Background: The study of small-molecule compounds with antitumor activity involves several crucial steps. These include determining their selective effects on cancer cells, understanding the type of cell death they induce, identifying the activated signaling pathways, pinpointing the target molecules, and elucidating the mechanisms of action. Among the plant-derived compounds with anticancer properties, flavonoids are notable for their ease of isolation and their abundance in food. Apigetrin, a representative flavonoid, is a secondary metabolite found in plants, and our previous study indicated that its anticancer selectivity index was 13.1. However, the specific mechanism by which apigetrin inhibits leukemia cell growth remains unclear. Aim: To study of the inhibitory action of apigenin on leukemia cell culture Materials and Methods: In this study, we evaluated the apoptosis of cells using flow cytometry and investigated the in volvement of the caspase pathway through the use of pancaspase inhibitors to explore the effects of apigetrin on leukemia cell growth. Results: After incubating leukemia RAW264.7 cells with 30 μM apigetrin for 24 and 48 hours, we did not detect any apoptosis through Annexin V and PI staining by flow cytometry. We compared the number of viable cells using the MTT assay after 24-hour treatment of apigetrin with or without pretreatment of Z-VAD, a pancaspase inhibitor, for 30 minutes. The results indicated that the pancaspase inhibitor did not reduce the inhibitory effect of apigetrin on the growth of RAW264.7 cells. In contrast, the positive control group, treated with doxorubicin—which induces apoptosis—showed not only significant apoptosis but also a reduction of the pancaspase inhibitor on the cell growth inhibition. Therefore, these data suggested that apigetrin likely has a cytostatic effect or inhibits the cell cycle rather than being cytotoxic. Future research should focus on determining which stage of the cell cycle RAW264.7 cells treated with apigetrin are in, as well as studying the signaling pathways involved in the cell cycle. Conclusions Apigetrin inhibits the proliferation of RAW264.7 leukemia cells in a caspase-independent and non-apoptotic manner.

Background: Cancer incidence and mortality are steadily increasing both globally and in Mongolia. As these rates rise, traditional Mongolian medicine has long utilized herbal formulas for the treatment of gastric and esophageal cancers and precancerous conditions. One such formulation—Hot Natured 3 Herbs (HN3H)—comprises three species from the Ranunculaceae family: Atragene sibirica L., Ranunculus repens L., and Pulsatilla bungeana L.. However, scientific validation of its anti-tumor effects is essential. This study aimed to investigate the effect of HN3H in a tumor-induced animal model. Aim: To identify the biologically active compounds of HN3H and evaluate their effect in an experimentally induced tumor model in animals. Materials and Methods: The three herbs comprising HN3H—Atragene sibirica L., Ranunculus repens L., and Pulsatilla bungeana L.—were collected during their flowering stage (May–June) in Khishig-Undur, Bulgan province, and dried according to official procedures. Extraction was carried out by maceration in 96% ethanol at a 1:10 ratio. The concentrated extract was suspended in water (1:1) and successively fractionated with dichloromethane, ethyl acetate, butanol, chloroform, and n-hexane. The study was approved by the Research Ethics Committee of the Mongolian National University of Medical Sciences (Protocol №2020/03-04). A colorectal cancer model was established by subcutaneous injection of MC-38 cells (Kerafast, USA) into C57BL/6 mice. Immunohistochemistry was performed using CK20, CDX2, Ki67, and p53 antibodies at 1:100 and 1:200 dilutions. Results: The ethanol extract of HN3H contained 2.98±0.04% total phenolics and 2.16±0.05% total flavonoids. Body weight and tumor volume were measured daily with three repetitions. All groups showed a time-dependent increase in body weight. Mice in groups 1A and 1B received ethanol extract at 50 and 100 mg/kg doses; groups 2A and 2B received dichloromethane extract at the same doses. The negative control group was administered 0.5 mg/kg PBS orally, while the positive control group received intraperitoneal injections of 5-fluorouracil (5FU) at 10 mg/kg twice a week. Tumor growth increased in a time-dependent manner across groups. Compared to the negative control, tumor volumes in four treatment groups showed statistically significant reduction (p˂0.05), while no significant difference was observed when compared to the positive control (p=0.08). Histological analysis revealed necrosis in all groups, with variation in extent. Conclusion The ethanol extract of HN3H exhibited moderate levels of phenolic compounds and a high concentration of flavonoids. HN3H extract inhibited tumor progression and activated lymphocyte-predominant inflammation in tumor tissues, indicating potential anti-tumor activity (p˂0.05).

