Background: Arterial hypertension (AH) is a major cardiovascular risk factor worldwide, with a prevalence of 33.1% in Mongolia according to the 2019 STEPS survey. Hematocrit (HCT) is the primary determinant of blood viscosity and has been associated with hypertension in international studies; however, this association has not been sufficiently investigated in the Mongolian population, providing the rationale for the present study. Aim: To investigate the association between hematocrit levels and arterial hypertension in the Mongolian population. Materials and Methods: From 57,108 records of the 2022–2023 national early detection program organized by the Government of Mongolia, 32,626 participants were selected using proportional stratified random sampling by region. AH was defined per Mongolia’s 2018 Clinical Guidelines for Arterial Hypertension in Adults, with blood pressure measured using an automated sphygmomanometer, as SBP ≥130 mmHg or DBP ≥80 mmHg. Statistical analysis included Mann-Whitney U test, Pearson and Spearman correlation, univariate and multivariate logistic regression, and ROC curve analysis. Result: AH was identified in 58.2% of participants (n=18,988). The median HCT in the AH group (43.60%) was significantly higher than in the normotensive group (42.40%, p<0.001). The correlation between HCT and SBP was r=0.152 (p<0.001), with the strongest association observed in the 18–40 age group (r=0.203). ROC curve analysis identified optimal cut-off values of 47.2% for males and 41.8% for females. Conclusion 1. Hematocrit levels were significantly higher in the hypertensive group compared to the normotensive group and showed a weak positive correlation with both systolic and diastolic blood pressure. 2. Although hematocrit was significantly associated with AH in univariate logistic regression, its independent effect was attenuated in multivariate analysis due to collinearity with hemoglobin. In a separate model with HCT alone adjusted for age, sex, and BMI, the independent association remained statistically significant (aOR=1.260, p<0.001). 3. ROC curve analysis identified sex-specific optimal cut-off values of 47.2% for males and 41.8% for females, highlighting the need to consider sex differences in the Mongolian population. These cut-off values should be regarded as supplementary indicators to be used alongside other cardiovascular risk factors.

Background: Sarcopenia is a multifactorial geriatric syndrome characterized by age-related loss of muscle mass, muscle strength, and physical performance. In recent years, neurotrophic and neuromuscular biomarkers have been investigated as potential diagnostic indicators of sarcopenia; however, evidence regarding their sex-specific differences remains limited. Aim: To evaluate the sex-specific associations of serum BDNF, GDNF, and CAF22 levels with sarcopenia and muscle-related parameters among older adults. Materials and Methods: This analytical cross-sectional study included adults aged 60 years and older. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS 2019) criteria. Serum BDNF, GDNF, and CAF22 levels were measured using ELISA. Group differences were analyzed using independent t-tests, correlations were assessed using Pearson correlation analysis, and diagnostic performance for sarcopenia was evaluated using receiver operating characteristic (ROC) analysis. Multivariable logistic regression analysis was also performed. Results: No statistically significant differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic participants in either the male or female groups (all p>0.05). ROC analysis demonstrated AUC values ranging from 0.540 to 0.542 in males and from 0.508 to 0.530 in females for BDNF, GDNF, and CAF22. Multivariable logistic regression analysis revealed that age (OR=1.12, 95% CI: 1.04–1.21, p=0.003) and lower fat-free mass index (OR=0.78, 95% CI: 0.66–0.91, p=0.001) were significantly associated with sarcopenia, whereas BDNF, GDNF, and CAF22 showed no independent association with sarcopenia. Conclusions 1. No statistically significant sex-specific differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic older adults (all p>0.05). 2. CAF22 levels were weakly negatively correlated with muscle mass and fat-free mass index in males (p<0.05), whereas BDNF levels showed weak positive correlations with handgrip strength and fat-free mass index in females (p<0.05). CAF22 levels also demonstrated a weak positive correlation with age (p<0.05). 3. ROC and multivariable logistic regression analyses indicated limited diagnostic utility of BDNF, GDNF, and CAF22 for sarcopenia (AUC=0.508–0.542), and none of these biomarkers showed an independent association with sarcopenia (all p>0.05). In contrast, older age (OR=1.12, p=0.003) and lower fat-free mass index (OR=0.78, p=0.001) were significantly associated with sarcopenia.

