Background: Meniere's disease is a condition caused by disturbances in the auditory and vestibular systems. It is characterized by symptoms such as dizziness, nausea, vomiting, and tinnitus. In the United States, the prevalence of Meniere's disease has been found to be 84 cases per 100,000 women and 56 cases per 100,000 men. Regionally, it is more common in less populated areas, and research has confirmed that the prevalence increases with higher household income. Aim: To evaluate the effectiveness of traditional medicine treatments and therapies for Meniere's disease. Results: The patient is a 43-year-old male, with symptoms of dizziness, vomiting, and tinnitus. Since 2023, he has sought care at the Central Hospital of Mongolian Medicine, where he received traditional medicine treatments including herbal therapy and other traditional therapies on three occasions. As a result, the frequency of dizziness has decreased and other clinical symptoms have improved. Conclusion Traditional medicine treatments have been shown to be effective in managing Meniere's disease by extending the interval between relapses, improving quality of life, and significantly reducing clinical symptoms.

Background: The main risk factors for childhood overweight and obesity include the consumption of sugar-sweetened beverages and other sweetened foods. The sugar content of sugar-sweetened beverages was different from the nutritional information on the packaging. Aim: To determine sugar and brix content in domestic manufactured sugar-sweetened beverages, and compare information on the packaging and regulatory standards. Materials and Methods: The sugar and brix content in sugar-sweetened beverages was determined by laboratory anal ysis, including 150 domestically manufactured sugar-sweetened beverages. Laboratory analysis carried out in the Chemical toxicology laboratory of the National Reference Laboratory for Food Safety, MASM, determined sugar using a saccharometer and brix using refractometry. : Results: The study included 150 Mongolian sugar-sweetened beverages, including 20.7% (n=31) carbonated drinks, 47.3% (n=71) fruit drinks, 16.0% (n=24) tea drinks, 1.3% (n=2) energy drinks, 14.7% (n=22) flavored water. Sugar content 0.0–15.6% in sugar-sweetened beverages. The laboratory analysis results compared with information on the packaging 72.0% (n=108) difference between 0.1–11.3%, 10.7% (n=16) same, do not have sugar content in the nutritional information on the packaging 17.3% (n=26). Brix contained 0.2–13.0% carbonated drinks, 4.9–15.7% fruit drinks, 0.6–9.8% tea drinks, 7.7–16.0% energy drinks, and 0.1–9.7% flavored water. Conclusions 1. Sugar content 0.0–15.6%, brix 0.0–16.0% in Mongolian sugar-sweetened beverages. 2. The laboratory analysis results compared with nutritional information on the packaging 72.0% (n=108) difference between 0.1–11.3%, 10.7% (n=16) same nutritional information on the packaging, do not have sugar content in the nutritional information on the packaging 17.3% (n=26). 3. 37.3% of Mongolian sugar-sweetened beverages are unsatisfied with regulatory standards.

Background: Membranous nephropathy (MN) is among the most common causes of nephrotic syndrome in adults. MN is diagnosed in one third of cases of nephrotic syndrome on kidney biopsy. Kidney biopsy is the gold standard for diagnosing MN and plays an important role in determining the severity of the disease and in determining treatment decisions and regimens. Therefore, the lack of research on kidney biopsy in Mongolia is the reason for this study. Aim: The aim of this study was to investigate the pathological features in the kidney tissues of patients with primary membranous nephropathy diagnosed by kidney biopsy. Materials and Methods: A retrospective study was conducted on 51 cases of MN diagnosed in kidney biopsies performed at the First Central Hospital of Mongolia (FCHM) over a period of 12 years. Renal function was calculated using the CKD-EPI (2021) formula and classified into the stage of CKD by eGFR. Histopathological findings were examined using 4 light microscopy (LM) stains (Hematoxylin-Eosin, Masson-Trichrome, PAS, and Methenamine silver staining) and 8 immunofluorescence (IF) microscopy stains (IgG, A, M, complement C3, C4, C1q, and kappa, lambda). The study excluded secondary MN based on viral markers, tumor markers, and serological tests. Statistical analysis was performed using SPSS and STATA 15.0 software, using t-tests, Pearson’s chi-square tests, and multiple group comparisons were performed using ANOVA and Kruskal-Wallis methods. The study design was approved by the Ethics Committee of the MNUMS, Mongolia. (№ 2023/3-07) Results: A total of 305 kidney biopsies performed at the Kidney Center of the FCHM between 2011 and 2023 resulted in the diagnosis of 51 cases of primary MN. The mean age of patients with membranous nephropathy was 40.6±9.3 years, with the oldest age of 65 and the youngest of 22 years, and 36 (70.59%) were male and 15 (29.41%) were female. In the kidney biopsy, the average number of glomeruli was 16.51±7.82 (min-max, 3-54), and by LM, 33.3% showed global sclerosis of glomeruli by hematoxylin-eosin staining, 94.12% showed thickening of the glomerular basement membrane (GBM), 31.2% showed double counter staining of subepithelial immune complexes by methenamine-silver staining, 88.24% showed holes in the GBM, and 54.9% showed spike-like changes by Masson-Trichrome staining. IF showed IgG 3+ in 37.3%, 2+ in 39.2%, 1+ in 13.7%, and trace staining in 9.8%, while 74.5% of the cases were positive for C3, 93.1% for kappa, and 79.5% for lambda. LM showed thickening of the GBM (OR 23.5, 95% CI 0.093-0.53, p value= 0.007) and interstitial fibrosis (95% CI 6.98-31.07, p value= 0.003) contributing to the decrease in eGFR. The mean time from the onset of the first symptoms of kidney disease to the time of kidney biopsy was 35.35±61.54 months. Patients who underwent biopsy later (in months) after the diagnosis of the disease had a higher incidence of interstitial fibrosis (74.6 ± 98.43, 95% CI -90.52-20.68, p value = 0.002). Conclusion The histopathological features of MN confirmed by kidney biopsy showed thickening of the GBM in 94.12%, global sclerosis in 33.3%, and holes in 88.2%. Immunofluorescence microscopy showed 100% IgG staining, while C3, kappa, and lambda were positive in 74.5%, 93.1%, and 79.5%, respectively.

