1.Whole-genome sequencing of SARS-CoV-2 from residual viral RNA present on positive rapid antigen test kits for genomic surveillance
Mohd Ishtiaq Anasir ; Khayri Kamel ; Nor Malizza G Adypatti ; Mohammad Syafiq Jamaluddin ; Farah Amira Ahmad ; Siti Nurhidayah Norhisham ; Muhammad Zulfazli Mohamad Sukri ; Nur Rafiqah Rosli ; Siti Norazrina Saif ; Nurul Izzati Basarudin ; Mohamad Azzam-Sayuti ; Akmal Hayat Abdul Karim ; Mahirah Kamil Puat ; Ravindran Thayan ; Rozainanee Mohd Zain
Western Pacific Surveillance and Response 2025;16(1):06-11
This report describes an approach to recover SARS-CoV-2 RNA from rapid antigen test kit (RTK-antigen) cassettes for whole-genome sequencing (WGS). RNA samples were recovered from 33 RTK-antigen cassettes for WGS, with 18 samples achieving more than 80% genome coverage. This work provides a proof-of-concept that positive RTK-antigen cassettes can be safely transported, stored and subjected to WGS, enabling swift identification of circulating variants.
2.Monitoring mortality in the setting of COVID-19 pandemic control in Victoria, Australia: a time series analysis of population data
Lalitha Sundaresan ; Sheena G Sullivan ; David J Muscatello ; Daneeta Hennessy ; Stacey L Rowe
Western Pacific Surveillance and Response 2025;16(1):29-39
Objective: Mortality surveillance was established in the state of Victoria just before the COVID-19 pandemic. Here, we describe the establishment of this surveillance system, justify the modelling approach selected, and provide examples of how the interpretation of changes in mortality rates during the pandemic was influenced by the model chosen.
Methods: Registered deaths occurring in Victoria from 1 January 2015 to 31 December 2020 were sourced from the Victoria Death Index. Observed mortality rates were compared to a raw historical 5-year mean and to predicted means estimated from a seasonal robust regression. Differences between the observed mortality rate and the historical mean (delta-MR) and excess mortality rate from the observed and predicted rates were assessed.
Results: There were 20 375 COVID-19 cases notified in Victoria as of 31 December 2020, of whom 748 (3.7%) died. Victorians aged >=85 years experienced the highest case fatality ratio (34%). Mean observed mortality rates in 2020 (MR: 11.6; 95% confidence interval [CI]: 11.4, 11.9) were slightly reduced when compared with the annual rate expected using the historical mean method (mean MR: 12.2; 95% CI: 12.1, 12.3; delta-MR: -0.57; 95% CI: -0.77, -0.38), but not from the rate expected using the robust regression (estimated MR: 11.7; 95% prediction interval [PI]: 11.5, 11.9; EMR: -0.05; 95% CI: -0.26, 0.16). The two methods yielded opposing interpretations for some causes, including cardiovascular and cancer mortality.
Discussion: Interpretation of how pandemic restrictions impacted mortality in Victoria in 2020 is influenced by the method of estimation. Time-series approaches are preferential because they account for population trends in mortality over time.
3.Effects of flavanone on cancer cells viability
Jadamba Ch ; Erdenezaya O ; Iderjavkhlan S ; Burnee M ; Gurbadam A ; Temuulen D ; Darambazar G ; Oldokh O ; Enkhmaa D ; Giimaa N
Mongolian Journal of Health Sciences 2025;88(4):28-32
Background:
In recent years, scientists have found that certain natural compounds have significant potential in cancer
prevention and early-stage cancer treatment. Flavanones, a class of polyphenolic compounds found in plants, vegetables,
seeds, fruit peels, and flowers, have been identified to possess anticancer, antioxidant, anti- inflammatory, and antibacterial bioactivities. Cancer has become a major global challenge in terms of both economic and public health concerns.
Global statistics indicate that 22.8% of deaths are attributed to non-communicable diseases, and 16.8% are caused by
cancer, accounting for one in four and one in six deaths, respectively.
Aim :
To investigate anticancer effects of Iris Tenuifolia-derived flavanone on cancer cell lines.
Materials and Methods :
The study was conducted at the Bio-Medical Research Institute of the Mongolian National Uni
versity of Medical Sciences, investigating the effect of flavanones on cancer cell viability under in vitro conditions using
the MTT assay. In the study, colon, liver, and lung cancer cells were cultured, stabilized, and used for the experiments.
