Background: Liver transplantation has become an effective treatment option worldwide for a wide range of malignant and non-malignant liver diseases. In Mongolia, the high prevalence of single and co-infections with viral hepatitis is a major contributing factor to the development of liver cirrhosis and primary liver cancer. However, data on the indications, clinical characteristics, and outcomes of liver transplantation in the Mongolian population remain limited. Aim: To evaluate the indications and clinical characteristics of patients undergoing liver transplantation and to determine their survival outcomes. Materials and Methods: This single-center, retrospective cohort study included 238 patients who underwent liver transplantation at the National Cancer Center of Mongolia between 2018 and feb 2026. Patients were categorized into two groups according to the indication for transplantation: malignant and non-malignant liver diseases. Demographic and clinical characteristics were compared between the groups. Overall survival was estimated using the Kaplan–Meier method, and differences in survival were assessed using the log-rank test. A p-value <0.05 was considered statistically significant. Result: The mean age of the liver transplant recipients was 49.0 ± 8.4 years. Relatively older male patients were more likely to undergo liver transplantation for malignant liver diseases, whereas younger female patients predominated among those transplanted for non-malignant conditions (p=0.0001). No statistically significant difference in body mass index was observed between the groups (p>0.05). MELD and Child–Pugh (CPT) scores, reflecting the severity and prognosis of liver disease, differed significantly between the two groups. However, no statistically significant difference in survival was observed between the groups at 1-, 3-, or 5- years after liver transplantation (p=0.974). Conclusion Although age, sex, and liver disease severity as assessed by MELD and Child–Pugh scores differed significantly between patients undergoing liver transplantation for malignant and non-malignant indications, no statistically significant difference was observed in survival at 1-, 3-, or 5- years following liver transplantation.

Background: Organizational culture, reflected through institutional values, beliefs, behavioral norms, communication culture, and patterns of collaboration, plays an important role in organizational development. In educational institutions that train health professionals, organizational culture influences not only the internal environment but also the formation of future professionals’ ethics, attitudes, and communication culture. In Mongolia, there is limited research that comprehensively examines organizational culture, institutional values, behavioral norms, and their relationship with satisfaction in higher education institutions. This formed the rationale for the present study. Aim: This study aimed to comparatively assess the perceptions and attitudes of faculty, staff, and students toward organizational culture at the School of Pharmacy, Mongolian National University of Medical Sciences. Materials and Methods: A cross-sectional analytical study design was employed. Data were collected using a structured questionnaire from 194 participants, including faculty, staff, and students of the School of Pharmacy. The data were analyzed using SPSS version 26.0, and a p-value of <0.05 was considered statistically significant. Results: A total of 194 participants were included in the study; 87.6% were students and 12.4% were faculty members. Most participants were female (93.3%), while 6.7% were male. Regarding self-assessed knowledge of organizational culture policy, 47.9% reported having moderate knowledge, 19.6% good knowledge, and 4.6% very good knowledge, whereas 24.2% reported not knowing and 3.6% reported having no knowledge at all. When comparing groups, the mean satisfaction score was 3.73 among faculty and staff, 4.19 among graduate and postgraduate students, and 3.42 among undergraduate students, showing a statistically significant difference (p=0.003). Among undergraduate students, fifth-year students rated organizational culture the highest, with scores of 3.99 for values, 4.14 for behavioral norms, and 3.56 for satisfaction. In contrast, fourth-year students had the lowest scores for behavioral norms (2.88) and satisfaction (2.41), with statistically significant differences (p<0.05). In terms of satisfaction level, 41.2% of participants rated their satisfaction as “Good” and 29.4% as “Very good.” A statistically significant positive association was observed between knowledge of organizational culture policy and satisfaction (p=0.001). Satisfaction was also positively correlated with organizational culture indicators, with the strongest correlations observed for internal environmental culture and comfort (r=0.802), institutional image (r=0.787), and accessibility of information (r=0.760) (p<0.01). Conclusions 1. The perceptions and evaluations of organizational cultural values and behavioral norms among faculty, staff, and students of the School of Pharmacy differed according to their position and level of experience. 2. Participants who demonstrated a higher level of knowledge regarding the institution’s cultural policy reported greater satisfaction, whereas those with limited knowledge showed lower levels of satisfaction.

Background: Choriocarcinoma is an aggressive trophoblastic malignancy characterized by rapid progression and a strong tendency for early hematogenous metastasis. It may occur in gestational or nongestational forms. Nongestational choriocarcinoma is extremely rare and is most commonly reported in young women. The tumor frequently metastasizes early to organs such as the lungs, liver, and brain. Case presentation: We report the case of a 21-year-old woman who presented with dyspnea and hemoptysis and was initially treated for pneumonia. Further evaluation revealed nongestational choriocarcinoma with pulmonary and hepatic metastases. Diagnosis: Contrast-enhanced computed tomography of the chest initially suggested pulmonary artery thromboembolism; however, the diagnosis was ultimately confirmed by histopathological examination. Conclusion The distinctive feature of this case is that the disease presented with clinical and radiological findings mimicking pulmonary artery thromboembolism. This case highlights the importance of considering metastatic choriocarcinoma in young women presenting with unexplained respiratory symptoms, hemoptysis, and atypical pulmonary vascular findings.

