Background: Since life style of the nation has changed, the prevalence of T2DM has steadily increased. According to T2DM related studies, estimated number of people with diabetes is 80.000 in Mongolia. Despite this, total number of diabetic patients registered in Mongolia is only 7000. Thus, approximately 90% of people with diabetes are undiagnosed and untreated.Objective: to assess anthropometric and laboratory parameters of newly diagnosed patients with T2DM.Materials and Methods: It was cross sectional study included 133 patients with type 2 diabetes newly diagnosed at the district hospital of Ulaanbaatar. We measured height, weight and waist circumference and analyzed body fat by bio-impedance analyzer machine. Fasting blood glucose, HbA1c, triglyceride, HDL-C, LDL-C were determined by methods of laboratory in venous plasma. We defined as subjects with metabolic syndrome used the IDF new definition of 2009.Results: 44.4% of all participants were male and 55.6% were female and mean age of all participants was 49.1±8.5. According to BMI 85.7% of patients was obese and overweight and 84.2% of patients identified central obesity by measuring waist circumference. In analyzing of body composition, 100% of all patients determined high body fat. 27.1% of men and 36.4% of women diagnosed arterial hypertension. According to HbA1c (%) level the 94% of patients determined 7.5 and above. The hypertriglyceridemia was 59.4%, hyper LDL-C was 76.7% and hypo HDL-C was 12% and increased LDL: HDL ratio was 8.1%. The prevalence of metabolic syndrome among the newly diagnosed patients with T2DM was 69.6%, male 66.1% and female 72.9%. Conclusion: Obese is major risk factor for T2DM in Mongolia. The study shows that assessing body fat is major identifying method of obese (p<0.03) and statistically significant association of high body fat mass with WC in diabetic patients (p<0.05). The prevalence of several risk factors of DM complications among newly diagnosed patients with T2DM is higher.

Introduction: Due to cervical spondylosispatients with cervical stenosis who hadhyperextension trauma developed spinalcord stress and contusions, tetraplegia anddisability and mortality. Cervical spondylosispatients with hyperextension traumatreatment management still not clearedout throughout the world and very fewresearch has been done in our country.We have been introduced our surgical andrehabilitation comparison research study ofcervical spondylosis trauma in 2015. Our goalis to develop treatment management forthe hyperextension trauma in patients withcervical spondylosis.1. To compare surgical treatmentresults between patients who hadhyperextension injury to the cervical spinewhich were treated at the Departmentof Spinal Surgery of the National Traumaand Orthopaedic Research Center ofMongolia.2. To study biomechanical effects after thesurgeryMaterial and methods: 42 cervicalspondylosis patients with hyperextensioninjury have been chosen retrospectively toevaluate the surgical, conservative, andrehabilitative treatments and results wereanalyzed by SPSS, EXCEL program who weretreated at the Department of Spinal Surgeryof the National Trauma and OrthopaedicResearch Center of Mongolia from 2012-September 2016. Over 20% canal stenosiscases were chosen for laminectomy andanterior discectomy and fusion surgeriesalong with conservative and rehabilitationtreatment. Up to 20% canal stenosis 10cases which is 23.8% of all patients weretreated by conservative treatment.Results: From 42 patients there was 10females and 32 males. Average ages were56±7.9. By the cause of injury 62% werecar accident, 23% motorcycle accident, 10%fall from horse riding and 5% were otherfalls respectively. All patients had neurologicdeficits according to the level of spinal cordinjury. 