1.Review on relationship between migraine and stroke
Delgermaa Ts ; Burmaajav B ; Tsagaankhuu G
Mongolian Medical Sciences 2026;215(1):140-158
Background:
Recent meta-analyses have consistently demonstrated a relationship between migraine and
stroke, which is well-defined for ischemic stroke and migraine with aura, is even stronger
in females on oral contraceptives or smokers. However, there seems to be no clear-cut
association between stroke in migraineurs and the common vascular risk factors, at least
in the young adult population. Migraineurs also run an increased risk of hemorrhagic stroke,
while the association between migraine and cardiovascular disease remain poorly defined.
Objective:
The aim was to conduct a systematic review of published sources on the relationships
between migraine and stroke in young people.
Methods:
The research sources were searched using keywords such as “Migraine”, “Headache”,
“Migraine-infarct”, “Vascular risk factors”, “Silent stroke”, “Leukoaraiosis”, “Patent foramen
ovale”, “Dissection”, “hereditary vascular disease” from the works published in international
platforms such as Cochrane Library, Datebase, Medline, PubMed, Google Scholar, and Web
of Science, and relevant information and data were selected from the collected sources and
a review article was developed.
Results:
It has been demonstrated that there is an increased frequency of ischemic lesions in the
white matter of migraineurs, especially silent infarcts in the anterior and posterior circulation
territories in patients with at least 10 attacks per month. Although there is a higher prevalence
of patent foramen ovale (PFO) in migraineurs, the relationship between migraine and PFO
remains controversial and PFO closure is not a recommended procedure to prevent migraine.
As an increased frequency of cervical artery dissections has been observed in migrainous
patients, it has been hypothesized that migraine may represent a predisposing factor for
cervical artery dissection.
Conclusion
Based on the research evidence, there is a clear relationship between
symptomatic migraine (with aura) and silent brain infarction, so early detection and treatment
of vascular risk factors are necessary in migraine patients.
2.Effect of adipose-derived stem cell therapy on Cisplatin-Induced primary ovarian insufficiency in mice
Bayarmanlai B ; Delgermaa B ; Serjnyam S ; Khongorzul B ; Anujin Ts ; Chimgee Ts ; Munkhtsetseg D ; Tungalagsuvd A
Mongolian Journal of Health Sciences 2026;96(6):189-193
Background:
Cisplatin is a widely used platinum-based chemotherapeutic agent, but its gonadotoxic effects can damage ovarian tissue, oocytes, and developing follicles and may lead to primary ovarian insufficiency (POI). Adipose-derived stem cells (ADSCs) are being investigated as a potential regenerative treatment because of their paracrine, anti-apoptotic, and tissue-repair effects.
Aim:
To evaluate the effect of ADSC therapy on estrous cyclicity, body weight, and ovarian follicular morphology in a mouse model of cisplatin-induced POI.
Materials and Methods:
Thirty 6-week-old female BALB/c mice were included. Six mice received saline as controls, while 24 mice received cisplatin 2 mg/kg intraperitoneally once daily for 10 days to induce POI. After POI induction, cisplatin-exposed animals were continued as an untreated POI group (n=15) or an ADSC-treatment group (n=9). The ADSC group received 1×10⁶ cells suspended in 0.2 mL medium via the tail vein. Body weight and vaginal cytology were monitored daily, and estrous stages were classified as proestrus, estrus, metestrus, and diestrus. Ovaries were collected for histologic evaluation at the end of the study.
Result:
After cisplatin exposure, mean estrous cycle length increased from 3.97 days in controls to 6.4 days in the POI group (p<0.05). During the post-treatment evaluation, mean cycle length was 5.65 days in untreated POI mice (n=4) and 4.5 days in ADSC-treated mice (n=7), representing a statistically significant improvement after ADSC therapy (p=0.013). Cisplatin caused significant body-weight loss, reaching a mean of 18.0 g on day 6 after completion of cisplatin administration (p<0.01). Histologically, untreated POI ovaries showed follicular atrophy and prominent degenerative changes, whereas ADSC-treated ovaries showed more morphologically preserved primary, secondary, and antral follicles and relatively fewer degenerative changes. Exploratory manual counting in three representative whole-ovary sections per group showed total intact/growing follicle counts of 15.00±2.65 in controls, 6.00±2.00 in POI, and 8.67±2.89 in ADSC-treated ovaries.
