Introduction: This study aimed to assess psychological distress among nursing students enrolled in bachelor’s and associate degree programs using the DASS-21 (Depression Anxiety Stress Scales-21). Objective: To evaluate levels of depression, anxiety, and stress and analyze their differences by age, gender, and year of study. Methods:: A cross-sectional design was employed. Data were collected from students and analyzed by age, gender, and year of study. Depression, anxiety, and stress levels were measured using DASS-21 standard scoring and categorized accordingly.
The findings showed that psychological distress levels were generally consistent with international trends. Bachelor’s students demonstrated higher levels of depression and stress, particularly in the second and final years. Anxiety levels were moderate among first- to third-year bachelor’s students. In contrast, associate degree students mostly exhibited normal to mild levels across all three domains. Female students reported relatively higher levels of depression and anxiety. Academic workload, clinical practice demands, financial difficulties, and environmental stressors such as traffic congestion and air pollution were identified as contributing factors. Conclusion Psychological distress among nursing students varies by academic level and is influenced by multiple factors. The results highlight the importance of implementing targeted mental health support and preventive interventions tailored to students’ academic stages.

Introduction: Psoriasis vulgaris is a chronic, immune-mediated inflammatory dermatosis characterized by erythematous, scaly plaques that substantially impair physical, psychological, and social well-being. Although modern therapies—topicals, phototherapy, systemic agents, and biologics—have improved disease control, many patients experience incomplete remission, adverse effects, or limited accessibility. Traditional Mongolian soaking therapy, particularly the “Five medicinal Springs” decoction, has historically been used to alleviate psoriasis-like conditions; however, contemporary evidence generated through rigorous clinical study remains limited. This randomized controlled trial aimed to evaluate its efficacy and safety. Methods: A total of 60 adults with psoriasis vulgaris were enrolled between October 2019 and February 2022 at the Affiliated Hospital of Inner Mongolia University for Nationalities. Participants were randomized equally into an intervention group (n=30) and a placebo group (n=30). The intervention group received daily decoction baths prepared from ledum palustre. L, Juniferus dahurica Pall, Myricaria longifolia Willd. Ehrenb, Ephedra monosperma S.G.Gmel ex C.A.Mey, and Artemisia frigida Willd, combined with composite glycyrrhizic acid and a hyaluronic biological membrane. The placebo group received warm-water baths with identical adjunct therapy. Treatment spanned 4 consecutive weeks. Clinical outcomes included PASI and its sub scores (erythema, scaling, infiltration), lesion area, pruritus score, Dermatology Life Quality Index (DLQI), and dermatoscopic grading. Statistical analysis employed Mann–Whitney U, Wilcoxon signed-rank, and χ² tests, with significance set at p<0.05.
Baseline characteristics were comparable between groups. After 4 weeks, the intervention group demonstrated significantly greater improvement in erythema (3.23→1.50), scaling (2.90→1.37), and infiltration (2.57→0.77) (all p<0.001). Overall clinical efficacy was higher in the intervention arm (76% vs 53%; p=0.031). DLQI, pruritus scores, and dermatoscopic findings also improved more prominently in the intervention group. No serious adverse events or abnormal laboratory findings were observed. Conclusion Four weeks of “Five medicinal Springs” decoction bathing produced meaningful clinical improvement in psoriasis severity, symptoms, and quality of life, with an excellent safety profile. Further multicenter, long-term randomized trials are warranted to validate these findings and elucidate underlying mechanisms.

Abstract According to the World Health Organization (WHO) report in 2023, arterial hypertension (HTN) remains one of the leading causes of global morbidity, with an estimated 1.3 billion individuals diagnosed worldwide. Among them, 42% were receiving antihypertensive treatment, and only 21% achieved adequate blood pressure control. In the United States, 47.7% of the adult population is diagnosed with hypertension, with prevalence increasing significantly with age [1,2]. Multiple factors such as lifestyle, body mass index (BMI), age, sex, genetics, and physical inactivity are well-documented contributors to hypertension, as evidenced by both international and local studies. Specifically, individuals classified as obese demonstrate a higher prevalence of hypertension based on BMI categorization.
However, in Mongolia, limited studies have investigated the contributing factors and treatment outcomes of hypertension, highlighting the necessity of this study.
A retrospective study was conducted by reviewing the medical records of 50 inpatients diagnosed with arterial hypertension (ICD-10 codes I10–I15) who were admitted to Sindura-Med Hospital between 2023 and 2024.
1. In patients with stage 1 and 2 arterial hypertensions, age, mean systolic and diastolic blood plessure, heart rate and elevated cholesterol levels were found to be correlated with body mass index (BMI). Among smokers, the risk of developing cardiovascular diseases is projected to increase over the next 10 years
2. In the hypertensive group aged 60 years and older, echocardiographic examination revealed structural and functional abnormalities.
3. In the pharmacological management of arterial hypertension, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, combination preparations, and diuretics were the most commonly prescribed medications.