Background: The human head is an integrated biological structure composed of the brain, cranial bones, facial structures, neuromuscular systems, and sensory organs, all interconnected through coordinated signaling. The relationship between brain development, function, and craniofacial growth is most evident after birth, during which the head increases approximately fourfold in size before adulthood. Brain morphology and volume are associated not only with neurological disorders but also with cognitive and behavioral characteristics. For example, children with holoprosencephaly often present with varying degrees of facial anomalies, while studies have shown that adolescents with malocclusion exhibit higher levels of anxiety, depression, and psychological stress. With the increasing availability of magnetic resonance imaging (MRI), it has become an essential diagnostic tool in clinical practice. MRI is particularly advantageous in pediatric populations due to the absence of ionizing radiation and its superior soft tissue contrast. Recent advances in image processing techniques have enabled comprehensive analysis of both brain structures and craniofacial morphology from a single MRI dataset, forming the basis of this study. Aim: To investigate the relationship between brain tissue volumes and maxillary hypoplasia using MRI-based voxelbased morphometry in children with neurological conditions. Materials and Methods: This study was conducted at the School of Biomedicine, Mongolian National University of Medical Sciences, in collaboration with Chifeng University, as part of the project titled “Investigation of the relationship between craniofacial anomalies and brain disorders using MRI”, funded by the Ministry of Education and Science. Voxel-based morphometry (VBM) analysis was performed on brain MRI scans of children aged 9–11 years. Results: Among the 25 children included in the study, 17 (68%) were male. The youngest average age was observed in the maxillary hypoplasia group (8.4±0.95 years). The signal-to-noise ratio (SNR) of MRI was lowest in the non-temporal epilepsy group (41.1±1.35) and higher in the maxillary hypoplasia group (49.6±8.22). Both epilepsy and maxillary hypoplasia groups demonstrated physiological asymmetry of the cerebral hemispheres, with left parietal lobe dominance (−0.1% and −0.3 cm, respectively). Right frontal lobe dominance (+1.1%) was observed only in the epilepsy group. Conclusion Children aged 9–11 years with maxillary hypoplasia showed a reduction in both gray and white matter volumes of the brain. These findings highlight the importance of early diagnosis of neurodevelopmental disorders affecting odontogenesis and emphasize the need for a multidisciplinary team-based management approach.

Background: As of 2024, approximately 39 million people worldwide are living with HIV, and approximately 1.3 million new infections are registered annually. In terms of human resources, there is an insufficient supply of doctors and specialists specializing in infectious diseases, and in some regions the workload per doctor is 1.5–2 times higher than the national average. Aim: To assess the current status of the structure and accessibility of human resources for STD, HIV, and AIDS care and services. Materials and Methods: The study was conducted using a cross-sectional design using quantitative and qualitative research methods. The “SARA-Service Availability and Readiness” standard questionnaire developed by WHO was used to assess the availability, type, location, and accessibility of STD, HIV, and AIDS care and services. The results of the study were processed using Microsoft Excel. Results: The current status of human resources providing STD, HIV, and AIDS care and services nationwide. A total of 56 STD, HIV, and AIDS doctors, 37 nurses, 10 junior doctors, 3 counselors, 16 senior laboratory doctors, and 33 laboratory technicians are working. The doctor-nurse ratio is 1:0.66. The average number of doctors and nurses working in the field of STDs, HIV, and AIDS is 0.21 per 10,000 population. The average number of doctors, junior doctors, and nurses providing STDs, HIV, and AIDS care and services per 10,000 population is 0.20. Provinces with a number of doctors, junior doctors, and nurses providing STDs, HIV, and AIDS care and services per 10,000 population is less than 0.10, which are provinces that do not have a qualified senior doctor or no doctor at all, that have a doctor but are not qualified but work alongside other doctors, and that do not have junior doctors or nurses. Six out of 21 provinces, or 29 percent, fall into the category of less than 0.10. The national STD, HIV, and AIDS care and services access index is 54.8. Conclusion When calculating the index of access to STD, HIV, and AIDS care and services based on indicators such as human resource adequacy and availability of clinics, access to care and services is poor.

