Background: As of 2024, digestive system diseases rank fourth among the causes of mortality in Mongolia. Among these, hepatocellular carcinoma (liver cancer) accounted for 20,501 deaths, leading in total mortality rates. In Traditional Mongolian Medicine, Scutellaria baicalensis Georgi is used to cool blood heat, clear internal heat, and regulate imbalances; Saussurea amara L. is used for its antibacterial, anti-infective, and anti-inflammatory properties; Carthamus tinctorius L. serves for disinfection, pain relief, fever reduction, and detoxification; and Chiazospermum erectum L. is used to eliminate toxic heat and febrile conditions. Studies have confirmed that the Hepaclin-4 formulation exhibits antioxidant, membrane-stabilizing, hepatoprotective, anti-necrotic, detoxifying activities, and reduces the accumulation of harmful byproducts from excessive peroxidation. Therefore, developing a solid dosage form from the raw herbal materials of Scutellaria baicalensis Georgi, Saussurea amara L., Carthamus tinctorius L., and Chiazospermum erectum L.in the He paclin-4 formula forms the basis of our research. Aim: To formulate and develop a tablet dosage form based on the compound prescription of Hepaclin-4 Materials and Methods: The raw materials of Scutellaria baicalensis Georgi, Saussurea amara L., Carthamus tinctorius L., and Chiazospermum erectum L.were weighed at a 1:1:1:1 ratio and extracted with 40% ethanol at a 1:10 ratio using the remaceration method. Ethanol was evaporated using a vacuum evaporator to obtain a thick extract, and quality indicators were determined. From the obtained thick extract, granules were prepared using two types of excipients through the wet granulation method, and their quality characteristics were studied. Based on the most suitable granules, tablet and capsule dosage forms were prepared and standardized according to the methods outlined in the Mongolian National Pharmacopoeia. Results: The Hepaclin-4 tablets were found to be round, well-formed, smooth, with intact edges, a slight characteristic odor, no unpleasant taste, and light yellow in color. The friability resistance of the 0.5 g tablet was 99.6±0.08%, hardness was 1.07±0.12 MPa, weight variation ranged from -2.6% to +3.9%, all within the acceptable 5% limit. The disintegration time was 4.23±0.05 minutes, and dissolution was 95.4±0.47%, meeting the permissible standards. When flavonoids in the tablets were detected by Thin Layer Chromatography (TLC), brownish-yellow spots appeared at Rf values identical to standard quercetin (Rf=0.94) and rutin (Rf=0.48). The total flavonoid content, determined by Spectrophotometric Method (SPM), was 0.165±0.01%. Conclusion Tablets were successfully developed from the thick extract of the Hepaclin-4 herbal compound. Upon eval uation, the tablets met all the required technical specifications.

Introduction: Scutellaria baicalensis Georgi, which is used in traditional medicine, has the ability to remove blood-drying heat. Chiazospermum erectum Bernh. has the ability to relieve typhoid fever and poison fever. Carthamus tinctorius L. has antiseptic, analgesic and anti-toxic properties. Saussurea amara L. has bactericidal, anti-infective, and anti-inflammatory properties. Researchers found that the Hepaclin-4 recipe has antioxidant, membrane-strengthening, liver-protective, necrosis-preventing, detoxification, and peroxidation product accumulation-reducing properties. Therefore, extracting the granular medicine form from the concentrated extract containing the Hepaclin-4 formulation is the basis of our research work. Goal: To obtain the granular medicine form from the concentrated extract containing ingredients of the Hepaclin-4 recipe. Materials and Methods: The research was carried out with the support of the Institute of Pharmaceutical Research and the University of Pharmaceutical Sciences. The raw materials for the Hepaclin-4 formula were extracted by remaceration with water, 40% ethanol, and 70% ethanol (1:10 ratio). Six types of granules were extracted from the concentrated extract using several excipients by the wet granulation method, and the pouring weight and flowability were determined. Results: The quality index of the concentrated extract of the Hepaclin-4 recipe complies with the standards outlined in the 11th Pharmacopoeia of the National Pharmacopoeia of Mongolia. In qualitative analysis of total flavonoid, spots were detected at the same level as standard quercetin (Rf=0.88) and rutin (Rf=0.4), indicating the presence of flavonoids. According to the results of the above research, lactose was found to be the suitable filler for extracting granules, and starch at 8% was identified as the appropriate binding agent from the concentrated extract of the Hepaclin-4 formula. Conclusion It was found suitable to select 8% lactose as a filler and starch as a binding agent from the concentrated extract of the Hepaclin-4 formula and obtain a granule drug form using the wet granulation method.

