Background: Problems related to sleep affect approximately 23-56% of the world’s population. In Mongolia, the prevalence of non-organic sleep disorders is estimated at 27.9%, among which 42.2% of the population have poor sleep quality. Long-term insomnia can have a negative impact on an individual’s normal work and life, increasing the risk of various health problems. Severe insomnia can reduce work efficiency and concentration, thereby causing serious harm. Traditional medicine has a long history of treating insomnia. However, there are currently no systematic studies on insomnia based on ancient traditional medical books. Goal: Based on the ancient medical literature of traditional medicine, identify the underlying diseases that cause insomnia and compare their symptoms. Materials and Methods: We adopted the checklist method to list the relevant information of insomnia from the literature, providing a prerequisite for further analysis and the issue of syndrome differentiation of insomnia was analyzed by using comparison methods.
The research protocol was reviewed and approved by the Medical Ethics Committee of the Mongolian National University of Medical Sciences at its meeting on June 24, 2025 (No. 04), and ethical clearance was granted for the conduct of this study. Results: The research materials we selected did not describe insomnia as a dedicated chapter, but mentioned the content related to insomnia in the form of disease symptoms, such as terms like ”sleeplessness”, ”reduced sleep” and ”light sleep”. We explore the underlying diseases of insomnia based on the above symptoms related to insomnia and analyze the syndrome differentiation of insomnia. Exploring the underlying disease of insomnia:
1. Insomnia caused by diseases resulting from Wind include Wind delirium, palpitations, bone marrow Wind, heart Wind, lung Wind, Wind-induced diabetes, Wind tsbs.
2. Insomnia caused by diseases resulting from Bile include heat Bile, heart Bile, liver sdembu, deficiency heat, Invisible heat and epidemic heat.
3. Other diseases include mugpo spreads to the heart, heart chuser, trichomoniasis and childhood evil spirit disease.
We also compared the symptoms of the underlying diseases that cause insomnia and listed their similarities and differences. Conclusion The underlying etiologies of insomnia were categorized into Wind, Bile, Mugpo, yellow fluid, parasitic and evil spirit disorders. Accordingly, effective management of insomnia requires differentiation based on the primary disease and an individualized treatment approach that integrates both etiological and symptomatic therapies.

Introduction: Problems related to sleep affect approximately 23-56% of the world’s population. In Mongolia, the prevalence of non-organic sleep disorders is estimated at 27.9%, among which 42.2% of the population have poor sleep quality. Long-term insomnia can have a negative impact on an individual’s normal work and life, increasing the risk of various health problems. Severe insomnia can reduce work efficiency and concentration, thereby causing serious harm. Traditional medicine has a long history of treating insomnia. However, there are currently no systematic studies on insomnia based on ancient traditional medical books. Methods & Materials: “Gjes bsdus snying nor”. We adopted the checklist method to list the relevant information of insomnia from the literature, providing a prerequisite for further analysis and the issue of syndrome differentiation of insomnia was analyzed by using comparison and theoretical analysis methods.
The research materials we selected did not describe insomnia as a dedicated chapter, but mentioned the content related to insomnia in the form of disease symptoms, such as terms like “sleeplessness”, “reduced sleep” and “light sleep”. We explore the underlying diseases of insomnia based on the above symptoms related to insomnia and analyze the syndrome differentiation of insomnia. Exploring the primary disease of insomnia:
1. Sleeplessness is mentioned among the common symptoms of wind disease, wind palpitation and bone marrow wind, heart wind and lung wind diseases also respectively present with symptoms of reduced sleep.
2. Heat Tri-pa and heart Tri-pa disease can lead to reduced sleep.
3. Mugpo spreads to the heart, it can cause sleeplessness.
4. Deficiency heat, Invisible heat and epidemic heat etc. can present with symptoms such as reduced sleep and light sleep.
5. Wind induced diabetes can also cause reduced sleep.
6. Palpitations and rheumatic heart disease can cause symptoms of reduced sleep.
7. Trichomoniasis can also lead to symptoms of reduced sleep.
These underlying diseases have both similar symptoms and differences, and they need to be differentiated. Conclusion According to our research, the syndrome types of insomnia include wind, Tri-pa, mugpo and microorganisms. Treatment should be based on syndrome differentiation, combining the treatment of the underlying disease with hypnotherapy.

