Background: Developing a standardized methodology and a reliable and valid assessment tool for assessing the professional competence of nurses in Mongolia is of great importance for nursing research and practice. Aim: To determine the psychometric properties of the Mongolian version of the Competency Inventory for Registered Nurses. Materials and Methods: This study was conducted using a methodological research design. The study included 550 nurses from 11 state hospitals and collected data between June and December 2024 using the Competency Inventory for Registered Nurses Scale (CIRN) developed by Ming Liu et al. (2007). Result: The internal reliability of the questionnaire was Cronbach’s alpha coefficient (Cronbach’s α=0.98). Content validity indices (Content Validity Index CVI) were I-CVI ≥ 0.78, S-CVI/Ave=0.98, and S-CVI/UA=0.85, indicating good content validity. Varimax factor analysis revealed factor loadings ranging from 0.380 to 0.780. Conclusion 1. The Mongolian version of the Competency Inventory Registered Nurses demonstrated adequate internal reliability. 2. The validity of the questionnaire was confirmed to be acceptable.

Background: Mediastinal lesions encompass a broad spectrum of malignant and benign conditions, and histopathological confirmation is often required to guide appropriate management. Computed tomography (CT)-guided transthoracic core needle biopsy (CNB) is a less invasive alternative to surgical biopsy; however, data on its diagnostic performance and safety in Mongolia remain limited. Aim: To evaluate the diagnostic yield and safety of CT-guided transthoracic CNB for mediastinal lesions and to identify factors associated with diagnostic outcomes and procedure-related complications. Materials and Methods: This retrospective–prospective observational cohort study included 58 CT-guided transthoracic CNB procedures performed in 55 patients with mediastinal lesions. CT characteristics, histopathological diagnoses, procedural variables, and complications were analyzed. Fisher’s exact test, Pearson’s χ² test with Monte Carlo simulation, and the Mann–Whitney U test were applied, with Holm adjustment for multiple comparisons. Results: The median age was 57 years [IQR, 46–67], and 63.6% of patients were male. Malignancy was confirmed in 76.4%, while 21.8% had non-malignant disease. A specific diagnosis was established in 54 of 58 procedures, yielding a diagnostic yield of 93.1% (95% CI, 83.6–97.3%). CT lesion composition, internal characteristics, and mediastinal location were not significantly associated with diagnostic category (all p>0.05). The overall complication rate was 6.9%, with CIRSE grade ≥3 complications occurring in 1.7%. All complications occurred when the needle-path depth exceeded 7 cm, an association that remained significant after Holm adjustment (adjusted p=0.007). Conclusion CT-guided transthoracic core needle biopsy is a highly effective diagnostic procedure with a favorable safety profile for mediastinal lesions. A needle-path depth >7 cm may indicate increased procedural risk and warrants validation in larger studies.

Background: Partial tears of the rotator cuff tendons are a common cause of shoulder pain and functional limitation among adults. Conservative management often provides only partial relief in chronic cases. Platelet-rich plasma (PRP) and hyaluronic acid (HA) injections have shown promising effects in tendon regeneration, pain reduction, and improved function. PRP delivers growth factors that promote healing and reduce inflammation, while HA maintains tendon elasticity and inhibits inflammatory cytokines. Combining PRP and HA may produce synergistic therapeutic effects; however, data on their combined use in Mongolian patients remain limited. Objective: To evaluate and compare the clinical outcomes of PRP, HA, and combined PRP + HA injections in patients with rotator cuff tendon disorders. Material and Method: Sixty patients diagnosed with rotator cuff pathology (ICD code M75.1) at the National Trauma and Orthopedic Research Center of Mongolia between June 2024 and June 2025 were enrolled. Participants were randomly divided into three groups: PRP + HA (n=20), PRP only (n=20), and HA only (n=20). Each patient received three ultrasound-guided injections at two week intervals. Clinical outcomes were assessed using pain score (VAS), range of motion (ROM), Constant–Murley score, and the Shoulder Pain and Disability Index (SPADI) at baseline, 4, 12, and 24 weeks. Data were analyzed using ANOVA, with p < 0.05 considered significant.
Ethics Approval. “Ach” Medical University, Ethics Committee Resolution, Date: June 30, 2023 Resolution No: 23/02/12, Location: Ulaanbaatar, Mongolia Results: The PRP+HA group demonstrated the greatest improvements across all parameters. Pain decreased by 60% at 12 weeks, and ROM increased by 20–25% from baseline (p<0.05). SPADI scores improved from 63.2 to 21.3 at 24 weeks (p < 0.001). No serious adverse effects occurred. Conclusion Combined PRP and HA injections significantly enhance pain relief, mobility, and shoulder function compared to either treatment alone. This combined therapy is safe, effective, and represents a promising approach for managing rotator cuff tendon disorders.

