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: Malaria is caused by parasite of the genus Plasmodium and considered one of the biggest public health issues because almost half of the world’s population is at risk of contracting malaria. It causes 2% of the world’s total deaths and millions of clinical infections. In 2022, 94% of cases and 95% of deaths occurred in the WHO African Region. Cerebral malaria the most severe neurological complication of infection with Plasmodium falciparum malaria. It is a clinical syndrome characterized by coma and asexual forms of the parasite on peripheral blood smears. The neurological complication, induced by cerebral malaria is irreversible and lethal, therefore it is of great significance to unravel its exact etiology, which may be beneficial for the effective management of this severe disease. In Mongolia, malaria normally not present unless the disease was contracted abroad. Considerable attention in malaria control and elimination is needed, yet, increasingly, domestic hospitals are unfamiliar with it, and so there is a risk of being overlooked. The following is the second case, to our knowledge, of cerebral malaria in Mongolia. Conclusion Although Mongolia is not a malaria-endemic region and routine malaria testing is not commonly performed, the number of imported cases is increasing due to the growing mobility of the population—travel, study, tourism, and peacekeeping missions to Africa and Southeast Asia. Therefore, neurologists should be aware of the possibility of cerebral malaria when evaluating patients with neurological deficits who have a history of travel to malaria-endemic areas. This case highlights important clinical, imaging, and laboratory considerations for suspecting and diagnosing malaria in such patients.

Background: Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is a rare neurodegenerative disease characterized by cerebral white matter abnormalities, which leads to progressive cognitive and motor dysfunction that usually presents in a middle-age. We present the pedigree, clinical, and imaging findings of familial cases with similar clinical features suggestive of progressive multiple sclerosis. Among our cases, two had died and the remaining one case is still alive, but with clinical symptoms getting worse, such as unable to verbally express themselves, unable to take care of themselves, worsening social relations and work abilities. Conclusion Because the clinical features and neuroimaging findings of inflammatory and neurodegenerative disorders of the nervous system often overlap, the definitive diagnostic test for ALSP (Adult-onset Leukoencephalopathy with Axonal Spheroids and Pigmented Glia) is genetic testing to identify CSF1R gene mutations. Although genetic testing is currently unavailable, it is advisable in clinical practice to apply diagnostic criteria and pay close attention to family history and characteristic neuroimaging findings when evaluating patients with progressive motor, cognitive, and language decline in order to suspect this condition.

Background: Cardiovascular diseases (CVDs) is a third leading cause of non-communicable diseases and a leading cause of mortality in Mongolia. Among these, acute myocardial infarction (AMI), a complication of coronary artery disease (CAD), is a leading cause of cardiovascular mortality. In patients with AMI, both epicardial artery blood flow, observed through coronary angiography, and coronary microcirculatory dysfunction (CMD) play critical roles in the disease’s pathophysiology. Recent advancements have introduced artificial intelligence (AI)-based softwares which are capable of analyzing coronary blood flow from coronary angiography images. The AI based softwares can assess not only epicardial blood flow but also CMD in recent studies. In this review, we discussed the role of CMD in pathophysiology of AMI, diagnostic approaches, the application of AI-based technologies, their clinical significance, and future directions. Aim: This review aims to explore the pathophysiological relationship of coronary microcirculatory dysfunction (CMD) in the context of acute myocardial infarction (AMI), diagnostic methodologies, the application of artificial intelligence (AI)-based technologies, and their clinical significance. Hypotheses: 1. AI-based software allows for highly accurate assessment of coronary microcirculation during AMI. 2. CMD during AMI is associated with structural and functional changes in the heart. 3. CMD during AMI is related to disease prognosis and patient outcomes. Methodology:: This narrative review was compiled using a systematic and logical approach, based on publicly available recent clinical and biomedical research literature addressing the above hypotheses. Conclusion In recent years, AI-based image processing software has been developed to analyze angiographic images obtained during percutaneous coronary intervention (PCI) and treatment procedures. These tools show significant promise for early detection and improved diagnosis of CMD during AMI, as well as for better assessment of short- and long-term patient risk.

Background: In 1904, Monkeberg was first described about the coronary calcification which is the degenerative change that occurs with aging process, but the last decades many studies have been confirmed that coronary calcification was an active process same as the signaling pathways with bone mineralization. Coronary calcification increases the risk of myocardial infarction during bypass graft surgery and PCI (СМ СN. Shanahan, 1999). Goal: To evaluate Agatston Coronary Artery Calcium score using contrast enhanced CT-Coronary angiography. Objectives:
1. To assess Agatston Coronary Artery Calcium score
2. Age and gender relationship of coronary calcification Materials and Methods: We evaluated total 215 patients who were admitted to the Reference center of Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary Professor of the Third State Central Hospital awarded with the Red banner of the Labor diagnosed with the coronary calcification by contrast enhanced 64 slice CT (Philips Ingenuity CT 64) between 2020 to 2022. Patient’s age was considered into 6 groups and coronary calcification was assessed by Agatston’s score. The result of our study determined by common statistical averages and errors and probabilities of the indicators were determined by Student’s criteria. Result: When evaluating Agatston coronary artery calcium scoring by CT-coronary angiography, 11-400 Agatston score was predominantly in our study with p value of (P<0.001). Considering relationship of age and gender, coronary calcification occurs 42.3% of patients aged 50-69, male and female ratio was 1.7:1. Conclusions
1. We established Agatston coronary calcification 11-400 was occurred in 66.96% of the patients.
2. Coronary calcification predominantly occurred in 65% patients aged 50-69 years.