Background: From the perspective of Mongolian medicine, hemorrhagic disease is a symptom of bleeding from any part of the body. This disease was compared to the immune thrombocytopenia disease of modern medicine. The treatment of this disease using two medical methods and the prevention of complications and relapses are issues facing the healthcare sector. In this regard, we have chosen this topic to clarify and prove the mechanism of action of the Mongolian drug Gurgem-8, which is widely used to treat bleeding disorders. Aim: To evaluate the therapeutic efficacy of Gurgem-8, in haemostatic treatment. Materials and Methods: The study was conducted using a randomized, controlled (active), open label, single centered clinical trial method. The study was conducted in two phases. First, an acute toxicity study of the Gurgem-8, was conducted in accordance with OECD guideline 423 and evaluated according to GHS classification. A chronic toxicity study was also conducted on Wistar rats (n=20) given the Gurgem-8, at doses of 500 mg/kg, 100 mg/kg, and 150 mg/kg daily for 60 days. Second, a clinical study was conducted on a total of 74 patients, who were randomly divided into 2 groups. The treatment group was given 3 grams of the Gurgem-8, daily, and the comparison group was given 4 capsules of Sheng Xue Xiao Ban Jiao Nang 3 times a day. The results were determined by laboratory methods. The study was conducted with the approval of the Research Ethics Committee of Mongolian National University od Medical Sciences (2024.01.19 №2024/3-01). Results: In the acute toxicity study, Turmeric-8 was found to be of low toxicity according to the GHS classification. No mortality was observed in the chronic toxicity test. As a result of the clinical study, there were significant differences in the blood hemoglobin (χ2=73.923, P<0.001), platelet (χ2=62.465, P<0.001), erythrocyte (χ2=77.113, P<0.001) and leukocyte (χ2=14.771, P<0.001) cell counts between the Gurgem-8, drug group and the comparison group. It was also determined that the platelet (χ2=138.3, P<0.001), erythrocyte (χ2=85.405, P<0.001) and leukocyte (χ2=10.961, P=0.027) cell counts were directly related to the treatment period and the group. When determining the effect on immune cells, there was no significant difference in the lymphocyte cell content before and after treatment (CD4+: t=0.233, P=0.817; CD8+: t=-0.264, P=0.793; CD4/CD8:Z=-0.119, P=0.905). However, the CD4/CD8 ratio was statistically significantly increased in each of the Gurgem-8, drug group and the comparison group (P<0.001, P=0.001). Conclusion In immune thrombocytopenia diseases, the Gurgem-8, has the effect of reducing hemoglobin levels in the blood, increasing platelet counts, reducing CD4+ and CD8+ T cell counts, and increasing the CD4/CD8 ratio.

: A study by Marsot and other investigators (2012) determined that the dose of vancomycin in adults is directly dependent on parameters such as creatinine clearance and body weight, as well as the need for dose correction. We used the MDRD equation to determine renal dysfunction in 113 inpatients and found grade I in 50.5%, grade II in 14.4%, grade III in 10.8%, grade IV in 6.3%, and grade V in 18%. There is a statistically significant difference (p=0.045) in renal dysfunction depending on the diagnosis. The average daily dose of vancomycin was 2.5 g, the total daily dose was 8.5 g, the total dose was 20.5 g. The daily dose and total dose of vancomycin were inversely proportional to age (g = -0.256), the daily dose was directly related to excess weight body (g=0.226), and days of vancomycin use are statistically significant (p=0.001) depending on the diagnosis. Conclusion Comprehensive programs are required to improve the vancomycin use in the hospitals. Vancomycin use should be monitored due to its large-scale empiric use. The rate of improper use of vancomycin in the infection and intensive care unit services may be high, and pharmacists must take appropriate action to optimize the use of the drug.