Conclusion
ADSC treatment was associated with partial restoration of estrous cyclicity and ovarian follicular development in a cisplatin-induced POI mouse model. These findings support further investigation of ADSC-based regenerative therapy for chemotherapy-associated ovarian injury.
3.Comprehensive Surgical Management of Combined Congenital Auricular and External Auditory Canal Malformations
Jargalkhuu E ; Ayanga G ; Tserendulam D ; Erdenetsogt J ; Delgermaa B ; Radnaatseren L
Mongolian Journal of Health Sciences 2026;93(3):17-26
Background:
According to the World Health Organization (WHO), approximately 2,000 types of congenital anomalies affecting the human body have been identified, among which craniofacial anomalies rank between second and fourth in prevalence. Hearing impairment occurs in approximately 1.62 per 1,000 live births, while congenital malformations of the external and middle ear occur in about 1.6 per 10,000 live births. The WHO epidemiological report (2022) indicates that severe combined congenital malformations of the external and middle ear, including microtia and aural atresia, occur in approximately 2.35–7 per 10,000 live births. The prevalence of microtia is relatively higher in certain regions of Asia and South America (1 per 1,500–3,000 live births), whereas lower rates have been reported in Europe and Africa.
Aim:
To evaluate the feasibility and outcomes of surgical reconstruction of the auricle and the external auditory canal–tympanic cavity (meatotympanoplasty) in patients with combined congenital malformations of the external and middle ear.
Materials and Methods:
Audiological evaluation revealed an air conduction hearing loss of 75–80 dB. Computed tomography grading showed scores of 5–6, corresponding to grade III congenital malformation of the external and middle ear, and classified as type III according to the Nagata–Weerda classification.In cases of unilateral combined congenital external and middle ear malformations (auricular deformity with associated aural atresia), auricular reconstruction and external auditory canal formation were performed in two surgical stages with a 6-month interval. At postoperative day 21, removal of the external auditory canal stent revealed no evidence of canal stenosis, and epithelialization of the skin graft had begun.
Result:
Postoperative audiological assessments conducted at 30, 45, and 60 days demonstrated a statistically and clinically significant improvement in hearing thresholds, which correlated directly with the healing status of the newly reconstructed tympanic membrane.
Conclusion
The findings of this study suggest that in patients with combined congenital malformations of the external and middle ear, simultaneous reconstruction of the auricle and the external auditory canal–tympanic cavity in a single surgical stage may be feasible. This approach has the potential to reduce overall treatment duration, surgical burden, and psychological stress for patients. However, further studies involving larger patient cohorts and long-term follow-up are required to evaluate hearing stability and the incidence of postoperative complications, including restenosis and secondary tympanic membrane changes.
4.Stress among university faculty members
Solongo D ; Odgerel B ; Taivanjargal G ; Ariunaa J ; Delgermaa S ; Orgilmaa R
Mongolian Journal of Health Sciences 2026;95(5):293-297
Background:
Teaching is a profession associated with high levels of stress. Research has shown that when job demands are high while organizational support is insufficient, levels of stress and burnout increase.
Aim:
Prior to conducting our study aimed at determining the stress levels among university faculty members, we performed a literature review.
Materials and Methods:
We conducted a literature search using the PubMed and Embase databases for studies published in English without restriction on publication year, including all relevant articles available up to September 2025. The search strategy included the following keywords: “stress,” “researchers,” “university professors,” “academic researchers,” “college,” “academics,” “scholars,” “teachers,” and “professors.”
