Background: The Pediatric Quality of Life Inventory™ (PedsQL™) is a modular, multidimensional instrument designed to assess health-related quality of life (HRQoL) in children and adolescents aged 2 to 18 years. It encompasses both child self-report and parent proxy-report formats and includes generic as well as disease-specific modules, enabling comprehensive HRQoL assessment across healthy and clinical pediatric populations. In Mongolia, gastrointestinal (GI) disorders represent the second leading cause of morbidity among children aged 10 to 14 years. The assessment of HRQoL in children with GI disorders — particularly those with chronic conditions — is of considerable importance for clinicians and researchers in conducting epidemiological surveillance, monitoring treatment outcomes, and evaluating findings from clinical trials. Aim: To translate the Pediatric Quality of Life Inventory–Gastrointestinal Symptoms Module Standard Form (PedsQL™-GI version standard form) into Mongolian and to evaluate its internal consistency reliability. Materials and Methods: The PedsQL™-GI version standard form was selected for translation following written authorization from the original developers. The bilingual forward translation was conducted by a team comprising a professional linguist and a pediatrician with 15 years of clinical experience and academic proficiency in English, adhering to the developer-provided translation protocol. The preliminary Mongolian version was subsequently reviewed by a senior pediatrician with 25 years of professional experience and academic English, with particular attention to medical terminology accuracy and linguistic equivalence. A separate bilingual team — consisting of a second linguist and a pediatrician — then performed the backward translation into English. A small-group expert panel comprising the back-translation team and the research investigators convened to review discrepancies and finalize the English reconciled version, which was submitted to the original developers for approval before the official release of the Mongolian version. To evaluate the internal consistency reliability of the Mongolian version, the instrument was administered to 25 children aged 8–12 years and 25 adolescents aged 13 years and above, along with their respective caregivers. Data were analyzed using SPSS version 25.0, employing the Intraclass Correlation Coefficient (ICC) and Cronbach’s alpha coefficient. Results: The Cronbach’s alpha coefficient for the total instrument was α=0.96, indicating excellent internal consistency reliability. Test-retest reliability, assessed using the Intraclass Correlation Coefficient, yielded ICC=0.79, demonstrating satisfactory measurement stability over repeated administrations. Conclusions 1. The overall semantic equivalence of the Mongolian version was 97.8%, and 96% of cognitive interview participants rated the questionnaire as “understandable” indicating that the clinical content and conceptual integrity of the original instrument were fully preserved throughout the translation process. 2. A total of 37 adaptation instances were identified during the translation process, encompassing six categories of linguistic and cross-cultural localization: age-appropriate modification, conversion of medical terminology into everyday language, linguistic and cultural adaptation, synonymous substitution, elaboration, and condensation. These adaptations collectively enhanced the content validity of the instrument. 3. The Mongolian version demonstrated excellent internal consistency reliability (Cronbach’s alpha α=0.96) and satisfactory test-retest reliability (Intraclass Correlation Coefficient ICC=0.79), both fully meeting international psychometric standards. These findings confirm that the instrument constitutes a reliable tool for assessing health-related quality of life in Mongolian children with chronic gastrointestinal disorders.

