Background: Evaluation of genotoxic potential is essential for reducing carcinogenic risk and for assessing the safety of newly developed pharmaceutical products, traditional herbal medicines, and health supplements. Such evaluation plays an important role in protecting human health. Therefore, in Mongolia, it is necessary to investigate the safety of domestically produced pharmaceutical preparations, natural products, and traditional medicines on a scientific basis in accordance with international standards; to develop and implement national policies and standards; to introduce and localize appropriate methodologies; to protect human health; to prevent cancer, hereditary diseases, and longterm adverse effects; and to promote the rational use of medicines. Aim: To investigate the mutagenic properties of an herbal combination preparation in vitro and its genotoxic effects in vivo. Materials and Methods: Extracts were prepared from Dasiphora fruticosa, Cynara scolymus, and Rosa acicularis, and a herbal combination preparation was formulated in specific proportions. Mutagenicity was evaluated according to OECD Guideline 471 (Bacterial Reverse Mutation Test) using the Salmonella typhimurium TA100 strain under both S9 (-) and S9 (+) conditions with the Muta-Chromoplate™ assay. The combination preparation was tested at concentrations of 5, 2.5, 1.25, 0.625, 0.3125, and 0.1562 mg/mL in 96 wells, and reverse-mutated bacterial colonies were assessed by counting the number of wells that changed color from purple to yellow. In addition, using the IPHASE Biosciences kit, the preparation was tested at doses of 5, 2.5, 1.25, 0.625, 0.3125, and 0.1562 mg/plate on Salmonella typhimurium TA100 and TA98 strains under both S9 (-) and S9 (+) conditions. After incubation, the number of bacterial colonies formed was counted and compared with that of the positive control group. Genotoxicity was assessed according to OECD Guideline 474 (Mammalian Erythrocyte Micronucleus Test) by evaluating the numbers of polychromatic erythrocytes (PCEs), normochromatic erythrocytes (NCEs), and micronucleated polychromatic erythrocytes in the bone marrow of BALB/c mice. Result: In the study using the Muta-Chromoplate™ assay, bacterial colonies were observed at doses ranging from 5.0 to 0.1562 mg/mL of the herbal combination preparation. However, compared with the positive control group (aminoanthracene), the number of bacterial colonies was significantly lower (p<0.05). In the study using the IPHASE Biosciences kit, 30–154 bacterial colonies were observed in Salmonella typhimurium TA98 and TA100 strains under S9 (-/+) conditions at doses ranging from 5.0 to 0.156 mg/plate, which was approximately threefold lower than that observed in the positive control groups. In the positive control group treated with cyclophosphamide, the number of micronucleated polychromatic erythrocytes was increased. Conclusion The herbal combination preparation showed no mutagenic activity in either of the two mutation detection assays using Salmonella typhimurium TA98 and TA100 strains under S9 (-/+) conditions. In addition, it showed no genotoxic effect in the micronucleus assay.

Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide, accounting for approximately 19.8 million deaths in 2022, or 32% of all deaths. Insulin resistance is an important pathophysiological mechanism not only in the development of type 2 diabetes mellitus (T2DM) but also in the development and progression of cardiovascular disease. Evidence remains limited regarding the simultaneous assessment of associations between selected anthropometric measures and insulin resistance in patients with ischemic heart disease (IHD). Aim: To investigate the association between waist-to-height ratio (WHtR) and insulin resistance indices (TG/HDL and HOMA-IR) in patients with chronic ischemic heart disease. Materials and Methods: This hospital-based cross-sectional study included 274 patients aged 40–75 years. Written informed consent was obtained from all participants. Data were collected using a structured questionnaire, anthropometric measurements were performed, and peripheral blood samples were collected. Laboratory measurements included fasting lipid profile, fasting glucose, and fasting insulin levels. WHtR was calculated as waist circumference (cm) divided by height (cm). Insulin resistance was assessed using the TG/HDL ratio, calculated as TG (mmol/L) divided by HDL (mmol/L), and the HOMA-IR index. Metabolic syndrome was defined according to the Joint Interim Statement (JIS-2009) criteria. Results: Among the 274 participants, 209 (76.3%) were male and 65 (23.7%) were female, with a mean age of 61.1±7.9 years. WHtR was significantly and positively correlated with HOMA-IR, with a weak-to-moderate correlation (Spearman’s ρ=0.303, p<0.001). A weak but statistically significant positive correlation was also observed between WHtR and the TG/HDL ratio (ρ=0.136, p=0.039). The discriminative ability of WHtR for insulin resistance was moderate (AUC=0.645, 95% CI: 0.562–0.729; p=0.001). The optimal cutoff value determined using the Youden index was 0.60, with a sensitivity of 63.2% and specificity of 64.2%. Multivariable logistic regression analysis showed that WHtR ≥0.60 was independently associated with insulin resistance. Conclusion WHtR was significantly and positively associated with HOMA-IR and the TG/HDL ratio, and WHtR ≥0.60 was independently associated with insulin resistance.

