Background: Asthma is a chronic inflammatory disease characterized by bronchoconstriction and breathing difficulties, which can be triggered by both allergic and non-allergic mechanisms. In allergic asthma, a hyperreactivity reaction occurs, leading to an increase in fractional exhaled nitric oxide (FeNO) levels. Therefore, FeNO is used to differentiate allergic and non-allergic types of asthma. In recent years, studies have been conducted to assess FeNO as an indicator of treatment effectiveness and symptom control. Our goal is to introduce FeNO measurement in Mongolia for the first time and utilize it for asthma diagnosis and treatment outcome evaluation. Aim: Study of FeNO levels in Asthma Diagnosis in Relation to Laboratory Findings and Lung Function Materials and Methods: This study included a total of 70 adult patients (18 years and older) with asthma who visited the Outpatient Clinic of Mongolia-Japan Hospital and Shargaljuut Spa Clinic from May to December 2024. Based on their allergic history, total IgE levels, and peripheral blood eosinophil count, participants were classified into allergic (>5%) and non-allergic (<5%) asthma. The study aimed to determine the diagnostic specificity and sensitivity of FeNO levels. Asthma control levels were assessed using the Asthma Control Test (ACT), lung function was evaluated using spirometry, and exercise capacity was measured with the 6-minute walk test. Results: In a single measurement, there were no differences between the allergic and non-allergic groups in parameters other than total IgE, peripheral blood eosinophil count, and FeNO levels. For diagnosing the allergic form of asthma, at a FeNO level of 25 ppb, sensitivity (Se) was 0.68, specificity (Sp) was 0.30 (p=0.008); at 40 ppb, Se was 0.77, Sp was 0.31 (p=0.001); and at 50 ppb, Se was 0.74, Sp was 0.33 (p=0.001). Lung function and exercise capacity were similar in both asthma groups. Conclusion The sensitivity of FeNO in distinguishing between allergic and non-allergic forms of asthma is 67-81%, and its sensitivity tends to increase as the FeNO level rises. By distinguishing the allergic type in which inhaled corticosteroids are more effective, the outcome of asthma treatment can be predicted in advance based on the FeNO level.

Background: Asthma management should be individualized, evidence-based, aimed at controlling clinical symptoms, preventing severe exacerbations, and improving quality of life. Studies have shown that inhalation therapy with iodine- bromide saltwater improves lung function in chronic obstructive pulmonary disease (COPD), while radon-containing mineral water inhalation reduces inflammation and oxidative stress in asthma. Several studies have analyzed the composition of the Shargaljuut hot spring, with Oyuntsesteg et al. identifying high levels of Na+-HCO3 - and Na+-SO4. Other studies on mineral water therapies have reported benefits such as thinning bronchial secretions, improving sputum clearance, reducing inflammation and acidity, mitigating oxidative stress, and enhancing quality of life. Aim: To study the effectiveness of combined asthma treatment with inhaled corticosteroids and hot spring inhalation. Materials and Methods: The study included 67 participants diagnosed with asthma who consented to participate and underwent 10 days of combined inhaled corticosteroid therapy and mineral water inhalation at Shargaljuut sanatorium. A total of 57 participants completed the pre- and post-treatment assessments. Treatment result was assessed using Asthma control questionnaire 7, asthma symptom control with Asthma Control Test (ACT), and exercise tolerance by a 6-minute walk test. Chest X-rays were taken for all participants to rule out pneumonia, cancer, or pulmonary fibrosis. Treatment outcomes were evaluated using ACT scores, peripheral blood eosinophil count, total IgE levels in serum, spirometry indices (FEV1, FVC, FEV1/FVC), and the 6-minute walk distance. Results: The average age of participants was 52±12 years, with a predominance of females. The mean asthma control score was 14.2±4.80, indicating poor asthma control. After 10 days of inhaling corticosteroids combined with hot spring inhalation post-treatment quality of life increased by 0.5 points, FEV1 improved by 7.5%, FVC by 4.2%, peripheral blood eosinophil count decreased by 0.3%, and total Ig E levels dropped from 73.3 (22.5; 216) to 73.2 (21.3; 223) u/ml (p=0.000). Conclusion In cases of uncontrolled asthma remission, combining of inhaled corticosteroid therapy with hot spring inhalation at Shargaljuut improved asthma symptoms, quality of life, enhanced lung function, and reduced inflammatory markers (p<0.001).

