Introduction: Hearing loss adversely impacts communication, cognitive function, and quality of life, yet early detection among adults remains inadequate. Despite the availability of portable, cost effective tablet-based audiometric screening tools, national-level prevalence data on adult hearing loss in Mongolia are scarce, and no large-scale screening studies in primary health care settings have been conducted to date. Goal: This study aimed to determine the prevalence of screen-detected hearing loss among adults in Ulaanbaatar, evaluate its association with age and test frequency, and identify associated factors. Material and Methods: A cross-sectional study was conducted at primary health care clinics across nine districts of Ulaanbaatar (2024–2025), enrolling 2,335 adults (≥18 years). Hearing screening was performed using the MAICO easyTone device with DD65 v2A headphones at 500–6000 Hz (30 dB HL at 500 Hz; 20 dB HL at remaining frequencies), with ambient noise monitored per ANSI S3.1-2008. Each ear was classified as Pass or Refer at each frequency. Outcomes included screen-detected hearing loss (SD-HL), speech-frequency hearing loss (SD SFHL, 500–2000 Hz), and high-frequency hearing loss (SD-HFHL, 4000–6000 Hz), each categorized as bilateral or unilateral. Associated factors were assessed by univariable and multivariable logistic regression. Results: SD-HL was identified in 37.2% of participants (bilateral: 31.5%; unilateral: 5.7%), SD-SFHL in 30.6%, and SD-HFHL in 36.3%. Prevalence increased markedly with age, from 29.9% (40–49 years) to 96.6% (≥70 years) (p<0.001). On multivariable logistic regression, male sex was inversely associated with a positive screening result (OR=0.65, 95% CI: 0.42–0.99, p=0.049). Conclusion The findings of this study confirm that the MAICO easyTone tablet-based hearing screening device is a feasible and appropriate tool for the early detection of hearing loss among adults in routine primary health care settings in Ulaanbaatar. The high prevalence of screening-detected hearing loss underscores the urgent need to establish adult hearing screening programs in Mongolia. Future studies should include standard audiometric confirmation in participants with positive screening results to determine the diagnostic validity of this hearing screening approach.