Background: To investigate relapse rates after the successful treatment of patients with non-atypical endometrial hyperplasia (EH) either a levonorgestrel impregnated intrauterine system (LNG-IUS; MIRENA®) or two regimens of oral dydrogesterone (DGS) after primary histological response. Currently, the incidence of EH is indistinctly reported to be around 200,000 new EH cases per year in Western countries. Methods: Patients were at their choice assigned to one of the following three treatment arms: LNG-IUS; 10 mg of oral DGS administered for 10 days per cycle for 6 months; or 10 mg of oral DGS administered daily for 6 months. The women were followed for 6 months after ending therapy. [Figure2] Women aged 25-55 years with low or medium risk endometrial hyperplasia met the inclusion criteria, and 35 completed the therapy. Results: Histological relapse was observed in 55/ (41%) women who had an initial complete treatment response. The relapse rates were similar in the three therapy groups (P = 0.66). In our study involved 25-55 (mean 42.2±1.61) aged 35 women. Among them had reproductive aged 31.43% (n= 11) premenopausal women 42.86 % (n= 15) postmenopausal women 25.71% (n= 9). Their mean body mass index had 28.8±1.15 kg/m², and normal weight 34.29% (n=12), overweight 34.29% (n=12), obese 17.14% (n=6), extremely obese 14.29 % (n=5). [Figure3] Types of obesity had normal 37.14% (n=13), android 25.71% (n=9), gynecoid 37.14% (n=13). Mean parity had 1.8±0.19 to nulliparous 14.29% (n=5), primiparous 60% (n=21), multiparous 25.71% (n=9). Smoke 17.14% (n=6). Non combined disease had 65.7% (n=23), diabetes mellitus 17.14% (n=6), PCOS 14.29% (n=5), cardiovascular disease had 2.86% (n=1). [Table1] Mean endometrial thickness of TVUS had ( 16.0±0.91mm). Smoke (p=0.0391), types of obesity (p=0.0436) and myoma of the uterus (p=0.0187) seen affected the endometrial thickness. LNG-IUD group had after treatment’s menstrual period 11.11% heavy 80ml (n=1), 88.89% light 5ml (n=8). DGS (5-25 day) group had after treatment’s menstrual period 9.09% heavy =80ml (n=1), 90.91% light5ml (n=10), DGS (16-25 day) group after treatment menstrual period 40% heavy 80ml (n=6), 46.67% normal 5-80ml (n=7), 13.33% light 5ml (n=2) байв. Therefore between the three treatment groups had no differences. But treatment’s before and after result had statistics probability differences (P= 0.4064). [Figure4] Conclusions Finally, given the long natural history of menorrhagia, study outcomes need to be assessed over a period that is longer than 2 years. In conclusion, our study showed that both the LNG-IUD, oral progestin treatment reduced the adverse effect of menorrhagia on women’s lives over the course of two years. LNG-IUD was the more effective first choice, as assessed impact of bleeding on the women’s quality of life.

Introduction: Researchers have found that people living in polluted areas have a lower ability to resist skin bacteria and increase the number of skin microflora. Decreased immune function increases the risk of sore throat, influenza, respiratory infections, pneumonia and gastrointestinal diseases. One of the main indicators of the human immune system is the normal microflora. Goal: To study the relationship between normal human microflora and specific immunity. Material and Methods: This study was conducted within the framework of the project “Effects of non-specific immune factors on injectable infectious disease immune system”. The survey sampled 10 households from Dornod aimag, 8th khoroo of Chingeltei district, Ulaanbaatar city, and 3rd khoroo of Baganuur district. A total of 176 people aged 6 months to 50 years were involved. A total of 528 swab samples and 31 blood samples were collected from the throat, tonsils, skin and mucous membranes to study the relationship between normal human microflora and specific immunity.
The research methodology was discussed at the meeting of the Academic Council of the Ministry of Social Welfare and the Medical Ethics Review Committee under the Ministry of Health (January 5, 2018, Resolution 646) and the research was approved. Results: The total number of normal microorganisms in the skin and mucous membranes of the study participants changed, and the number of hemolytic strains and fungi increased. 58%-67% of the participants had normal and long-term immunity against diphtheria and tetanus, while 5% -14% were not. This result was as high as in urban and rural areas. Conclusion This result was as high as in urban and rural areas. As the age group increases, the level of the body’s specific immunity decreases, the structure of the normal microflora changes, and the number of fungi and hemolytic bacteria increases. Furthermore, it is necessary to study specific and nonspecific immunity in detail in relation to environmental pollution indicators.

