Introduction: The primary issue following lumbar discectomy for disc herniation is the risk of reherniation in the post-operative period. Many surgical techniques have been proposed to treat disc reherniation, however, the optimal one remains variable. This meta-analysis aimed to investigate the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the contributing factors. Materials and methods: Identification of published literature was performed on PubMed, Google Scholar, Scopus, and Web of Science databases. Studies published until 14 February 2024 reported the prevalence of symptomatic reherniation after using a Bone-anchored annular closure device following lumbar discectomy and the associated contributing factors. A random effects model was used to conduct Bayesian frequentist network meta-analysis and pair-wise meta-analysis, with the assessment based on standardised mean difference (SMD) and 95% confidence interval (CI). Results: Eleven studies published in 2012 − 2022 recruiting a total of 5195 patients were included in the meta-analysis. The prevalence of reherniation in ACD and control groups was 23.2% (95% CI: 18.2% − 28.1%) and 36.4% (95% CI: 28.2% − 44.5%), respectively. The moderator effect of sample size is significant for pooled data of the ACD group (p-mod=0.002), but not for the control group (pmod=0.278). After the adjustment with sample size, the prevalence rates were 13.6% (95% CI: 6.2% − 21.1%) and 29.6% (95% CI: 14.9% − 33.2%) for ACD and control groups, respectively. Conclusion: Comparatively to lumbar discectomy alone, using a Bone-anchored annular closure device following lumbar discectomy decreased the symptomatic reherniation rate and post-operative complications, as well as the necessity for subsequent surgeries.

Traumatic crush injury of the thumb is devastating and often resulted in poor functional outcome. Various reconstruction options available according to surgical expertise. Masquelet technique is well-established in the long bones of lower limb. Only a handful of cases reported for thumb, especially in Asia region. We described a case of crush injury of right thumb following a trauma. The bony defect was initially filled with antibiotic spacer and subsequent reconstruction with tricortical iliac graft, a modified Masquelet two-stage technique. It is a versatile tool which provide satisfactory functional outcome and hand appearance.

Objective: There is increased use of 3-dimensional (3D)-printing for manufacturing of interbody cages to create microscale surface features that promote bone formation. Those features may be vulnerable to abrasion and/or delamination during cage impaction. Our objective was to quantify loss of mass and changes in surface topography of 3D-printed titanium interbody cages due to surgical impaction. Methods: Eight surfaces of four 3D-printed titanium modular interbody fusion cages were tested. The cages were impacted into the Sawbones model with compression preload of either 200N or 400N using a guided 1-lb (0.45 kg) drop weight. Mass and surface roughness parameters of each endplate were recorded and compared for differences. Results: Significant weight loss was observed for the superior endplate group and for both 200N and 400N preloads. For pooled data comparison, significant postimpaction decreases were observed for mean roughness, root-mean-squared roughness, mean roughness depth, and total height of roughness profile. No significant differences were observed for profile skewness and kurtosis. There were significant changes in almost all roughness parameters in the anterior region of the cage postimpaction with significant changes in 2 out of 6 parameters in the middle, posterior, and central regions postimpaction. Conclusion Three-dimensional-printed titanium interbody fusion cages underwent loss of mass and alteration in surface topography during benchtop testing replicating physiologic conditions. There was an endplate- and region-specific postimpaction change in roughness parameters. The anterior surface experienced the largest change in surface parameters postimpaction. Our results have implications for future cage design and pre-approval testing of 3D-printed implants.

