Background: High-resolution esophageal manometry (HREM) is the reference standard for the assessment of esophageal motor function and classification of esophageal motility disorders. HREM was introduced into clinical practice in Mongolia in 2022; however, the spectrum of manometric diagnoses and factors associated with major esophageal motility disorders in this population have not been systematically characterized. Aim: To characterize major esophageal motility disorders among adults undergoing HREM and to identify clinical factors independently associated with these disorders. Materials and Methods: This retrospective observational study included 1,033 adults who underwent HREM at Intermed Hospital between September 2022 and March 2026. Manometric studies were interpreted according to the Chicago Classification version 4.0 (CCv4.0). Major esophageal motility disorders were defined as achalasia, manometric esophagogastric junction outflow obstruction (EGJOO), distal esophageal spasm, hypercontractile esophagus, and absent contractility. Multivariable logistic regression was used to identify factors independently associated with major motility disorders. Result: Major esophageal motility disorders were identified in 112 patients (11.2%). Compared with patients with normal motility or ineffective esophageal motility, those with major motility disorders had a significantly lower mean body mass index (BMI) (24.7±4.9 vs. 27.5±4.2 kg/m; p<0.001) and a higher prevalence of dysphagia (50.5% vs. 21.3%; p<0.001) and referral for suspected esophageal motility disorders (70.5% vs. 25.2%; p<0.001). In multivariable analysis, older age per 10-year increment (adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 1.12–1.61), lower BMI (aOR per 1-kg/m increase, 0.90; 95% CI, 0.85–0.95), dysphagia (aOR, 1.95; 95% CI, 1.20–3.15), and referral for suspected motility disorders (aOR, 5.47; 95% CI, 3.22–9.31) were independently associated with major esophageal motility disorders. Conclusion 1. Major esophageal motility disorders were identified in 11.2% of adults undergoing HREM in this clinical cohort. 2. Referral for suspected motility disorders was the strongest clinical correlate, while older age, lower BMI, and dysphagia were also independently associated with major motility disorders.

Background: Non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases and remains one of the leading causes of cancer-related mortality worldwide. Advances in molecular oncology have shown that mutations in the epidermal growth factor receptor (EGFR) gene play a crucial role in diagnosis and in guiding targeted therapy with tyrosine kinase inhibitors (TKIs). However, the detection of EGFR mutations is influenced by specimen type and quality, and differences may exist between bronchoscopic and surgical samples. In Mongolia, studies addressing this issue remain limited. Aim: To evaluate the feasibility of detecting EGFR gene mutations in bronchoscopic and surgically obtained tissue samples from patients with non-small cell lung cancer (NSCLC). Materials and Methods: This prospective comparative study included 35 formalin-fixed, paraffin-embedded (FFPE) tissue samples, of which 19 were bronchoscopic and 16 were surgical specimens. Tumor cell content was assessed histologically, and genomic DNA was extracted from each sample. EGFR mutation analysis was performed using the cobas® EGFR Mutation Test v2 with real-time PCR. Statistical analysis was conducted using SPSS version 26.0, and differences between groups were evaluated using Fisher’s exact test. Results: The mean age of the participants was 64.5±10.5 years; 74% were male and 26% were female. Significant differences in tumor cell content and DNA yield were observed between specimen types. Bronchoscopic samples showed a mean tumor cell content of 34%, with sufficient DNA yield in 73.6% of cases, whereas surgical specimens demonstrated a mean tumor cell content of 93%, with adequate DNA yield in all cases. EGFR mutations were detected in 31.3% of surgical specimens (including exon 19 deletion, L858R, and T790M mutations). In bronchoscopic samples, insufficient DNA yield in some cases precluded PCR analysis, thereby limiting mutation detection. A statistically significant difference in EGFR mutation detection rates was observed between the two groups (p=0.045). Conclusions 1. Bronchoscopic samples demonstrated lower tumor cell content and DNA yield, which may limit their suitability for molecular analysis in some cases. 2. Compared to bronchoscopic samples, surgically obtained specimens provided higher-quality tissue and demonstrated a greater feasibility for EGFR mutation detection.

