Background In recent years, Mongolian cardiac surgery, which included many people who have contributed to the history of development? One of them is an academician T.Shagdarsuren, whose historic feat is exceptional. He spent the great times of scientifi c, hospital, surgical fi eld. The coursework is continuing to learn and study from the experienced person. It is an essential example for our younger generations. Objective To study the history of cardiac surgery of the world and an academician Tundev Shagdarsuren’s contributions to the development of the Mongolian cardiac surgery Materials and Methods Major methodological principles have been made by anthropology and history, text sources, analytical methods, that to analyze T.Shagdarsuren’s biographies and works related to the archives, to fi nd some materials scientists at the Institute of Medicine, researchers and memories of his disciples’ talk and texts. As well as research work and time were done in to the correct order due to enrich other works of the additional information in according to rules of conducting medical research discipline. Results T.Shagdarsuren established thoracic surgical department of the fi rst surgical hospital in Mongolia in 1954. Furthermore, he did the fi rst thoracic surgery and cardiac surgery in this department. Cardiac surgical treatment is resolved some of the priority issues. As a result, with the advent of thoracic surgery of medical care for sick people closer, improved surgery techniques. Therefore, Cardiovascular research for improving the quality of medical diagnosis, which is achieved a new approach to medical practice by introducing. Conclusion: Academician T.Shagdarsuren is a famous doctor and good organizer, who initially established a team for providing cardiovascular medical services including a number of surgeries. He introduced new technologies which contributed to the development of chest cavity and cardiovascular diagnosis and surgeries and allowed us to be on the same path of other countries around the world.

Introduction: Leading cause of mortality was cardiovascular disease alone last two decade and occurs5500-6000 deaths annually in Mongolia. Familial hypercholesterolemia is the most common inheritedmetabolic disorders and is characterized by severely elevated LDL-cholesterol levels. The prevalenceof the heterozygous state has been estimated at 1 in 200 to 1 in 500 and of the homozygous state from1 in 160,000 to 1 in 1,000, 000.Goal: To identify Heterozygous Familial hypercholesterolemia among the patients with cardiovasculardisease and study clinical features.Materials and Methods: After view medical examination patients with coronary heart disease andcerebral vascular disease, we selected 183 patients among 26 family who possible to have HeterozygousFamilial hypercholesterolemia. We analyzed family history, clinical examination and lipid parameters.And identifi ed Heterozygous Familial hypercholesterolemia by diagnostic criteria of Netherlands.Results: The mean age for males was 42.3±14, for females was 45.8±15 and gender distribution was42.6% (78) male, 57.4% (105) female. Hypertension occurred in 80.9% (148). BMI was increasedwith age in both sexes (P<0.001). The frequency of tendon xanthoma was 26.8% (49) and cornealarcus was 36.6% (67). The level of total cholesterol and LDL-C were signifi cantly elevated in patients.Identity Heterozygous Familial hypercholesterolemia by criteria of Netherlands was certain-36.1%,probable-42.6%, possible-18.6%, unlikely FH-2.7%.Conclusion: Identifi cation of these individuals at an early age and an aggressive treatment of all knownrisk factors are important for reduce mortality of cardiovascular disease. The Netherland’s criteria issuitable for diagnosing Familial hypercholesterolemia in the Mongolian population, although it does notdiagnose the condition at the genetic level.

BackgroundIn the worldwide, each year registered about 357 million new cases of sexual transmitted diseases.39 % of all infectious diseases were STI diseases in Mongolia in 2013 and which also 56.8 % of totalinfectious diseases Dornod province.ObjectiveTo investigate sexual transmitted diseases among the population of Dornod province and its commonrisk-factors.Materials and MethodsIn the survey were chosen 600 persons which is aged from 15 to 64 by random selection methodand divided into 6 cluster and each cluster had 100 persons. In the survey attended 300 male, 300female.ResultsThe survey respondents were married 59.1%, 50.7% of the employed, and 49.3% of the unemployed.2,1% of the survey population has already been tried drug abuse, but in the group of age 15-24,indicate level of the knowledge about drug abusing is very low which is 29,4%, a little or less knowabout drug abusing 35,6%, not know about drug abusing 35%. In other hand beverage usage levelwas very high which is 67% and 51,3% is using an alcohol in the last year constantly.Examination of specialized doctors 38.3% were suspected of sexual transmitted infections. Theyincluded laboratory testing.The 4.9 percent of total respondents had sexually transmitted diseases. It were syphilis 57.1%,gonorrhea 10.2%, trichomonasis 6.1%.The 83 percent of total respondents had sexual intercourse. The average age of first sexualintercourse was 18 ± 1 (95% CI 16.8 - 19.1), 7.1% had two or more sexual partners. Men had toused alcohol while sexual intercourse was 32.1 percent. Women were 49.2 percent and 38.5 percentof people infected with sexually transmitted diseases not use condoms during sexual intercourse.Conclusion1. One in 20 people surveyed, women aged 15-24 and men aged 35-44 have sexual transmissioninfection.2. Risk factors are had two or more sexual partners, had to used alcohol while sexual intercourseand using condoms during sex with casual partners are not enough.

