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.

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.

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.

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.

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.

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.

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.

The result of determination of some risk factors of hearing loss, deafness in neonates and infants Background: Newborns born prematurely or with high risk for hearing loss are 10 times more likely to develop hearing loss than well babies. Also, 1 out of 50 newborns hospitalized in the neonatal intensive care unit are at risk of hearing loss. The risk factors of hearing loss and deafness in children was first developed and tracked by Joint Committee on Infant Hearing in 1972, and has been further refined and updated since then. The last update was made in 2007 and used worldwide. The risk factors of hearing loss for children vary by age. Materials and methods: A case-control study was performed to identify some risk factors for the development of hearing loss and deafness in neonates and infants. The research case group included all the cases in which the diagnosis of congenital hearing loss or deafness was confirmed by the auditory brainstem response test (ABR) in the 3 stages of the study or the stage of diagnosis confirmation, while the control group included infants whose diagnosis was not confirmed and normal hearing was confirmed by the auditory brainstem response test (ABR). The study groups were selected in 1:1 ratio. Results: The perinatal disorders (OR 7.67; 95% CI; 3.61-16.34; p=<0.0001), genetic predisposition (OR 8.45; 95% CI; 1.04-68.46; p=0.045), PCOS (OR 2.85; 95% CI; 1.27-6.41; p=0.011), premature birth (OR 3.90; 95% CI; 1.27-6.41; p=<0.0001), hearing of children with congenital malformations (OR 16.55; 95% CI; 2.15-127.01; p=0.007) reduction and deafness are statistically significant. Conclusion: The perinatal disorders (OR 5.31), genetic factors (OR 10.01), congenital malformations (OR 2.65), ear disorders (OR 8.94), and premature birth (OR 2.57) are statistically significant factors in the development of hearing loss and deafness in neonates and infants.

The result of a study of prevalence, type and degrees Of hearing impairment in newborns and infants Introduction: Significant bilateral hearing loss is the most common congenital disorder of the newborn, occurring 2-3 times per 1000 live infants. In December 2012, for the first time in Mongolia, neonatal hearing screening was introduced at the National Center for Maternal and Child Health. We aimed at investigated the outcomes of neonatal hearing screening and diagnostics of type and degree of hearing loss in neonates and infants. Materials and methods: During the study period, 2019-2020, a total of 70,614 infants born in Urguu, Khuree, Amgalan maternity hospitals, Baganuur district health center, Intermed hospital, and the National Center for Maternal and Child Health were included in the prospective cohort study. The study was performed in three phases, following the clinical guidelines for neonatal hearing screening. Results from the well-baby newborn hearing screening program and diagnostic follow-up of referred children from 2019 to 2021 were included in calculating prevalence rates. Hearing loss was classified according to the degree and type. Results: A total of 94.1% of 70,614 children eligible for screening were included. A prevalence rate of bilateral hearing loss 2.23 per 1000 children was found. A prevalence rate of bilateral severe and profound hearing loss 1 per 1000 children was found. The mild sensorineural hearing loss 28 (26.0%) was most common in children, followed by moderate 19 (17,6%), severe 21 (19.4%), profound 19 (17.6%) and deaf 21 (19.4%). Conclusions: The coverage of hearing screening in maternity hospitals in Ulaanbaatar is relatively good (94.1%), but there is a repeat screening (62.1%) and follow-up and diagnostic tests (49.9%). shows that the system needs to be improved. Because of the well-by hearing screening program, reported results approximate prevalence rates of permanent hearing loss by severity.

Result the subtypes and effectiveness of functional endoscopic sinus surgery(FESS) using a microdebrider Introduction: Chronic rhinitis in children has been on the rise in recent years, and polyps account for the majority of benign nasal cancers in children. Surgery is necessary when drug treatment is ineffective. We use pediatric rhinoplasty. Aimed at calculating the subtypes and effectiveness of Functional endoscopic sinus surgery(FESS) using a microdebrider. Material and methods: The survey was conducted between March and April 2020, based on the Otolaryngology Surgery Department of the National Center for Maternal and Child Health, using the cross-section of analytical design under Objectives 1 and 2 and the longitudinal design under Objective 3. Under Objectives 1 and 2, participants' information was collected from a pre-prepared questionnaire from their medical history. The questionnaire has four chapters that provide general information about the patient, clinical signs, surgical structure, and biopsy results. The pain was assessed by the “Sino-Nasal Outcome Test (SNOT-20)”. A total of 98 patients were included in the statistical analysis of the survey results using the STATA 15.0 program, and the results of the surgery were evaluated by 20 patients. Results: In children with chronic rhinitis, the SNOT20 test showed a statistically significant difference of 1.6 ± 0.6 before surgery and an average of 0.51 ± 0.11 after surgery. Conclusion: In chronic rhinitis, FESS with microdebrider surgery is an effective treatment for children.