Background: Sarcopenia is a multifactorial geriatric syndrome characterized by age-related loss of muscle mass, muscle strength, and physical performance. In recent years, neurotrophic and neuromuscular biomarkers have been investigated as potential diagnostic indicators of sarcopenia; however, evidence regarding their sex-specific differences remains limited. Aim: To evaluate the sex-specific associations of serum BDNF, GDNF, and CAF22 levels with sarcopenia and muscle-related parameters among older adults. Materials and Methods: This analytical cross-sectional study included adults aged 60 years and older. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS 2019) criteria. Serum BDNF, GDNF, and CAF22 levels were measured using ELISA. Group differences were analyzed using independent t-tests, correlations were assessed using Pearson correlation analysis, and diagnostic performance for sarcopenia was evaluated using receiver operating characteristic (ROC) analysis. Multivariable logistic regression analysis was also performed. Results: No statistically significant differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic participants in either the male or female groups (all p>0.05). ROC analysis demonstrated AUC values ranging from 0.540 to 0.542 in males and from 0.508 to 0.530 in females for BDNF, GDNF, and CAF22. Multivariable logistic regression analysis revealed that age (OR=1.12, 95% CI: 1.04–1.21, p=0.003) and lower fat-free mass index (OR=0.78, 95% CI: 0.66–0.91, p=0.001) were significantly associated with sarcopenia, whereas BDNF, GDNF, and CAF22 showed no independent association with sarcopenia. Conclusions 1. No statistically significant sex-specific differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic older adults (all p>0.05). 2. CAF22 levels were weakly negatively correlated with muscle mass and fat-free mass index in males (p<0.05), whereas BDNF levels showed weak positive correlations with handgrip strength and fat-free mass index in females (p<0.05). CAF22 levels also demonstrated a weak positive correlation with age (p<0.05). 3. ROC and multivariable logistic regression analyses indicated limited diagnostic utility of BDNF, GDNF, and CAF22 for sarcopenia (AUC=0.508–0.542), and none of these biomarkers showed an independent association with sarcopenia (all p>0.05). In contrast, older age (OR=1.12, p=0.003) and lower fat-free mass index (OR=0.78, p=0.001) were significantly associated with sarcopenia.

Background: Cardiovascular disease is the leading cause of death in Mongolia, and atherosclerosis is its main pathogenic factor. The cardio-ankle vascular index (CAVI) is a marker of arterial stiffness, and measuring it allows atherosclerosis to be detected before clinical symptoms appear. This study was based on the need to assess CVD risk in older adults and to plan prevention accordingly. Aim: To determine whether CAVI independently predicts CVD mortality in older adults. Materials and Methods: This prospective cohort study included 1,403 adults aged 55–95 years from five regions of Mongolia who had participated in the study “Factors Influencing Population Longevity,” (2011–2015). CAVI was measured with a VaSera VS-1000 device (Fukuda Denshi, Japan). Mortality data as of December 20, 2025 were obtained from the Center for Health Development by linking participants’ national registration numbers to the death registry. Deaths coded I00–I99 under the International Classification of Diseases, 10th revision, were classified as CVD deaths. Participants were divided into four equal groups by CAVI value (quartiles: Q1 <8.0, Q2 8.0–8.8, Q3 8.9–9.7, Q4 ≥9.8), and the cumulative incidence of CVD mortality was estimated with the Aalen–Johansen method. Cox regression analysis was adjusted for age, sex, hypertension, smoking, LDL cholesterol, HDL cholesterol and estimated glomerular filtration rate. A Fine–Gray sensitivity analysis was also performed. Results: The mean age of participants was 66.8±7.9 years. During follow-up (median 13.2 years), 121 CVD deaths (8.6%) and 127 deaths from other causes (9.1%) were recorded. The cumulative incidence of CVD mortality rose stepwise from 3.3% in Q1 to 6.0% in Q2, 9.3% in Q3 and 14.1% in Q4 (Gray’s test p<0.001). Compared with Q1, the hazard of CVD death was higher in Q3 (HR 2.03 [95% CI 1.04–3.98]) and Q4 (HR 2.42 [95% CI 1.23–4.76]) (p-trend=0.012). Per 1-unit increase in CAVI, the HRs were: crude: 1.42 [95% CI 1.24–1.63], age- and sex-adjusted: 1.19 [95% CI 1.03–1.38] and fully adjusted: 1.17 [95% CI 1.00–1.36], p=0.045. Hypertension was an independent risk factor for CVD mortality (HR 1.53 [95% CI 1.06–2.21]). Conclusion In older adults, higher CAVI predicts CVD mortality independently of age, sex and traditional risk factors, and the risk of CVD death rises stepwise with higher CAVI quartiles.