Background: Over the past 20 years, world wide scale social and economic reforms, technological breakthroughs, and the population growth (increased by 1.64 billion), especially in urban areas, have had a negative impact on human health; changes in living and working conditions (environmental and air pollution), population density, traffic jam, unhealthy lifestyles, workload, and work stress – all contribute to non-communicable diseases – are increasing. According to researchers from Stanford University in the United States, “Stress plays a key role in the development of behavioral disorders such as poor diet, lack of exercise, alcohol and tobacco use, and addiction. Furthermore, these behavioral disorders play a major role in the development of metabolic disorders and cancer, such as hypertension, cardiovascular disease such as myocardial infarction, and diabetes and obesity. “Stress, in particular, depends on the type of workplace, work environment, and occupation in which the person spends most of their life. Materials and Methods: The study is covered 473 nurses from the specialized tertiary level hospitals in Mongolia. We determined their perceived work stress by the WPS (3 parts 57 questions) questionnaire of American scientist Rice. The work stress results were analytically analyzed with the cross-sectional method regarding the nurses’ arterial blood pressure. Results: Totally 473, or 121, 89, 146, and 117 nurses participated from NCTO (1), NCMH (3), NCID (4), and NCC (4). In present study, 34 or 7.2% of 18-24 year olds, 139 or 29.4% of 25-30 year olds, 99 or 20.9% of 31-40 year olds, 169 or 35.7% of 41-50, and 32 or 6.8% over 51 year olds. The study was conducted by collecting an age group similar to the age pyramid of nurses working in the hospital. The participants illustrated low levels of work stress in 7.6%, medium levels in 27.1%, and high levels of work stress in 65.3%, respectively. When we examine whether the level of stress exposure of nurses differs between the groups by high, medium, and low levels of workplace stress, the analysis of one factor variance confirms the statistical real difference (F = 3.071), (p = 0.028). The study results revealed that long lasted accumulated work stress trigger the hypertention. Conclusion The onset of stress in a nurse’s workplace depends on many different social factors, such as age, gender, organizational characteristics, organization, place of work, and years of experiences. In conclusion, we agreed with Spruil Tanya et al., that chroronic stress at work can be the reason for the high blood pressure.

Background: The WHO recommends the ideal rate for cesarean section to be 15% of the total birth, but researchers are still attracting attention to the fact that in recent years this rate has been steadily increasing, and risk is not decreasing worldwide. Incidence of postcesarean section inflammation and infection are 8-10 times higher than vaginal birth. The determination of lactate levels in early diagnosis of sepsis is clinically significant and the higher the lactate level increases the risk of mortality. Objective: The aim of the study is to improve early detection of inflammation and infection and prevention of serious complications by using risk factors of postcesarean section inflammation and infection, and detecting procalcitonin and lactate in maternal blood. Materials and Methods: This research is conducted between 2015-2017 based at the “Urguu” Maternity Hospital, Obstetric Clinic of National Center for Maternal and Child Health of Mongolia. Factors affecting postcesarean section inflammation and infection are calculated based on multifactorial regression analysis. Procalcitonin was determined by enzyme binding assay while lactate, C-reactive protein, and lactate dehydrogenase were determined by “E-311” the fully automated analyzer. Results: According to the results of the study, the probability of inflammatory and infectious complication is 2.4% when the duration of labor increases by one unit, 34.8% when the risk of amniotic fluid increases, 14.6% when the pregnancy process become more complicated. Whereas, excessive fetal weight statistically increases the risk of infection, but its impact is low. The result of the study shows that the procalcitonin sensitivity was 65%, and the specificity was 96%. Lactate resulted in sensitivity of 56%, but with only 67% specificity. C-reactive protein had a sensitivity of 65% and a specificity of 96%. Lactate dehydrogenase resulted in sensitivity of 95%, and specificity of 82% in the diagnosis of sepsis. Conclusion Postterm pregnancy, premature rupture of membranes, multifetal pregnancy, prolonged labor, placenta previa, pyelonephritis, chronic hepatitis, chronic hypertensive disorder, anemia, emergency cesarean section, preeclampsia are risk factors and it is statistically significant at (P<0.0001). The biomarkers have a direct correlation to all stages of inflammation and infections, which are important for the diagnosis.

