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.