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: Plants of the family Gentianaceae in Mongolia are rich in bitter iridoid glycosides, flavonoids, and polyphenolic compounds, and have been traditionally used in Mongolian medicine to promote digestion, protect the liver, and reduce fever. However, standardized information on the micro-morphology and histochemical characteristics of the widely distributed species Gentiana decumbens L.f. is scarce, limiting the assessment of its quality as a medicinal raw material. Aim: To identify the morphological and anatomical characteristics of the aerial and underground parts of Gentiana decumbens and to localize the distribution of starch, polysaccharides, and phenolic compounds using histochemical methods. Materials and Methods: Plant materials were collected in July 2024 from Tsagaan-Uul soum, Khuvsgul province, andshade-dried. Samples were softened in a water–ethanol–glycerol solution (1:1:1) for 24 hours, and transverse and longitudinal sections of stem, leaf, root, and floral parts (anther, petal, receptacle/bract) were prepared using a hand microtome. Sections were cleared with 10% chloral hydrate. Histochemical reagents included potassium dichromate (K2Cr2O7), ferric chloride (FeCl3), Lugol’s iodine (I₂+KI), thymol + concentrated H₂SO₄, and methylene blue. Slides were mounted in glycerin and examined under an Olympus light microscope at 40× and 100× magnifications, and images were recorded using a 12 MP digital camera. Results: Leaf: The leaf exhibits a dorsiventral structure with a dense palisade parenchyma on the adaxial side and a loosely arranged spongy mesophyll on the abaxial side. Stomata are hypostomatic, and collenchyma is well developed around the vascular bundles. Histochemical reactions were negative for starch and phenolic compounds. Stem: The stem consists of an epidermis, a wide cortex, a continuous ring of sclerenchyma, 12–15 collateral vascular bundles, and a broad central parenchyma. Histochemical tests showed a brownish-yellow coloration with potassium dichromate (K2Cr2O7), indicating the presence of polyphenols and lignin, and a brown coloration with Lugol’s iodine, confirming the presence of starch. Reactions with ferric chloride (FeCl₃), methylene blue, and thymol + H2SO4 were mostly negative in cross sections. However, in longitudinal sections, Lugol’s and thymol + H2SO4 showed positive reactions, suggesting the presence of starch and polysaccharides, respectively. Root: The root displays a primary structure with radial xylem and phloem, a distinct endodermis with Casparian strips, and a pericycle layer. Positive reactions were observed with K2Cr2O7 and FeCl₃, indicating phenolic compounds and lignin. Lugol’s iodine showed abundant starch granules in parenchyma cells. Receptacle / Bract: The receptacle is covered by a thick cuticular epidermis with trichomes, and composed of outer and central parenchyma layers containing numerous small closed (amphivasal-type) vascular bundles. Positive reactions were detected with K2Cr2O7 and FeCl₃, indicating polyphenols, flavonoids, and tannins; Lugol’s iodine confirmed the presence of starch; thymol + H2SO4 showed partial positivity for polysaccharides. Stamen (longitudinal section): The stamen structure includes epidermis, endothecium, pollen sacs, and a distinct vascular bundle. Positive staining was observed with K2Cr2O7, Lugol’s iodine, and FeCl3, confirming the presence of polyphenolic compounds, lignified elements, and starch. Conclusion The anatomical features of G. decumbens indicate adaptations to dry, high-light environments through well-developed mechanical strengthening (sclerenchymatous ring), efficient photosynthetic structure (compact palisade mesophyll), and nutrient storage (starch-rich pith and cortex). Histochemical analysis revealed the localization of polyphenolic compounds and starch/polysaccharides mainly in the root, stem, and floral organs, while absent in the leaves, demonstrating organ-specific accumulation patterns. These findings scientifically support the plant’s traditional medicinal uses for digestive stimulation and hepatoprotection.

