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: Carotid artery stenting is increasingly being selected as the treatment for severe (≥70%) carotid artery stenosis, creating a growing need to prevent potential secondary complications associated with the procedure. In-stent restenosis (ISR) remains an important complication during long-term follow-up after carotid artery stenting. In this clinical case, we have addressed risk factors, pathogenesis, diagnosis, treatment, and monitoring of in-stent restenosis. Case Presentation: We describe the case of a 70-year-old man with severe, symptomatic IRS detected 1.8 years after carotid artery stenting (CAS). Conclusion IRS following carotid artery stenting is a clinically significant complication that may adversely affect cerebral perfusion and increase the risk of recurrent ischemic stroke. Early detection and follow-up with carotid duplex ultrasonography, regular follow-up, and lifestyle modifications, particularly smoking cessation, are essential for prevention of adverse cerebrovascular events.

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: 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: 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: Gliomas are common primary brain tumors of glial origin in adults with a poor prognosis. Tumor-related inflammatory cytokines such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and aquaporin-4 (AQP-4) water channel protein have been reported to be expressed in gliomas Aim: This study aimed to determine their serum levels in patients with primary brain tumors compared to healthy controls and to evaluate their potential diagnostic value. Materials and Methods: Serum AQP-4 levels were measured by ELISA in 28 patients with primary brain tumors (PBT) and 26 healthy controls. IL-6 and TNF-α were assessed by flow cytometry in 59 PBT patients and 52 controls. Results: Among the primary brain tumor cases, 45.61% were meningiomas, 26.32% anaplastic astrocytomas, 8.77% glioblastomas, and 12.28% other tumors (including chondroma, ependymoma, schwannoma, craniopharyngioma). Serum IL-6, TNF-α, and AQP-4 levels were significantly higher in the PBT group compared with healthy controls. Conclusion Elevated serum levels of AQP-4, IL-6, and TNF-α in patients with primary brain tumors suggest that these biomarkers molecules could represent valuable non-invasive biomarkers for the early detection of PBT.

Introduction: According to the World Health Organization (WHO) in 2020, brain and central nervous system (CNS) cancers account for 2% of all newly diagnosed cancers in the world and 1.5% in Mongolia. Approximately 85-90% of all brain and other CNS tumors were diagnosed primary brain tumor. In 2019, the average 5 year survival probability was 50% for other cancers and 11% for the primary brain tumors. There were 28 patients with primary brain tumor and 33 relatively healthy individuals in our study. Goal: To study the diagnostic value of serum aquaporin-4 and glial fibrous acidic protein in the diagnosis of primary brain cancer Material and Methods: The Department of Neurosurgery at Third central hospital included 28 patients with primary brain cancer and 33 relatively healthy people. The study was conducted under the permission of the Medical Ethics Review Committee of the Ministry of Health on June 19, 2019 №119. Serum aquaporin-4 and glial fibrous acidic protein content was determined by the ELISA kits method using the human aquaporin-4 and glial fibrous acid protein test kit of the Chinese company “Sanlong”. The level is assumed to be true if the p value is less than 0.05. Results Mean age of the all participants was 42.9±16.5, 64% female and 36% male. Serum aquaporin-4 protein levels were 175.71±13.3 pg/ml and serum glial fibrilliary acidic protein levels were 2.682±0.218 ng/ml in patient with primary brain tumor. Serum aquaporin-4 protein and glial fibrilliary acidic protein levels were statistically significant high (p<0.001) in patient with primary brain tumor. Serum aquaporin-4 protein and glial fibrilliary acidic protein level differences were statistically significant (p<0.05) in benign and malignant tumor. There was no statistically significant correlation between serum aquaporin-4 and glial fibrillary acidic protein level and primary brain tumor grade.

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.

BACKGROUND: Toll like receptors (TLRs) are a class of proteins that key role in the innate immune system. TLR7 is expressed on monocytes, macrophages and dendritic cells, T cell, B cell and eosinophiles. TLR7, originally identified as recognizing imidaquinoline, loxibrine, broprimine and ssRNA, ssRNA viruses such as vesicular stomatitis virus, influenza A virus and human immunodefiency virus. It is known that virus ssRNA affects signaling molecule of IFN-y. Objective: To determine gene and protein activation of IFN-y signal transduction by TLR7 ligand in the endothelial cells. MATERIAL: In study we used mouse aortic linear endothelial cell which is cultured (END-D) in 5% heat- inactivated fetal calf serum (FCS), medium (DMEM) containing antibiotic mix(penicillin G, streptomycin, amphotericin B) at 37°C (5% CO2). Endothelial cells treated with synthetic IFN-γ and imiquimodligands, then the NO (nitric oxide) concentration in the supernatant is determined by Griess reagent. Endothelial cells are cultured in 6 well cell culture plate and in each well 2*104cells are expected to be grown for 24 hours of culture. Then, the cells are treated with synthetic IFN-γ and имиквимод ligand for 6 hours and the NO signaling gene activation iNOS mRNA expression which is induced by IFN-γ is determined by RT-qPCR. Endothelial cells are cultured in 12 well cell culture plate and in each well 2*104 cells are expected to be grown for 18 hours of culture. Then, the cells are treated with synthetic IFN-γ and imiquimodligands for 24 hours and the NO signaling protein iNOS expression which is induced by IFN-γ is determined by western blotting. The experiment was conducted as representation mean of at least three test results. The difference between statistical probabilities is determined by the “Students” t test. The p<0.01 value is assumed to be statistically different. RESULTS: TLR7 ligand imiquimodaugmented interferon gamma induced nitric oxide production TLR7 ligand imiquimodincreased interferon gamma induced iNOS mRNA gene expression. TLR7 ilgand imiquimodup-regulated interferon gamma induced iNOS protein expression. CONCLUSIONS: TLR7 ligand imiquimod augments IFN-γ signaling in the endothelial cells. This synergistic effect has revealed in the levels of gene and protein expression.