Results:
We searched for English-language publications in the PubMed and Embase databases without year restrictions, including studies published up to September 2025. The search was conducted using the following mesh terms: “stress,” “researchers,” “university professors,” “academic researchers,” “college,” “academics,” “scholars,” “teachers,” and “professors.” A total of 3,961 articles were identified from the database search. After screening titles, 2,944 articles were excluded. Subsequently, 58 articles were reviewed based on their abstracts, and 12 studies that were relevant to our research objectives and questionnaire were selected for analysis.
Conclusion
This review study demonstrated that stress levels among university and college faculty members are high. Stress is associated with multiple factors, including workload, organizational support, and performance demands, leading to negative physical and psychological consequences. Therefore, it is necessary to implement systematic institutional-level interventions to support the well-being of faculty members.
5.A systematic review: epidemiology, etiology and risk factors of stroke in young adults
Delgermaa Ts ; Juramt B ; Tsagaankhuu А
Mongolian Journal of Health Sciences 2025;88(4):6-14
Background:
The annual incidence of stroke in different regions of the world ranges from 100 to 336 per 100,000 pop
ulation, and mortality ranges from 36 to 136, and in Mongolia there are 220 new cases of stroke per 100,000 people and 113 deaths annually, making it one of the countries with the high stroke incidence rate.
Aim:
To conduct a systematic review of published sources on the epidemiology, causes, and risk factors of ischemic stroke in young people.
Materials and Methods:
The research sources were searched using keywords such as “Stroke”, “Definition”, “Epidemi
ology”, “Etiology”, “Risk factors”, “Young Adult”, “Ischemia”, “Hemorrhage”, “Silent stroke” from the works published in international platforms such as Cochrane Library, Datebase, Medline, PubMed, Google Scholar, and Web of Science, and relevant information and data were selected from the collected sources and a review article was developed.
Results:
According to the WHO MONICA project report, stroke incidence was reported in 16 countries, with 101–285 men and 47–198 women per 100,000 people aged 35–64 years, while in the United States it was 113.8 per 100,000 people under 55 years, of which 73.1 were cerebral infarctions per 100,000 people, and more than 10 percent were under 55 years. A recent study in Mongolia found that 21–26% of stroke patients were young people (20-50 year old), compared with 10–13% in Western countries. Among the traditional causes and risk factors for stroke in young people, arterial
hypertension accounts for 45-60%, smoking 40-60%, alcoholism 40-50%, heart disease 18-30%, dyslipidemia 30%, diabetes 13%, obesity 7-36%; among the specific risk factors, migraine accounts for 10-35%, taking hormonal contraceptives 10-22%, vasculitis 6-10%, blood clotting disorders 2-10%, vascular dissection 6-40%. According to the TOAST
classification, large vessel disease accounts for 16-17%, small vessel occlusion 14-15%, cardiac embolism 19-20%, other
determined etiologies 22-23% and undetermined 26-27%.
Conclusion
Epidemiological indicators of stroke vary significantly depending on the level of development of the country, geographical characteristics of the region, lifestyle, age, and gender (stroke incidence rate range: 100–336 per 100,000 population; mortality: 36–136 per 100,000 population). Mongolia is among the countries with high rates of stroke incidence and mortality (incidence rate 220 per 100 000, mortality 113 per 100 000 population). While stroke among
young people accounts for 10–13% of all cases in Western countries, this figure reaches 21–26% in Mongolia, which is
explained by a combination of traditional and specific risk factors. As stroke is becoming more common among younger
populations, it is essential to study its causes and risk factors in detail and to intensify efforts in diagnosis, treatment, and
prevention.
6.Management and monitoring of hypokalemia occurring during certain diseases
Temuulen Ts ; Maral B ; Baasanjargal B ; Agidulam Z ; Burenbayar Ch ; Ankhbayar D ; Tsogdulam S ; Amardulguun S ; Otgon-Erdene M ; Anujin G ; Khongorzul U1 ; Delgermaa Sh ; Odgerel Ts
Mongolian Journal of Health Sciences 2025;86(2):51-54
Background:
Hypokalemia is considered when the serum potassium level is less than 3.5 mmol/L. Clinical research indicates
that hypokalemia affects 20% of hospitalized patients, and in 24% of these cases, inadequate interventions result
in life-threatening complications. At present, there is no research available on the prevalence, management, and outcomes
of hypokalemia in hospitalized patients, which justifies the need for this study.