Background: Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD), emphasizing the need for its early detection and prognosis. Objective: This study aimed to determine the serum NT-proBNP levels in participants with CKD and establish a cut-off value for predicting heart failure. Methods: A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study received approval from the Ethics Committee of the Institute of Medical Sciences (Approval No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology Department of the third state hospital were enrolled based on predefined inclusion and exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence quantitative analyzer. Data were analyzed with SPSS 26.0. Results: The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly between heart failure and non-heart failure groups (p<0.05). Significant differences were also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05). NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%, specificity: 55%). Conclusion Serum NT-proBNP levels are elevated in CKD patients regardless of heart failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).

Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney function over time. As the disease progresses, it leads to an increased risk of cardiovascular complications, which are the leading cause of morbidity and mortality in CKD patients. B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart failure. Their role in CKD, however, is complex due to the overlapping pathophysiological mechanisms between cardiac and renal dysfunctions. This literature review aims to explore the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting their clinical relevance, the impact of renal function on their levels, and potential therapeutic implications. The review focuses on studies published in the last decade, examining the clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP as biomarkers in CKD patients.

Background: To prevent and combat the spread of the COVID-19 pandemic, the Government of Mongolia has implemented measures such as movement and time restrictions, social distancing and isolation, closure of schools, kindergartens and public places, immunization, and others. It has caused adverse consequences for people, social relations, and the economy, causing health, social, economic, and humanitarian crises. Not only does this situation, medical students, as frontline healthcare workers, are more susceptible to virus infection. Vaccines against COVID-19 have been researched quickly due to the pandemic and are being used under emergency use authorization. In our country the approach of mixing vaccine doses from different manufacturers was used (fractional doses). Therefore, there is no study on the exposure of medical students to the COVID-19 infection and the adverse effects after receiving a dose of a heterologous vaccine. Objective: To study the exposure to the COVID-19 infection and vaccination status of medical students. Methods: The survey was conducted from November 2023 to December 2023 using a cross-sectional study design, and 170 students who study at ASUSU and live in the dormitory were included. Results: A total of 170 students participated in the study. 55.9% (n=95) of them were in the first year, 22.4% (n=38) were in the second year, 10% (n=17) were in the third year, 7.6% (n=13) were in the fourth year, 2.4% (n=4) were from the 5th year and 1.8% (n=3) were from the 6th year students. 88.2% (n=150) of students were female and 11.8% (n=20) were male. In this study, 37.1% of the students were infected by COVID-19 infection previously. Among them, 50% of the students were infected from family members, 16.7% from the school environment, and 15.2% did not know about the source of infection. 76.2% of the respondents were diagnosed with COVID-19 in a medical institution, and forty-one students answered that they were treated at the hospital. 83% of the cases were treated at home and were cured within 14 days. In contrast, 93.8% of the hospitalized students were treated within four months to 1 year. The current study demonstrates neurological, respiratory, sensory, cardiovascular, psychiatric, digestive, and dermatological symptoms were in 37.6%, 24.1%, 27.6%, 17.6%, 11.8%, 11.2%, and 10% of the students who participated in the study, respectively. For a year or more, symptoms of all organ systems were present, but neurological symptoms appeared to be the highest. 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine, 3.5% (n=6) did not receive the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects and 65% (n=106) had no side effects. Conclusion In this study, 37.1% of the students were infected by COVID-19 infection previously. According to the current study, symptoms related to the nervous system was the most prevalent and 55.9% (n=115) of the enrolled students received 3 or 4 doses of the vaccine. In total, 35% (n=60) of the enrolled students experienced side effects.

