Background: Health insurance systems are a core component of social protection, aimed at safeguarding populations from financial risks, ensuring equitable access to health care services, and ultimately achieving universal health coverage. In recent years, Mongolia’s health insurance system has faced significant policy-level challenges related to efficiency, accessibility, and financial sustainability. Therefore, there is a growing need to conduct comparative analyses of internationally successful health insurance models. Aim: To comparatively examine Mongolia’s health insurance system in relation to the health insurance systems of selected countries. Materials and Methods: A comparative document review methodology was employed to analyze the health insurance and health financing systems of Canada, Germany, Japan, the Republic of Korea, and Kyrgyzstan. The analysis was based on policy documents, legal and regulatory frameworks, reports from international organizations, and relevant statistical data. Result: In countries such as Canada, Germany, Japan, and the Republic of Korea, health expenditure as a share of GDP exceeds the global average, while out-of-pocket payments by households remain relatively low. In contrast, Mongolia and Kyrgyzstan exhibit high levels of out-of-pocket expenditure, weaker financial protection, and comparatively lower performance indicators of the health system. Conclusion The findings suggest that increasing health expenditure as a share of GDP toward the global average, improving the management of health insurance funds, and reducing out-of-pocket payments by households are important considerations for enhancing the performance of Mongolia’s health system.

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: Inflammatory bowel disease (IBD) is a chronic immune-related condition caused by interactions between genetics, immune dysfunction, gut microbiota changes, and environmental factors, often presenting as persistent or recurring diarrhea. Clinically, it commonly presents with chronic diarrhea and other gastrointestinal symptoms. The global prevalence of IBD is increasing, currently affecting approximately 0.5% of the population, with projections suggesting a rise to nearly 1% by 2030. Fecal calprotectin is a neutrophil-derived S100 calcium-binding protein that is elevated in intestinal mucosal inflammation and serves as a reliable noninvasive biomarker of inflammatory activity. Due to its high stability and close association with intestinal inflammatory activity, fecal calprotectin has been established as a dependable, non-invasive marker for identifying intestinal inflammation. In clinical practice, it is extensively used to distinguish IBD from functional gastrointestinal disorders, especially irritable bowel syndrome, among patients presenting with chronic diarrhea. However, its diagnostic utility in Mongolia remains underexplored, and this study aims to determine its sensitivity and specificity in inflammatory bowel disease and compare its diagnostic performance with other inflammatory markers. Aim: To determine the sensitivity and specificity of fecal calprotectin in inflammatory bowel disease and to compare it with other inflammatory markers. Materials and Methods: A total of 109 participants aged 18-87 years with chronic diarrhea, who attended the gastroenterology outpatient clinics of the Mongolia–Japan Hospital and Intermed Hospital between December 2024 and December 2025 and provided informed consent, were enrolled in this study. Data were collected using structured questionnaires, and laboratory investigations included complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and measurement of fecal calprotectin levels from stool samples. Based on fecal calprotectin results, selected participants underwent colonoscopic examination as clinically indicated. Results: Among the 109 participants included in the study, 17.4% were diagnosed with inflammatory bowel disease (IBD), with a mean age of 47.41±15.52 years. Fecal calprotectin levels were significantly higher in the IBD group compared to the control group (p<0.001). Fecal calprotectin demonstrated a weak positive correlation with C-reactive protein (CRP) and leukocyte count (p=0.042, p=0.06), while no significant correlation was observed with erythrocyte sedimentation rate (ESR). At a cutoff value of 250 µg/g, fecal calprotectin showed a sensitivity of 94.4%, specificity of 69.2%, positive predictive value (PPV) of 37.8%, and negative predictive value (NPV) of 98.4%. Receiver operating characteristic (ROC) curve analysis identified an optimal cutoff value of approximately 400 µg/g (AUC=0.919, Youden index=0.724), at which the sensitivity remained 94.4% and specificity increased to 78.0%. In contrast, CRP and ESR demonstrated comparatively lower diagnostic performance, with AUC values of 0.640 and 0.644, respectively. Conclusion This study demonstrates that fecal calprotectin has superior diagnostic performance compared to conventional inflammatory markers in differentiating inflammatory bowel disease (IBD). An optimal cutoff value of approximately 400 µg/g yielded the highest sensitivity and specificity. Therefore, fecal calprotectin may serve as a valuable tool in clinical practice for both screening and diagnostic confirmation.

