Introduction:The traditional lipid and lipoprotein levels in patients with familial combined hyperlipidemia (FCHL) are relatively mildly elevated and do not fully explain the increased risk of cardiovascular disease (CVD). Hypercholesterolemia, hypertriglyceridemia, and elevated levels of apolipoprotein-B (apo-B) characterize FCH. Familial combined hyperlipidemia (FCHL) is a common lipid disorder characterized by elevated levels of plasma cholesterol and triglycerides that is present in 10% to 20% of patients with premature coronary artery disease. The importance of plasma TG as an independent risk factor for CAD was recognized provided support for the earlier observation that plasma TG levels predict relative risk in relatives of FCHL patientsGoal: To study of correlation between of lipid metabolism disorders and coronary atherosclerosisObjectives:- To define correlation of parameters of lipid metabolism in ischemic and control groups- To compare number of injured coronary arteries and parameters of lipid in ischemic menResults:In our study we involved 86 patients who were investigated coronary angiography. Of them 72 (82.7%) patients revealed changes of coronary artery, and one vessel change was 30 (41.6%), two vessels changes were 28 (38.9%), and three vessels 14 (19.4%) respectively. Lipid levels were significantly increased in case group compared with controls. There were no significant difference in number of injured coronary artery and lipid level.Conclusion:In this study found triglyceride was high level than cholesterol, LDL in ischemic disease. Familial combined disorder of metabolism lipid is possible to depend on hyperlipoproteinemia IIB type. Apolipoprotein B (108.5±3.2 mg/dl) was increased compare with control group (89.6±3.4 mg/dl) in ischemic disease.

A lot of factors can cause coronary heart disease and ischemic stroke including external risk factors such as tobacco, alcohol consumption, decreased physical activity, obesity while arterial maintenance, high blood sugar, increased LDL are internal risk factors. We can reduce our external risk factors by changing our lifestyle. Recent studies have shown increased blood Lp(a) levels are independent risk factor for cardiovascular disease. After 1987, the number of publications has increased since the cDNA homology sequence of Lp(a) and plasminogen 2 was identified. Lp(a) is protein complex consisting from apolipoprotein, phospholipid, free cholesterol, cholesterol esters and tryglyceride. Apoliprotein is a lipid that binds with lipoprotein. Lipoproteins have water-soluble and fat-soluble parts, and those parts bind to lipids and are transported in the bloodstream.How is elevated Lp(a) a risk factor for cardiovascular disease? How much does lowering Lp(a) reduce CVD risk factors? If high Lp(a) concentrations are present, mitigation measures are outlined below.

Most of the infected patients completely recovered after covid-19 infection. However, a substantial proportion of patients who have been infected with SARS-CoV-2 continue to have symptoms long past the time that they recovered from the initial phases of covid-19 disease. At NICE guideline,
1. Acute covid-19: signs and symptoms of covid-19 for up to 4 weeks,
2. Ongoing symptomatic covid-19: signs and symptoms of covid-19 from 4 to 12 weeks,
3. Post-covid-19 syndrome: signs and symptoms that develop during or after an infection consistent with covid-19, continue for more than 12 weeks and are not explained by an alternative diagnosis.
In addition to the clinical case definitions, ‘long covid’ is commonly used to describe signs and symptoms that continue or develop after acute covid-19. As the pandemic of covid-19 continues, numerous additional symptoms, such as fever, dry cough, shortness of breath, fatigue, myalgias, vomiting or diarrhea, headache and weakness. Other critical and severe complications of covid-19 can include impaired function of the heart, brain, lung, liver, kidney, and coagulation system. Early reports have now emerged on post-acute infectious consequences of covid-19, with studies from the United States, Europe and China reporting outcomes for those who survived hospitalization for acute covid-19. An observational cohort study from 38 hospitals in Michigan, United States evaluated the outcomes of 1,250 patients discharged alive at 60 day. Of 488 patients who completed the telephone survey in this study, 32.6% of patients reported persistent symptoms. Dyspnea while walking up the stairs 22.9% was most commonly reported, while other symptoms included cough 15.4% and persistent loss of taste/smell 13.1%. Post-hospital discharge care of COVID-19 survivors has been recognized as a major research priority by professional organizations.

