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.

Background: A 2018 study on the global burden of disease, accidents, and risk factors reported that 1.6 million peo ple died in 2017 due to household air pollution. Poor indoor air quality has been highlighted as a contributing factor to respiratory diseases, cardiovascular conditions, and exacerbation of asthma and allergies. A 2019 study estimated that long-term exposure to fine particulate matter (PM2.5) with a diameter of 2.5 micrometers or less reduces average life expectancy by 1.8 years, with more severe effects in highly polluted regions. Additionally, a study by Miller et al. (2007) found that prolonged exposure to PM2.5 increases the risk of cardiovascular diseases, particularly among women. Direct measurement devices are highly effective in determining indoor PM2.5 concentrations, identifying sources of pollution, tracking pollutant dispersion, and monitoring temporal variations. Studies suggest that direct measurement is an accurate, cost-effective method that provides detailed data suitable for local conditions. Aim: To investigate the indoor air quality of houses and apartments in Darkhan city during the winter season using the Purple Air monitoring device. Materials and Methods: A cross-sectional study was conducted with a targeted sample of 128 households in Darkhan city. The study examined factors such as stove type, type of coal used, annual and daily coal consumption, frequency of heating, and chimney sealing conditions. To collect data, the Purple Air monitoring device was installed in each house hold for a month, after which it was retrieved. During retrieval, participants completed a questionnaire. The questionnaire consisted of 55 questions across 7 pages at the time of device installation and 25 questions across 3 pages at the time of device retrieval. The collected data was analyzed using SPSS 25.0. Results: A total of 128 households in Darkhan city participated in the study. The average duration of residence in the current home was 9.5 years, with no statistically significant variation. The distribution of housing types was as follows: traditional Mongolian gers (40.6%), houses (39.1%), and apartments (20.3%). The 24-hour average PM2.5 concentration was highest in gers (70.9 μg/m³), followed by houses (46.8 μg/m³) and apartments (22.8 μg/m³), with a statistically significant difference (p=0.0001). PM2.5 levels were most variable in gers, followed by houses and then apartments. House holds using central heating (apartments) had an average 24-hour PM2.5 concentration of 22.8 μg/m³, whereas households using stoves (gers and houses) had a significantly higher concentration of 59.4 μg/m³ (p=0.0001). However, there was no statistically significant difference between traditional and improved stoves. Among study participants, 21.4% reported that someone in their household smoked indoors. Additionally, 86.5% regularly burned incense, candles, or herbs, while 99.2% did not use an air purifier. Conclusion The indoor particulate matter concentration in houses and gers in Darkhan was 59.4μг/m3. Variations in stove types, poor chimney sealing limited space, and frequent gaps and cracks contribute to increased spread of indoor air pollutants.

Background: Medicinal herbs have been used in traditional medicine to treat systemic inflammatory disease for many years. For instance, Rhodiola rosea L extracts were used to enhance behavioural stresses for improving fatigue and depression. Gallic acid, found in Rhodiola rosea L and Rhodiola quidrifida is, a natural polyphenol, exhibits multiple therapeutic activities, including anti-inflammatory, anti-cancer, antioxidant, and anti-angiogenic effects. Saposhnikovia divaricate (its ethanol extract mainly) notified to support function of musculoskeletal tissue and to enhance tissue regeneration by its anti-inflammatory effect. The Salsola laricifolia L has been studied for its strong antioxidant activity, improve immune function, boost energy, and exhibit anti-inflammatory effects. This study allowed us to screen anti-inflammatory effects of medicinal plants and future therapeutic possibility. Aim: To study the content of phenolic compounds (gallic acid) in the composition of complex products of plants widely used in Mongolian traditional medicine, which have been found to have biological activity of the extracts Materials and Methods: The herbal extract was extracted from Rhodiola rosea L, Saposhnikovia divaricata (Tuscz) Schischk, Rhodiola quidrifida Pall.Fisch, Salsola laricifolia Turcz.ex Litv in laboratory of the Drug Research Institute of Monos Group, Mongolia. We used solvents for HPLC grade was used to identify the bioactive components that Gallic acid in the compound plant extract. : Results: The bioactive compounds in each of the Rhodiola rosea L, Rhodiola quadrifida Pall.Fisch and four medicinal plant extracts were identified using HPLC, confirming the presence of Gallic acid. Conclusion Our research results showed that the quantitative content of Gallic acid in the composite plant extract was high, at 1.02%.

