Background: The first confirmed case of COVID-19 in Mongolia was reported on November 11, 2020. In response, the government imposed a nationwide lockdown, which significantly impacted the population’s mental health. Heightened levels of stress, anxiety, loneliness, and depression during the pandemic altered individuals’ psychological stability and behavior. Personality traits—defined as relatively stable patterns of emotion, cognition, and behavior—play a key role in stress responses and emotional regulation under pressure. Emerging evidence suggests that these psychological factors may influence the immune system’s responsiveness, including vaccine-induced antibody production. Aim: To evaluate the association between post-vaccination antibody responses and personality types following two doses of COVID-19 vaccines. Materials and Methods: A total of 738 participants who received two doses of COVID-19 vaccines (AstraZeneca ChAdOx1, n=29; Pfizer-BioNTech, n=119; Sinopharm BBIBP, n=590) and had no prior SARS-CoV-2 infection were enrolled. Serum samples were collected 21–28 days after the second dose, and SARS-CoV-2 RBD (S) IgG antibodies were measured using ELISA (Proteintech Inc., USA). Personality types were assessed using a 56-item temperament questionnaire developed by A. Belov, categorizing individuals into classical temperament types (choleric, phlegmatic, sanguine, melancholic). Logistic regression and ROC analysis were used to examine associations between personality types and antibody response. Results: The presence of an antibody response was significantly higher among individuals with a melancholic temperament, and significantly lower among those with a phlegmatic temperament. Furthermore, antibody titers were higher in participants with melancholic and sanguine temperaments and lower in those with a phlegmatic type. Conclusions 1. During the early period following the second dose of COVID-19 vaccination, the antibody response was higher in individuals with a pure melancholic temperament, while it was lower in those with a phlegmatic temperament. 2. After the second dose of the Sinopharm BBIBP COVID-19 vaccine, antibody titers were higher in individuals with pure melancholic and sanguine temperaments, and lower in those with a phlegmatic temperament.

Background: In the treatment of plaque-induced gingivitis, in addition to mechanical plaque control, the use of chemical plaque control such as mouth rinses for a certain period has shown a positive effect on treatment outcomes and prognosis. Aim: To evaluate the efficacy of a probiotic mouthwash in the treatment of plaque-induced gingivitis. Materials and Methods: A randomized controlled clinical trial was designed for a period of 2 weeks on 45 systemically healthy subjects between 20 and 25 years having plaque-induced gingivitis. The study population was divided into three groups. Group 1-15 subjects were advised experimental (probiotic) mouthwash. Group 2-15 subjects were advised positive control (chlorhexidine) mouthwash and Group 3-15 subjects into a negative control group. Oral prophylaxis was done for all groups at baseline. After the proper oral hygiene instructions, groups 1 and 2 were instructed to rinse their mouth with 15 ml of their respective mouthwashes, for 1 min twice daily, 30 min after brushing. Clinical parameters such as Full mouth plaque score (FMPS), Full mouth bleeding score (FMBS) were assessed at baseline, 2 weeks respectively. Results: At baseline, there was no statistically significant difference between the groups in terms of FMBS and FMPS mean values (p=0.174, p=0.887). At day 14, the FMPS, FMBS mean values were significantly reduced by all treatment modalities ranking probiotic and chlorhexidine is greater than negative control group (p<0.001, p<0.001). Conclusion The probiotic mouthwash was effectively used as an adjunct to mechanical plaque control in the treatment of plaque-induced gingivitis.