Abstract The Five Medicinal Essences (“Ganlu”) are traditionally described in Mongolian medicine as five sacred, sweet elixirs believed to promote health and longevity. This concept is incorporated into the theoretical framework of traditional fomentation therapy, which aims to restore balance among physiological functions, mental state, and internal energy.
The formulation consists of five plant materials: Ledum palustre L., Juniperus dahurica Pall., Myricaria longifolia (Willd.) Ehrenb., Ephedra przewalskii Stapf, and Artemisia frigida Willd., combined in a ratio of 1:1:2:2:3. The herbal materials are prepared as a decoction and administered as a medicinal extract for external therapeutic application in balneotherapy.
Traditionally, this formulation has been used in Mongolian and integrative medical practice for the management of rheumatic joint disorders, ankylosis, spondylitis, brucellosis, postpartum wind-related disorders, dermatological diseases—particularly psoriasis—and neurological conditions such as hemiplegia and paralysis. Reported therapeutic effects include improvement of blood circulation, modulation of physiological functions, stimulation of metabolic processes, promotion of detoxification, muscle relaxation, and relief of localized pain. However, the therapy is contraindicated in patients with acute infectious diseases (e.g., typhoid fever), severe systemic debilitation, purulent or inflammatory conditions, necrotizing processes, stage II–III hypertension, malignant neoplasms, or venous thrombosis.
Further pharmacological and clinical investigations are necessary to clarify the mechanisms of action of the constituent plants and to provide scientific evidence supporting the integration of this traditional formulation into modern healthcare practice.

Abstract Temperament is an innate psychological characteristic that influences emotional responses, behavioral patterns, learning styles, and academic performance. In educational settings, understanding students’ temperament has become increasingly important for improving learning outcomes, engagement, and instructional effectiveness.
This review aims to synthesize theoretical and empirical evidence on the relationship between student temperament and learning outcomes, and to identify teaching methods and instructional strategies that are aligned with different temperament types.
In reviewed studies, a variety of methods have commonly been used to assess students’ learning styles, temperament, and psychological attitudes, including questionnaires, learning ability tests, standardized psychological tests, and teacher evaluations. Statistical techniques such as correlation, regression, and cluster analysis are often employed to analyze data and provide a comprehensive evaluation of learning outcomes.
Previous studies consistently demonstrate that temperament significantly influences learning behavior, attention, stress responses, and academic achievement. Sanguine and choleric students benefit more from interactive and competitive learning environments, whereas phlegmatic and melancholic students achieve better outcomes in stable, structured, and supportive settings. Empirical evidence further suggests that aligning teaching strategies with students’ temperament characteristics enhances learning effectiveness and student engagement.
Temperament is a critical individual factor affecting learning outcomes and academic success. Rather than attempting to change temperament, educational strategies should focus on recognizing and supporting individual differences.
Integrating temperament-sensitive teaching approaches into curriculum design can substantially improve educational quality and learning outcomes.

Introduction: Clinical practice is a critical component of professional development for healthcare students; however, exposure to ethical dilemmas is common in real clinical settings. Limited evidence exists regarding how nursing and traditional medicine students make ethical decisions during clinical practice and the factors influencing their decision-making in the Mongolian context. Methods: A mixed-methods design was employed. The quantitative phase included 95 undergraduate students undertaking clinical practice. Ethical decision-making was assessed using a 16-item Likert-scale questionnaire based on Rest’s Four-Component Model of Moral Behavior. The qualitative phase involved semi-structured phenomenological interviews with 18 purposively selected students. Quantitative data were analyzed using SPSS version 28.0 and R software, while qualitative data were interpreted using Van Manen’s hermeneutic phenomenological approach. Results: The mean ethical decision-making score was 65.06 ± 9.96, with 66.3% of participants demonstrating a high level of ethical competence. Ethical sensitivity showed the lowest mean score (15.87 ± 3.02) among the four components. Significant positive correlations were identified among ethical sensitivity, moral judgment, moral motivation, and moral character (r = 0.592–0.747, p < .001). Qualitative analysis revealed five major themes influencing ethical decision-making: ethical awareness, fear and lack of moral courage, hierarchical relationships and organizational culture, support systems, and personal moral development. Students frequently reported difficulties in acting on ethical concerns due to perceived authority gradients and evaluation-related pressures. Conclusion Although students demonstrated a generally high level of ethical decision-making competence, deficiencies in ethical sensitivity and institutional support were evident. Strengthening ethics education through case-based learning, simulation training, reflective discussions, and supportive clinical learning environments may enhance students’ ethical decision-making capabilities.

