Background: Dental caries remains a major public health concern among children and adolescents in Mongolia. The mineral composition of drinking water-particularly fluoride and other essential minerals plays a crucial role in enamel mineralization and caries prevention. Fluoride directly influences the demineralization–remineralization balance of dental enamel and forms a temporary layer of fluid fluorapatite on the enamel surface when exposed to acids, thereby reducing the critical pH for dissolution and increasing acid resistance. In addition, fluoride inhibits the acid-producing metabolism of bacteria such as s.mutans within the biofilm and lowers biofilm acidity, thus slowing the rate of demineralization. Therefore, determining the relationship between population groups and water mineralization is essential for developing effective preventive strategies. Aim: To determine the severity and prevalence of dental caries among 5-, 12-, and 15-year-old children living in the 21 provinces of Mongolia and to evaluate the effects of selected minerals in drinking water (Ca, Mg, Cl, F) on dental caries. Materials and Methods: The study utilized oral examination data from a total of 421,970 children aged 0-17 years across 21 provinces and 321 soums in Mongolia. Sampling was conducted in Ulaanbaatar city (48.1%) and in all 21 rural provinces. Dental caries was assessed according to WHO criteria, and the effects of minerals in drinking water were analyzed using linear regression. Result: The average caries severity of primary teeth in 5-year-old children was 3.0-3.1 dft, which was higher than the caries severity of permanent teeth in 12- and 15-year-olds (1.54DMFdft–1.93 DMFT). Among 5-year-olds, boys had a slightly higher caries severity (3.17±3.52) compared to girls (2.92±3.40), while in the 12- and 15-yearold groups, girls showed higher caries severity than boys. Overall, 5566% of children had at least one carious tooth, and the prevalence among 5-year-olds was 63.5-66.2%. Linear regression analysis showed that fluoride (beta=–0.449, p<0.001) and magnesium (beta=–0.031, p<0.001) in drinking water had a statistically significant protective effect in reducing dental caries in both primary and permanent teeth. Conclusion The findings indicate that fluoride (F) and magnesium (Mg) in drinking water are important protective elements against dental caries, whereas calcium (Ca) and chloride (Cl) show no consistent association with caries experience.

Introduction: According to the World Health Organization (WHO) data from 2022, 19.9 million people were diagnosed with cancer globally, and 9.7 million people died from the disease. In recent years, the incidence of colorectal cancer (CRC) has been rapidly increasing, ranking 4th among all cancers with 18.4 cases and 8.1 deaths per 100,000 population. In Mongolia, 826 new cases of CRC have been registered over the past six years, with an incidence rate of 8.2 cases and a mortality rate of 5.03 per 100,000 population. It is projected that by 2030, the incidence will reach 13.28 cases and the mortality rate will rise to 8.72 per 100,000 population. We aimed to comprehensively examine the risk factors for colorectal cancer among the population of Mongolia, establish a scientific basis for early detection and prevention, and strengthen preventive measures. Materials and Methods: A case-control study was conducted from 2022 to 2024. The study enrolled a total of 305 subjects, including 98 patients with colorectal cancer, 101 patients with colon polyps, and 106 healthy subjects. The risk. questionnaire consisted of 50 questions divided into 10 sections. All statistical analysis was performed with SPSS version 23.0 software (SPSS Inc., Chicago, IL, USA) and P value <0.05 was considered statistically significant. categorical data was represented as numbers and percentages. Pearson’s chi-squared and Fisher’s exact test were used to compare categorical variables. Multivariate logistic regression was used to identify the risk factor associated with recurrence. The study protocol was approved by Ethics Review Committee of Ministry of Health of Mongolia on 17 March 2023 (approval number: 23/012). Results: The average age of the participants was 57.1±12.8 years. Among all study participants, 37.6% (115) were male and 62.4% (188) were female. Comparison of colorectal cancer incidence by age and gender revealed no statistically significant differences (p=0.021; p=0.422). Regular physical exercise was found to have a protective effect against colorectal cancer (p=0.076; OR 0.341 95% Cl 0.118-.0986). The frequency of fruit consumption, 4 to 6 times per week (p=0.008, OR 0.08, 95% Cl 0.01-0.45), frequency of vegetable consumption 4 to 6 times per week (p<0.00; OR 0.07, 95% Cl 0.02-0.19), no dining out (0.007, OR 0.3, 95% Cl 0.18-0.68), and meat consumption (p=0.001) are decreased risk of colorectal cancer. Conclusion The patient's age and the presence of colon polyps are risk factors for colorectal cancer, while regular physical activity and a diet rich in fruits and vegetables are protective factors that help reduce the risk of developing colorectal cancer.