Background: In recent years, work-life balance has become a pressing issue for healthcare workers in many developing countries around the world. An imbalance between work and personal life leads to psychological stress, health problems, loss of self-confidence, job dissatisfaction, and decreased work productivity due to an inability to concentrate. It also results in a decline in the quality of treatment and services. Furthermore, it increases the risk of medical errors and contributes to both physical and mental burnout, ultimately leading to resignation. Aim: The study analyzed the work-life balance and turnover intentions of employees at family health centers. Materials and Methods: The study was conducted using a cross-sectional model and a quantitative survey method. The work-life balance of employees at Family Health Centers was examined using the work-life balance assessment question naire developed by Hayman (2005), and turnover intentions were assessed using the standard questionnaire developed by Auerbach et al. (2014). The research was carried out in 2024. The study included 123 employees from 22 Family Health Centers located in the Bayangol, Bayanzurkh, Sukhbaatar, Songinokhairkhan, Khan-Uul, and Chingeltei districts of Ulaanbaatar. Results: Of the participants, 95.1% were female, with an average age of 35.2±9.5. Among them, 55.3% were doctors, 29.3% were nurses, 9.8% were health social workers, and 5.7% were other non-medical staff. The income of Family Health Center employees was found to be insufficient; 8.9% had incomes below the minimum subsistence level, and their ability to meet basic household needs was very limited. The results show that participants’ work negatively impacted their personal life (WIPL–23.5), and personal life negatively affected their work (PLIW–15), both of which scored high. Meanwhile, the positive interaction between work and personal life (WPLE–10.7) was low, indicating a disruption in their work-life balance. Working overtime was statistically significant in relation to work-life imbalance (p=0.038). As age and years worked at the current organization increased, the negative impact of work on personal life and personal life on work tended to decrease. Conclusion The work-life balance of Family Health Center employees has been disrupted. The level of work negatively affecting personal life and personal life negatively affecting work is high. 65% of Family Health Center employees are considering leaving their current organization, and 41% are considering leaving the healthcare field.

Background: In recent years, the incidence of liver diseases due to complications of non-alcoholic fatty liver disease (NAFLD) has shown a significant upward trend in Southeast Asian countries. NAFLD is a hepatic disorder characterized by lipid accumulation in the microstructure of the liver in individuals who consume little to no alcohol. It is often associated with insulin resistance and is diagnosed when steatosis affects more than 5% of hepatocytes histologically, or when the fat signal intensity on MRI exceeds 5.6%, based on fat-to-water ratio measurements. In Mongolia, histological studies using frozen liver sections with routine and special staining techniques are limited, highlighting the necessity of this study. Aim: To determine and compare the degree of steatosis and fibrosis in frozen liver tissue samples of patients with NAFLD through histological analysis. Materials and Methods: This study was conducted at the the Department of Anatomy, School of Biomedicine and Bio medical Research Institute of MNUMS in collaboration with the Second State Central Hospital. Ethical approval was obtained from the Research Ethics Committee of MNUMS (Protocol No. 2024/3-06). All procedures adhered strictly to laboratory biosafety protocols. Participants were selected among patients undergoing elective laparoscopic cholecystectomy, from whom informed consent was obtained. Based on inclusion criteria, five participants were grouped as follows: healthy control (n=1), NAFLD without fibrosis (n=2), and NAFLD with fibrosis (n=2). Liver biopsies (approx. 1 cm in size) were obtained intraoperatively, immediately deep-frozen in liquid nitrogen, and prepared for histological evaluation. Results: In patients with NAFLD compared to the healthy liver group, disruption of hepatocyte columnar architecture and mild periportal lymphocytic infiltration were observed. Oil Red O staining revealed 34–66% micro- and macrovesicular steatosis, corresponding to grade 2 steatosis. Masson’s trichrome staining showed no fibrotic changes in perivenular or periportal areas (Ishak grade 0/4) at this stage. However, upon progression to grade 3 steatosis, early-stage fibrosis was observed in both perivenular and periportal regions (Ishak grade 1/4). Further progression to stage 4 fibrosis was characterized by the development of connective tissue septa, although no significant changes in droplet size were observed. Conclusions 1. Increasing stages of fibrosis are not directly influenced by the severity of hepatic steatosis in NAFLD. 2. Although the degree of steatosis increases, the absence of corresponding fibrotic changes in early stages indicates a complex progression pattern of NAFLD requiring further investigation.

Background: Cleft lip and palate (CLP) is a congenital anomaly that accounts for approximately 65% of all craniofacial malformations. In Mongolia, the prevalence of CLP is estimated at 0.93 to 1 per 1,000 live births, which is comparable to the global average but slightly higher than the average reported among Asian countries. The incidence is observed to be twice as common in males compared to females. Diagnosis: The patient is a 15-year-old male with a history of congenital unilateral cleft lip and palate. He underwent primary surgical repair of the cleft at the age of 9. As of May 2022, clinical examination revealed maxillary hypoplasia, anterior crowding, and a combination of bilateral posterior and anterior crossbite. Cephalometric analysis demonstrated a skeletal Class III malocclusion with midfacial deficiency. Treatment: Orthodontic treatment was initiated in October 2022 using a non-removable, self-ligating bracket system (MBT 0.022” slot, stainless steel). In the first month, CuNiTi 0.014 archwires were placed, and cross elastics were applied from the maxillary to mandibular canines on the left side for two months. On December 10, 2022, CuNiTi 0.014×0.025 archwires were placed in both arches, accompanied by coil springs to open space. Subsequent phases involved transitioning to stainless steel (SS) and titanium-molybdenum alloy (TMA) archwires for alignment and leveling. Treatment Outcome: At the end of treatment, a Class I molar and canine relationship was achieved. The axial inclinations of the upper and lower incisors reached normative values based on lateral cephalometric analysis. The maxillary arch form was expanded and improved to a more ideal rounded contour. Dental crowding was resolved without extraction, and both transverse and sagittal occlusal relationships were significantly improved. Conclusion This clinical case demonstrates that fixed orthodontic treatment in a patient with unilateral cleft lip and palate can effectively correct dental crowding, normalize occlusal relationships, and significantly improve facial esthetics, phonetics, and overall quality of life. Orthodontic intervention played a vital role in restoring function and supporting psychosocial and physical development.