BACKGROUND:Congenital heart defects (CHD) turn out to be the leading cause of infant mortality in their first yearafter infectious diseases. Per 1,000 infants, born with CHD, about 19-75 failed to survive. It revealsthe fact that CHD is a major cause of childhood mortality in worldwide. Beyond the progress ofmedicine and surgery, the cause of CHD is not fully defined. The majority of studies reveal that CHDis triggered by many factors, such as the genetic and environmental factors.Based on the evidences of the sequence of the human genome and advances in moleculartechnology, genetic factors play a major role. Per 100 newborninfants, they’re found one child, bornwith a CHD is concerned as a highly frequent incident for birth anomaly. Only 0.5% of these congenitaldefects enable to be inherited in accordance with Mendel’s genetic laws, which is associated withthe change and mutation of a single gene. Many found that most congenital anomalies dependupon mutation or change in multiple genes and other relevant factors. As a result of the progressivedevelopment of molecular biology in the past 20 years discovered a range of genes involved in fetusformation, development, growth and control of processes. In our country case, corrective surgeryfor CHD dominates among all cardiovascular surgery in Mongolia. Particularly, for all incidents donesome corrective surgery of congenital heart defects, atrial septal defect operation occupies 42.44%,in other word it is a substantial part of the CHDoperation (D.Tsegeenjav, 2009). Molecular geneticsstudy of infant born with heart defects and simultaneous anomaly of other organ system researchstill has not been done for Mongolian population. In many cases the diagnosis of CHD is delayeduntil their adulthood, which is a research gap to address without further delay and the finding mustbe applied in practice in the near future.GOAL:The aim of the research is to conduct a molecular genetic study of children, born with CHD andcombined abnormalities of other organs and systems, identify gene lesion, location and characteristicsof mutations, pathogenetic mechanism of congenital defects and anomalies among the Mongolianpopulation.RESULT:For this study, there are 118 patients, with congenital heart disease, received surgical treatmentin the cardiovascular department of III central state hospital named P.N. Shastin, involved afterconfirmed diagnosis through objective and instrumental investigations (ECG, Fluoroscopy, EchoKG).The 118 healthy family members of patients sampled as a control group. According to the diagnosisof patients with congenital heart defect, such as atrial septal defects-95 (81.2% ± 3.6), ventricularseptal defects-17 (14.5% ± 3.3), patent ductusarteriosus- 2 (1.7± 0 .0%) have combined severedefects - 4 (3.3% ± 1.0). Out of 118 patients with congenital heart defects, 32.2% (38 patients)was male, whereas women accounted for 67.8% (80 patients) with average age of 22, 3 ± 12.9(minimum 1.0 year, maximum 51 year). These comprised 42.4% in 1-17 years old (average age10 ± 5.27) and 57.6% in 18-51 years old (average age 31 ± 9.54). The 33.9% ± 4.4 (40 patients) of operated patients responded the questionnaire that they have a hereditary heart defect. Shortnessof breath, heart pain, and recurrent pneumonia were the main complaints of patients with CHDthat significantly authentic to statistical probability. From the taken 118 blood samples, 95 werediagnosed ASD, in 7 diagnosed VSD, in 2 diagnosed PDA, in 4 diagnosed combined defects. Forthe 95 samples, we decided to examine the ASD associated GATA4, TBX5gene. It draws attentionto the fact that 81.2% of all congenital heart defects found only ASD. To examine the ASD genes inthe sample, the following changes have occurred. The study found 8 variants of mutations formingASD. It includes on exon 1 Gly 93 Ala (c.278G> C), on exon 1 P163S (c.487C>T).CONCLUSIONS:1. Patients with ASD alone occupy 81,2% of all heart defects in our study.2. For the samples of ASD, the study found 8 different mutations of GATA4.3. In the sample of blood not found TBX5 gene mutation.4. In the samples, one patient with dextrocardiasitusinvertus was combined with congenital heartdefects found E359Xfs (c.1075delG) deletion variation on exon3.