Background: Thrombotic alterations play a central role in the pathogenesis of both macrovascular and microvascular complications of diabetes mellitus. D-dimer, a fibrin degradation product generated during fibrinolysis, has emerged as a potential biomarker for predicting chronic diabetic complications and assessing their severity. Aim: To determine D-dimer levels in individuals with type 2 diabetes mellitus (T2DM) and investigate their association with various microvascular complications. Materials and Methods: This cross-sectional study included 215 participants with T2DM. Individuals diagnosed with other forms of diabetes, those receiving anticoagulant therapy, and those with liver disease were excluded according to the predefined exclusion criteria. Participants were categorized into two groups according to their D-dimer levels: ≤0.260 μg/mL and >0.260 μg/mL. The prevalence of diabetic retinopathy, nephropathy, and neuropathy was compared between the groups. Multivariable logistic and linear regression models were adjusted for age, sex, and body mass index (BMI). Results: A total of 215 individuals with T2DM were included in the study. The median D-dimer level was 0.260 μg/mL (interquartile range [IQR]: 0.190–0.460). The prevalence of at least one microvascular complication was significantly higher among participants with D-dimer levels above the median than among those with levels at or below the median (51.4% vs. 37.0%, p=0.034). The prevalence of diabetic nephropathy was 33.6% versus 13.0% (p<0.001), while that of diabetic neuropathy was 20.6% versus 10.2% (p=0.035), respectively, indicating a higher burden of chronic complications in the group with elevated D-dimer levels. Participants with D-dimer levels above the median had 2.23 times higher odds of having at least one diabetic microvascular complication (OR=2.23; 95% CI: 1.19–4.18; p=0.013). Conclusions 1. Elevated D-dimer levels were observed in 21.4% of individuals with type 2 diabetes mellitus included in the study. 2. D-dimer levels above the median (0.260 μg/mL) were associated with a twofold increase in the odds of having diabetic microvascular complications (OR=2.23; 95% CI: 1.19–4.18; p=0.013).

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: Hyperferritinemia, characterized by elevated serum ferritin levels, affects approximately 5–25% of the general population. Given the frequent coexistence of liver iron overload syndrome and metabolic syndrome—both of which significantly contribute to global morbidity and mortality—it is essential to investigate their interconnections. However, there is a lack of sufficient evidence, both in Mongolia and internationally, regarding the relationship between iron storage indicators, metabolic syndrome, and its components. A deeper understanding of iron’s role in disease progression is needed. Aim: This study aims to assess the association between hyperferritinemia and metabolic syndrome parameters. Materials and Methods: A cross-sectional analytical observational study was conducted on 159 male participants who met the inclusion criteria. Data were collected using a standardized questionnaire, and anthropometric measurements were taken. Blood samples were analyzed to determine glucose, triglyceride, total cholesterol, and high-density lipoprotein (HDL) levels using an automated biochemical analyzer. Serum ferritin concentrations were measured via the ELISA method (DRG Instruments GmbH, Germany), with hyperferritinemia defined as a serum ferritin level exceeding 400 ng/ ml. Metabolic syndrome was diagnosed based on the Harmonized criteria. Statistical analyses included the chi-square test and Fisher’s exact test for categorical variables, the Mann-Whitney U test for non-normally distributed data, and Spearman’s correlation test to assess relationships between glycemic levels, lipid parameters, and metabolic syndrome components. Results: The findings indicate that 59 participants (37.1%) had metabolic syndrome, while 33 (20.8%) presented with hyperferritinemia. The presence of metabolic syndrome and hyperglycemia increased the likelihood of developing hyperferritinemia by 3.4 and 3.7 times, respectively, whereas abdominal obesity raised the risk by 2.2 times. Conclusion There was a significant correlation between serum ferritin levels and certain parameters of metabolic syndrome among the male participants in this study.

