Background: Numerous studies have shown that air pollution is a serious public health threat and risk worldwide. Mongolia is the world leader in outdoor and indoor air pollution, and the morbidity and mortality caused by it are increasing every year. People spend most of their lives indoors, and it is necessary to regularly assess and study indoor air pollution. Aim: To study the concentration of PM2.5 particles in the indoor air of households in Ulaanbaatar and Darkhan cities in relation to some symptoms of respiratory diseases. Materials and Methods: The study was conducted using an analytical cohort design from October 2023 to July 2025, and the 4 districts of the central Ulaanbaatar city and Darkhan cities were included in the study. A total of 240 households were included in the study, including 48 households living in ger and house, 24 households living in apartments, and 48 households living in ger and house, and 24 households living in apartments from Ulaanbaatar city. A direct measurement device (PurpleAir) was installed in the households for 3-4 weeks to measure PM2.5 particles in the indoor air for 24 hours. After measuring PM2.5 particles in the indoor air of the household, data were collected through questionnaires from the participants aged 18-60 who participated in the study and underwent health examinations. The results were processed using STATA-19.0 and R programs. Result: 213-239 households were selected for the study, including households living in 17-26 apartments, 42-58 houses, and 38-50 houses. The 24-hour average concentration of PM2.5 particles in the ambient air of households in Ulaanbaatar city was measured relatively higher in winter and summer than in households in Darkhan city. Among the districts of Ulaanbaatar city, the highest concentration of PM2.5 particles was measured in Songinokhairkhan district, and the lowest concentration was measured in Bayanzurkh district. Considering the cities by heating type, households with stoves are more polluted than households with centralized heating. In Darkhan city, the lowest concentration was measured in apartments (22.78-31.53 μg/m³), houses (44.53-68.17 μg/m³), and the highest concentration was measured in traditional felt houses (houses) (63.20-68.25 μg/m³). In Ulaanbaatar, PM2.5 concentrations were relatively high in all types of housing, including apartments (41.61-58.37 μg/m³), houses (79.22-92.50 μg/m³), and traditional felt dwellings (76.69-86.31 μg/m³). In the summer, PM2.5 concentrations in Darkhan were 3.10-10.03 μg/m³ in apartments, 7.67-14.37 μg/m³ in houses, and 7.98-17.90 μg/m³ in traditional felt dwellings (houses). The concentration of PM2.5 particles in the ambient air of the settlement is statistically significantly associated with shortness of breath, fatigue, weakness, muscle pain, nausea, palpitations, sneezing, runny nose, conjunctivitis, pain in the eye socket, tearing of the eyes, headache, fever, nasal congestion, cough, loss of appetite, sore throat, phlegm, wheezing, and chest pain. Conclusion The 24-hour average concentration of PM2.5 particles in indoor air in households in Ulaanbaatar and Darkhan cities is higher than the Mongolian standard during winter and is statistically significantly associated with some symptoms of respiratory diseases.

Background: Lumbar spine stability is maintained by three distinct yet interconnected systems that control intersegmental stability. Lumbar spine instability is a primary cause of low back pain and a significant contributor to disability. Globally, the “Lumbar Spine Instability Questionnaire (LSIQ)” is widely utilized in clinical practice. This validated tool is effective not only for patients with confirmed lumbar instability but also for individuals experiencing general low back pain. Aim: To determine the Mongolian version of the LSIQ and evaluate its reliability. Materials and Methods: The translation process commenced after obtaining permission from the original copyright holder of the LSIQ. Following Beaton’s five-stage guidelines for cross-cultural adaptation of self-report measures, a preliminary Mongolian version was developed. Ethical approval was granted by the Research Ethics Committee of the Mongolian National University of Medical Sciences (MNUMS) on November 21, 2025 (Decision No. 25-26/03-01). A total of 68 participants were initially recruited, with 5 excluded based on exclusion criteria. The final 63 participants with non-specific low back pain completed the Mongolian LSIQ. Statistical analysis was performed using SPSS-27.0. Result: Internal consistency of the Mongolian LSIQ, assessed using Cronbach’s alpha, was alpha=0.85, indicating good reliability. Test-retest reliability, evaluated over a 24-hour interval using the Intraclass Correlation Coefficient (ICC), yielded ICC=0.999 (95% CI:0.999–1.000, p<0.001), demonstrating excellent stability and reliability of the instrument. Conclusion The Mongolian version of the Lumbar Spine Instability Questionnaire (M-LSIQ) is clear in content and possesses high internal consistency and reliability. The results indicate that the LSIQ is a reliable and stable tool for assessing lumbar instability in the Mongolian clinical setting, meeting the necessary diagnostic standards for effective evaluation.

