Background: Non-traumatic intracerebral haemorrhage (ICH) is a neurological emergency, because it carries a burden of mortality and long-term disability worldwide. Aim: To compare urban and rural differences in hospitalisation due to ICH. Materials and Methods: An analytical study was conducted among ICH cases admitted to the Third State Central Hospital between 2022 and 2024, and statistical analysis was performed using SPSS 27.0. Result: The study included 373 cases of acute ICH diagnosed by computed tomography between 2022 and 2024 at the Third State Central Hospital, of which n=313 were from Ulaanbaatar city, and n=60 were transported from the rural area. Compared to the urban group, the rural group had fewer males, but a history of arterial hypertension prevailed (98.3% vs 90.1%, p=0.041), and lower blood pressure at the time of hospitalisation (systolic pressure 159.7±34.7 mm Hg vs 179.0±32.9 mm Hg, p<0.001; diastolic pressure 99.7±21.4 mm Hg vs 106.5±21.8 mm Hg, p=0.026). Cases in the rural group had a longer hospital stay from the onset of clinical symptoms than those in the urban group (12.1±17.9 hours vs 4.2±4.3 hours, p=0.001). Multivariate regression analysis showed that lower hematoma volume (adjusted odds ratio [aOR] 0.92, p=0.047) and lower NIHSS score at hospital admission (aOR 0.67, p<0.001) were associated with better outcomes. However, multivariate regression analysis showed that hospital admission NIHSS score was the only risk factor directly associated with mortality after 3 months (aOR 1.14, p=0.005). Conclusion Our study found that indicators for patients transported from rural areas with IHC were no different from those for patients in urban areas. On the contrary, mortality was independent of length of hospital stay and residency.

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: The corneal endothelium, the innermost layer of the cornea, is composed of hexagonal cells that maintain corneal transparency and provide essential nutrients to the stroma. These cells play a critical role in preserving visual acuity. Previous studies have demonstrated that endothelial cells do not regenerate, and their density progressively declines with age, accompanied by morphological alterations. Given the individual variability in corneal thickness and endothelial morphology, establishing normative reference values is crucial for diagnosing corneal diseases, planning corneal transplantation, and optimizing surgical strategies for cataract surgery. However, there is a scarcity of data regarding central corneal thickness, endothelial cell density, and cell morphology among Mongolian adults. This knowledge gap provided the rationale for the present study. Aim: To study the central corneal thickness and endothelial cell morphology in Mongolian adults. Materials and Methods: This study was conducted using an analytical cross-sectional design. A total of 198 individuals aged 20 to 79 years were randomly selected, and comprehensive ophthalmic examinations were performed. Corneal parameters—including central corneal thickness, endothelial cell density, mean cell area, coefficient of variation of cell size, and the percentage of hexagonal cells—were quantitatively assessed using a non-contact specular microscope. Ethical approval was obtained from the Research Ethics Committee of the Mongolian National University of Medical Sciences (Approval No. 2024/3-06), and written informed consent was obtained from all participants prior to enrollment. Results: The mean age of the study participants was 48.4±14.5 years, with 48.9% (n=97) being male and 51.1% (n=101) female. In the central cornea, the mean endothelial cell density (ECD) was 2857.14±291.49 cells/mm², the mean central corneal thickness (CCT) was 526.25±33.67 µm, the mean cell area was 335.11±37.82 µm², the percentage of hexagonal cells was 64.81±3.94%, and the coefficient of variation (CV) in cell size was 0.31±0.04. With increasing age, both ECD and the percentage of hexagonal cells showed a statistically significant decline, while the mean cell area and CV demon strated a significant inverse correlation (P=0.0001). No statistically significant differences were observed in corneal thickness or endothelial morphometric parameters between the right and left eyes or between sexes. Among the Mongolian adults, the endothelial cell density decreases by approximately 0.3% annually (r=0.2107, p<0.0001). Conclusion 1. The mean central corneal thickness (CCT) in adult Mongolian individuals was 526.25±33.67 μm, which is comparable to reported averages from other populations. However, the mean endothelial cell density (ECD) was relatively higher, measured at 2857.14±291.49 cells/mm². 2. With advancing age, a progressive decline in central endothelial cell density and the proportion of hexagonal cells was observed, whereas the coefficient of variation (CV) in cell size and the mean cell area showed a corresponding increase