Background: The COVID-19 pandemic has triggered a global mental health crisis. According to WHO estimates, anxiety and depression rose by 25% in the first year. In the post-COVID era, over 70% of patients experience depression, anxiety, insomnia, PTSD, and OCD, which can persist for up to 24 months. Hospitalized individuals face heightened risks due to infection severity, treatment stress, and social isolation. However, studies examining treatment outcomes and influencing factors remain limited. In Mongolia, mental health issues escalated sharply from 2020 to 2022; WHO data indicate that anxiety and stress were prevalent among healthcare workers and patients. Children and youth were particularly affected, with UNICEF studies emphasizing the urgent need for intervention. Suicide rates increased from 18.3 per 100,000. Long-term research on post-COVID mental disorders is scarce, impeding policy formulation. This study evaluates treatment outcomes in COVID patients and identifies key factors. By comparing case and control groups at 3 and 12 months, it uncovers differences in symptoms and treatment responses. The comparative design assesses statistical significance via P-values and subgroup success rates for CBT and SSRI therapies. Findings will enhance Mongolia’s mental health services. Larger-scale studies are essential moving forward. Objective: To evaluate treatment outcomes for post-COVID mental disorders and identify influencing factors. To analyze differences in psychological symptoms and treatment between case (COVID-19 positive) and control groups over 3 and 12 months. Material and Method: Retrospective comparative analysis of records from 281 patients (cases n=181, controls n=100) at a unified hospital from 2020-2022. At 12 months, n=200 (cases n=100, controls n=100). Patients were categorized by anxiety, depression, insomnia, and stress-related symptoms, with P-values calculated. Detailed subgroup analysis (n=47 treated patients) was conducted. Results: At 3 months, cases showed higher anxiety (56.4%, P=0.002), depression (41.4%, P<0.001), and insomnia (58%, P=0.107). At 12 months, differences lessened but anxiety (52%, P=0.023) and depression (35%, P=0.042) remained significant. COVID-related new symptoms were elevated in cases (e.g., depression 24.3%, P<0.001). Treatment subgroup success was 95.7% (P<0.001), with duration influencing outcomes (P=0.03). Conclusion Post-COVID mental symptoms persist long-term in cases, and extended treatment durations yield better results. Larger studies are required

Background: Nurses spend the most time with patients when providing medical care, making them a crucial factor in ensuring appropriate and effective treatment. Their assessment skills play a vital role in pain management. Aim: This study aims to determine the validity and reliability of the Mongolian version of the Knowledge and Attitudes Survey Regarding Pain (KASRP). Materials and Methods: A cross-sectional, quantitative study was conducted using the Knowledge and Attitudes Survey Regarding Pain (KASRP) questionnaire. A total of 145 nurses from the surgical, emergency, and intensive care units of the National Trauma and Orthopedic Research Center (NTORC), the National Cancer Center of Mongolia (NCCM), and the National Center for Maternal and Child Health (NCMCH) participated in the study. Statistical analysis was performed using SPSS-25 software. Results: The study included 115 female and 30 male nurses, with an average age of 37.21±7.50 years and an average work experience of 13.43±7.57 years. The face validity index (FVI) for each item ranged from 0.81 to 1.00. The content validity index (CVI) for each item ranged from 0.66 to 1.00. The internal consistency of the questionnaire was assessed using Cronbach’s alpha, which was found to be 0.88. Conclusion The Mongolian version of the KASRP demonstrates satisfactory face validity, content validity, and reliability, making it suitable for practical application.

Background: The COVID-19 pandemic has profoundly impacted mental health, particularly exacerbating conditions such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD), and emotional disorders among hospitalized patients. This study examined the prevalence of COVID-19-related mental health issues and risk factors in hospitalized patients affiliated with MNUMS, compared to a control group. Aim: To assess the prevalence of mental health disorders such as depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD), and to identify their associated risk factors. Materials and Methods: The study was conducted at hospitals under MNUMS, including the Mongolian-Japanese Hospital, Central Hospital, and the National Center for Maternal and Child Health. A total of 552 participants (399 case group, 153 control group) who were hospitalized were included. Depression (PHQ-9≥10), anxiety (GAD-7≥10), insomnia (ISI≥15), and PTSD (PCL-5≥33) were assessed using standardized scales. Analysis was performed using chi-square tests and binary logistic regression (crude odds ratio [cOR]/adjusted odds ratio [aOR], 95% confidence interval [CI]), adjusted for group, age, and sex. Results: In the case group, depression (23.1% vs. 13.7%, p=0.015, cOR=1.884 [1.124-3.156]), anxiety (16.8% vs. 11.1%, p=0.096), and any mental disorder (18.0% vs. 13.7%, p=0.225) were higher, while insomnia was lower (19.5% vs. 30.1%, p=0.008). PTSD was low overall (1.8% vs. 0.7%, p=0.333). Risk factors included female sex (p<0.001, cOR=0.362 for depression in males), younger age (p=0.004), unemployment (p=0.017), and prior trauma (p<0.001). COVID-19 symptoms (difficulty breathing) increased the risk of depression (p<0.001, cOR=2.828 [1.708-4.682]). Conclusion Hospitalization for COVID-19 increases the risk of depression and anxiety, modulated by demographic, clinical, and socioeconomic factors. Targeted interventions for vulnerable groups are essential.