Introduction: Lung cancer is the leading cause of cancer-related deaths in the world, and half of all new cases (59.6%) are recorded in Asia. Smoking remains the leading cause of death from lung cancer and COPD, followed by air pollution. Therefore, in Ulaanbaatar, where the population concentration is high and air pollution is high, there is a need to study the new cases and deaths of lung cancer in detail. Purpose: It is aimed to evaluate the prevalence of new cases and deaths of lung cancer among the population of Ulaanbaatar. Materials and Methods: This study analyzed new cases and deaths diagnosed with lung cancer from 2013 to 2023 in the city of Ulaanbaatar using a single-moment design of descriptive research. The quantitative data of the study included the diseases recorded using the International Classification of Diseases X (ICD-10) and lung cancer codes C-33 and C-34. The numerical data collected during the research were processed in the Microsoft Office Excel-13 program and processed using the IBM SPSS Statistics 23 program. Results: A review of the newly registered lung cancer epidemic in Ulaanbaatar from 2014-2022 has observed an increase in the number of new cases recorded in Songinokhairkhan, Sukhbaatar, Khan-Uul, and Baganuur districts in those years and in recent years in the Bayanzurkh and Sukhbaatar districts. Men were three times more likely than women to develop lung cancer, with new cases and deaths highest in the 55-69 age group. The cancer diagnosis was diagnosed using imaging devices. Of the total cases diagnosed, 9 out of every 10 people diagnosed are diagnosed later, or 3.4 per cent, and 69.5 per cent are diagnosed with jumping stages. Conclusion Although the number of new cases and deaths among the population of Ulaanbaatar is relatively lower than the national average, there has been an increasing trend in recent years.

BACKGROUND: According to International osteoporosis foundation report, osteoporosis is a multifactorial condition associated with an increased risk of fracture and is caused by social, behavioral and physiological factors. Overall incidence is increasing in every country due to people’s life style changes, diet and increased life expectancy. OBJECTIVES: To evaluate the some hormonal effects in bone mineral density among Mongolian population. METHODS: Bone density was measured in the distal one third of radius using the Sunlight Omnisense (Sunlight Medical, Rehovot, Israel) and classified into 3 groups according to WHO osteoporosis criteria. Normal participants were selected into control group and osteoporotic participants were selected into control group. We have evaluated PTH, calcitonin, 25-hydroxy vitamin D in case-control group. RESULT: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. It was clear that PTH elevated group (>30.3pg/ml) had more risk of osteoporosis. CONCLUSION: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. PTH elevation is risk factor in men.

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.

Trough WHO recommendation hysteroscopy is the golden standart technique of uterine cavity evalution. First Maternity Hospital of Mongolia have been implemented gynecological laparoscopic surgery since 2009, then from 2013 we have started diagnostic and operative hysteroscopy. A hysteroscopy may be done to find the cause of abnormal bleeding or bleeding that occurs after a woman has passed menopause. It also may be done to diagnose infertility. Also a hysteroscopy can be used to remove growths in the uterus, such as fibroids or polyps. We evaluated results of gynecological diagnostic and operative hysteroscopy, which was done in First maternity hospital.We took special questionnaires from 39 women and did prospective analyses.39 patients, who were done hysteroscopy were involved our study from November 2013 to January 2015. 51% of participants were reproductive age women. Under 20 years old participants who underwent diagnostic hysteroscopy due to hyperplasia of endometrium were 3%, they were performed biopsy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. After diagnostic and operative hysteroscopy, 97% of patients had no symptoms, but last 3% of patients had lower abdominal pain. If clarify diagnosis which is approved after diagnostic and operative hysteroscopy 51.3% was displaced IUD, 35.9% was endometrial polyp, 2.6% was hyperplasia endometrium, 10.3% was infertility. Complication was 2.6% through postmenopausal participants if compared with premenopausal women. Diagnostic and operative hysteroscopic procedure has benefits for synehia, septum of uterus, endometrial hyperplasia, abnormal uterine bleeding, submucosal myomectomy. From all participants 87,2% performed operative hysteroscopy, 12,8% was diagnostic hysteroscopy. Hysteroscopy was done when displaced IUD (51.3%), polyp of endometrium (35.9%), hyperplasia of endometrium (2.6%), and infertility (10.3%).Complications after hysteroscopy depends from menopause.