Background: Hepatitis virus infections are widespread and highly endemic in Mongolia and ranks first in the world for liver cancer mortality per 100,000 population, eight times the world average. The World Health Organization estimates that more than 2 billion people are infected with the hepatitis B virus. Each year, 1 million people die from the infection, 4 million are newly infected, and approximately 350-400 million are chronic carriers. In 2018, 475 cases of viral hepatitis were recorded nationwide, accounting for 1.1 percent of all communicable diseases, a decrease of 59 cases or 0.2 per 10,000 population compared to the previous year. In 2016, 194 WHO member countries joined forces to develop a strategy to reduce viral hepatitis, with the goal of reducing mortality by 65% and new infections by 90% by 2030. In order to achieve this goal, the strategic goal states that each country must conduct a comprehensive public health study and intervention on the spread of infection, risk factors, and early detection. Aim: Study to the coverage of hepatitis B immunization among children aged 0-9 years in urban and rural Mongolia and to determine the influencing factors. Materials and Methods: A Nationwide population based cross-sectional study design was used in this study. Mongolia is geographically divided into the western, Khangai, eastern, and central regions. A total of 14 provinces were selected randomly in addition to Ulaanbaatar city. The appropriate sample size was estimated at 4500 children aged 0-9 years, based on 2019 demographic data from the National Statistics Office. The questionnaire contained closed and semi-closed questions on demographics, socio-economic status, vaccination history and etc. Results: A total of 5027 children aged 0-9 years were enrolled in this study out of which 33.7% (n=1692) and 66.3% (n=3335) were enrolled from capital city Ulaanbaatar and provinces, respectively. Almost half (n=2552) of the study participants were boys whereas the remaining were girls 50.0% (n=2554). According to the history of Hepatitis B vaccination by questionnaire of parents’, 91.2% [91.2-92.0] were vaccinated with Hepatitis B. The proportion was 89.7% [89.7-90.8] and 94.1% [94.1-95.2] in rural and urban areas, respectively. Nearly 90% [89.6-90.5] of children were vaccinated in hospitals, 2.3% [2.0-5.0] were vaccinated at home, 8.1% [7.9-10.7] were unaware of the study participants’ location of vaccination. There were no statistically significant differences by urban and rural residences. Vaccination coverage against Hepatitis B was 91.5% (n=2300) and 90.9% (n=2284) among boys and girls, respectively and 89.6% (n=4506) were vaccinated at hospitals. Vaccination coverage were similar by sex. We also used Health Documents /pink book of children/ or vaccination card for each child to determine the coverage. According to the data from the children’s vaccination card and health documents’, 917 (18.2%) children were not vaccinated against hepatitis, 57 (1.1%) children received 1 dose, 235 (4.7%) children received 2 doses, and 3818 (75.9%) children received all 3 doses of hepatitis B vaccine. There was no significant difference by sex, though the coverage varied by age. For instance, proportion of children with no written documentation in the vaccination card was 13.5% among children aged 1 years that increased to 22.5% and 25.3% among children aged 8 and 9 years, respectively. In contrast the coverage rate of 3 doses of hepatitis B vaccination declined from 77.8% to 70.7% among children aged 1 years and 9 years, respectively. Hepatitis B vaccination coverage according to the vaccination card was different by provinces and within the districts of Ulaanbaatar city. Conclusion A total of 5027 children aged 0-9 years were included in the study, of which 917 (18.2%) children were not vaccinated against hepatitis, 57 (1.1%) children were vaccinated against the first dose, 235 (4.7%) children were vaccinated against the second dose, and 3818 (75.9%) children were fully vaccinated against the first-third dose. Although the coverage of the study participants varied depending on age and place of residence, no significant differences were observed in terms of gender. The current rate of children who are not fully vaccinated stands at 18.2%, emphasizing the need to ensure all children receive full vaccinations for hepatitis B and the required five doses as per the schedule. Furthermore, it is essential to mandate booster vaccinations for those with delayed immunizations and improve the accuracy of registration data.