Aim:
The study aimed to examine the prevalence of hypokalemia and the effectiveness of its management in hospitalized
patients within the internal medicine department, in relation to the knowledge of doctors and resident physicians.
Materials and Methods:
This hospital-based retrospective study included a total of 553 cases of patients hospitalized in
the Internal Medicine Department of the Mongolia Japan Hospital between January 2024 and August 2024. Patients with
a potassium level of <3.5 mmol/L were diagnosed with hypokalemia, and the effectiveness of potassium replacement
therapy was evaluated according to the method of supplementation employed.
Results:
The prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department was 9.8%
(54 cases). Based on the study criteria, 42 cases of hypokalemia were selected for further analysis, and a total of 118 potassium
replacements were performed through oral, intravenous, and mixed methods. Following potassium replacement
therapy, 37.3% (44) of patients achieved normalized potassium levels, while 62.7% (74) still had persistent hypokalemia.
Conclusion
According to the study results, the prevalence of hypokalemia among hospitalized patients in the Internal
Medicine Department is 9.8%. The method of potassium replacement and the severity of hypokalemia do not impact the
normalization of potassium levels, with the critical factor being the proper dosage of supplementation. The knowledge
of doctors and resident physicians regarding hypokalemia is insufficient, and there is a need to implement guidelines and
protocols for potassium replacement therapy in daily clinical practice.
7.Analysis of various risk factors associated with poor sleep quality
Purevdulam B ; Khishigsuren Z ; Tovuudorj A ; Tsagaankhuu G ; Delgermaa Ts
Mongolian Journal of Health Sciences 2025;85(1):207-213
Background:
Sleep quality is frequently highlighted in the literature as a key factor for overall health. Poor sleep quality
significantly affects both physical and mental health, diminishing quality of life and potentially harming personal finances. While this issue is influenced by various risk factors, no well-studied research has been conducted on it in Mongolia.
Aim:
The aim of this study was to assess the frequency of poor sleep quality among visitors to the Sleep center in Mongolia and to identify the factors associated with poor sleep quality.
Materials and Methods:
This study, conducted using a cross-sectional design, included 200 participants aged 18 to 65
years who visited the Sleep Center at the General Hospital for State Special Servants between January and May 2024.
Data were collected using a structured questionnaire. Sleep quality was assessed using the Mongolian version of the Pittsburgh Sleep Quality Index, with a global score above 6 indicating poor sleep. Participants were divided into two groups:
“Good sleepers” (n=105) and “Poor sleepers” (n=95). Socio-demographic and clinical variables such as age, sex, levels
of education were also recorded. The level of depression, anxiety, and stress was assessed using the DASS 21 (Depression
Anxiety Stress Scale) criteria. Univariate analysis was performed using the t-test, Mann-Whitney U test for continuous
data, the Х2 or Fishers’s exact test for categorical data, and logistic regression for multivariable analysis. A P-value of less
than or equal to 0.05 was considered significant.
Results:
Poor sleep quality, indicated by a PSQI global score above 6, was observed in 52.5% of the total participants.
Univariate analtysis’s test results showed that age, being female, having depression, anxiety, BMI ≥ 25, alcoholism,
comorbidities, and using concomitant medications were significantly associated with poor sleep quality (all p<0.05). In
the multivariate logistic regression analysis, 50 < age (OR 3.133, 95% CI, 1.245-7.884, p<0.05), BMI ≥ 25 (OR 2.084,
1.039-4.179, p<0.05), alcoholism (OR 3.018, 95% CI, 1.495-6.093, p<0.01) and depression (OR 15.957, 95% CI, 1.592-159.922, p<0.05) were identified as significant risk factors for poor sleep quality. Depression and alcoholism were associated with longer sleep latency and decreased daytime activity (p<0.05).
