Introduction: Recently, there has been a significant focus on developing extended-release tablets that regulate drug release at a predetermined rate to maintain optimal therapeutic plasma concentrations. Extended-release formulations offer several clinical advantages, including reducing the frequency of drug administration, minimizing fluctuations in plasma drug concentrations, decreasing adverse effects, and improving therapeutic outcomes.
According to Mongolia’s national pharmaceutical policy, it is essential to conduct quality assurance and safety monitoring studies on imported substitute products included in the national essential medicines list. The policy also mandates the quality control of pharmaceuticals in internationally accredited laboratories compliant with MNS ISO/ IEC 17025:2018 standards. Methods: The quality control parameters of Diclofenac Sodium Retard 100 mg tablets from three different manufacturers were evaluated by the methodologies outlined in the United States Pharmacopeia USP32 and USP44. The study assessed physical appearance, average weight, weight variation, friability, dissolution, and quantitative drug content determination. Results: The average weight and weight variation of Diclofenac Sodium Retard 100 mg tablets from three different manufacturers were as follows: Tablet A: (+3.60%, -2.84%), Tablet B: (+1.53%,-1.86%), Tablet C: (+2.53%,-1.96%). The friability and mechanical strength tests determined that all three tablets exhibited 99.9% friability resistance. The quantitative determination of Diclofenac Sodium content per tablet was: Tablet A: 0.098 g, Tablet B: 0.105 g, Tablet C: 0.104 g. Microbiological purity analysis showed that in all three tablets (A, B, and C), The total aerobic bacterial count was <101 CFU. The total mold and yeast count was <101 CFU and Escherichia coli was not detected. Dissolution test results showed the following percentage of drug released at different time points: Tablet A: 60 min: 16.1%, 120 min: 24.7%, 240 min: 39.6%, 360 min: 52.3%, 600 min: 73.6%. Tablet B: 60 min: 18.4%, 120 min: 26.1%, 240 min: 39.1%, 360 min: 55.8%, 600 min: 75.2%. Tablet C: 60 min: 18.6%, 120 min: 31.4%, 240 min: 52.9%, 360 min: 65.9%, 600 min: 77.0%. These results demonstrate that all tested tablets met the dissolution requirements of USP 44, 2021. Conclusion The findings indicate that the three manufacturers’ Diclofenac Sodium Retard 100 mg tablets comply with the quality standards set by the United States Pharmacopeia (USP 32 and USP 44) and Mongolian Pharmacopoeia 2011.

Background: Herpes zoster (shingles) is an acute inflammatory skin disease caused by the reactivation of the Varicel la-zoster virus. International studies show that the disease severely reduces patients’ quality of life, and chronic pain negatively affects daily activities. In clinical practice, bloodletting pricking therapy has been effectively used for herpes zoster, with positive effects including reducing disease symptoms, alleviating skin inflammation, and promoting skin regeneration. Due to the limited research on treating herpes zoster with combined bloodletting pricking therapy and acupuncture, this clinical study was conducted. Aim: To evaluate the effectiveness of combining bloodletting pricking therapy with acupuncture in patients diagnosed with herpes zoster. Materials and Methods: The study was conducted using a non-randomized clinical trial design based at the Internation al School of Mongolian Medicine of MNUMS and the Inner Mongolia International Mongolian Medicine Committee (IMIMC). The study included 70 patients diagnosed with herpes zoster (ICD 10-B02.9) who met the inclusion criteria. The treatment group received bloodletting pricking therapy combined with acupuncture. The control group received Acyclovir 800 mg 5 times daily for 7-10 days and Pregabalin 75 mg twice daily for 14 days. Treatment effectiveness was evaluated using the VAS linear scale for pain assessment, the SF-12 (Short Form-12 health survey) questionnaire for quality of life, and the Athens Insomnia Scale (AIS) to measure sleep quality and evaluate insomnia. The treatment outcome was assessed according to the Mongolian Traditional Medicine Diagnostic and Treatment Standards. Results: The average age of participants was 47.29±11.11 in the treatment group and 44.43±11.63 in the control group, with 34% male and 66% female participants. According to the VAS linear scale, the treatment group showed a statistically significant greater reduction in pain (P<0.001). The quality-of-life assessment using the SF-12 questionnaire showed that the Physical Component Summary (SF-12-PCS) in the treatment group increased from 32.71±7.38 before treatment to 52.99±2.02 after treatment (t=-17.18, p<0.001), while in the control group, it increased from 36.10±7.41 to 51.56±7.9 (SF-12-3.9) (p<0.001). According to the AIS questionnaire, the sleep quality in the treatment group was significantly better than in the control group (P<0.05). According to the Mongolian Traditional Medicine Diagnostic and Treatment Standards, the combined treatment of pricking therapy and acupuncture resulted in a 100% recovery rate. Conclusion 1. The combination of bloodletting pricking therapy and acupuncture in treating herpes zoster effectively reduces pain. 2. For patients diagnosed with herpes zoster, combining bloodletting pricking therapy with acupuncture effectively improves quality of life in terms of sleep quality as well as physical and mental functioning.

