Background: In recent years, scientists have found that certain natural compounds have significant potential in cancer prevention and early-stage cancer treatment. Flavanones, a class of polyphenolic compounds found in plants, vegetables, seeds, fruit peels, and flowers, have been identified to possess anticancer, antioxidant, anti- inflammatory, and antibacterial bioactivities. Cancer has become a major global challenge in terms of both economic and public health concerns. Global statistics indicate that 22.8% of deaths are attributed to non-communicable diseases, and 16.8% are caused by cancer, accounting for one in four and one in six deaths, respectively. Aim : To investigate anticancer effects of Iris Tenuifolia-derived flavanone on cancer cell lines. Materials and Methods : The study was conducted at the Bio-Medical Research Institute of the Mongolian National Uni versity of Medical Sciences, investigating the effect of flavanones on cancer cell viability under in vitro conditions using the MTT assay. In the study, colon, liver, and lung cancer cells were cultured, stabilized, and used for the experiments. Colorectal cancer cells (MC38), liver cancer cells (HepG2), and lung cancer cells (A549) were revived, cultured, and stabilized for use in the experimental procedures. Statistical analysis of the results was performed using Microsoft Excel 2010, and graphs were generated using GraphPad Prism 8. Differences between groups were analyzed using Student’s t-test, and a p-value of <0.05 was considered statistically significant. Results : We treated MC38, HepG2, and A549 cancer cells with different concentrations of flavanone (2.5 µM, 5 µM, and 10 µM) for 24 to 48 hours to evaluate cell viability. Flavanone inhibited A549 cell viability by 2.5 μM-10%, 5 μM-25%, and 10 μM-38%, respectively. For HepG2 cells, flavanone treatment at concentrations of 5-10 µM reduced cell viability by 28–58%. No statistically significant effect on the viability of MC38 cells was observed following treatment with flavanone at concentrations ranging from 2.5 to 10 µM. Additionally, although MC38 inhibited cell viability in a dose-de pendent manner in cell cultures, it had a statistically significant effect at higher concentrations of 30-200 μM (p<0.01). Conclusion Flavanone inhibits the cancer cell viability in a dose and time dependent manner

Background: The first confirmed case of COVID-19 in Mongolia was reported on November 11, 2020. In response, the government imposed a nationwide lockdown, which significantly impacted the population’s mental health. Heightened levels of stress, anxiety, loneliness, and depression during the pandemic altered individuals’ psychological stability and behavior. Personality traits—defined as relatively stable patterns of emotion, cognition, and behavior—play a key role in stress responses and emotional regulation under pressure. Emerging evidence suggests that these psychological factors may influence the immune system’s responsiveness, including vaccine-induced antibody production. Aim: To evaluate the association between post-vaccination antibody responses and personality types following two doses of COVID-19 vaccines. Materials and Methods: A total of 738 participants who received two doses of COVID-19 vaccines (AstraZeneca ChAdOx1, n=29; Pfizer-BioNTech, n=119; Sinopharm BBIBP, n=590) and had no prior SARS-CoV-2 infection were enrolled. Serum samples were collected 21–28 days after the second dose, and SARS-CoV-2 RBD (S) IgG antibodies were measured using ELISA (Proteintech Inc., USA). Personality types were assessed using a 56-item temperament questionnaire developed by A. Belov, categorizing individuals into classical temperament types (choleric, phlegmatic, sanguine, melancholic). Logistic regression and ROC analysis were used to examine associations between personality types and antibody response. Results: The presence of an antibody response was significantly higher among individuals with a melancholic temperament, and significantly lower among those with a phlegmatic temperament. Furthermore, antibody titers were higher in participants with melancholic and sanguine temperaments and lower in those with a phlegmatic type. Conclusions 1. During the early period following the second dose of COVID-19 vaccination, the antibody response was higher in individuals with a pure melancholic temperament, while it was lower in those with a phlegmatic temperament. 2. After the second dose of the Sinopharm BBIBP COVID-19 vaccine, antibody titers were higher in individuals with pure melancholic and sanguine temperaments, and lower in those with a phlegmatic temperament.

