The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.

The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.

Background: Currently, colorectal cancer (CRC) ranks as the third most common cancer and the second leading cause of cancer-related mortality worldwide. CRC frequently metastasizes to the liver (50%), lungs (10–15%), peritoneum (4%), bones (10.7%–23.7%), brain (0.3%–6%), and spinal cord. Approximately 35% of CRC cases are diagnosed before distant metastasis, 36% upon lymph node involvement, and 23% after distant organ metastasis. Although several studies have established primary tumor models in mice in our country, there are limited studies on experimental lung metastasis models, prompting the need for this research. Aim: To establish and evaluate a lung metastasis model of colorectal cancer in C57BL/6J mice using the MC38 cell line. Materials and Methods: This study was conducted at the Institute of Biomedical Sciences, Mongolian National University of Medical Sciences. Approval was obtained from the Ethics Review Board of the Mongolian National University of Medical Sciences (2023/3-09) and all laboratory safety regulations and protocols were strictly followed. Male C57BL/6J mice bred at the Experimental Animal Center of Mongolian National University of Medical Sciences were used. MC38 murine colorectal carcinoma cells were cultured and injected intravenously (via the tail vein) at a concentration of 0.25×10⁶ cells per mouse (n=12) to induce lung metastasis. Histological analysis was subsequently performed. Results: Histological examination revealed significant alterations in lung tissue architecture, characterized by areas of dense infiltration by pleomorphic, hyperchromatic cells, disrupting the normal alveolar structure. No histological abnormalities were observed in other organs. Conclusion Intravenous injection of MC38 colorectal adenocarcinoma cells into the tail vein of C57BL/6J mice successfully induced lung metastases, characterized by hyperchromatic, pleomorphic cell infiltrates forming glandular structures within the lung parenchyma.

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: Infertility is defined as the inability of couples to conceive despite engaging in regular, unprotected sexual intercourse for over a year. Assisted reproductive technology (ART), particularly in vitro fertilization (IVF), has emerged as the most widely utilized solution for infertility. The cause of infertility, a woman's ovarian reserve, response, egg and sperm quality, the number and quality of embryos, and various other factors influence the outcome of IVF. Despite significant advancements in ART, predicting IVF outcomes remains challenging, especially when tailoring treatment strategies to individual patient factors. Aim: To investigate the clinical indicators, ovarian reserve markers, and stimulation outcomes influencing the success of IVF treatment in Mongolian women. Materials and Methods: A prospective study was conducted at the Unimed International Hospital IVF Center between October 2023 and August 2024. Clinical and demographic factors, ovarian reserve markers (FSH, AMH, AFC), and ovarian stimulation outcomes were analyzed in 242 women aged 25-44 years undergoing IVF. Logistic regression analysis was performed to identify risk factors and predictors of clinical pregnancy, with a statistical significance threshold set at p<0.05. Results: Among 208 women who underwent embryo transfer, the clinical pregnancy rate was 36.5%, and biochemical pregnancy was observed in 38.4%. Age was a significant predictor, with older age groups (35-39 years: OR=7.11, p=0.004; 40-44 years: OR=12.65, p=0.004) associated with reduced IVF success. Ovarian reserve markers, including AMH (OR=2.49, p<0.001) and AFC (OR=1.56, p<0.001), were significantly correlated with pregnancy outcomes, whereas FSH was not significant (p=0.518). Higher numbers of pre-ovulatory follicles (POF) (OR=1.03, p=0.040) and high-grade embryos (OR=1.26, p=0.045) increased the likelihood of clinical pregnancy. No significant associations were observed between total gonadotrophin dosage, ovarian sensitivity index, and fertilization rate with pregnancy outcomes. Conclusion Age and ovarian reserve markers (AMH, AFC) are critical predictors of IVF success, while pre-ovulatory follicle counts and number of high-grade embryos significantly enhance pregnancy likelihood. These findings emphasize the importance of personalized ART protocols tailored to ovarian reserve and age-related factors to optimize IVF outcomes.

Background: A rare angioproliferative condition of the larynx, Kaposhi sarcoma typically affects the skin. Immunosuppressive treatment following organ transplantation and human immunodeficiency virus infection are the causes. Every type of Kaposi sarcoma has human herpesvirus-8. Laryngeal kaposi sarcoma is uncommon in immunocompromised patients; since its initial identification in 1965, 18 cases have been documented globally. A CO2 laser-assisted laryngeal microsurgery is performed through the mouth cavity to remove tumor when kaposi sarcoma of the larynx obstructs the airway. Case report: A 77-year-old woman complained of hoarseness, dry mouth, odynophagia, and dysphagia three months prior when she arrived at the Mongolian-Japan Hospital. Two years ago, she acquired hard, sensitive lumps that were palpable on her right arm, left ankle, and right thigh. At that time, she was diagnosed with Kaposiform hemangiodermatitis and treated at the National Center for Dermatology. HIV test results were negative. Immunohistochemistry: CD31 +/-, CD34 /+/. Using flexible nasopharyngeal endoscopy to get the diagnosis: There was a mass that was about 1.5–2–5 cm in diameter, bluish in color, smooth and movable, and spongy and vascular on the larynx, on the nasopharynx, behind the palatine tonsills, and supraglottic. Surgery: Through the use of Kleinsasser laryngoscopy and a 0-degree endoscope, pathological tissues were extracted under general anesthesia using a laryngeal microsurgical instrument and a laparoscopic bipolar coagulator. The tissues were then sent for histological evaluation, which revealed Kaposi sarcoma, sarcoma grade 1. Results of treatment Pain decreased and quality of life increased following surgery. Upon nasopharyngeal endoscopy, the vocal cord mobility was normal and the surgical incision was clean. Conclusion: Kaposi sarcoma is an extremely uncommon illness. A lower quality of life and further issues can be avoided with an early diagnosis and suitable therapy. It also needs to be continuously monitored because it is a potentially repeatable disease.

