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.

Introduction: Khuumii (throat singing) is a unique form of art derived from the nomadic population of Central Asia, producing two or more “simultaneous” sounds and melodies through the organ of speech. Material and Methods: The aim of the study is to identify the anatomical structures involved in the formation of khuumii and the features and patterns of their functions and compare each type of khuumii as performed by Mongolian people. A total of 60 participants aged 18-60 years (54 men and 6 women) were selected by non-random sampling method using cross-sectional study. Statistical analysis was performed using SPSS 23 software using questionnaires, X-ray, endoscopy, sound research method, and general blood tests. Results: 90.7% of the khuumii singers were male and 9.3% were female. The average height of the participants was 172.91±0.93 cm (arithmetic mean and mean error), average body weight was 77.53±2.46 kg, and body mass index was 25.93±5.31 respectively. Heart rate was 92.19±20.71 per minute prior to khuumii while 133.19±19.09 after performing khuumii and 85.81-98.56 at 95% confidence interval. In terms of ethnicity (ethnographically), the Khalkh were the largest ethnic group (72.1%), followed by Bayad, Buryatia, Darkhad, Torguud, and Oirat (2.3%), respectively. 60.5% of the participants were professional khuumii singers who graduated from relevant universities and colleges. The process of Khuumii was recorded by X-ray examination, and laryngeal endoscopy evaluated the movement of true and false vocal chords, interstitial volume, movements of epiglottis and arytenoid cartilage, and mucosa. Khuumii increases the workload of the cardiovascular system by 70-80%. Furthermore, the sound frequency is 2-4 times higher than that of normal speech, and sound volume is 0.5-1 times higher. 95.3% of throat singers did not have a sore throat, 88.4% did not experience heavy breathing, and 74.1% had no hoarseness. During the formation of khuumii sound, thoracic cavity, diaphragm, and lungs regulate the intensity of the air reaching the vocal folds, exert pressure on the airways and vibrate the sound waves through air flows passing through the larynx and vocal folds. Mouth-nose cavity as well as pharynx are responsible for echoing the sound. Conclusion It is appropriate to divide khuumii into two main types according to structural and functional changes in the organs involved; shakhaa and kharkhiraa. Khuumii, the “Human music” originating from the people of Altai Khangai basin by imitating the sounds of nature with their own voice in ancient times, spread all over the world from Mongolia and it is proposed to classify khuumii into two main types of shakhaa and kharkhiraa in terms of structural involvement and functionality.

Background: Headache is a common disorder among population. 47% of population of the world suffers from the primary headache. Due to the chronic lasting process of headaches, individuals lose productivity, get depression because of negative impact on people’s quality of life and economic status.
Headache disorders are amongst the top ten causes of disability in Europe [4]. Three of these (migraine, tension-type headache and medication-overuse headache) are important in primary care because they are common and responsible for almost all headache-related burden.
The burden is immense on workers, women and children in terms of missing work and school days. The personal and social burden of primary headache is high. Health, occupational, social, and psychological factors contributing to burden in people with disabling headache have not been fully unraveled. Headache disorders are not perceived by the public as serious since they are mostly episodic, do not cause death, and are not contagious. A large number of people with headache disorders are not diagnosed and treated: worldwide only 40% of those with migraine or tension-type headache (TTH) are professionally diagnosed and only 10% of those with medication-overuse headache (MOH).
There are no studies on the burden and disability assessment in patients with primary headache in our country, therefore a need for conducting this study. Goal: The burden and disability assessment in patients with primary headache in Mongolian adults. Methods and Materials: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old randomly were selected from four aimags of Mongolia and three districts of Ulaanbaatar city. They were visited by door to door calling and surveyed using the HARDSHIP and Migraine Disability Assessment (MIDAS) questionnaire. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program, and level of depression in headache present patients was determined by odds ratio (OR). Study methodology introduced at Ethical review Committee of “Ach” Medical University and approved in 2017 (№17/3/2). Results: There were 2043 participants 39.7% and 60.3% of them were men and women respectively. The mean age of them was 38.0±13.4 years. 57.4% (n=1173) of participants had headache, and 27.4%, 30.0%, 11.2% and 7.5% of them had migraine, tension-type headache, chronic headache and medication overuse headache respectively. 42% of participants with headache had the median duration of suffering 7 years (IQR=3-13 years). Out of 1173 participants with headache 20.7% had depression. 23% of participants with migraine had depression whereas 68.2 % and 47% of participants with chronic headache and medicine overuse headache had depression respectively. Participants with migraine were 1.85 (OR: 1.85, CI: 95%, 1.39-2.47) times, with chronic headache 3.40 (OR: 3.40, CI: 95%, 2.04-5.67) times and medicine overuse headache 3.31 (OR: 3.31, CI: 95%, 1,50-7.30) times more likely to suffer from depression compare to participants with no headache.
People with migraine loses their productivity 10.6 days/m, with chronic headache 19.7 days/m, with MOH 20.3 days/ m. According the MIDAS (migraine disability assessment) people with migraine has mild disability, while people with chronic headache and MOH had middle score of disability. Conclusion The prevalence of primary headaches is high among Mongolian adults. These headaches cause disability, impair work, study and daily activities, decrease life quality, and brings unrecognized socioeconomic burden.