Background: According to the World Health Organization (WHO), air pollution was responsible for 8.1 million deaths globally in 2021, making it the second leading cause of death, including among children under 5 years old. Air pollution is also linked to a range of diseases such as stroke, chronic obstructive pulmonary disease, lung cancer, and asthma. In Ulaanbaatar, the capital of Mongolia, the average daily concentration of PM2.5 particles in the air reaches 750 μg/m3 during winter, which is 50 times higher than the WHO’s recommendation, making it one of the most polluted cities in the world. Air pollution continues to pose a significant public health challenge not only in Mongolia but also in many countries globally. However, there is a lack of comprehensive research and studies that summarize and review the existing work in this field. Aim: To summarize and review thematic works on air pollution conducted by researchers from Mongolian universities. Materials and Methods: A systematic review and analysis were performed on thematic works by researchers who completed their master’s and doctoral degrees in the field of air pollution between 2011 and 2024. Results: In terms of the type of master’s and doctoral dissertations, 76.0% (n=19) were master’s theses and 24.0% (n=6) were doctoral dissertations. Among the total number of works included in the study, 36.0% (n=9) focused on the health effects of air pollution, while 64.0% (n=16) addressed other related areas. Some studies indicated that PM2.5 levels in the air between 2011 and 2024 were 1-6 times higher than the Mongolian standard, with the highest levels observed from November to February and the lowest in July. Additionally, some studies suggested a reduction in PM2.5 levels following the introduction of improved fuel in Ulaanbaatar. Air pollution was found to increase the risk of respiratory and cardiovascular diseases, as well as cancer, and to contribute to reduced fetal weight. Conclusion When examining thematic studies on air pollution conducted by state-owned universities in Mongolia, the primary focus has been on the composition, concentration, and health impacts of air pollution. Going forward, research aimed at mitigating air pollution should be driven by collaborative efforts and leadership from universities, with the results being effectively communicated to policymakers.

Background: Employee satisfaction in the healthcare sector has a direct impact not only on the quality of medical services, but also on workforce stability and overall organizational performance. High levels of job satisfaction are associated with improved work performance, whereas low satisfaction often leads to negative outcomes such as stress and burnout. Although studies on job satisfaction have been conducted in Mongolia, research specifically targeting healthcare workers—and identifying the key factors influencing their satisfaction—remains relatively limited. This gap provides the rationale for the present study Aim: The objective of this study is to examine job satisfaction among healthcare workers at primary and referral hospitals and to identify key factors influencing it. Materials and Methods: The study was conducted between 2022 and 2024 among 1,883 physicians, nurses, and other healthcare professionals aged 18–65 years from 11 provinces and Ulaanbaatar city, using a quantitative research approach with a cross-sectional design. Job satisfaction was assessed with a questionnaire comprising six subdomains (supportive leadership, opportunities for human resource development, professional ethics, organizational culture, quality of healthcare services, and workplace safety), rated on a three-point Likert scale. Data analysis was performed using IBM SPSS Statistics version 26.0. Results: The overall level of job satisfaction among participants was 77.6%. Among the subdomains, workplace safety and supportive environment scored the lowest at 71.7%, whereas the quality and safety of healthcare services scored the highest at 83.4%. The findings indicated that holding a managerial position in hospitals in Ulaanbaatar and working as a physician in primary-level hospitals were positively associated with job satisfaction (p < 0.05). Age demonstrated a statistically significant association with job satisfaction, while years of work experience showed a negative correlation, with satisfaction decreasing as tenure increased (r = −0.09, p < 0.001). The findings indicate that improving healthcare workers’ job satisfaction requires strengthening and supporting several organizational dimensions, including supportive leadership, opportunities for human resource development, organizational culture, workplace safety, and a supportive work environment Conclusion Workplace safety and support, opportunities for human resource development, and organizational culture were found to be critical determinants of employee job satisfaction. The findings suggest that job satisfaction can be enhanced by optimizing organizational support, ensuring opportunities for professional growth, and strengthening workplace safety