Colorectal cancer cells (MC38), liver cancer cells (HepG2), and lung cancer cells (A549) were revived, cultured, and
stabilized for use in the experimental procedures. Statistical analysis of the results was performed using Microsoft Excel
2010, and graphs were generated using GraphPad Prism 8. Differences between groups were analyzed using Student’s
t-test, and a p-value of <0.05 was considered statistically significant.
Results :
We treated MC38, HepG2, and A549 cancer cells with different concentrations of flavanone (2.5 µM, 5 µM, and
10 µM) for 24 to 48 hours to evaluate cell viability. Flavanone inhibited A549 cell viability by 2.5 μM-10%, 5 μM-25%,
and 10 μM-38%, respectively. For HepG2 cells, flavanone treatment at concentrations of 5-10 µM reduced cell viability by 28–58%. No statistically significant effect on the viability of MC38 cells was observed following treatment with flavanone at concentrations ranging from 2.5 to 10 µM. Additionally, although MC38 inhibited cell viability in a dose-de
pendent manner in cell cultures, it had a statistically significant effect at higher concentrations of 30-200 μM (p<0.01).
Conclusion
Flavanone inhibits the cancer cell viability in a dose and time dependent manner
4.Diabetic Ketoacidosis and Associated Laboratory Abnormalities in New-Onset Type 1 Diabetes Mellitus
Azjargal B ; Khishigjargal B ; Erdenetuya G
Mongolian Journal of Health Sciences 2025;88(4):33-37
Background :
Diabetic ketoacidosis, an early and common complication at the initial diagnosis of Type 1 Diabetes Mel
litus (T1DM), remains a significant clinical concern. The high prevalence of this complication in the pediatric population
provided the rationale for conducting the present study.
Aim:
Our study aims to compare the incidence, clinical features, and physical measurements associated with diabetic
ketoacidosis (DKA) at the time of initial diagnosis of Type 1 Diabetes Mellitus (T1DM), and to classify the severity of
DKA based on selected laboratory findings.
Materials and Methods:
We conducted a retrospective observational study of newly diagnosed T1DM with DKA in
children aged less than 18 years old at National Center for Maternal and Child Health during the period 2017-2022. The
study compared the analysis of medical and laboratory records from patients medical charts. The severity of diabetic ketoacidosis (DKA) was classified based on laboratory criteria according to the 2022 guidelines of the International Society
for Pediatric and Adolescent Diabetes (ISPAD). The study data were analyzed using STATA-16.0.
Results:
During the period from 2017 to 2022, a total of 124 children under 18 years of age (mean age: 9.11±3.84 years)
were newly diagnosed with T1DM and included in the study, of whom 67.7% (n=84) presented with diabetic ketoacidosis
(DKA). Of the children with DKA, 57.2% (n=48) had severe, 17.8% (n=15) had moderate, and 25.0% (n=21) had mild
severity. Girls were more frequently affected (67.1%, n=47; p=0.871). Having a viral infection before the first diagnosis
of type 1 diabetes (51.2%, n=43, p=0.011) and having high blood glucose levels at that time (25.8±9.32 mmol/l, p=0.012)
were statistically significantly associated with diabetic ketoacidosis. The blood gas analysis of children with ketoacidosis showed pH 7.05±0.15, HCO3 8.68±4.27 mEq/l, and the group with severe ketoacidosis had higher blood potassium
levels (4.08±0.8 mEq/l, 3.6±0.56 mEq/l, p=0.049) and blood glucose levels (28.37±9.23 mmol/L, 21.96±9.18 mmol/L,
p=0.012) compared to the group with mild ketoacidosis.
Conclusions
1. Diabetic ketoacidosis (DKA) was identified in 67.7% (n=84) of the children included in the study.
2. At the initial diagnosis of Type 1 Diabetes Mellitus (T1DM), vomiting and fatigue were the predominant clinical manifestations of DKA.
3. Severe DKA was observed in 57.1% (n=48) of the participants, with elevated serum potassium and glucose levels
noted as contributing factors to the severity of ketoacidosis.