Background: Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by abnormal proliferation of megakaryocytes in the bone marrow, resulting in persistent thrombocytosis in the peripheral blood and clinical manifestations including thrombotic and hemorrhagic complications. Approximately 90% of patients with ET harbor driver mutations in JAK2, CALR, or MPL, with JAK2V617F being the most frequently detected mutation. The JAK2V617F mutation induces constitutive activation of the JAK–STAT signaling pathway, leading to abnormal megakaryocytic proliferation and increased platelet production. Consequently, patients are predisposed to thrombotic complications; however, qualitative platelet dysfunction may also contribute to an increased risk of bleeding. Among large-vessel thrombotic complications, venous thromboembolism is relatively common, whereas pulmonary artery thromboembolism is an uncommon complication. Moreover, thrombotic risk is generally lower in patients with JAK2-negative ET. Case presentation: In this report, we present a rare case of essential thrombocythemia presenting with respiratory failure secondary to pulmonary artery thromboembolism. Conclusion This case demonstrates that essential thrombocythemia may initially manifest with life-threatening thrombotic complications, including pulmonary thromboembolism, even in the absence of the JAK2 V617F mutation. Accordingly, unexplained thrombocytosis warrants evaluation for an underlying myeloproliferative neoplasm, while early assessment of thrombotic risk is essential for guiding appropriate clinical management and reducing the risk of adverse outcomes.

Background: This study presents research on the traditional knowledge regarding Gentian (Gentiana L.) plants and their utilization. Aim: The objective of the study is to explore traditional knowledge about Gentian plants, their medicinal and other uses in various local communities, as well as to identify their vernacular names. Materials and Methods: The research was conducted in certain regions of Mongolia and the Inner Mongolia Autonomous Region (IMAR), involving 190 cultural heritage bearers through 36 questionnaires. The collected data were analyzed to determine the utilization index and frequency index of Gentian plants, assessing how they are used in the respective regions. Results: The results indicated the identification of four species of Gentian plants: Gentiana algida, G. macrophylla, G. decumbens, and Gentianopsis barbata. The relative frequency indices in Mongolia showed high usage with values of 0.37 for G. macrophylla, 0.51 for G. decumbens, and 0.55 for Gentiana algida. In contrast, the values in IMAR were lower, with 0.08 for white Gentian, 0.18 for large-leaved Gentian, and 0.21 for creeping Gentian. These findings suggest that the utilization of Gentian plants is influenced by intensive livestock farming and agricultural practices in the area. Conclusion The use of Gentian plants varies across regions, and the cultural heritage bearers from both countries name them differently based on flower color, size, and local dialects. This study provides valuable information for preserving local traditional knowledge and can be beneficial for researchers and cultural heritage protectors.

