Background: Employee satisfaction in the healthcare sector has a direct impact not only on the quality of medical services, but also on workforce stability and overall organizational performance. High levels of job satisfaction are associated with improved work performance, whereas low satisfaction often leads to negative outcomes such as stress and burnout. Although studies on job satisfaction have been conducted in Mongolia, research specifically targeting healthcare workers—and identifying the key factors influencing their satisfaction—remains relatively limited. This gap provides the rationale for the present study Aim: The objective of this study is to examine job satisfaction among healthcare workers at primary and referral hospitals and to identify key factors influencing it. Materials and Methods: The study was conducted between 2022 and 2024 among 1,883 physicians, nurses, and other healthcare professionals aged 18–65 years from 11 provinces and Ulaanbaatar city, using a quantitative research approach with a cross-sectional design. Job satisfaction was assessed with a questionnaire comprising six subdomains (supportive leadership, opportunities for human resource development, professional ethics, organizational culture, quality of healthcare services, and workplace safety), rated on a three-point Likert scale. Data analysis was performed using IBM SPSS Statistics version 26.0. Results: The overall level of job satisfaction among participants was 77.6%. Among the subdomains, workplace safety and supportive environment scored the lowest at 71.7%, whereas the quality and safety of healthcare services scored the highest at 83.4%. The findings indicated that holding a managerial position in hospitals in Ulaanbaatar and working as a physician in primary-level hospitals were positively associated with job satisfaction (p < 0.05). Age demonstrated a statistically significant association with job satisfaction, while years of work experience showed a negative correlation, with satisfaction decreasing as tenure increased (r = −0.09, p < 0.001). The findings indicate that improving healthcare workers’ job satisfaction requires strengthening and supporting several organizational dimensions, including supportive leadership, opportunities for human resource development, organizational culture, workplace safety, and a supportive work environment Conclusion Workplace safety and support, opportunities for human resource development, and organizational culture were found to be critical determinants of employee job satisfaction. The findings suggest that job satisfaction can be enhanced by optimizing organizational support, ensuring opportunities for professional growth, and strengthening workplace safety

Introduction: Cardiovascular disease-related mortality accounts for 34% globally, 23% in the United States, and 22% in Europe, with Asia representing 35% of total deaths as of 2019. In Asia, ischemic heart disease and stroke are the most common causes of cardiovascular diseases (CVD), and the prevalence of these two types of CVD varies significantly across different regions and countries in Asia. Over the last 10 years, the average number of deaths due to cardiovascular diseases has been 5.7 thousand annually, representing 33.7% of total mortality. Cardiovascular diseases account for 11.1% of all illnesses, and as of 2021, the rate has increased by 128 compared to the average of the past 10 years, reaching 936 per 10.000 population. As cardiovascular disease-related mortality is the leading cause of death worldwide, every country has criteria for calculating the 10-year risk of CVD to reduce cardiovascular morbidity and mortality. These criteria are crucial for predicting the risk of stroke and cardiovascular diseases in individuals with or without diabetes. Purpose: To assess the risk of heart disease in people aged 40-74 years without cardiovascular disease. Material and Methods: A total of 394 individuals aged 40-74 were included in the study. Blood samples were taken to determine lipid profiles and fasting glucose levels. Using the World Health Organization's (2019) revised cardiovascular disease risk assessment model (which considers age, systolic blood pressure, smoking, total cholesterol, LDL and BMI), the 10-year risk of developing cardiovascular disease was calculated using both laboratory-based and non-laboratory based risk assessment criteria. Statistical analysis of the study was performed using SPSS 26 software, with a p-value of less than 0.05 considered statistically significant. Ethics: The methodology was approved by the Medical Ethics Sub-Committee of the Ach medical university on the 30th of June, 2023 (Decision #23/02/03) Result: The average age of the adults included in the study was 49.3±14.7 years. Among those aged 40-74 who participated in the CVD risk assessment criteria, the average age was 53.7±9 years, with men having an average age of 54.6±9.3 (117 participants) and women having an average age of 53±8.7 (223 participants). The total cardiovascular risk of the study participants was 54.8% very low, 15.7% low, 13.2% moderate, 8.1% high, and 8.1% very high according to laboratory-based assessment, while the non-laboratory based assessment showed 49% very low, 20.7% low, 16.8% moderate, 7.7% high and 5.9% very high risk).
Among all participants, the prevalence of cardiovascular risk factors was assessed as follows: 26.9% (95% CI: 22.6–31.6%) were smokers, 60.5% (95% CI: 55.4–65.3%) consumed alcohol, 46.4% (95% CI: 42.4–50.2%) had arterial hypertension, 10.4% (95% CI: 0.76–13.9%) had diabetes mellitus, 75% were obese, 78.4% (95% CI: 74.2–81.6%) had central obesity, 24.4% (95% CI: 18.5–31%) had hyperglycemia, 42.6% (95% CI: 35.6–49.9%) had hypercholesterolemia, 19.3% (95% CI: 14–25.5%) had hypertriglyceridemia, and 11.3% (95% CI: 0.71–16.7%) had elevated low-density lipoprotein levels.
The total cardiovascular risk of the study participants was 54.8% very low, 15.7% low, 13.2% moderate, 8.1% high, and 8.1% very high according to laboratory-based assessment, while the non-laboratory based assessment showed 49% very low, 20.7% low, 16.8% moderate, 7.7% high and 5.9% very high risk.
These distributions showed a statistically significant difference compared to the group without arterial hypertension (p<0.0001). Additionally, comparison of risk between individuals with and without diabetes mellitus using laboratory-based assessment also revealed a statistically significant difference (p<0.0001). The concordance between the two models was 88.8% (95% CI: 83.6–92.9) with a Cohen’s kappa coefficient of κ=0.6, indicating moderate agreement with statistically significant difference (p<0.001). Conclusion 75% of the people surveyed were obese and 78.4% had central obesity, with men at greater risk than women. The cardiovascular risk of having arterial hypertension and diabetes is further increased. The correlation coefficient of the risk estimates showed a strong correlation across gender and age groups. The agreement between the risk estimate models was 88.8%, or a moderate agreement with Cohen's coefficient (k=0.6).