5.Technologycal study of preparing tablet formulations from hepaclin-4 prescription
Otgontsetseg B ; Khuslen M ; Byambasuren G ; Tserendolgor B
Mongolian Journal of Health Sciences 2025;88(4):38-41
Background:
As of 2024, digestive system diseases rank fourth among the causes of mortality in Mongolia. Among
these, hepatocellular carcinoma (liver cancer) accounted for 20,501 deaths, leading in total mortality rates. In Traditional
Mongolian Medicine, Scutellaria baicalensis Georgi is used to cool blood heat, clear internal heat, and regulate imbalances; Saussurea amara L. is used for its antibacterial, anti-infective, and anti-inflammatory properties; Carthamus tinctorius L. serves for disinfection, pain relief, fever reduction, and detoxification; and Chiazospermum erectum L. is used to
eliminate toxic heat and febrile conditions. Studies have confirmed that the Hepaclin-4 formulation exhibits antioxidant,
membrane-stabilizing, hepatoprotective, anti-necrotic, detoxifying activities, and reduces the accumulation of harmful
byproducts from excessive peroxidation. Therefore, developing a solid dosage form from the raw herbal materials of
Scutellaria baicalensis Georgi, Saussurea amara L., Carthamus tinctorius L., and Chiazospermum erectum L.in the He
paclin-4 formula forms the basis of our research.
Aim:
To formulate and develop a tablet dosage form based on the compound prescription of Hepaclin-4
Materials and Methods:
The raw materials of Scutellaria baicalensis Georgi, Saussurea amara L., Carthamus tinctorius
L., and Chiazospermum erectum L.were weighed at a 1:1:1:1 ratio and extracted with 40% ethanol at a 1:10 ratio using
the remaceration method. Ethanol was evaporated using a vacuum evaporator to obtain a thick extract, and quality indicators were determined. From the obtained thick extract, granules were prepared using two types of excipients through
the wet granulation method, and their quality characteristics were studied. Based on the most suitable granules, tablet
and capsule dosage forms were prepared and standardized according to the methods outlined in the Mongolian National
Pharmacopoeia.
Results:
The Hepaclin-4 tablets were found to be round, well-formed, smooth, with intact edges, a slight characteristic
odor, no unpleasant taste, and light yellow in color. The friability resistance of the 0.5 g tablet was 99.6±0.08%, hardness
was 1.07±0.12 MPa, weight variation ranged from -2.6% to +3.9%, all within the acceptable 5% limit. The disintegration
time was 4.23±0.05 minutes, and dissolution was 95.4±0.47%, meeting the permissible standards. When flavonoids in the
tablets were detected by Thin Layer Chromatography (TLC), brownish-yellow spots appeared at Rf values identical to
standard quercetin (Rf=0.94) and rutin (Rf=0.48). The total flavonoid content, determined by Spectrophotometric Method
(SPM), was 0.165±0.01%.
Conclusion
Tablets were successfully developed from the thick extract of the Hepaclin-4 herbal compound. Upon eval
uation, the tablets met all the required technical specifications.
6. Impact of Individual Temperament on the Immune Response After COVID-19 Vaccination
Burenjargal B ; Dashpagam O ; Shatar Sh ; Khongorzul T ; Ariunzaya B ; Zolmunkh N ; Gansukh Ch ; Ulziisaikhan B ; Chimidtseren S ; Baasanjargal B ; Enkh-Amar B ; Nomin-Erdene Ts ; Davaalkham D ; Tsogtsaikhan S ; Batbaatar G
Mongolian Journal of Health Sciences 2025;88(4):47-51
Background:
The first confirmed case of COVID-19 in Mongolia was reported on November 11, 2020. In response, the
government imposed a nationwide lockdown, which significantly impacted the population’s mental health. Heightened
levels of stress, anxiety, loneliness, and depression during the pandemic altered individuals’ psychological stability and
behavior. Personality traits—defined as relatively stable patterns of emotion, cognition, and behavior—play a key role in
stress responses and emotional regulation under pressure. Emerging evidence suggests that these psychological factors
may influence the immune system’s responsiveness, including vaccine-induced antibody production.
Aim:
To evaluate the association between post-vaccination antibody responses and personality types following two doses
of COVID-19 vaccines.
Materials and Methods:
A total of 738 participants who received two doses of COVID-19 vaccines (AstraZeneca
ChAdOx1, n=29; Pfizer-BioNTech, n=119; Sinopharm BBIBP, n=590) and had no prior SARS-CoV-2 infection were enrolled. Serum samples were collected 21–28 days after the second dose, and SARS-CoV-2 RBD (S) IgG antibodies
were measured using ELISA (Proteintech Inc., USA). Personality types were assessed using a 56-item temperament
questionnaire developed by A. Belov, categorizing individuals into classical temperament types (choleric, phlegmatic,
sanguine, melancholic). Logistic regression and ROC analysis were used to examine associations between personality
types and antibody response.
Results:
The presence of an antibody response was significantly higher among individuals with a melancholic temperament, and significantly lower among those with a phlegmatic temperament. Furthermore, antibody titers were higher in
participants with melancholic and sanguine temperaments and lower in those with a phlegmatic type.