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: According to the 2024 national health statistics of Mongolia, colorectal cancer accounts for 5.1% of all newly diagnosed cancers, with 74.1% detected at an advanced stage. Although population-based screening programs have recently been implemented, no studies have established a risk factor–based scoring system with an optimal cut-off value or evaluated its clinical utility in resource-limited settings in Mongolia. Aim: To develop a modified APCS (mAPCS) scoring system and evaluate its clinical applicability for colorectal cancer screening. Materials and Methods: A hospital-based prospective cross-sectional study was conducted between December 2024 and February 2026 at the outpatient clinics of the Mongolian National University of Medical Sciences and the Mongolia–Japan Hospital. A total of 447 eligible participants were enrolled. Anthropometric measurements (height and weight) were obtained, and six categories of questionnaires (demographic data, APCS risk score, behavioral factors, medical history, and medication use) were administered. Eleven participants declined colonoscopy; therefore, 436 participants underwent colonoscopic examination, with histopathological evaluation performed when indicated. Results: A total of 436 participants were included, of whom 282 (64.7%) were female, with a mean age of 54.8±11.5 years. Colorectal adenomas (advanced and non-advanced) and colorectal cancer were detected in 199 (45.6%) participants. Among them, 43 (21.6%) had advanced colorectal neoplasia. Multivariable regression analysis identified age ≥55 years (OR 4.8), BMI ≥28 kg/m² (OR 3.6), and a family history of colorectal cancer (OR 3.1) as independent risk factors for advanced neoplasia. The optimal cut-off value for the mAPCS score was 4, with an overall diagnostic accuracy of 41.7% (sensitivity 97.7%, specificity 35.6%). Conclusions 1. Age ≥55 years, BMI ≥28 kg/m², and a family history of colorectal cancer were identified as independent risk factors for advanced colorectal neoplasia. At a cut-off value of ≥4, the mAPCS scoring system demonstrated high sensitivity (97.7%), low specificity (35.6%), high negative predictive value (99.2%), and low positive predictive value (14.2%). 2. Therefore, the mAPCS scoring system may serve as a useful tool for risk stratification and efficient allocation of limited resources in colorectal cancer screening.