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%).

Background: Headache disorders are most prevalent public-health problem. Worldwide, among the adults 46% suffer from primary headache, where the migraine presents 11% and tension type headache (TTH) presents 25%. Recently, one type of the primary headache, medication overuse headache tends to increase. Nowadays, there is no sufficient study about primary headache in Mongolia. So that, it is necessary to investigate prevalence, clinical type and risk factors of the primary headache. Purpose: To study prevalence and risk factors of primary headache in Mongolia. Materials and Methods: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old were randomly selected from four provinces and three districts of Ulaanbaatar city. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program. Results: A total of 2043 participants (812 men and 1231 women) were reviewed. The participant’s average age was 38.6±13.4years. 1350 (66.1%) participants reported recurrent headache within the last 1 year. Of the total study population, the prevalence rate of primary headache was 1305 (63.9%). Number of people who suffered from migraine was 494 (24.2%), significantly greater in female than male participants (p=0.0001), with most frequent attacks at age 26-45 years. The risk of migraine associated with sex, education and family history (p=0.001). 592 (29.0%) of participants had TTH, mean age of them was 37.7±5.24, significant high rate in female than men, risk of TTH depends on education and job. The medication overuse headache was diagnosed at 116 (5.7%), 29.4% in men and 70.5% in women with average of 45.6±11.4 and 43±12.7 respectively. Among the participants 38.6% used medications, 28% people had one drug, 8.5% two drugs and 2% used three or more drugs. Use of non-steroid anti-inflammatory drugs (NSAID) made up major percent in headache patients. Increased frequency of medication and multidrug affected to medication overuse headache (p=0.008). Conclusion More than half of studied population had primary headache. Migraine was in 24.2%, TTH in 29.0% of people, and associated with sex, education and family history. Use of non-steroid anti-inflammatory drugs made up major percent in headache patients.

Background: The primary headache disorders are one of the most common complaints among children and adolescents. Migraine and tension-type headache (TTH) are the most frequently types of primary headache, with prevalence of approximately 9.1% for migraine and 10–24% for TTH among children.
The aim of this study was to determine the 1-year prevalence and some risk factors of primary headache disorders in school-aged children. Material and Methods: A cross-sectional, school-based survey consisting of semi-structured questionnaires was administered to randomly select aged 6-11 years using stratified multistage cluster sampling during the period from April to June 2018. The questionnaire of primary headache was based on International Classification of Headache Disorders-III criteria. Statistical analysis was performed by using the SPSS, version 21. Student’s T-test, chi-square test and analysis of variance were used for comparisons when appropriate. The level of statistical significance was set at p<0.05. Results: We surveyed totally 635 participants; the one-year prevalence of all types of headache was 54.6%. Prevalence of migraine and tension-type headache was 3.0% and 5.4%, respectively. Elucidated biometric and socio-demographic risk factors showed statistically significant difference in prevalence of migraine: type of household, life situation and residential quarter. Conclusion Our study found that frequency of prevalence of primary headaches among the school-aged children is relatively high and comparable with other countries.