Background: The study of small-molecule compounds with antitumor activity involves several crucial steps. These include determining their selective effects on cancer cells, understanding the type of cell death they induce, identifying the activated signaling pathways, pinpointing the target molecules, and elucidating the mechanisms of action. Among the plant-derived compounds with anticancer properties, flavonoids are notable for their ease of isolation and their abundance in food. Apigetrin, a representative flavonoid, is a secondary metabolite found in plants, and our previous study indicated that its anticancer selectivity index was 13.1. However, the specific mechanism by which apigetrin inhibits leukemia cell growth remains unclear. Aim: To study of the inhibitory action of apigenin on leukemia cell culture Materials and Methods: In this study, we evaluated the apoptosis of cells using flow cytometry and investigated the in volvement of the caspase pathway through the use of pancaspase inhibitors to explore the effects of apigetrin on leukemia cell growth. Results: After incubating leukemia RAW264.7 cells with 30 μM apigetrin for 24 and 48 hours, we did not detect any apoptosis through Annexin V and PI staining by flow cytometry. We compared the number of viable cells using the MTT assay after 24-hour treatment of apigetrin with or without pretreatment of Z-VAD, a pancaspase inhibitor, for 30 minutes. The results indicated that the pancaspase inhibitor did not reduce the inhibitory effect of apigetrin on the growth of RAW264.7 cells. In contrast, the positive control group, treated with doxorubicin—which induces apoptosis—showed not only significant apoptosis but also a reduction of the pancaspase inhibitor on the cell growth inhibition. Therefore, these data suggested that apigetrin likely has a cytostatic effect or inhibits the cell cycle rather than being cytotoxic. Future research should focus on determining which stage of the cell cycle RAW264.7 cells treated with apigetrin are in, as well as studying the signaling pathways involved in the cell cycle. Conclusions Apigetrin inhibits the proliferation of RAW264.7 leukemia cells in a caspase-independent and non-apoptotic manner.

Background: Mongolia’s long-term development policy, Vision 2050, aims to ensure that every citizen has full access to primary health care services and to increase the country’s average life expectancy. According to the “Primary Health Care Service Quality and Accessibility Survey,” the diagnostic capacity of family health centers (FHCs) in Mongolia was 42.1%. There is a need to further identify issues related to laboratory human resources, equipment supply, quality assurance, and monitoring. Aim: To assess the current status of laboratory diagnostic services in family health centers in Ulaanbaatar city. Materials and Methods: The study collected data using a questionnaire developed based on resources such as the WHO’s Service Availability and Readiness Assessment (SARA), USAID’s Laboratory Assessment Tools, the Ministry of Health’s 2023 Order No. A/283 on updated guidelines for services provided by family, soum, and bagh health centers, and the national standard “Structure and Operation of Family Health Centers (MNS 5292:2017).” A total of 46 FHCs in Ulaanbaatar were randomly selected for the study. Results: The average population served by the participating FHCs was 10,228±4043, with 73.9% (n=34) serving over 8,000 people. On average, each center employed 5±2 physicians and nurses. A clinical pathologist was employed at 50.0% (n=23) of the centers, of which 26.1% (n=6) were full-time and 73.9% (n=17) were contract-based. Availability of laboratory equipment was as follows: Complete blood count (CBC) analyzers: 60.9% (n=28) Biochemistry analyzers: 50.0% (n=23) Urinalysis equipment: 97.8% (n=45) The availability of laboratory equipment was not significantly associated with the size of the population served (p=0.54; p=0.63; p=0.74). Among FHCs with laboratory equipment: 82.1% (n=23) performed CBC tests 87.0% (n=20) performed biochemistry tests 97.8% (n=44) conducted urinalysis tests. Participation in internal and external quality control programs was significantly higher among centers with specialized laboratory staff compared to those without (p=0.008; p=0.08). The number of tests and biochemistry parameters performed was also significantly higher in centers with specialized laboratory personnel (p=0.001, p=0.001). However, the availability and use of rapid diagnostic tests did not differ based on population size or the presence of specialized laboratory staff (p=0.8; p=0.6). Conclusion 1. In Ulaanbaatar, only half of the family health centers have specialized laboratory personnel. 2. Laboratory equipment availability was between 50.0% and 60.9%. Centers with specialized laboratory staff showed significantly better performance in internal and external quality control and broader diagnostic testing services. 3. Differences in diagnostic services were associated with both the population size served and the availability of specialized laboratory staff, indicating the need to strengthen primary health care accessibility and capacity.