Background: Erkhem-8 medicine is a composed Crocus Sativus L, Lagotis integrifolia, Gentiana barbata froel etc, used for the treatment of respiratory diseases, specially pneumonia and fever or hot disease in Mongolian Traditional Medicine. Aim: The effects of Erkhem-8 medicine to determine the some sourcebook study results. Materials and Methods: An evaluation of its effects on wind, bile, and phlegm was conducted using Traditional Mongolian Medicine methods (Dagvatseren B, 1996). In order to clarify the structure and composition of Erkhem-8 traditional medicines, and the treatment of lung fever from traditional medical sources. Text and source-study and comparison method were used in the study. Results: The study found that Erkhem-8 medicine demonstrated a varying capacity to suppress wind, bile, and phlegm, with bile suppression being the most significant at 0.68, followed by wind suppression at 0.58, and phlegm suppression at 0.16. Erkhem-8 is composed of 8 ingredients, which are safflower Carthamus tinctorius L, gmeline Bostaurus domesticus, Schizostachoum chinense Rendle, wood Santalum album L, Odontitis rubra Baung.Opiz, flora Gentiana decumbens L, herba Lagoti sintegrifolia Schischk, flora Aconitum Kusnezoffii Reichenb. These herbs themselves have a variety of biological activities, including reduce heat, pain relief, anti-oxidant and anti-tumor, anti-inflammation activity. Conclusions 1. The study found that Erkhem-8 exhibited the highest suppression of bile (0.68), followed by wind (0.58), and phlegm (0.16), indicating its effectiveness in modulating these elements. 2. Most of the raw materials included in the composition of Erkhem-8 medicine have a bitter and sweet taste and have the ability to remove heat, especially heat of the solid organs, i.e. heat of the lungs, liver, blood, specially pneumonia and fever or hot disease in Traditional Mongolian Medicine.

Background: Globally, an estimated 13% of adolescents aged 10–19 are affected by mental disorders. As of 2020, the number of children under the age of 19 in Mongolia was reported to be 1,289,587, reflecting a 0.9% increase compared to 2015. A 2013 study on adolescents found that 60.5% were categorized as mentally healthy, 30.5% exhibited emotional and behavioral difficulties, and 9% were diagnosed with a mental disorder. A study conducted in Govi-Altai Province between 2018 and 2019 reported that 58.6% of adolescents were classified as healthy, 36.1% experienced psychological difficulties, and 5.2% were diagnosed with a mental disorder. Internationally, adolescent mental health has been widely assessed using the Strengths and Difficulties Questionnaire (SDQ), with an increasing number of studies employing artificial intelligence-based predictive models. However, in Mongolia, research utilizing artificial intelligence and machine learning for analyzing large-scale mental health data remains limited. This gap underscores the need for the present study. Aim: Machine learning models were compared to determine adolescent emotional and behavioral problems using the SDQ. Materials and Methods: Data was collected from teenagers, teachers, and parents in Govi-Altai Province, and the databases were created for each group. The teenager database was divided into 10 folds by cross-validation, and the models were developed using machine learning methods and evaluated using their performance measures. The results were mainly analyzed using the Bayes model. Results: The teenagers have emotional and behavioral problems due to emotional and peer interactions, but they are at risk of developing disorders due to hyperactivity and behavioral changes. Conclusion Comparing the model performance results with previous studies, Bayesian model accuracy decreased by 0.03, sensitivity decreased by 0.08, and specificity increased by 0.01. Also, the difference between the performance evaluation metrics of the C50 and Bayesian models is very small, between 0.01 and 0.02. This shows that the performance of the Bayesian method is good when the number of attributes in the database increases. Compared to the results of the knowledge generated by the research, the participants are more likely to develop emotional and behavioral disorders due to their peer relationship indicators, such as other children generally not liking them, getting on better with adults, and due to emotional symptoms such as being unhappy and depressed.