Coronary heart disease is a leading cause of mortality in many countries. Acute coronary syndrome is the basis pathophysiology of coronary heart disease. Complication of coronary atherosclerosis composes rupture of plaque and erosion of vulnerable plaque. Endothelial dysfunction is main influence of coronary plaque erosion. But then recently research oxidative stress and reaction of immunocomplex is leading cause of coronary plaque rupture. So the research background will study markers of endothelial dysfunction, oxidative stress, immune reaction in the complication of coronaryatherosclerosis. Aim: Determine the effect of some marker for causing complication of the coronary atherosclerosis. The research has been conducted using case-control study method. In the case group, patients with complication of the coronary atherosclerosis as determined by coronary angiography (stenosis >85%) as in the control group healthy people with carotid artery stenosis (<0.7mm) has been involved. In the study we defined Anti-oxLDL (anti-oxidized low density lipoprotein) using ELISA Kit (Eucardio Lab, USA) and oxLDL (oxidized low density lipoprotein) titer by ELISA Kit (Mercadio, USA), ADMA (Asymmetric dimethylarginine) titer by ELISA kit (Eucardio Lab, USA) reagents in the enzyme binding reaction. Total antioxidant capacity (TAC) was determined by using spectrophotometer method. The average age of people involved in the research is 57.2±9.72 and for the average age is case group 28 (32%) and 50 (68%) for the control group. ADMA titer level for complication of coronary atherosclerosis or case group is (30.1±1.98 ng/ml) which is (13.2±0.57 ng/ml) greater than the control group. It was statistically significant result (p<0.001). Also titer level for case group is oxLDL (72±2.75 mU/l), anti-oxLDL antibody (766±29.8 mU/ml), which is oxLDL (45.1±2.28 mU/l), anti-oxLDL antibody(603±17.74 mU/ml) greater than the control group. It was statistically significant result (p<0.001). But TAC titer level for control group is (116±2.47 nmol/l) which is (108.3±5.43 nmol/l) greater than the case group. It was not statistically significant result (p=0.098). According to the Binary Logistic Regression test the anti-oxLDL (OR=0.992, p<0.001), ADMA (OR=0.681, p<0.001), TAC (OR=1.017, p=0.105), oxLDL (OR=0.900, p<0.001) levels significantly influence the complication of coronary atherosclerosis. Therefore according to the Binary Logistic Regression test the anti-oxLDL level high significantly influence the complication of coronary atherosclerosis. Anti-oxLDL antibody titer are correlated directly with oxLDL (r=0.413, p<0.01), ADMA (r=0.42, p<0.001) levels. However, correlated negative directly with TAC (r=-0.233, p<0.01) level. Markers of endothelial dysfunction (ADMA OR=0.681, p<0.001) and oxidative stress (oxLDL, OR=0.900, p<0.001), (anti-oxLDL antibody, OR=0.992, p<0.001) high influence causing of complication of coronary atherosclerosis.