Background: Children with developmental disabilities benefit from support in motor skills, sensory processing, cognitive development, and social skills. Mongolia has trained occupational therapists for a decade, with 37% specializing in pediatrics, but long-term therapy facilities remain limited. Aim: This study provides a case report on a child with developmental disabilities who received occupational therapy to evaluate improvements in sensory processing, social communication, and daily living skills. Materials and Methods: The study participants were purposively selected from children undergoing occupational therapy at the “Enerel” Child Development Center. Participant A is a 16-year-old male with hearing and speech impairments, as well as an intellectual disability. The initial assessment showed poor sensory processing and behavioral problems and communication difficulties. A tailored program incorporating sensory-based therapies, communication cards, and sign language was developed with caregiver collaboration. Occupational therapy was conducted five times weekly for 11 weeks. Pre and post test assessments included goal attainment scaling (GAS) and Sensory profile 2 (Child). Results: The participant showed improved communication using cards and sign language, better emotional regulation, enhanced sensory processing, and reduced hyperactivity to external stimuli. Goal Achievement (GAS) +2, meaning the goal was achieved better than expected and positive changes were found on the Sensory profile 2, with large effect sizes. Conclusion The study found that sensory- based occupational therapy and sign language training improved occupational performance and goal achievement in children with sensory, behavioral, and communication difficulties.

Background: Organ transplantation has been rapidly advancing in Mongolia in recent years. The number of successful kidney, liver, and bone marrow transplants performed in national central hospitals has been increasing annually. While the number of successful kidney transplants is increasing, post-transplant immune monitoring remains insufficiently studied. Aim: To assess post-transplant immune status by analyzing inflammatory cytokine levels in kidney transplant recipients Materials and Methods: A prospective cohort study was conducted at the First Central Hospital of Mongolia. Serum samples from kidney transplant recipients were analyzed using flow cytometry to measure the levels of 13 inflammatory cytokines, including TGF-β1, PAI-1, sTREM-1, PTX3, sCD40L, sCD25 (IL-2Ra), CXCL12 (SDF-1), sST2, sTNF-RI, sTNF-RII, sRAGE, CX3CL1 (Fractalkine), and sCD130 (gp130). Statistical analysis was performed to assess the results. Results: The mean creatinine level significantly decreased on post-transplant days 7 and 30 compared to pre-transplant levels (p<0.001, ANOVA). No statistically significant difference was found in the 13 cytokine levels between the high risk and low-risk groups based on creatinine levels on post-transplant day 30 (p>0.05). However, the levels of TGF-β1, CX3CL1, sTREM-1, and sTNF-RI showed statistically significant differences between post-transplant days 7 and 30 (p<0.05). No significant correlation was found between the measured cytokine levels and CRP (p > 0.05). On post-transplant day 7, sTREM-1 had a weak correlation with TGF-β1 (r=0.40, p=0.02) and sTNF-RI (r=0.36, p=0.05) but showed a strong correlation with CX3CL1 (r=0.65, p=0.0001). On post-transplant day 30, sTREM-1 remained strongly correlated with CX3CL1 (r=0.73, p=0.0001) and moderately correlated with sTNF-RI and TGF-β1 (r=0.45, p=0.01). Conclusions 1. The levels of TGF-β1, CX3CL1, sTREM-1, and sTNF-RI significantly varied between post-transplant days 7 and 30 (p< 0.05, T-test). 2. On post-transplant day 30, these cytokines were not correlated with CRP but were interrelated among themselves.

