Background: The aging of the world’s population will determine global health trends. According to the 2021 report of the Capital City Health Department, the average life expectancy of the Mongolian population is 71.3 years (male 67.3, female 76.7), the difference between male and female life expectancy is 9.4 years, and elderly people aged 60 and over account for 8.1% of the total population. The report also shows that 6.5% of all outpatient visits are for people aged 60-64, and 9% are for people aged 65 and over, which means that they do not receive adequate health care services. Therefore, it is important to increase the access to and quality of health care services provided to the elderly in order to improve their health and quality of life. Comorbidities that are common among the elderly are one of the pressing issues in the health sector. Aim: We aimed to study the prevalence and risk factors of multi-morbidities among older adults (aged sixty years and over) in urban and rural areas. Materials and Methods: To accomplish our aim, we conducted 156 lifestyle related questionnaires and 18 health related questionnaires among 720 older people in Ulaanbaatar city and rural areas, and created the database. Pearson correlation coefficient was used to determine the relationship between the quantitative influence of factors using single and multi-factor linear (β-coefficient) and binary logistic regression (odds ratio, CI 95%) methods, and p value less than 0.05 was considered statistically significant. The Apriori algorithm in SPSS was used to determine the relationship between multiple chronic diseases in the elderly people. Results: The prevalence of comorbidity was higher in urban areas (48.1%) and rural areas (51.9%), and ageing (urban areas OR: 2.45, 95% CI: 0.9-6.2; rural areas OR: 6.35, 95% CI: 1.47-27.4, P<0.01) was a risk factor of multi-morbidities. Multimorbidity is defined as the presence of 2 or more chronic conditions, and 3, 4, and 5 chronic conditions were co-occurred to older adults with chronic conditions, 28.7% (165). 11 common patterns of relationships in urban areas and 18 common patterns of relationships in rural areas (support (A→B)>3%, confidence (A→B)>30%, lift (A→B)>1) were determined. Conclusion Multimorbidity was different in urban and rural areas, 11 common patterns in urban areas and 18 common patterns in rural areas were determined. It has shown that the prevalence of multimorbidity was different in urban and rural areas.

Background: Iron deficiency (ID) and iron deficiency anemia (IDA) are among the most common forms of anemia worldwide. Although the underlying causes of ID may vary depending on a country’s developmental level, lifestyle, and other factors, blood loss remains the principal cause leading to ID and subsequent IDA. In hemophilia, recurrent bleeding due to deficiencies of coagulation factors (FVIII, FIX, FXI) can lead to ID, which may progress to IDA and adversely affect the quality of life in these patients. The absence of studies evaluating the prevalence of ID and IDA among hemophiliac patients in Mongolia provided the impetus for this investigation. Aim: To assess the prevalence of ID and IDA among patients with hemophilia. Materials and Methods: A cross-sectional study was conducted among 45 patients with hemophilia registered at the Hemophilia Comprehensive Center (HCC), Mongolia-Japan Hospital, Mongolian National University of Medical Sciences. All participants underwent laboratory testing, including complete blood count (CBC) and serum ferritin levels—were performed using the SYSMEX XN2000 and COBAS BM6010 analyzers. Data analysis was carried out using SPSS 27.0 and MS Excel 2010. Results: Among the 45 cases, 41 were Hemophilia A and 4 were Hemophilia B. Reduced serum iron levels were found in 33.3% (15), and low ferritin levels were observed in 22.2%. Detailed blood tests revealed microcytic hypochromic changes in 43.9% (18) of Hemophilia A cases and in 100% (4) of Hemophilia B cases. The overall prevalence of ID was 13.3%, while the prevalence of IDA was 22.2%. Among the IDA cases, 90.0% were classified as mild and 10.0% as moderate. Notably, 80.0% of the IDA cases occurred in children under 15 years of age. Conclusion ID and IDA are common among hemophiliac patients. The high prevalence among children under 15 years of age suggests an age-related predisposition, emphasizing the need to improve disease management and to implement preventive measures against anemia in this population.