Background: Pre-procedural mouth rinsing has been shown to reduce pathogenic microorganisms, prevent secondary infections, and shorten healing time prior to periodontal treatment, oral surgeries, and endodontic procedures. In Mongolia, most dental clinics routinely recommend mouth rinsing before treatment. Moreover, since the COVID-19 pandemic, there has been a notable increase in the public’s use of various mouth rinses outside clinical settings. However, there is a lack of comparative clinical studies assessing the efficacy of these commercially available rinses. Aim: To clinically compare the effects of various commonly used mouth rinses with different active ingredients on the oral environment. Materials and Methods: A case-control study was conducted involving 210 participants with mixed dentition, receiving care at the Pediatric and Preventive Dentistry Department of the Central Dental Hospital of Mongolian National University of Medical Sciences. Participants completed a 17-question survey in three groups, followed by clinical examinations. Oral pH, malodor, and bacterial counts were measured using a phase-contrast microscope (OMAX 40X-2500X, USA) after collecting plaque and saliva samples. Ethical approval was obtained from the Research Ethics Committee of the Mongolian National University of Medical Sciences. Data analysis was performed using STATA 14. Results: A total of 210 children participated (mean age 9.04±1.2 year; 52.2% male, 47.8% female). The average DMFT index was 6.3 DMF+df/t (high), and oral hygiene index was 1.53 score (moderate). The baseline oral pH was 6.3±0.5 score. After rinsing with sodium bicarbonate, the pH increased to 7.4±0.4 score, and remained at 6.61±0.31 score after 40 minutes. In contrast, the placebo group showed minimal change (6.06±0.45 to 6.09±0.31 score). Statistically significant differences between groups were observed. Baseline oral malodor averaged 80.8±1.4 ppb. After rinsing with povidone-iodine, it decreased to 76.1±3.4 ppb at 40 minutes, while in the placebo group it decreased from 74.2±4.9 ppb to 66.3±3.8 ppb. Bacterial count prior to rinsing was 18.85±0.77 score. Chlorhexidine gluconate reduced this to 11.06±0.68 score immediately after rinsing and to 8.8±3.8 score after 40 minutes, whereas the placebo group showed minimal reduction (15.21±2.02 to 17.6±2.2 score). Conclusions Pre-procedural mouth rinsing demonstrated a statistically significant positive impact on the oral environ ment, including improvements in breath odor and a reduction in microbial load. The effectiveness of these outcomes was found to vary depending on the specific composition of the mouthwash used. These findings suggest that selecting an appropriate mouthwash based on the clinical setting can enhance treatment efficiency. Nonetheless, all evaluated solutions contributed to maintaining or improving the balance of the oral environment.