Background: In recent years, the incidence of liver diseases due to complications of non-alcoholic fatty liver disease (NAFLD) has shown a significant upward trend in Southeast Asian countries. NAFLD is a hepatic disorder characterized by lipid accumulation in the microstructure of the liver in individuals who consume little to no alcohol. It is often associated with insulin resistance and is diagnosed when steatosis affects more than 5% of hepatocytes histologically, or when the fat signal intensity on MRI exceeds 5.6%, based on fat-to-water ratio measurements. In Mongolia, histological studies using frozen liver sections with routine and special staining techniques are limited, highlighting the necessity of this study. Aim: To determine and compare the degree of steatosis and fibrosis in frozen liver tissue samples of patients with NAFLD through histological analysis. Materials and Methods: This study was conducted at the the Department of Anatomy, School of Biomedicine and Bio medical Research Institute of MNUMS in collaboration with the Second State Central Hospital. Ethical approval was obtained from the Research Ethics Committee of MNUMS (Protocol No. 2024/3-06). All procedures adhered strictly to laboratory biosafety protocols. Participants were selected among patients undergoing elective laparoscopic cholecystectomy, from whom informed consent was obtained. Based on inclusion criteria, five participants were grouped as follows: healthy control (n=1), NAFLD without fibrosis (n=2), and NAFLD with fibrosis (n=2). Liver biopsies (approx. 1 cm in size) were obtained intraoperatively, immediately deep-frozen in liquid nitrogen, and prepared for histological evaluation. Results: In patients with NAFLD compared to the healthy liver group, disruption of hepatocyte columnar architecture and mild periportal lymphocytic infiltration were observed. Oil Red O staining revealed 34–66% micro- and macrovesicular steatosis, corresponding to grade 2 steatosis. Masson’s trichrome staining showed no fibrotic changes in perivenular or periportal areas (Ishak grade 0/4) at this stage. However, upon progression to grade 3 steatosis, early-stage fibrosis was observed in both perivenular and periportal regions (Ishak grade 1/4). Further progression to stage 4 fibrosis was characterized by the development of connective tissue septa, although no significant changes in droplet size were observed. Conclusions 1. Increasing stages of fibrosis are not directly influenced by the severity of hepatic steatosis in NAFLD. 2. Although the degree of steatosis increases, the absence of corresponding fibrotic changes in early stages indicates a complex progression pattern of NAFLD requiring further investigation.

Background: Among the total healthcare waste generated from health-related activities, 10–20% is considered haz ardous, posing significant threats to both the environment and human health. Approximately 3% of healthcare waste is pharmaceutical waste. In Ulaanbaatar city, an estimated 2.65 tons of healthcare waste is generated daily (0.78 tons of medical waste and 1.87 tons of general waste). With the continuous increase in pharmaceutical consumption, the improper disposal of pharmaceutical waste has emerged as a major environmental concern, adversely affecting nature, animals, and the food chain. Contamination from pharmaceutical waste, such as the development of antibiotic resistance, is closely linked to inadequate public awareness of waste management. Aim: This study aimed to assess the knowledge, skills, and attitudes of pharmacy technicians in community pharmacies regarding pharmaceutical waste management. Materials and Methods: A cross-sectional survey was conducted among pharmacy technicians across Mongolia. As of 2023, there are 4,959 licensed pharmacy professionals in the country. Using a representative sampling method, data were collected from 360 pharmacist and pharmacy technicians. Data were analyzed using MS Excel and SPSS version 26. Results: A total of 360 pharmacists from both urban and rural areas participated in the study. The assessment was based on a 5-point Likert scale, with scores of 1-2 considered negative and 3–5 considered positive. The average scores for knowledge, skills, and attitudes were 3.3, 3.06, and 3.25 respectively. While individual scores were satisfactory, the results of questions targeting social awareness were relatively low. Conclusion The knowledge, skills, and attitudes of pharmacy technicians regarding pharmaceutical waste management were found to be satisfactory. However, to further improve knowledge levels, it is recommended to implement additional training programs related to pharmaceutical waste management among pharmacy technicians.