Background: Hypokalemia is considered when the serum potassium level is less than 3.5 mmol/L. Clinical research indicates that hypokalemia affects 20% of hospitalized patients, and in 24% of these cases, inadequate interventions result in life-threatening complications. At present, there is no research available on the prevalence, management, and outcomes of hypokalemia in hospitalized patients, which justifies the need for this study. Aim: The study aimed to examine the prevalence of hypokalemia and the effectiveness of its management in hospitalized patients within the internal medicine department, in relation to the knowledge of doctors and resident physicians. Materials and Methods: This hospital-based retrospective study included a total of 553 cases of patients hospitalized in the Internal Medicine Department of the Mongolia Japan Hospital between January 2024 and August 2024. Patients with a potassium level of <3.5 mmol/L were diagnosed with hypokalemia, and the effectiveness of potassium replacement therapy was evaluated according to the method of supplementation employed. Results: The prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department was 9.8% (54 cases). Based on the study criteria, 42 cases of hypokalemia were selected for further analysis, and a total of 118 potassium replacements were performed through oral, intravenous, and mixed methods. Following potassium replacement therapy, 37.3% (44) of patients achieved normalized potassium levels, while 62.7% (74) still had persistent hypokalemia. Conclusion According to the study results, the prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department is 9.8%. The method of potassium replacement and the severity of hypokalemia do not impact the normalization of potassium levels, with the critical factor being the proper dosage of supplementation. The knowledge of doctors and resident physicians regarding hypokalemia is insufficient, and there is a need to implement guidelines and protocols for potassium replacement therapy in daily clinical practice.

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.

Background: This study explores the potential of food industry by-products, such as plant peels, stems, and slags, as valuable sources of lignocellulosic material (LCM), which contains 25-40% xylan. These underutilized resources, often discarded as waste, hold the promise of sustainable applications in biotechnology. By safely extracting xylooligosaccharides (XOS) from LCM biomass, the value of these materials can be significantly enhanced, contributing to green production and supporting sustainable development. XOS, recognized for its prebiotic activity, has been shown to promote the growth of beneficial gut bacteria, making it a vital research area in the fields of food science, medicine, and technology. Aim: To extract and characterize oligosaccharides derived from by-products of the food industry, evaluate their physicochemical properties, and investigate selected biological activities. Materials and Methods: This study utilized microwave pretreatment and enzymatic hydrolysis to isolate and purify XOS from wheat bran and brewers’ spent grains (BSG), provided by Altan Taria LLC and APU CoL, respectively. Microwave irradiation at 200°C for 5 minutes was employed as a pretreatment step, followed by hydrolysis using commercial xylanase (Thermomyces lanuginosus, recombinant Aspergillus oryzae, 2500 BXU/g) at 55°C for 24 hours. The resulting hydrolysate underwent filtration with activated carbon and ethanol precipitation to yield purified XOS. Analytical methods, including FTIR spectroscopy, TLC and HPLC, were used for structural and compositional analysis of the purified oligosaccharides. In vitro tests evaluated the ability of XOS to support the growth of beneficial gut bacteria, including Bifidobacterium spp., Lactobacillus fermentum (ATCC 9338), and Lactobacillus casei (ATCC 344), using XOS-enriched media. Additionally, in vivo studies were conducted on rats to determine the biological effects of XOS on gut microbiota. Results: The results demonstrated that prolonged enzymatic hydrolysis for more than 10 hours, using 0.25 g of xylanase per 100 g of substrate, resulted in optimal yields. XOS purity was measured at 87.6% with an 8.1 g yield from wheat bran and 89% purity with a 7.2 g yield from brewers’ spent grains. Structural analysis confirmed the presence of xylobiose, xylotriose, and xylotetraose, with xylotetraose being the most abundant component in WBP-XOS (47.5%), and xylobiose dominating BGS’s derived XOS (47.8%). Biological effects revealed that wheat bran-derived XOS significantly supported the growth of Bifidobacterium spp. and L. fermentum (ATCC 9338) in a concentration-dependent manner, whereas no significant effect was observed on L. casei (ATCC 344). In vivo studies confirmed that XOS consumption increased populations of Bifidobacterium spp. and Akkermansia muciniphila spp. in gut microbiota (p<0.05). Furthermore, XOS consumption reduced plasma cholesterol, triglycerides, and LDL-C levels while increasing HDL-C levels, demonstrating metabolic benefits. Conclusion This research establishes that XOS with prebiotic activity can be efficiently extracted and purified from food industry by-products using microwave-assisted enzymatic hydrolysis. This approach highlights the potential of utilizing agricultural and industrial waste for producing functional prebiotics, contributing to sustainable practices and offering valuable applications in health and nutrition.