Background: COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways (e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al., BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and PTSD among COVID-19 patients over 12 months, compared to a control group. Aim: To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic stress disorder (PTSD) among individuals who have had COVID-19 Materials and Methods: In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021 and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12 months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and multivariable logistic regression (p < 0.05). Results: Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12 months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p = 0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19 group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and individuals aged 40–59 years were at elevated risk. Conclusions 1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control group. 2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected after 12 months; this resolution is posited to be associated with the adaptive capacity of the population. 3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.

Introduction: According to statistics from the World Health Organization, more than 19.2 million population were diagnosed with cancer in 2020, and 9.9 million population died from cancer. Furthermore, Mongolia leads the world in terms of cancer mortality. In Mongolia, 5981 new cancer incidences were registered in 2021, including cervical cancer, which accounts for 5.2 percent. The average incidence rate of cervical cancer is 19.1 cases per 100,000 females, and the mortality rate is 9.6 cases per 100,000 females, which is high in the region. As of 2021, 68,163 females have undergone early screening of cervical cancer. This represents 28.6 percent of eligible women. It can be seen that the rate of early screening of cervical cancer is low. Thus, it is essential to increase the percentage of early screening by providing knowledge regarding cervical cancer in women. Purpose: The study is aimed to screen the women for cervical cancer and make a conclusion among women, living in the 4th khoroo of Bayangol district. Material and method: The study was conducted using an analytical cross sectional design. A total of 100 women aged between 30 and 60 years of the 4th khoroo of Bayangol District were randomly chosen, cervical Pap tests were performed, and STATA13 software was used for statistical analysis. Result:
- Out of a total of 100 females participating in the study, 79% were married, 24.9% had an abortion, 82% do not use contraception, and 17% were post menopausal.
- 80% of the women who participated in the study had a healthy cervical cytology or no tumor cells, while 62% had vaginitis (coccobacillus 71%). Conclusion Cervical pap smear results that are healthy or not precancerous indicate good coverage.

Introduction: Worldwide, an estimated two billion people have evidence of HBV infection, and approximately 240 million have CHB. In this study, a representative group of Mongolian adults was tested for hepatitis B virus (HBV) in 2017. The prevalence estimates of HBV the general Mongolian adult population were found to be 11.1%, respectively.
In April 2017, EASL added a drug newly approved for treatment of CHB, tenofovir alafenamide (TAF) to their list of recommended first-line therapies. The requirement for long-term therapy in chronic HBV highlights the importance of these efficacy and safety trends, however their true clinical relevance is yet to be established and further studies with long-term follow up and real-world clinical data are needed. Goal: Evaluate for result of tenofovir alafenamide in the treatment of chronic hepatitis B infection. Materials and Methods: The clinical trials have evaluated TAF in HBeAg-positive and HBeAg-negative chronic HBV patients. The trials have similar designs and are randomized, double blind, non-inferiority studies. The primary efficacy endpoint was the proportion of patients with HBV DNA<29 IU/ml at week 24 and 48. Other prespecified efficacy endpoints were the proportion of patients with HBsAg seroncoversion to anti-HBs at week 24 and 48. Key secondary safety end- points at week 24 and 48 included the percentage change in T-score, and Z-score bone mineral density (BMD), percentage change in BMD and change from baseline serum creatinine. Results: The primary efficacy endpoint, an HBV DNA level <29 IU/ml at week 24, was achieved by 120 (59.1%) of 203 patients receiving TAF, which was non-inferior to the 63 (55.2%) of 114 patients receiving TDF who had an HBV DNA<29 IU/ml. After 24 weeks of treatment, patients receiving TAF had significantly smaller reductions in bone mineral density (BMD) compared with patients receiving TDF. Conclusion The development of TAF, specifically designed to deliver potent antiviral activity but with an improved safety profile compared with TDF, is therefore timely.