36 (85.7%) patients had C4-C5 andC5-C6 level injury and 15 (35.7) patients wererecovered from spinal shock after high dosesteroid treatment. According to the X-RAYall patients had cervical spondylosis signand 4 (9.5%) of them had facet fractureswith stable spine condition. After CT scanspinal cord injury located at C3-C4, C4-C5and C5-C6 levels and patients developedfacet arthrosis, ossification of ligaments andintervertebral discs. Clinical signs and CT scans were evaluated and 4 cervical spondylosispatients with hyperextension injury hadlaminectomy and 2 patient had anteriordiscectomy and fusion surgeries. Canalstenosis is decompressed after laminectomysurgery and cervical lordosis is reduced by 7degrees but after anterior discectomy andfusion surgery cervical lordosis is reducedby 3 degrees. Neurological deficit increasinglaminectomy cases had C5 palsy becauseof cord shift (2.4-4mm) which resulted bydenticulate ligament tethering.Conclusion: There were no significantstatistical (P≤.05) differences betweensurgical and rehabilitation treatmentsin cervical spondylosis patients withhyperextension injury who’s canal stenosiswere below 20% [1,2,3,4,5].In our practice itis essential to make laminectomy and anteriordiscectomy and fusion surgeries in 72 hoursafter trauma to help the patient recoverfrom the spinal shock and reabsorption ofcord contusion. For one or two level canalstenosis especially with the OPLL, artificialdisc replacement and ADF surgeries showedbetter results. In multiple level canal stenosiswith OLF and OPLL cases laminectomyand laminoplasty are choice for surgery. Incomparison to foreign study/ Biomechanicalinvestigation of spinal cord injury and diseasein cervical spine Batbayar.K Seoul.2016[2]/ our surgical treatment showed similarresults. Among cervical spondylosis patientswith hyperextension trauma cases whotreated in Spine Department of NationalTrauma and Orthopaedic Hospital, mortalityand disability is increasing and it is essentialto follow correct diagnostic and treatmentalgorithms.

Background: Esophageal cancer ranks as the fourth most prevalent malignancy in Mongolia. Among esophageal disorders, gastroesophageal reflux disease (GERD) accounts for 55% of cases, while esophageal motility disorders constitute 40%. Enhancing the diagnosis and management of esophageal disorders, alongside preventative strategies for esophageal cancer, necessitates a comprehensive understanding and widespread clinical application of esophageal functional assessment. However, epidemiological data and classification of esophageal motility disorders remain scarce in Mongolia, highlighting the necessity of this investigation. Aim: to identify specific risk factors associated with ineffective esophageal motility (IEM) Materials and Methods: This study was performed an analytical case-control design and was conducted at Intermed Hospital. A total of 702 HRM test results from patients attending the Gastroenterology and Endoscopy Center’s outpatient department, Intermed hospital Participants diagnosed with IEM based on HRM findings were assigned to the case group, while individuals with esophageal normal motility disorders were designated as the control group at a 1:2 ratio. Results: A total of 612 participants aged 21–80 years were included in this study of whom 57.8% (n=354) were female and 42.2% (n=258) were male, with a mean age of 51.1±12.7 years. The prevalence of IEM demonstrated a statistically significant increase in the 60–69 and ≥70 age groups compared to the control group (p<0.000). Participants diagnosed with IEM exhibited a mean lower esophageal sphincter (LES) pressure of 329.61±246 mmHg and a mean complete liquid bolus transit rate of 46.88±22.7%, both of which were significantly lower than those observed in the control group (p=0.000). Furthermore, the incidence of IEM was found to increase in correlation with the severity of hiatal hernia, as classified by both endoscopic and manometric criteria, demonstrating statistical significance (p=0.000). Conclusion IEM is more prevalent among elderly individuals and increases in incidence with the progression of hiatal hernia size. In cases of IEM, esophageal bolus transit is significantly delayed, and lower esophageal sphincter pressure is diminished. Further studies are warranted to elucidate additional risk factors contributing to ineffective esophageal motility.