BACKGROUND. The aim of this study was to investigate the prognostic impacts of drug-eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI) and risk factors of stent restenosis. MATERIAL AND METHODS. We conducted a retrospective cohort study based on the Angiographic diagnostic and treatment Department of 3rd State Central Hospital of Mongolia. Patients who had undergone coronary stenting between 2000 and 2017 were recruited and monitored until the end of 2010. RESULTS. Among a total of 4520 selected patients with a mean age of 58±7 years, 2125 subjects had BMS and 2395 subjects had DES. The incidence of stent restenosis and stent thrombosis were significantly lower in the DES (37; 1,5%) group as compared with the BMS (201; 9,4%) group. Patients who have stent restenosis presented comorbidities, such as diabetes 214(47,8%), hypertension 54(22,6%), prior PCI 21(8,2%), re-infarction 12(5,04%), chronic kidney disease 16(6,7%), hyperlipidemia 21(8,2%). СONCLUSION. Implantation of DES was related to better outcomes than for BMS, in terms of reducing restenosis and stent thrombosis after PCI. STEMI patients who have co morbidities have greater risk of stent stenosis and thrombosis

Introduction: Traditional Mongolian medicine contents a whole idea of preventive medicine. Traditional Mongolian medicine main theory is “Rlung-Mkhris-Badgan” which is composed human body. These elements confirm human healthy during metabolite balance but when any of these lacks or exists in an excessive amount, then there is an illness. Understanding on the theory “Rlung-Mkhris-Badgan” by modern medicine there are called cell universal regulation system.[1] A striking feature of metabolism is the similarity of the basic metabolic pathways and components of “Rlung-Mkhris-Badgan” even vastly different metabolic pathways. Human has own Rlung-Mkhris Badgan`s portion differently when they were born, during all life must obey their attribute manner. There are seven individualities which expressed human characters.
Furthermore in traditional Mongolian medicine have richness experience of concerning with three elements unbalanced time to come disease early diagnosis and remedy them effectively. Accordingly organic body must adaption four seasons` biological accommodation and follow up four seasons` suitable food technology and climate condition. Purpose:
1. To determine human characteristic types by traditional Mongolian medicine main theory.
2. To suggest healthy live advice for people who participate randomized in preventive medical examination by used modern and traditional medical diagnostic methods. Method: Biomedicine and Clinical Pharmacy Department doctor teachers were organized “Healthy life starts every day right habit” topic preventive medical examination for all students of Mongolian University of Pharmaceutical Sciences 09-29 days of September, 2016. Participant by diagnosed medical basic physical examination methods and filled out questionnaire in human characteristics based traditional Mongolian medicine main theory. Results: There had 513 participants, 29 of them were “rlung” characteristic personality, 26 of “mkhris” characteristic personality, 22 of them “badgan” characteristic personality, 163 of them “rlung and mkhris” combined characteristics, 118 of them “rlung and badgan” combined characteristics”, 68 of them “Badgan and Mkhris” combined characteristics, 87 of them were composite characteristic personalities. Conclusion
1. Determined 85% of participants are respectively combined and composed types of characteristic personalities, and these participants supposed to be better metabolism balance. Determined 15% of participants are one element dominantly personalities.
2. We made a Healthy Life Guidance depending on human characteristics.

IntroductionCoronary artery disease is a leading cause of death among men and women globally. Researchershave focused on apolipoproteins for coronary artery disease (CAD) than traditional lipid parameterssuch as total cholesterol, LDL-C and HDL-C. Measuring Apolipoprotein B (Apo-B) provides a directestimate of the total number of atherogenic particles. Also lipoprotein (a) [LP (a)] is super atherogeniclipoprotein that resembles the LDL containing apo-B in its structure and associated with development ofatherosclerosis and thrombogenesis.GoalTo determine some specifi c lipid markers such as apo-B, LP (a) and traditional lipid parameters forcoronary atherosclerosis and compare with healthy groupMaterials and MethodsHospital based case control study. The study included 42 patients undergoing coronary angiographywith >75% narrowing of main coronary arteries and 43 healthy controls. We collected data of traditionallipid parameters by “endpoint” method and apo-B, LP (a) by “immunoturbidometry method” from ROCHECOBAS 6000 analyzer series.ResultÀpo-Â and Lp(a) were 108.88±26.61 mg/dl, 19.50±24.86 mg/dl and signifi cantly higher in patientswith coronary artery disease (CAD) versus control group. Total cholesterol, especially LDL-C thatApo-B is major on its surface signifi cantly different in the study groups (p<0.05). Also, other lipoproteinthat containing apo-B, one of them is LP (a) were higher in the case group (p≤0.05) compared withhealthy controls. Logistic regression analysis showed that Apo-B were one of main risk factors for CAD(OR=1.024, p=0.013).ConclusionOur fi ndings suggest that LDL-C