Coronary heart disease is a leading cause of mortality in many countries. Acute coronary syndrome is the basis pathophysiology of coronary heart disease. Complication of coronary atherosclerosis composes rupture of plaque and erosion of vulnerable plaque. Endothelial dysfunction is main influence of coronary plaque erosion. But then recently research oxidative stress and reaction ofimmunocomplex is leading cause of coronary plaque rupture. So the research background will study markers of endothelial dysfunction, oxidative stress, immune reaction in the complication of coronaryatherosclerosis. Aim: Determine the effect of some marker for causing complication of the coronary atherosclerosis.The research has been conducted using case-control study method. In the case group, patients with complication of the coronary atherosclerosis as determined by coronary angiography (stenosis >85%) as in the control group healthy people with carotid artery stenosis (<0.7mm) has been involved. In the study we defined Anti-oxLDL (anti-oxidized low density lipoprotein) using ELISA Kit (Eucardio Lab, USA) and oxLDL (oxidized low density lipoprotein) titer by ELISA Kit (Mercadio, USA), ADMA (Asymmetric dimethylarginine) titer by ELISA kit (Eucardio Lab, USA) reagents in the enzyme binding reaction. Totalantioxidant capacity (TAC) was determined by using spectrophotometer method. The average age of people involved in the research is 57.2±9.72 and for the average age is case group 28 (32%) and 50 (68%) for the control group. ADMA titer level for complication of coronaryatherosclerosis or case group is (30.1±1.98 ng/ml) which is (13.2±0.57 ng/ml) greater than the control group. It was statistically significant result (p<0.001). Also titer level for case group is oxLDL (72±2.75 mU/l), anti-oxLDL antibody (766±29.8 mU/ml), which is oxLDL (45.1±2.28 mU/l), anti-oxLDL antibody(603±17.74 mU/ml) greater than the control group. It was statistically significant result (p<0.001). But TAC titer level for control group is (116±2.47 nmol/l) which is (108.3±5.43 nmol/l) greater thanthe case group. It was not statistically significant result (p=0.098). According to the Binary LogisticRegression test the anti-oxLDL (OR=0.992, p<0.001), ADMA (OR=0.681, p<0.001), TAC (OR=1.017, p=0.105), oxLDL (OR=0.900, p<0.001) levels significantly influence the complication of coronary atherosclerosis. Therefore according to the Binary Logistic Regression test the anti-oxLDL level high significantly influence the complication of coronary atherosclerosis. Anti-oxLDL antibody titer arecorrelated directly with oxLDL (r=0.413, p<0.01), ADMA (r=0.42, p<0.001) levels. However, correlated negative directly with TAC (r=-0.233, p<0.01) level.Markers of endothelial dysfunction (ADMA OR=0.681, p<0.001) and oxidative stress (oxLDL, OR=0.900, p<0.001), (anti-oxLDL antibody, OR=0.992, p<0.001) high influence causing of complication of coronary atherosclerosis.

BackgroundOut of total 209550 cases of cardiovascular diseases in 2011, 66,7% were newly registered cases.Cardiovascular diseases are the number one cause of mortality in Mongolia; an estimated 6291 peopledied from CVDs in 2011, representing 36.7% of all deaths. It shows that CVD mortality level is higherthan in other countries.Materials and MethodsOur survey is a cross sectional study. We have investigated 600 people of the age of 20-40 whowere randomly selected from 6 urban districts of Ulaanbaatar city. With a permission #4 issued bythe Medical Ethics Control Committee of the Ministry of Health on 25th March 2011, our survey wascarried out between the 1st of July 2011 and the 1st of January 2012 based on the Functional DiagnosticLaboratory, Department of Physiology and Pathophysiology, School of Biomedicine, Health SciencesUniversity of Mongolia.ResultsThe CAVI was significantly higher (p<0.001) in 30-40 aged adults (6.68, 95% CI 6.58-6.78) than 20-29 aged adults (6.42, 95% CI 6.32-6.52). Also CAVI has a direct correlation with the cholesterol level(p<0.05, R2=0,011). Serum cholesterol, triglycerides and LDL levels were significantly higher (p<0.05)in men than women. Framingham Heart Score was in the normal range in 99.2% of the participantswith 4 cases having the score of 10% or higher representing a risk score.ConclusionsDislipidemia, overweight and obesity in young adults are the main causes of vascular dysfunctionsleading to cardiovascular diseases. Thus, the findings of the study demonstrate that helping youths todevelop healthy lifestyles including healthy eating and physical activities shall play a critical role for theprevention and intervention programs designed for development of healthy behavior and lifestyle fromchildhood, especially for the male population, are vital for fulfillment of this role.