Background: The clinical course of sickle cell anemia (SCA) is variable, with chronic hemolysis and end-organ damage caused by microvascular occlusion. We evaluated the efficacy and safety of thalidomide plus hydroxyurea (HU) compared with HU alone to determine whether the combination provides a superior clinical benefit and safety profile. Methods: This was an open-label quasi-experimental clinical trial (Clinical Trials Registry of India, CTRI Registration Number 2023/04/065682). Patients with SCA aged > 12 years and postmenopausal females aged > 45 years were allocated 1:1 to receive either HU (20 mg/kg/day) and thalidomide (50 mg/day) in Group A or HU (20 mg/kg/day) only in Group B. Results: The frequency of vaso-occlusive crises (VOCs), transfusion requirements, variations in hematological parameters (hemoglobin [Hb], fetal hemoglobin [HbF], and sickle hemoglobin [HbS]), and side effects between the groups were assessed over 12 months. Repeated-measures analysis of variance was used to determine changes across the observation period. The mean age of the 66 patients diagnosed with SCA (homozygous HbS mutation) was 32.9 (standard deviation ± 11.5) years, and 57.6% were males. Over the 12-month observation period, Group A had significantly fewer VOCs (3.48 ± 2.81) and packed red blood cell transfusions (3.61 ± 2.19) than Group B (11.36 ± 4.20 VOCs; 13.27 ± 3.70 transfusions) (p = 0.0001). There was a significant increase in Hb (8.2 ± 1.8 to 11.8 ± 1.2 g/dL), a decrease in HbS% (72.5 ± 5.5 to 64.5 ± 5.4), and a rise in HbF% (18.9 ± 5.1 to 28.4 ± 5.6) (p < 0.0001) in Group A. Conclusion Combining thalidomide with HU significantly reduced VOCs and transfusion requirements, improved Hb and HbF%, and decreased HbS levels.

Background: This study analyzed the epidemiology and treatment outcomes of germ cell tumorpatients at a single institution. Methods: A retrospective analysis was conducted on intracranial germ cell tumor (iGCT) pa-tients treated at a single tertiary hospital from 2004 to 2019. Patients were categorized based on treatment modality: Korean Society for Pediatric Neuro-Oncology (KSPNO) protocol or bleomycin, etoposide, and cisplatin with radiation therapy. Results: Forty-nine iGCT patients treated with combined chemotherapy and radiotherapywere analyzed. The median age was 19 years (range: 6–40), with a median follow-up duration of 148.0 months (range: 10.5–265.5). Tumors were most common in the pineal gland (51.0%). Although no significant differences in outcomes were observed between treatment modalities, outcomes varied significantly by pathological type. The 10-year progression-free survival rates for germinoma and non-germinomatous germ cell tumors (NGGCTs) were 88.1% and 32.7%, respectively (p=0.003), while the 10-year overall survival rates were 92.9% and 67.5%, respectively (p<0.001). Fourteen patients experienced CTCAE (Common Terminology Criteria for Adverse Events) grade ≥3 adverse events, with one eventrelated death. Conclusion Pure germinoma demonstrated higher survival and lower recurrence rates comparedto NGGCT. The KSPNO protocol appears to be an acceptable and safe treatment option for iGCT patients. Further multi-institutional studies with larger cohorts are warranted.

Background: Remimazolam is a novel short-acting benzodiazepine that has recently been used for general anesthesia. This study compared the safety and efficacy of remimazolam-based total intravenous anesthesia (TIVA) and volatile agent-based anesthesia in adults undergoing general anesthesia. Methods: We searched electronic databases including PubMed, Embase, CENTRAL, and Scopus for relevant studies. The primary outcome was the proportion of patients who experienced hypotension during surgery. Secondary outcomes included incidence of bradycardia, extubation time, duration in the post-anesthesia care unit hospital stay, and incidence of postoperative nausea and/or vomiting (PONV). We estimated the relative risk (RR) and mean difference with 95% CIs using a random-effects model. Results: A total of 969 patients from 12 randomized controlled trials were included. The incidence of hypotension was 14% and 34% in the remimazolam and volatile agent groups, respectively. Remimazolam significantly lowered the incidence of hypotension (RR: 0.43, 95% CI [0.29–0.63], P = 0.0000, I2 = 26%). The remimazolam group had a PONV incidence of 13%, compared to 28% in the volatile agent group, indicating a significant difference (RR: 0.51, 95% CI [0.37–0.72], P = 0.0001, I2 = 15%). No significant differences were observed in the other outcomes. Conclusions Remimazolam-based TIVA demonstrated favorable hemodynamic effects, with a lower incidence of hypotension and similar bradycardia rates, compared to volatile agent-based anesthesia. Furthermore, the reduction in PONV supports the use of remimazolam-based TIVA as a valuable method for general anesthesia.

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.