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

Background: According to the World Health Organization (WHO), 6.7 million people die annually due to air pollution caused by solid fuel use, with the majority of deaths resulting from respiratory diseases and cardiovascular conditions. In Mongolia, air pollution ranks as the fourth leading risk factor contributing to mortality, following hypertension, diabetes, and other major health risks. Although there have been numerous studies on outdoor air pollution in Mongolia, research linking indoor air pollution at the household level with the health status of residents remains limited. Aim: To compare indoor PM2.5 concentrations in households of Ulaanbaatar and Darkhan and examine their association with hypertension during the winter season. Materials and Methods: The study was conducted during November and December 2023, and January 2024, involving 240 households in Ulaanbaatar and Darkhan. Indoor PM2.5 concentrations were measured using Purple Air real-time sensors continuously for 24 hours over approximately one month. After measuring indoor air pollution, individuals aged 18–60 years living in the selected households were recruited based on specific inclusion criteria. Blood pressure was measured three times and the average value was recorded. Information on respiratory illnesses was collected through structured questionnaires. Statistical analysis was performed using STATA version 19.0. Results: A total of 241 households participated in the study, with 116 from Ulaanbaatar and 125 from Darkhan. Of the participants, 46.5% were male and 53.5% were female. In terms of housing type, 96 households (39.8%) lived in gers, 97 (40.2%) lived in stove-heated houses, and 48 (19.9%) lived in apartments. Among all participants, 66.0% (n=159) had hypertension and 34.0% (n=79) had normal blood pressure. Among participants aged over 40, 69.9–88.5% had hypertension, which is statistically significantly higher compared to younger individuals (p=0.0001). By body mass index, 75.3% (n=72) of overweight individuals and 78.4% (n=58) of obese participants had hypertension, showing a statistically significant difference compared to participants with normal weight (p=0.0001). The 24-hour average concentration of indoor PM2.5 was measured using the Purple Air device, and the levels in gers and stove-heated houses exceeded the limit set by the MNS 4585:2025 standard (37.5 µg/m³) Conclusion This study identified a relationship between environmental factors, such as air pollution and housing type, and the prevalence of hypertension. The indoor PM2.5 concentration in gers and stove-heated houses was above the standard limit, indicating a negative impact on the health of those residents. Furthermore, the high prevalence of hypertension among participants over the age of 40 and those who are overweight suggests a possible link to lifestyle and environmental conditions.

Background: Saponins are secondary metabolites in plants that play an important role in defense mechanisms and physiological processes. Since stomatal cells are crucial for gas exchange and water balance in plant tissues, studying the anatomical and biochemical features of stomatal cells in saponin-rich plant species provides insight into the interactions between these compounds and cellular mechanisms. This serves as the basis of our study. Aim: To determine the structure, types, and functions of stomatal cells in saponin-containing medicinal plants Materials and Methods: During June–September 2024, nine species of saponin-containing medicinal plants were collected from Bulgan, Tuv provinces, and “Gorkhi-Terelj National Park” in Mongolia. Prepared microscopic specimens were examined using macroscopic and microscopic techniques to study the structure, position, number, and epidermal features of stomatal cells. Results: The study revealed that Anemone crinita Juz. exhibited the highest stomatal density (107 stomata/mm²) and epidermal cell density (229 cells/mm²), indicating strong adaptation and protective capacity in arid conditions. Vicia baicalensis (Turcz.) B. Fedtsch. showed the highest stomatal index (39.6), highlighting its significant role in regulating transpiration. Stomatal types varied among species: • Anomocytic stomata were observed in Potentilla multifida and Vicia baicalensis. • Anisocytic stomata were found in Delphinium grandiflorum and Ranunculus borealis. • Paracytic stomata were present in Gentiana algida, Adenophora remotiflora, Helianthemum nummularium, Anemone crinita, and Ranunculus acris. Conclution In the study of the structure, form, and number of stomatal cells in saponin-containing plants growing in Mongolia, Anemone crinita Juz. was found to have the highest number of stomatal and epidermal cells, indicating its high efficiency in gas exchange, water regulation, and protection against external stress. Furthermore, Vicia baicalensis (Turcz.) B.Fedtsch. showed the highest stomatal index, confirming its strong capacity for active regulation of gas exchange. The variation in stomatal cell types among plant species was identified as playing an important role in ecological and biological adaptation as well as protective mechanisms.