Background: Driven by the rapid global development of the digital environment, the e-pharmacy market was valued at USD 150.7 billion in 2025 and is projected to expand at a Compound Annual Growth Rate (CAGR) of 19.40% through 2034. While e-pharmacies enhance healthcare accessibility and offer time savings, they also introduce critical risks, including the proliferation of substandard and falsified medical products, irrational non-prescription drug use, and personal data breaches. Despite the rapid growth of the e-pharmacy sector, Mongolia’s legal framework governing these operations remains insufficient compared to international standards. Thus, refining regulatory frameworks to safeguard consumer health and mitigate the risks of counterfeit and substandard pharmaceuticals forms the primary rationale for this study. Aim: To define the legal and regulatory needs required to establish a sustainable and secure e-pharmacy framework in Mongolia. Materials and Methods: We conducted a comparative analysis of domestic and international legislation, legal acts, regulatory frameworks, and research reports using descriptive and documentary research methodologies. Results: Applying the World Health Organization (WHO) Global Benchmarking Tool (GBT) evaluation approach to compare international e-pharmacy regulatory frameworks revealed: Singapore and Germany: Achieved an Implemented status across all regulatory domains, including licensing, e-prescribing, delivery standards, data protection, and oversight. South Korea: Demonstrated strong e-prescribing and pharmacist-led controls, but designated online delivery as Not Implemented due to strict legal restrictions. Kazakhstan and Mongolia: Exhibited Partially Implemented statuses across all regulatory indicators, reflecting weak specialized frameworks in Mongolia. Conclusion Although e-pharmacy services are advancing rapidly worldwide, legal and regulatory frameworks remain substantially heterogeneous across jurisdictions. Mongolia urgently requires comprehensive regulatory enhancements to guarantee pharmaceutical safety and consumer protection.

Background: Medical experts in pharmacies are the most accessible health professionals and play a key role in primary health care. They must strike a balance between their autonomy, the objectives of the company, and professional standards, while facing a lot of ethical dilemmas. This phenomenon can impact the quality of pharmaceutical care, as highlighted in several studies. Numerous studies have been carried out internationally to explore the medical ethics knowledge of pharmacists working in community pharmacies, their attitudes towards emerging ethical issues, and identification of their common problems. However, research in this area is scarce in Mongolia, which serves as the basis for conducting this study. Aim: Assessing the knowledge, attitudes, and practices of pharmacists regarding professional ethics in community pharmacies in Ulaanbaatar city. Materials and Methods: This study was conducted using an analytical cross-sectional study design and included 374 pharmacists who had been working in community pharmacies in Ulaanbaatar for more than three months, had a valid professional license, and consented to participate in the study between March and September 2024 (ethical approval number 2024/3-01). To determine the degree of knowledge, attitude, and practice, a questionnaire including 39 closed questions and 4 groups was used to gather survey data. For statistical analysis, SPSS-25 software was utilized. Results: Of those who took part, 301 (80.48%) were pharmacists, 73 (19.52%) were pharmacy technicians, and 339 (90.4%) were women. Additionally, 259 (69.3%) work in secondary pharmacies, and 305 (81.6%) have received ethics training. The study shows that 56.1% of pharmacists had insufficient knowledge of professional ethics, 54.5% had poor attitudes towards ethical issues, and 48.9% had inappropriate practices. When analyzed in relation to their profession, the ethical knowledge of pharmacists did not differ by profession, age, years of experience in community pharmacies, professional degree, and university graduated, but it was statistically significantly correlated with the participants’ self-assessed ethical knowledge (CL 95%, p=0.0001). Conclusions 1. The knowledge of professional ethical principles and standards is insufficient among pharmacists. 2. While handling emerging ethical issues, they have a negative attitudes and inappropriate practices. Consequently, it is compulsory to intensify training on the ethical code of conduct for medical experts s based on the needs of pharmaceutical professionals.

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer originating from liver cells, classified as a chronic liver disease. This cancer ranks third in the world in terms of mortality rate. The MELD (Model for End-Stage Liver Disease) and Child-Pugh scoring systems are utilized to assess the prognosis of chronic liver diseases. Based on studies suggesting that certain blood test indicators, particularly red cell distribution width (RDW), could be used to predict the prognosis of liver cancer and other cancers, as well as serve as diagnostic markers, this topic was chosen to evaluate the clinical significance of RDW in hepatocellular carcinoma. Aim: The aim is to study some blood test indicators and compare them with the MELD score and Child-Pugh score systems in order to determine the prognosis of chronic liver diseases. Materials and Methods: A retrospective, single-center, cross-sectional study was conducted at Mongolia-Japan Hospital. Among 322 patients diagnosed with HCC, 24 patients were selected for the case group, and 37 patients with liver cirrhosis were included in the control group. Results: According to the research criteria, 61 patients were selected and divided into 3 groups, and statistical analysis was performed. In the detailed blood test, platelet count and WBC count showed statistically significant differences among the 3 groups (p< 0.024). In the biochemical tests, C-reactive protein (CRP) was p< 0.018, total bilirubin p< 0.001, and the mean albumin level p< 0.015, all showing statistically significant differences among the 3 groups. A statistically significant inverse correlation was observed between RDW-CV and the clinical MELD score (r=-0.356). Conclusion Platelet count, RDW, CRP, total bilirubin, and average albumin levels are significantly different across the studied groups. RDW-CV shows a moderate inverse correlation with MELD scores, suggesting its potential as a prognostic marker in chronic liver diseases. Further research with larger sample sizes is recommended to confirm these findings.