Background: Inflammatory bowel disease (IBD) is a chronic immune-related condition caused by interactions between genetics, immune dysfunction, gut microbiota changes, and environmental factors, often presenting as persistent or recurring diarrhea. Clinically, it commonly presents with chronic diarrhea and other gastrointestinal symptoms. The global prevalence of IBD is increasing, currently affecting approximately 0.5% of the population, with projections suggesting a rise to nearly 1% by 2030. Fecal calprotectin is a neutrophil-derived S100 calcium-binding protein that is elevated in intestinal mucosal inflammation and serves as a reliable noninvasive biomarker of inflammatory activity. Due to its high stability and close association with intestinal inflammatory activity, fecal calprotectin has been established as a dependable, non-invasive marker for identifying intestinal inflammation. In clinical practice, it is extensively used to distinguish IBD from functional gastrointestinal disorders, especially irritable bowel syndrome, among patients presenting with chronic diarrhea. However, its diagnostic utility in Mongolia remains underexplored, and this study aims to determine its sensitivity and specificity in inflammatory bowel disease and compare its diagnostic performance with other inflammatory markers. Aim: To determine the sensitivity and specificity of fecal calprotectin in inflammatory bowel disease and to compare it with other inflammatory markers. Materials and Methods: A total of 109 participants aged 18-87 years with chronic diarrhea, who attended the gastroenterology outpatient clinics of the Mongolia–Japan Hospital and Intermed Hospital between December 2024 and December 2025 and provided informed consent, were enrolled in this study. Data were collected using structured questionnaires, and laboratory investigations included complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and measurement of fecal calprotectin levels from stool samples. Based on fecal calprotectin results, selected participants underwent colonoscopic examination as clinically indicated. Results: Among the 109 participants included in the study, 17.4% were diagnosed with inflammatory bowel disease (IBD), with a mean age of 47.41±15.52 years. Fecal calprotectin levels were significantly higher in the IBD group compared to the control group (p<0.001). Fecal calprotectin demonstrated a weak positive correlation with C-reactive protein (CRP) and leukocyte count (p=0.042, p=0.06), while no significant correlation was observed with erythrocyte sedimentation rate (ESR). At a cutoff value of 250 µg/g, fecal calprotectin showed a sensitivity of 94.4%, specificity of 69.2%, positive predictive value (PPV) of 37.8%, and negative predictive value (NPV) of 98.4%. Receiver operating characteristic (ROC) curve analysis identified an optimal cutoff value of approximately 400 µg/g (AUC=0.919, Youden index=0.724), at which the sensitivity remained 94.4% and specificity increased to 78.0%. In contrast, CRP and ESR demonstrated comparatively lower diagnostic performance, with AUC values of 0.640 and 0.644, respectively. Conclusion This study demonstrates that fecal calprotectin has superior diagnostic performance compared to conventional inflammatory markers in differentiating inflammatory bowel disease (IBD). An optimal cutoff value of approximately 400 µg/g yielded the highest sensitivity and specificity. Therefore, fecal calprotectin may serve as a valuable tool in clinical practice for both screening and diagnostic confirmation.

Background: According to the World Health Organization (WHO), 6.7 million people die annually due to air pollution caused by solid fuel use, with the majority of deaths resulting from respiratory diseases and cardiovascular conditions. In Mongolia, air pollution ranks as the fourth leading risk factor contributing to mortality, following hypertension, diabetes, and other major health risks. Although there have been numerous studies on outdoor air pollution in Mongolia, research linking indoor air pollution at the household level with the health status of residents remains limited. Aim: To compare indoor PM2.5 concentrations in households of Ulaanbaatar and Darkhan and examine their association with hypertension during the winter season. Materials and Methods: The study was conducted during November and December 2023, and January 2024, involving 240 households in Ulaanbaatar and Darkhan. Indoor PM2.5 concentrations were measured using Purple Air real-time sensors continuously for 24 hours over approximately one month. After measuring indoor air pollution, individuals aged 18–60 years living in the selected households were recruited based on specific inclusion criteria. Blood pressure was measured three times and the average value was recorded. Information on respiratory illnesses was collected through structured questionnaires. Statistical analysis was performed using STATA version 19.0. Results: A total of 241 households participated in the study, with 116 from Ulaanbaatar and 125 from Darkhan. Of the participants, 46.5% were male and 53.5% were female. In terms of housing type, 96 households (39.8%) lived in gers, 97 (40.2%) lived in stove-heated houses, and 48 (19.9%) lived in apartments. Among all participants, 66.0% (n=159) had hypertension and 34.0% (n=79) had normal blood pressure. Among participants aged over 40, 69.9–88.5% had hypertension, which is statistically significantly higher compared to younger individuals (p=0.0001). By body mass index, 75.3% (n=72) of overweight individuals and 78.4% (n=58) of obese participants had hypertension, showing a statistically significant difference compared to participants with normal weight (p=0.0001). The 24-hour average concentration of indoor PM2.5 was measured using the Purple Air device, and the levels in gers and stove-heated houses exceeded the limit set by the MNS 4585:2025 standard (37.5 µg/m³) Conclusion This study identified a relationship between environmental factors, such as air pollution and housing type, and the prevalence of hypertension. The indoor PM2.5 concentration in gers and stove-heated houses was above the standard limit, indicating a negative impact on the health of those residents. Furthermore, the high prevalence of hypertension among participants over the age of 40 and those who are overweight suggests a possible link to lifestyle and environmental conditions.