Background: Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD), emphasizing the need for its early detection and prognosis. Objective: This study aimed to determine the serum NT-proBNP levels in participants with CKD and establish a cut-off value for predicting heart failure. Methods: A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study received approval from the Ethics Committee of the Institute of Medical Sciences (Approval No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology Department of the third state hospital were enrolled based on predefined inclusion and exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence quantitative analyzer. Data were analyzed with SPSS 26.0. Results: The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly between heart failure and non-heart failure groups (p<0.05). Significant differences were also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05). NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%, specificity: 55%). Conclusion Serum NT-proBNP levels are elevated in CKD patients regardless of heart failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).

Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney function over time. As the disease progresses, it leads to an increased risk of cardiovascular complications, which are the leading cause of morbidity and mortality in CKD patients. B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart failure. Their role in CKD, however, is complex due to the overlapping pathophysiological mechanisms between cardiac and renal dysfunctions. This literature review aims to explore the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting their clinical relevance, the impact of renal function on their levels, and potential therapeutic implications. The review focuses on studies published in the last decade, examining the clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP as biomarkers in CKD patients.

Background and Aims: The BALAD scores are developed to provide an objective determination of prognosis for hepatocellular carcinoma (HCC) by incorporating five serum markers, namely albumin, bilirubin, alpha-fetoprotein (AFP), agglutinin-reactive alpha fetoprotein (AFP-L3), and des-γ-carboxy prothrombin. We aim to study the applicability of BALAD score and prognostication of the three tumor markers, albumin and bilirubin. Methods: Patients who were served by clinical laboratory were prospectively enrolled. All the baseline characteristics and serum albumin and bilirubin level were documented at base line. The levels of the three tumor markers (AFP, AFP-L3, and des-γ-carboxy prothrombin) were determined in serum samples. assays of AFP, AFP-L3, and DCP were conducted in the same serum sample by using a microchip capillary electrophoresis and liquid phase binding assay on a μTAS Wako i30 analyzer (Wako Pure Chemical Industries, Ltd, Osaka, Japan). To detect albumin and bilirubin amount were using the cobas 6000 analyzer series that is a fully automated, software-controlled system for immunoassay and photometric analysis intended for qualitative and quantitative in vitro determinations. Results: A total of 103 patients who were served by clinical laboratory were recruited. AFP, albumin, bilirubin, DCP and AFP-L3 levels were independent prognostic factors. When the study participants evaluated BALAD scores, 45.63% scored 0 points, 28.16% scored 1 point, 10.68% scored 2 points, 8.74% scored 3 points, 3.88% scored 4 points, 1.94% 5 points, and 0.97% 7 points. Conclusion BALAD score is applicable in the population of hepatitis B and C virus related HCC. When AFP L3% increases by one unit, BALAD scores are 0.04 times higher (P=0.0001) that is presenting statistically significance.

Cardiovascular diseases related death rates have been declining over, but during the two decades, mortality and morbidity attributable by cardiovascular diseases are continuously taking the first place among the leading causes of morbidity and deaths among the population. Statistics show that >4 million people die each year from cardiovascular disease (CVD) causes in Europe. The World Health Organization reports that in less developed and developing countries, obesity and mortality are expected to continue to increase, depending on the age of the population and the characteristics of lifestyle.
Dyslipidaemia is characterized by elevated low-density lipoprotein cholesterol (LDL-C) and decreased high-density lipoprotein cholesterol (HDL-C) and is a known risk factor for development and progression of atherosclerosis in CAD.
Dyslipidemia and hypertension are major risk factors for cardiovascular disease (CVD) and account for more than 80% of deaths and disability in low- and middle-income countries. Increased serum levels of total cholesterol (TC), triglycerides (TG), high-density lipid (HDL)-cholesterol and decreased low-density lipid (LDL)-cholesterol are known to be associated with major risk factors for CVD. The Framingham study and others that followed could show that HDL-C is an independent cardiovascular risk factor and that the increase of HDL-C of only 10 mg·L(-1) leads to a risk reduction of 2-3%. A recent meta-analysis, including 302.430 subjects from 68 long-term prospective studies, supported the importance of HDL-C measurement in the risk assessment for CAD.
However, data about the relationship between cardiovascular disease and lipid profile among Mongolian adult are rare in the literature. In recent years, rapid urbanization, unhealthy diet, increased life expectancy and lifestyle changes have led to an increased rate of CVD around the world.

A lot of factors can cause coronary heart disease and ischemic stroke including external risk factors such as tobacco, alcohol consumption, decreased physical activity, obesity while arterial maintenance, high blood sugar, increased LDL are internal risk factors. We can reduce our external risk factors by changing our lifestyle. Recent studies have shown increased blood Lp(a) levels are independent risk factor for cardiovascular disease. After 1987, the number of publications has increased since the cDNA homology sequence of Lp(a) and plasminogen 2 was identified. Lp(a) is protein complex consisting from apolipoprotein, phospholipid, free cholesterol, cholesterol esters and tryglyceride. Apoliprotein is a lipid that binds with lipoprotein. Lipoproteins have water-soluble and fat-soluble parts, and those parts bind to lipids and are transported in the bloodstream.How is elevated Lp(a) a risk factor for cardiovascular disease? How much does lowering Lp(a) reduce CVD risk factors? If high Lp(a) concentrations are present, mitigation measures are outlined below.