Background: Hepatitis C virus (HCV) is a blood-borne infectious disease that, if left untreated, can lead to chronic infection, liver cirrhosis, and hepatocellular carcinoma. In Mongolia, the prevalence of HCV is relatively high, posing significant public health concerns. In alignment with the global goal to eliminate hepatitis B and C by 2030, this study aimed to investigate the prevalence, genotype distribution, and associated risk factors of HCV infection among the general population in Arkhangai province, Mongolia. Aim: To determine the prevalence of hepatitis C virus infection among the relatively healthy population of Arkhangai Province and to study its genotypes and risk factors. Materials and Methods: A cross-sectional analytical study was conducted using a two-stage sampling method, enrolling 2,304 individuals aged 0–80 years. Participants completed a structured questionnaire, and blood samples were collected for anti-HCV and HBsAg testing using enzyme-linked immunosorbent assay (ELISA) at the central laboratory of the provincial hospital. Serum from anti-HCV positive individuals was preserved at –80°C and transported to Ulaanbaatar for HCV RNA quantification via real-time polymerase chain reaction (RT-PCR) and genotyping through molecular diagnostics. Statistical analyses were conducted using SPSS version 26.0. Results: A total of 2,304 individuals from the provincial center and 8 soums participated in the study, of whom 57.8% were female. The overall HCV seroprevalence was 12.0%, with chronic HCV infection confirmed in 7.16%. Among patients with chronic HCV, genotype 1b was identified in 98.2% of cases. Risk factor analysis revealed statistically significant associations between HCV infection and undergoing cosmetic procedures, receiving injections in non-medical settings, cupping therapy, and sharing shaving equipment. Conclusion This study HCV seroprevalence of 12.0% among the relatively healthy population in Arkhangai province, with genotype 1b detected in 98.2% of chronic HCV cases. The following risk factors were found to be independently associated with HCV infection: undergoing cosmetic procedures (OR: 2.3), cupping therapy (OR: 1.7), receiving nonmedical injections (OR: 2.4), and sharing shaving tools (OR: 1.5) (p<0.001)

Background: Chronic hepatitis C virus (HCV) infection remains a major global health concern. Approximately 55–85% of individuals with acute HCV infection progress to chronic disease, which is often asymptomatic. Therefore, early diagnosis and treatment are crucial to prevent long-term complications. This provided the rationale for our study to evaluate the clinical characteristics, diagnosis, and treatment outcomes of chronic HCV patients using direct-acting antivirals (DAAs), with comparisons by viral genotype. Aim: To compare the clinical features, diagnosis, and treatment outcomes of chronic hepatitis C according to viral genotypes. Materials and Methods: A total of 1203 chronic HCV patients attending the outpatient department of Arkhangai Provincial General Hospital were included in this prospective and retrospective cohort study. HCV genotyping was performed, and patients received DAA therapy. Clinical manifestations, laboratory findings, HCV RNA levels, and fibrosis scores (APRI and FIB-4) were assessed at baseline, at week 4 of treatment, and at 12 weeks post-treatment. Statistical analysis was conducted using SPSS version 26.0. Results: : Among all patients, 6.7% had liver cirrhosis, and 1.4% had previously received interferon-based therapy. Patients with cirrhosis more frequently reported fatigue, abdominal discomfort, insomnia, right upper quadrant pain and loss of appetite (p<0.001). Virologic response at week 4 was 98.9%, and sustained virologic response at 12 weeks post-treatment was 99.3%. The mean APRI score decreased from 0.71±0.67 to 0.31±0.54, and FIB-4 from 1.61±0.41 to 1.16±0.26 (p<0.001). The most common adverse events were fatigue, headache, and nausea. Conclusion Treatment outcomes were 99.5% in patients with genotype 1b, 100% in genotype 1a, and 75% in genotype 2, with statistically significant differences (p<0.001). Both APRI and FIB-4 scores significantly decreased after treatment, confirming the effectiveness of DAA therapy in improving liver fibrosis (p<0.001).