Background: Cardiovascular diseases (CVDs) is a third leading cause of non-communicable diseases and a leading cause of mortality in Mongolia. Among these, acute myocardial infarction (AMI), a complication of coronary artery disease (CAD), is a leading cause of cardiovascular mortality. In patients with AMI, both epicardial artery blood flow, observed through coronary angiography, and coronary microcirculatory dysfunction (CMD) play critical roles in the disease’s pathophysiology. Recent advancements have introduced artificial intelligence (AI)-based softwares which are capable of analyzing coronary blood flow from coronary angiography images. The AI based softwares can assess not only epicardial blood flow but also CMD in recent studies. In this review, we discussed the role of CMD in pathophysiology of AMI, diagnostic approaches, the application of AI-based technologies, their clinical significance, and future directions. Aim: This review aims to explore the pathophysiological relationship of coronary microcirculatory dysfunction (CMD) in the context of acute myocardial infarction (AMI), diagnostic methodologies, the application of artificial intelligence (AI)-based technologies, and their clinical significance. Hypotheses: 1. AI-based software allows for highly accurate assessment of coronary microcirculation during AMI. 2. CMD during AMI is associated with structural and functional changes in the heart. 3. CMD during AMI is related to disease prognosis and patient outcomes. Methodology:: This narrative review was compiled using a systematic and logical approach, based on publicly available recent clinical and biomedical research literature addressing the above hypotheses. Conclusion In recent years, AI-based image processing software has been developed to analyze angiographic images obtained during percutaneous coronary intervention (PCI) and treatment procedures. These tools show significant promise for early detection and improved diagnosis of CMD during AMI, as well as for better assessment of short- and long-term patient risk.

Introduction In 1987 Jerome Ritchie, David Auth and colleagues first introduced rotational atherectomy (rotablation) as a technique for the endovascular treatment of obstructive atherosclerotic disease. Rotational atherectomy covers 3-5% of all procedures in big PCI centers, while <1% in smaller centers. By study of Warth DC et al. in 1994, at early period when it was first introduced, procedure complication of rotablation was about 40%, those with coronary dissection 29%, coronary artery occlusion 11.2%, side branch occlusion 1.8%, distal occlusion 0.9%, no relow phenomenon 6.1%, severe vasospasm 13.8% and vascular perforation 1-2%.
By advanced techniques and technologies that kind of complications reduced significantly, it occurs as same as other PCI procedures.
In our country PCI procedure was first introduced in Third State Central Hospital in 2000, since then 20 years has passed. During this period coronary intravascular diagnosis and treatment developed progressively performing 14751 PTCA procedures, of those 8355(56,6%) PCI cases. By statistics of 2017, myocardial infarction occurred 1145.6 in 10000 population, showing sharp increase, and cardiovascular mortality became number one cause and has tendency to increase further.
To inform first outcome of rotational atherectomy of atherosclerosis that is severely calcified and unavailable to introduce balloon catheter or stent. To conduct atherectomy treatment methods, accustoming professionals, order and get ready the treatment materials for necessity.
We successfully performed rotablation in severely calcified mLAD of 56 years of male patient by staged PCI, whose infarct related artery Lcx was revascularized 3 months previously. As a result the patient was fully revascularized, the balloon catheter passed through the narrowing and stent was implanted successfully.