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: Anemia is still being a population’s challenging issue regardless of high development of countries around the world. According to a study regarding prevalence and etiology of anemia conducted in 187 countries around the world, the anemia rate is 23 176 per 100 000 population. In accordance with the “5th National Nutrition Survey” study conducted in our country in 2017, one of every five women (21.4%), aged 15-49 years, 16.2% of reproductive age women and 3.0% of men are anemic. The current study was conducted due to it is still essential to study and identify the etiology of anemia, determine its prevalence, plan appropriate intervention, and organize future preventive measures, depending on the socio-economic conditions, location, diet, and customs of the Mongolians. Aim: To identify anemia among the adult population, determine the type and severity of anemia. Materials and Methods: The cross sectional study was conducted during between May 2022 and Sep 2023 and adults aged above 18 years were included. Moreover, we identified anemia cases based on the laboratory test results and determined the anemia severity grade. Statistical analysis was performed by using SPSS software. Results: Among the participants, 6.7% of them, 9.9% of females and 2.8% of males are anemic. Prevalence of mild, moderate and severe anemia is 66.7%, 30% and 3.3%, respectively. While the prevalence of anemia among reproductive age women is higher, the prevalence of anemia increases with age. The anemia prevalence in Ulaanbaatar region, Western region, Khangai mountainous region, Central region and Eastern region is 583 (25.6%); 171 (7.5%); 343 (15.1%); 921 (40.4%); and 261 (11.4%), respectively. By regional location, the prevalence is high in the Central region, with varying prevalence in other regions. Conclusion Anemia was detected in 6.7% of the total study population, 9.9% of females, and 2.8% of males were anemic. Of those with anemia, 66.7% had mild anemia, 30% had moderate anemia, and 3.3% had severe anemia. Moderate and severe anemia were more common in females than in males.

Introduction: Anemia is still being a population’s challenging issue regardless of high development of countries around the world. According to a study regarding prevalence and etiology of anemia conducted in 187 countries around the world, the anemia rate is 23 176 per 100 000 population. In accordance with the “5th National Nutrition Survey” study conducted in our country in 2017, one of every five women (21.4%), aged 15-49 years, (16.2%) of reproductive age women and (3.0%) of men are anemic. The current study was conducted due to it is still essential to study and identify the etiology of anemia, determine its prevalence, plan appropriate intervention, and organize future preventive measures, depending on the socio economic conditions, location, diet, and customs of the Mongolians. Aim: To determine the prevalence, red blood cell morphology, and severity of anemia among adults. Method: The cross sectional study was conducted during between May 2022 and Sep 2023 and adults aged above 18 years were included. Moreover, we identified anemia cases based on the laboratory test results and determined the anemia severity grade. Statistical analysis was performed by using SPSS software. Result: Overall, (6.7%) of participants were anemic: (9.9%) of women and (2.8%) of men. The distribution by severity was: mild anemia (66.7%), moderate anemia (30%), and severe anemia (3.3%). Among women of reproductive age, prevalence was higher, whereas in men, anemia prevalence increased with age. Regionally, the Central region showed the highest prevalence, while other regions varied. Analysis of anemia by red blood cell morphology showed that normocytic anemia accounted for (51.6%), hypochromic anemia 66%, and mean hemoglobin concentration hypochromic (53.6%). Moderate and severe anemia was more common in women than men. Conclusion Anemia was detected in (6.7%) of the total study population, (9.9%) of females, and (2.8%) of males were anemic. Of those with anemia, (66.7%) had mild anemia, (30%) had moderate anemia, and (3.3%) had severe anemia. Moderate and severe anemia were more common in females than in males.