Conclusions
1. In our study, more than half of the participants experienced poor sleep quality.
2. Age over fifty, depression, BMI ≥ 25, and alcoholism emerged as independent significant risk factors for sleep disturbance. Alterations in sleep latency, sleep disruption, and impaired daytime functioning may be associated with
poor sleep quality.
8.A Study on the Learning Motivation and Engagement Level of Generation Z Students
Otgontsend O ; Ganbaatar B ; Odgerel B ; Ariunaa J ; Enkhbold D ; Delgermaa S ; Orgilmaa R ; Solongo D
Mongolian Journal of Health Sciences 2025;90(6):200-204
Background:
Generation Z students, born after 1995, are characterized by their ability to multitask, low tolerance for
traditional learning methods, impatience, short attention span, and preference for working independently rather than
collaboratively. They are also considered more vulnerable to mental health challenges compared to previous generations.
Aim:
To assess the level of academic engagement among Generation Z students studying in the School of Nursing.
Materials and Methods:
This descriptive, cross-sectional quantitative study was conducted from February 1 to April
1, 2025. A total of 420 students majoring in nursing, midwifery, physical therapy, occupational therapy, and traditional
medicine nursing at the School of Nursing, Mongolian National University of Medical Sciences, participated in the study.
The Student Course Engagement Questionnaire (Handelsman, 2005) was used to evaluate students’ engagement levels.
The reliability of the questionnaire was confirmed with a Cronbach’s α of 0.955. Statistical analysis was performed using
SPSS version 25, and results were considered statistically significant at p<0.05.
Results:
Among the 420 participants, 91.9% were female and 8.1% were male. By major, 57.1% studied nursing, 22.6%
midwifery, 8.8% physical therapy, and the remainder were from other disciplines. Student engagement was analyzed
across three domains: academic involvement, personal responsibility and effort, and learning attitude and motivation.
Pearson correlation analysis revealed strong positive correlations between academic involvement and personal responsibility/
effort (r=0.828), learning attitude and motivation (r=0.825), and between responsibility/effort and learning attitude/
motivation (r=0.903) (p<0.01). Age showed a weak positive correlation with year of study (r=0.381), while major and
year of study had a weak negative correlation (r= -0.146) (p<0.01). Year of study and learning motivation also showed a
weak negative correlation (r=-0.107, p<0.05).
Conclusion
The learning motivation and class engagement of Generation Z nursing students were found to be strongly
correlated with their sense of responsibility, effort, and learning attitude (r=0.82–0.90, p<0.01). Most students demonstrated
consistent participation and motivation to learn, showed less interest in traditional teaching approaches, and preferred
practical training.
9.Prevalence of Micronutrient Deficiencies Among Mongolian Pregnant Women
Oyundelger D ; Bolormaa N ; Munkhjargal L ; Munkhtamir M ; Davaasuren M ; Amarsanaa B ; Delgermaa D ; Ganzorig T ; Munkhtsetseg P ; Bayasgalan J
Mongolian Medical Sciences 2025;214(4):24-31
Background:
Vulnerable populations at risk of micronutrient deficiencies include children and women,
especially pregnant women, lactating mothers, infants and young children. According to
WHO guidelines, a population with a micronutrient (vitamin and mineral) deficiency of more
than 20% is considered a public health problem.
Although Mongolia has made significant progress in improving the nutritional status of the
population, especially children and women, the 2024 VI survey found that micronutrient
deficiencies are high among pregnant women.
The MMS (Multi-ingredient Micronutrient Supplement) distributed to pregnant women by
soum and household health centers contains all the essential vitamins and minerals for
pregnant women, but coverage has remained inadequate for more than 10 years.
Goal:
To establish the prevalence of micronutrients deficiency in pregnant women
Materials and Methods:
Totally 2796 pregnant women included in cross-sectional study from urban and rural
area. Survey procedures consisted of interview, anthropometric measurements, clinical
examinations, and the collection of biological (blood and urine) samples for pregnant
women. Micronutrient deficiencies were assessed by tests for hemoglobin, serum, ferritin,
soluble transferrin receptor (sTfR), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for
determination of urinary iodine concentration.
