Background: Ambient and household air pollution remain leading risk factors for global morbidity and mortality. Exposure to fine particulate matter (PM₂.₅) is associated with increased risks of cardiovascular and respiratory diseases, as well as lung cancer, metabolic and neurological disorders, and immune dysfunction. In urban areas of Mongolia, air pollution reaches critical levels during the winter season. Although improved solid fuels have been introduced in recent years, their impact on both outdoor and indoor air quality remains insufficiently characterized. Aim: To compare outdoor and household air pollution levels in Ulaanbaatar and Darkhan cities. Materials and Methods: Outdoor air pollution data for Ulaanbaatar were obtained from fixed monitoring stations of the National Agency for Meteorology and Environmental Monitoring for the period 2014–2026, with seasonal comparisons performed. For indoor air quality assessment, a longitudinal study was conducted among 240 households (apartments, houses, and traditional gers) in Ulaanbaatar and Darkhan from 2023 to 2026. PM₂.₅ concentrations were measured using real-time sensors (PurpleAir sensor), deployed for 14–21 days per season (winter and summer) in each household, recording data at 10-minute intervals over 24-hour periods. Result: Between 2014 and 2026, the 24-hour mean concentrations in Ulaanbaatar were 60.5 µg/m for PM₂.₅, 117.3 µg/m for PM₁₀, 37.3 µg/m for NO₂, 41.8 µg/m for SO₂, and 27.5 µg/m for O₃. While particulate matter levels showed a decreasing trend following the introduction of improved fuels, SO₂ concentrations increased, and overall pollution levels remained higher than those observed in Darkhan. Indoor PM₂.₅ concentrations were higher in Ulaanbaatar compared to Darkhan (60.7±86.1 vs 48.4±96.7 µg/m). Significant differences were observed by housing type (p<0.0001), with higher concentrations in households using solid fuels (houses and gers) and lower levels in apartments. These findings indicate substantial variability in indoor air pollution by city, housing type, and season, with persistently elevated exposure levels. Conclusion Outdoor air pollutant concentrations in Ulaanbaatar, including particulate matter, NO₂, and SO₂, exceed national standards and WHO guideline values by 1–4 times. Indoor PM₂.₅ pollution is higher in Ulaanbaatar than in Darkhan and varies significantly by housing type and season, indicating a high and heterogeneous exposure burden among urban populations.

Background: Respiratory and gastrointestinal infectious diseases are the leading causes of morbidity in children. Numerous international studies have demonstrated that handwashing with soap is one of the most effective and cost-efficient methods for preventing these diseases in children. A previous study conducted in Ulaanbaatar found that only 50.1% of general education school students practiced proper handwashing, which is considered insufficient even in areas with relatively adequate facilities. In Mongolia, 56.1% of the 865 schools lack handwashing facilities and soap, and 25% do not meet the WASH standards. Although knowledge about handwashing increased during the COVID-19 pandemic, sustained behavioral change remained limited, highlighting a gap between knowledge and practice and indicating the need for targeted educational interventions. Furthermore, there is limited research comparing the effectiveness of such interventions across different school environments and urban–rural settings, which provides the rationale for this study. Aim: To evaluate the effectiveness of a handwashing educational intervention among primary school students and determine differences in knowledge change across four schools in urban and rural areas. Materials and Methods: A quasi-experimental study design was used from December 2024 to June 2025. A total of 1,353 students from grades 3–5 in four general education schools (two in Ulaanbaatar and two in rural areas) were included in the study. Preand post-intervention handwashing knowledge scores were analyzed using paired t-tests and one-way ANOVA (α=0.05) with STATA 14.0. Ethical approval was obtained from the Ethics Committee of the Mongolian National University of Medical Sciences. Result: The mean handwashing knowledge score increased significantly from 9.68 (±2.64) before the intervention to 10.30 (±2.74) after the intervention, with a mean difference of +0.63 (p<0.001). The differences in improvement between schools were also statistically significant (ANOVA: F(3,1335)=5.90, p=0.0005). The highest improvement was observed in urban School A (+1.49), while the lowest was observed in School B (+0.16). Rural schools C and D showed moderate and relatively consistent improvements (+0.51 and +0.70, respectively). Conclusion School-based handwashing educational interventions effectively improve knowledge among primary school students. However, environmental factors, such as infrastructure and geographic location, significantly influence the effectiveness of the intervention. Therefore, educational interventions should be implemented alongside infrastructure improvements.