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer originating from liver cells, classified as a chronic liver disease. This cancer ranks third in the world in terms of mortality rate. The MELD (Model for End-Stage Liver Disease) and Child-Pugh scoring systems are utilized to assess the prognosis of chronic liver diseases. Based on studies suggesting that certain blood test indicators, particularly red cell distribution width (RDW), could be used to predict the prognosis of liver cancer and other cancers, as well as serve as diagnostic markers, this topic was chosen to evaluate the clinical significance of RDW in hepatocellular carcinoma. Aim: The aim is to study some blood test indicators and compare them with the MELD score and Child-Pugh score systems in order to determine the prognosis of chronic liver diseases. Materials and Methods: A retrospective, single-center, cross-sectional study was conducted at Mongolia-Japan Hospital. Among 322 patients diagnosed with HCC, 24 patients were selected for the case group, and 37 patients with liver cirrhosis were included in the control group. Results: According to the research criteria, 61 patients were selected and divided into 3 groups, and statistical analysis was performed. In the detailed blood test, platelet count and WBC count showed statistically significant differences among the 3 groups (p< 0.024). In the biochemical tests, C-reactive protein (CRP) was p< 0.018, total bilirubin p< 0.001, and the mean albumin level p< 0.015, all showing statistically significant differences among the 3 groups. A statistically significant inverse correlation was observed between RDW-CV and the clinical MELD score (r=-0.356). Conclusion Platelet count, RDW, CRP, total bilirubin, and average albumin levels are significantly different across the studied groups. RDW-CV shows a moderate inverse correlation with MELD scores, suggesting its potential as a prognostic marker in chronic liver diseases. Further research with larger sample sizes is recommended to confirm these findings.