Background: Written communication skill is of the important skills for medical doctors and medical professionals. Written communication includes daily notes, letters, memos, personal requests, summaries, reports, editorials, and essays. An essay is a form of written assessment used by educators to make inferences about a problem, evaluate a situation, and assess their knowledge and understanding among students. Essay writing is an important tool for developing thinking, critical thinking, and analytical skills. Aim: To do a comparative evaluation of essays by first-year students of pre-med and pre-health education Materials and Methods: In this study, essays written on the topic “My Childhood” by students who studied Communication Skills in the 2022–2023 and 2023–2024 academic years were evaluated using the 6 criteria of the Rubric and the group discussion identified the problems students faced when writing essays. Results: Among the essays of 568 first-year basic education students who studied in the 2022–2023 academic year, 32.6% had spelling errors, 25.5% had grammatical and composition errors, and 20.4% were insufficiently written in terms of content. It was identified that 28.6% of the essays of 525 students who studied in the 2023–2024 academic year contained spelling errors, 21.8% contained compositional errors, and 18.6% lacked content. Additionally, 10.5% did not have the required essay structure for writing their essays. Conclusion This indicates the need for content reforms in the curriculum to further improve students' writing skills.

Background: Squamous cell carcinoma, which accounts for 90-95% of oral cancer, arises from the uncontrolled and disordered growth of keratinocyte cells in the mucous of lip and oral cavity. It occupies 2-3% of all cancers and 38% of head and neck cancers. Aim: To study recurrence and prognosis of patients with tongue squamous cell carcinoma Materials and Мethods: Our study, based on retrospective cohort method was conducted from medical reports of 207 patients who were diagnosed with squamous cell carcinoma of oral cancer and at the Department of Head and Neck Surgery, Radio and Chemotherapy of the National Cancer Center of Mongolia between 2009-2019 years. All statistical analysis were carried out using STATA version 15.0 and we performed survival analysis using Kaplan-Meier method. All statistical tests were two sided, and P-values less than 0.05 were considered significant. The study was approved by the Research Ethics Committee of the Mongolian National University of Medical Sciences on June 08, 2021 (№ 2021/3-07). Results: A total of 207 oral cancer cases were registered during the study period. The most common site of oral cancer was the tongue (47.3%, 98/207). Of these, cases 69.4% (68) presented in males and 30.6% (30) in females. At the time of diagnosis, 77 patients (78.5%) were in late stage (III, IV) and 76 cases (77.6%) were well-differentiated. During the study period, 20 patients (20.4%) experienced tongue cancer recurrence; female patients (18.8%, 3/20) had significantly less chance of recurrence compared to men (81.2%, 17/20), (p=0.033). Patients over 61 years old had higher oral cancer recurrence than patients under 60 years, but there was no significant difference in age groups. 90.6% (18/20) of tongue cancer recurrence had with lymph node metastasis; compared to patients without lymph node metastasis (9.4%, 2/20), tongue cancer recurrence was significantly higher (p=0.025). And there was a statistical difference in tongue cancer recurrence percentage among clinical stages (p=0.003). Thirteen (69.4%) patients diagnosed in stage IV had oral cancer recurrence. Pathological grading, and tumor size did not significantly influence cancer recurrence. Conclusion 1. The gender, advanced stage and lymph node metastasis of patients with tongue cancer were significantly associated with the presence of tongue cancer recurrence. (p=0.033, p=0.025, p=0.003). 2. The 5-year survival rate for tongue cancer was the lowest among the oral cancer, which we consider to be due to factors such as late-stage diagnosis, and anatomical characteristics of tongue.