Background: Studies on the risk of kidney stone disease by age and gender show that the prevalence varies by countries and regions, particularly influenced by the conutry development, population diet, etc. In our country, research on kidney stones has been scarce over the past two decades. Aim: To study the age and gender characteristics of patients undergoing surgical treatment for kidney stones. Materials and Methods: Data from a total of 551 individuals who underwent surgical treatment at the Urology Department of the First State Central Hospital over a six-month period (01.01.2024-06.01.2024) were analyzed. The age and gender characteristics of patients diagnosed with kidney stones were studied, and logistic regression was used to test the true probabilities. Statistical analysis was performed using SPSS 27 software, with a significance level set at 0.05. Results: Kidney stones were present in 12.5% of surgical patients (n=69), while other urological diseases accounted for 87.5% (n=482). The mean age of patients with kidney stones was 46.46±12.6 years, which is relatively younger compared to patients with other urological surgical conditions (mean age=55.77, SD=16.174). Regarding the prevalence of kidney stones by gender, females accounted for 56.5% and males 43.5%. Considering the gender distribution of all patients receiving urological surgical care, females constituted 19.9% compared to 8.5% for males, nearly double the incidence. According to logistic regression analysis, women had a 1.5-fold higher risk of developing kidney stones compared to men (OR=1.5, 95% CI: 1.5–4.2, p<0.01). The highest prevalence was observed in the 36–55-year age group, while individuals aged over 55 years had a significantly lower risk (OR=0.19, 95% CI: 0.10–0.39, p<0.001). Conclusion Kidney stones were identified in 12.5% of individuals who underwent urological surgery. The majority of hospitalized patients with kidney stones were aged 36–55 years, and women comprised 56.5% of these cases.

Background: In Mongolia, the prevalence of non-communicable diseases and their intermediate risk factors has continuously increased in recent years. From results of early detection and prevalence studies of non-communicable diseases in Mongolia, studies linking intermediate risk factors to insulin resistance are scarce. Aim: To identify the prevalence of insulin resistance among the population and study its connection with intermediate risk factors of non-communicable diseases. Materials and Methods: This study was approved by the MNUMS Ethics Committee on February 23, 2024 (2024/3- 02), and was conducted based on the data of participants who took part in the “Population-based Preventive and Early Detection Screening of Infectious and Non-Infectious Diseases” organized by the Mongolian government from 2022 to 2023. Insulin resistance was identified using the triglyceride-glucose index (TyG), calculated by the formula Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) / 2]. “Ln” refers to the natural logarithm, based on Euler’s number, approximately 2.71828. TyG levels were classified into low risk (<8.5), medium risk (8.5-9.0), and high risk (>9.0). Defined intermediate risk factors for non-communicable diseases according to stages of hypertension and diabetes. Results: The mean age of participants was 44.3±15.2 years, with 39.2% (n=49,270) male and 41.4% (n=49,749) residing in urban areas. Among the participants, 59.1% had overweight or obesity, 23.6% had diabetes or impaired fasting glucose, 61.4% had hypertension, and 19.7% had elevated triglycerides. Analyzing by levels of insulin resistance risk, 62.8% of the population had low risk, 22.5% medium risk, and 14.7% high risk. Comparing systolic blood pressure across levels of insulin resistance risk showed that even without central obesity or diabetes, as the level of insulin resistance increased, the level of systolic blood pressure also increased (low risk group: 117.0±11.7, medium risk group: 121.1±10.9, high risk group: 123.5±16.2 mmHg). Regression analysis of the risk of hypertension by insulin resistance risk level showed that the risk increased with higher levels of insulin resistance (medium risk group OR=1.35, p<0.0001; high risk group OR=1.63, p<0.0001). Conclusion 22.5% of the population is at medium risk and 14.7% at high risk of insulin resistance. The increase in hypertension risk with higher insulin resistance levels is statistically significant, independent of central obesity and diabetes stages.

