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: Type 2 diabetes has increased risk of heart failure 2-4 times more than those in non-diabetic subjects. The early detection of asymptomatic ventricular dysfunction by using NT-pro BNP test in diabetic patients is the best strategy for decreasing morbidity and mortality of heart failure. Aim: The aims of this study were to detect asymptomatic cardiac ventricular dysfunction by using NT-pro BNP test in subjects with type 2 diabetes and to define the factors associated with elevated NT-proBNP. Materials and Methods: This cross-sectional study was included diabetic and non diabetic subjects aged from 35- to 64 years, who had no clinical symptoms of heart failure. Cardiovascular risk factors were detected by clinical examinations. NT-pro BNP determination was performed on an immunoassay analyzer (FIA1100, Getein Bio Medical Inc, China), which uses reagent strip to obtain quantitative NT-pro BNP results in plasma. The cut-off point for NT-pro BNP was 300 pg/ml. Results: A total of 536 subjects without clinical symptoms of heart failure were included in the study of which, 150 were diabetic and 386 were non diabetic. The mean age was 52.8 ± 7.8 years and 281 (52.4%) were females. Cardiac ventricular dysfunction was detected in 7.3% of diabetic and 5.2% of non diabetic subjects. Cardiac ventricular dysfunction in diabetic subjects was increased with age and non-significantly higher in females than in males (8.3% vs 6.4%, p>0.05). In the logistic regression analysis, uncontrolled hypertension (OR 3.80, 95% CI 1.07–13.44), long duration of disease (OR 5.30, 95% CI 1.36-20.66), and ageing (OR 5.40, 95% CI 1.29–22.88) were significantly correlated cardiac ventricular dysfunction in subjects with type 2 diabetes. Conclusion Cardiac ventricular dysfunction in subjects with type 2 diabetes was detected 1.4 times more than those in non diabetic subjects. The likelihood of positive NT-pro BNP test in subjects with type 2 diabetes was independently (p<0.05) associated with advanced age, uncontrolled hypertension and long duration of diabetes.

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.

Lung cancer has the highest mortality rate in the world and is the most common cancer type in Asiancountries. In developed countries, new cases and lung cancer among women tend to increase, while in less developed countries, the death rate of this cancer is high and its prevalence is higher among males.
Moreover, in many studies conducted in recent years worldwide, a sample of the studies containing early detection, diagnosis, and treatment that can be implemented at the national level was translated and compiled.
Improvement of public health education, availability of health care services, an increase of human resource capacity, implementation of early detection programs among the public, and early detection with a reduced dose of KTG among the target group are expectations of the public health sector.
Special attention should be paid to issues such as reducing smoking among the people of Mongolia, immediately solving the problem of air pollution in central areas, assessing and reducing the risk factors of occupational diseases of mining workers, and introducing modern methods of treatment and diagnosis in health care services. The time has come to take multifaceted measures to prevent lung cancer, which has a high global disease burden and economic burden, with public participation.

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: Vitamins are nutrients essential for human health. They act as coenzymes that help trigger important chemical reactions necessary for energy production. Reference values for vitamins help physicians evaluate the health status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some water-soluble vitamins of Mongolian adults. Materials and Methods: Three hundred and forty healthy adults (170 males and 170 females) of 17 to 69 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the Resolution No.76 of 2018 of the Medical Ethics Review Committee of the Ministry of Health. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of vitamins B₆, B₉, B₁₂ and vitamin C were measured using a high performance liquid chromatography method. The lower- and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean blood level of vitamin C was 11.88 mg/L (95% CI 10.47-13.29) for men and 9.62 mg/L (95% CI 8.11-11.13) for women. The calculated reference interval for males was 1.40-19.40 mg/L and 1.17-18.04 mg/L for females. The mean concentration of vitamin B₁₂ in the blood of males was 938.45 ng/L (95% CI 747.22-1129.68) and that of females was 864.03 ng/L (95% CI 603.81-1124.25). The reference interval for vitamin B₁₂ was 233.03-1597.00 ng/L in men and 132.45-1623.86 ng/L in women. The mean level of vitamin B₉ was 8.47 ng/mL (95% CI 5.64-11.30) for men and 6.91 ng/mL (95% CI 4.89-8.93) for women. The calculated reference interval for this vitamin in males was 1.04-24.74 ng/mL and that in females was 1.04-21.46 ng/mL. As for vitamin B₆, the mean concentration for men was 44.42 ng/mL (95% CI 37.01-51.83) and for women was 34.67 ng/mL (95% CI 29.97-39.39) with the reference intervals of 5.90-79.02 ng/mL for men and 5.27-61.72 ng/mL for women. Conclusion The reference values for vitamins B₆, B₉, B₁₂ and vitamin C of Mongolian adults do not differ significantly from those observed in other populations. The calculated reference intervals can be used in the practice of health laboratories.

