Background: Polymyositis (PM) is a rare idiopathic inflammatory myopathy characterized by symmetric proximal muscle weakness, elevated muscle enzyme levels, dysphagia, and respiratory muscle weakness. Rhabdomyolysis is a potentially life-threatening condition caused by extensive skeletal muscle breakdown, resulting in myoglobinuria and an increased risk of acute kidney injury and multiorgan complications. The coexistence of rhabdomyolysis in patients with polymyositis is uncommon and may complicate both diagnosis and management. Case Presentation: A 65-year-old man was admitted with fever up to 39°C, generalized skin rash, dysphagia, progressive muscle weakness, dyspnea, decreased urine output, and dark tea-colored urine. Physical examination revealed symmetric proximal muscle weakness, with muscle strength graded 3/5 in both upper extremities and 4/5 in both lower extremities. Neck muscle strength was 4/5. Dysphagia and a generalized skin rash were also present. Laboratory investigations showed markedly elevated creatine kinase (CK) at 9,943.1 U/L, alanine aminotransferase (ALT) at 449.1 U/L, aspartate aminotransferase (AST) at 222.1 U/L, lactate dehydrogenase (LDH) at 1,342.9 U/L, and C-reactive protein (CRP) at 70.6 mg/L. Urinalysis showed blood 3+ and protein 2+, while no erythrocytes were detected on urine sediment microscopy. Electromyography demonstrated myopathic changes, and muscle biopsy revealed inflammatory infiltrates and necrotic muscle fibers. Conclusion Comprehensive assessment of clinical manifestations, laboratory findings, autoantibody testing, electrophysiological studies, and muscle biopsy is essential for the diagnosis of polymyositis complicated by rhabdomyolysis. An integrated diagnostic approach facilitates confirmation of the diagnosis, differentiation from clinically similar disorders, and appropriate treatment selection. Early recognition of rhabdomyolysis and other potentially life-threatening complications is crucial for preventing organ damage and improving patient outcomes.

Background: Ambient and household air pollution remain leading risk factors for global morbidity and mortality. Exposure to fine particulate matter (PM₂.₅) is associated with increased risks of cardiovascular and respiratory diseases, as well as lung cancer, metabolic and neurological disorders, and immune dysfunction. In urban areas of Mongolia, air pollution reaches critical levels during the winter season. Although improved solid fuels have been introduced in recent years, their impact on both outdoor and indoor air quality remains insufficiently characterized. Aim: To compare outdoor and household air pollution levels in Ulaanbaatar and Darkhan cities. Materials and Methods: Outdoor air pollution data for Ulaanbaatar were obtained from fixed monitoring stations of the National Agency for Meteorology and Environmental Monitoring for the period 2014–2026, with seasonal comparisons performed. For indoor air quality assessment, a longitudinal study was conducted among 240 households (apartments, houses, and traditional gers) in Ulaanbaatar and Darkhan from 2023 to 2026. PM₂.₅ concentrations were measured using real-time sensors (PurpleAir sensor), deployed for 14–21 days per season (winter and summer) in each household, recording data at 10-minute intervals over 24-hour periods. Result: Between 2014 and 2026, the 24-hour mean concentrations in Ulaanbaatar were 60.5 µg/m for PM₂.₅, 117.3 µg/m for PM₁₀, 37.3 µg/m for NO₂, 41.8 µg/m for SO₂, and 27.5 µg/m for O₃. While particulate matter levels showed a decreasing trend following the introduction of improved fuels, SO₂ concentrations increased, and overall pollution levels remained higher than those observed in Darkhan. Indoor PM₂.₅ concentrations were higher in Ulaanbaatar compared to Darkhan (60.7±86.1 vs 48.4±96.7 µg/m). Significant differences were observed by housing type (p<0.0001), with higher concentrations in households using solid fuels (houses and gers) and lower levels in apartments. These findings indicate substantial variability in indoor air pollution by city, housing type, and season, with persistently elevated exposure levels. Conclusion Outdoor air pollutant concentrations in Ulaanbaatar, including particulate matter, NO₂, and SO₂, exceed national standards and WHO guideline values by 1–4 times. Indoor PM₂.₅ pollution is higher in Ulaanbaatar than in Darkhan and varies significantly by housing type and season, indicating a high and heterogeneous exposure burden among urban populations.