Background: The skin barrier serves as the primary defense against environmental factors. Mongolia’s extreme climate conditions may contribute to skin barrier impairment, increased trans-epidermal water loss (TEWL), and decreased skin moisture. Objective: To determine and compare skin moisture, TEWL, and skin pH levels in children. Methods: A cross-sectional study was conducted in June 2023 with 104 relatively healthy children selected through random sampling. Skin physiological parameters, including skin moisture, skin pH and TEWL were measured following the EEMCO (European Group on Efficacy Measurement of Cosmetics and Other Topical Products) guidelines using the Multi Skin Test MC750 device (Courage+Khazaka Electronics, Germany) at nine different sites. Data analysis was performed using Microsoft Excel and Stata-14 software. Results: Among the participants, 51.9% (n=54) reported having dry skin (p<0.0001). Additionally, 64.5% (n=67) used moisturizers, but their usage did not show a statistically significant difference in skin moisture (p=0.929), skin pH (p=0.378), or TEWL (p=0.332). 14.42% (n=15) had extremely dry skin, while 85.58% (n=89) had dry skin, with no participants falling within the normal skin moisture range. TEWL showed a moderate inverse correlation with age (r=-0.331, p=0.0006). When analyzed by age groups, skin moisture (p=0.023) and TEWL (p=0.038) differed significantly between groups. Conclusion Skin moisture and TEWL significantly differ across age groups. Given that all participants had dry skin, moisturization is crucial. Mongolia’s extreme climate is likely a key contributing factor to childhood skin dryness.

Background/Aims: A latex agglutination turbidity (LA) assay to test for serum antibodies has been approved in Japan and Korea for mass screening of Helicobacter pylori infection. In this study, we evaluated the LA assay for diagnosing H. pylori infection and predicting gastric mucosal changes in a Mongolian population. Methods: In total, 484 individuals were classified into H. pylori-positive (n=356) and H. pylorinegative (n=128) groups, as determined by histology and H. pylori culture. Results: The best cutoff, sensitivity, and specificity values for the LA assay were 18.35 U/mL, 74.2%, and 65.6%, respectively. The LA values in the atrophic gastritis group were statistically higher than those in the other groups (healthy, chronic gastritis, intestinal metaplasia, and gastric cancer, p<0.0001). The cutoff value to distinguish the atrophic gastritis group from the other four groups was 32.0 U/mL, and its area under the curve was 0.673, which was the highest among the E-plate, pepsinogen (PG) I, PG II, and PG I/II ratio tests in our data. The odds ratios for atrophic gastritis determined by the LA assay and PG I test in multiple logistic regression were 2.5 and 1.9, respectively, which were significantly higher than for the other tests. Conclusions The LA assay can determine the risk of atrophic gastritis, which in turn is a considerable risk factor for gastric cancer. We propose using this assay in combination with the PG I/II ratio to avoid missing gastric cancer patients who have a low LA value (less than 32.0 U/mL).

Introduction: The development of analytical methods for evaluation of quality standard parameters of drugs and other health prophylactic, diagnostic, and therapeutic products is essential from the beginning in the process to release to the market finished product. Validation of developed analytical methods is one crucial part of the analysis.
Quantitative determination methods of the total main active compounds of the tincture prepared from the root and the herb of Paeonia anomala L. were developed. In order to verify whether the analytical procedure is suitable for its intended purpose parameters – accuracy, reproducibility, intermediate precision, and linearity were validated. Materials and methods: The total phenolics in the tincture were determined by the reaction with Folin Chicolteau reagent and total monoterpene glycosides by the reaction with hydroxylamine in alkaline solution and ferric (III) chloride following spectrophotometric examination, respectively. Based on the achieved results of the developed quantitative methods which were validated according to the accepted and pursued technical documents in our country the Eurachem guide “The Fitness for Purpose of Analytical Methods” and Russian Pharmacopoeia 13 “Validation of analytical methodology”, where parameters as accuracy, precision – reproducibility, intermediate precision, and linearity are involved. Conclusions Statistical analysis of total phenolic compounds and total monoterpene glycosides in the Paeonia anomala tincture demonstrated that the bias calculated was for accuracy 0.674% and 0.703%, relative standard deviations were for reproducibility 0.896% and 0.798%, for inter- mediate precision 0.922% and 0.696%, respectively and the linearity – R²=0.9985 and R²=0.9997. All achieved results validated the appropriateness of the developed quantitative methods for the intended purpose.

