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.

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.

Introduction: Over 800,000 people in the world contract HCC each year and approximately 700,000 die from the disease. HCC is the 6th most common cancer in the world. HCC is the 3rd leading cause of cancer deaths in the world. 2/3 of liver cancer deaths are caused by hepatitis. In the U.S, HCV infection is the more common cause of HCC, while in Asia and Africa, HBV is more common. Mongolia ranks first in the world in mortality from liver cancer, indicating the need for early detection and treatment of cirrhosis. Sysmex Corporation has introduced for HISCL series analyser, a new cirrhosis marker M2BPGi of non-invasive, blood-testing. In 2016, the test was introduced at Medipas Hospital in Orkhon province. It is possible to study the advantages and significance of the marker for use in clinical practice. Materials and methods: From a total of 385 patients who underwent M2BPGi marker testing in 2016-2017Medipas hospital laboratory, data from a total of 283 patients tested for hepatitis B and C virus and M2BRGi markers were selected. A comparison of age, sex, and test parameters of a total of HCVab and HBsAg positive 172 patients tested for Total bilirubin, GPT, GOT, GGT, AFP and M2BPGi. HCV Ab, HBsAg, AFP, M2BPGi markers were analyzed by SysmexHISCL-5000 fully automated immunological analyzer, Liver function tests were performed with a fully automatic biochemical analyzer JEOL Biomajesty BM6010/C. Results: Of the M2BPGi marker tested 283 patients 94 (33%) were infected with the C virus, 78 (28%) were with the B virus,11 (4%) were co-infected with B and C viruses, 100 (35%) no any viral infection. Of the 172 patients diagnosed with hepatitis B and C virus infection, 97 (56%) were male, 75 (44%) were female. In terms of age, 72% of the population is over 45 years old.
Of the 172 patients, 115 (67%) had M2BPGi marker abnormal or > 1.0 COI. Of the M2BPGi marker abnormal patients, 47 (41%) were infected with the B virus and 68 (59%) with the C virus. In terms of age, 27.7% of hepatitis B patients and 10.3% of hepatitis C patients were under 45 years of age, 72.3% of hepatitis B patients and 89.7% of hepatitis C virus patients were over 45 years of age.
Hepatitis B and C viruses are slightly more common in men than in women. The majority of patients infected with the hepatitis virus over the age of 45. The majority of patients with hepatitis virus have abnormal liver function. Increased M2BPGi markers in people under the age of 45 with hepatitis B virus infection are relatively higher for hepatitis B virus infection than for C virus infection. Conclusions The M2BPGi marker was abnormal in 67% of hepatitis virus infected patients. It has been observed that the probability of an increase in M2BPGi marker is slightly higher in hepatitis C virus infection than in hepatitis B virus infection.

Introduction : In recent years, there has been a significant increase of cerebrovascular disease in Mongolia, which is the second leading cause of mortality. There are dozens of Mongolian traditional medicine which is good efficiency for cerebral ischemia that contains musk. Aim: Therefore, we aimed to investigate the effect of musk under the cerebral ischemia/reperfusion in rats. Materials and Methods: Cerebral middle cerebral artery occlusion was established in male rat (90-minute occlusion followed by 24-hour reperfusion). Rats were divided into following groups: control group, ischemia group (cerebral ischemia and reperfusion), nimodipine administrated group (cerebral ischemia and reperfusion + treated with nimodipine), musk administrated group (cerebral ischemia and reperfusion + musk 50 mg/kg and 100 mg/kg). The brain tissue levels of IL-1β, TNF-α, IL-6, IL-10 cytokines were measured using enzyme linked immunosorbent assay (ELISA) every 1, 3, 7th days. Results: Levels of cytokines (IL-1β, TNF-α and IL-6) were significantly lower in musk treated group compared to brain ischemia group (p<0.05). In contrast, treatment with musk was significantly improved neurological function with stimulation of M2 phenotype microglia cells and increased the anti-inflammatory cytokine level of IL-10 in the ischemic hemisphere of brain in rats Conclusion The mechanisms of musk are associated with increasing the brain tissue levels of IL-10, and reducing the levels of proinflammatory cytokines such as IL-1β, TNF-α, IL-6 subsequently stimulating neurogenesis and reduced ischemic zone. Musk may have neuroprotective effects against cerebral ischemia with stimulating M2 phenotype microglia cells in the brain. Regarding the ELISA, the effects of musk may be due to anti-inflammatory properties through inhibition of some of proinflammatory cytokines and stimulation of anti- inflammatory cytokines.