Background: Esophageal cancer ranks as the fourth most prevalent malignancy in Mongolia. Among esophageal disorders, gastroesophageal reflux disease (GERD) accounts for 55% of cases, while esophageal motility disorders constitute 40%. Enhancing the diagnosis and management of esophageal disorders, alongside preventative strategies for esophageal cancer, necessitates a comprehensive understanding and widespread clinical application of esophageal functional assessment. However, epidemiological data and classification of esophageal motility disorders remain scarce in Mongolia, highlighting the necessity of this investigation. Aim: to identify specific risk factors associated with ineffective esophageal motility (IEM) Materials and Methods: This study was performed an analytical case-control design and was conducted at Intermed Hospital. A total of 702 HRM test results from patients attending the Gastroenterology and Endoscopy Center’s outpatient department, Intermed hospital Participants diagnosed with IEM based on HRM findings were assigned to the case group, while individuals with esophageal normal motility disorders were designated as the control group at a 1:2 ratio. Results: A total of 612 participants aged 21–80 years were included in this study of whom 57.8% (n=354) were female and 42.2% (n=258) were male, with a mean age of 51.1±12.7 years. The prevalence of IEM demonstrated a statistically significant increase in the 60–69 and ≥70 age groups compared to the control group (p<0.000). Participants diagnosed with IEM exhibited a mean lower esophageal sphincter (LES) pressure of 329.61±246 mmHg and a mean complete liquid bolus transit rate of 46.88±22.7%, both of which were significantly lower than those observed in the control group (p=0.000). Furthermore, the incidence of IEM was found to increase in correlation with the severity of hiatal hernia, as classified by both endoscopic and manometric criteria, demonstrating statistical significance (p=0.000). Conclusion IEM is more prevalent among elderly individuals and increases in incidence with the progression of hiatal hernia size. In cases of IEM, esophageal bolus transit is significantly delayed, and lower esophageal sphincter pressure is diminished. Further studies are warranted to elucidate additional risk factors contributing to ineffective esophageal motility.

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.

Background: This study explores the potential of food industry by-products, such as plant peels, stems, and slags, as valuable sources of lignocellulosic material (LCM), which contains 25-40% xylan. These underutilized resources, often discarded as waste, hold the promise of sustainable applications in biotechnology. By safely extracting xylooligosaccharides (XOS) from LCM biomass, the value of these materials can be significantly enhanced, contributing to green production and supporting sustainable development. XOS, recognized for its prebiotic activity, has been shown to promote the growth of beneficial gut bacteria, making it a vital research area in the fields of food science, medicine, and technology. Aim: To extract and characterize oligosaccharides derived from by-products of the food industry, evaluate their physicochemical properties, and investigate selected biological activities. Materials and Methods: This study utilized microwave pretreatment and enzymatic hydrolysis to isolate and purify XOS from wheat bran and brewers’ spent grains (BSG), provided by Altan Taria LLC and APU CoL, respectively. Microwave irradiation at 200°C for 5 minutes was employed as a pretreatment step, followed by hydrolysis using commercial xylanase (Thermomyces lanuginosus, recombinant Aspergillus oryzae, 2500 BXU/g) at 55°C for 24 hours. The resulting hydrolysate underwent filtration with activated carbon and ethanol precipitation to yield purified XOS. Analytical methods, including FTIR spectroscopy, TLC and HPLC, were used for structural and compositional analysis of the purified oligosaccharides. In vitro tests evaluated the ability of XOS to support the growth of beneficial gut bacteria, including Bifidobacterium spp., Lactobacillus fermentum (ATCC 9338), and Lactobacillus casei (ATCC 344), using XOS-enriched media. Additionally, in vivo studies were conducted on rats to determine the biological effects of XOS on gut microbiota. Results: The results demonstrated that prolonged enzymatic hydrolysis for more than 10 hours, using 0.25 g of xylanase per 100 g of substrate, resulted in optimal yields. XOS purity was measured at 87.6% with an 8.1 g yield from wheat bran and 89% purity with a 7.2 g yield from brewers’ spent grains. Structural analysis confirmed the presence of xylobiose, xylotriose, and xylotetraose, with xylotetraose being the most abundant component in WBP-XOS (47.5%), and xylobiose dominating BGS’s derived XOS (47.8%). Biological effects revealed that wheat bran-derived XOS significantly supported the growth of Bifidobacterium spp. and L. fermentum (ATCC 9338) in a concentration-dependent manner, whereas no significant effect was observed on L. casei (ATCC 344). In vivo studies confirmed that XOS consumption increased populations of Bifidobacterium spp. and Akkermansia muciniphila spp. in gut microbiota (p<0.05). Furthermore, XOS consumption reduced plasma cholesterol, triglycerides, and LDL-C levels while increasing HDL-C levels, demonstrating metabolic benefits. Conclusion This research establishes that XOS with prebiotic activity can be efficiently extracted and purified from food industry by-products using microwave-assisted enzymatic hydrolysis. This approach highlights the potential of utilizing agricultural and industrial waste for producing functional prebiotics, contributing to sustainable practices and offering valuable applications in health and nutrition.

