Background: Watershed infarction is a distinct subtype of ischemic stroke occurring in the border zones between the terminal vascular territories of major cerebral arteries. Aim: To investigate the clinical and magnetic resonance imaging (MRI) features of watershed infarction. Materials and Methods: This hospital-based prospective cohort study included 200 patients with acute ischemic stroke admitted to the Stroke Unit of the Third State Central Hospital between July 2025 and July 2026. Patients were classified into WI (n=53) and non-watershed infarction (NWI, n=147) groups based on diffusion-weighted imaging (DWI) and cerebral arterial territories. WI was further classified into cortical, internal, and combined subtypes, and their anatomical and morphological features were evaluated on DWI. Stroke etiology was classified using the TOAST criteria and neurological severity using the National Institutes of Health Stroke Scale (NIHSS). Statistical analyses were performed using Stata 14.2 (p<0.05). Result: Of 200 patients, 53 (26.5%) had WI and 147 (73.5%) had NWI. Mean NIHSS scores were lower in the WI than NWI group at admission (4.75±3.32 vs 9.71±5.08) and discharge (2.53±2.73 vs 6.90±4.93; both p<0.001). Among patients with WI, 40 (75.5%) had cortical, 7 (13.2%) internal, and 6 (11.3%) combined WI. Mean NIHSS scores for cortical, internal, and combined WI were 3.30±1.92, 10.14±2.34, and 8.17±2.79 at admission and 1.33±1.14, 7.43±2.57, and 4.83±2.79 at discharge, respectively (both p<0.001). On DWI, the MCA–PCA watershed territory was the most frequent location of cortical WI (47.5%), and 77.5% had a wedge-shaped component. Confluent distribution was observed in 57.1% of internal WI, while cigar-shaped morphology was present in 61.5% of cases with an internal watershed component. Etiology differed among WI subtypes (p=0.030), with all internal WI cases attributed to large-artery atherosclerosis. Conclusion Watershed infarction subtypes differed in clinical severity and etiological distribution, while MRI demonstrated distinct anatomical, distributional, and morphological characteristics of cortical and internal watershed infarctions.

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.

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.

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.

Background: A drug related problem is defined by the Pharmaceutical Care Network Europe Association as an an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes. One critical aspect of preventing such errors is proper dose adjustment, which plays a vital role in the diagnosis and treatment of disease. For instance, adjusting the dose of warfarin based on the patient’s INR level is essential. In a 1995 study conducted in England, clinical pharmacists recommended target doses of angiotensin-converting enzyme (ACE) inhibitors for patients with chronic heart failure. As a result, patients experienced a significant reduction in pulmonary and peripheral edema, along with improved exercise test outcomes. At the Mongolian-Japanese Hospital of the Mongolian Medical University of Science and Technology, it is important to analyze dosage-related issues identified by clinical pharmacists and inform healthcare professionals about common dosage selection errors and associated risks. Aim: We analyzed issues related to medication dosage. Materials and Methods: A retrospective study was conducted to examine problem related to dosage detected through prescription monitoring at the Mongolian Japanese Hospital of the Mongolian National University of Health Sciences from 2023 to 2024. Results: Out of a total of 2340 drug-related problem identified across five inpatient wards during this period, 581 (100%) were related to dosage. Clinical pharmacists performed prescription review on approximately 67% of all inpatients, which was consistent between years. However, medication-related problems tended to decrease from 41.1% (n=1499) in 2023 to 22.3% (n=841) in 2024 (p=0.05). The majority of dose-related problems, 75.6% (n=440), were overdoses. Medication-related problems were most common in the surgical department, with 59.5% (n=346) (p=0.001). The most frequent dosage-related errors involved exceeding the daily dose of diclofenac, administering higher- than-recommended doses of ceftriaxone, failing to adjust cefotaxime for renal function, and using inappropriate doses of metronidazole in patients with impaired liver function. The leading cause of these errors was failure to adhere to guideline-recommended dosing, which accounted for 71.3% (n=415) of cases (p=0.001). When dosage-related recommendations were provided to physicians before of treatment, acceptance rates increased by 14% (p=0.001). These interventions resulted in an estimated cost saving of 1.267.219₮ and a reduction of 363 injections. Conclusion Therefore, clinical pharmacist-led prescription review can help reduce the risk of dosage errors, lower associated healthcare costs, and alleviate the burden on medical staff.

Background: The relationship between alcohol consumption and sleep disorders is a complex issue. Although alcohol has a sedative effect in small doses, this effect diminishes when alcohol consumption exceeds an average of 7 grams per hour. Aim: To assess the sleep quality of individuals dependent on alcohol. Materials and Methods: A quantitative study was conducted using a survey-based research design. A total of 120 men participated in the study, including 60 alcohol-dependent individuals and 60 in the control group without alcohol dependence. The study utilized demographic questionnaires, the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, and the Alcohol Use Disorders Identification Test (AUDIT) to determine the level of alcohol dependence. Results: The average age of alcohol-dependent participants was 45.3±42.4 years, while the control group had an average age of 42.4±5.1 years. The AUDIT score for the alcohol-dependent group was 25.6±9.8, indicating a high level of dependence, whereas the control group scored 7.2±3.2, suggesting low consumption levels. This difference was statistically significant (t=3.98, p=0.001). In the alcohol-dependent group, sleep latency was prolonged (p=0.042), sleep efficiency scores were lower (p=0.012), and sleep disturbances were more frequent (p=0.039) compared to the control group. The overall PSQI score was 9.82±2.8 for the alcohol-dependent group, whereas it was 4.1±1.2 for the control group. A correlation analysis revealed that poor subjective sleep quality (p=0.023), sleep latency of more than 30 minutes (p=0.012), sleep efficiency below 75% (p=0.021), and sleep disturbances (p=0.019) were significantly associated with higher AUDIT scores. Conclusion Alcohol dependence negatively affects sleep quality, particularly in terms of subjective sleep perception, sleep latency, and sleep efficiency, leading to sleep disorders.

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: 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.