Introduction Betulin, a pentacyclic triterpenoid abundant in the outer bark of birch trees (Betula pendula Roth.), has gained significant attention in pharmaceutical research due to its potent anti-inflammatory, antioxidant, and skin-regenerative properties. However, its therapeutic application is severely hindered by its extreme lipophilicity and poor aqueous solubility, leading to low bioavailability. Conventional topical formulations often fail to deliver betulin across the skin’s lipid barrier, retaining it primarily in the stratum corneum. Furthermore, while betulin exhibits efficacy against Gram-positive bacteria (S. aureus, B. subtilis), recent studies indicate a lack of inhibitory effect on Gram-negative strains (E. coli), presenting a challenge in the comprehensive management of infected burn wounds.
To address these limitations, this study proposes a "dual-action" hybrid delivery system by integrating betulin with metallic nanoparticles (AgNPs and ZnO NPs) using nanotechnology-based platforms. These nano-structured systems—such as liposomes and nano-emulsions are designed to enhance the solubility of betulin, facilitate deep dermal penetration, and reduce systemic side effects. Simultaneously, the inclusion of silver and zinc oxide nanoparticles expands the antimicrobial spectrum to include Gram-negative pathogens and provides antiseptic synergy.
This innovative approach provides a robust scientific and technological framework for developing next-generation dermatological products. By utilizing Mongolia's extensive birch forest resources, this research contributes to the production of high-value, export-oriented pharmaceutical innovations that serve as advanced alternatives to imported wound-care treatments.

Background: Laryngeal papillomatosis is a chronic recurrent benign tumor of the airway caused by infection with human papillomavirus (HPV) types 6 and 11, developing in the epithelial lining of the laryngeal mucosa. According to R. Y. Seedat et al., clinical manifestations of the disease include hoarseness (25.9%), dyspnea (51.9%), and stridor (70.1%). Hyperplasia and keratinization of the mucosa lead to increased numbers of abnormal cells, which invade beyond the basement membrane and induce atypical changes in normal cells, resulting in uncontrolled proliferation. This causes benign tumor growth, and when mucosal integrity is disrupted, viral proteins may reactivate, leading to recurrence. Surgical treatment is required for each recurrence, and impaired vocal fold vibration negatively affects voice quality. In the early stages, the disease may be misdiagnosed as asthma or allergy, and in some cases, can present as acute respiratory distress, posing a life-threatening risk. Patients with juvenile-onset recurrent respiratory papillomatosis (JORRP) require surgery an average of 4.4 times annually and 19.7 times during their lifetime. The goals of surgical treatment are to remove papillomatous lesions, reduce symptoms, secure the airway, preserve vocal function, extend the interval between recurrences, and improve quality of life. However, surgery alone cannot completely prevent recurrence. Currently, traditional cold instruments, microdebriders, and CO₂ lasers (10,600 nm) are widely used, but no standardized guideline exists. Aim: To compare the outcomes of traditional cold instrument surgery with microdebrider-assisted microsurgery in the treatment of laryngeal papillomatosis. Materials and Methods: A hospital-based case–control study was conducted at the Department of Otolaryngology, National Center for Maternal and Child Health. A total of 76 patients diagnosed with laryngeal papillomatosis were included. Clinical records of 52 patients treated with cold instruments between 2018 and 2022 were reviewed as the control group, while 24 patients who underwent microdebrider-assisted microsurgery formed the case group. Disease severity was assessed using the Derkay staging system, and voice outcomes were evaluated with the GRBAS scale and Voice Handicap Index (VHI). Statistical analyses included group comparisons and correlation testing, with significance set at p<0.05. Results: Of the 76 patients, 52 were in the control group and 24 in the case group. The control group included 36 males (69.2%) and 16 females (30.8%) with a mean age of 42.2±15.7 years, while the case group included 15 males (62.5%) and 9 females (37.5%) with a mean age of 44.6±15.9 years. No significant differences in age or Derkay scores were found between groups (p>0.05). The case group had significantly shorter operative times (24.6±17.6 vs. 30.3±7.8 min, p=0.014) and hospital stays (2.8±2.6 vs. 3.3±0.9 days, p<0.001). However, the recurrence interval was longer in the control group (5.7±6.3 vs. 1.5±3.6 months, p=0.001), while the total number of surgeries per patient was higher in the case group (22.8±36.9 vs. 8.7±11.8). Voice outcomes improved more significantly in the case group, with lower GRBAS (5.3±2.3 vs. 8.4±2.9, p<0.01) and VHI scores (36.8±11.7 vs. 66.4±12.4, p<0.001). Positive correlations were observed between Derkay scores and total number of surgeries (ρ=0.35), as well as between GRBAS and VHI scores (ρ=0.37). Conclusion Microdebrider-assisted surgery for laryngeal papillomatosis significantly reduced operative time and hospital stay while improving postoperative voice outcomes compared with cold instrument surgery. However, the shorter recurrence interval and higher surgery frequency in some cases indicate the need for long-term monitoring and further evaluation of this method.