Background: The skin barrier serves as the primary defense against environmental factors. Mongolia’s extreme climate conditions may contribute to skin barrier impairment, increased trans-epidermal water loss (TEWL), and decreased skin moisture. Objective: To determine and compare skin moisture, TEWL, and skin pH levels in children. Methods: A cross-sectional study was conducted in June 2023 with 104 relatively healthy children selected through random sampling. Skin physiological parameters, including skin moisture, skin pH and TEWL were measured following the EEMCO (European Group on Efficacy Measurement of Cosmetics and Other Topical Products) guidelines using the Multi Skin Test MC750 device (Courage+Khazaka Electronics, Germany) at nine different sites. Data analysis was performed using Microsoft Excel and Stata-14 software. Results: Among the participants, 51.9% (n=54) reported having dry skin (p<0.0001). Additionally, 64.5% (n=67) used moisturizers, but their usage did not show a statistically significant difference in skin moisture (p=0.929), skin pH (p=0.378), or TEWL (p=0.332). 14.42% (n=15) had extremely dry skin, while 85.58% (n=89) had dry skin, with no participants falling within the normal skin moisture range. TEWL showed a moderate inverse correlation with age (r=-0.331, p=0.0006). When analyzed by age groups, skin moisture (p=0.023) and TEWL (p=0.038) differed significantly between groups. Conclusion Skin moisture and TEWL significantly differ across age groups. Given that all participants had dry skin, moisturization is crucial. Mongolia’s extreme climate is likely a key contributing factor to childhood skin dryness.

Background: According to the results of the research conducted in Mongolia in 2011 within the framework of the national program "Oral Health", 86.2% of young children had tooth decay, and the intensity of tooth decay was 6.2, which is a high level. In recent years, not only in our country, but also in the world, due to the increase in the prevalence of tooth decay in young children, the disease of other organ systems caused by tooth decay has also increased, which is the basis of our research. Purpose: To study the intensity of dental caries among secondary school students and comparing them with some indicators Objective:
1. To estimate the intensity of dental caries among secondary school students
2. To study the intensity of dental caries among secondary school students by comparing some parameters. Methodology: A total of 1298 students aged 6-18 years of Bayanzurkh Complex School of the capital were included in the study. Determine the body mass index ,The Lith the lip method was used to calculate the intensity of dental caries and it was assessed by the World Health Result: 675(52%) of the respondents were male and 623(48%) were female, 7.6% were underweight, 68% were normal weight, 14.7% were overweight, and 9.7% were obese.
When examining the state of dental disease of the participants, 9% were healthy, 91% had dental disease, the intensity of caries was 4.9 CSI, and the need for rehabilitation was 319. Out of this, in children with permanent teeth, the intensity of caries in great molars and in children with mixed teeth is higher in second molars. Conclusion The intensity of dental caries is 4.9 cla/sh or more, and the prevalence is high, and there are 319 children who need to be treated immediately.
The intensity of dental caries was medium for 6-13 year olds and low for 14-19 year olds, and the caries intensity of normal weight children was 3.3 or medium.