After low back pain and knee pain, shoulder pain has been estimated to be the third most common musculoskeletal presentation in primary care. The prognosis for people presenting with musculoskeletal shoulder pain varies widely between individuals with, on average, 50% of people with shoulder pain still reporting symptoms 6months after presenting in primary care. In addition to pain, functional disabilities are common and can interfere with work, hobbies, social, and sporting activities and may also be associated with psychological distress and reduced quality of life. Shoulder pain consequences generate high costs to society.

Background: Specifically, stomach cancer ranks as the fifth leading cause of cancer morbidity and mortality worldwide. Early-stage detection significantly improves survival rates, with over 90% of patients diagnosed at stages I and II living beyond five years. To improve the early detection of gastric cancer, it is necessary to complement the conventional method of endoscopic examination with biomarker analysis. We aimed to compare biomarkers such as pepsinogen C (PGC), matrix metalloproteinase 2 (MMP2), matrix metalloproteinase 9 (MMP9), and the cell proliferation marker Ki-67 with immunohistochemical analysis. Purpose: A comparative study and evaluation of biomarkers for the early detection of gastric cancer. Materials and Methods: The study was conducted using a retrospective cohort design. Research ethics issues were discussed at the meeting of the Medical Ethics Control Committee of the Ministry of Health on October 13, 2023, and permission to start the research was obtained (Resolution No. 23/051). The information was gathered based on the criteria for K29.3, K29.4, K31, and C1 diagnoses according to the international ICD 10 classification, and participants were selected accordingly. Proteins such as PGC, MMP2, MMP9, and Ki-67 were examined using a tissue microarray kit and evaluated through immunohistochemical analysis. Results: Negative gastric tumor markers PGC, Ki-67, MMP2 and MMP9 were evaluated by immunohistochemical analysis. The mean PGC protein staining values were 6.20±2.61 for chronic superficial gastritis, 5.45±2.47 for atrophic gastritis, 3.61±2.0 for metaplasia, and 3.31±1.75 for gastric cancer, with statistically significant differences between the groups (P<0.001). The mean Ki-67 protein staining values were 0.1 ± 0.4 for chronic superficial gastritis, 0.33 ± 0.55 for atrophic gastritis, 0.09 ± 0.39 for metaplasia, and 2.62 ± 0.78 for gastric cancer, also showing statistically significant differences (P<0.001). The mean MMP2 and MMP9 protein staining values were 0.2±0.76 and 1.2±2.04, respectively, for chronic superficial gastritis; 0.28±0.52 and 3.28±2.82 for atrophic gastritis; 0.35±1.04 and 1.12±1.45 for metaplasia; and 1.38±2.11 and 5.29±2.51 for gastric cancer, with all differences being statistically significant (P<0.001). Conclusion PGC protein, a negative tumor marker, decreases during the transition from a gastric cancer precursor to cancer. MMP2 protein, a marker of cell migration and metastasis, has little diagnostic value, while the expression of MMP9 and the Ki 67 are highly effective in gastric cancer. Immunohistochemical analysis of endoscopic biopsy tissue to detect the negative tumor marker PGC, the positive marker Ki-67, and MMP9 can be used for early detection of gastric cancer.

Introduction: In Mongolia, data on the etiology and risk factors of cardioembolic stroke (CES) is scarce and few clinical studies have been performed to date. Timely identification and control of cardiovascular risk factors are priority objectives for adequate primary and secondary prevention of CES. Goal: The goal of this study was to describe risk factors for CES in our setting. Results: The case-control study enrolled a total of 525 subjects. CES was detected in 63 (35.7%) out of 176 (33.5%) ischemic stroke patients with a predominance in age group of 60-69 and men (33%). The main risk factor of CES was non-valvular atrial fibrillation (AF). AF especially paroxysmal AF increased the risk of CES by 4.6 times (p=<0.0001, OR 4.6, 95% CI 1.4-44.6). The second main cerebrovascular risk factors were hypertension and dyslipidemia. Conclusion CES accounted for 1/3 of ischemic stroke. The commonest underlying medical conditions were non-valvular atrial fibrillation, hypertension, dyslipidemia, alcohol consumption and obesity. Hence, all patients with hypertension and non-valvular AF should be meticulously screened for prevention of CES.