Background: Obesity and metabolic disorders are significant contributors to hypertension and cardiovascular disease (CVD). While body mass index (BMI) and waist circumference are known to be associated with systolic blood pressure (SBP), the interplay between adiposity, glucose levels, triglycerides, and SBP is not fully understood. This study aims to investigate the relationships between BMI, waist circumference, glucose, triglycerides, and SBP in a large population-based cohort. Methods: A cross-sectional analysis was conducted on [insert total number] participants with complete data on BMI, waist circumference, blood pressure, glucose, and triglycerides. Descriptive statistics, ANOVA, Pearson correlations, mediation analysis, and multiple regression were used to explore the associations between variables. The moderation effect of glucose on the BMI-SBP relationship was examined using an interaction term in the regression model. Results: The mean age of the study population was 44.3 ± 15.2 years. The mean BMI was 26.7 ± 4.9 kg/m², and 22.7% of participants were classified as obese. Central obesity, measured by waist circumference, was prevalent in 55.9% of the population. BMI, waist circumference, glucose, and triglycerides were significantly associated with SBP (p < 0.0001). Mediation analysis showed that waist circumference partially mediated the effect of BMI on SBP. The interaction term for BMI and glucose was significant (β = 0.32, p < 0.05), indicating that glucose levels moderated the relationship between BMI and SBP, with higher glucose levels amplifying the hypertensive effect of BMI. Conclusion This study highlights the complex interplay between BMI, waist circumference, glucose, triglycerides, and SBP. Waist circumference partially mediates the effect of BMI on SBP, and glucose levels moderate this relationship, amplifying the impact of obesity on blood pressure.

Background: Complete blood count (CBC) is one of the most widely used clinical tests, offering a high-quality, inexpensive, and routine diagnostic tool for various diseases and for monitoring treatment outcomes. Due to modern technological advancements, blood cells are now measured in greater detail, with 36 parameters being evaluated. The prevalence of diabetes mellitus (DM) is rapidly increasing, not only globally but also in our country. This rise in prevalence leads to numerous adverse consequences, including delayed diagnosis, poor control, an increase in chronic complications, and treatment failure. Hyperglycemia is a predisposing factor for chronic inflammation, and a relatively new inflammatory marker, the neutrophil-to-lymphocyte ratio (NLR), may be useful for assessing diabetes control. In recent years, NLR has been studied as a composite biomarker that more effectively reflects systemic inflammation and is easier to detect compared to other inflammatory markers. An increase in neutrophil count and percentage indicates chronic, low-grade, toxic, and non-specific inflammation, while a decrease in lymphocyte count suggests insufficient immune regulation. Thus, an elevated NLR not only reflects the immune system’s functional state in chronic inflammation, but it is also studied as a reliable and selective marker of systemic inflammation in chronic diseases. NLR is considered more stable than the total leukocyte count, is less affected by physiological and pathological factors, is inexpensive, and can be incorporated into daily clinical practice. Aim: To study the relationship between the neutrophil-to-lymphocyte ratio in a complete blood count and diabetes control and complications Materials and Methods: A cross-sectional study was conducted involving 145 patients with type 2 diabetes mellitus, who were treated at the Endocrine Clinic of the Mongolian-Japanese Hospital, Mongolian National University of Medical Sciences. Data on the neutrophil-to-lymphocyte ratio (NLR), glycated hemoglobin (HbA1c), and diabetic complications, including retinopathy, neuropathy, and foot complications, were collected from the Carte-Hospital Management System. Based on the frequency distribution of the NLR parameter, the values were classified into three groups: low, medium, and high. These groups were subsequently compared with glycemic control and complications using correlation and linear regression analyses, with statistical significance set at p<0.05. Results: The mean age of the study participants (n=145) was 57.3±12.9 years, with 46.8% (n=131) being male. The mean duration of diabetes was 9.6 years (range: 1-31 years), and the mean HbA1c level was 8.6±2.47%. Among the participants, 59.3% (n=86) exhibited poor glycemic control. Regarding complications, 52.3% of participants experienced at least one diabetes-related complication. Of these, 25.2% had one complication, 13.3% had two, and 7.1% had three or more. The most common complications were retinopathy (25.7%), nephropathy (18.6%), and macrovascular complications (11.9%). A statistically significant increase in the mean HbA1c level was observed across groups stratified by NLR levels (p=0.003). Linear correlation analysis revealed a statistically significant positive correlation between HbA1c levels (r=0.194, p=0.001) and the number of chronic diabetes complications (r=0.162, p=0.002). Conclusion The NLR level is positively correlated with both diabetes control and the occurrence of chronic complications. As an inexpensive and easily accessible test, it can be used for daily monitoring and early detection of complications.