ХУРААНГУЙ. Дутуу төрөлт нь анагаах ухаан төдийгүй нийгэм эдийн засгийн тулгамдсан асуудал юм. Дутуу болон жин багатай төрөх нь нярайн эндэгдэлийн тэргүүлэх шалтгааны нэг болж байна. Шүдний тулгуур эдийн үрэвсэлт өвчний үед зарим нянгийн бүрэлдэхүүн хэсгүүд нь жирэмсэлтийн явц ба ургийн хөгжилд нөлөөлж болдог гэдгийг харуулсан судалгааны үр дүнгүүд байдаг. Иймээс жирэмсэн эмэгтэйчүүдийн тулгуур эдийн өвчин нь нярайн дутуу болон жин багатай төрөх эрсдэлт хүчин зүйл болж байгаа эсэхийг судлахад энэхүү судалгааны зорилго оршино. Уг судалгааг эмнэлэгт суурилсан тохиолдол хяналтын загвараар Нийслэлийн Өргөө Амаржих Газар болон Эх Хүүхдийн Эрүүл Мэндийн Үндэсний Төв (ЭХЭМҮТ)-ийн нийт 90 оролцогчийг хамруулан хийж гүйцэтгэлээ. Тохиолдлын бүлэг 30 (37 долоо хоногоос бага тээлттэй, 2500 гр-aaс бага жинтэй нярай) оролцогч, хяналтын бүлэгт 60 (хэвийн тээлттэй) оролцогч хамрагдсан. Судалгаанд оролцогчдийн шүд цоорох өвчний (ШЦӨ) тархалт хяналтын бүлэгт 99%, эрчим 8.32 ЦЛА/ш, тохиолдолын бүлэгт ШЦӨ тархалт 100%, эрчим 11.33 ЦЛА/ш байв. Амны хөндийн эрүүл ахуйн (АХЭА) үзүүлэлтийг үнэлэхэд хяналтын бүлэгт 2.4 буюу ‘’дунд’’, тохиолдолын бүлэгт 3.2 буюу ‘’муу’’ үнэлгээтэй байлаа. Тулгуур эдийн өвчин, шүдний чулуу (***p<0.008), шүд буйлны эмгэг хөндийн гүн 4-6 мм байх нь (***p<0.006) жин багатай дутуу нярай (ЖБДН) төрөх эрсдэлт хүчин зүйл болж байгаа нь статистик ач холбогдол бүхий үр дүнг үзүүллээ. Буйлны үрэвсэл нь ЖБДН төрөх эрсдэлийг 5.5 дахин нэмэгдүүлж байна. Community Periodontal Index of Treatment Needs (CPITN) үзүүлэлт нь АХЭА үзүүлэлтээс хамааралтай болох нь статистикийн хувьд ач холбогдолтой байлаа (***р<0.000). Тулгуур эдийн өвчин шүдний чулуу, шүд буйлны эмгэг хөндийтэй байх нь ЖБДН төрөх эрсдэлт хүчин зүйл болж байгаа нь судалгааны үр дүнгээс ажиглагдлаа.

Preterm birth is not only health problem but also one of major socioeconomic issues. Preterm Low Birth Weight (PLBW) is leading causative factor of neonatal mortality. Some researches results showed that during periodontal inflammatory disorder some bacterial components could affect pregnancy and fetal development. Therefore aim of our study is to assess and confirm periodontal disease of pregnant females whether or not risk factor of PLBW. We performed our study on the First Maternity Hospital and National Centre for Maternal and Child Health of Mongolia by clinical based case control method on 90 participants. Case group has 30 females (<37 weeks of gestation, and Neonates Birth Weight <2500), control group has 60 females (Normal birth) (ratio was 1:2). Dental caries prevalence on control group was 99%, the mean of DFM/t was 8.32 “average”, prevalence of case group was 100%, and mean of DFM/t was 11.33, which was also “average”. Oral hygiene examination assessment was poor. Study results showed that patients with periodontal disease such as dental calculus (***p<0.008) and periodontal pocket with depth of 4-6mm (***p<0.006) were risk factors for PLBW. Gingivitis is increased to have PLBW baby by 5.5 times. CPITN index was highly associated with dental hygiene index and it was statistically significant. (***p<0.000). Within the limits of this study poor periodontal health status of mothers may be a potential risk factor for a preterm low birth weight.