Background: In recent years, the use of social networking sites has rapidly increased, enabling people to communicate more efficiently, quickly, and effectively, as well as to access and share information in real time. Accordingly, various research tools and measurement instruments have been developed to assess the impact of social media on individuals’ daily lives. However, most of these instruments primarily focus on the duration and frequency of use, failing to comprehensively capture the true influence of social media. Therefore, there remains a need to evaluate social media use more broadly. Aim: Determine the reliability and validity of the Social Media Use Scale among adolescents. Material and Methods: This analytic cross-sectional study was conducted among 421 students aged 12–17 years (mean age 15.1±3.6), including 43.7% male and 56.3% female participants. The study assessed the reliability and validity of the Mongolian version of the Social Media Use Integration Scale (SMUIS). Construct validity was examined using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), while reliability was evaluated using Cronbach’s alpha coefficient. Results: The Mongolian version of the Social Media Use Integration Scale revealed two subfactors (eigenvalue > 1.0). In the principal component analysis, all 10 items showed sufficient factor loadings (≥ 0.4) with no cross-loading items (<0.4). Structural regression analysis indicated positive and significant effects among the subfactors (B=0.42–0.82). The reliability of the validated questionnaire was acceptable, with Cronbach’s alpha values above 0.6. Conclusion The Mongolian version of the Social Media Use Integration Scale demonstrated satisfactory validity and reliability and can be appropriately used to assess adolescents’ electronic media use. Further studies are recommended to test the reliability of this instrument among other population groups.

Risk factors for severe postpartum hemorrhage: a case-control study Introduction: Postpartum hemorrhage (PPH) is an obstetric emergency. It is one of the top five causes of maternal mortality in both resource-abundant and resource-limited countries. PPH occurs in approximately 1% to 3% of all deliveries and is the leading cause of obstetric morbidity and mortality worldwide, accounting for approximately 8% of maternal deaths in developing countries and 20% of maternal deaths in developed countries. The United States has one of the highest maternal mortality rates at 11% and continues to rise, increasing from 8 to 40 cases per 10,000 deliveries. In Europe, PPH occurs in approximately 13% of deliveries. Uterine atony, the primary cause of PPH, accounts for 70% to 80% of all hemorrhages.Traditionally, PPH is defined as more than 500 mL of estimated blood loss in a vaginal delivery or more than 1000 mL of estimated blood loss during Cesarean delivery. These parameters were redefined in 2017 by the American College of Obstetrics and Gynecology as a cumulative blood loss of more than 1000 mL with signs and symptoms of hypovolemia within 24 hours of the birth process, regardless of the mode of delivery. A loss of an approximate total blood volume of more than 1500 mL will typically cause clinical features of hypovolemia. Materials and methods: The study was conducted using a retrospective, case-control research design. The study population consisted of women who gave birth between January 1 and August 1, 2024 at the Department of Obstetrics and Gynecology at the National Center for Maternal and Child Health and were diagnosed with hemorrhage. The study participants were divided into 2 groups according to the amount of blood loss in the early postpartum period: the control group was less than 1500 ml (n=72), and the case group was women with blood loss of 1500 ml or more (n=26). Research data were collected through a questionnaire with 60 questions in 3 groups pre-designed from medical history. Statistical analysis was performed using IBM SPSS 26 software. Results: The study included 98 women, maternal age was 17-44 which average 30.2±6.7 years. There were no significant differences in age, marital status, mode of delivery, and drug dosage in the case-control group. The risk of major bleeding in the early postpartum period was associated with Preeclampsia, 1.9 (OR: 1.99; 0.71-5.57), cardiovascular disease 11.2 (OR=11.2; 1.1-18.5), placenta accrete spectrum 6.5 (OR=6.5; 2.01- 21.1), increasing anemia during pregnancy 8.05 (OR=8.5; 1.08-12.5). Also, pregnancy with twins and the weight of the fetus increased the amount of postpartum hemorrhage. Also, the amount of blood lost in mothers with other births was positively correlated with the duration of labor (r=0.348). There is a risk of increased bleeding in case of co-occurring causes of bleeding (p=0.042). Conclusions: The risk of major bleeding in the early postpartum period was associated with Preeclampsia, cardiovascular disease, placenta accrete spectrum, increasing anemia during pregnancy. Also, pregnancy with twins and the weight of the fetus increased the amount of postpartum hemorrhage. Also, the amount of blood lost in mothers with other births was positively correlated with the duration of labor. There is a risk of increased bleeding in case of co-occurring causes of bleeding.