Introduction: Extracorporeal shockwave lithotripsy (ESWL) revolutionizedthe treatment of urolithiasis and graduallybecame the favorite treatment option sothat today it is considered to be the first lineof treatment for patients with urolithiasis.The purpose of this study was assessment oftherapeutic efficacy, complications of ESWLin urolithiasis in Mongolia.Material and methods: A total of46 patients harboring renal and ureteralstones underwent ESWL between March2016 and September 2016 at First CentralHospital of Mongolia. Karl Storz ModulithSLK electromagnetic machines were usedto impart shock waves. All collected stonefragments sent for biochemical analysis.Results: A total of 46 patients 23 weremales (50%). Patients were mean age of34. The stone size distribution was 0.5cmto 3.1cm. The average treatment time wasranging from 75-110 minutes. The averagenumber of shock waves per treatmentwas 3172±378 (range 1500-4000). Theoverall success rate was 75.73%. All calculidisintegrated satisfactorily except for 3stones, which is located lower 1/3rd ofureter. Stone composition analysis proved tobe composed entirely or predominantly ofcalcium oxalate monohydrate. These patientsrequired to have ureterolithoextraction. Calculicomposition for remaining patients 12 werecalcium oxalate monohydrate, 17 calciumoxalate dehydrate, 6 uric acid and 1 struvite.Complications were mostly minor and rare.Most of the patients (90.7%) developedmacroscopic hematuria after treatment; fewpatients developed mild bruising at the entryand exit sites of the shockwaves on the bodywall. Severe complications such as renalhematoma and steinstrasse were diagnosedfor one patient each and their managementwas non-surgical.Conclusion: ESWL is therefore the firstline treatment for urolithiasis with stonesize smaller than 2cm. It has an efficiencyrate above 75, low procedure time, highsafety and good tolerability and minimalcomplication.

Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney function over time. As the disease progresses, it leads to an increased risk of cardiovascular complications, which are the leading cause of morbidity and mortality in CKD patients. B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart failure. Their role in CKD, however, is complex due to the overlapping pathophysiological mechanisms between cardiac and renal dysfunctions. This literature review aims to explore the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting their clinical relevance, the impact of renal function on their levels, and potential therapeutic implications. The review focuses on studies published in the last decade, examining the clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP as biomarkers in CKD patients.

Cardiovascular diseases related death rates have been declining over, but during the two decades, mortality and morbidity attributable by cardiovascular diseases are continuously taking the first place among the leading causes of morbidity and deaths among the population. Statistics show that >4 million people die each year from cardiovascular disease (CVD) causes in Europe. The World Health Organization reports that in less developed and developing countries, obesity and mortality are expected to continue to increase, depending on the age of the population and the characteristics of lifestyle.
Dyslipidaemia is characterized by elevated low-density lipoprotein cholesterol (LDL-C) and decreased high-density lipoprotein cholesterol (HDL-C) and is a known risk factor for development and progression of atherosclerosis in CAD.
Dyslipidemia and hypertension are major risk factors for cardiovascular disease (CVD) and account for more than 80% of deaths and disability in low- and middle-income countries. Increased serum levels of total cholesterol (TC), triglycerides (TG), high-density lipid (HDL)-cholesterol and decreased low-density lipid (LDL)-cholesterol are known to be associated with major risk factors for CVD. The Framingham study and others that followed could show that HDL-C is an independent cardiovascular risk factor and that the increase of HDL-C of only 10 mg·L(-1) leads to a risk reduction of 2-3%. A recent meta-analysis, including 302.430 subjects from 68 long-term prospective studies, supported the importance of HDL-C measurement in the risk assessment for CAD.
However, data about the relationship between cardiovascular disease and lipid profile among Mongolian adult are rare in the literature. In recent years, rapid urbanization, unhealthy diet, increased life expectancy and lifestyle changes have led to an increased rate of CVD around the world.

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.