Background: Leptopyrum fumarioides (L.) Reichenb a relatively widely distributed annual herbaceous plant belonging to the Ranunculaceae family, grows predominantly in the dry steppe regions of Mongolia. In recent years, the global use of traditional medicine and natural products has increased substantially. In this context, elemental studies of medicinal plants including macroelements, microelements, and heavy metals provide a fundamental scientific basis for evaluating their nutritional value, therapeutic efficacy, safety, and standardization. Therefore, the investigation of the elemental composition of Leptopyrum fumarioides (L.) Reichenb is of significant importance as a foundational study supporting its medicinal application. Aim: To investigate the chemical elements, present in Leptopyrum fumarioides (L.) Reichenb. Objectives: 1. To prepare plant samples and determine the contents of aluminum oxide, silicon dioxide, iron oxides, and calcium oxide in the plant material. 2. To identify and quantify the mineral elements present in the plant material. 3. To investigate the heavy metals in the plant material. Materials and Methods: Leptopyrum fumarioides (L.) Reichenb were collected from Altanbulag soum, Töv Province, Mongolia, during the flowering stage in June 2023. The collected plant materials were air dried in accordance with standard procedures and used for analysis. The quantitative contents of macroelements, microelements, and ultra-trace elements in the plant were determined using high precision X ray fluorescence (XRF) analysis. Result: In the raw plant material of Leptopyrum fumarioides (L.) Reichenb, the silicon dioxide (SiO₂) content was 15.99%, which increased to 33.69% in the extracted residue. Titanium dioxide (TiO₂) was present at 0.16% in the raw material and 0.379% in the plant residue. Aluminum oxide (Al₂O₃) was 3.54% in the raw material and 7.52% in the extracted residue. Iron oxide (Fe₂O₃) was 1.14% in the raw material and 2.51% in the residue. Other oxides, including calcium oxide (CaO), potassium oxide (K₂O), and phosphorus pentoxide (P₂O₅), remained in the extracts. The concentrations of trace elements in the plant were determined as follows: copper (Cu) 40.5 mg/kg, zinc (Zn) 211 mg/kg, chromium (Cr) 8.5 mg/kg, and nickel (Ni) 8 mg/kg. The levels of Zn (211 mg/kg) and Cu (40.5 mg/kg) were found to be relatively higher compared to those reported in other plant species. Conclusion 1. In the raw plant material of Leptopyrum fumarioides (L.) Reichenb, silicon dioxide (SiO₂) content was 15.99%, increasing to 33.69% in the extracted residue. Titanium dioxide (TiO₂) was 0.16% in the raw material and 0.379% in the residue. Aluminum oxide (Al₂O₃) was 3.54% in the raw material and 7.52% in the extracted residue. Iron oxide (Fe₂O₃) was 1.14% in the raw material and 2.51% in the residue. Other oxides, including calcium oxide (CaO), potassium oxide (K₂O), and phosphorus pentoxide (P₂O₅), were retained in the extracts. 2. The trace element analysis revealed the following concentrations: copper (Cu) 40.5 mg/kg, zinc (Zn) 211 mg/kg, chromium (Cr) 8.5 mg/kg, and nickel (Ni) 8 mg/kg. The levels of Zn (211 mg/kg) and Cu (40.5 mg/kg) were higher than those typically found in most plants; however, these concentrations are below the threshold considered toxic to plant physiology. Rubidium (Rb) at 49 mg/kg and zirconium (Zr) at 69 mg/kg were also relatively high compared to other elements. This may be related to the ability of Leptopyrum fumarioides (L.) Reichenb to accumulate certain elements when growing in moderately contaminated soils near cultivated fields. 3. Rare earth elements, such as cerium (Ce) and ytterbium (Yb), were found to be below the general concentration range and can be considered within normal limits. Furthermore, the plant contains numerous trace elements that participate in various enzymatic activities and contribute to the components of the blood coagulation system.

Background: Speech audiometry is a widely used standard diagnostic method in the evaluation of hearing and auditory function. It requires word materials that are developed in the native language of the target population and that reflect its phonetic characteristics. Because the phonetic structure, pronunciation, and familiarity of words directly influence speech recognition, it is essential to use language-specific word lists that are phonetically balanced, uniformly distributed, and psychometrically validated to ensure the accuracy and reliability of testing. Therefore, there is a strong need to develop Mongolian bisyllabic word lists that are balanced in both phonetic and psychometric properties, which forms the basis of this study. Aim: To develop psychometrically balanced Mongolian bisyllabic word lists for use in speech audiometry and to evaluate their suitability for determining the Speech Recognition Threshold (SRT). Materials and Methods: Fifty-five commonly used and phonetically balanced Mongolian bisyllabic words were selected and recorded by a professional female speaker. The recordings were presented to 50 normal-hearing participants aged 18–29 years at ten intensity levels ranging from –4 to 14 dB HL in 2-dB steps. Based on participants’ responses, the 50% SRT and the 20–80% slope of the psychometric function for each word were calculated using logistic regression. Chi-square and one-way ANOVA analyses were performed to examine the equivalence between lists. On the basis of these results, two psychometrically balanced half-lists, each containing 25 words, were constructed, and digital level adjustments were applied to ensure uniform intensity. Result: The slopes of the psychometric functions for the two half-lists ranged from 11.2 to 11.6 %/dB. Chi-square and one-way ANOVA analyses showed no statistically significant differences between the two lists in terms of the 50% SRT and psychometric slope derived from logistic regression [χ²(24, N=50) = 2.21, p = 0.99; F(1,48) = 0.00895, p = 0.925]. The mean pure-tone average (PTA) threshold of the 50 normal-hearing participants was 2.23 dB HL with a standard deviation of 4.4 dB. The difference between PTA and SRT was less than 10 dB HL for all participants, which is within the clinically acceptable range. Conclusion The developed Mongolian bisyllabic word lists, consisting of two 25-word sets, are suitable for determining the Speech Recognition Threshold and can be reliably applied in clinical speech audiometry practice.