Background: Occupational stress among dentists has both direct and indirect effects on individual mental health and work productivity. Furthermore, it is a critical factor influencing patient satisfaction, quality of care, human resource stability, and the sustainable development of healthcare organizations. Aim: To assess job satisfaction among dentists and to identify selected factors associated with it. Materials and Methods: This analytical cross-sectional study included a total of 98 dentists providing oral healthcare services in both public and private dental clinics in Mongolia. Data were collected using a structured questionnaire administered via Google Forms. The questionnaire consisted of 30 items across three sections, covering general information, working conditions, and job satisfaction. Data were analyzed using Microsoft Excel and SPSS version 31.0. Results: The overall job satisfaction score among participating dentists was above average (3.68±0.77). The findings revealed that workplace comfort (r=0.570), colleague relationships (r=0.560), salary (r=0.501), managerial professional competence (r=0.484), and opportunities for professional advancement (r=0.482) were significantly and positively correlated with job satisfaction (p<0.001). Workload did not show a statistically significant association with job satisfaction (p>0.05). Notably, the level of satisfaction regarding institutional support for professional skill development was relatively low (1.87±0.86). Conclusions 1. Factors such as workplace comfort, colleague relationships, salary, managerial competence and opportunities for professional advancement showed a statistically significant positive correlation with job satisfaction among dentists (p < 0.001). 2. The level of job satisfaction among dentists was assessed as above average (3.68±0.77).

Introduction: Arsenic is a widespread environmental metalloid that poses a global health risk, particularly through contamination of drinking water. Exposure arises from natural and human activities through ingestion, inhalation, and skin absorption. Its absorption and toxicity vary by chemical form, with trivalent arsenic generally more toxic than pentavalent arsenic. Once absorbed, arsenic can accumulate in tissues and body fluids. Objective: To compare urinary arsenic concentrations among adults residing in selected mining and non-mining areas of Mongolia. Materials and Methods: This cross-sectional study included 422 adults from mining areas (n = 333; Bayan-Undur, Tsogtsetsii, and Khanbogd) and non-mining areas (n = 89; Bulgan and Bayandalai). Questionnaire data on sociodemographic characteristics, occupation, smoking, and dietary habits were collected. Urine samples were analyzed using inductively coupled plasma mass spectrometry. Arsenic concentrations were summarized as geometric means (GMs) with 95% confidence intervals (CIs). Results: Of the 422 participants, 242 (57.3%) were women. The GM urinary arsenic concentration was 31.10 µg/L [95% CI, 28.96–33.58] in mining areas and 26.42 µg/L [95% CI, 22.98–30.39] in non-mining areas. Among mining communities, GMs were 33.45 µg/L in Bayan-Undur, 25.49 µg/L in Tsogtsetsii, and 24.82 µg/L in Khanbogd. In the non-mining communities, GMs were 29.43 µg/L in Bulgan and 23.02 µg/L in Bayandalai. Conclusion The urinary arsenic concentration was higher among adults in the selected mining areas, with variation between communities. Further analyses accounting for potential confounders, together with arsenic speciation and environmental measurements, are needed to clarify exposure sources and the contribution of mining activities.

Introduction: Noise pollution is an important environmental factor that can adversely affect human health and quality of life. Exposure to excessive or prolonged noise is associated not only with hearing impairment but also with sleep disturbance, psychological stress, cognitive dysfunction, and cardiovascular health risks. Goal: The aim of this review was to examine the effects of noise pollution on human health, with particular attention to the short- and long-term consequences of noise exposure and its physiological, psychological, cognitive, and cardiovascular effects. Materials and Methods: A narrative review of scientific literature was conducted using the references included in the present study. Published research addressing environmental and transportation noise, noise exposure, sleep disturbance, stress-related responses, cognitive function, cardiovascular health, mental health, and related outcomes was reviewed and synthesized. The reviewed evidence was considered according to exposure duration, intensity, and reported health effects. Results: The reviewed studies indicate that short-term exposure to high-intensity noise may cause annoyance, fatigue, reduced concentration, sleep disturbance, and temporary physiological and psychological responses. Prolonged and repeated exposure may increase the risk of sleep disorders, psychological stress, cardiovascular disease, hearing impairment, and cognitive dysfunction. Environmental noise may also affect children’s language, reading, and comprehension abilities. Transportation noise has been associated with cardiovascular and immune-system responses, while anthropogenic noise can affect communication and behavior in various animal species. Conclusion Noise pollution should be considered a significant environmental health risk extending beyond hearing damage. Reducing exposure to excessive environmental noise and implementing appropriate noise-control measures are important for protecting human health, improving quality of life, and supporting ecological well-being.