Background: Patient safety is a core dimension of healthcare quality and has become a global priority. According to the report by the U.S. Institute of Medicine, between 44,000 and 98,000 deaths occur annually due to medical errors in hospitals. One of the key indicators of patient safety is the Adverse Events (AE), defined as unintended harm to a patient that results from medical care rather than from the underlying disease. The assessment of adverse events is not only a tool for detecting errors but also an active strategy for improving system reliability and safety. Accurate identification of adverse events is therefore essential for enhancing patient safety and serves as a critical performance indicator with financial implications for hospitals. Aim: To determine the incidence of adverse events in referral hospitals and to analyze the relationship between triggers and adverse events. Material and Methods: Data were collected during 2023–2024 from three referral hospitals, the First, Second, and Third State Central Hospitals after obtaining institutional approval. The study was conducted within the framework of the Whole System Measures methodology developed by the Institute for Healthcare Improvement (IHI), which is internationally used for system-wide performance assessment. Data extraction was performed from electronic health records and inpatient departments, and statistical analyses were conducted using SPSS version 25. Results: The study identified 8.3% adverse events per 1,000 patient-days, which is 1.66 times higher than the international reference rate. A statistically significant association was observed between the number of triggers and the occurrence of adverse events, indicating that the use of triggers facilitates the active detection of adverse events. Conclusion The incidence of adverse events in tertiary specialized hospitals was found to be higher than international benchmarks. The application of trigger-based active surveillance proved to be an effective method for identifying adverse events and enhancing patient safety monitoring systems.

Introduction: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) has increased significantly over the last three decades worldwide, from 17.6% in 1990 to 23.4% in 2019. The development of this disease depends on many risk factors, including genetics, lifestyle, and environment. The PNPLA3 (patatin-like phospholipase domain-containing protein 3) gene is the most relevant genetic factor influencing the risk of metabolic dysfunction-associated steatotic liver disease. The PNPLA3 rs738409 GG genotype impairs adiponutrin function, accumulating triglyceride in liver cells and forming small fat droplets within the liver. Aim: To determine rs738409 and rs2896019 single nucleotide polymorphisms of the PNPLA3 gene in metabolic dysfunction-associated steatotic liver disease and their correlation with some parameters of anthropometric and laboratory tests. Materials and Methods: This study was conducted with a case-control design in 2023–2024. There were 150 participants in the study, 50 in the control group without MASLD, and 100 in the case group with MASLD. The PNPLA3 (rs738409, rs2896019) gene’s single nucleotide polymorphism was identified by the RFLP-PCR technique. All statistical analysis was performed using SPSS 23 software. Categorical variables were described by numbers and percentages, and the numerical variables were characterized by the median (min and max) for the normal distribution, and mean± standard deviation for the non-normal distribution. The statistical tests utilized were the Chi-square test, Fisher’s exact test, student t-test, and Mann–Whitney test. Ethical approval for the survey was obtained from the Medical Ethics Committee under the Ministry of Health Of Mongolia in January 2023. Results: The participants’ average age was 46.73±11.45, with 60% being women (90) and 40% being men (60). Among all patients, the PNPLA3 gene’s single nucleotide polymorphism rs738409 revealed 44.7% (67) CC, 54.7% (82) GC, and 0.7% (1) GG (OR-CG+GG genotype- 2.9, p=0.003). In addition, as a result of determining the PNPLA3 gene rs2896019 single nucleotide polymorphism, the frequency of the TT genotype was significantly higher in the control group than in the case group (48%, 31%, p = 0.042). Conclusion The frequency of CG/GG genotypes rs738409, and rs2896019 of the PNPLA3 gene is higher in the case group, suggesting that they may be more susceptible to MASLD.