Background: In 2022, the World Health Organization (WHO) reported that globally, 2.5 billion (43%) of adults aged 18 and older were overweight, with 890 million (16%) of these individuals classified as living with obesity. Some genes such as the FTO gene are strongly associated with obesity and overweigh. The FTO protein is crucial in regulating food consumption, appetite, energy equilibrium, and expenditure. Aim: The identify single nucleotide polymorphisms rs9939609 and rs17817449 of the FTO gene, which are associated with obesity, and to study their correlation with antropometric measurements and some laboratory test parameters. Materials and Methods: According to the inclusion and exclusion criteria, 50 obese (BMI >30 kg/m²) were included in the case group, and 50 relatively healthy and normal weight (BMI 18.5-24.9 kg/m²) were enrolled in the control group, for a total of 100 people matched for age and gender (1:1). We took physical measurements and collected peripheral blood samples after obtaining informed consent from each participant. Laboratory analyses assessed some parameters of lipid and glucose metabolism. We used the PCR-RFLP technique on two genotype SNPs. A p-value below 0.05 was considered a statistically significant result. Results: In this study, including 100 people aged 23 to 75, the mean age was 46.81±11.54 years, with 60% being female. In terms of antropometric measurements, body mass index, waist circumference, and arterial pressure were markedly elevated in the case group compared to the control group (p<0.001). In laboratory measures, fasting blood glucose, cholesterol, and mean LDL mean levels were statistically significantly higher in the case group compared to the control group. On the other hand, HDL cholesterol levels were lower in the case group compared to the control group. The FTO gene rs9939609 single nucleotide polymorphism was identified in 62% of the total study individuals as TT, 35% as AT, and 3% as AA genotypes. Also, FTO gene rs17817449 single nucleotide polymorphism was identified in 62% of the total study individuals as TT, 33% as AT, and 5% as AA genotypes. Conclusion The rs9939609 AT/AA genotype of the FTO gene elevates the risk of obesity and is associated with increased body weight, waist circumference, and BMI.

Background: Globally, an estimated 13% of adolescents aged 10–19 are affected by mental disorders. As of 2020, the number of children under the age of 19 in Mongolia was reported to be 1,289,587, reflecting a 0.9% increase compared to 2015. A 2013 study on adolescents found that 60.5% were categorized as mentally healthy, 30.5% exhibited emotional and behavioral difficulties, and 9% were diagnosed with a mental disorder. A study conducted in Govi-Altai Province between 2018 and 2019 reported that 58.6% of adolescents were classified as healthy, 36.1% experienced psychological difficulties, and 5.2% were diagnosed with a mental disorder. Internationally, adolescent mental health has been widely assessed using the Strengths and Difficulties Questionnaire (SDQ), with an increasing number of studies employing artificial intelligence-based predictive models. However, in Mongolia, research utilizing artificial intelligence and machine learning for analyzing large-scale mental health data remains limited. This gap underscores the need for the present study. Aim: Machine learning models were compared to determine adolescent emotional and behavioral problems using the SDQ. Materials and Methods: Data was collected from teenagers, teachers, and parents in Govi-Altai Province, and the databases were created for each group. The teenager database was divided into 10 folds by cross-validation, and the models were developed using machine learning methods and evaluated using their performance measures. The results were mainly analyzed using the Bayes model. Results: The teenagers have emotional and behavioral problems due to emotional and peer interactions, but they are at risk of developing disorders due to hyperactivity and behavioral changes. Conclusion Comparing the model performance results with previous studies, Bayesian model accuracy decreased by 0.03, sensitivity decreased by 0.08, and specificity increased by 0.01. Also, the difference between the performance evaluation metrics of the C50 and Bayesian models is very small, between 0.01 and 0.02. This shows that the performance of the Bayesian method is good when the number of attributes in the database increases. Compared to the results of the knowledge generated by the research, the participants are more likely to develop emotional and behavioral disorders due to their peer relationship indicators, such as other children generally not liking them, getting on better with adults, and due to emotional symptoms such as being unhappy and depressed.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.

The transition of young patients with inflammatory bowel disease (IBD) from pediatric to adult-centered healthcare presents a significant challenge, particularly in regions like Oman, where transfer occurs as early as 14 years old. Although both pediatric and adult patients require multidisciplinary management, key differences in disease characteristics, vaccination needs, growth considerations, and treatment approaches necessitate a carefully structured transition process. Effective communication between pediatric and adult gastroenterologists is crucial for ensuring optimal management for these young patients. This mini-review explores the complexities involved in transitioning young patients with IBD to adult healthcare services.