Background: Stress, insomnia, and anxiety are among the most prevalent mental health disorders in society and are associated with negative consequences such as reduced work capacity, decreased quality of life, and an increased risk of chronic diseases worldwide. During stress, the sympathetic nervous system becomes activated, leading to physiological changes such as increased heart rate, vasoconstriction, and elevated arterial blood pressure. If prolonged, these changes may increase the risk of developing hypertension and cardiovascular diseases. In recent years, pharmacological research on medicinal plants with sedative, hypnotic, and anxiolytic effects has been intensively conducted. Therefore, there is a growing need to develop a combined herbal preparation from Valeriana officinalis L. and Leonurus sibiricus L., which have been used in traditional medicine for sedative, hypnotic, and anxiolytic effects, and to investigate their effects on arterial blood pressure. Aim: To investigate the effect of an herbal complex preparation on arterial blood pressure. Materials and Methods: An herbal complex preparation was formulated from 70% ethanol extracts of Valeriana officinalis L. and Leonurus sibiricus L. in a 30:70 ratio. Its effects on normal blood pressure and Angiotensin II-induced hypertension were evaluated in C57BL/6 mice. The preparation was administered orally at doses of 750 and 1000 mg/kg. Systolic and diastolic blood pressure were measured using a Softron BP-98AWU system and compared between groups. Results: At doses of 750 and 1000 mg/kg, the complex preparation reduced systolic blood pressure (SBP) by 6.4-12.0% and diastolic blood pressure (DBP) by 16.1-28.1% under normal conditions (p<0.05). In the intraperitoneal Angiotensin II-induced hypertension model, SBP decreased by 5.9-19.6% and DBP by 6.3-20.1% (p<0.05). In the osmotic pump-induced Angiotensin II hypertension model, the 750 mg/kg dose reduced SBP by 18.2-33% and DBP by 17.2-28.3% (p<0.001). Conclusion The herbal complex preparation at doses of 750 and 1000 mg/kg demonstrated a significant antihypertensive effect in both normal and Angiotensin II-induced hypertensive mice.

Background: Allergic and atrophic forms of chronic rhinitis are common among the population, characterized by a chronic progressive course with a tendency toward increasing prevalence. Worldwide, allergic rhinitis affects approximately 10–40% of adults and 2–25% of children. According to a study conducted in Mongolia, the prevalence of allergic rhinitis among adults in Ulaanbaatar was reported to be 23.6%, with an increasing trend anticipated in the future. In allergic and atrophic rhinitis, structural alterations occur in the nasal mucosa, including disruption of the normal architecture of the pseudostratified epithelium and ciliated cells, accompanied by changes in goblet cell number and dysfunction of their activity, resulting in a complex pathological process. In otorhinolaryngology practice in Mongolia, there is a relative lack of studies investigating the ultrastructural changes of the nasal mucosa in allergic and atrophic rhinitis. Aim: To compare ultrastructural and histological changes of the nasal mucosa in allergic and atrophic rhinitis. Materials and Methods: Ethical approval was obtained from the Research Ethics Review Committee of the Mongolian National University of Medical Sciences at the meeting held on April 24, 2020 (Protocol No. 2020/З-04). Appropriate ethical permission was also obtained from the EMJJ ENT Hospital. Nasal mucosal tissue samples were collected from surgically resected specimens of patients aged 20–45 years diagnosed with allergic and atrophic rhinitis. The mucosal specimens were processed at the Institute of Biomedical Sciences of the Mongolian National University of Medical Sciences. Samples were fixed and dehydrated according to the protocol, coated with 100 Å gold, and examined using a scanning electron microscope (FEI Quanta FEG 250, USA). In addition, paraffin blocks were prepared, sectioned at 4 μm thickness, stained with Hematoxylin and Eosin, and analyzed histologically. Results: In allergic rhinitis, the pseudostratified epithelium was relatively preserved; however, disorganization of ciliated cells, partial loss of cilia, and goblet cell hyperplasia were observed. In contrast, atrophic rhinitis showed epithelial thinning, near-complete loss of ciliated structures, glandular atrophy, and submucosal fibrosis. Conclusion Allergic rhinitis is associated with relatively mild and predominantly functional mucosal alterations, whereas atrophic rhinitis demonstrates severe structural damage with irreversible impairment of mucosal protective function.

