Background: Sjögren’s syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, particularly the lacrimal and salivary glands, as a result of genetic and environmental factors, and it is mainly manifested by mucosal dryness. Sjögren’s syndrome is a rare disorder with a prevalence of approximately 6 cases per 1,000 population and shows a marked female predominance. It is most commonly diagnosed between the ages of 40 and 60 years. Anemia is observed in about 70% of patients diagnosed with Sjögren’s syndrome; however, autoimmune hemolytic anemia occurs in only approximately 3% of cases. In this report, we present a rare case of Sjögren’s syndrome that manifested with warm autoimmune hemolytic anemia. Conclusion In cases of autoimmune hemolytic anemia of unknown etiology, it is crucial to investigate the underlying causes leading to hemolysis in order to establish the differential diagnosis and to confirm or exclude the condition. Sjögren’s syndrome typically presents initially with sicca symptoms, with chronic anemia developing during the course of the disease and its treatment. In contrast, in our case, persistent manifestations of autoimmune hemolytic anemia over a prolonged period represented the initial clinical presentation that led to the diagnosis of Sjögren’s syndrome. Immunological markers play a key role in the diagnosis of this syndrome, as they are essential for early detection of Sjögren’s syndrome, timely diagnostic confirmation, monitoring of disease progression, and adjustment of therapeutic dosing.

Background: Branch atheromatous disease (BAD) is believed to be one subtype of ischemic stroke brought on by plaque accumulation that obstructs or stenoses the entrance of penetrating branches. Based on clinical status, risk factors, laboratory results, and radiographic features of infarct and blood vessel morphologies, BAD has been differentiated from large-vessel occlusion and small-vessel disease. BAD-induced stroke has been strongly associated with worse outcomes than lacunar strokes, including high rates of early neurological deterioration (END), recurrent transient ischemic attacks and strokes, and disability. Determining treatment options and each patient’s prognosis depends on early identification of BAD. Case Presentation: A 34-year-old male with a history of recurrent acute ischemic stroke within 7 months, caused by stenosis of the M1 segment of the right middle cerebral artery, was hospitalized twice at the Third Central Hospital of Mongolia. Intravenous Thrombolytic therapy (tPA) was administered during each admission. Conclusion Precise diagnosis of BAD is crucial for planning subsequent treatment and secondary prevention.

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: Chronic gastric disorders, including Helicobacter pylori-related diseases, remain an important health issue. In classical Mongolian medical sources, gastric disorders are described through concepts such as gastric parasitic disease, badgan worm and tsankh. However, these descriptions have not been sufficiently synthesized through a source-based approach. Aim: This study aimed to systematically summarize terminology, etiology, pathogenesis, classification, symptoms, treatment principles, prescriptions and medicinal raw materials related to gastric parasitic disease in traditional Mongolian medical sources, and to cautiously compare selected concepts with modern knowledge of H.pylori. Materials and Methods: A qualitative source-study design was used. Classical and commentary sources, including Bumshi, the Four Medical Tantras, Moon King of Therapy, Altan Khadmal, Bider-Onbo, Managlkhantav, Four Nectars, Uvdisyn Dalai and Mash Gaikhamshigt Khurimyn San, were reviewed. Textual analysis, thematic coding, content analysis, hermeneutic interpretation and comparative analysis were applied. A limited comparison with H.pylori morphology, pathogenesis and symptoms, as well as selected research directions on ingredients of Ruda-6, was included. Results: The sources describe gastric parasitic disease as a condition associated with badgan predominance, digestive weakness, putrefactive processes and accumulation in the stomach. Traditional descriptions such as twisted, thin, long and bundled forms were not considered identical to H.pylori, but they may be compared cautiously with the spiral and motile characteristics of the bacterium at a descriptive level. Repeated symptoms included epigastric pain, stabbing or twisting pain, bitter or sour regurgitation, vomiting, indigestion and weakness. Treatment principles mainly included resolving putrefaction, pacifying the worm, supporting digestion and restoring the balance of badgan. Some medicinal materials used in Ruda-6 have been discussed in modern research in relation to antimicrobial, anti-inflammatory or gastroprotective effects, which may provide a basis for further experimental studies. Conclusion The traditional concept of gastric parasitic disease has a relatively comprehensive structure in terms of terminology, pathogenesis, symptoms, treatment principles, medicinal raw materials, and prescription use. This study systematizes information from traditional sources and related works and, without directly equating it with H. pylori, provides a basis for comparative interpretation and a foundational resource for future classification, pharmacological, and clinical research.