Background and Aims: Hepatocellular carcinoma (HCC) is a common cause of cancer related death in Mongolia. Early diagnosis is the very important management to increase successful treatment and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC) tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic biomarker of HCC. Methods: We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP) levels were measured using commercially available enzyme-linked immunosorbent assay kits. The diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and estimated sensitivity and specificity of each biomarker. Results: sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999 (0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6 ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 % with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%). Conclusion Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC. Combination of two markers showed greatest diagnostic accuracy.

Introduction: Air pollution has become one of the major problems in socio-economic and health issues in Mongolia. Among the various hazards of particulate matter (PM) pollutants, microorganisms in PM2.5 and PM10 are thought to be responsible for various allergies and for the spread of respiratory diseases. Recent studies have shown that PM2.5 particles can cause chronic heart failure, heart arrhythmias, and strokes, as well as lung damage, cirrhosis, inflammation, cancer, cardiovascular disease, and metabolic disorders. Furthermore, some studies have concluded that PM2.5 particles in the environment are a risk factor for gastrointestinal, liver, colon, and lung cancer as well as it affects the growth and metastasis of various cancer cells caused by other factors. In our country, the health effects of air pollution and the relationship between the pathogenesis of cancer research are scarce. Therefore, the study of the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis) can provide a significant role for cancer treatment, diagnosis, and prevention. Purpose: Determining the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis) in in-vitro Material and Methods: A human liver cancer cell line (HepG2), human gastric cancer cell line (AGS) were obtained from the central scientific research laboratory in the Institute of medical sciences. HepG2, AGS cells were seeded at a concentration of 1*105 cells/mL in a culture flask and cultured in RPMI-1640 medium supplemented with 10% FBS, 1% antibiotic mix (penicillin, streptomycin) in a humidified atmosphere of 5% CO2 at 37 °C. The cytotoxic effect of PM 2.5 in AGS, HepG2 cells were evaluated by MTT, CCK8 assays. AGS, HepG2 cells were incubated in 96 well plates for 24h then treated with different concentrations (0, 5, 10, 25, 50 and 100 μg ) of Bayankhoshuu, Buhiin urguu, and Zaisan samples for 24h, respectively. Results: Concentrations of 10, 25, and 50 μg/ml of samples collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth, while doses of 25, 50 μg/ml of samples collected from Bayankhoshuu in March and December increased HepG2 cell growth. Therefore, concentrations of 25 and 50 μg/ml of samples collected from Bayankhoshuu in March increased AGS cell growth, while concentrations of 25, 100 and μg/ml of samples collected in December increased AGS cell growth. However, no cytotoxic effect was observed in the sample collected from Zaisan in March, whereas the PM2.5 sample enhanced AGS cell growth in dose dependent manner in December.(p <0.05) Conclusion High levels of heavy metals were detected in samples collected in December from Bayankhoshuu, Bukhiin urguu and Zaisan of Ulaanbaatar. Concentration of 25 μg/ml of samples collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth. Concentrations of 25 μg/ml of PM2.5 collected from three regions around Ulaanbaatar increased HepG2 and AGS cell migration.

Research of function of vitamin D on immune system has been studying since the study revealed that vitamin D receptor is expressed on the surface of the immune cells. 1,2-dihydroxyvitamin D3 [1,25(OH)2D], physiologically active form, can be generated through hydroxylation of 25-hydroxyvitamin D3 [25(OH)D], inactive form of vitamin D, in a liver, connecting with specific VDR make biological action. Vitamin D make different biological actions depends on connecting with different immunological cells. Some studies indicated that Vitamin D plays pivotal role in antibacterial innate immune responses through regulating reaction of the main cells as macrophages and dendritic cells. Moreover, calcitriol, the active form of vitamin D, is connected with VDRE, modulates the innate immune response through directly inducing expression of catelicithin and β-defensin as antimicrobial peptides, reducing secretion of IL-1b, IL-6, TNF-a, RANKL, COX-2 as proinflammatory cytokines and increasing production of IL-10, an anti-inflammatory cytokine. Vitamin D plays in proliferation and differentiation of T and B cells and regulates the activities of over 500 genes. Vitamin D differently impacts on per se stages of T cells’ proliferation. Vitamin D indirectly mitigates the differentiation from immature B cells to plasma B cells while it directly impacts on regulation of overloaded production of antibodies in plasma B cells. In conclusion, vitamin D modulates the innate- and adaptive immune response through regulation on activation of APCells, proliferation and differentiation of immune cells, secretion of some antibacterial peptides.