Background: Choriocarcinomas after full-term pregnancies are a rare entity. Case presentation: A 34-year-old woman was admitted to the hospital with a seizure in a comatose state. A computed tomography scan revealed an intracerebral haemorrhage in the right parietal region. A chest CT scan showed a single metastatic lesion in the right upper lung field. The patient delivered a viable infant at 39 weeks of gestation, 4 months before the hospitalisation. Her pregnancy course was uncomplicated. Despite receiving intensive treatment, the patient died 1 day later. Choriocarcinoma was diagnosed at the autopsy. Conclusion Metastatic choriocarcinoma should always be in the differential diagnosis for women of childbearing age presenting with unexplained stroke-like symptoms.

Background: Cancer is not only a physiological disease but also a complex condition that profoundly affects an individual’s psychological well-being and social relationships. Misconceptions about cancer within the public, including its association with death and the tendency to attribute blame to patients as being “personally responsible,” contribute to the development of social stigma among cancer survivors. This stigma negatively impacts patients’ engagement in treatment and their quality of life, highlighting the need to assess societal attitudes based on survivors’ lived experiences. Aim: To examine the everyday lived experiences of cancer survivors, measure perceived social stigma, and identify psychological challenges as well as sources of support. Materials and Methods: A mixed-methods design was employed. In the quantitative component, the Cancer Stigma Scale (CASS) and the Attitudes Toward Cancer Questionnaire (ATCQ) were translated and their content validity was evaluated by an expert panel using the Content Validity Index (CVI), followed by pilot testing to confirm feasibility (FVI). In the qualitative component, focus group discussions were conducted with cancer survivors, and coping ability was assessed using psychological assessment tools. Result: A total of 207 participants (68% female; mean age 33.82±13.7 years) were included in the quantitative study. Participants experienced a moderate level of cancer-related stigma, with negative attitudes most strongly associated with perceptions of disease severity and individual responsibility. Qualitative findings revealed that physician communication and family support played a decisive role in psychological responses at the time of diagnosis disclosure. Excessive sympathy or social distancing increased psychological distress, whereas normal interpersonal interaction and realistic encouragement were identified as the most effective forms of support. Conclusion To improve psychosocial support for cancer survivors, it is essential to enhance healthcare professionals’ communication skills, promote accurate public understanding of cancer, and strengthen the sustainability of survivor support group activities.

Background: Respiratory and gastrointestinal infectious diseases are the leading causes of morbidity in children. Numerous international studies have demonstrated that handwashing with soap is one of the most effective and cost-efficient methods for preventing these diseases in children. A previous study conducted in Ulaanbaatar found that only 50.1% of general education school students practiced proper handwashing, which is considered insufficient even in areas with relatively adequate facilities. In Mongolia, 56.1% of the 865 schools lack handwashing facilities and soap, and 25% do not meet the WASH standards. Although knowledge about handwashing increased during the COVID-19 pandemic, sustained behavioral change remained limited, highlighting a gap between knowledge and practice and indicating the need for targeted educational interventions. Furthermore, there is limited research comparing the effectiveness of such interventions across different school environments and urban–rural settings, which provides the rationale for this study. Aim: To evaluate the effectiveness of a handwashing educational intervention among primary school students and determine differences in knowledge change across four schools in urban and rural areas. Materials and Methods: A quasi-experimental study design was used from December 2024 to June 2025. A total of 1,353 students from grades 3–5 in four general education schools (two in Ulaanbaatar and two in rural areas) were included in the study. Preand post-intervention handwashing knowledge scores were analyzed using paired t-tests and one-way ANOVA (α=0.05) with STATA 14.0. Ethical approval was obtained from the Ethics Committee of the Mongolian National University of Medical Sciences. Result: The mean handwashing knowledge score increased significantly from 9.68 (±2.64) before the intervention to 10.30 (±2.74) after the intervention, with a mean difference of +0.63 (p<0.001). The differences in improvement between schools were also statistically significant (ANOVA: F(3,1335)=5.90, p=0.0005). The highest improvement was observed in urban School A (+1.49), while the lowest was observed in School B (+0.16). Rural schools C and D showed moderate and relatively consistent improvements (+0.51 and +0.70, respectively). Conclusion School-based handwashing educational interventions effectively improve knowledge among primary school students. However, environmental factors, such as infrastructure and geographic location, significantly influence the effectiveness of the intervention. Therefore, educational interventions should be implemented alongside infrastructure improvements.