Endometriosis is described as a chronic inflammatory disease, characterized by endometrial-like tissue, found outside the uterine cavity which cause chronic pelvic pain, infertility,dysmenorrhea. The prevalence of endometriosis is difficult to determine accurately but in asymptomatic women, the prevalence of endometriosis ranges from 2- 22 %, depending on the population studied , in infertile women 20-50 % and in those with pelvic pain, between 40-50% (Balasch, 1996; Eskenazi, 2001; Meuleman, 2009).Endometriosis is found 7-10% of reproductive agewomen and 20-90% in with chronic pelvic pain, infertility cases. Pathogenesis of endometriosis is not yet fully understood but one potential cause of the disease is retrograde menstruation which results in the deposition of endometrial tissue into the peritoneal cavity. Today a composite theory of retrograde menstruation with implantation of endometrial fragments in conjunction with peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Susceptibility to endometriosis is thought to depend on the complex interaction of genetic, immunologic, hormonal and environmental factors. To determine prevalence and severity of clinical symptoms, compare meta-analysis to changes the clinical value of serum CA-125 and peritoneal fluid cytology in women with endometriosis of Ulaanbaatar city. We had selected total of 60 woman with endometriosis which were registered from January to December 2014 in gynecologic clinic of First Maternity Hospital. The research group registered in questionnaire with 28 questions. During the inspection laboratory analysis of serum CA-125, ultrasound analysis and peritoneal fluid cytology were done. Assessment of pelvic pain by means of a 10-point linear analog scale / pain score/ which provided by International Pain Association. The research result was worked out by prospective method. Average age of patients 33.4±8.9. Pain location: Chronic pelvic pain 30%; Dysmenorrhea 28.3%; Dysparunea 10%; Pain during defecation 6,7%; Without pain -25%. Average level of Serum СА125 was 38.13±20.6. Location of endometriosis: adenomyosis - 8.4%, endometrioma-15% endometriotic lesion at cul de suc 68.3%, rectal involment 1.7%, tubal lesion-3.3%, combined 3,3%. 76.7% of surgery for endometriosis have done by laparoscopy and 23.3% by laparotomy. Ultrasound examination result: endometrioma d=0-2cm-1.7%, d= 3-5cm-36.2%, d=6-8cm-10.3%, d=9cm<-12.1%. Cytology result: Peritoneal fluid contains 75% of erythrocytes, mesothelial cells and it needs to further study.CONCLUSION:Most of patient /58.3%/ had chronic pelvic pain and dysmenorrhea. The severity of pain was significantly improved after operative laparoscopy. /p<0.05%/51,7% of patient had infertility problem.Value of serum CA-125 was higher in study group with large sized and not clear content ovarian endometrioma by ultrasound examination. /p<0.05%/The local environment of peritoneal fluid surrounding the endometriotic implant is immunologically dynamic and links the reproductive and immune systems. Peritoneal factors to stimulate cell growth is the most widely accepted explanation for peritoneal endometriosis. Peritoneal fluid contains a variety of free floating cells, including macrophages, mesothelial cells, lymphocytes, erythrocytes, eosinophils and mast cells. In our cytology results: peritoneal fluid contains 75% of erythrocytes, mesothelial cells.