Background: The most common clinical manifestation of HCV infection, which includes both hepatic and extrahepatic manifestations, is mixed cryoglobulinemia, which is characterized by the precipitation of certain proteins in the blood at temperatures below 37°C (in vitro), aggregation, and deposition in the walls of small and medium-sized vessels, causing vasculitis, which is clinically manifested by a triad of joint pain, fatigue, and rash on the soles of the feet. Cryoglobulinemia is commonly diagnosed in people with HCV infection, with a prevalence ranging from 10% to 70%. Vasculitis that occurs when cryoglobulinemia is detected mainly affects the small vessels of the skin, kidneys, and peripheral nerves, causing complications in other organ systems. Aim : To determine the prevalence of cryoglobulinemia in people with HCV infection, study it in relation to the stage of liver fibrosis, and determine its clinical relevance. Materials and Methods : 200 chronic HCV infected individuals were included in the study according to the inclusion and exclusion criteria. After obtaining informed consent from each participant, a questionnaire was used to collect information, perform physical measurements, and collect peripheral blood samples. Complete blood count and biochemical tests (liver and kidney function) were performed. The degree of liver fibrosis was assessed non-invasively (APRI, FIB4). The glomerular filtration rate was calculated electronically using the MDRD GFR Equation. Skin examination was performed to assess the presence of rash, ulcers, and scarring on the shins and ankles of cryoglobulinemia. To determine cryoglobulinemia, 8 ml of blood was collected in a tube without anticoagulant, and the sample was kept motionless for 1 hour at room temperature until clotting was complete. After centrifugation, the samples were separated and stored in a refrigerator at +4°C for 7 days, and then at room temperature for 30 minutes, the precipitate was detected. Results : A total of 200 people participated in the study, of which 71 were men (35.5%), the average age was 53.39±13.0. Cryoglobulinemia protein precipitates were determined in a total of 148 people, of which 50 were men (33.8%), the average age was 52.95±13.0. Cryoglobulinemia protein precipitates were detected in 89 people, or 60.1% of the study participants. Of the total study participants, 176 (88.0%) had chronic hepatitis C (CHC). Of these, 57 people had CHC with cryoglobulinemia. Comparing laboratory parameters, the mean GGT level in the cryoglobulinemia group was statistically significantly higher than in the non-cryoglobulinemia group (p=0.039). However, when laboratory parameters were grouped by increasing or decreasing, AST and ALT levels were significantly higher in the cryoglobulinemia group, indicating more hepatocellular damage (p<0.000). Increased creatinine levels may be associated with the risk of renal dysfunction. The FIB-4 index and APRI index showed a more severe degree of fibrosis in the cryoglobulinemia group (p<0.005; p<0.000). Univariate logistic regression analysis showed that age was associated with the occurrence of cryoglobulinemia (OR=2.48; 95% CI:1.31–4.70; p=0.005). Platelet count had a statistically significant positive effect in multivariate analysis (OR=14.38; 95% CI:1.26–163.89; p=0.032). Conclusion The prevalence of cryoglobulinemia among HCV-infected patients was 60.1%, and older age and decreased platelet count among infected individuals were associated with the occurrence of cryoglobulinemia.