Background: Liver transplantation (LT) recipients frequently develop complication kidney dysfunction (KD), but the predisposing factors and long-term consequences of KD are not well understood. Post-LT complications that lead to graft failure and patient morbidity/mortality can be generally categorized as vascular, biliary, parenchymal and malignant. Main reasons for our study are to identify complications’ rate for early post-transplant KD and to evaluate the post-LT patients and graft survival rate. Aim: Our aim was to evaluate complications in recipients with early post-transplant KD and to investigate the survival rate after LT. Material and Methods: This study retrospectively and prospectively analyzed the demographic characteristics, preoperative and perioperative clinical parameters, as well as postoperative outcomes of patients who underwent liver transplantation (LT) at the First Central Hospital of Mongolia (FCHM) between September 2011 and December 2024. Renal function was evaluated by estimating the glomerular filtration rate (GFR) using the Cockcroft-Gault creatinine clearance formula at baseline (pre-transplantation) and at 24 hours, 72 hours, 7 days, 14 days, and 28 days following LT. Early and late complications following LT were classified according to the international classification. Ethical approval for the study was obtained at a meeting of the Research Ethics Review Board of the Mongolian National University of Medical Sciences (MNUMS). Results: In our study KD rate was 29.7%. Several factors increased the risk of KD among recipients. Post-LT complications’ related risk factors for KD was high MELD score (OR, 1.11; 95%CI, 1.06-1.16), Child-Turcotte-Pugh scores of B and C (OR, 5.57; 95%CI, 1.27-24.52 and OR, 8.21; 95%CI, 1.87–36.54), comorbidities (OR, 1.92; 95%CI, 1.14-3.23), post-LT acute bleeding (OR, 3.22; 95%CI, 1.22-8.46), early relaparotomy for revision (OR, 3.12; 95%CI, 1.34-7.28 respectively. Additionally, the survival rates for recipients with post-LT KD were 90.7% at 1 year and 81.3% at 3 years. Conclusions 1. Variables like a recipient high age (p<0.001), female gender (p<0.001), elevated liver function scores (p<0.002), comorbidities (p=0.013), severe ascites (p=0.001), preop intensive care (p=0.026) are pre-LT risk factors for post- LT KD. 2. Acute bleeding (p=0.013), early revision (p=0.006) are risk factors for post-LT KD. 3. Early KD in recipients who underwent LT affects both patient survival (Log Rank p=0.522; HR 1.3) and graft survival (Log Rank p=0.457; HR 1.26).

Background: Generation Z students, born after 1995, are characterized by their ability to multitask, low tolerance for traditional learning methods, impatience, short attention span, and preference for working independently rather than collaboratively. They are also considered more vulnerable to mental health challenges compared to previous generations. Aim: To assess the level of academic engagement among Generation Z students studying in the School of Nursing. Materials and Methods: This descriptive, cross-sectional quantitative study was conducted from February 1 to April 1, 2025. A total of 420 students majoring in nursing, midwifery, physical therapy, occupational therapy, and traditional medicine nursing at the School of Nursing, Mongolian National University of Medical Sciences, participated in the study. The Student Course Engagement Questionnaire (Handelsman, 2005) was used to evaluate students’ engagement levels. The reliability of the questionnaire was confirmed with a Cronbach’s α of 0.955. Statistical analysis was performed using SPSS version 25, and results were considered statistically significant at p<0.05. Results: Among the 420 participants, 91.9% were female and 8.1% were male. By major, 57.1% studied nursing, 22.6% midwifery, 8.8% physical therapy, and the remainder were from other disciplines. Student engagement was analyzed across three domains: academic involvement, personal responsibility and effort, and learning attitude and motivation. Pearson correlation analysis revealed strong positive correlations between academic involvement and personal responsibility/ effort (r=0.828), learning attitude and motivation (r=0.825), and between responsibility/effort and learning attitude/ motivation (r=0.903) (p<0.01). Age showed a weak positive correlation with year of study (r=0.381), while major and year of study had a weak negative correlation (r= -0.146) (p<0.01). Year of study and learning motivation also showed a weak negative correlation (r=-0.107, p<0.05). Conclusion The learning motivation and class engagement of Generation Z nursing students were found to be strongly correlated with their sense of responsibility, effort, and learning attitude (r=0.82–0.90, p<0.01). Most students demonstrated consistent participation and motivation to learn, showed less interest in traditional teaching approaches, and preferred practical training.