Introduction: We classify peritonitis as end-stage if it lasts for more than 72 hours or more than three days. At this point, the pleural effusion of the posterior abdominal wall, the pleural layer of the gastrointestinal tract, and the dimples of the esophagus are all scattered with pus. During the first operation, it is very difficult to completely cleanse these abscesses. After the operation, pus will collect in the abdomen and abscesses will form, which will require another operation. If this postoperative complication is not diagnosed in time and operated again (relaparotomy), many other complications can occur and the risk of death is high. 48-hour relaparotomy mortality is higher than early surgery (21.8% -76.8%). Necrotic pancreatitis is chronic peritonitis (an abscess of the lower extremities) in which only non-pancreatic adipose tissue, sebum glands, pericardial effusions, pericardial effusions, and kidney adipose tissue become necrotic. Purpose: Endoscopic surveillance for chronic pleurisy with pancreatic necrosis Objectives:
1. Endoscopic monitoring of the postoperative course of pancreatic necrosis.
2. Calculate the results of washing and cleaning using binoculars. Method: Patients with advanced peritoneal inflammation and necrotizing pancreatitis should be selected for reoperation. After removing the dead pancreatic tissue (necrosectomy), all layers of the abdomen are temporarily closed. A 6 mm short tube with surgical rubber is cut into the small pancreas, inserted 2 cm deep into the standard abdomen and sutured to the skin. Or use a silicone tube 4 - 5 cm long. Result: The study was carried out on 56 patients in 2016-2020. The mean age was 50 (89%) for men, 6 (11%) for women, and 47.5 ± 8.6. Conclusion
1. Endoscopic follow-up showed 19 (76%) persistent postoperative peritonitis and re-clearance, and 6 (24%) patients were not diagnosed with persistent peritonitis.
2. 25 (50%) cases of persistent peritonitis after surgery were washed 1-3 times. This method has proven to be a safe and easy procedure and can be used in any urban or rural hospital.

Introduction: About 20-30% of patients with acute pancreatitis have a severe disease and mortality rate among inpatients were 15%. There are many causes of acute pancreatitis (AP), but most common cause of AP is an alcohol. According to some studies in our country, alcohol is the number one cause of acute pancreatitis and the mortality rate is 15.3%. Very important for prognosis of disease optimal choice of treatment tactics, detection of infectious evidence of necrotizing pancreatitis. Therefore, based on the above, there is an urgent need to conduct research to address important issues and to improve the diagnosis and treatment of acute alcohol-induced pancreatic necrosis. Goal: Determine the importance of early diagnostic assessment of alcohol induced severe acute necrotizing pancreatitis. Materials and Methods: Research model and research method. We conducted our research using an observational research model and a factual research method.Sampling of research materials will be carried out by targeted sampling. From November 1, 2008 to January 1, 2020, 122 patients who were hospitalized with alcohol-inducedAP were selected and archival documents or medical histories were selected. Statistical analysis was performed using averages and regression analysis methods to calculate the laboratory parameters in the analysis related to the new evaluation system. Results: The minimum age of patients with ANP was 25 and the maximum was 71, with the majority (87.4%) aged 26 to 60 years. When the Person Correlation method calculates the relationship between alcohol consumption and mortality, it is assumed that the weaker the correlation, the higher the amount of alcohol consumed, the lower the cure and the higher the mortality. Of the 31 deaths reported in the study, 24 (77.4%) were hospitalized more than 72 hours after the onset of the disease. Late hospitalization and late treatment of patients with acute necrotizing pancreatitis (ANP) disease have been shown to adversely affect the prognosis of the disease. In our study, all parameters were significant, but procalcitonin, serum amylase, serum lipase, serum LDG8 C-reactive protein, serum glucose was found to be higher than the value specified in the evaluation system for the variable (in determining pancreatic necrosis). АNOVA analysis test showed that white blood cells, procalcitonin, serum amilza, serum lipaza, serumglucose, serum LDG, C-reactive protein were higher than those specified in the evaluation system, and that the level of significance for the variable (indicating a severe pancreatitis or poor prognosis) was higher than other test results (P <0.01). According to the new evaluation system, 12 out of 122 patients were classified as A class or 0-3, 69 (56.5%) patients were class B or 4-6, and 41 (33.6%) patients were class C or >7 points. Of the total cases, 90.1% were rated as severe form of ANP and pancreatic necrosis by the classification system we developed. When we assessed the prognosis with the new assessment system, we found that 100 percent of patients in category A were cured, 89.8 percent of patients in category B were cured, and 41.5 percent of patients in category C were cured and 58.5 percent died. Statistical calculations using the correlation analysis method for the correlation between the score and the cure of the evaluation system shows negative correlation (P <0.01) other words, the higher the score of the evaluation system, the lower the cure rate and the higher the mortality rate. Conclusion In Mongolia, relatively young men suffer from alcohol-induced pancreatitis.Factors contributing to the development of necrosis in acute pancreatitis include alcohol abuse, prolonged alcohol use, delayed hospitalization, and delayed treatment.In our study, following clinical signs and laboratory findings are effective in distinguishing severe forms of acute necrotizing pancreatitis, early diagnosis, assessment of prognosis. Laboratorytests include: increase in white blood cells, procalcitonin, serum amylase, serum LDH, serum lipase, C-reactive protein and a decrease in hematocrit, serum calcium.

