Background: Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin lymphoma that is confined to the brain, spinal cord, leptomeninges, or eyes. Case: Our patient was a 52-year-old immunocompetent male who presented with progressive ataxia, dizziness, weakness and pain in both legs, imbalance, nausea, bladder/bowel retention and fever for over 18 months. After repetitive brain and spinal MRI, he was diagnosed with encephalomeningomyelitis and received four courses of steroid therapy, but his clinical symptoms continued to worsen. He was unable to undergo brain tissue analysis due to his persistent fever. We present a case of PCNSL based on the history, clinical presentation, repeated brain imaging, cerebrospinal fluid analysis, and clinical treatment. Conclusion Early diagnosis through accurate interpretation of imaging and timely management is crucial for improved outcomes in PCNSL.

Background: Progressive supranuclear palsy (PSP), a rare neurodegenerative disorder, is mainly characterised by supranuclear palsy, trunk imbalance, and cognitive impairment. Its prevalence is believed to be high, although it remains underdiagnosed. Various clinical presentations have been linked to this entity, often making its diagnosis difficult and leading to delays of three to four years before it is established. PSP diagnosis mainly relies on clinical data and can only be confirmed with the neuropathological findings at autopsy. However, recent research indicates that neuroimaging, namely, brain MRI, can aid in earlier diagnosis. Case presentation: We report the case of a 60-something-year-old male with a history of recurrent and unexplained falls over the last few years that had been wrongly attributed to Parkinson’s disease. He initially presented complaining of ataxia and a tendency to recurring falls that got progressively worse, and eventually, he was not able to walk on his own. Concomitantly, there was also a cognitive dysfunction with frontal predominance. An exhaustive physical examination and clinical history revealed indicators consistent with PSP. Conclusion PSP diagnosis demands a high clinical suspicion, and hence, clinicians should have a good understanding of this disease for its early recognition. Although it is a devastating disorder and no medications that can reverse the disease course are currently available, early diagnosis of PSP may contribute to improving the quality of life of the patients and their families and prevent complications. This report highlights the importance of clinical examinations, particularly eye examinations and radiological imaging, in patients with PSP.

Background: Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory disorder of the hair follicle that predominantly affects areas rich in apocrine sweat glands, such as the axillae and groin. Clinically, it is characterized by painful nodules, abscess formation, sinus tract development, and scarring. Diagnosis is primarily based on clinical findings; however, due to limited awareness of the disease, it is often diagnosed at a late stage. Misdiagnosis and inappropriate management are common, leading to chronic disease progression. Consequently, HS significantly impairs quality of life through reduced work capacity, psychological distress, and social isolation. Disease severity is commonly assessed using the Hurley staging system and the Sartorius scoring system. We present a rare case of hidradenitis suppurativa encountered in dermatological practice. Case presentation A 35-year-old male patient (initials L.B.) presented with recurrent, painful lesions in both axillary regions associated with purulent discharge. The condition had persisted over a prolonged period with repeated exacerbations. The patient had attempted self-treatment at home without improvement and was subsequently admitted to the Department of Dermatology at the National Center for Dermatology with a diagnosis of DS: L73.2 (hidradenitis suppurativa). The patient was treated with systemic antibiotics (doxycycline and cefazolin), retinoids, supportive therapy, and topical treatment. In addition, intralesional triamcinolone injections were administered into active nodules, which proved effective in rapidly reducing inflammation, pain, and purulent discharge.

Background: Patient safety is a core dimension of healthcare quality and has become a global priority. According to the report by the U.S. Institute of Medicine, between 44,000 and 98,000 deaths occur annually due to medical errors in hospitals. One of the key indicators of patient safety is the Adverse Events (AE), defined as unintended harm to a patient that results from medical care rather than from the underlying disease. The assessment of adverse events is not only a tool for detecting errors but also an active strategy for improving system reliability and safety. Accurate identification of adverse events is therefore essential for enhancing patient safety and serves as a critical performance indicator with financial implications for hospitals. Aim: To determine the incidence of adverse events in referral hospitals and to analyze the relationship between triggers and adverse events. Material and Methods: Data were collected during 2023–2024 from three referral hospitals, the First, Second, and Third State Central Hospitals after obtaining institutional approval. The study was conducted within the framework of the Whole System Measures methodology developed by the Institute for Healthcare Improvement (IHI), which is internationally used for system-wide performance assessment. Data extraction was performed from electronic health records and inpatient departments, and statistical analyses were conducted using SPSS version 25. Results: The study identified 8.3% adverse events per 1,000 patient-days, which is 1.66 times higher than the international reference rate. A statistically significant association was observed between the number of triggers and the occurrence of adverse events, indicating that the use of triggers facilitates the active detection of adverse events. Conclusion The incidence of adverse events in tertiary specialized hospitals was found to be higher than international benchmarks. The application of trigger-based active surveillance proved to be an effective method for identifying adverse events and enhancing patient safety monitoring systems.