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.

Background: Nucleic acid sequencing is a multi-step process taken place in medical research or diagnostic laboratories. Since the emerge of second generation sequencing technology generally referred as next generation sequencing (NGS), the mass parallel reads covering human genome or transcriptome is achieved by cost cut down over thousand folds. Though the technology made tremendous push forward to various applications, its data analysis time and effort still takes worrisome time and human effort, bringing the emerge of next-step demand: targeted mass sequencing of only desired part from human genome or transcriptome with lower material cost and labor. By targeted sequencing, both run cost and data analysis process can be further cut down, and the read results are more reliable on changes such as determining varied number of repeats, heterozygote alleles, deletions, chromosomal scale abnormality and more. Objective: In this study, we explored the utilization of biotinylated RNA baits on captured sequencing of cancer marker genes functional regions. Method: Targeted NGS was achieved by capturing desired genomic regions using preparatory nucleic acid probes. RNA bait capturing of desired genomic regions has shown to have high specificity and quality.
The study was carried out with informed consent obtained from patients, with the approval №53 in 2018.03.15 by Medical Ethics committee, Ministry of Health, Mongolia. Result: By preparing library of biotinylated RNA baits with 75000 unique sequences, we achieved mass parallel sequencing of human 410 cancer-marker-genes’ exons and UTRs with average read depth ~760, and covered thousands of SNPs on 5 genomic DNA samples. Tissue samples derived from breast cancer and ovary cancer had SNP and deletion on 7 marker genes (BRCA1, BRCA2, ATM, BRIP1, PTEN, TP53, RAD51C) not registered in database. Conclusion Experiments showed RNA baits with up to 117 nucleotide length, produced from ssDNA oligonucleotide stock, can be utilized to capture desired regions of human genome, and bring the cost of captured mass sequencing to 1500 USD, with 93.14-93.33% of Q30 read quality.

Abstract: Demographical, social and cultural factors including population health, diagnoses, introduction of new treatment methods, capacity of the health organizations, enhancement of professional skills of medical practitioners, as well as drug efficacy affect the needs of drug. There are many methods used to estimate needs of drug. For example; Essential medicine list, medicines prescribed for specific illnesses and medicines consumed by norms. Moreover, there are two ways to estimate the demand of the essential medicines making basic comparisons of essential drug needs and morbidity indicators of the other countries in compliance with the recommendation of WHO.¹
Actual needs of the essential medicines for most common diseases and other medicines have determined by selecting from the records of inpatients by classification and amount as well as estimating the classification, amount and price of the medicines sold by pharmacy for the given period. This estimation reveals the temptation of the needs of the drug so that the amount of the supply will be determined by upcoming month, season and year. More importantly, It will not only benefit the classification, amount of the necessary medications but also it will estimate the budget for the certain period.
In the recent 9 years, the community acquired pneumonia cases among the 0 to 5 year old children admitted to the hospitals of Ulaanbaatar city have increased by 15.7%.
Therefore, we have studied the needs of drug in the treatment actual consumption of medicine the CAP in children among 0 to 5 year old.
The research was referenced by the method of determining drug needs by consumption and morbidity indicators, other methods developed by scientists such as Hogerzell H.V., Jonathan D.Quick., James R.Rakin., Richard O.Laing., Ronald W.O.Connor., Andrew, Kobzari L.V, Dryomovo N.B, Glembotskaya G. T, Mnushko Z.N. Numerical data has been determined by average and standard deviation as well as maximum or minimum value employing variation analysis method. Result of the study Having determined the average number of CAP in children cases, temp of annual growth, fluctuations, statistical report of the last decade based on the actual medicine consumption for the treatment of CAP in children of all the participants (96 inpatients aged from 0 to 5 year) and disease prognoses; as result, it has been estimated the necessary drug needs for 27591-33869 CAP in children cases which will be treated in the hospitals of Ulaanbaatar city from 2019-2013.
There’s a tendency that approximately 31509 patients aged from 0 to 5 year are going to be hospitalized for CAP in children so that it’s estimated to require 1156848.1 MNT for the treatment.