Background: Reconstruction of mandibular and maxillary defects resulting from malignant tumors has remained a complex challenge in recent years. Defects caused by tumors—as well as trauma, inflammatory diseases, and congenital anomalies—lead to impaired essential functions such as mastication, swallowing, and speech. Prior to the 1950s, reconstruction of maxillofacial hard tissue was not commonly performed. Instead, metal plates were used to reestablish bony continuity, and surrounding tissues were utilized to close soft tissue defects, without effectively restoring function. With modern advances in three-dimensional (3D) virtual planning, it is now possible to accurately plan free bone flaps for reconstructing jaw defects. During surgery, manually bending reconstruction plates to fit donor bone precisely is often not feasible. Preoperative 3D planning allows for precise fabrication of surgical guides and fixation plates, improving accuracy and significantly reducing operative time. Additionally, incorporating dental implant planning into the reconstruction process facilitates restoration of both structural and functional outcomes. Aim: To evaluate the outcomes of mandibular defect reconstruction using scapular free flaps in Mongolia and explore potential approaches to optimize the technique. Materials and Methods: This was a case study series. Data from reconstructive surgeries performed at the National Cancer Center of Mongolia, Central Dental Hospital, and the Mongolia-Japan Hospital were collected. Variables included patient age and sex, etiology of the mandibular defect, size of the scapular bone segment, operative time, ischemia time of the free flap, number of vascular anastomoses performed, and pedicle length. For 3D planning, CT scans of the patient's head and lower limb (slice thickness <1 cm) were used to generate 3D models via the 3D Slicer software. Cutting guides for the mandible and scapula (ASIGA), as well as the reconstruction models (AMS), were printed using a 3D printer. Results: A total of 400 free flap reconstructions were performed during the study period. Of these, 29 cases involved reconstruction of mandibular defects using scapular free flaps. The mean age of patients was 40.0 ± 18.3 years, with 52% (15 patients) being female. The etiologies of the defects included malignant tumors (13 cases, 45%), benign tumors (6 cases, 21%), and pre-existing defects (10 cases, 34%). In one case, tumor resection and mandibular reconstruction were performed using 3D planning. The total operative time was 9 hours and 30 minutes, and the ischemia time was 2 hours and 40 minutes. Conclusion Between 2012 and 2025, a total of 29 mandibular reconstructions using scapular free flaps were performed in Mongolia. Traditional reconstruction methods were associated with prolonged ischemia time. The use of 3D surgical planning has shown potential in significantly reducing ischemia time and improving surgical outcomes.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.

Introduction: Factors such as social and economic conditions, technological development, modern urbanization, lifestyle, physical activity, nutrition, and air pollution affect physical growth and development. Aim: To study the physical development of Mongolian children. Objectives: 1. To measure the physical indices (weight, height) of children aged 6-17 years old with some influencing factors. Material and method: Using a random sampling method, children's body height and weight were examined at a particular point in time using widely accepted methods. Statistical analysis was performed using the "SPSS ver.25" program. Result: The growth of children's height and weight is progressing according to general patterns of age and gender. Girls grow rapidly between the ages of 10-13 and stabilize after wards, while boys a sharp growth spurt between the ages of 13-17, with the average height of 17-year-old boys being 171.44 cm and 160.25 cm for girls, which is slightly higher than previous studies (Otgon G, 2006, Munkhzaya M, 2020). The trend of weight growth is more prominent in boys. However, compared to international standards (Russia, WHO, CDC), our children's height and weight are lower. The statistics show that parental education, income, exercise, and living environment positively influence growth and development, whereas excessive television watching and air pollution negatively affect it (p< 0.05). Conclusion 1. Children's growth is normal, but observed increase of the body weight of boys. Having healthy and well educated parents, as well as engaging in physical activity positively influences children's height. A lack of physical activity negatively affects height and increases weight. Mongolian children are shorter and lighter compared to foreign children (from Russia and America - CDC).

Emergency cesarean section risk factors of Robson 1, 2A, 3, 4A Introduction: Cesarean section rates in Mongolia exceed WHO recommendations of 5–15%, reaching 27.6% nationally and 34.1% at the First Maternity Hospital between 2019–2023. C-sections, while life-saving, increase risks of hemorrhage, infection, uterine complications, and reduced maternal quality of life. This study aimed to analyze emergency C-sections by Robson classification and identify associated risk factors in groups 1, 2a, 3, and 4a. Material and methods: A retrospective case-control study was conducted using 886 medical records (443 emergency C-sections and 443 vaginal deliveries) from 2021–2023. Data were analyzed with IBM SPSS 24.0, and binary logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: Robson 2a was the most frequent category (43.8%), followed by 4a (25.7%), 1 (20.1%), and 3 (10.4%). Significant risk factors for emergency C-section included maternal age (p<0.001), early cervical dilation (<5 cm) at labor diagnosis (OR 3.54), abnormal CTG, pre-eclampsia, PROM, amniotomy, infertility, and malposition. Multivariate analysis showed PROM (aOR 14.66), amniotomy (aOR 6.85), fetal weight ≥4000 g (aOR 4.07), and maternal age (aOR 1.48) as key predictors. Conclusions: Emergency C-sections were most common in Robson group 2a. Major contributing factors included PROM, amniotomy, maternal age, macrosomia, and abnormal labor patterns. Targeted interventions to manage these risk factors could reduce unnecessary emergency C-sections.