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: Azoospermia is the most severe form of male infertility, affecting approximately 1% of male population and 10–15% of infertile men. In azoospermia cases, sperm retrieval from the testis or epididymis through surgical procedures is used for assisted reproductive treatments. When no sperm is retrieved, recent approaches in medicine suggest using immunohistochemical methods to evaluate spermatogenesis in testicular tissue and plan further treatments. Aim: To evaluate spermatogenesis in testicular tissue of azoospermic patients using immunohistochemistry and compare the findings with the clinical outcomes of sperm retrieval procedures. Materials and Methods: This study included 71 azoospermic men who underwent micro-TESE procedures at the IVF center (RMC) between 2019 and 2023. The excised testicular tissues were fixed, processed histologically, and evaluated using Johnson’s score. The presence of spermatozoa in seminiferous tubules was detected by immunohistochemical and immunofluorescence staining, using markers such as TEX101 and LDHC. Results: Johnson’s score was categorized into three groups: poor, moderate, and good spermatogenesis. These were statistically compared with hormonal levels and surgical sperm retrieval outcomes. There were significant differences in Johnson’s scores and serum FSH and LH levels among the three groups (p < 0.005). TEX101 and LDHC proteins were strongly expressed in the good group, weakly in the moderate group, and absent in the poor group. The success rate of sperm retrieval was 100% (17/17) in the good group, 96.29% (26/27) in the moderate group, and only 29.62% (8/27) in the poor group. Conclusion Histological evaluation of spermatogenesis in azoospermic patients can help predict the outcome of surgical sperm retrieval, indicating its clinical value in treatment planning.

Background: The development of accurate and non-invasive diagnostic tools is essential for improving early detection of cancers. Recent studies have shown that serum biomarkers may be useful for early detection of gastric cancer. Aim: We aimed to evaluate the diagnostic accuracy of PGI and PGR biomarkers for detection of the gastric cancer and atrophic gastritis. Materials and Methods: To identify relevant studies, the MEDLINE (PubMed) database was searched using the keywords (((“Gastritis, Atrophic”[Mesh]) OR “Stomach Neoplasms”[Mesh]) AND “Pepsinogen A”[Mesh]) AND “Sensitivity and Specificity”[Mesh]). Based on the inclusion and exclusion criterias, studies were selected according to the PRISMA guidelines. Meta-analysis was performed using Review Manager 5.4.1 and STATA/IC 15.0 (StataCorp LLC, USA, 2017). Results: According to the PRISMA guidelines, we selected a total of 18 studies in this meta-analysis. The meta-analysis results showed that the sensitivity of the PGI for the detection of atrophic gastritis was 58.5% (95% CI, 44.5-71.3), specificity was 90.2% (95% CI, 68.4-97.5), and DOR was 13.0 (95% CI, 2.6-64.6); the sensitivity of the PGR was 69.9% (95% CI, 58.1-79.5), specificity was 80.9% (95% CI, 52.4-94.2), and DOR was 9.8 (95% CI, 2.6-36.9). However, the sensitivity of the PGI biomarkers for detecting gastric cancer was 72.6% (95% CI, 54.7-85.3), specificity was 66.9% (95% CI, 52.5-78.7), DOR was 5.4 (95% CI, 3.1-9.3); PGR sensitivity was 77.8% (95% CI, 64.4-87.4), specificity was 65.0% (95% CI, 53.2-75.1), DOR was 6.6 (95% CI, 3.7-11.7); PGI+PGR sensitivity was 62.3% (95% CI, 51.1-72.2), specificity was 87.6% (95% CI, 78.0-93.3), DOR was 11.6 (95% CI, 6.8-19.8). Conclusion PGI and PGR tests demonstrated high specificity but moderate sensitivity. Although serum pepsinogen cannot replace endoscopy, it is considered to be an additional test and can be used to select high-risk populations.