Background: According to a study by US scientists, 1/3 percent of the world’s population uses tobacco, and the use of tobacco has steadily decreased over the years, while the use of tobacco-like products, including electronic cigarettes, has increased rapidly. In order to combat this problem, it is necessary to assess the knowledge about e-cigarettes among young people, who are considered to be the main users of e-cigarettes. The lack of research on e-cigarettes is the basis for this study. Aim: To evaluate the knowledge of electronic cigarettes among Nursing students of the School of Nursing. Materials and Methods: The study was conducted by randomly selecting 128 first-year Bachelor of Nursing students from the School of Nursing and taking a questionnaire. The results of the research were statistically processed using the IBM statistics SPSS-25.0 program. Results: Considering the age of the students in the study, 18 years old (41.4%), 19 years old (46.9%), and 20 years old (11.7%) were included. Regarding gender, 113 (88.3%) were female and 15 (11.7%) were male. 65 (50.8%) of the students are enrolled from Ulaanbaatar city, 63 (49.2%) from the local area. When assessing knowledge about electronic cigarettes, 100 (78.1%) had knowledge and 28 (21.9%) had no knowledge. Among students who smoke, 34 (87.2%) smoke e-cigarettes and 5 (12.8%) smoke cigarettes. Sex, where you started, and who you live with are irrelevant to e-cigarette use. But the smoking status is that 32 (36.0%) smoke by themselves with someone in the family who smokes, 7 (17.9%) smoke by themselves without a smoker in the family, friends smoke e-cigarettes 37 (34.3%) smoke by themselves, friends 2 (10%) are related to self-attractors who do not attract friends. (p=0.022) who the participants live with is the motivation for smoking. 36% of students who live with their parents smoke, while 64% of students who live apart from their parents smoke. 84.4% of respondents do not know that e-cigarettes contain propylene glycol, 15.6% do, 63.3% do not know that electronic cigarettes contain benzene, and 36.7% do. Conclusion The level of knowledge about electronic cigarettes among nursing students was insufficient. In addition, having family members or friends who smoke was found to influence students smoking behavior.

Background: Bone mineral density (BMD) is a key indicator reflecting bone strength and resistance to fracture. It is influenced by multiple factors, including age, sex, genetic background, body composition, nutrition, and physical activity. During young adulthood, peak bone mass is actively formed; therefore, identifying early variations in this period is essential for predicting future skeletal health risks. Accordingly, assessing BMD and evaluating its relationship with physical characteristics among first-year nursing students provides a scientific rationale for this study. Aim: To examine the relationship between bone mineral density and selected physical parameters among students. Materials and Methods: A total of 297 first-year students aged 17-35 years from the School of Nursing, Mongolian National University of Medical Sciences were included. Bone mineral density was assessed by measuring the speed of sound through the radius using an ultrasound bone densitometry device. Handgrip strength was measured using an electronic dynamometer. Physical parameters including age, sex, height, and body weight were measured using standardized procedures, and statistical analysis was performed. The study was approved by the Research Ethics Committee of MNUMS on November 21, 2025 (No. 26/1) and March 28, 2026 (No. 26/03-B02), with no ethical violations identified. Results: According to T-scores, 37.1% (n=110) of participants had normal bone status and 62.9% (n=187) showed reduced bone density. Based on Z-scores, 52.5% (n=159) were normal, while 45.6% (n=138) had decreased values. T-score values were 1.87±0.69 (<20 years), 1.44±0.55 (20–30 years), and 1.10±0.31 (>30 years), while Z-score values were −0.73±1.38, −0.43±1.23, and −0.02±1.27, respectively. ANOVA analysis revealed statistically significant differences among age groups (p<0.01). A positive correlation was observed between T-score and age, whereas no significant correlations were found with other physical parameters. Z-score showed a positive correlation with handgrip strength. Conclusions 1. A high prevalence of reduced bone mineral density was observed among the students, which may be associated with incomplete attainment of peak bone mass in adolescents and young adults. 2. A significant difference in bone mineral density was found between age groups (p<0.01), indicating that age is an important factor influencing bone mineral density.