Background: Female pattern hair loss (FPHL), a common form of alopecia in postmenopausal women, is influenced by multiple factors. Several contributing factors have been identified in the development of FPHL, which include aging, alterations in sex steroid hormones, genetic predisposition, nutritional deficiencies, and obesity. Aim: This study aimed to estimate the prevalence of FPHL among postmenopausal women and investigate its association with metabolic risk factors. Materials and Methods: This cross-sectional study was conducted between January and March 2026 at the National Dermatology Center, enrolling 30 postmenopausal women aged 50–65 years. Hair density was assessed using the ASL 202 Lens (Aram Huvis, South Korea). Severity of FPHL was classified according to Ludwig Classification into grades I–III. Results: The average age and BMI were 55.63±3.55 years and 27.85±4.3 kg/m², respectively. Severity of FPHL by Ludwig grades I, II, and III was 56.7% (n=17), 40% (n=12), and 3.3% (n=1), respectively. The average BMI and fasting glucose level were significantly higher in the grade I group, compared to grades II and III (p=0.001). According to Spearman’s correlation analysis, a negative correlation was observed between BMI and hair density (r=-0.53, p=0.003). Linear regression analysis revealed that BMI (β coefficient 0.413; 95% CI: 0.007, 0.09; p=0.023) and fasting glucose level (β coefficient 0.458; 95% CI: 0.028, 0.2; p=0.011) were significantly associated with FPHL. Conclusion Among postmenopausal women, grade I female pattern hair loss was the most prevalent type, and elevated BMI and fasting glucose level might be associated with increased severity of FPHL.

Background: Human papillomavirus (HPV) is the primary cause of cervical cancer, with HPV genotypes 16 and 18 classified as high-risk types. In Mongolia, HPV testing has been increasingly implemented in recent years, alongside updates to the national screening program. These developments highlight the need for additional testing approaches to encourage regular participation in the national screening program, improve diagnostic accuracy, and facilitate timely treatment planning. These considerations provided the rationale for this study. Aim: To detect HPV infection in cervical samples collected by healthcare professionals and vaginal samples self-collected by women, determine the concordance between the test results, and evaluate the feasibility of self-sampling for cervical cancer screening. Materials and Methods: A total of 206 women aged 25–68 years participated in the study. Two types of samples for HPV testing and one sample for PAP smear were collected from the participants. 14 high-risk of HPV genotypes were classified into three groups, and cytological findings were evaluated according to the 2014 Bethesda System. Statistical analyses were performed using SPSS version 30.0. Results: The concordance between the two sampling methods for HPV detection kappa was 0.949. High-risk HPV genotypes were detected in 50 women (35.2%) among the participants with available test results. Cytological abnormalities were identified in 51% of women who tested positive for HPV. Conclusion Self-sampling is a reliable method for HPV detection, demonstrating good concordance with healthcare professional-collected cervical samples. It has considerable potential to increase cervical cancer screening coverage and improve access to screening, particularly in geographically remote areas.

Background: Multidrug-induced long QT syndrome is a serious heart rhythm disorder where multiple medications prolong the QT interval on an electrocardiogram, increasing the risk of a potentially fatal arrhythmia. Long QT syndrome is characterised by heart rate corrected QT interval prolongation and life-threatening arrhythmias, such as polymorphic ventricular tachycardia, Torsades de pointes leading to syncope and sudden death. Case: 21-year-old woman required resuscitation from an apparent cardiac arrest that had occurred after status epilepticus. The woman was diagnosed with long QT syndrome, cardiac channelopathy. She had a long history of syncope, seizure and palpitations. Family history was non-contributory. Home medications included levetiracetam 500 milligrams orally twice and fluoxetine 20 milligrams orally once a day which the patient reported non-compliance with. Levetiracetam is a widely used anti-epileptic medication secondary to its favorable safety profile. To our knowledge, there are few other case reports documenting torsades de pointes after levetiracetam administration, and specifically our case report will be the first documenting cardiac arrest after multidrug administration. Long QT syndrome is not often included in the differential diagnosis of epileptic and non-epileptic seizures. Early recognition of the syndrome is very important because of prognostic and therapeutic consequences. Conclusion Although no hereditary cause was confirmed, this case represents Torsades de Pointes triggered by multiple medications—including long-term low-dose carbamazepine, fluoxetine, diazepam, and high-dose levetiracetam—on a background of probable Romano–Ward syndrome or predisposition to QT prolongation. The arrhythmia progressed to cardiac arrest, requiring ICD implantation.