BACKGROUND: According to International osteoporosis foundation report, osteoporosis is a multifactorial condition associated with an increased risk of fracture and is caused by social, behavioral and physiological factors. Overall incidence is increasing in every country due to people’s life style changes, diet and increased life expectancy. OBJECTIVES: To evaluate the some hormonal effects in bone mineral density among Mongolian population. METHODS: Bone density was measured in the distal one third of radius using the Sunlight Omnisense (Sunlight Medical, Rehovot, Israel) and classified into 3 groups according to WHO osteoporosis criteria. Normal participants were selected into control group and osteoporotic participants were selected into control group. We have evaluated PTH, calcitonin, 25-hydroxy vitamin D in case-control group. RESULT: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. It was clear that PTH elevated group (>30.3pg/ml) had more risk of osteoporosis. CONCLUSION: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. PTH elevation is risk factor in men.

BACKGROUND: Children’s development and childhood disability are a public health issues to their consequences on quality of life and productivity not only for affected children but also for families and populations as a whole. WHO and the World Bank estimate that more than a billion people live with some form of disability, which equates to approximately 15% of the world’s population (1). Citing the Global Burden of Disease study of 2004, the World Report further estimates that amongst those aged 0-14 years, roughly 5.1% of all children (93 million) live with a ‘moderate or severe’ disability and 0.7%, or 13 million children, live with severe difficulties. Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and other risks, which are affect their cognitive, motor, and social emotional development. There are few research result and national statistics on the childhood disabilities of under 5 years children in Mongolia. OBJECTIVES:The objective of the screening was to determine the rate of disabilities in children aged 9 months to 5 years in Ulaanbaatar. MATERIALS AND METHODS: Population based cross-sectional study design used childhood disabilities screening among under 5 years children in Ulaanbaatar. TQ-(ten questions) screening method used to determine childhood disabilities. The structured interview checklist (TQ) and a guide to collect background and risk factors information were administered in a face-to-face interview of the child’s caregivers. The screening covered 8838 children from 6 districts, Ulaanbaatar. RESULTS: The study covered totally 8838 children (50.4 %) were male and 193 (48.4 %) were female. Over 81 % of the persons responding to the questions were mothers of the children, 10 % fathers. 9 % were the child’s relative and child’s sibling. Based on the ‘ten questions’ screen, 1960 out of 8838 children were positive (disabled). CONCLUSIONS: The positive rate of disabilities by TQ was a higher. At the post verification stage there is need to estimate sensitivity, specificity and negative predictive value of TQ. The second step of evaluation among positive cases should take diagnosis by comprehensive evaluation and clinical assessment.

Introduction Coronary TIMI flow gradewas previously demonstrated to be related to outcome after acute myocardial infarction. However, the relationship between coronary flow grade and left ventricular global longitudinal strainin patients with acute myocardial infarction (AMI) treated by primary percutaneous intervention (PCI) were unclear. Goal In this study, we aimed to reveal the relationship between coronary TIMI flow grade and LV GLS in patients with AMI. Materials and Methods We prospectively selected patients with AMI who treated by primary PCI. Based on whether TIMI 3 flow achieved at the end of the procedure patients were divided into two groups. Group I (TIMI 3 flow was achieved, n=367), Group II (TIMI 3 flow was not achieved, n=47). The LV GLS was assessed by 2dimensional speckle-tracking echocardiography (2D STE). Results A total of 413 patients (mean age 60±13, 84% male) were included and TIMI 3 flow was achieved in 367 patients (88%). LV GLS was significantly impaired in patients who had TIMI 3 flow not achieved compared with TIMI 3 flow achieved group (-13.1±4.8% vs. -15.3±3.8%, p<0.001). Multiple linear regression analysis which included age, gender, clinical, biochemical and angiographic variables showed that coronary TIMI flow grade of culprit artery was independently associated with LV GLS. There was negative correlation between coronary TIMI flow grade and LV GLS (Pearson’s r=-0.183, p<0.001). Simple linear regression analysis revealed that coronary TIMI flow grade is directly associated with LV GLS (β=-1.61, p<0.001) and which indicated that every 1 scale increase of final coronary TIMI flow grade resulted -1.61% increase of LV GLS. Conclusion Our study demonstrated the coronary TIMI flow grade of the culprit artery was independently associated with LV GLSin patients with AMI treated by primary PCI.