Background: Particulate matter in ambient air is an important risk factor for cardiovascular and respiratory diseases. Accurate and appropriate air quality monitoring is therefore critical for public health. In this context, it is necessary to investigate the feasibility of using low-cost direct monitoring devices (such as PurpleAir) in outdoor environments during the winter season, particularly in urban areas where fixed monitoring stations are not available. Aim: To assess and compare the outdoor PM2.5 concentrations in Ulaanbaatar and Darkhan during the winter season. Materials and Methods: The study was conducted in the capital city of Mongolia. The data collected for 45 days during the winter season, from December 9, 2024 to February 14, 2025. Continuous low-cost sensor was collected using a light scattering device (PurpleAir Classic) at a total of 25 locations and for 24 hours. Of these, 1 location was located next to a fixed measurement point and 3 locations (Zuun 4 zam, Yarmag, Selbe) were located within 200m of the study area, and the measurement results were compared using PM2.5. We used R software for statistical analysis. Results: The average PM2.5 concentration measured at the 13 fixed monitoring sites during the study period was 65 μg/ m³, while the average from the 25 PurpleAir sensors was 88 μg/m³. Parallel measurements conducted with the PurpleAir sensors and the UB4 fixed monitoring station showed a moderate correlation (r=0.44, R²=0.22, p<0.05). The measurement results at the Zuun 4 zam, Yarmag, and Selbe locations have a moderate correlation (r=0.38, r=0.61, r=0.25). Conclusion In situations where it is not possible to measure PM2.5 particulate matter in outdoor air automatically or by conventional methods, it is possible to monitor air quality by measured by low-cost sensors.

Backgroun: Air pollution is a major global public health concern that poses serious risks to human health regardless of a country’s level of economic or technological development. According to the World Health Organization (WHO, 2021), nine out of ten people worldwide breathe polluted air, and air pollution is responsible for the deaths of approximately 800 people every hour and 13 people every minute. Prolonged exposure to polluted air has been linked to a wide range of chronic illnesses, including chronic obstructive pulmonary disease (COPD), lung and bronchial cancers, asthma, and stroke. In Mongolia, air pollution reaches its highest levels during the winter months, particularly in Ulaanbaatar, where the majority of the country’s population resides. A study conducted by Enkhjargal G. (2012) reported that the concentrations of PM10 and PM2.5 in Ulaanbaatar were 7–8 times higher than the WHO recommended guidelines. In response to such challenges, many countries have increasingly adopted low-cost, direct measurement devices such as PurpleAir to monitor air quality. These devices are valued for their accessibility, network connectivity, and potential role in smart city pollution management systems. Despite their global application, there remains a lack of research in Mongolia on the use of PurpleAir sensors to measure PM2.5 concentrations and compare the results with official monitoring station data. Addressing this gap is essential for improving local air quality monitoring capacity and informing effective public health and environmental policies. Aim: Determination of PM2.5 particulate matter pollution in the outdoor environment of Ulaanbaatar city using a direct measurement device (Purple Air). Materials and Methods: A cross-sectional study design was employed. Direct measurement devices (Purple Air) were installed in selected districts of central Ulaanbaatar between December 2024 and February 2025, measuring PM2.5 concentrations at two-minute intervals over 24-hour periods. All data were statistically processed and analyzed using the SPSS-26 software package. Results: The average concentration of PM2.5 particles in the air of Ulaanbaatar city in winter is 66.68 μg/m3. Compared to the districts, the highest concentration was determined in SKHD (118.58±90.22 μg/m3), while the lowest concentration was determined in KHUD (42.37±43.51 μg/m3). Compared to the days of the week, the highest concentrations were measured on Monday (76.68±71.98 μg/m³), Saturday (77.50±71.63 μg/m³), and Sunday (80.34±74.45 μg/m³). The highest concentration of PM2.5 particles occurred from 6 pm to 1 am, and the lowest concentration was measured during the day (between 2 pm and 4 pm). The highest concentration of PM2.5 was measured in December (74.22±73.45 μg/m3), while the lowest concentration was measured in February (50.25±57.44 μg/m3). Conclusion The concentration of PM2.5 in the air of Ulaanbaatar city is 1.7 times higher than the general standard and technical requirements of Mongolia in winter, and the highest concentration is in the SKHD. The highest concentration of PM2.5 occurs more often in December and at night than in the winter months.

Background: Particulate matter with an aerodynamic diameter of 2.5 micrometers or smaller (PM2.5) penetrates deep into the alveoli through the respiratory tract and is characterized by its ability to induce oxidative stress, systemic inflammation, and vascular inflammation. Mongolia ranks among the countries with the highest levels of air pollution. In Ulaanbaatar, where more than half of the country’s population resides, wintertime PM2.5 concentrations often exceed 200 μg/m³, which is about eight times higher than the World Health Organization (WHO) guideline value. A study involving 1,200 adults in Ulaanbaatar showed that quality of life deteriorated sharply during periods of high air pollution, with effects more pronounced among individuals who already had impaired respiratory function. Aim: To examine the relationship between indoor household PM2.5 concentrations and lung function indicators among adults in Ulaanbaatar and Darkhan. Materials and Methods: This analytical cross-sectional study recruited adult participants from Ulaanbaatar and Darkhan through targeted sampling. Household air quality was measured using PurpleAir sensors, which were installed in participants’ homes for one month. After exposure measurement, lung function was assessed via spirometry. Statistical analyses were conducted using SPSS version 25.0. Results: A total of 236 participants were included: 114 (48.3%) from Ulaanbaatar and 122 (51.7%) from Darkhan. The sample consisted of 111 men (47.0%) and 125 women (53.0%). The mean indoor PM2.5 concentration was 66.24 μg/m³ (SD 44.87 μg/m³), ranging from a minimum of 7.79 μg/m³ to a maximum of 264.55 μg/m³. Stratification by housing type showed the highest PM2.5 levels in gers (82.34 μg/m³), followed by detached houses (67.34 μg/m³), while apartments had the lowest concentrations (32.24 μg/m³). Correlation analysis revealed statistically significant negative associations between PM2.5 levels and measures of expiratory function, including the FEV1/FVC ratio, peak expiratory flow (PEF), and mid-expiratory flow (FEF25–75). Reduced forced vital capacity (FVC) was observed in 9.4% of participants, reduced forced expiratory volume in one second (FEV1) in 15.3%, and a decreased FEV1/FVC ratio in 3.8%. Conclusion Indoor household PM2.5 concentrations were highest in gers, and expiratory flow-related lung function parameters showed significant negative associations with particulate exposure. This suggests that indoor PM2.5 primarily affects airflow limitation rather than overall lung volumes in this population.