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: According to WHO research, there are approximately 24 million people living with schizophrenia worldwide and schizophrenia is characterized by a combination of psychotic and non-psychotic symptoms. Since the cause of the disease is not fully understood, antipsychotic medications are used as symptomatic treatment. According to the 2022 statistics of the NCMH, 718 people with schizophrenia are being treated under active surveillance in Mongolia. The reason for conducting this study is that the manifestation of drug side effects resulting movement disorders in patients with schizophrenia, which has not been studied in Mongolia. Aim: To investigate the relationship between adherence of medication regimen and abnormal involuntary movements in patients with schizophrenia. Materials and Method: The study was conducted using a descriptive method, cross-sectional design, purposive sampling with the questionnaire and standardized tests. Ethical approval for this study was approved by the NCMH (№3/77 30th of January, 2023) and Research Ethics Review Committee of MNUMS (№2023/3-02). Each participant was asked to complete 5 groups of 36 questionnaires, and standard tests were used to assess patients’ adherence to medication regimens (Morisky scale) and abnormal involuntary movement scale (AIMS). The study was conducted between March and August 2023, and the results were summarized and analyzed using STATA 14 software. Results: The study included 209 patients with schizophrenia, aged 18-79 years, of whom 47.4% (n=99) were male and 52.6% (n=110) were female (p=0.21). Of the participants, 28.2% (n=59) had less than secondary education, 76.5% (n=160) were unmarried, and 85.2% (n=178) had a disability due to mental health. 32.5% (n=68) of the patients with schizophrenia in the study used a combination of typical and atypical medications, and the most commonly used antipsychotic drugs were haloperidol (30.6%), chlorpromazine (26.8%), levomepromazine (25.8%), risperidone (24.4%), and quetiapine (21.1%). 1.4% (n=3) of the patients had good, 52.6% (n=110) had moderate, and 45.9% (n=96) had poor adherence to the medication regimen (Cronbach’s α=0.781). However, according to the results of the test for assessing abnormal involuntary that are performed without self-control, 49.76% (n=104) responded that they felt more sensitive to facial and oral movements, and 44.5% (n=93) to limb movements. The patients’ adherence to the medication regimen was statistically significant with facial and oral movements (n=104; p=0.036) and general body movement disorders (n=94; p=0.05). Conclusion 32.5% of patients with schizophrenia were taking typical and atypical antipsychotics, and 45.9% had poor adherence to medication regimens and were more likely to exhibit clinical forms of abnormal involuntary movements, including facial (p=0.036) and general movement disorders (p=0.05).

Background: Identifying reliable biomarkers for early detection, risk stratification, and prognosis of CVD in the context of CKD is, therefore, of critical importance. Cystatin C has emerged as a potential biomarker capable of reflecting both cardiac injury and renal impairment, particularly in patients with arterial hypertension. This study aimed to evaluate the association between serum cystatin C levels, left ventricular hypertrophy, and chronic kidney disease in individuals with hypertension. Objective: To assess serum cystatin C concentrations in patients with left ventricular hypertrophy and chronic kidney disease secondary to arterial hypertension. Materials and Methods: A case-control analytical study was conducted, enrolling 44 patients aged 45 years or older with both left ventricular hypertrophy and chronic kidney disease due to arterial hypertension alongside a control group of apparently healthy individuals. Serum cystatin C levels were measured using immunoturbidimetric assay. Statistical analysis was performed using SPSS version 25.0. Group comparisons were made using independent-sample t-tests, while multivariate regression and receiver operating characteristic (ROC) analyses were employed to explore associations and the predictive value of cystatin C. Results: The mean serum cystatin C concentration in the case group was 1.6±0.1 mg/L, significantly higher than in the control group (0.88±0.03 mg/L, p<0.05). Similarly, the estimated glomerular filtration rate (eGFR) was markedly reduced in the case group (44.88±6.8 mL/min/1.73 m²) compared to the controls (92.88±3.4 mL/ min/1.73 m², p<0.05). In the case group, a statistically significant inverse correlation was observed between serum cystatin C levels and glomerular filtration rate (GFR), with a regression coefficient of β=−0.028 (p<0.006). Conclusion The elevated serum cystatin C levels (1.6±0.1 mg/L) and decreased eGFR (38.99±12.7 mL/min/1.73 m²) observed in the case group suggest that cystatin C may serve as a potential biomarker for the early diagnosis of left ventricular hypertrophy due to arterial hypertension and chronic kidney disease, as well as for predicting related complications.