Background: Mastication is a biomechanical process that involves the jaws and teeth working together to effectively break down food through the contraction of masticatory muscles. The efficiency of this process is influenced by factors such as bite force, the integrity of the dental arch, and individual characteristics, including age, gender, and body weight. Previous research has investigated the bite force of natural teeth, comparing the differences between removable and fixed denture teeth. For instance, Gibbs et al. estimated the bite force of Eskimo individuals to be 348 lbs (138 kg), while Al-Zarea et al. reported a bite force of 580.9 N for fixed partial dentures. Additionally, J. Urangua estimated the bite force of first permanent molars to be 472 N. Although studies have explored the bite force of Mongolian individuals with removable dentures, there has been no investigation into the bite force of fixed partial dentures, highlighting a significant gap in the literature that the current study aims to address. Aim: This study aims to assess the bite force following the restoration of teeth with Zirconia and Porcelain-Fused-to-Metal crowns. Materials and Methods: The study involved 20 individuals aged 18 to 34 years, each of whom had their mandibular molars restored with Zirconia and Porcelain-Fused-to-Metal (PFM) crowns on one side, while the other side retained their natural teeth, which had not undergone root canal treatment and exhibited no significant alveolar bone loss. A single-instance design was employed to measure occlusal force using the Occlusal Force Meter GM10. Statistical analysis was conducted using SPSS 26.0 software, with results considered statistically significant at a probability level of p < 0.05. Results: The cohort comprised 20 subjects aged 18 to 34 years, with 65% (13) male and 35% (7) female, yielding a mean age of 28.2 ± 3.5 years. The mean bite force for teeth covered with crowns was (393.2±0.3 N), compared to (445.5±70 N) for natural teeth. Notably, the bite force of the Zirconia crown (407.0±0.7 N) was higher than that of the Porcelain-Fused-to-Metal (PFM) crown 367.7±0.9N. When analyzed by gender, the bite force of natural teeth in men averaged 484.1±46.2N, while that of crowns was 445.3±43.7N. In women, the bite force of natural teeth averaged 373.7±15.4N, compared to 296.4±19.6 N for crowns. Conclusion 1. The bite force of zirconia porcelain crowns was 407.0±76N, while the bite force of metal porcelain crowns was 367.7±97N. 2. When determining the bite force of crowns and natural teeth, the bite force of crowns and natural teeth was 296.4±19.6N, and the bite force of uncoated teeth was 445.5±70N, respectively. 3. When compared by gender, the bite force of uncoated teeth in men was 484.1±46.2N, the bite force of coated teeth was 445.3±43.7N, and the bite force of uncoated teeth in women was 373.7±15.4N, and the bite force of coated teeth was 296.4±19.6N, and the bite force was significantly related to gender (p<0.0001).

Background: The craniofacial region is one of the most frequently injured parts of the human body, with mandibular fractures being the most common type of facial skeletal injury. The leading causes of mandibular fractures include traffic accidents, falls, interpersonal violence, and sports-related injuries. In Mongolia, mandibular fractures are prevalent, with a higher incidence among males. However, to date, no national-level analysis of mandibular fractures has been conducted. This study aims to comprehensively examine mandibular fractures in Mongolia by identifying demographic factors and causes of injury. Aim: To determine the incidence and causes of mandibular fractures recorded in Mongolia over the past ten years. Materials and Methods: This study collected data on mandibular fractures recorded in the Health Development Center of Mongolia between 2014 and 2023. Cases were identified using the International Classification of Diseases (ICD-10) code S02.6. Information on patient age, gender, and hospital diagnosis was collected, along with the cause of injury, classified according to ICD-10 codes. Patient age was categorized based on the classification system of the National Statistics Office. Statistical analysis was performed using SPSS 26.00 software, employing the chi-square test for data analysis. Results: During the study period, a total of 2,872 patients were diagnosed with mandibular fractures, with the highest incidence occurring in the 20-40 age group. The average patient age was 31.1±12 years. Males were 5.6 times more likely to sustain mandibular fractures compared to females. The primary causes of injury were interpersonal violence (42%), mechanical trauma (17%), falls (16%), and traffic accidents (15%). Conclusion Between 2014 and 2023, 2,872 cases of mandibular fractures were recorded in Mongolia, with the majority occurring in individuals aged 20-40 years. The leading causes of mandibular fractures were interpersonal violence, mechanical trauma, falls, and traffic accidents. Specialized trauma care services were accessed differently in urban and rural areas.