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide, accounting for approximately 1.8 million deaths annually and representing 18% of all cancer deaths¹. According to the GLOBOCAN 2024 report, 2.4 million new cases were registered globally, ranking second after breast cancer². Non-small cell lung cancer (NSCLC) constitutes 85% of lung cancer cases, with adenocarcinoma being the most common subtype³. The objective of this study is to map the prevalence of HER2 activation and mutations in EGFR, EML4-ALK, ROS1, BRAF, and KRAS genes among lung cancer patients in Mongolia, and to evaluate their correlations with clinical and morphological parameters (age, sex, smoking status, stage, and morphology). Aim: To determine the distribution pattern of HER2 activation and EGFR, EML-ALK, ROS1, BRAF, KRAS gene mutations among patients with lung cancer in Mongolia, and to evaluate their associations with clinical and morphological characteristics. Materials and Methods: A retrospective study was conducted using archived materials from lung cancer patients at the Clinical Pathology, Molecular Genetics, and Pathology Laboratories of the National Cancer Center of Mongolia, covering the period from 2019 to June 2025. DNA Extraction from Tumor Tissue: Formalin-fixed paraffin-embedded (FFPE) tissue blocks from patients diagnosed with lung cancer, stored in the pathology department archives, were selected for the study. Sections of 5–10 μm thickness were cut, mounted on glass slides, stained with hematoxylin and eosin (H&E), and reviewed by a pathologist. Areas containing ≥20–30% tumor cells were identified and macro-dissected for analysis. Real-Time PCR Assay for Detection of EGFR/BRAF/KRAS/EML4-ALK/ROS1 Mutations: EGFR mutation detection was performed using the PANAMutyper™ EGFR Mutation Detection Kit (Panagene, Daejeon, South Korea) according to the manufacturer’s instructions. PCR reactions were carried out on a compatible instrument (Roche LightCycler 480, Germany) as recommended by the manufacturer. Statistical analysis was performed using Prisma-10 software. Results: A total of 282 lung cancer cases were included in the study. EGFR mutations were detected in 44% of cases and were absent in 56%. No significant age-related differences were observed (p=0.2636); however, EGFR mutations were significantly more frequent in females (36.6% vs. 19.6%, p=0.0019). No statistically significant differences were found across disease stage, T, N, or M classifications (p>0.05). No association was identified between smoking status and EGFR mutations (p=0.4178). Morphologically, EGFR mutations were significantly more prevalent in adenocarcinoma (54.83%) compared to squamous cell carcinoma (SCC) (31.8%; p=0.002). Of the 282 cases, adenocarcinoma accounted for 155 (54.9%) and SCC for 116 (41.1%). Overall, EGFR mutations were positive in 43.97% of cases, with a higher prevalence in adenocarcinoma (24.82%) than in SCC (13.1%). By exon: - Exon 18 mutations were detected in 6% of cases, predominantly in adenocarcinoma (6%, 4.25%). - Exon 19 mutations occurred in 8.15% and are associated with sensitivity to targeted therapy. - Exon 20 mutations were found in 3.19%, with the T790M resistance variant in 1.77%. - Exon 21 mutations were observed in 9.57%, more common in adenocarcinoma (9.57%) than in SCC (3.19%). Survival analysis stratified by stage at diagnosis showed significantly longer median survival in early-stage patients (18.6 months). Kaplan-Meier curve comparison, log-rank test, and hazard ratio calculations confirmed statistically significant differences (p < 0.05), indicating that disease stage is a key prognostic factor. Conclusion The study findings reveal a high prevalence of EGFR mutations among Mongolian patients with lung adenocarcinoma, underscoring the need for widespread implementation of targeted therapy (EGFR-TKIs). In contrast, mutation rates were lower in SCC and other morphological subtypes, highlighting the importance of investigating alternative molecular markers in these subgroups.

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

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

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.