Abstract: Respiratory diseases are the most common among the population of Mongolia, besides, the data regarding the pneumonia and chronic obstructive lung disease (COLD) among the community acquired pneumonia in children specially 0-5 year old has taken into much consideration when re- viewing the statistical report of 2010-2018 of Mongolia.¹
Looking at the details, as regards 2010-2011 there were 82 CAP case, which increased by 6.8%, but in 2011-2012, 48 cases were registered, which dropped into 3.7%. Again in 2012-2013, jumped by 2.6 % by reporting 33 cases. Then from 2013 to 2014, it has become 406 cases, increased by 31.8% whereas it added up to 848 cases registered in 2014-2015, which fell by 50.4%. 788 cases reported in 2015-2016 , rose by 94.7%. Then the figure decreased by 2.2%, only 36 reported cases in 2016-2017, again it soared up to 14.1% when 224 cases were registered in 2017-2018. In the last 9 years, the community acquired pneumonia among the 0 to 5 year olds in Ulaanbaatar city has increased by 10.4%.
Reviewing the Statistical Report of 2010-2018 of Mongolia, hospitalized cases of the children aged from 0-5 year old for CAP has gradually increased from 2010 to 2014; the total number of the above mentioned cases has become 8603 and the average increase was 13,1%.
In fact, the figure fell by 40% by reporting 8071 cases in 2014-2015 which whereas in 2015- 2016 there were 13073 cases, an increase of 108.3%. Then, in 2016-2017, the number has de- creased by 6.3% with 1604 reported cases. But in 2017-2018, registering 3260 cases, the rated jumped by 13.9%.²
In the recent 9 years, the pneumonia cases among the 0 to 5 year old children admitted to the hospitals of Ulaanbaatar city have increased by 15.7%. Therefore we have studied the actual medicine consumption in the treatment of the CAP among 0 to 5 year old.
The research data was processed by cross-sectional study by employing retrospective analysis is used to randomly select actual drug consumption from the records of the inpatients who diag- nosed as CAP. Result of the study In the last 9 years, the CAP among the 0 to 5 year old children hospitalized in Ulaanbaatar city has increased by 15.7%.
The number of the inpatients diagnosed as the CAP has reached 21535 cases, which is increased by 6.2% in 2014-2018. Furthermore, there is tendency to increase pneumonia cases by 31509; it’s possible to have approximately an increase of 5.1% in the 2019-2023.
We have revealed 30 different types of medicines have been used for the treatment of the CAP after examining prescribed drugs.

Abstract Mana-4, an herbal medicine, had been used to treat incomplete-mannered and infection-caused hot disease in Mongolian traditional medicine. It has already reported that Mana-4 acts as an anti-inflammation agent, an activator of T and B cells, an immune-modulator and an inducer of cellular proliferation. Moreover, it enhances the immune system and energy level of human body. It was confirmed that the main active compounds in Mana-4 are inulin and total flavonoids which are effective for many diseases. Drug formulation types are very important to delivery the drugs to the targeted tissues and organs without loss of active ingredients. Total flavonoids in the extract of Mana-4 and granulated Mana-4 was qualitatively evaluated by TLC and yellow-brown spots (Rf was 0.4) were found on TLC plates, indicating that the preparations contained flavonoids. Also, it confirmed that the appropriate extractor of total flavonoids from Mana-4 was 70% of ethanol. In conclusion, the tablet formulation from Mana-4 was successfully prepared and the quality requirements was allowable.