Background: Gout is a chronic inflammatory joint disease that damages many joints. Monosodium urate-deposition accumulates in the joints and soft tissues due to long-term untreated condition and leading to loss of function, further reducing the quality of life. It is the most common inflammatory joint disease in the world. Hyperuricemia, sedentary lifestyle including diet, obesity, and the use of certain medications are risk factors for gout. A study published in the Asia Pacific Journal of Nutrition in 2018 found that excessive consumption of meat, alcohol, carbonated beverages, and fructose containing drinks increases serum uric acid levels and the risk of gout. Aim: To investigate certain risk factors associated with gout and asymptomatic hyperuricemia among study participants. Materials and Methods: This study was conducted using an analytical cross-sectional design. Data were coded, error- checked, and analyzed using the SPSS 29.0 software. Results: A total of 145 individuals participated in the study, with an average age of 55.0 ± 13.9 years, and 75.2% were male. Based on diagnostic criteria, 29.7% had gout, 35.2% had asymptomatic hyperuricemia, and 35.2% had normal uric acid levels. The consumption of different food products over the past month was analyzed among study groups, and alcohol intake was found to be statistically significant. A univariate regression analysis showed that obesity was associated with hyperuricemia, male sex was associated with gout, and alcohol consumption was a potential risk factor for both hyperuricemia and gout. Conclusion Among the study participants, 29.7% had gout, and 35.2% had asymptomatic hyperuricemia. Obesity, male sex, and alcohol consumption were identified as risk factors contributing to increased serum uric acid levels and gout development.

Background: The morphological characteristics of the alveolar bone thickness between the maxillary sinus and root ca nal tips of the premolars and molars is important for dental implant and orthodontic treatment. The hypotheses formulated were that there would be differences in the morphological characteristics of the alveolar bone at various tooth positions in the posterior maxilla and that age and sex would not influence the findings. This study may provide useful information for dental implant and mini-implant treatment, so as to help lead to successful treatment outcomes. Aim: To evaluate the vertical relationship between the maxillary sinus and molar teeth using cone beam computed tomography (CBCT). Materials and Methods: The study design was retrospective study. We selected 30 CBCT images that were taken in the Central Dental Hospital, Mongolian National University Medical Sciences (MNUMS), between 2021 and 2023. We collected all images according to the inclusion and exclusion criteria. We used Full CBCT (16cm*8cm) images using the target sampling method. The all CBCT images (85kW, 7mA) were obtained with HDX, WILL (DENTRI, Seoul, Korea) using OnDemand3D (CyberMed. Seoul. Korea). The vertical relationship between the maxillary sinus and the maxillary molars was classified into 5 categories according to Kwak’s classification. The study was approved by the Research Ethics Committee of MNUMS. Statistical analyses were done by IBM SPSS version 27 software. Results: A total of 202 maxillary premolars and molars were examined using CBCT images, and were taken in 30 patients. The patient group consisted of 12 men and 18 women with an average age of 26.87 years (range, 16–42 years). In the maxillary first premolars: Class I was 77.4%, Class II was 13.2%, Class V was 9.4%, Classes III and IV were not observed. In the maxillary second premolars: Class I was 44.8%, Class V was 37.9%, Class II was 17.2%. In the maxillary first molars: Class V was 62.3%, Class I was 24.4%, Class II was 6.7%, Class III was 4.4%, Class IV was 2.2%. In the maxillary second molars: Class V was 63.1%, Class I was 23.9%, Class II was 6.5%, Class III was 6.5%. When examining the distance from the apex of the root of the molars to the floor of the maxillary sinus, the distance between the root of the buccal side of the second molar was the smallest, 0.67±1.36mm, and the distance between the root of the first premolar was the furthest, 5.14±4.32mm (p<0.01). Conclusion Among the maxillary posterior teeth, the second molar was positioned closest to the floor of the maxillary sinus, whereas the first premolar was located at the greatest distance. Regarding the maxillary molars, Type V characterized by root protrusion into the floor of the maxillary sinus was the most frequently observed configuration. Conversely, for the premolars, Type I defined by a distinct separation from the sinus floor was the predominant anatomical relationship.