Introduction: 16% of the world's 8 billion people, or more than 1.3 billion, are people with special needs or people with disabilities. Of these, there are unofficial studies that show that there are about 650 million people with disabilities in Asian countries. [1] One of the most common problems faced by people with special needs is that disability service organizations, especially pharmacies, do not have access to complete information on their necessary medications.
According to the 2019 data of the National Statistics Committee [4] in our country, 3.4 percent of the total population or 107.6 thousand are citizens with special needs. Article 1.1 of the Law "On the Rights of Persons with Disabilities" [5] provides for the equal rights of persons with disabilities to participate in social relations, to ensure and implement them, to provide an accessible environment, to create conditions, housing, public buildings, roads, public transport, and information., communication technology is included as being accessible to people with disabilities. However, health and pharmacy services for people with special needs are very challenging.
The main basis of this research work is to make pharmacy services easier for people with special needs, especially people with speech, hearing, visual, mental, and motor disabilities, and to identify and solve problems. Methods: The research was carried out in a one-moment model. Based on the General Department of Development of People with Disabilities, data was collected by questionnaire using the minimum sample size calculation, which was calculated as 478 people per 1000 population. Statistical analysis was carried out using SPSS-23 software.
Our survey was conducted between November to December 1, 2022 using a snapshot model. Processing of results was carried out using survey data processing. Conclusion
1. According to the 2019 data of the National Statistics Committee, 3.4 percent or 107.6 thousand of the total population of our country are citizens with special needs. This information has not been updated for 2021-2022.
Out of a total of 478 people in the survey, 54% were male, while 42.8% of the respondents were 20-30 years old. 48.8% of citizens use pharmacies independently, 42.4% with the help of a guardian, and 8.8% of other citizens use pharmacies. The lack of understanding of drug information on prescription forms affects the physician's prescription, drug information, visual and hearing impairments, and misunderstandings.
2. People with speech, hearing, visual, mental, and motor disabilities face the biggest problem in using the pharmacy. Therefore, it is a priority to make certain innovative changes in order to make pharmacy operation* equal to citizens. These include: Prescription forms can be read using technology such as Qr and AR on the phone, delivering medication instructions and information in audio form to people with visual and mental disabilities, providing more clear and understandable information to people with speech and hearing disabilities identifying medications for people with visual impairments, and using drugs correctly. We believe that suggestions and solutions are needed, such as placing names and instructions in braille on product labeling and packaging, implementing stairs and doors for people in wheelchairs or with mobility impairments in accordance with standards in all buildings, and providing seats for stairwells between floors. In most cases, it takes 10-20 minutes for people with disabilities to visit a pharmacy. Some citizens are experiencing delays in services for up to an hour. It can be seen that spending a lot of time to visit a pharmacy is difficult for citizens.
In order to solve this problem, under the supervision of a manager and a pharmacist, a post-graduate student of "Pharmacy" of the "University of Pharmaceutical Sciences" should be created to provide advice and information to citizens and reduce the burden.

Background: The global urgency for environmentally friendly technologies has steadily intensified, and as a result, the synthesis of silver nanoparticles with antibacterial properties derived from medicinal plants traditionally used to combat bacterial infections has garnered significant interest. Goals: This research endeavors to synthesize silver nanoparticles utilizing Jidanga and Banzdo plants, widely recognized in traditional medicine, while elucidating their physical, chemical attributes, and biological potential. Methods: The physicochemical characteristics of these silver nanoparticles, synthesized through phytosynthesis, were meticulously examined via various analytical techniques. Ultraviolet and visible light spectrophotometry (UV/Vis), Photon Cross Correlation Spectroscopy (PCCS), Atomic Force Microscope (AFM), Infrared Spectroscopy (FTIR), and X-ray Crystallography (XRD) were employed for comprehensive analysis. Additionally, their antitumor efficacy was assessed via MTT assay utilizing RAW264.7 cell cultures, while antibacterial properties were evaluated through agar diffusion tests against selected bacterial strains. Results: Silver nanoparticles exhibited distinctive UV/Vis absorption peaks at 407-426 nm, affirming their composition. PCCS measurements revealed nanoparticles with hydrodynamic diameters spanning from ~100 nm to ~450 nm, while AFM imaging showcased spherical nanoparticles ranging from ~35 nm to ~97 nm. Crystallography analysis identified both simple cubic and polycrystalline structures. FTIR analysis unveiled the presence of organic compounds adsorbed onto the nanoparticle surfaces, in addition to silver bonds. Notably, the aqueous and ethanolic extracts of Banzdo plants demonstrated dose-dependent inhibition of RAW264.7 cell growth via the MTT assay. Furthermore, the silver nanoparticles exhibited antibacterial activity against a range of test bacteria with inhibition zones spanning 1-4 mm. Conclusion This study successfully synthesized silver nanoparticles utilizing Jidanga and Banzdo plants from traditional medicine, comprehensively characterizing their physicochemical attributes and demonstrating their biological activity. These findings hold promise for the future utilization of phytosynthetically derived silver nanoparticles.