Introduction: Cancer continues to be one of the world’s major health issues, with Mongolia continues to lead Asia in esophageal (100’000: 17.1) and gastric cancer incidence (100’000: 41.0). In the previous decade, 8,137 new cases of gastric cancer were reported in Mongolia. According to TNM staging, eight out of every ten people are diagnosed late, recognizing the need to improve people’s knowledge, attitudes, and practices. Methods: The survey was carried out using a questionnaire. A total of 320 participants between 17- 80 ages from the aimags of Uvs, Khovd, and Zavkhan were chosen at random for the survey, and data was collected through social media. SPSS (v28.0, SPSS Inc., Chicago, IL, USA) software was used for statistical analysis. Results: The survey included 110, 106, and 104 participants from the aimags of Uvs, Zavkhan, and Khovd. A total of 320 participants, with 20.9% (67) and 79.1% (253) being male and female respectively. The average age was 35.56±9.15 years. The participants’ mean knowledges, attitudes and practices scores were 7.54±2.7, 9.6±2.2, and 3.82±1.1 respectively in the first survey. Following the advocacy campaign, the mean knowledge, attitude, and practice scores increased to 9.3±2.7, 10.1±2.2, and 4.00±1.2, respectively. Conclusion The attitudes and practices of the participants were related to their level of knowledge. It is critical to increase health education and advocacy efforts in order to develop the appropriate attitudes and behaviors to reduce cancer-related deaths.

Introduction: Studies demonstrated that the apolipoprotein B/apolipoprotein A-I (Apo B/apo A-I) ratio predicts cardiovascular risk better than any of the cholesterol indexes. Apo B and Apo A-1 are assumed to be superiormarkers for lipoprotein abnormalities [1,2]. The concentrations of Apo B and Apo A-1 are associated with cardiovascular disease more strongly than the corresponding lipoprotein cholesterol fractions, the discriminant value of these apoproteins in absolute terms appears to be less important than of their ratio (the Apo B/Apo A-1 ratio) [3, 5-7]. The Apo B/Apo A-1 ratio reflects the balance of atherogenic and antiatherogenic lipoproteins in plasma [4]. Multiple clinical and epidemiological studies have confirmed that the Apo B/Apo A-1 ratio is a superior marker for cardiovascular disease compared with lipids and lipoproteins or their ratios [8, 9]. Goal: We determined the variation limits of the Apo B/Apo A-1 ratio in healthy participants with normolipidemia and the relationship of this ratio with other lipid parameters. Material and Methods: A total of 146 normolipidemic healthy participants aged 25–60 years were included in the study. Anthropometric measurements (height and weight) and other personal information were obtained during the clinical examination and the interview. Participants were included in the study using the following criteria:
1. body mass index < 30 kg/m2;

2. TC < 5.2mmol/L;
3. triglycerides (TG) ≤1.7 mmol/L;
4. HDL-C ≥1.03 mmol/L ( woman), ≥ 1.29 mmol/L (male) .
The plasma levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apo A-I, Apo B and Apo B/Apo A-1 were determined after a 12 h fasting period. The non-HDL-C was calculated as the difference between the TC and HDL-C. Most research data emphasized that the values for the Apo B/Apo A-1 ratio that define a high cardiovascular risk were proposed to be 0.9 for men and 0.8 for women. Statistical Analysis. The statistical analysis was performed using SPSS 21.0 (USA). Differences between the groups were analyzed using the Mann-Whitney test and the chi-squared test. Correlations between the indices were assessed using the Spearman’s rank correlation. A value of < 0.05 was accepted as statistically significant. Results: The relationship of ratio of apolipoprotein (Apo) B/Apo A-1 with other indicators of lipid metabolism in healthy people with normal lipidemia was analyzed. The Apo B/Apo A-1 ratio in the studied normolipidemic subjects was 0.69 ± 0.17. The percentage of subjects with the Apo B/Apo A-1 ratio exceeding 0.9 (the accepted risk value of cardiovascular disease) was 36.3 %.The subjects with Apo B/Apo A-1>0.9 were characterized by higher HDL-C levels and atherogenic Aпo B, Apo B/Apo A-1 but lower values Apo A-1. Conclusion The subjects with normolipidemia the unfavorable Apo B/Apo A-I ratio> 0.9 had more atherogenic lipid profile.