Background: In our country, the high prevalence of chronic liver diseases is influenced by factors such as hepatotoxic viruses, excessive alcohol and drug consumption, and a high incidence of obesity among the population. Although the point at which liver fibrosis becomes irreversible remains unclear, some researchers have suggested, based on clinical studies, that fibrosis may still be reversible in the early stages of cirrhosis. Aim: Therefore, in this study, we aimed to evaluate the degree of liver fibrosis using key markers involved in the pathogenesis of hepatic scarring—MMP-1 (matrix metalloproteinase-1), MMP-2 (matrix metalloproteinase-2), and PIIINP (N-terminal propeptide of type III procollagen)—as well as non-invasive serum markers of hepatocyte injury (APRI and FIB-4), and to compare these findings with the results of liver biopsy. Materials and Methods: This analytical case-control study included 50 patients in the State Third Central Hospital. Peripheral blood samples were analyzed for platelet count, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) using a fully automated analyzer, while serum direct markers were measured using ELISA. Non-invasive serum markers (APRI and FIB-4) were calculated using the MD+CALC online system. Liver tissue for histological examination was obtained via biopsy, and the degree of liver fibrosis was assessed according to the METAVIR scoring system. Differences in mean values of quantitative variables between two groups were analyzed using the Mann-Whitney U test was applied. The correlation between METAVIR stages and serum markers was evaluated using Spearman’s correlation. Results: Among the study participants, according to the METAVIR classification, 15 individuals (30%) had no or minimal fibrosis (F0–F1), 26 individuals (52%) had significant fibrosis without cirrhosis (F2–F3), and 9 individuals (18%) had cirrhosis (F4). As the stage of fibrosis increased, the mean levels of AST (r=0.326, p=0.021), ALT (r=0.392, p=0.005), MMP-2 (r=0.393, p=0.005), PIIINP (r=0.472, p=0.001), as well as APRI (r=0.503, p<0.001) and FIB-4 (r=0.482, p<0.001) showed an increasing trend. In contrast, mean platelet count (r=–0.507, p<0.001) and MMP-1 (r=–0.383, p=0.006) decreased with advancing fibrosis stages. Using AUC-ROC analysis to assess the diagnostic performance of both direct and indirect serum markers, the ability to detect significant fibrosis and cirrhosis was estimated as follows: APRI 80%, FIB-4 75%, MMP-1 67.1%, MMP-2 72.2%, and PIIINP 72.3%. Conclusion In our study, the diagnostic performance of both direct and indirect serum markers for predicting liver fibrosis exceeded 65%. Mean levels of AST, ALT, MMP-2, PIIINP, APRI, and FIB-4 increased with advancing fibrosis stages, whereas mean platelet counts and MMP-1 levels decreased.

Introduction: Hepatitis C virus (HCV) infection has both hepatic and extrahepatic manifestations, and it is one of the leading cause of liver transplantation. There’s limited research on extrahepatic symptoms of chronic HCV in Mongolia, thus we aimed to investigate the relationship between cryoglobulinemia and it’s related factors. Methods: The study included 200 participants with active HCV, collecting blood samples for various tests (biochemical analysis, kidney function, and cryoglobulinemia detection). The degree of liver fibrosis was assessed using APRI and FIB4 scores, and the study evaluated other health conditions through a questionnaire. Statistical analysis was performed using SPSS-26. Results: Out of 200 participants, 148 checked for cryoglobulin precipitation and 89 (60.1%) were positive. There was a statistically significant age difference between those with and without cryoglobulinemia (54.62 vs. 50.44 years). A higher percentage of participants with cryoglobulinemia had significant liver fibrosis (10.8% vs. 4.7% without). Liver fibrosis scores tended to increase with age, especially in men. Conclusion Liver fibrosis scores above 3.25 are associated with older age, lower platelet counts, elevated AST and ALT levels, and the presence of cryoglobulinemia. FIB4 scores were higher in men with active HCV and cryoglobulinemia.