Background: Data from yearly statistical reports on morbidity and mortality in Mongolia show that young adults account for approximately 20-26% of all stroke patients as opposed to 10-13% in Western countries. Objectives: The aim of this study was to compare characteristics of ischemic stroke between young (20-49 years) and old (50-79 years) patients undergoing investigations and treatment according to one common protocol in a tertiary hospital. Material and Methods: This hospital based prospective study included 110 young and 130 old patients with acute ischemic stroke. Data regarding the etiology of the stroke, diagnostic neuroimaging test results and degree of functional improvement of patients were examined during their observation. Results: The frequency of ischemic stroke at the age of 20-49 years grows from 9.6% to 24.2% and is predominant in the male sex (17.1%), which indicates a young stroke in mongolians is not uncommon. Young adults with ischemic stroke frequently bear both traditional and specific vascular risk factorsthan elderly people (p<0.05). The most common TOAST subtype in the young and old groups was undetermined (26.4% vs.12.3%; p=0.004), other determined cause (22.7% vs. 6.9%; p<0.001), and cardioembolism (20.0% vs. 22.3%) followed by Large-artery atherosclerosis (17.3% vs. 26.2%) and small vessel occlusion (15.6% vs. 33.8%; p<0.001). Partial anterior circulation infarcts were more common among young patients (p<0.001), than in posterior circulation infarcts. Silent brain infarcts and leukoaraiosis are not uncommon brain imaging findings (<0.05) in hypertensive and migraineur patients and should not be overlooked due to their potential prognostic relevance. Outcomes in young adults with hemispheric ischemic stroke can safely be improved with Low- molecular-weight-heparin therapy (OR 1.58; 95% CI, 0.99-2.51; p=0.001).
There were large differences between two groups concerning the 6-month outcome which showed beneficial effect for young stroke patients (mRS:89.1% vs. 66.9%, p=0.002; BI: 84.2% vs.73.1%). Conclusion There are significant differences between young and old patients with ischemic stroke regarding to risk factors, etiological subtypes and improvement of functional deficits associated with the stroke. However, severity of stroke on admittance is similar but six weeks outcome is different among young and old patients with relatively rapid improvement of functional deficit in young stroke patients than old one (mRS: 89.1% vs. 66.9%, p=0.002; BI: 84.2% vs.73.1%).

The main goal of this study is to examine the development of auditory perception performances of a cochlear implanted child who receive auditory verbal therapy. Present study included a child with prelinguistic hearing loss who received cochlear implant at the Department of ENT, 1st State Central Hospital and enrolled in Auditory Verbal Therapy (AVT) in the Speech Therapy Unit of “ Aid” Clinic. This hearing impaired child participated in auditory verbal therapy with their mother and/or father for 5 months, and the family was given training programs to apply at home after each therapy session. The auditory perception performances of a child were evaluated before implantation and after: twice every week in total 32 Audio-Verval Therapy sessions were performed with the help of Medel LittlEars Auditory Questionnaire, LIP (Listening Process Profile), Ling’s Five Sound Test, the Multiple Frequency Animal Sound Test (mFAST) and MTP (Monosyllable and Polysyllable Test). The auditory perception performances of a child joining auditory verbal therapy programs increased after 5 months of implantation. According to the Ling’s test all 5 sounds are determined (20-60dB) in 1m distance, but discrimination is observed in frequency range between 40-60 dB for sounds “A”, “U” and “M”. Parents active participation as well as full attendance in the AVT treatment shows progress in auditory development of a child. Furthermore evaluation and data analysis is needed.

This study investigates cochlear implant surgical and Audio Verbal Therapy (AVT) practice patterns of patients with hearing loss (HL) based on data of “Aid” ENT Clinic and Speech Therapy Unit of School of Dentistry, Mongolian National University of Medical Sciences (MNUMS) between 2009-2018. Our aim was to describe and collect related data on surgical interventions, using cochlear implant for patients with severe hearing loss and their involvement in the AVT sessions. Hospital based registry data by audiologistwere retrospectively investigated. Descriptive statistics are used to describe the basic features of the data in the study. In total 78 patients had cochlear implantation surgery with chronological age between 2 months and 55 years. From total subjects 46 (54.59%) were male and 32 (33.41%) female. The distribution of etiology for the hearing loss showed that the majority of hearing loss 47 (60%) had due to infectious diseases, other diseases or injury, 25 (32%) congenital and 6 (8%) unknown causes. Documentation and proper registration is essential for better outcome of cochlear implantation surgery, especially teamwork of speech therapist doing AVT and audiologist in charge of fitting. Furthermore, epidemiological studies are important for evaluation and monitoring of interventions by every specialists included in the treatment team.