Background: Thrombotic alterations play a central role in the pathogenesis of both macrovascular and microvascular complications of diabetes mellitus. D-dimer, a fibrin degradation product generated during fibrinolysis, has emerged as a potential biomarker for predicting chronic diabetic complications and assessing their severity. Aim: To determine D-dimer levels in individuals with type 2 diabetes mellitus (T2DM) and investigate their association with various microvascular complications. Materials and Methods: This cross-sectional study included 215 participants with T2DM. Individuals diagnosed with other forms of diabetes, those receiving anticoagulant therapy, and those with liver disease were excluded according to the predefined exclusion criteria. Participants were categorized into two groups according to their D-dimer levels: ≤0.260 μg/mL and >0.260 μg/mL. The prevalence of diabetic retinopathy, nephropathy, and neuropathy was compared between the groups. Multivariable logistic and linear regression models were adjusted for age, sex, and body mass index (BMI). Results: A total of 215 individuals with T2DM were included in the study. The median D-dimer level was 0.260 μg/mL (interquartile range [IQR]: 0.190–0.460). The prevalence of at least one microvascular complication was significantly higher among participants with D-dimer levels above the median than among those with levels at or below the median (51.4% vs. 37.0%, p=0.034). The prevalence of diabetic nephropathy was 33.6% versus 13.0% (p<0.001), while that of diabetic neuropathy was 20.6% versus 10.2% (p=0.035), respectively, indicating a higher burden of chronic complications in the group with elevated D-dimer levels. Participants with D-dimer levels above the median had 2.23 times higher odds of having at least one diabetic microvascular complication (OR=2.23; 95% CI: 1.19–4.18; p=0.013). Conclusions 1. Elevated D-dimer levels were observed in 21.4% of individuals with type 2 diabetes mellitus included in the study. 2. D-dimer levels above the median (0.260 μg/mL) were associated with a twofold increase in the odds of having diabetic microvascular complications (OR=2.23; 95% CI: 1.19–4.18; p=0.013).

Background: Cerebral venous sinus thrombosis (CVST) is defined as the formation of a blood clot within the cerebral venous drainage system. Its incidence is approximately 11.6 cases per 1 million population, and it occurs about twice as often in women as in men. Mortality and disability are reported in 20–25% of patients. Headache is the most common presenting symptom; therefore, differential diagnosis based on pain intensity, location, and clinical examination is essential. Case presentation: In this case, early diagnosis was established using MR venography, and timely, appropriate treatment led to successful dissolution of a thrombus in the sagittal sinus, preventing potential complications and long-term disability. Treatment included high-dose unfractionated and low-molecular-weight heparin administered parenterally, resulting in symptom relief, reduced headache intensity, and improvement in orientation and self-care ability. Prolongation of aPTT seconds indicated a favorable therapeutic response. Subsequently, the patient was transitioned to oral anticoagulant therapy with rivaroxaban (Xarelto) 20 mg. To improve the diagnosis of CVST, the implementation of MR venography and CT venography is recommended in Darkhan-Uul province. Conclusion This is the first case of CVST diagnosed in Darkhan-Uul province, suggesting that further cases may occur. Because headache is the most common presenting symptom, differential diagnosis based on its intensity, character and clinical examination is essential. Early diagnosis with MR venography and timely anticoagulation resulted in recanalization of the superior sagittal sinus and prevented complications and disability. MR and CT venography should be introduced for the diagnosis of CVST in Darkhan-Uul province.