Background: Hypokalemia is considered when the serum potassium level is less than 3.5 mmol/L. Clinical research indicates that hypokalemia affects 20% of hospitalized patients, and in 24% of these cases, inadequate interventions result in life-threatening complications. At present, there is no research available on the prevalence, management, and outcomes of hypokalemia in hospitalized patients, which justifies the need for this study. Aim: The study aimed to examine the prevalence of hypokalemia and the effectiveness of its management in hospitalized patients within the internal medicine department, in relation to the knowledge of doctors and resident physicians. Materials and Methods: This hospital-based retrospective study included a total of 553 cases of patients hospitalized in the Internal Medicine Department of the Mongolia Japan Hospital between January 2024 and August 2024. Patients with a potassium level of <3.5 mmol/L were diagnosed with hypokalemia, and the effectiveness of potassium replacement therapy was evaluated according to the method of supplementation employed. Results: The prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department was 9.8% (54 cases). Based on the study criteria, 42 cases of hypokalemia were selected for further analysis, and a total of 118 potassium replacements were performed through oral, intravenous, and mixed methods. Following potassium replacement therapy, 37.3% (44) of patients achieved normalized potassium levels, while 62.7% (74) still had persistent hypokalemia. Conclusion According to the study results, the prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department is 9.8%. The method of potassium replacement and the severity of hypokalemia do not impact the normalization of potassium levels, with the critical factor being the proper dosage of supplementation. The knowledge of doctors and resident physicians regarding hypokalemia is insufficient, and there is a need to implement guidelines and protocols for potassium replacement therapy in daily clinical practice.

Background: According to the World Health Organization (WHO), approximately 70-95% of developing countries rely on traditional medicine, which includes around 365 plant, animal, and mineral-based preparations. Natural products consist of numerous biologically active compounds that exert effects against pathogens, making up about 25% of modern pharmaceuticals derived from plants. Since plants are a combination of various metabolites, they can have therapeutic effects, side effects, and toxicity in the human body. Based on the traditional use of medicinal herbs in Mongolian and Tibetan medicine for their sedative properties, we selected the medicinal herbs Valeriana officinalis L. and Leonurus sibiricus L., The objective is to develop new medicinal preparations that can be utilized in modern medical practice to treat, prevent, or supplement the treatment of depression and anxiety. Consequently, it is necessary to prepare a herbal complex from these selected plants and conduct studies to investigate their subchronic toxicity and sedative activities. Aim: To study subchronic and sedative activity of herbal complex preparations. Materials and Methods: The herbal complex preparation was prepared from the 70% ethanol extract of the roots of Valeriana officinalis L. and the aerial parts of Leonurus sibiricus L., and a compound preparation was made in a 30:70 ratio. Subchronic toxicity study was conducted on Wistar rats weighing 180-250 g according to the OECD-407 guidelines. The sedative activity of herbal complex preparation was studied on C57BL/6 and BALB/c mice using the dark/light transition test according to Takao K., and the hole-board test according to Hiroshi Takeda. Results: In the sub-chronic toxicity study of the herbal complex preparation, biochemical analysis of the serum (including ALT, AST, creatinine, and urea) and histopathological examination of the liver, kidney, and heart showed no statistically significant changes when comparing the experimental groups to the control group. The herbal complex preparation at a dose of 1000 mg/kg increased the time spent in the dark area, decreased the time spent in the light area, and the number of transitions between the two areas of mice in the dark/light transition test, and reduced the number of head-dipping into the holes of mice in the hole-board test. Conclusion The herbal complex preparation exhibited low toxicity at doses of 1000 mg/kg and 1500 mg/kg based on biochemical and histopathological examinations in the subchronic toxicity study. Furthermore, the preparation demonstrated sedative effects at a dose of 1000 mg/kg.