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: Nasal bone fracture is the most common facial bone injury and remains a significant clinical and forensic concern. Although perceived as minor, management can lead to long-term complications such as external nasal deformity, septal perforation, nasal obstruction, and chronic rhinosinusitis. These sequelae compromise quality of life and frequently give rise to medico-legal disputes regarding the assessment of health damage and work capacity. Aim: To characterize nasal bone fractures and septal deformities and to evaluate their correlation with the severity of health damage and loss of work capacity. Materials and Methods: A cross-sectional study was conducted involving 70 patients individuals with acute nasal bone fractures treated at the Department of Otorhinolaryngology, First Central Hospital of Mongolia, and patients with minor injuries assessed at the National Forensic Agency of Mongolia. Data collection included structured questionnaires, physical examination, nasal endoscopy and computed tomography. Nasal bone fractures were classified according to Hwang (2002) and septal deviations were categorized using Mladina’s classification (1987). Statistical analyses were performed to explore associations between fracture type, septal deviation, nasal obstruction and functional impairment. Results: Septal deviation was identified in 60% of patients without fracture and in 40% of those with concurrent fractures. Among 60 cases of blunt nasal trauma, septal deviation showed a statistically significant association with septal fracture (p=0.001). Hwang type II, III, and IV fractures demonstrated the strongest correlation with unilateral or bilateral nasal obstruction (χ²=29.72). Bilateral nasal bone fractures were more frequently associated with septal deviation, while logistic regression analysis revealed an increased risk of impaired work capacity (coefficient 0.237). Conclusion 1. In 40% of the study participants with nasal trauma, nasal bone fractures were accompanied by septal injury, initially classified as mild. 2. These patients underwent surgical treatment; however, when the recovery period extended beyond four weeks a reassessment of health impairment was required. According to the criterion of prolonged disruption of health, the degree of impairment was subsequently reclassified as moderate.

: Pleurotus ostreatus (Jacq) P. Kumm) is the second cultivated and most popular edible mushroom after Agaricus bisporus in the world. The fruiting bodies of these mushrooms have high nutritional value and are beneficial for health. Pleurotus ostreatus are an interesting source of bioactive glucans and other polysaccharides. This study focuses on the isolation and structural characterization of glucans from the fruiting bodies and stems cultivated mushrooms Pleurotus ostreatus. Methods: Physicochemical properties of fruiting bodies and stems cultivated Pleurotus ostreatus in Mongolia, were studied using standard methods. Glucans were extracted and purified using the precipitation method and Sevag reagent, and functional groups were determined by FT-IR. Conclusion The characteristic absorption bands of the water and alkali-soluble fractions were found near 1070, 1044, 869 and 777-769 cm-1. These IR bands are characteristic of fungal (1→3)(1→6)-β-D- glucans, and indicating these fractions are glucan-type polysaccharides

Introduction: Cases of gastric cancer have been declining worldwide in recent years. However, gastric cancer incidence increased in the last decade in Mongolia. In Mongolia, over 80% of gastric cancer cases are diagnosed during the late stage. Several studies have revealed that serum pepsinogens (PGs) level reflects, indirectly, histological and functional characteristics of the gastric mucosa. Goal: We aimed to evaluate the risk of gastric cancer and its precancerous condition based on serum PGI, PGI/II biomarkers. Materials and Methods: This case-control study enrolled 114 subjects, including patients with gastric cancer (n=36), atrophic gastritis (n=40) and healthy controls (n=138). The questionnaires were obtained to determine risk factors. Serum PGI, PGII, and H. pylori IgG levels were measured by ELISA (Pepsinogen I ELISA; Pepsinogen II ELISA; H.Pylori IgG ELISA; BIOHIT Plc, Helsinki, Finland). PGI to PGII ratio was calculated. Patients were classified into the ABC(D) group according to Miki K approach. Also, we developed new scoring system based on some risk factors and serum PGI, PGI/II ratio. Logistic regressions were performed to evaluate risk and expressed by odds ratio (OR) and 95% confidence intervals (95%CI). Results: Mean age of the subjects was 60±10.9 years. H.Pylori was positive in 67 subjects. The serum PGI and PGI/II ratio levels were significantly decreased in gastric cancer and atrophic gastritis groups compared to the healthy control. According to classification ABC(D), group D (OR 5.04, 95% CI 1.13-22.50) had higher proportion of atrophic gastritis cases, group C (OR 6.19, 95% CI 1.04-36.78) had higher proportion of gastric cancer cases than others. Additionally, we created a risk prediction scoring system with a score ranging from 0 to 7, based on variables age, family history of gastric cancer, prior disease history, PGI and PGI/II ratio levels. For the atrophic gastritis patients, 17 (42.5%) were classified into medium-risk category (OR 4.49, 95% CI 1.38-14.58) and 17 (42.5%) were classified into high-risk category (OR 7.69, 95% CI 2.16-27.43). Whereas, 11 (30.6%) patients with gastric cancer were classified into medium-risk category (OR 4.35, 95% CI 1.13-16.85), 21 (58.3%) were classified into high-risk category (OR 14.25, 95% CI 3.60-56.43). Conclusion The methods based on serum PGI and PGI/II may identify a high risk population of gastric cancer and atrophic gastritis.