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.

Background: The prevalence of neck pain among adults worldwide is 4.9-22.3%. It occurs in 34.7% of office workers in industrialized countries. Aim: To study the effect of massage therapy of Mongolian medicine on neck pain Materials and Methods: In this study, a parallel clinical trial design was used, and 50 patients with neck pain were divided into two groups: the treatment group received massage therapy of Mongolian medicine and the control group received exercise therapy, and the treatment results were compared. VAS assessment, NDI, Digital Algometer, and European Quality of Life Questionnaire were used in the study. Results: 52 % of the study participants were male, while 48 % were female, and their mean age was 43.3±21.3. The VAS score for pain assessment was 5.44±0.96 in the treatment group and 5.44±0.96 in the comparison group before treatment, but after the treatment it decreased to 0.80±0.71 in the treatment group and 1.44±0.77 in the comparison group, respectively, which showed a statistically significant difference. Massage therapy of Mongolian medicine has a greater pain-relieving effect than exercise therapy in the treatment of neck pain (p<0.01). The pressure pain threshold was 934±154.60 in the treatment group and 934±154.60 in the comparison group before treatment, but after treatment, it increased to 1536±22.91 in the treatment group and 1392±83.77 in the comparison group, which was statistically significant (p<0.01). The neck disability index of patients with neck pain was 11.44±2.87 in the treatment group and 11.56±2.55 in the comparison group before treatment, but after treatment it decreased to 0.84±0.69 in the treatment group and 1.40±0.87 in the comparison group. Although exercise therapy has the effect of reducing the neck disability index, when comparing the treatment results of the two groups, massage therapy of Mongolian medicine had greater effect (p<0.05). European Quality of Life Questionnaire was 8.64±2.25 in the treatment group and 8.16±1.60 in the comparison group before treatment, but after treatment it was 5.28±0.54 in the treatment group and 7.44±1.23 in the comparison group. Massage therapy of Mongolian medicine has a greater effect on improving the quality of life of people with neck pain compared to exercise therapy (p<0.01). The neck forward bending was 36.60±2.45 in the treatment group and 37.24±2.35 in the comparison group before treatment, but after treatment, it increased to 42.32±2.14 in the treatment group and 39.32±2.14 in the comparison group, which was statistically significant (p0.01).The neck abduction was 36.20±1.89 in the treatment group and 36.56±2.24 in the comparison group before treatment, but after treatment, it increased to 42.80±2.06 in the treatment group and 39.76±1.88 in the comparison group, which was statistically significant (p=0.01).The neck left rotation was 60.84±3.77 in the treatment group and 61.56±4.31 in the comparison group before treatment, but after treatment, it increased to 75.08±3.55 in the treatment group and 67.20±4.29 in the comparison group, which was statistically significant (p0.01). The neck right rotation was 61.80±4.39 in the treatment group and 62.00±4.42 in the comparison group before treatment, but after treatment, it increased to 76.52±2.95 in the treatment group and 68.04±4.46 in the comparison group, which was statistically significant (p0.01).When comparing the treatment results of the two groups, Mongolian medical bariatric surgery was more effective (p<0.01). Conclusions 1. Massage therapy of Mongolian medicine reduces disability index in people with neck pain (p<0.05). 2. Massage therapy of Mongolian medicine has a significant effect on reducing pain and pressure pain threshold in people with neck pain (p<0.01). 3. Massage therapy of Mongolian medicine has the effect of improving the quality of life of people with neck pain (p<0.01).