Statistical processing :
The data from the survey questionnaires were entered into a database created in the
“EpiData 3.1” software environment. The data created and verified in the EpiData software
environment were converted to the “SPSS–25” program, and statistical analysis was also performed using the SPSS-25 program. The results table was prepared using Microsoft
Word 2021 and Microsoft Excel 2021 programs.
Research ethics:
The research methodology was discussed at the meeting of the Medical Ethics Review
Committee under the Ministry of Health on 2023.03.27 (23/017), and permission to conduct
the study was obtained
Result :
The prevalence of anemia, as measured by hemoglobin, was 22.3% and the iron deficiency
anemia (IDA), as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR)
was (39.8%/9.0%). Prevalence of iron deficiency as measured by serum ferritin was also
highest in Western 41.9% and lowest in Khangai region 40.2% (P<0.01). The prevalence of
vitamin D deficiency among pregnant women was high at 92.5%, and 7.5% of all pregnant
women had adequate vitamin D status. The median concentration of 76.4µg/l indicates
inadequate iodine status in pregnant women, as the desired range for adequate iodine
nutrition in pregnancy 150-249 µg/l.
Conclusions
1. 22.3 percent of pregnant women are anemic, and the prevalence of anemia has not
decreased from 2017 levels and remains common.
2. The prevalence of iron deficiency (as measured by ferritin levels) was 39.8 μg/L and the
soluble transferrin receptor level was 9.0 μg/L, which is higher than previous studies.
3. The prevalence of vitamin D deficiency among pregnant women remains common, with
76.6% having severe or moderate deficiency, and 15.9% having mild deficiency.
10.The prevalence of overweight and obesity among men aged 15-49 in Mongolia
Tuvshinbayar B ; Ganzorig T ; Oyundelger D ; Delgermaa D ; Bayasgalan J
Mongolian Medical Sciences 2025;214(4):32-37
Background:
Men’s health is a vulnerable associated with higher risk behaviors and is less considered
to their health compared to women. According to NSO, of the total population, 49.3 percent
were males and 50.7 percent were females in Mongolia. There is a difference in average
life expectancy between man and woman, and males live in average eight years (9.2) fewer
compared to females.
Objective:
To determine nutrition status among men aged 15-49 in Mongolia
Materials and Methods:
The target population was divided into 5 strata based on Mongolia’s socio-economic regions
and Ulaanbaatar City. 1950 men aged 15-49 were randomly selected. The confidence
interval was set at 95%, with a precision of ±5% or less for all indicators. The sample size
was sufficient to obtain representative data on the nutrition status of men at the national level
and to calculated using WHO recommendation for adults.
Ethics consideration:
The survey methodology was discussed at the Scientific committee
of National Center for Public Health, on February 6, 2023. Ethics approval was obtained
from Medical Ethics Review Committee under the Ministry of Health on March 27, 2023. All
participants were participated voluntarily and written informed consent were obtained from
participants.
Results:
The prevalence of overweight and obesity among men was 57.4%, with 17.0% classified as
obese. Overweight and obesity rates were highest in men aged 30-39 years (62.2%) and 40
49 years (64.5%) among other age groups.
Conclusion
In Mongolia, the prevalence of overweight and obesity among men aged 15–49
increased by 9.4 percentage point to reach 57.4%, since 2017 and 17.0% of men aged
15-49 years are now classified as obese, with biggest increase in age group 20-29. The
prevalence of obesity was higher among men in the above-average and affluent groups
(20.0% and 20.6%) compared to men aged 15-49 living in the average and below-average
income groups (10.8% and 13.1%).
Conclusion: In Mongolia, one in two men age between 15-49 years were overweight and obese. The
prevalence of overweight and obesity has increase age between 30-49 years compared with
other groups.
Result Analysis
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