Background : Low triglycerides and cholesterol was associated with hepatitis C virus (HCV) infection. Chronic HCV infection is the main cause of liver injury and it may influence to serum lipid levels. We aimed to evaluate the effect of antiviral treatment on the change of lipid profiles during interferon-based anti-HCV treatment. Material and Methods : Totally 863 patients who completed the interferon-based antiviral therapy in Kaohsiung Medical University Hospital were included in this present study. The lipid profile measured and assessed in the baseline of the treatment and after 6 months of completion of the treatment. Results : The most of the patients (81.2%) were achieved sustained virological response (SVR) by antiviral therapy. There was no significant difference between baseline triglycerides (TG) levels in the SVR group and non SVR groups. The TG levels at 6 months after completion of the treatment was significantly elevated in SVR group (102.9±57.0 mg/dL, p=0.0001) but did not elevated in non SVR group (94.5±45.6 mg/dL, p=0.690) compared with baseline TG levels.
After adjusting patients by four indexes for fibrosis (FIB4) in cut-off point 3.25, serum TG levels significantly increased in low FIB4 group (103.2±57.9 mg/dL, p=0.0001) but not in high FIB4 group (98.1±49.6 mg/dL, p=0.095) after 6 months end of the treatment. Serum TG level was increased greater in patients who had low FIB4 score and patients who achieved SVR (baseline 89.1±34.8 mg/dL; 6 months after treatment 104.3±59.3 mg/dL, paired T test p=0.0001). Conclusion The eradication of HCV is the main cause of the increase of lipids after Pegylated Interferon and Ribavirin treatment.
However advanced fibrosis also has an effect in increase of TG after the treatment.

Familial hypercholesterolemia (FH) (OMIM#143890) is the most common metabolic autosomal disorder. The prevalence of the homozygous FH has been reported as 1 in a million in the general population, compared to much more mild form heterozygous FH with prevalence of 1 in 200-500. Mutations in the low-density lipoprotein receptor (LDLR), apolipoprotein B (ApoB), proprotein convertase subtilin/kexin9 (PCSK9), and low-density lipoprotein receptor adapter protein 1 (LDLRAP1) genes have been linked to FH. These mutations result in a disorder in low-density lipoprotein cholesterol (LDL-C) catabolism, and significantly increasing the levels of LDL-C, total cholesterol in serum, leading to specific clinical signs such as tendon xanthoma, corneal arcus, cardiovascular diseases, and early death from coronary heart disease if left unattended. Therefore, there is an ardent need for early diagnosis followed by aggressive therapeutic intervention and lifestyle modification. Currently, FH can be diagnosed either clinically or genetically. There have three main clinical diagnostic criteria for FH: the US MedPed Program, the Simon Broom Register Group in the UK, and the Netherland’s criteria. The occurrence of so many different LDLR mutations and their widespread distribution throughout the gene imposes severe practical limitations on simple genetic screening. Indeed, exon by exon sequencing of LDLR and other genes in each patient is the best screening genetic methods of choice. Although the hypercholesterolemia associated with FH can be controlled with cholesterol-lowering drug therapy (statins and other), patient response can vary quite widely.

Background: The development of accurate and non-invasive diagnostic tools is essential for improving early detection of cancers. Recent studies have shown that serum biomarkers may be useful for early detection of gastric cancer. Aim: We aimed to evaluate the diagnostic accuracy of PGI and PGR biomarkers for detection of the gastric cancer and atrophic gastritis. Materials and Methods: To identify relevant studies, the MEDLINE (PubMed) database was searched using the keywords (((“Gastritis, Atrophic”[Mesh]) OR “Stomach Neoplasms”[Mesh]) AND “Pepsinogen A”[Mesh]) AND “Sensitivity and Specificity”[Mesh]). Based on the inclusion and exclusion criterias, studies were selected according to the PRISMA guidelines. Meta-analysis was performed using Review Manager 5.4.1 and STATA/IC 15.0 (StataCorp LLC, USA, 2017). Results: According to the PRISMA guidelines, we selected a total of 18 studies in this meta-analysis. The meta-analysis results showed that the sensitivity of the PGI for the detection of atrophic gastritis was 58.5% (95% CI, 44.5-71.3), specificity was 90.2% (95% CI, 68.4-97.5), and DOR was 13.0 (95% CI, 2.6-64.6); the sensitivity of the PGR was 69.9% (95% CI, 58.1-79.5), specificity was 80.9% (95% CI, 52.4-94.2), and DOR was 9.8 (95% CI, 2.6-36.9). However, the sensitivity of the PGI biomarkers for detecting gastric cancer was 72.6% (95% CI, 54.7-85.3), specificity was 66.9% (95% CI, 52.5-78.7), DOR was 5.4 (95% CI, 3.1-9.3); PGR sensitivity was 77.8% (95% CI, 64.4-87.4), specificity was 65.0% (95% CI, 53.2-75.1), DOR was 6.6 (95% CI, 3.7-11.7); PGI+PGR sensitivity was 62.3% (95% CI, 51.1-72.2), specificity was 87.6% (95% CI, 78.0-93.3), DOR was 11.6 (95% CI, 6.8-19.8). Conclusion PGI and PGR tests demonstrated high specificity but moderate sensitivity. Although serum pepsinogen cannot replace endoscopy, it is considered to be an additional test and can be used to select high-risk populations.