Background: Pneumonia caused by COVID-19 tends to be more severe in middle-aged and elderly individuals, often leading to decreased pulmonary ventilation function and negatively impacting quality of life post-recovery. However, studies on this topic are limited in Mongolia. Aim: To evaluate pulmonary ventilation function and exercise tolerance in middle-aged and elderly individuals after COVID-19 pneumonia. Materials and Methods: A hospital-based case-control study was conducted from June 2022 to December 2023 at Gurvan Gal United Hospital and the First Central Hospital of Mongolia. The study group included 65 individuals aged 50- 69 who had recovered from COVID-19 pneumonia, while the control group consisted of 65 age-matched individuals who had not contracted the infection. Participants underwent a questionnaire, spirometry, and a 6-minute walk test (6MWT) to assess lung function and exercise tolerance. Results: A total of 123 participants were included in the study. The study group showed a significant reduction in FEV1 (P=0.015). compared to the control group. However, no statistically significant differences were observed in FVC or the 6MWT results between the two groups (P=0.464). Symptoms such as chest pain, cough, fatigue, and insomnia were significantly more common in the study group than in the control group (P<0.0001). Conclusion Individuals aged 50-69 who had COVID-19 pneumonia exhibited prolonged symptoms such as persistent cough, chest pain, nasal congestion, sore throat, fatigue, and sleep disturbances at a significantly higher rate compared to the control group (P<0.0001). Pulmonary ventilation function showed a mild decline, with FEV1% being lower than in the control group (P=0.015). Additionally, pulmonary fibrosis was significantly more prevalent among the post-COVID-19 group compared to the control group (P=0.026).

Background: In December 2019, SARS-CoV-2 spread rapidly worldwide, leading the World Health Organization (WHO) to declare it a pandemic in March 2020. COVID-19 is an infectious disease with symptoms similar to the flu, varying in severity from mild to critical. Post-COVID-19 syndrome refers to the persistence of certain symptoms after recovery from the acute infection. The most common symptoms, such as fatigue, shortness of breath, coughing, and headaches, negatively affect patients’ daily lives. Aim: To investigate the clinical manifestations of post-COVID-19 syndrome concerning the severity of the initial infection. Materials and Methods: A hospital-based cross-sectional study was conducted between 2022 and 2023 at the Pulmonology and Allergy Center of the National Center for Health. In this study, we included participants who came for follow-up one year after being diagnosed with COVID-19. The severity of COVID-19 was categorized according to Living guidance for clinical management of COVID-19 issued by WHO and the COVID-19 diagnostic and treatment guidelines approved by the Minister of Health (A/549). Post-COVID-19 conditions were assessed using the 6-minute walk test, Borg rating of perceived exertion, and Fatigue Severity Scale (FSS). The Chi-square and Mann-Whitney U tests used on SPSS 26.0, with a p-value of <0.05 considered statistically significant. This study was approved by the Research Ethics Committee of the Mongolian National University of Medical Science (2022/03-06). Results: A total of 185 participants were included, comprising 74 men (40%) and 111 women (60%), with a mean age of 57.15±11.29 years. Among them, 90 (48.6%) had severe COVID-19, while 95 (51.4%) had non-severe cases. Clinical symptoms, including cough, dyspnea, fatigue, headache, and myalgia, were statistically different between the non-severe and severe groups. The median FSS score was 45 in the severe group and 38 in the non-severe group, showing a statistically significant difference (p<0.05). The median of 6-minute walking distance was 265 meters in the severe group and 282 meters in the non-severe group (p<0.05). The median Borg score was 2 in the severe group compared to 1 in the non-severe group (p<0.05). Conclusion Individuals who experienced severe COVID-19 exhibited reduced exercise tolerance, increased breathlessness, and more pronounced fatigue than those with non-severe cases.