Introduction: We began treatment of multi drug resistant tuberculosis first from 2003. At that time there was a 1960 cases and most of the cases were from Ulaanbaatar, Darkhan, Selenge, Tuv, Dornod provinces. From all the cases only 62% or 1058 cases were included in treatment. From that 336 patient or 19% deceased, 296 patient or 18% didn’t get a treatment. We did this study because there were never done any research or study of surgical treatment of multi drug resistant tuberculosis in Mongolia. Materials and Methods: We studied cases of patients who undergone lobectomy, since 2007. There were 48 cases of 46 patients, 2 patients surgery were done on both sides. Respondents aged between 14- 45, 25 male (52%), 23 female (48%), all patients got a first - line anti-tuberculosis treatment, such as cat-1, cat-1+cat-2 and 10 variants of these drugs. It was done based on sputum culture test results of NCCD TB surveillance and research department’s laboratory. Results: From the all patients only 77.08% had undergone surgery within the first 3 years. 92% patients were diagnosed with multi drug resistance TB only with the sputum and sputum culture test results, and the rest of the patients were diagnosed using a tissue analyses on the above tests. It was revealed that HR resistant -91.66%, HR+(Z,E,S) -3 drugs resistant -18.78%, HR+(ZSE)-4 or 5 drugs resistant. In the patients TB lesion locations was on the right upper lobe 54%, left upper lobe 31%, on a both upper lobes 85%, cavernous fibrosis tubercles 60%, combined TB lesions 77%, tubercles 21%.87.5% of total patients received a multi - drug resistant TB treatment between 7 - 24 months prior surgery. All 48 patients had a totally 69 surgeries. Surgeries included 9% pneumonectomy, 28% lobectomy, 30% Wedge resection, 23% pleurectomy decortication, 7% Wedge resection on both sides, one bilobectomy. There were no complications during the surgery but 5 of patients had an empyema after surgery. No fatal cases.Three patients out of 5 who had a surgery due to pulmonary hemorrhage developed an empyema after surgery. Drainage tubes were taken after the surgery within 2-3 months.Therewere no complication and escalations in the patients who received a surgical treatment, after the surgery from 6 months to 5 years. Conclusion: In study it shows that surgical treatment is effective to do after 6 months of anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows that combining of medical and surgical treatment is healing up to 98% in the patients who were rightly chosen according to surgical indications.This research result shows that in our country multi - drug resistant TB surgical treatment complication is only 10.41%, which is below in the other countries who have same anti-tuberculosis drug treatment.

Introduction: We began treatment ofmulti drug resistant tuberculosis first from2003. At that time there was a 1960 cases andmost of the cases were from Ulaanbaatar,Darkhan, Selenge, Tuv, Dornod provinces.From all the cases only 62% or 1058 caseswere included in treatment. From that 336patient or 19% deceased, 296 patient or 18%didn’t get a treatment. We did this studybecause there were never done any researchor study of surgical treatment of multi drugresistant tuberculosis in Mongolia.Materials and Methods: We studiedcases of patients who undergone lobectomy,since 2007. There were 48 cases of 46patients, 2 patients surgery were done onboth sides. Respondents aged between 14-45, 25 male (52%), 23 female (48%), allpatients got a first - line anti-tuberculosistreatment, such as cat-1, cat-1+cat-2 and 10variants of these drugs. It was done basedon sputum culture test results of NCCDTB surveillance and research department’slaboratory.Results: From the all patients only77.08% had undergone surgery within thefirst 3 years. 92% patients were diagnosedwith multi drug resistance TB only with thesputum and sputum culture test results, andthe rest of the patients were diagnosedusing a tissue analyses on the above tests.It was revealed that HR resistant -91.66%,HR+(Z,E,S) -3 drugs resistant -18.78%,HR+(ZSE)-4 or 5 drugs resistant. In thepatients TB lesion locations was on the rightupper lobe 54%, left upper lobe 31%, ona both upper lobes 85%, cavernous fibrosistubercles 60%, combined TB lesions 77%,tubercles 21%.87.5% of total patientsreceived a multi - drug resistant TB treatmentbetween 7 - 24 months prior surgery.All 48 patients had a totally 69 surgeries.Surgeries included 9% pneumonectomy,28% lobectomy, 30% Wedge resection,23% pleurectomy decortication, 7% Wedgeresection on both sides, one bilobectomy.There were no complications during thesurgery but 5 of patients had an empyemaafter surgery. No fatal cases.Three patientsout of 5 who had a surgery due to pulmonaryhemorrhage developed an empyema aftersurgery. Drainage tubes were taken afterthe surgery within 2-3 months.Therewere nocomplication and escalations in the patientswho received a surgical treatment, after thesurgery from 6 months to 5 years.Conclusion: In study it shows that surgicaltreatment is effective to do after 6 monthsof anti-tuberculosis drug treatment in multi -drug resistant TB patients.Also it shows thatcombining of medical and surgical treatmentis healing up to 98% in the patients whowere rightly chosen according to surgicalindications.This research result shows that inour country multi - drug resistant TB surgicaltreatment complication is only 10.41%,which is below in the other countries whohave same anti-tuberculosis drug treatment.