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 annual incidence of pulmonary thromboembolism is reported to be 39–115 cases per 100,000 population, with rates of 60–120/100,000 in Western countries and 10–20/100,000 in Asian countries. In Mongolia, few studies revealed the prevalence of risk factors and clinical manifestations of acute pulmonary embolism. Over the past 30 years, the incidence of risk factors for non-communicable diseases, which are mainly triggered by lifestyle and social parameters, has rose. Moreover, environmental conditions such as cold climate, hypoxia, and blood hyperviscosit may contribute to higher incidences of acute pulmonary embolism in high-altitude regions. This condition is potentially fatal and can become impair quality of life. Aim: We aimed to compare risk factors and clinical characteristics based on age and sex, and to evaluate laboratory findings and diagnostic tests among Mongolian patients diagnosed with acute pulmonary embolism. Materials and Methods: This retrospective research included total 232 patients meeting inclusion criteria. The information was collected from patient histories, including general demographics, risk factors, comorbidities, symptoms, and physical examination findings. Laboratory analyses included complete blood count, coagulation profile, and immunological markers (D-dimer, NT-proBNP, troponin, protein C, homocysteine, and C-reactive protein), as well as selected imaging parameters. We used Wells and Geneva scoring systems to assess probability of acute pulmonary embolism and Pulmonary Embolism Severity Index to determine disease severity. Differences by age and sex were analyzed using independent t-tests for continuous variables and chi-square tests for categorical variables. Results: Among participants with acute pulmonary embolism, the prevalence of tobacco and alcohol use was significantly higher among males (p<0.001). Among comorbidities, arterial hypertension and other pulmonary diseases were more common in males, whereas cardiac diseases were more frequent in females (p=0.028). Participants aged 65 years and older showed higher rates of comorbid conditions and regular medication use (p<0.001). The most common symptoms were dyspnea (90.9%), chest pain (74.2%), cough (70.5%), leg pain (38.9%), hemoptysis (20.7%), and cyanosis (9.3%). According to sPESI scoring, 69.8% (n=162) were at high risk of death within 30 days, with no significant difference by sex. However, mortality risk within 30 days was significantly higher in participants aged 65 years and above (p<0.001). As increasing age, the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were elevated, indicating an acute inflammatory response (p=0.001). Contrast-enhanced CT scans revealed that 95 participants (44.2%) had main pulmonary artery involvement, with no significant sex difference, though involvement of the main pulmonary artery was more frequent in those aged 65 and older. Conclusion Dyspnea, chest pain, and cough were the most common symptoms among patients diagnosed with acute pulmonary embolism. The 30-day mortality risk associated with it was higher among males and increased with advancing age.

Background: The Roland-Morris Disability Questionnaire (RMDQ) is an internationally recognized assessment tool that can assess disability caused by back pain in adults, is an easy-to-use 24-question questionnaire related to activities of daily living, and documents the results and plans of physical therapy. The validity and reliability of the Mongolian version of this assessment method has not been studied in the Mongolian field of physical therapy. The lack of Mongolian versions of assessments specifically aimed at evaluating disability from low back pain provided the rationale for conducting this study. Aim: The goal is to evaluate the validity and reliability of the Mongolian version of Roland-Morris disability questionnaire. Materials and Methods: The validity of the RMDQ-M version was assessed by the expert committee and the reliability was assessed by Cronbach’s alpha using R 4.4.3. Results: When evaluating the validity of the RMDQ-M version among physical therapists, 97.5% (n=39) of the words were all understandable, and 2.5% (n=1) of the words were unclear. The reliability of the RMDQ-M version, measured by Cronbach’s Alpha, ranges from 0.903 to 0.939. Conclusion The RMDQ-M version is considered a valid and reliable tool for assessing low back pain–related disability among patients receiving physical therapy.

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.