Introduction: In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM. Methods: A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test. Results: The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003). Conclusion The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.

Background: The basics of the development of the Traditional Medicine (TM) in the XXI century are to study medical books created by physicians of the early period; and need to scientific - based understanding the concepts in those scripts. Goals: To investigate the physical properties and the composition of saturated and unsaturated fatty acids (FA) sesame oil which used the symptoms of the wind humor root diseases (the symbolic terminology in TM) comparing with some vegetable oils or seed oils. Materials and methods: We are used “The Instruction Tantra” of “The Quintessence Tantras”, “The Golden Decoration” (གསེར་རྒྱན།) of Darma maaramba Luvsanchoidog which is the explanation scripts of “The Instruction Tantra”. The research was conducted through the method of original manuscript analysis, the comparison method, induction and deduction method. Results: The sesame oil has the saturated FA (14.2%) and unsaturated FA (81.4%) and which approximately amount with the olive oil (13.8%; 83.5%), sunflower oil (9.7%; 87.4%), corn oil (12.9%; 82.3%), soybean oil (15.6%; 80.5%). Conclusions Sesame oil has saturated (14.2%) and unsaturated fatty acids (81.4%); and has been used for the treatment of wind humor such as light, mobile, non-oily, cool nature – external characteristics of body in Ancient Indian Ayurvedic Medicine. We can be substitute olive oil, sunflower oil, corn oil, soybean oil which have rich of the amount of unsaturated FA (especially high level of mono and poly unsaturated FA) instead of the sesame oil in the treatment.

Atherogenic dyslipidemia comprises a triad of increased blood concentrations of small, dense low density lipoprotein (LDL) particles, decreased high-density lipoprotein (HDL) particles, and increased triglycerides. A typical feature of obesity, the metabolic syndrome, atherogenic dyslipidemia has emerged as an important risk factor for cardiovascular disease. We have determined levels of serum lipid profiles in 1861 older people who lives 5 regions in Mongolia. The concentrations of total cholesterol, triglycerides and high density lipoprotein cholesterol (HDL-C) were measured using a biochemical reagents by biochemical fully automated analyzer. The levels of LDL-C were calculated by the Friedewald equation. Overall prevalence of dyslipidemia was 4.3% in men and 3.0% in women. Logistic regression showed that Odds ratio of the atherogenic dyslipidemia was OR=1.3, p=0.001 (CI 95% 0.93-2.47) for body mass index, OR=1.6, p=0.02 (CI 95% 1.0-2.88) for waist circumference, OR=1.76, p=0.03 (CI 95% 1.12-3.54) for waist hip ratio. Odds ratio of the atherogenic dyslipidemia was OR=0.98, p=0.001 (CI 95% 0.34-1.05) for gender and OR=1.0 p=0.001 (CI 95% 0.65-1.03) for age. Overall, 3.3% of older people had atherogenic dyslipidemia and 4.3% of men and 3.0% of women had atherogenic dyslipidemia. An increase of physical parameters are getting a risk factor of atherogenic dyslipidemia.

As the proportion of aged population has been increasing worldwide by the rapid development of socio-economy, health science, and educational level that affect the policy against health service and social welfare, one of the urgent issues of Mongolian society and medical science facing is to develop healthy aging process and prevention of pathological aging. As we know, healthy aging process depends upon several factors such as heritage, biological and physiological internal factors, living condition, climate, geography, socio-economy, nutrition, drinking water, lifestyle etc,. Thus, the development of healthy aging and its influential factors is an immediate issue of Mongolian medicine and society.A cross-sectional regression analysis has been used to measure socioeconomic and physiological factors for longevity. Total of 1897 participants aged less than 80 are randomly collected from Ulaanbaatar city and Mongolian 4 regions.Total of 1897 participants, less than 80 years old are involved in this study. People in an urban area are higher than those in countryside. About housing condition, 63.5% of total participants are in apartment at UB and 37.8% is in House and 44.3% in Mongolian Ger. Estimating participant’s income, 25% of relatively healthy population is below than the minimum of subsistence. However 50% of elderly people aged between 75-80 is below than minimum of subsistence. Comparing income level by age and gender income is decreased while age is increased, males are relatively higher than females. Middle income people are by 20.9%, high income people are by 57.7% less the risky than low income people. Unhealthy status is increased by 1.0% while a year of smoking, LDL by 96.5%, HDL by 94.7%, Triglycerid by 71.2%, CAVI by 91% increase risks respectively.Below indicators are more influential for the healthy aging of Mongolian elderly people as follows, education level (ρ-0.001), household income (OR=0.423, ρ<0.0001), living conditions (OR=0.326, ρ<0.05), LDL (OR=0.035, ρ<0.0001), HDL (OR=0.053, ρ<0.0001), glucose (OR=0.014, ρ<0.0001), CAVI (OR=0.090, ρ<0.0001). Higher density of healthy aged populations is found in the central region of Mongolia where altitude is 1000-1500 meters above than sea level (MASL) and temperature is between 0-6 Celsius.