Introduction: Due to social transition and change of many societal activities in Mongolia, there is an increasing need for pharmaceutical drugs to treat anxiety, stress, fatigue and insomnia. It is considered that medicinal plants used in traditional medicine as sedatives, anti-anxiety and anti-depressive activities could be effective. Our study focuses on exploring optimal methods for preparing tinctures from Paeonia L. genus species, a sedative in Mongolian traditional medicine, and studying their phytochemical compositions. Materials and methods: Root and herb of Paeonia anomala L., grown in Mogod soum in Bulgan province, were used for the study.
Prepared herb and root were chopped and sieved into 1 mm, 2 mm, 3 mm, 4 mm and 5 mm sizes. Then from each size of two samples, a set was created with a 1:1 ratio. Finally 40 % ethanol (1:10 ratio with a set) was applied to prepare tincture through a traditional maceration method. The obtained tincture was analyzed for its color, quantity of biologically active compounds, dry residue, and absorption coefficient using an optimal particle size of samples, volume of the extractive liquid and tincture yield.
Tincture from the set of herb and root of Paeonia anomala L. was prepared using 3 methods, namely, by the traditional maceration; intensified maceration using the ultrasonic bath processing with 45 kHz at an ambient temperature; constant shaking in a heat of 30o-40oC. Conclusion The more optimal and effective method for preparing tincture from Paeonia anomala L. has been found to be the ultrasonic bath processing with 45 kHz for 6 h at an ambient temperature. Crude drug mixture of 2 mm sizes with 40% ethanol (where volume absorption coefficient was accounted to be 2.8) was mixed at a ratio of 1:10. In the obtained tincture, total phenols were determined as 0.58±0.003% in gallic acid equivalent and total monoterpene glycosides as 1.96±0.002% in paeoniflorin, which were the highest compared to other methods, indicating the method is the more optimal one.

Introduction: It is important to standardize a tincture prepared from the herb and root of Paeonia anomala L, which is widely used as a sedative in traditional medicine, based on the results of the studies its chemical composition, biological and pharmacological activities. Moreover, there is a need to carry out a quantitative stability testing in order to establish the ability to maintain quality under certain storage condition, shelf-life and to develop suitable packaging information. Materials and methods: Standardization parameters of prepared Paeonia anomala tincture have been evaluated according to WHO guidelines for the determination of crude drug material, plant preparations and finished products technical parameters, along with the Mongolian National Pharma- copoeian (MNP) and Russian XIV Pharmacopoeian methods for tincture. The color of a tincture, dry residue, special density, alcohol content, and microbiological content were determined according to the methods described in MNP. A qualitative analysis of biological active constituents has been evaluated by thin-layer chromatography, the total phenolic compounds were determined by the reaction with Folin Chicalteu reagent and total monoterpene glycosides by the reaction with hydroxylamine in alkaline solution and ferric (III) chloride following spectrophotometric examination, respectively.
The stability testing study was performed according to the “General requirements for the stability testing study of drug-active compounds” MNS-6439-2014 using the real-time methods for the standardization parameters of the tincture. Conclusions The standardized parameters of tincture prepared from the herb and root of Paeonia anomala L. were approved by the National Reference Laboratory for Food Safety analysis. Consequently, the Mongolian pharmacopoeian article on Paeonia anomala tincture was officially permitted under the number ҮФӨ-0327-2017.
The stability study of tincture was carried out according to the MNS-6439-2014 by real-time tests for 24 months which provided that the changes in tincture quality were within the permitted limits. Consequently, it can conclude that the storage condition and shelf-time of Paeonia anomala tincture are 2 years under not above 25°С.