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: Gastric cancer is still one of the most leading causes of mortality in the world. The highest mortality rate of gastric cancer is estimated in Mongolia. South Korea and Japan, where leading the incidence of gastric cancer, mortality rates are observed in 51th and 31nd rank respectively. In Mongolia, gastric cancer is the second leading site, after liver cancer. Goal: We aimed to determine the cause of late diagnosis of gastric cancer and to evaluate supply of upper endoscopy devices and human resource for gastric cancer in the general hospital of provinces and districts. Materials and Methods: In this study, 84 patients suffering from gastric cancer (42 patients in III, IV TNM stage; 42 patients in I, II TNM stage)were investigated in National Cancer Center, Mongolia. A survey questionnaire which included age, gender, education, income, risk factors and clinical questions was detected from all patients. And we conducted study of supply of upper endoscopy devices and human resource for gastric cancer in general hospitals of from 21 provinces and general hospitals of 6 districts by questionnaire. Results: Seventy three(86.9%) patients were over 50 years old and the highest rates of gastric cancer were in group of 61-70 years (40.5%). From the results, the reason to visiting hospital was significantly different between two groups. 55.1% of patients suffering from early-stage gastric cancer were voluntarily diagnosed by upper endoscopy. In contrary, 55.8% of patients suffering from late-stage gastric cancer have visited the hospital due to worsening symptoms or dysphagia and vomiting. Factors such as age, gender, education, employment status and income had no significant effect on late diagnosis of gastric cancer. In totally 24(89%)general hospitals out of 27 had upper endoscopy devices and 22 (81.5%) hospitals had endoscopist. Although 75% of total general hospitals conduct annual cancer screening, 64% of them do not perform the endoscopy in annual screening. Conclusion In our country, late diagnosis of gastric cancer is related to the attitudes of patients for preventing and screening disease. Therefore, it is important to improve the health education of the population and to develop healthy, right attitudes and practices. And the study revealed that general hospitals have insufficient for upper endoscopy devices and human resource.

Background: Academician Ragchaa B made a profound contribution to the foundation and development of internal medicine in Mongolia. He was among the first graduates of the Faculty of Medicine at the National University of Mongolia, becoming the country’s first internal medicine physician, educator, and researcher in the field of internal pathology. Ragchaa B achieved numerous pioneering roles, including being, the first Mongolian head of the Department of Internal Medicine, and the first professor in this specialty. His extensive contributions helped establish and advance internal medicine and medical education in Mongolia. Aim: The aim of this study is to analyze the scholarly works of Academician Ragchaa Byambajav to explore and disseminate his valuable contributions to the foundation and development of the science of “Internal Medicine Diagnostics” and hepatology Materials and Methods: This study utilized a documentary research method to analyze the contributions of the distinguished scholar, Academician Ragchaa B. The research involved a comprehensive review of his published books, textbooks, scientific articles, presentations, and archival materials. Additionally, the study examined references to Ragchaa B in books, newspapers, and collected written and oral recollections from his former students across different generations. Through systematic analysis of these sources, the study aimed to provide an in-depth understanding of his academic and professional legacy. Results: Academician Ragchaa B, during his teaching career, graduated approximately 4,000 medical professionals and produced a total of 156 scholarly works. Drawing from his vast knowledge, skills, and experience, he became renowned for writing the textbooks “Clinical Aspects of Botkin’s Disease” (1969) and “Diagnosis of Internal Diseases” (1970), earning recognition as the first scholar to author a Mongolian medical textbook. In 1977, Professor Ragchaa B consolidated his research on liver diseases and authored the monograph “Clinical Aspects of Botkin’s Disease,” which led to him earning the Doctor of Medical Sciences (Sc.D.) degree. Conclusion 1. Academician Ragchaa Byambajav was a distinguished scholar who made significant contributions to the science of internal medicine diagnostics. He served as the first Mongolian head of the “Department of Internal Medicine Diagnostics” in 1953, teaching for over 50 years and acting as a consultant in internal medicine for more than 40 years. 2. He directed research on viral hepatitis and authored the monograph “Clinical Aspects of Botkin’s Disease”, which led to his achievement of a Doctor of Medical Sciences degree in 1977. This accomplishment established him as the first specialized researcher and educator in hepatology in Mongolia.

Gastric cancer has been and still considered one of the most common causes of cancer-related mortality and it continues to be a major public health issue. The incidence and mortality of gastric cancer in Mongolia is the highest in the world. For this reason, this paper provides the information about current status of gastric cancer in Mongolia in the first section. Morbidity and mortality of gastric cancer increased steadily during the last decade. In the second section we overview the most important factors that can accelerate the risk of gastric cancer. Evidence from case-control, cohort studies and meta-analysis have suggested that the risk of gastric cancer is related to several factors including genetics, Helicobacter pylori, other factors related to the environment and lifestyle. Risk factors could have different effects on the onset and the evolution of gastric cancer.