Background: A rare angioproliferative condition of the larynx, Kaposhi sarcoma typically affects the skin. Immunosuppressive treatment following organ transplantation and human immunodeficiency virus infection are the causes. Every type of Kaposi sarcoma has human herpesvirus-8. Laryngeal kaposi sarcoma is uncommon in immunocompromised patients; since its initial identification in 1965, 18 cases have been documented globally. A CO2 laser-assisted laryngeal microsurgery is performed through the mouth cavity to remove tumor when kaposi sarcoma of the larynx obstructs the airway. Case report: A 77-year-old woman complained of hoarseness, dry mouth, odynophagia, and dysphagia three months prior when she arrived at the Mongolian-Japan Hospital. Two years ago, she acquired hard, sensitive lumps that were palpable on her right arm, left ankle, and right thigh. At that time, she was diagnosed with Kaposiform hemangiodermatitis and treated at the National Center for Dermatology. HIV test results were negative. Immunohistochemistry: CD31 +/-, CD34 /+/. Using flexible nasopharyngeal endoscopy to get the diagnosis: There was a mass that was about 1.5–2–5 cm in diameter, bluish in color, smooth and movable, and spongy and vascular on the larynx, on the nasopharynx, behind the palatine tonsills, and supraglottic. Surgery: Through the use of Kleinsasser laryngoscopy and a 0-degree endoscope, pathological tissues were extracted under general anesthesia using a laryngeal microsurgical instrument and a laparoscopic bipolar coagulator. The tissues were then sent for histological evaluation, which revealed Kaposi sarcoma, sarcoma grade 1. Results of treatment Pain decreased and quality of life increased following surgery. Upon nasopharyngeal endoscopy, the vocal cord mobility was normal and the surgical incision was clean. Conclusion: Kaposi sarcoma is an extremely uncommon illness. A lower quality of life and further issues can be avoided with an early diagnosis and suitable therapy. It also needs to be continuously monitored because it is a potentially repeatable disease.

Background: Globally, an estimated 13% of adolescents aged 10–19 are affected by mental disorders. As of 2020, the number of children under the age of 19 in Mongolia was reported to be 1,289,587, reflecting a 0.9% increase compared to 2015. A 2013 study on adolescents found that 60.5% were categorized as mentally healthy, 30.5% exhibited emotional and behavioral difficulties, and 9% were diagnosed with a mental disorder. A study conducted in Govi-Altai Province between 2018 and 2019 reported that 58.6% of adolescents were classified as healthy, 36.1% experienced psychological difficulties, and 5.2% were diagnosed with a mental disorder. Internationally, adolescent mental health has been widely assessed using the Strengths and Difficulties Questionnaire (SDQ), with an increasing number of studies employing artificial intelligence-based predictive models. However, in Mongolia, research utilizing artificial intelligence and machine learning for analyzing large-scale mental health data remains limited. This gap underscores the need for the present study. Aim: Machine learning models were compared to determine adolescent emotional and behavioral problems using the SDQ. Materials and Methods: Data was collected from teenagers, teachers, and parents in Govi-Altai Province, and the databases were created for each group. The teenager database was divided into 10 folds by cross-validation, and the models were developed using machine learning methods and evaluated using their performance measures. The results were mainly analyzed using the Bayes model. Results: The teenagers have emotional and behavioral problems due to emotional and peer interactions, but they are at risk of developing disorders due to hyperactivity and behavioral changes. Conclusion Comparing the model performance results with previous studies, Bayesian model accuracy decreased by 0.03, sensitivity decreased by 0.08, and specificity increased by 0.01. Also, the difference between the performance evaluation metrics of the C50 and Bayesian models is very small, between 0.01 and 0.02. This shows that the performance of the Bayesian method is good when the number of attributes in the database increases. Compared to the results of the knowledge generated by the research, the participants are more likely to develop emotional and behavioral disorders due to their peer relationship indicators, such as other children generally not liking them, getting on better with adults, and due to emotional symptoms such as being unhappy and depressed.