BACKGROUND. To evaluate educational environment, it is important to use confidential and accepted tool. Dundee Ready Education Environment Measure (DREEM) (3) is a globally accepted and widely used tool to measure the education environment. Regular assessment of educational environment to evaluate teachers’ teaching method, students’ perception and their outcome and making the necessary adjustment to it is one of the factors affecting students’ knowledge, clinical practice and their motivation (4). In the MNUMS program, educational environmental assessment is one of the most important parts and we are unaware of any report of research work. Therefore, the researchers decide to carry this study. AIM OF THE STUDY. This study aimed to evaluate the educational environment in Nursing school of MNUMS using globally accepted DREEM Questionnaire. MATERIALS AND METHODS. This cross-sectional analytic study was carried out in Faculty of Nursing in Darkhan, Dornogobi and Gobi-Altai aimag out of 9 branch school of MNUMS during the academic year 2015-2016 and 2016-2017. DREEM questionnaire was used to collect data from 306 nursing students. RESULT. Most of the participants were female accounted around 89.9% (275) and male were 10.1% (31). By age, age of 17-19 were 25.5%(78), 20-22 were 52.0% (159), 23-25 were 15.0%(46), >26 were 7.5% (23). The mean item score was highest in Dornogobi school of 3.8 and lowest in Nursing school of 3.6. 4th year students’ 68.6% (210) agreed to “more on positive side” for their academic self perception and 22.5% (69) agreed “moving in right direction” for their academic self perception. All domains were statistically significant specially the perception of curriculum (0.854**) and perception of learning (0.803**) have high correlation. On the other hand, perception of educational atmosphere (0.444**) and perception of teachers have moderate correlation. The reliability of questionnaire was confirmed by Cronbach alpha and it is counted as reliable if it is more than 0.7. The perception of curriculum was relatively low in 2nd year students but higher in 3rd year students. The perception of educational atmosphere was relatively low in 4th year students but higher in 1st year students. CONCLUSION. The nursing school program is in same level. Students are satisfied with their academic self perception and perception of teachers. The result showed that 68.2% (209) of students consider positive aspect of educational environment (p<0.001). Students of all 4 school of MNUMS with same level of nursing school program are satisfied with their knowledge, clinical skills and educational atmosphere among the students. Dornogobi school students’ 65% assessed perception of teacher as “model instruction”.

BACKGROUND Helicobacter pylori (H.pylori), the main cause of gastric and duodenal ulcer, is considered as a type 1 carcinogen. The primary prevention of gastric cancer is eradicating chronic H.pylori infection. However, the antimicrobial eradication rates are decreasing as low as 80% in some countries, less than 70% in Europe and are inversely correlated with antibiotic resistance rates reported worldwide. The current international guidelines recommended several regimens with higher success rate including sequential, combined, bismuth-containing and resistance-guided treatment and states that the local susceptibility testing in H.pylori should be studied. The research data that is covering correlation between H.pylori associated gastric changes and precancerous diseases, evaluation of H.pylori eradication rate are sparse in Mongolia. METHODS Totally, 495 eligible candidates were enrolled into this study. 225 patients who visited to endoscopy unit, received gastroscopy with multiple biopsies for rapid urease test, histology and H.pylori culturing. Out of these, 131 (52.2%) patients were positive for H.pylori infection. These were further tested for antibiotic resistance. 76 patients were treated with targeted therapy based on antibiotic resistance testing. Another 270 eligible patients with confirmed H.pylori associated gastritis were randomized into the following 1st line therapy regimen groups clarithromycin-based triple therapy (CBTT, n=90); bismuth-based quadruple therapy (BBQT, n=90) and sequential therapy (ST, n=90). In 43 patients that were not responded to 1st line therapy, levofloxacin-based triple therapy (LBTT) was prescribed as a second line treatment. Eradication rates were assessed using H.pylori stool antigen test 28 days of therapy just subsequent to termination of treatment. RESULTS During the gastroscopy, presence of active gastritis, nodular change and atrophy were 32.9%, 12% and 52.9% respectively. Epigastric pain was reported in 73.3%, 62.2%, 60-80% and 41.3% of patients with normal mucosa, nodular change, stomach and duodenal ulcer and antral atrophy (p<0.05). Abdominal fullness was more common among patients with extensive gastric atrophy (69.2%, p<0.05). In <40 age group gastritis was predominantly in the prepylori, while in the >50 age group it was predominantly the corpus region. H.pylori resistance rates to amoxicillin, clarithromycin, metronidazole and more than 2 antibiotics were 8.4%, 37.4%, 74% and 30.5%. On ITT analysis, eradication rates of 1st line H.pylori targeted treatment, CBTT, BBQT and ST were 92.1%, 71.1%, 87.8% and 67.8% (p<0.0001); on PP analysis, that were 94.6%, 72.7%, 89.8% and 68.5% (p<0.0001) respectively. Eradication rates of 2nd line treatment LBTT were 55.8% and 60% by ITT and PP analysis. Higher side-effects were reported during the second line treatment. CONCLUSION H.pylori infection rate was high among the dyspeptic patients resulting chronic gastritis and atrophic change. H.pylori resistance rate to metronidazole and clarithromycin was high. Among 1st line therapies; the eradication rates of CBTT and ST were poor, while BBQT and Targeted therapy had a higher success rate. 2nd line therapy showed higher failure rate.