Introduction: The high rate of malnutrition in young children remains a serious public health issue. Intervention strategies aimed to rectify this situation have succeeded in reducing anaemia, with levels falling to 28.5%. Even so, anaemia levels are still unacceptably high, especially among infants aged 6 to 24 months. Goal: The aim of this survey was to investigate the prevalence of anaemia and iron and folate deficiencies that may contribute to the relatively high rates of anaemia among children aged 6 to 36 months. Subjects and methods: This study involved 243 apparently healthy children (122 boys, 121 girls) from Ulaanbaatar city and Bulgan, Bayankhongor, Dornod and Khovd aimags aged 6 to 36 months with no evidence of infection within the previous 7 days. Ethical approval of the study was obtained from the Medical Ethics Committee of the Mongolian Ministry of Health. Written informed consents were obtained from the guardians of each child.
Morning, non-fasting venipuncture blood samples were used for the determination of the levels of hemoglobin by the hemoglobinometer, of ferritin by the microparticle enzyme immunoassays technology and of folate by the microtiter technique.
The statistical analysis of test results was carried out using SPSS program, with a p-value <0.05 indicating statistical significance. Results: The mean hemoglobin and ferritin concentrations were the highest in the oldest children (i.e., 24 to 36 months). The mean values for hemoglobin were higher in the participants from Ulaanbaatar, whereas the ferritin levels were higher in their counterparts from the rural settings.
Overall, 24% of the children were anaemic. Anaemia prevalence was greater among the children in the rural area than in Ulaanbaatar. The prevalence of iron deficiency anaemia was 15%, and unlike anaemia, was independent of setting. The oldest children aged 24 to 36 months had the lowest prevalence of iron deficiency anaemia in both Ulaanbaatar and the rural area.
The mean serum folate concentration was 19.9 nmol/L. The concentrations decreased with age in both settings, although the mean values in Ulaanbaatar were significantly higher for each age group than those for the rural settings. Only 4% of the children had folate deficiency. None of the participants in Ulaanbaatar had low serum folate concentrations. In the rural settings, the oldest children had the highest prevalence of folate deficiency. Conclusion The prevalence of anaemia and iron deficiency anaemia is high among children aged 6 to 36 months. This finding emphasizes the necessity for programs that supply young children and their mothers with micronutrients such as iron and folate.

Background: The main service of medical laboratories is provision of test results. The test results and other patient data are kept in either electronic system or paper-based systems or both. We assessed the current status of the use of information management system by medical laboratories in Mongolia. Methods: Twenty four laboratories of health organizations representing government and private sectors as well as urban and rural locations were included in the survey. The assessment was carried out using a questionnaire based on MNS ISO 15189:2015 requirements. Results: Out of the twenty four participant laboratories 54.2% (12) recorded the test results both in a workbook and in an electronic database, and 12.5% logged the results to the electronic database only. All patient data kept in the electronic system were protected, but the data protection was difficult to implement for paper-based records. Servers of the electronic information management system provided a long-time guaranteed back-up for patient results and enabled data retrieval for the analysis. 68.8% (16) of the laboratories used an information management system called E-health supported by the Ministry of Health. Conclusion Electronic information management system is widely implemented in medical laboratories but it needs further development and broader involvement of laboratories of all levels.

Background: Minerals are important for the proper body functioning. They also play a role in preventing and fighting diseases. Reference values for minerals help physicians evaluate the mineral status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some minerals to be used for evaluation of the nutrition status of Mongolians. Materials and Methods: Two hundred and forty healthy adults (120 males and 120 females) of 17 to 70 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the ethical committee of the Ministry of Health of Mongolia. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of iron (Fe), zinc (Zn) and copper (Cu) were measured by graphite furnace atomic absorption spectrometry. The lower and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean level of blood iron was 30.50 µmol/L (95% CI 29.71-31.29) for men and 30.91 µmol/L (95% CI 30.03-31.79) for women. The calculated reference interval for males was 21.39-37.72 µmol/L and 19.87-39.67 µmol/L for females. The mean concentration of zinc in the blood of males was 11.00 µmol/L (95% CI 10.69-11.31) and that of females was 11.79 µmol/L (95% CI 11.39-12.19). The reference interval for blood zinc was 8.20-14.92 µmol/L in men and 8.52-16.67 µmol/L in women. The mean level of blood copper was 15.28 µmol/L (95% CI 14.64-15.89) for men and 18.08 µmol/L (95% CI 17.30-18.86) for women. The calculated reference interval for copper in males was 9.72-22.34 µmol/L and that in females was 11.18-27.27 µmol/L. Conclusion The reference values for zinc, copper and iron of Mongolian adults do not differ significantly from those observed in other countries. The calculated reference intervals can be used for evaluation of the nutrition status and making clinical decisions.

Background: Reference values are very important for the clinical decisions in laboratory diagnosis and clinical management of patients. Method: A total of 340 adults (apparently healthy individuals) between 18 to 70 years resident in the Ulaanbaatar city were randomly selected and enrolled in this survey. 340 adults made up of 170 males, 170 females were assessed by a clinician to be healthy. About 5 ml of blood was collected with EDTA test tube and analyzed using automated analyser to enumerate the hematological parameters (red blood cell, white blood cell, hemoglobin and haematocrit). Reference values were determined at 2.5^th and 97.5^th percentiles. Results: Reference values estabilished include: red blood cell 4.69-6.04×1012/L, white blood cell 3.98-9.11×109/L, haemoglobin 145-176 g/L, haematocrit 42.6-52.9% for males and red blood cell 4.10-5.20×1012/L, white blood cell 3.50-9.08×109/L, haemoglobin 121.8-148.2 g/L, haematocrit 36-44.7% for females. Conclusion We were determined mean and reference range of haematological parameters (red blood cell, white blood cell, haemoglobin, haemotocrit) which are important for assessing the nutritional status of adults according to the international standard methodology. The international reference range shows that white blood cells counts do not indicate gender and our data (р=0.0964 are statistically insignificant) also offers no significant difference was found between samples for male and female subjects.