Background: Esophageal cancer ranks as the fourth most prevalent malignancy in Mongolia. Among esophageal disorders, gastroesophageal reflux disease (GERD) accounts for 55% of cases, while esophageal motility disorders constitute 40%. Enhancing the diagnosis and management of esophageal disorders, alongside preventative strategies for esophageal cancer, necessitates a comprehensive understanding and widespread clinical application of esophageal functional assessment. However, epidemiological data and classification of esophageal motility disorders remain scarce in Mongolia, highlighting the necessity of this investigation. Aim: to identify specific risk factors associated with ineffective esophageal motility (IEM) Materials and Methods: This study was performed an analytical case-control design and was conducted at Intermed Hospital. A total of 702 HRM test results from patients attending the Gastroenterology and Endoscopy Center’s outpatient department, Intermed hospital Participants diagnosed with IEM based on HRM findings were assigned to the case group, while individuals with esophageal normal motility disorders were designated as the control group at a 1:2 ratio. Results: A total of 612 participants aged 21–80 years were included in this study of whom 57.8% (n=354) were female and 42.2% (n=258) were male, with a mean age of 51.1±12.7 years. The prevalence of IEM demonstrated a statistically significant increase in the 60–69 and ≥70 age groups compared to the control group (p<0.000). Participants diagnosed with IEM exhibited a mean lower esophageal sphincter (LES) pressure of 329.61±246 mmHg and a mean complete liquid bolus transit rate of 46.88±22.7%, both of which were significantly lower than those observed in the control group (p=0.000). Furthermore, the incidence of IEM was found to increase in correlation with the severity of hiatal hernia, as classified by both endoscopic and manometric criteria, demonstrating statistical significance (p=0.000). Conclusion IEM is more prevalent among elderly individuals and increases in incidence with the progression of hiatal hernia size. In cases of IEM, esophageal bolus transit is significantly delayed, and lower esophageal sphincter pressure is diminished. Further studies are warranted to elucidate additional risk factors contributing to ineffective esophageal motility.