Osteoporosis is a disease in which the density of bone is decreased with consequent increase in bone fragility and susceptibility to fracture risk. Vitamin D deficiency may cause secondary hyperparathyroidism and low bone mineral density. Our study was aimed to assess relation between vitamin D status and parathyroid hormone and bone density in adults. Relatively healthy 369 participants aged between 20-60 were randomly selected from Ulaanbaatar city. Specially designed questionnaire was used in the survey. Bone mass density was diagnosed according to the WHO criteria by the T-score. Respondents serum calcium and phosphorus levels were described by the fully automated analyzer (Cobas Integra 2800, Germany). Serum parathyroid hormone and 25-hydroxivitamin D levels were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the Molecular biology laboratory of MNUMS.The statistical result was analyzed by SPSS 21 program. The subjects mean age was 47.61±12.92, with a range of 20-83. The mean T-score was -0.60±2.17. Our study showed that negative correlation between bone mass density values at parathyroid hormone (r=-0.58, p<0.05), 25-hydroxyvitamin D (r=-0.48, p<0.05) and serum calcium (r=-0.21, p<0.05). Our study showed increased serum parathyroid hormone led the releasing calcium from bone and decreasing bone mass density.

Osteoporosis is a disease in which the density of bone is decreased with consequent increase in bone fragility and susceptibility to fracture risk. Vitamin D deficiency may cause secondary hyperparathyroidism and low bone mineral density. Our study was aimed to assess relation between vitamin D status and parathyroid hormone and bone density in adults.Relatively healthy 369 participants aged between 20-60 were randomly selected from Ulaanbaatar city. Specially designed questionnaire was used in the survey. Bone mass density was diagnosed according to the WHO criteria by the T-score. Respondents serum calcium and phosphorus levels were described by the fully automated analyzer (Cobas Integra 2800, Germany). Serum parathyroid hormone and 25-hydroxivitamin D levels were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the Molecular biology laboratory of MNUMS.The statistical result was analyzed by SPSS 21 program.The subjects mean age was 47.61±12.92, with a range of 20-83. The mean T-score was -0.60±2.17. Our study showed that negative correlation between bone mass density values at parathyroid hormone (r=-0.58, p<0.05), 25-hydroxyvitamin D (r=-0.48, p<0.05) and serum calcium (r=-0.21, p<0.05).Our study showed increased serum parathyroid hormone led the releasing calcium from bone and decreasing bone mass density.

IntroductionOsteoporosis is becoming an increasingly important economic and public health problem as ourpopulation ages. Different results are reported about osteoporosis rate among various geographicalzones and ethnic groups even in same country. These differences cannot be attributed to hormonalstate or to the dietary intake of calcium, but do accord in general with the living standards of the differentcountries and the degree of physical activity undertaken by the different populations and sexes.GoalTo determine the osteoporosis rate among Mongolian adults and evaluate the geographical distributionsof osteoporosis rateMaterials and MethodsOur study group was 1990 adults who are over 18 years and participated from Uvs, Arkhangai, Dundgovi,Sukhbaatar province and Ulaanbaatar. We have evaluated serum PTH, 25-hydroxyvitamin D level andbone mineral density via bone sonometer (Sunlight Mini-Omni, Beammed, USA). Lifestyle risk factorswere evaluated through a specific questionnaire.ResultsThe osteoporosis rate is 25.5% (n=507) among Mongolian adults and 2 times higher in women thanmen in all age group. SOS was inversely correlated with age in both sexes (men: r=-0.286, p<0.01,women: r=-0.513, p<0.01). Osteoporosis rate was lowest in Ulaanbaatar but highest in Arkhangai(male osteoporosis) and Dundgovi province (female osteoporosis). Of 25-hydroxyvitamin D values 29%were below 20ng/ml (deficient), 39.8% ranged from 20-29.9ng/ml (insufficient) and 31.2% were above30ng/ml (sufficient). In addition, 25-hydroxivitamin D concentrations were not related to bone density.Serum 25-hydroxivitamin D level was highest in Dundgovi province in both sexes. Mean PTH level was26.0±17.7pg/ml and inversely correlated with T-score (r=-0.248, p<0.01) in men.ConclusionOsteoporosis rate among Mongolian adult is lowest in Ulaanbaatar comparing to other rural areas. Andserum 25-hydroxivitamin D deficiency is 68.8% in Mongolian adults.