Introduction: Polycythemia vera (PV) is Philadelphia chromose (Ph)-negative and chronic myeloproliferative disorder (MPN). Moreover, 0.01-2.6 incidences are diagnosed for every 100,000 population. In Polycythemia vera, guanine on 1849th base of 14th ex-one of 9th hromosome is replaced by thymidine and homozygous state is developed. As a result, valine on 617 of JH2 domain in JAK2 is replaced by fenylalanine and activation of tyrosine kinase is increased. Then, signal pathways such as JAK-STAT, PI3K/Akt and ERK1 are independently activated. The JAK2 V617F mutation is identified in approximately 95% of total polycythemia vera diagnosed cases. Furthermore, the average age group of patients with polycythemia vera is 61 and 10% of them are aged under 40 years and male:female ratio is 1:1.
In accordance with World Health Organization criteria of 2016: If three major criterias or first two criteria plus one minor criteria are identified, Polycythemia vera is diagnosed.
Although life expectancy rate of PV cases in follow-up is high, is lower in comparison with the general same age group of population and essential thrombocythemia (ET). In accordance with an international and large study (n=1545), the average life expectancy rate was 14.1 years among Polycythemia Vera diagnosed patients. More than half of mortality related to the disorder (53%) was caused by unknown etiology. On the other hand, (36\347, 10.3%), (36\347, 10.3%), (32\347, 9.2%) and (13\347, 3.7%) of the remaining mortality cases were caused by acute leukemia, secondary malignancy, thrombotic complications and cardiac failure, respectively. Objective: We aimed to determine JAK2 V617F gene mutation on patients with suspected polycythemia vera and evaluate the CBC/complete blood count/ parameters and clinical signs. Material and method: The cross sectional study was conducted during 8/Mar/2022 ad 20/May/2022 and 13 individuals with suspected polycythemia vera who received outpatient service at hematology department of State First Central hospital (SFCH) and Mongolia-Japan hospital of MNUMS were included. Ethical approval was received by order (№2022/3-02) of 28/Feb/2022 and research ethics review committee. Each and every participant received informed consents and agreed to participate in the study. The current study was conducted with the support of integrated laboratory of Clinical pathology of State First central hospital. Result Total of 13 participants were included in the study, 38.4% (n=5) and 61.5% (n=8) of them were male and females, respectively. The mean age group was 58.69±7.7 years. The JAK2 V617F mutation was detected in 92.3% (12/13) of patients. The average age group was 57.8 (52-68) for males and 58.6 (43-71) for females. Complete blood count parameters of males with the JAK2 V617F mutation are shown.
By questionnaire, some of clinical signs such as fatigue, pruritus after bath, headache, dizziness, bone and muscle pain, hands and feet peripheral cyanosis, numbness and nocturnal sweating were detected on patient with positive mutation.

Introduction: Diarrhea is defined as a person excretes more than three times in 24 hours with pathological impurities of more than 10 mg/kg per day. According to the fact sheets of the World Health Organization in 2019, diarrhea is the second leading cause of death among children under 5 years of age. Researchers suggest that about 50 percent of infantile diarrhea occurs in temperate countries and it reaches almost 80 percent in winter which is mainly caused by rotavirus. While immunization is the most effective way to prevent rotavirus infection, there were two types of rotavirus vaccines that have been licensed and available on the global market since 2006. Rotavirus immunization in young children is a safe and effective public health method for controlling rotavirus infection which therefore can reduce childhood morbidity and mortality. Study aim: To study the incidence, clinical manifestations, and complications of rotavirus among children hospitalized with acute diarrhea. Methodology: The study will be conducted using the observational method including descriptive analysis. Statistical data for 2018-2020 will be obtained and analyzed from the pediatric wards of the “Gurvan Gal” hospital. Children diagnosed with rotavirus diarrhea who meet the criteria to be included in the study will be selectively sampled with further analysis of the incidence, clinical features, toxicity, and dehydration of acute diarrhea according to the medical history. Results Universal immunization is important to significantly reduce rotavirus-associated diarrhea, thereby reducing infection and the risk of disease in infants and young children.