Background: Particulate matter with an aerodynamic diameter of 2.5 micrometers or smaller (PM2.5) penetrates deep into the alveoli through the respiratory tract and is characterized by its ability to induce oxidative stress, systemic inflammation, and vascular inflammation. Mongolia ranks among the countries with the highest levels of air pollution. In Ulaanbaatar, where more than half of the country’s population resides, wintertime PM2.5 concentrations often exceed 200 μg/m³, which is about eight times higher than the World Health Organization (WHO) guideline value. A study involving 1,200 adults in Ulaanbaatar showed that quality of life deteriorated sharply during periods of high air pollution, with effects more pronounced among individuals who already had impaired respiratory function. Aim: To examine the relationship between indoor household PM2.5 concentrations and lung function indicators among adults in Ulaanbaatar and Darkhan. Materials and Methods: This analytical cross-sectional study recruited adult participants from Ulaanbaatar and Darkhan through targeted sampling. Household air quality was measured using PurpleAir sensors, which were installed in participants’ homes for one month. After exposure measurement, lung function was assessed via spirometry. Statistical analyses were conducted using SPSS version 25.0. Results: A total of 236 participants were included: 114 (48.3%) from Ulaanbaatar and 122 (51.7%) from Darkhan. The sample consisted of 111 men (47.0%) and 125 women (53.0%). The mean indoor PM2.5 concentration was 66.24 μg/m³ (SD 44.87 μg/m³), ranging from a minimum of 7.79 μg/m³ to a maximum of 264.55 μg/m³. Stratification by housing type showed the highest PM2.5 levels in gers (82.34 μg/m³), followed by detached houses (67.34 μg/m³), while apartments had the lowest concentrations (32.24 μg/m³). Correlation analysis revealed statistically significant negative associations between PM2.5 levels and measures of expiratory function, including the FEV1/FVC ratio, peak expiratory flow (PEF), and mid-expiratory flow (FEF25–75). Reduced forced vital capacity (FVC) was observed in 9.4% of participants, reduced forced expiratory volume in one second (FEV1) in 15.3%, and a decreased FEV1/FVC ratio in 3.8%. Conclusion Indoor household PM2.5 concentrations were highest in gers, and expiratory flow-related lung function parameters showed significant negative associations with particulate exposure. This suggests that indoor PM2.5 primarily affects airflow limitation rather than overall lung volumes in this population.

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: During knee flexion and extension, imbalance in the forces controlling the patella can cause lateral displacement of the patella, resulting in abnormal loading on the femoral groove and leading to anterior knee pain (AKP). Management of AKP is typically non-surgical. Therefore, the purpose of this study was to investigate the effect of inelastic and elastic taping on knee kinematics during stair descent. Aim: To examine the effects of elastic and inelastic taping on knee joint kinematics during stair descent Materials and Methods: A total of 60 female participants were recruited. Each participant descended a standardized 20 cm step while being recorded from sagittal and frontal plan using high-speed cameras. Three test conditions were assessed: no taping, elastic taping, and non-elastic taping. Motion analysis was performed using the “Motion Analysis Image J” program to measure knee flexion range of motion, knee valgus angle, Q-angle, and pelvic drop Results: The mean knee flexion angles were 61.47±5.72 degree (no taping), 61.35±6.33 degree (elastic taping), and 60.21±8.60 degree (inelastic taping), with no significant difference (p=0.305). However, the knee Q-angle differed significantly among conditions: 20.97±11.31 degree (no taping), 20.34±9.10 degree (elastic taping), and 10.16±7.24 degree (inelastic taping) (p=0.001). Knee valgus angle also showed significant differences (8.14±5.72 degree p=0.001). Pelvic drop angles were 10.19±6.31 degree (no taping), 9.06±5.31 degree (elastic taping), and 5.17±4.15 (inelastic taping), with p=0.001, indicating statistical significance. Conclusion During stair descent, the use of inelastic taping reduces the knee valgus angle, whereas elastic taping is more effective in reducing pelvic drop. Both elastic and inelastic taping reduced the knee Q-angle to a similar extent compared to the no-tape condition; however, neither had an effect on knee flexion range of motion. These findings suggest that inelastic taping is more effective for controlling excessive knee valgus, while elastic taping is more effective for improving pelvic stability during daily activities.