Background: Hand hygiene is a fundamental component of infection prevention and control in healthcare settings. Effective hand hygiene requires functional infrastructure and the consistent availability of essential supplies, including clean water, soap, hand disinfectants, and hand-drying materials. Assessing these conditions is essential for identifying gaps in service provision and informing targeted improvements in healthcare facilities. Aim: To assess hand hygiene conditions and the availability of essential handwashing supplies in selected healthcare facilities in Mongolia. Materials and Methods: An analytical cross-sectional study was conducted in 20 healthcare facilities located in urban and rural areas of Mongolia. Hand hygiene conditions and the availability of essential supplies were assessed at 186 handwashing stations using a structured observation checklist. Additionally, information on the budgeting and financial planning of handwashing supplies was collected from each participating healthcare facility using a structured questionnaire. Data were analyzed using IBM SPSS Statistics version 27.0. Ethical approval was obtained from the Research Ethics Committee of the Mongolian National University of Medical Sciences on April 17, 2026 (Approval No. 26/04-01). Results: Of the 186 observation points, 55.9% were located in urban areas and 44.1% in rural areas. Overall, 92.5% had functional handwashing sinks, 88.2% had access to clean water, 73.7% had liquid soap, 57.0% had disposable paper towels, and 52.2% had hand sanitizer available at the handwashing station. Accessible handwashing facilities for persons with disabilities were identified at 26.3% of observation points. The availability of liquid soap (82.7% vs 62.2%; p=0.002) and hand sanitizer (72.1% vs 26.8%; p<0.001) was significantly higher in urban than in rural areas. Among the 20 healthcare facilities, 80.0% allocated a budget for handwashing supplies, but only 5.0% based their budget planning on actual soap consumption reports. Conclusion Although basic handwashing infrastructure was generally available in the surveyed healthcare facilities, gaps persisted in the availability of essential hand hygiene supplies, particularly in rural areas. Limited accessibility for persons with disabilities and the infrequent use of consumption data in budget planning indicate areas requiring improvement. Strengthening the continuous provision of hand hygiene supplies, improving accessible infrastructure, and adopting consumption-based budgeting practices are essential priorities for improving hand hygiene conditions in healthcare facilities.

Introduction: Safe and accessible WASH services in healthcare facilities are crucial for maintaining high quality care, especially for maternal and newborn health. The WHO-UNICEF JMP on Water Supply, Sanitation, and Hygiene provides reports on progress in water supply, sanitation, and hygiene services at global, regional, and national levels, covering populations, schools, and healthcare facilities. This assessment was conducted to address the insufficient data on the level of hand hygiene services in healthcare facilities, following the methodology of the JMP. Materials and Methods: A cross-sectional study was conducted in 319 healthcare facilities. Availability of hand hygiene services in the study healthcare facilities was assessed using questionnaire of methodology of the JMP. Data were analyzed using SPSS 25.0 software. Relevant parametric and non parametric statistical analysis were conducted. Results: Overall, 72% and 28% of healthcare facilities had basic and limited hand hygiene service respectively. About 18% of private healthcare facilities had limited hand hygiene service compared to 34% of state healthcare facilities. While 20% of urban healthcare facilities had limited hand hygiene service, 56% of rural healthcare facilities do. When examining the level of hand hygiene services by type of medical care, specialty hospitals have 100% basic services. Among primary care facilities, 83% of family health centers provide basic services, while 41% of soum and village health centers meet these standards. Conclusion The basic hand hygiene services in urban healthcare facilities and specialty hospitals were generally sufficient. There need to enhance basic hand hygiene service at the soum and village level. Among the assessed facilities, 81.0% met four out of the five key hand hygiene requirements outlined in the national standard. However, additional budget allocation for maintenance and operational costs for keeping soap and sustaining water running remains crucial to ensure sustained compliance and quality.

Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder characterized by degeneration of upper and lower motor neurons, leading to muscle weakness, spasticity, dysarthria, and dysphagia. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune-mediated neuropathy that primarily affects nerve fibers specifically myelin sheets. Clinically, CIDP presents with distal muscle weakness, prominent sensory disturbances, and diminished or absent deep tendon reflexes. The co-occurrence of ALS and CIDP is exceptionally rare and poses significant diagnostic and therapeutic challenges due to overlapping and distinct clinical features. A Case: A 44-year-old male presented to the Department of Neurology at the Mongolia-Japan Hospital, Mongolian National University of Medical Sciences, with progressive muscle weakness in both upper and lower extremities, along with dysphagia, especially for solids with frequent choking episodes. The initial symptoms began in May 2023 with muscle fasciculations, followed by progressive weakness, initially in the right upper limb and gradually progressing to the left. By August 2023, the patient developed bilateral arm weakness, dysarthria, and worsening dysphagia. From August 2024, episodes of head drop were noted. A progressive weight loss of 11 kg was recorded since January 2024. Comprehensive neurological evaluation, including antibody profiling, electromyography (EMG), and nerve conduction studies (NCS), supported a diagnosis of amyotrophic lateral sclerosis with chronic inflammatory demyelinating polyradiculoneuropathy-like neuropathy. Outcome: One month after hospital discharge, the patient demonstrated improvement in self-care abilities and increased muscle strength in both proximal and distal upper limb muscles. Notably, there was marked improvement in overall clinical status. Conclusion To our knowledge, this is the first reported case in Mongolia documenting the simultaneous presentation of ALS and CIDP-like neuropathy. Globally, such cases are exceedingly rare. Timely and accurate diagnosis, along with appropriate treatment, contributed to improved clinical outcomes and a deceleration of disease progression in this patient.

Background: Since ancient times, humans have used medicinal plants for medicinal purposes, and they have been recognized as beneficial to health. The basis of the treatment of these plants is phytochemical substances and in modern times, with the development of science and technology, the substances contained in these plants are extracted and medicinal substances and drugs are produced to treat many diseases. There are more than 800 medicinal plants in Mongolia, and their chemical structure and properties are studied in detail, biological activity and main features are discovered, and new medicines are produced. From the Thalictrum squarrosum plant, 25 compounds have been identified, such as triterpenoids with 17 carbon atoms in the cycloartane type ring, saponins, oleic acid glycosides, phytosterols and their glycosides etc., and the structures of 7 new compounds have been determined and the research on phenolic compounds and antioxidant activity has been limited, which is the basis for this research. Aim: Determination of total phenolic content and antioxidant activity of Thalictrum squarrosum. Materials and Methods: Total phenolic compounds were determined spectrophotometrically using Folin-Chicolte color reagent in 1.0 raw material of the Thalictrum squarrosum. Antioxidant activity was determined by DPPH, FRAB and ABTS in sub-extracts of 4 groups. Results: The total phenolic compounds of Thalictrum squarrosum were determined to be 1.9±0.001%. In the study of biological activity of Thalictrum squarrosum plants, the antioxidant activity of 4 groups of sub-extracts was tested by DPPH method, and the IC50 of total alkaloids (pH 9-10) was 201.58±0.1 μg/ml, ethyl acetate sub-extract 94.34±0.66 μg/ml, aqueous extract 824.18±0.08 μg/ml, and butanol sub-extract 128.75±0.58 μg/ml. When tested by ABTS method, the IC50 of total alkaloids (pH 9-10) was 35.83±0.44 μg/ml, ethyl acetate sub-extract 90.45±0.62 μg/ml, aqueous extract 104.19±0.93 μg/ml, dichloromethane sub-extract 156.44±0.48 μg/ml, and butanol sub-extract 170.03±0.61 μg/ml. When tested for antioxidant activity at 800 μg/ml by the FRAB method, the ethyl acetate sub-extract was 8946.16±14.79 μg/ml, the dichloromethane sub-extract was 1670.12±39.28 μg/ml, the butanol sub-extract was 4863.97±25.98 μg/ml, and the total alkaloids (pH 9-10) were 4897.99±58.12 μg/ml. Conclusion The ethyl acetate extract of the plant Thalictrum squarrosum has been found to be highly antioxidant active and total phenolic compound was 1.9±0.001%.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.