Introduction In 1987 Jerome Ritchie, David Auth and colleagues first introduced rotational atherectomy (rotablation) as a technique for the endovascular treatment of obstructive atherosclerotic disease. Rotational atherectomy covers 3-5% of all procedures in big PCI centers, while <1% in smaller centers. By study of Warth DC et al. in 1994, at early period when it was first introduced, procedure complication of rotablation was about 40%, those with coronary dissection 29%, coronary artery occlusion 11.2%, side branch occlusion 1.8%, distal occlusion 0.9%, no relow phenomenon 6.1%, severe vasospasm 13.8% and vascular perforation 1-2%.
By advanced techniques and technologies that kind of complications reduced significantly, it occurs as same as other PCI procedures.
In our country PCI procedure was first introduced in Third State Central Hospital in 2000, since then 20 years has passed. During this period coronary intravascular diagnosis and treatment developed progressively performing 14751 PTCA procedures, of those 8355(56,6%) PCI cases. By statistics of 2017, myocardial infarction occurred 1145.6 in 10000 population, showing sharp increase, and cardiovascular mortality became number one cause and has tendency to increase further.
To inform first outcome of rotational atherectomy of atherosclerosis that is severely calcified and unavailable to introduce balloon catheter or stent. To conduct atherectomy treatment methods, accustoming professionals, order and get ready the treatment materials for necessity.
We successfully performed rotablation in severely calcified mLAD of 56 years of male patient by staged PCI, whose infarct related artery Lcx was revascularized 3 months previously. As a result the patient was fully revascularized, the balloon catheter passed through the narrowing and stent was implanted successfully.

Background: An aim of this study was to evaluate the long-term functional outcomes of laparoscopic ureteropyeloplasty compared to that of open surgery at the Urology and Andrology Center of the First Central Hospital of Mongolia. Ureteropelvic junction (UPJ) is the most common site for upper urinary tract obstruction occurring 1 in 750 - 1500 births. Laparoscopic pyeloplasty was first reported in 1993 by Schuessler WW and its technique was dismembered pyeloplasty. Material and Methods: In the period from June 2018 to September 2019, we have operated 91 ureteropyeloplasty cases. Patients were randomized into Group I (45 laparoscopy) operated by the laparoscopic ureteropyeloplasty and Group II (46 open surgery) operated by the open ureteropyeloplasty. All the patients had ureteropelvic junction obstruction and ureteropyeloplasty was performed. Both groups were compared according to the operative time, and recovery duration. We studied restoration of renal function and causes of conditions. Demographic data including age, gender and complications were recorded. Renal diethylenetriamine penta-acetate scintigraphy was respectively performed 6 months after surgery. Results: Mean age was 32±12.05 ranging 16-62 in all the study population. A total of 91 (55 men and 36 women) were participated. Ureteropelvic junction stricture was occurred 75.66% in laparoscopic cases and 84.78% in open cases which leads to hydronephrosis and it was statistically different (p<0.028). Compared to that of open surgery, wound size was 6 time smaller, blood loss and hospital stay less than 2 fold and wound healing is 5 days shorter than open surgery. There was statistical different (p<0.001) between parameters of 2 groups. In laparoscopic and open group respectively, renal function was 41.78±10.02ml/min, 42.15±11.34 ml/min (1.73м2). After intervention, renal function was increased by (46±10.17ml/min, 46.09±11.50ml/min) and there was difference between 2 groups (p<0.003). In laparoscopic group, renal function was more improved than open group (p=0.05). Conclusion Laparoscopic surgery had less blood, less analgesics usage, fewer hospital stays, and faster wound healing. Renal function was improved 6 months after surgery.