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 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: Since ancient times, humans have used medicinal plants for medicinal purposes, and they have been recognized as beneficial to health. The basis of the treatment of these plants is phytochemical substances and in modern times, with the development of science and technology, the substances contained in these plants are extracted and medicinal substances and drugs are produced to treat many diseases. There are more than 800 medicinal plants in Mongolia, and their chemical structure and properties are studied in detail, biological activity and main features are discovered, and new medicines are produced. From the Thalictrum squarrosum plant, 25 compounds have been identified, such as triterpenoids with 17 carbon atoms in the cycloartane type ring, saponins, oleic acid glycosides, phytosterols and their glycosides etc., and the structures of 7 new compounds have been determined and the research on phenolic compounds and antioxidant activity has been limited, which is the basis for this research. Aim: Determination of total phenolic content and antioxidant activity of Thalictrum squarrosum. Materials and Methods: Total phenolic compounds were determined spectrophotometrically using Folin-Chicolte color reagent in 1.0 raw material of the Thalictrum squarrosum. Antioxidant activity was determined by DPPH, FRAB and ABTS in sub-extracts of 4 groups. Results: The total phenolic compounds of Thalictrum squarrosum were determined to be 1.9±0.001%. In the study of biological activity of Thalictrum squarrosum plants, the antioxidant activity of 4 groups of sub-extracts was tested by DPPH method, and the IC50 of total alkaloids (pH 9-10) was 201.58±0.1 μg/ml, ethyl acetate sub-extract 94.34±0.66 μg/ml, aqueous extract 824.18±0.08 μg/ml, and butanol sub-extract 128.75±0.58 μg/ml. When tested by ABTS method, the IC50 of total alkaloids (pH 9-10) was 35.83±0.44 μg/ml, ethyl acetate sub-extract 90.45±0.62 μg/ml, aqueous extract 104.19±0.93 μg/ml, dichloromethane sub-extract 156.44±0.48 μg/ml, and butanol sub-extract 170.03±0.61 μg/ml. When tested for antioxidant activity at 800 μg/ml by the FRAB method, the ethyl acetate sub-extract was 8946.16±14.79 μg/ml, the dichloromethane sub-extract was 1670.12±39.28 μg/ml, the butanol sub-extract was 4863.97±25.98 μg/ml, and the total alkaloids (pH 9-10) were 4897.99±58.12 μg/ml. Conclusion The ethyl acetate extract of the plant Thalictrum squarrosum has been found to be highly antioxidant active and total phenolic compound was 1.9±0.001%.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.

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.