Introduction: The worldwide prevalence of obesity and its metabolic complications have increased substantially in recent decades. According to the World Health Organization (WHO) indicate that in 2016, over 1.9 billion adults were overweight and, of these, over 650 million were obese. Obesity is a major risk factor for heart disease, type 2 diabetes, steatotic liver, chronic liver disease, stroke, and some cancers. The global prevalence of obesity and its associated comorbidities continue to increase on a pandemic scale. Aim: To determine metabolic changes in overweight and obese adults and their related diseases based on some parameters of anthropometric and laboratory tests. Materials and Methods: This study was conducted with a case-control design in 2023–2024. There were 150 participants in the study, 50 in the control group with normal weight, 50 in the overweight (BMI<29.9kg/m2) case group, and 50 in the obesity (BMI>30kg/m²) case group. Subjects of three groups were matched by age (±1) and sex. We estimated anthropometric parameters and biochemical laboratory analysis including glucose, lipid, ferrum, and liver parameters. CBC All statistical analysis was performed using SPSS 23 software. Categorical variables were described by numbers and percentages, and the numerical variables were characterized by the median (min and max) for the normal distribution, and mean± standard deviation for the non-normal distribution. The statistical tests utilized were the Chi-square, Fisher’s exact, student t-test, and Mann–Whitney tests. Ethical approval for the survey was obtained from the Medical Ethics Committee under the Ministry of Health Of Mongolia in January 2023. Results: The participants' average age was 46.73±11.45, with 60% being women (90) and 40% being men (60). The prevalence of central obesity and fat % were 52.3% and 37.2%, respectively. Between study groups, there were significant differences in fat% (p=0.004), central obesity (p<0.001), FBG (p=0.024), cholesterin (p=0.017), LDL (p=0.018), HDL (p=0.003), ferrum (p=0.010), АЛАТ (p=0.020), and GGT (p<0.001). Conclusion In overweight and obesity groups, the body fat, fasting blood glucose, cholesterol, LDL, and ALT levels are increased. These changes often lead to conditions like type 2 diabetes, arterial hypertension, steatotic liver disease, and liver fibrosis. Therefore, it is important to develop plans for prevention, early detection, public awareness, and intervention programs targeting obesity in the general population.

Background: Various cytokine dynamics has been associated with chronic hepatitis C virus (HCV) infection. We hypothesized that cytokines have an important role in fibrosis development in HCV infection. Methods: All patients received liver biopsies to validate the severity of chronic hepatitis when enrolled in this study. Fluorescent Bead immunoassay was used to measure the following serum cytokine levels: Interferon γ, tumor necrosis factor α, interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and IL-12. Various statistical analyses were used as appropriate. Results: From all the liver biopsy proven 92 HCV-infected patients, 49 (53.3%) were male, 23 (25%) patients had advanced (fibrosis grades 3-4) fibrosis, and the mean age of the study population was 51.9 ± 9.4 years. Elevation of baseline IL-4 level (>490 pg/mL) was associated with liver fibrosis grade by X2 test (odds ratio [OR] = 2.99; 95%, CI = 1.02-8.78; p = 0.042) and multivariate logistic regression (OR = 4.26; 95% CI = 1.13-16.02; p = 0.032). Also, IL-4 had strong diagnostic value in advanced liver fibrosis by using area under receiver operating characteristics curve analysis. Assessment of fibrosis score was consequently developed from our findings and compared with other noninvasive serum markers to assess liver fibrosis. Conclusion This study provides evidence that increased IL-4 expression predicted advanced liver fibrosis in treatment of HCV-infected patients.

Introduction: According to the World Health Organization, 251 vaccines against coronavirus infection are under development. Although vaccination has been introduced nationwide to prevent coronavirus infection, vaccine activity varies (50-95%), and the risk of infection and complications may vary depending on the individual’s physical condition and immune activity. In addition, due to the prevalence of variant of concern, which reduces the activity of some vaccines and increases the risk of complications and mortality of COVID-19, each country and region needs to improve the knowledge and attitudes of citizens about the vaccine. there is a need to study. Goal: To study the knowledge and attitudes of people who have been vaccinated against COVID-19 among the target population of Uvs province. Materials and methods: The study was conducted using a descriptive method of observational research. Quantitative and qualitative methods were used to collect the survey data, and the data were collected in April 2021 through a questionnaire. A random sample of 4,212 people from 11 organizations involved in the Covid-19 vaccine was randomly selected from 24 organizations, and a total of 264 people were surveyed using 12 types of Covid-19 vaccine and analyzed using SPSS software. Result: According to the results of the survey, 4212 people from 11 organizations and 24 people from each organization were randomly selected from a total of 264 people. Mostly female participants (57.5%) have been included in this study. 67.4% of the respondents reported that they do not feel fear associated with vaccination and it means that most of the participants did not show any signs of panic. 91.2% participants did not have any symptoms after the vaccination. 30.4% from total participants was used anti-inflammatory or pain relief pills after vaccination at home. 45.8% of the respondents self reported that they have moderate knowledge about Covid-19 vaccine. Conclusion Overall knowledge of people from Uvs province was insufficient. However, attitude was good enough.