Yoga is a therapeutic practice renowned for its multifaceted benefits across the body's systems. Its positive impact spans the physical, mental and emotional realms, fostering harmony and well-being. Through a combination of postures, breathing techniques and meditation, yoga offers profound effects, enhancing flexibility, strength and balance while simultaneously promoting relaxation and reducing stress. This integrative approach not only cultivates physical resilience but also supports mental clarity, emotional balance and overall vitality, showcasing yoga as a comprehensive and impactful system for holistic health. The review delved into the multifaceted ways in which yoga exerts a positive influence on the body's various systems. It highlights how yoga serves as a beneficial tool in addressing and counteracting the underlying factors associated with different diseases. By examining yoga's effects on these systems and its potential in combating illness, the paper sheds light on the comprehensive therapeutic benefits that yoga offers. Please cite this article as: Pandey S, Pandey AC, Kotecha VR. Yoga-A complementary and traditional medicine for human health. J Integr Med. 2025; 23(2): 93-105.
Yoga ; Humans ; Meditation ; Complementary Therapies ; Medicine, Traditional ; Holistic Health

Medullary thyroid cancer (MTC) is a rare carcinoma of calcitonin producing C cells of the thyroid which is often undiagnosed until after metastatic spread with clinical presentation.Surgical management with radiographic planning is necessary with excision of complete cervical lymph nodes to prevent recurrence. Here, we report a case of an exceedingly rare unplanned converted operation of an incidentally discovered metastatic MTC in a 28-year-old white female. Prior to the operation, ultrasound revealed an 8-mm nodule of mixed cystic and solid mural components, fine needle aspiration showing atypia of indeterminate etiology, Bethesda 3 with mildly suspicious appearance. Surgical exploration revealed a 10-cm right sided mass extending inferiorly from the clavicular head to the thyroid fat pad, encompassing the carotid sheath with the recurrent laryngeal nerve and extension on to the esophagus. Careful dissection with preservation of all vital structures and the recurrent laryngeal nerve was performed and is presented. Postoperative follow-up included serum calcitonin and carcinoembryonic antigen measurements, which returned to normal levels.This case underscores the importance of thorough preoperative evaluation, intraoperative vigilance, and shared decision-making when unexpected findings arise. It contributes uniquely to the literature by highlighting the challenges and decision-making processes involved in managing unexpected metastatic MTC discovered intraoperatively, emphasizing the need for preparedness for potential extensive surgery even when preoperative evaluations suggest low risk.

Atypical presentation and delayed diagnosis of Herlyn-Werner-Wunderlich Syndrome: A case report and literature review Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare and complex Mullerian duct abnormality that is diagnostically challenging. It is also known as OHVIRA syndrome. The triad of uterine didelphys, obstructed hemivagina and ipsilateral renal anomaly characterises the syndrome. A 25-year-old lady was referred with prolonged foul-smelling vaginal discharge. Her periods were regular with normal flow. A vaginal examination revealed a normal cervix and fullness of left adnexa. A pelvic ultrasound showed a left adnexal mass. Computed tomography imaging of the abdomen and pelvis revealed two uterine cavities with a large cystic lesion at the level of the cervix. This lesion was communicating with the uterine cavity, raising the possibility of obstruction. Only the right kidney was present. A diagnosis of HWWS was made. The patient underwent diagnostic laparoscopy, examination under anaesthesia and excision of the vaginal septum. At follow-up, she remained well at 6 weeks and 3 months. The normal mesonephric duct plays an important role in the formation of the uterus, vagina and the upper urinary tract. HWWS occurs when one of the mesonephric ducts is absent or injured during embryogenesis. Women with HWWS usually present after menarche with varied symptoms, causing delays in diagnosis and treatment. Therefore, having a high suspicion index and awareness of Mullerian duct abnormalities is crucial. The gold standard for the evaluation of HWWS is magnetic resonance imaging. Surgical excision of the septum is the advocated treatment of choice. Prompt intervention lowers complications that impair fertility.

ObjectiveThe internal transcribed spacer （ITS） 2 region of ribosomal gene， a DNA barcode， was employed to identify 12 medicinal Aconitum species and the genetic relationship among the species was analyzed. MethodA total of 30 samples of the 12 species were collected. The DNA was extracted with spin column plant genomic DNA kit and the universal primers of ITS2 sequence were used for polymerase chain reaction （PCR） amplification， followed by electrophoresis detection and bi-directional sequencing. The yielded sequences were aligned and spliced by CodonCode Aligner 17.0 and sequence variation was analyzed by MEGA 7.0. The secondary structure was predicted by ITS2 Database and the neighbor-joining （NJ） method was applied to generate the phylogenetic tree. ResultThe ITS2 sequences of the 12 species were 220-221 bp， with the average guanine and cytosine （GC） content of 64.09%， 140 variable sites， 137 informative sites， and 81 conservative sites. The intraspecific genetic distance （K2P） was smaller than the interspecific genetic distance. According to the secondary structures of ITS2 sequences and NJ cluster analysis， A. scaposum， A. sinomontanum， and A. barbatum had close genetic relationship， while the rest nine showed close kinship， particularly A. soongaricum and A. yinschanicum. ConclusionITS2 sequence is of great value for the molecular identification and genetic relationship determination of Aconitum， which provides a new method for the study of ethnomedicine.

Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is an aggressive subtype of inflammatory myofibroblastic tumor (IMT) harboring anaplastic lymphoma kinase (ALK) gene fusions and is associated with high risk of local recurrence and poor prognosis. Herein, we present a young, non-smoking male who presented with complaints of cough and dyspnoea and was found to harbor a large right lower lobe lung mass. Biopsy showed a high-grade epithelioid to rhabdoid tumor with ALK and desmin protein expression. The patient initially received 5 cycles of crizotinib and remained stable for 1 year; however, he then developed multiple bony metastases, for which complete surgical resection was performed. Histopathology confirmed the diagnosis of EIMS, with ALK gene rearrangement demonstrated by fluorescence in situ hybridization. Postoperatively, the patient is asymptomatic with stable metastatic disease on crizotinib and has been started on palliative radiotherapy. EIMS is a very rare subtype of IMT that needs to be included in the differential diagnosis of ALKexpressing lung malignancies in young adults.

Background: Thyroid transcription factor (TTF-1) is a diagnostic marker expressed in 75%–85% of primary lung adenocarcinomas (ACs). Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene is the most common targetable driver alteration in lung AC. Previous studies have shown a positive correlation between TTF-1 and EGFR mutation status. We aimed to determine the predictive value of TTF-1 immunoexpression for underlying EGFR mutation status in a large Indian cohort. Methods: This retrospective designed study was conducted with medical record data from 2011 to 2020. All cases of primary lung AC and non–small cell lung carcinoma not otherwise specified (NSCLC, NOS) with known TTF-1 expression diagnosed by immunohistochemistry using 8G7G3/1 antibodies and EGFR mutation status diagnosed by quantitative polymerase chain reaction were retrieved, reviewed, and the results: were analyzed. Results: Among 909 patient samples diagnosed as lung AC and NSCLC, NOS, TTF-1 was positive in 76.8% cases (698/909) and EGFR mutations were detected in 29.6% (269/909). A strong positive correlation was present between TTF-1 positivity and EGFR mutation status (odds ratio, 3.61; p < .001), with TTF-1 positivity showing high sensitivity (90%) and negative predictive value (87%) for EGFR mutation. TTF-1 immunoexpression did not show significant correlation with uncommon/dual EGFR mutations (odds ratio, 1.69; p = .098). EGFR–tyrosine kinase inhibitor therapy was significantly superior to chemotherapy among EGFR mutant cases irrespective of TTF-1 status; however, no significant differences among survival outcomes were observed. Conclusions Our study confirms a strong positive correlation between TTF-1 expression and common EGFR mutations (exon 19 deletion and exon 21 L858R) in advanced lung AC with significantly high negative predictive value of TTF-1 for EGFR mutations.

Background: Thyroid transcription factor (TTF-1) is a diagnostic marker expressed in 75%–85% of primary lung adenocarcinomas (ACs). Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene is the most common targetable driver alteration in lung AC. Previous studies have shown a positive correlation between TTF-1 and EGFR mutation status. We aimed to determine the predictive value of TTF-1 immunoexpression for underlying EGFR mutation status in a large Indian cohort. Methods: This retrospective designed study was conducted with medical record data from 2011 to 2020. All cases of primary lung AC and non–small cell lung carcinoma not otherwise specified (NSCLC, NOS) with known TTF-1 expression diagnosed by immunohistochemistry using 8G7G3/1 antibodies and EGFR mutation status diagnosed by quantitative polymerase chain reaction were retrieved, reviewed, and the results: were analyzed. Results: Among 909 patient samples diagnosed as lung AC and NSCLC, NOS, TTF-1 was positive in 76.8% cases (698/909) and EGFR mutations were detected in 29.6% (269/909). A strong positive correlation was present between TTF-1 positivity and EGFR mutation status (odds ratio, 3.61; p < .001), with TTF-1 positivity showing high sensitivity (90%) and negative predictive value (87%) for EGFR mutation. TTF-1 immunoexpression did not show significant correlation with uncommon/dual EGFR mutations (odds ratio, 1.69; p = .098). EGFR–tyrosine kinase inhibitor therapy was significantly superior to chemotherapy among EGFR mutant cases irrespective of TTF-1 status; however, no significant differences among survival outcomes were observed. Conclusions Our study confirms a strong positive correlation between TTF-1 expression and common EGFR mutations (exon 19 deletion and exon 21 L858R) in advanced lung AC with significantly high negative predictive value of TTF-1 for EGFR mutations.

Objectives: Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. Materials and Methods: In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures. Results: Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001). Conclusion Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.