Conclusions
1. During the early period following the second dose of COVID-19 vaccination, the antibody response was higher
in individuals with a pure melancholic temperament, while it was lower in those with a phlegmatic temperament.
2. After the second dose of the Sinopharm BBIBP COVID-19 vaccine, antibody titers were higher in individuals with
pure melancholic and sanguine temperaments, and lower in those with a phlegmatic temperament.
7.Comparison of ambient air PM2.5 pollution in Mongolian cities by raw and improved coal consumption
Buyantushig B ; Enkhjargal G ; Batzorig B ; Ulziihhutag B ; Davaalkham D
Mongolian Journal of Health Sciences 2025;88(4):62-66
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.
8.Utilizing lactic acid bacteria for the cultivation of health-safe vegetables
Anuujin G ; Munkhjargal B ; Tsend-Ayush D ; Gerelmaa E ; Baigalmaa J
Mongolian Journal of Health Sciences 2025;88(4):67-70
Background:
Research on lactic acid bacteria has confirmed how specific strains possess probiotic properties and impart unique sensory characteristics to food products. The use of probiotic lactic acid bacteria in many food products, thus confers various health benefits to humans when they are frequently consumed in adequate amounts.
Aim:
To determine the effect of lactic acid bacteria on the growth of tomatoes.
Materials and Methods:
The lactic acid bacteria were cultured using the Lactobacillus medium from whipping cream
and Dandelion (Taraxacum mongolicum) and identified using the MALDI-TOF MS automated microbial identification
analyzer. A solution was prepared using Lactobacillus delbrueckii isolated from whipping cream and Lactobacillus gasseri isolated from Dandelion (10^7CFU/ml), and sterilized tomato seeds were watered for 10 days with the solution, while
sterilized distilled water was used as a control. The germination rate of the seeds and the root length were measured and
recorded every day.
Results:
The solution of L.delbrueckii bacteria isolated from cream germinated 100% of the seeds, which is 4% higher
than the control seeds, while the solution of L.gasseri bacteria isolated from Dandelion germinated 100%, supporting 4%
higher than the control seeds. Seedlings irrigated with the L.delbrueckii bacterial solution exhibited an average length of
10.3cm, which was 1.3cm longer than the control (P=0.003), indicating a statistically significant difference. Similarly,
those treated with the L.gasseri solution had an average length of 11.5cm, 2.5cm longer than the control (P=0.005), also
demonstrating statistical significance.
Conclusion
The application of the lactic acid bacterial solution significantly enhanced both the germination of tomato
seeds and the growth of the plants compared to the control solution.
9.Study results of PM1 and PM10 particulate matter concentrations in Ulaanbaatar city’s household environments using low-cost sensors.
Ulziimaa D ; Jargalsaikhan G ; Ser-Od Kh ; Enkhjargal G ; Myagmarchuluun S ; Gantuya D ; Munkh-Erdene L ; Damdindorj B ; Khurelbaatar N ; Davaalkham D
Mongolian Journal of Health Sciences 2025;88(4):88-91
Background:
According to the World Health Organization (WHO), 99 percent of the world’s population is exposed to air
that exceeds WHO recommendations, with low- and middle-income countries being the most affected. The main causes
of indoor air pollution include human activities such as fuel burning, cooking, cleaning, and smoking; housing characteristics such as walls, floors, ceilings, and furniture; ventilation; and outdoor air pollution.
Aim :
To assess PM1 and PM10 concentrations in 120 selected households in Ulaanbaatar.
Materials and Methods :
Indoor PM1 and PM10 concentrations were measured using Purple Air real-time sensors in
randomly selected Ulaanbaatar households between October 2023 and January 2024. Supplementary data on factors affecting the PM2.5 concentration were collected via questionnaires. Each measurement was taken in 10-minute intervals,
yielding 51,309 data for analysis.
Results :
PM1 concentrations were measured at 55.5±53.2 μg/m³ in gers, 54.9 ± 46.7 μg/m³ in houses, and 31.6±40.1 μg//m³ in apartments (p<0.001) and measuring PM10 concentrations were 110.6±108.6 μg/m³ in gers, 110.6±96.7 μg/m³ in
houses, and 62.2±83.0 μg/m³ in apartments (p<0.001) When considering the concentration of PM1, PM10 by heating
type, PM1 was 55.3±50.1 μg/m³ and PM10 was 110.6±103.0 μg/m³ in households with stoves and furnaces, and PM1
was 31.6±40.1 μg/m³ and PM10 was 62.2±83.0 μg/m³ in households connected to the central heating system (p<0.001).