Background: During inversion injuries of the ankle joint, the anterior talofibular ligament (ATFL) is the most commonly injured structure. Injuries to the lateral collateral ligaments of the ankle, either in isolation or in combination with injury to the calcaneofibular ligament (CFL), account for approximately 60-65% of all ankle ligament injuries. In recent years, several studies have examined the impact of lateral ankle ligament injuries on lifestyle and overall health. Repeated inversion injuries-particularly those occurring three or more times-can lead to chronic ankle instability (CAI). In the treatment of ankle instability, both open and arthroscopic surgical techniques are widely used internationally. In Mongolia, there is an increasing clinical need to evaluate and compare the outcomes of arthroscopic versus open surgical repair of lateral ankle ligament injuries. This need forms the basis of the current study. Aim: The comparative studies on open vs arthroscopic anterior talofibular ligament (ATFL) repair are limited. This study aimed to compare the early therapeutic efficacy and cost between the traditional open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL for chronic lateral ankle instability. Materials and Methods: A total of 40 patients with chronic lateral ankle instability undergoing repair of the ATFL be tween September 2024 and February 2025 were retrospectively included with a traditional open surgery (n=10) group and an arthroscopy (n=17) group. The surgery duration, surgical cost, postoperative complications, and the preoperative/postoperative American Orthopaedic Foot & Ankle Society Score (AOFAS) and Karlsson-Peterson score were compared between groups. Results: Compared to the anatomical group, the non-anatomical group had significantly shorter surgery and hospitalization durations. Three months after the operation, the AOFAS and Karlsson scores significantly improved in both groups. Nevertheless, there was no significant difference in the AOFAS and Karlsson scores between groups at both preoperative and postoperative assessments. No significant difference was found in the incidence of postoperative complications between the two groups. Conclusion 1. These results suggest that open Broström-Gould repair and all-arthroscopic anatomical repair of the ATFL have comparable therapeutic efficacy for chronic lateral ankle instability. 2. The arthroscopic surgery had a smaller incision, while the open Broström-Gould had a shorter surgery duration and lower cost.

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: One-third of people with epilepsy have drug-resistant epilepsy, making surgical treatment necessary. Comprehensive pre-surgical evaluations, including long-term video-electroencephalographic (VEEG) monitoring, magnetic resonance imaging (MRI), and neuropsychological testing, are essential components of epilepsy presurgical evaluation. The Epilepsy Center at the Mongolian-Japanese Hospital of MNUMS was established in September 2022 and introduced long-term video-EEG monitoring in May 2023. This marked the first time in Mongolia that comprehensive evaluation for epilepsy surgery became available. Aim: To evaluate the role and outcomes of long-term video-EEG monitoring in the pre-surgical assessment of epilepsy patients Materials and Methods: A prospective cohort study was conducted at the Epilepsy Center of the Mongolian-Japanese Hospital from May 2023 to March 2025. Patients who underwent VEEG and comprehensive pre-surgical evaluation were included. Data included demographic information, seizure history, imaging findings, and neurophysiological assessments (routine, sleep-deprived, and long-term video EEG). Patients were divided into two groups based on whether they met criteria for epilepsy surgery, and surgical outcomes were compared between these groups. Results: A total of 297 patients (104 children and 193 adults) participated in the study. Of these, 96 (32%) were diagnosed with temporal lobe epilepsy and underwent pre-surgical evaluation. The mean age of this group was 33±9.2 years; male-to-female ratio was 1:1. Age of seizure onset was 20±10.9 years, and the mean duration of epilepsy was 14.8±10.3 years. Etiologies included meningitis (21.7%), febrile seizures (15.2%), birth complications (12.5%), and traumatic brain injury (12.5%). The average duration of VEEG monitoring was 1.45±0.68 days, during which 161 seizures were recorded (average 2.64 per patient). No seizures were captured in 35 patients. Among the 96 patients, 29 met the criteria for surgical intervention, and 11 underwent temporal lobe epilepsy surgery. Surgical outcomes were significantly better compared to the non-surgical group (p<0.05). Conclusion Long-term video-EEG monitoring plays a critical role in precisely localizing the epileptogenic zone, identifying seizure types, establishing differential diagnoses, and optimizing surgical candidacy. It is confirmed as an essential diagnostic tool in the pre-surgical evaluation for epilepsy surgery.

Complete androgen insensitivity syndrome (CAIS), also known as Morris syndrome, is a rare X-linked recessive disorder characterized by a 46XY karyotype and a female external phenotype. We present the case of a 32-year-old patient who presented to Unimed International Hospital in 2024 with primary amenorrhea, infertility, and chronic pelvic pain. Clinical examination, imaging, and laboratory investigations led to the diagnosis of CAIS. Laparoscopic surgery was performed to remove bilateral gonadal structures and a cystic mass on the left side. Histopathological analysis revealed testicular tissue and a serous cystadenoma originating from the left mesonephric remnant. Following gonadectomy, hormone replacement therapy was initiated, resulting in stabilization of hormone levels. This rare case highlights the possibility of mesonephric remnant-derived cystadenoma in CAIS and underscores the diagnostic value of cytogenetic and histological evaluations, especially in distinguishing between ovarian and testicular tissue when imaging findings are inconclusive.