Background: Lish-6 has been used for treatment pharyngitis, flu and throat disease. Lish-6 is composed from Eugenia caryophylla Thumb, Saussurea lappa C.B.Clark, Schizostachoum chinense Rendle, Glycyrrhiza uralensis Fisch, Gentiana algida Pall, Terminalia chebula Retz. Anti-fever properties of these plants and their bio-active compounds have extensively been studied. Aim: To determine the pain relief and antibacterial effects of Lish-6. Materials and Methods: To conduct acute toxicity study using V.B. Prozorovsk method. Average lethal dose, lethal and maximum nonlethal doses were determined. Acetic acid (1%-0.1 ml) was injected into the rat abdominal cavity to induce pain. Wistar rat of either sex (n = 6) weighing 18–22g were used. All animals were withdrawn from food 2h before the start of experiment and were divided in five groups. Group I was injected with normal saline (10ml/kg) as control, Diclodenk was given orally at concentration of 25 mg/kg. Group II III, IV, V and VI were injected with Lish-6 was given orally at concentrations of 9.2, 18, 36, 92, 184 mg/kg injection of acetic acid. The number of abdominal constrictions (writhes) were counted of acetic acid injection for the period of 20 min. To determine the antibacterial effect by dilution method. Results: Average lethal dose of Lish-6 was found to be LD50=0.92 (0.6-1.04) g/kg suggesting that it is slightly toxic animals. Control group animals abdominal constrictions 72.4±8.8. Lish-6 concentrations of 9.2, 18, 36, 92, 184 mg/kg group animal reduced acitic acid induced pain by 41.9-78.7% suggesting that it is pain relief effect (p<0.001). 4 g of Lish-6 medicine is active against gram-positive bacteria (S.aureus, Streptococcus pneumonia). However, it is inactive against gram-negative bacteria. In other words, Lish-6 medicine inhibits the growth of methicillin-resistant and non-resistant S.aureus bacteria at a dose of 500 mg. It was also found to inhibit Streptococcus pneumonia at a dose of 250 mg. Conclusion Average lethal dose of Lish-6 was found to be LD50=0.92 (0.6-1.04) g/kg suggesting that it is slightly toxic animal. Lish-6 reduced acitic acid induced pain by 41.9-78.7% suggesting that it is pain relief effect. Lish-6 traditional drug has an antibacterial effect.

: Pleurotus ostreatus (Jacq) P. Kumm) is the second cultivated and most popular edible mushroom after Agaricus bisporus in the world. The fruiting bodies of these mushrooms have high nutritional value and are beneficial for health. Pleurotus ostreatus are an interesting source of bioactive glucans and other polysaccharides. This study focuses on the isolation and structural characterization of glucans from the fruiting bodies and stems cultivated mushrooms Pleurotus ostreatus. Methods: Physicochemical properties of fruiting bodies and stems cultivated Pleurotus ostreatus in Mongolia, were studied using standard methods. Glucans were extracted and purified using the precipitation method and Sevag reagent, and functional groups were determined by FT-IR. Conclusion The characteristic absorption bands of the water and alkali-soluble fractions were found near 1070, 1044, 869 and 777-769 cm-1. These IR bands are characteristic of fungal (1→3)(1→6)-β-D- glucans, and indicating these fractions are glucan-type polysaccharides