Regarding the months of measurement, the highest concentration was observed in December 2023, at 77.1±94.1 μg/m³. The highest concentrations for both PM₁ and PM₁₀ were recorded in January 2024, at PM₁: 64.8±55.1 μg/m³, PM₁₀:
131.4±116.0 μg/m³.
Conclusion
1. Indoor PM10 concentrations in residential environments in Ulaanbaatar city were within the MNS4585:2016 Air
Quality Standard, however, it was exceeded the WHO air quality guidelines, indicating an excessive risk of increasing morbidity and mortality among the population.
2. Indoor PM1 and PM10 concentrations in residential environments in Ulaanbaatar varies depending on location, type
of housing, type of heating, and month of measurement.
10.Association between serum cryoglobulinemia and clinical manifestation in chronic hepatitis C patients
Amin-Erdene G ; Gantogtokh D ; Yumchinsuren Ts ; Dolgion D ; Bolor U ; Otgongerel N ; Enkhmend Kh ; Ganchimeg D ; Tulgaa L ; Sarnai Ts ; Batbold B
Mongolian Journal of Health Sciences 2025;88(4):92-99
Background:
The most common clinical manifestation of HCV infection, which includes both hepatic and extrahepatic
manifestations, is mixed cryoglobulinemia, which is characterized by the precipitation of certain proteins in the blood at
temperatures below 37°C (in vitro), aggregation, and deposition in the walls of small and medium-sized vessels, causing
vasculitis, which is clinically manifested by a triad of joint pain, fatigue, and rash on the soles of the feet. Cryoglobulinemia is commonly diagnosed in people with HCV infection, with a prevalence ranging from 10% to 70%. Vasculitis that
occurs when cryoglobulinemia is detected mainly affects the small vessels of the skin, kidneys, and peripheral nerves,
causing complications in other organ systems.
Aim :
To determine the prevalence of cryoglobulinemia in people with HCV infection, study it in relation to the stage of
liver fibrosis, and determine its clinical relevance.
Materials and Methods :
200 chronic HCV infected individuals were included in the study according to the inclusion
and exclusion criteria. After obtaining informed consent from each participant, a questionnaire was used to collect information, perform physical measurements, and collect peripheral blood samples. Complete blood count and biochemical
tests (liver and kidney function) were performed. The degree of liver fibrosis was assessed non-invasively (APRI, FIB4). The glomerular filtration rate was calculated electronically using the MDRD GFR Equation. Skin examination was
performed to assess the presence of rash, ulcers, and scarring on the shins and ankles of cryoglobulinemia. To determine
cryoglobulinemia, 8 ml of blood was collected in a tube without anticoagulant, and the sample was kept motionless for
1 hour at room temperature until clotting was complete. After centrifugation, the samples were separated and stored in a
refrigerator at +4°C for 7 days, and then at room temperature for 30 minutes, the precipitate was detected.
Results :
A total of 200 people participated in the study, of which 71 were men (35.5%), the average age was 53.39±13.0.
Cryoglobulinemia protein precipitates were determined in a total of 148 people, of which 50 were men (33.8%), the
average age was 52.95±13.0. Cryoglobulinemia protein precipitates were detected in 89 people, or 60.1% of the study
participants. Of the total study participants, 176 (88.0%) had chronic hepatitis C (CHC). Of these, 57 people had CHC
with cryoglobulinemia. Comparing laboratory parameters, the mean GGT level in the cryoglobulinemia group was statistically significantly higher than in the non-cryoglobulinemia group (p=0.039). However, when laboratory parameters
were grouped by increasing or decreasing, AST and ALT levels were significantly higher in the cryoglobulinemia group,
indicating more hepatocellular damage (p<0.000). Increased creatinine levels may be associated with the risk of renal
dysfunction. The FIB-4 index and APRI index showed a more severe degree of fibrosis in the cryoglobulinemia group
(p<0.005; p<0.000). Univariate logistic regression analysis showed that age was associated with the occurrence of cryoglobulinemia (OR=2.48; 95% CI:1.31–4.70; p=0.005). Platelet count had a statistically significant positive effect in multivariate analysis (OR=14.38; 95% CI:1.26–163.89; p=0.032).
Conclusion
The prevalence of cryoglobulinemia among HCV-infected patients was 60.1%, and older age and decreased
platelet count among infected individuals were associated with the occurrence of cryoglobulinemia.


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