Background: Since August 2021 in Mongolia, the rapid spread of the SARS-CoV-2 Delta variant among the population coincided with the reopening of all levels of educational institutions, including universities, general education schools, and kindergartens, for in-person learning. Aim: To examine the impact of the measures implemented when school was reopened with in-person learning on COVID-19 morbidity among school children, to assess the overall infection situation in children, and to determine whether any school-based outbreak clusters occurred during the Delta variant surge. Materials and Methods: This study used national data from confirmed COVID-19 cases recorded in the electronic surveillance system between January 1, 2021, and February 28, 2022, including all cases and those among children aged 0-17 years. The 7-day moving average of the proportion of cases among children was calculated, representing the average proportion of pediatric cases during the preceding seven days. Additionally, the study compared the incidence and relative risk (RR) of COVID-19 among children aged 0-17 years at the time of school reopening on September 1, 2021, with those observed during previous outbreaks caused by the SARS-CoV-2 Wuhan, Alpha, and Omicron variants. As vaccination was available only for adolescents aged 12-17 years, the analysis was stratified by three age groups: 0-4, 5-11, and 12-17 years. Results: Throughout the study period, the proportion of COVID-19 cases among children aged 0–17 years nationwide ranged from 0.73% to 5.93% across outbreaks caused by the four SARS-CoV-2 variants (min 0.73%; max 8.57%). The 14-day confirmed case rate per 10,000 population was highest during the Delta (107.57) and Omicron (113.56) variant outbreaks. When comparing age groups, children aged 5–11 years were used as the reference group. During outbreaks, the relative risk for the 12–17-year group was lowest during the wild-type virus wave (RR=0.47) and highest during the Delta wave (RR=0.78). Conclusion During COVID-19 outbreaks, the proportion of pediatric cases (0-17 years) among total cases ranged from 0.73% to 5.93%, consistent with findings from studies conducted in other countries. Overall, infection rates were higher among the 0-4 and 12-17 age groups, with the highest rates among 0-4-year-olds during the Delta variant outbreak. No clustered outbreaks involving six or more cases were reported in school settings. Future studies should focus on assessing the transmission dynamics of respiratory infections among children in both household and school settings, especially during influenza and influenza-like illness outbreaks, to generate evidence for preventive measures against respiratory pathogen transmission.

Background: Research on lactic acid bacteria has confirmed how specific strains possess probiotic properties and impart unique sensory characteristics to food products. The use of probiotic lactic acid bacteria in many food products, thus confers various health benefits to humans when they are frequently consumed in adequate amounts. Aim: To determine the effect of lactic acid bacteria on the growth of tomatoes. Materials and Methods: The lactic acid bacteria were cultured using the Lactobacillus medium from whipping cream and Dandelion (Taraxacum mongolicum) and identified using the MALDI-TOF MS automated microbial identification analyzer. A solution was prepared using Lactobacillus delbrueckii isolated from whipping cream and Lactobacillus gasseri isolated from Dandelion (10^7CFU/ml), and sterilized tomato seeds were watered for 10 days with the solution, while sterilized distilled water was used as a control. The germination rate of the seeds and the root length were measured and recorded every day. Results: The solution of L.delbrueckii bacteria isolated from cream germinated 100% of the seeds, which is 4% higher than the control seeds, while the solution of L.gasseri bacteria isolated from Dandelion germinated 100%, supporting 4% higher than the control seeds. Seedlings irrigated with the L.delbrueckii bacterial solution exhibited an average length of 10.3cm, which was 1.3cm longer than the control (P=0.003), indicating a statistically significant difference. Similarly, those treated with the L.gasseri solution had an average length of 11.5cm, 2.5cm longer than the control (P=0.005), also demonstrating statistical significance. Conclusion The application of the lactic acid bacterial solution significantly enhanced both the germination of tomato seeds and the growth of the plants compared to the control solution.

Introduction: Valproic acid (VPA) has been used in the treatment of seizures and bipolar disorders. In the present study, we examined how VPA affected PI3K-Akt pathway in response to LPS by using mouse RAW 264.7 macrophage cells. Material and methods: Mouse RAW 264.7 macrophage-like cells cultured and the cell viability checked by MTT and TUNEL assay. In addition, protein expression and protein interaction were detected by immune blotting and immune precipitation, respectively. TLR4 expression on cell surface studied by FACS analysis. Results: The MTT and TUNEL assays demonstrated no significant difference between VPA at 2 mM treated and untreated control cells. VPA attenuated LPS-induced phosphorylation of phosphatidylinositol 3-kinase (PI3K) and Akt, but not nuclear factor (NF)-κB and mitogen activated protein kinases (MAPKs). There was no significant difference in the TLR4 expression on the cell surface between cells treated with or without VPA. VPA inhibited LPS-induced PI3K/Akt signal transduction in a dose dependent manner. Conclusion VPA at 2mM exhibits nontoxic effect in the RAW 264.7 cells. VPA down regulates LPS-induced phosphorylation of Akt via inhibition of PI3K activation.