Background: Plants have played a significant role in maintaining human health and improving the quality of human life for thousands of years and have served humans as valuable components of seasonings, beverages, cosmetics, dyes and medicines. There are a number of medicinal plants used in the traditional medicine in the Mongolia to form “tan” prescriptions which are mostly consist of the mixture of individual medicinal plants and used by nomads during the long history for their health care as medicines. Lancea tibetica (Scrophulariaceae) is a traditional herbal medicinal plant in Mongolia, China and Tibetan. In Mongolian traditional medicine, L.tibetica different exclusive forms of preparations are effective for treatment of some disorders such as pulmonary, cough and heart disease. Aim: This study aim was to define the biochemical some composition antibacterial activity and mineral elements content in air-dried samples Lancea tibetica of Mongolia. Material and Method: The antibacterial activity and Minimal Inhibitory Concentration (MIC) of the extracts was collected of the seed, aboveground part and root for the Lancea tibetica. From three different organs of plant Lancea tibetica was collected of the Tsenkher district Arkhangai province (2017.07.28) and Tunel district Khuvsgul province (2018.08.27) were evaluated by means of the Disk diffusion method against five bacteria (Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Micrococcus luteus, Enterococcus faecalis). We have taken extracts of plant 3 organs from organic solvent (7) ethyl acetate, hexane, n-butanol, methanol, chloroform, ethanol and distilled water for antibacterial activity. MIC of the extracts were defined and compared with each other. The macro-and microelements were determined by X-ray fluorescence spectrophotometer analysis (XRFA). Result: We have taken a dried seed, aboveground part and root of Lancea tibetica in the investigation. In these three samples were determined biochemical composition of 11 components for quantitative analysis: moisture was 6.2±0.2%, ash 4.8%, protein content was 1.67±0.1%, raw oil 5.9±0.3%, reduction sugar 0.39±0.1%, vitamin Р 16.6±1.8 mg%, extractive substances 18.6±0.2%, tanning matter 0.05±0.02% and flavonoids 0.2±0.01% in seed. The same moisture was 6.7±0.4%, ash 9.7%, protein content 1.89±0.2%, raw oil 6.1±0.8%, reduction sugar 0.52±0.1%, vitamin С 3.52±2.2mg%, vitamin Р (rutin) 20.3±0.2mg%, carotene 12.8mg%, extractive substances 16.8±0.1%, tanning matter 0.08±0.01% and flavonoids 0.6±0.24% in aboveground part. Besides this, in root: the moisture was 6.1±0.3%, ash was 14.9%, protein content was 2.1±0.3%, raw oil was 2.9±0.2%, reduction sugar 0.62±0.02%, vitamin Р 17.8±0.05mg%, extractive substances 20.3±0.4%, tanning matter was 0.06±0.03%, flavonoid was 0.35±0.002%. Besides this, we revealed the saponin by method quality analysis in aerial part and root of Lancea tibetica. But not triterpenoid saponin in seed. The same not revealed alkaloid all the samples.
Eighteen extracts (5mg/disc) of three organs (seed, aerial parts and root) showed antibacterial activity diverse. The MIC in ethanol and butanol extracts of seed, aboveground part and root was more than others.
From thoroughly air-dried aboveground part samples of Lancea tibetica from Tsenkher district of Arkhangai province and Tunel district of Khuvsgul province. We determined the 43 mineral elements. 11 elements were defined by percentage, 10 elements were oxide forms (SiO₂, TiO₂, Al₂O₃, Fe₂O₃, CaO, MgO, Na₂O, K₂O, MnO, P₂O₅) of them. Other elements were defined by mg/kg unit. The same heavy metallic, mobile elements (Cu, Cr, Zn, Mn, Pb, Ni, Co) and rare earth elements (Ce, La, Nd, Pr, Sm) were determined. Conclusion In the result of this research work to determine the content of biologically active substances in Lancea tibetica. Plants produce a great variety of organic compounds that are not directly involved in primary metabolic processes of ground and development. Study of the biochemistry of plant natural products has many practical applications. Various detectable contents of useful or macronutrient and micronutrient oxide was found in the ash of aerial parts. Some macronutrient and micronutrient elements were detected by oxide forms.

BACKGROUND: In the recent years, mesenchymal stem cells have become increasingly utilized in regenerative medicine and tissue engineering applications because of their properties for self-renewal, differentiation and immunoregulation. The use of stem cells of various clinical applications is highly expected and the production of good quality stem cells is very critical for basic studies. In the bone marrow, hematopoietic and mesenchymal stem cells from an unique niche in which the oxygen tension is low. Hypoxia may have a role in maintaining stem cell fate, self renewal and multi-potency. We investigated whether low oxygen culture would be beneficial for hematopoietic stem cell and mesenchymalstemcell. MATERIAL: BMCs from 8-12 week aged, 15 mice were subjected to hypoxic conditioning by culture for 8-10 days in 20%, 3%, 1% oxygen. For culture 1x105cell/ml were seeded in colony forming assay and 2x106cell/ml were seeded in L-glutamin mediain chamber slide. We counted cell colonies under different hypoxic condiontins by Olympus IX71 fluorescence microscope. After cell culture in chamber slide, we stained cells by anti-CD90 and anti-CD105 then counted positive cells by Olympus IX71 fluorescence microscope. RESULTS: Compared to normoxic cells and hypoxic cells well morphologically differentiated and counted by Olympus IX71 microscope. More colonies were observed at 3%, 1% oxygen. Statistical significances were identified with granulocytes and macrophage colony (p<0.05) in hypoxic condition. More anti-CD90 and anti-CD105 markers were observed at 3% oxygen condition. Statistical significances were identified in 3% oxygen condition with cell markers(p<0.001). CONCLUSIONS: Our data suggests low physiological oxygen culture could improve the stemness of macrophage and granulocytes colony and improve the differentiation of mesenchymal cells. Long term culturewith additional cell markers will be necessary to confirm whether low physiological oxygen levels also improve genomic stability