total of 142 deep drilled wells amongst 62 selected soums. According to the ISO-MNS 11885:2007 standard, arsenic content (As) were tested in the samples by using Optical Emission Spectrometer with brand name of Varian 720 -ESICP. Test analyses were assessed after comparison with the content level of arsenic in drinking water standard of Mongolia as coded MNS 900:2005 and the recommended levels stated in "Guidelines for drinking water quality", developed by the WHO. Results: Arsenic contents were presented 106 samples, represented 74.6 percent of the total samples from the 142 deep drilled wells in the selected sites of 62 soums among 5 Gobi provinces. In additionally, existing arsenic contents in 22 samples were 15.4 percent of the selected samples counted 1 to 6 times higher than the drinking water standard of Mongolia as coded MNS 900:2005 and the recommended levels stated in "WHO - Guidelines for drinking water quality". Total drinking water arsenic contents across the selected 5 Gobi provinces were statistical mean 0.0084 ± 0.0009 mg/l. Conclusion: 15.4 percent arsenic contents in drinking water in Gobi provinces were greater than the drinking water standard of Mongolia as coded MNS 900:2005 and the recommended levels stated in "WHO - Guidelines for drinking water quality".

BACKGROUND: Tuberculosis (TB) morbidity and mortality has been one of the pressing issues in the health sector of our country. In Mongolia, 2 people out of 1000 people developed tuberculosis annually, which leads to becoming one of the 7 countries with high TB morbidity among 37 countries of the Western Pacifi c Region.OBJECTIVE: The aim of the study is to have the baseline to understand and measure knowledge, attitudes and practices regarding tuberculosis among non-tuberculosis health care workers including family group practitioners, nurses and specialized doctors at the primary, secondary and tertiary health care level of Mongolia.MATERIALS AND METHOD: Cross-sectional descriptive qualitative study. Self-admitted questionnaire were performed for 572 health care workers. Total of 4 aimags/provinces and 3 districts were randomly selected. Selenge, Darkhan-Uul, and Khentii aimags are regions with high tuberculosis burden, Dornogobi and Orkhon aimags are with low Tuberculosis incidence and prevalence in 2008.Altogether 572 doctors and health professionals from selected health facilities were involved in survey questionnaire and 39.9% (228 people) of respondents were working at the primary level, 31.3% (179 people) in secondary level, and 28.8% (165 people) in the tertiary level health facility, respectively. Altogether 23 focus group discussions were organized, involving 130 people.RESULTS: Around 98.6% of respondents answered that TB is spread when infected person coughs and sneezes. However, one of every three respondents answered TB can be transmitted when sharing cups, dishes and other cooking utensils with the infected person, one in every ten people–shaking hands with the infected person, and one in every four people–through mother to child transmission. Such misconception is common among the health professionals, especially among nurses of the secondary and tertiary level health facilities. Around 47.6% or 272 people answered correctly that TB patients have symptoms such as coughing for 2 weeks and longer, develop sputum with blood traces, fever and sweating during night sleep, and loss of weight. However, there is some misunderstanding among the doctors and nurses such as there are skin rashes. When doctors and nurses where asked which form of TB is the infectious one, 86.9% answered correctly that TB with positive smear test is infectious. On assessing the knowledge, attitude and practice on TB treatment, about 93.4% of the respondents answered that treatment shall be done by anti-TB drugs and this result is equally strong among health professionals at all service delivery levels (p=0.075). However, there are some misconceptions among the nurses that TB patients should buy anti-TB drugs from the pharmacies, try traditional medicines and follow religious rituals. This should be paid further attention and issues covering TB should be included in their curriculum. Every second person knows the treatment continuation period of drug susceptible TB patient, which is relatively low knowledge level. According to survey results, every second person knows what DOTS stand for. In other words, 55.4% of the respondents identifi ed correctly what is DOTS, and 13.8% answered that it is a combination of anti-TB drugs, 3 .3% - as TB treatment method, 5.6% - as combination of TB reduction measures, and 2.2% answered that they don’t know.CONCLUSION: Many misunderstandings were found in the fi eld of transmission, BCG vaccination, treatment and anti-TB drugs. There is a need to provide training for non-TB medical doctors and nurses.