Background: Starting in 2019, the project "To compile and publish 108 volumes of traditional medicine, to protect the heritage of the ancient medical sources, and to open up its commercial opportunities for use" has been implemented.
As a result of this project, 50 volumes of books were published, including books created by Mongolian ancient doctors and maarambas, translated medical books from Chinese, Manchu, and Tibetan, as well as some books written by traditional medicine researchers and scientists between 1990-2020, have been published and made available to the public. During the creation of 108 volumes of traditional medicine, dozens of ancient medical scriptures were newly discovered. Among them, we have found medicinal books written by Indian and Tibetan scholars and monks from the 8th and 13th centuries. One of them is The Third Karmapa, Rangjung Dorje's sutra, "The Ocean of Medicinal Names." Therefore, it is imperative that we first study the biography and works of The Third Karmapa, Rangjung Dorje. Purpose: Clarifying the biography and works of The Third Karmapa, Rangjung Dorje, the author of the book "The Ocean of Medicinal Names". Research methods: Research of source documents (ancient sources), hermeneulic approach, analysis, and synthesis methods were used. Conclusion
1. The Third Karmapa, Rangjung Dorje, who lived between 1284 and 1339, was a prominent Tibetan religious and cultural figure, a famous author of many books who contributed to strengthening the foreign relations between Mongolia and Tibet and increasing the influence of the Garmaa Gaajud tradition in Yuan Dynasty.
2. Although Karmapa. Rangjung Dorje lived at the end of the 13th century and the first half of the 14th century, he was a well-known, active and creative monk. Therefore, his image has been left in many paintings and cast as God's image. In particular, he wrote an interesting book about medicinal raw materials called "The Ocean of Medicinal Names," which has only a few pages but briefly contains the names and potencies of 768 medicinal raw materials.

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.

Introduction: Nowadays people are restricting their use of chemical drugs as much as possible, creating a growing need for a systematic study of the use of herbal, animal and mineral medicines at a new level through traditional and innovative methods. Based on the study of traditional national technologies, it is important to study and apply in practice the drugs and pharmaceutical ingredients that contain the most modern scientific achievements including cardiovascular drugs, obtained from ancient rare scriptures. Research materials and methods: Data collected from the Clinical Department of Stress-Related Mental Disorders of the National Center for Mental Health was the primary source for this study. Secondary sources included statistics on the hospital’s website, internal reports of the organization, research related to health services, and legal documents. Research method: Serum cortisol levels were determined with a STATFAX-2100 ELISA (450 nm) according to the manufacturer’s specific methodology (www.melsin.com, Human Cortisol, ELISA KIT- CAT. NO:EKHU-0704).
The amount of cortisol in human serum was calculated as a linear quantitative assay by diluting 7.5 ug/L-90 ug/L in a standard working solution. Conclusion “Srog ‘dzin-5” has a clinical effect of reducing serum cortisol by an average of 27.3%. The statistic (p<0.01) is likely to increase this percentage depending on the time taken. Clinical observations have shown that “Srog ‘dzin-5” has pharmacological action against stress, depression and mental illness.

Introduction: Delayed or wrong diagnosis in patients with appendicitis can result in perforation and consequently increased morbidity and mortality. Serum total bilirubin may be a useful marker for appendiceal perforation. The aim of this study was to determine and compare pre-operative total bilirubin level and other diagnostic tools (patient age, duration of symptoms, Alvarado score, white blood cell, C-reactive protein, ultrasound and contrast enchanced CT scan) in cases of acute appendicitis in order to improve the clinical decision making. Materialsand methods: We identified 102 patient with acute appendicitis after excluding those with other causes of hyperbilirubinemia among the 180 patients that underwent a laparoscopic or an open appendectomy from June, 2011 to March, 2015 in UB Songdo Private Hospital. These cases were also subjected to liver function tests and clinical diagnosis was confirmed perioperatively and postoperatively by histopathological examination. According to histological results, these cases were classified two groups: positive(acute appendicitis with perforation and/or gangrene) and negative(acute appendicitis without perforation or gangrene). Their clinical and investigative data were compiled and analyzed. Statistical analysis was performed using independent sample t test, Chi square test, and direct logistic regression. The level of significance was set at P< 0.05. Results: Serum total bilirubin was found to be significantly increased(1,5mg/dL) in case of negative group and much higher (3,6mg/dL) in cases of positive group (P <0.001). The level of total bilirubin was higher than 3 mg/dL in cases of gangrenous/ perforated appendicitis while in cases with acute appendicitis it was lower than 3 mg/ dL. Also Alvarado score (P <0.01), C-reactive protein (P <0.001) and contrast enchanced CT scan (P <0.05) were statistically significant diagnostic tools for acute appendicitis. Conclusion: Assessment of preoperative total bilirubin is useful for the differential diagnosis of gangrenous/perforated appendicitis.