Introduction: The treatment of antibiotic-resistant bacterial infections has become a pressing problem for humanity worldwide, and antibiotic-resistant bacterial infections are likely to be the leading cause of death by 2050.Due to the mutation of infectious disease-causing bacteria and the emergence of bacterial resistance due to the improper use of antibiotics, the time and cost of infectious disease treatment increases, and in some cases, it leads to an increase in mortality, so it is the focus of the health sector in every country, regardless of the income level of the population. In addition, bacterial resistance has a negative impact on public health, food safety, the environment, and the economy.
As of 2015, Mongolia ranks among the countries with the highest consumption of antibiotics in the world, with 64.41 units of antibiotics prescribed per 1,000 people per day. Bacteria resistant to broad spectrum antibiotics have increased dramatically, and among Gram-positive bacteria, drug-resistant Staphylococcus aureus (MRSA) has become one of the most common and dangerous cause Purpose: Determine the external structure of liposome-encapsulated antibiotics and evaluate their antibacterial activity. Materials and Methods: We conducted this study using an experimental research design. Phospholipids were isolated by intermittent evaporation, antibiotic encapsulation by freeze-thaw method, and antibiotic sensitivity was determined using standard strains by disc diffusion andmicro dilution method. Research ethics: Permission to submit the survey was granted by the Ethics Review Committee of the MNUMS. The survey was granted in accordance with the rules and regulations. Results: In liposome-encapsulated antibiotic sensitivity assays, azithromycin and clarithromycin did not form sacred circles, whereas doxycycline hyclate was sensitive by forming a 16 mm circle. Doxycycline hyclate encapsulated in liposomes formed a 16 mm circle with sensitive results, whereas blank liposomes were inactive. When the rabbits were infected with a standard strain of methicillin-resistant Staphylococcus aureus, the infected area was purulent 24 hours later. A cream containing antibiotics was started at this time. A deep wound was recovered after 12 days after the pus was removed. Nevertheless, after 24 days, the wound on the rabbit’s infected part healed and the hair on the scraped part grew back. Conclusion According to the dilution method, liposome-encapsulated doxycycline hyclate inhibited bacterial growth at 2-fold lower doses than pure doxycycline hyclate. In experimental animal models, liposome-based antibiotic ointment has shown antibacterial activity.

COVID-19 and pregnancy: a national registry based study Background: According to a cohort study involving 2,130 pregnant women from 16 countries, the impact of COVID-19 on maternal morbidity and mortality was higher in low- and middle-income countries. Other one study found that the coronavirus pandemic increased maternal mortality by 1.37 times. The COVID-19-related mortality risk is 3 times higher in pregnant women than in the general population. In our country, there is a lack of evidence that determine the impact of COVID-19 on maternal mortality based on the national registration system. We aimed to study the relationship between COVID-19 and maternal mortality and complications based on national registry data Materials and methods: The study was conducted between February 20, 2022 and March 1, 2022 based NCMCH. The impact of the coronavirus pandemic on maternal mortality was performed based on the 2020-2021 maternal mortality data of Mongolia through a retrospective and time series analysis. In order to estimated factors that affect the complications of a pregnant women’s COVID-19 infection, it was conducted a retrospective study design based on the database of pregnant women diagnosed with a COVID-19 infection. The study data was collected through a prepared questionnaire. Results: According to analysis, the maternal mortality rate in Mongolia in 2021 was 1.9 times higher than the predicted rate. In 2021, 67.6% of maternal deaths are due to COVID-19. In 2021, the maternal mortality rate due to Covid-19 was 64.2 per 100,000 live births, which is twice as high as maternal mortality due to other diseases. In 2020-2022, 17,789 pregnant women between the ages of 14 and 46 who were infected with the coronavirus were included in the study to determine the factors affecting the complications of COVID-19. The mean age of the participants was 30 ± 5.8 (95% CI 29.7 – 29.9) and their gestational age was 24 ± 10 weeks. Of all participants, 71.6% was diagnosed and treated in Ulaanbaatar. 52.7% of pregnant mothers diagnosed with coronavirus and presenting with complications have not been vaccinated, which is a relatively high rate compared to the group of pregnant mothers without complications. Not being vaccinated against coronavirus had a 70% increased risk of complications (OR = 1.7, 95.0% CI: 1.4–2.0). However, the probability of hospitalization increased by 20% (OR = 1.2, 95.0% CI: 1.0 – 1.4). The COVID-19 severity depends on the age of the maternal and the length of the pregnancy. Conclusion: The COVID-19 pandemic has had a significant impact on maternal mortality, has increased. The maternal mortality rate in Mongolia is low compared to other countries, but it is higher than the recommended level for reducing maternal mortality. COVID-19 vaccination, on the other hand, reduced the complications of pregnant women and had a protective effect. It is important to build evidence by examining the effects of COVID-19 and vaccines on pregnant women.