Introduction: The treatment of antibiotic-resistant bacterial infections has become a pressing problem for humanity worldwide, and antibiotic-resistant bacterial infections are likely to be the leading cause of death by 2050.Due to the mutation of infectious disease-causing bacteria and the emergence of bacterial resistance due to the improper use of antibiotics, the time and cost of infectious disease treatment increases, and in some cases, it leads to an increase in mortality, so it is the focus of the health sector in every country, regardless of the income level of the population. In addition, bacterial resistance has a negative impact on public health, food safety, the environment, and the economy.
As of 2015, Mongolia ranks among the countries with the highest consumption of antibiotics in the world, with 64.41 units of antibiotics prescribed per 1,000 people per day. Bacteria resistant to broad spectrum antibiotics have increased dramatically, and among Gram-positive bacteria, drug-resistant Staphylococcus aureus (MRSA) has become one of the most common and dangerous cause Purpose: Determine the external structure of liposome-encapsulated antibiotics and evaluate their antibacterial activity. Materials and Methods: We conducted this study using an experimental research design. Phospholipids were isolated by intermittent evaporation, antibiotic encapsulation by freeze-thaw method, and antibiotic sensitivity was determined using standard strains by disc diffusion andmicro dilution method. Research ethics: Permission to submit the survey was granted by the Ethics Review Committee of the MNUMS. The survey was granted in accordance with the rules and regulations. Results: In liposome-encapsulated antibiotic sensitivity assays, azithromycin and clarithromycin did not form sacred circles, whereas doxycycline hyclate was sensitive by forming a 16 mm circle. Doxycycline hyclate encapsulated in liposomes formed a 16 mm circle with sensitive results, whereas blank liposomes were inactive. When the rabbits were infected with a standard strain of methicillin-resistant Staphylococcus aureus, the infected area was purulent 24 hours later. A cream containing antibiotics was started at this time. A deep wound was recovered after 12 days after the pus was removed. Nevertheless, after 24 days, the wound on the rabbit’s infected part healed and the hair on the scraped part grew back. Conclusion According to the dilution method, liposome-encapsulated doxycycline hyclate inhibited bacterial growth at 2-fold lower doses than pure doxycycline hyclate. In experimental animal models, liposome-based antibiotic ointment has shown antibacterial activity.

Hepatitis B (HBV) and C (HCV) are viral infections which can cause acute and chronic hepatitis and are the leading causes for hepatic cirrhosis and cancer, thus creating a significant burden to healthcare systems due to the high morbidity/mortality and costs of treatment. The risk of HBV infection in an unvaccinated person from a single HBV-infected needle stick injury ranges from 6–30. The prevention of HBV infection among HCWs has become a crucial issue. HBV can effectively be prevented by vaccination. A safe and effective HBV vaccine has been available since the 1980s and can prevent acute and chronic infection with an estimated effectivity of 95%. In 2017, the São Paulo Declaration on Hepatitis was launched at the World Hepatitis Summit 2017, calling upon governments to include hepatitis B vaccines for HCWs in national immunization programs. The vaccine is 95% effective in preventing infection and its chronic consequences and has an outstanding record of safety and effectiveness. Data on current hepatitis B vaccine coverage among HCWs in Mongolia is scarce. According to Azzaya et al, the protection level of the subjects was 67.2% >100 mIU/ml, 18.8%, 11-100 mIU/mL and 14.1%, 0-10 mIU/mL based on antibody titer level respectively among the vaccinated HCWs at the 2nd Central hospital. Thus, the HBV vaccination among public and private sector HCWs in Mongolia to inform the health authorities about the HCWs HBV vaccination status along with associated problems and challenges for further improving vaccination strategy among HCWs.

Introduction: Oligophrenia makes 7.3% of all mental disorders in our country. It is known that almost 4% of all diagnosed cases of oligophrenia developed as a result of an inherited disturbance of amino acid metabolism. In most countries, the frequencies of inherited diseases of amino acid metabolism in the population are determined, and preventive screening programs of newborns are implemented. No study has been conducted so far into the issue of inherited diseases of amino acid metabolism in the Mongolian population. The goal of our survey was to detect inherited disorders of amino acid metabolism in the population at risk. Materials and Methods: The collection of samples and the laboratory analysis were carried out in the following two stages:
1. The screening analysis of 514 individuals diagnosed with mental retardation was performed by paper chromatography;
2. The positivecases detected by the screening were analyzed using high-performance liquid chromatography. Results: The screening testing detected twelve potential disturbances of amino acid metabolism. Out of the twelve positive cases four individuals refused to participate in the confirmatory stage of the survey. Among the remained eight individuals, cases of hypertyrosinemia, hypervalinemia, hyperglycinemia, hyperlysinemia and pyridoxine-dependent epilepsy were detected. Conclusions
1. The fact that cases of inherited disorders of amino acid metabolism were detected among mentally retarded individuals show that the disorder is one of causes of oligophrenia.
2. A screening program of newborns should be implemented for early detection of inherited disorders of amino acid metabolism.
3. A genetic counselling and testing centre could assist in reduction of number of individuals with inherited disorders.