Background: Urinary tract infections (UTIs) are common, affecting 150 million people worldwide annually. It is estimated that 1% of the population suffers from urinary tract infections. The most common infections in kidney and urinary tract are Escherichia coli, Staphylococcus saprophyticus, Klebsiella, Enterobacter and Proteus which account 80%, 5-15% and 5-10%, respectively. Oxidative stress, inflammation, and apoptosis are critical factors involved in the pathogenesis of kidney disease. Oxidative stress, a pathological condition characterized by an imbalance between reactive oxygen species (ROS) and the body’s antioxidant defenses, leads to cellular damage and is directly implicated in the initiation and progression of acute kidney injury. Antioxidants serve a protective role by mitigating the harmful effects of free radicals and oxidative stress on cellular structures. Drawing upon the extensive resources of medicinal plants and the therapeutic practices of traditional medicine, plants rich in antioxidant compounds, including Dasiphora fruticosa (L.), Cynara scolymus (L.), and Rosa acicularis (L.), were selected for the development of the Phytonephro-SAN preparation. The phytochemical profile and nephroprotective properties of these plants have been investigated and validated. Moving forward, further studies are warranted to assess the safety profile of the formulation, including comprehensive toxicity evaluations. Aim: To investigate and establish the subacute toxicity and antibacterial activity of the Phytonephro-SAN preparation. Materials and Methods: The subacute toxicity assessment of the Phythonephro-SAN preparation was conducted on Wistar rats following the OECD-407 guidelines. The study of the antibacterial activity of the preparation was determined by the broth dilution method. Results: The subacute toxicity assessment, evaluated through parameters such as body and organ weights and complete blood count (CBC), revealed no statistically significant differences between the groups administered the Phytonephro-SAN preparation at doses of 500 mg/kg and 1000 mg/kg, and the control group. According to the study of antibacterial activity, Phytonephro-SAN preparation has antibacterial activity at 90 mg/ml and 80 mg/ml doses. Conclusion The administration of the Phytonephro-SAN preparation to Wistar rats at doses of 500 mg/kg and 1000 mg/kg over 28 days did not result in mortality, and no significant changes were observed in body and organ weights or CBC parameters. These findings support the conclusion that the preparation possesses minimal toxicity. Additionally, the preparation demonstrated effective antibacterial activity against specific urinary tract pathogens at higher concentrations.

Background: Systemic sclerosis-related interstitial lung disease (ILD) is a major cause of mortality among patients with systemic sclerosis. During this disease, when the forced vital capacity (FVC) is <50% on spirometry, the prognosis is considered poor. Although early changes in systemic sclerosis-related ILD can be identified by chest computed tomography (CT), evaluating the spirometry test is essential for monitoring further follow-up and assessing treatment outcomes. This study aimed to highlight the importance of considering the role of the spirometry test among patients with systemic sclerosis. Materials and Methods: We conducted this study using a cross-sectional research design based at a single-center hospital. The study included 40 patients diagnosed with systemic sclerosis who were attending the rheumatology outpatient clinic at the Mongolia-Japan Hospital. The inclusion criteria were patients diagnosed with systemic sclerosis who had undergone chest imaging (chest x-ray, chest CT scan) and spirometry tests. Results: In our study, in 62.5% of patients diagnosed with systemic sclerosis, a chest CT scan revealed abnormalities indicative of SSc-ILD. There were statistically significant differences (p<0.05) in certain parameters of spirometry between the two groups (normal chest CT, abnormal chest CT). The group with abnormal chest CT had a higher usage of mycophenolate mofetil (p<0.05). A negative correlation was found between changes on chest CT scan and FVC (r= -.453, p<0.05). However, no statistically significant correlation was observed between FVC and disease duration or comorbidities. Conclusion Using spirometry to assess pulmonary function in patients with systemic sclerosis-related interstitial lung disease may be an appropriate method for evaluating the progression of the disease and detecting complications.

Coating agents are used in medicine to protect tablets from air or moisture, to mask bitter tastes, or to provide special characteristics for drug release, such as enteric release. There are three main coatings: sugar coating , film coating, and enteric-coating. In this review, we discuss the status of the most commonly used pharmaceutical film coating materials and data were obtained from electronic databases such as PubMed, Google Scholar, and other scientific websites. There are various materials for creating a tablet coating, but the most commonly used material is a water soluble polymer which is used for making a water-soluble film coating.