Background: Among the total healthcare waste generated from health-related activities, 10–20% is considered haz ardous, posing significant threats to both the environment and human health. Approximately 3% of healthcare waste is pharmaceutical waste. In Ulaanbaatar city, an estimated 2.65 tons of healthcare waste is generated daily (0.78 tons of medical waste and 1.87 tons of general waste). With the continuous increase in pharmaceutical consumption, the improper disposal of pharmaceutical waste has emerged as a major environmental concern, adversely affecting nature, animals, and the food chain. Contamination from pharmaceutical waste, such as the development of antibiotic resistance, is closely linked to inadequate public awareness of waste management. Aim: This study aimed to assess the knowledge, skills, and attitudes of pharmacy technicians in community pharmacies regarding pharmaceutical waste management. Materials and Methods: A cross-sectional survey was conducted among pharmacy technicians across Mongolia. As of 2023, there are 4,959 licensed pharmacy professionals in the country. Using a representative sampling method, data were collected from 360 pharmacist and pharmacy technicians. Data were analyzed using MS Excel and SPSS version 26. Results: A total of 360 pharmacists from both urban and rural areas participated in the study. The assessment was based on a 5-point Likert scale, with scores of 1-2 considered negative and 3–5 considered positive. The average scores for knowledge, skills, and attitudes were 3.3, 3.06, and 3.25 respectively. While individual scores were satisfactory, the results of questions targeting social awareness were relatively low. Conclusion The knowledge, skills, and attitudes of pharmacy technicians regarding pharmaceutical waste management were found to be satisfactory. However, to further improve knowledge levels, it is recommended to implement additional training programs related to pharmaceutical waste management among pharmacy technicians.

Background: Community pharmacies are accessible healthcare institutions that offer services without the need for appointments or prepayment. In recent years, the scope of pharmacist responsibilities has expanded from merely dispensing medications and medical devices to providing patient-centered pharmaceutical care, health promotion, and disease prevention. As a result, pharmacists are increasingly confronted with ethical challenges in their daily practice. Aim: To identify the ethical issues faced by pharmacists working in community pharmacies in Ulaanbaatar, Mongolia. Materials and Methods: A cross-sectional survey was conducted between March and September 2024 among pharmacists working in community pharmacies in Ulaanbaatar. Participants included 374 pharmacists who had been working for at least three months, held valid professional licenses, and voluntarily agreed to participate. A structured questionnaire was used to collect data. Descriptive statistics were analyzed using SPSS version 25.0. Results: Among the respondents, 339 (90.4%) were female, 301 (80.48%) were pharmacists, and 230 (61.5%) were under 30 years old. Additionally, 214 (57.2%) had worked in a community pharmacy for less than five years. Open-ended responses were coded into three major categories and 15 subcategories: (1) pharmacy management and organization, (2) compliance with laws and regulations, and (3) professional communication with clients. The most frequently reported ethical issues were: Customers demanding prescription-only medications without a valid prescription (56.6%), Negative or inappropriate client behavior (27.5%), Attempts to use expired or invalid prescriptions (14%) Conclusion 1. A total of 56.1% of pharmacists demonstrated insufficient knowledge of the Code of Ethics for healthcare professionals, which is essential for their professional practice. 2. Among pharmacists, 54.5% showed a negative attitude, and 48.9% exhibited inappropriate practices when faced with certain ethical situations. 3. The most common ethical challenges faced by pharmacists include: Requests from clients to dispense prescription-only medicines without a valid prescription (56.6%), Unethical or inappropriate behavior from clients (27.5%), Attempts to obtain medicines using invalid prescriptions (14%).

Introduction: Coronavirus infection 2019 (Ковид-19) is an infection caused by a novel virus and induces severe ARDS. КОВИД-19 pandemic has rapidly spreaded in 221 countries, 245,373,039 cases and 4,979,421 mortalities have been reported. Pulmonary and renal thrombotic angiopathy occur in patients with complications of ARDS, sepsis, and multi-organ failure. Elevated D-dimer in КОВИД-19 patients has been reported firstly by doctors in Wuhan, China. In addition, many studies have revealed that elevated D-dimer has been associated with the severity of the diseases, an increased rate of poor prognosis. Objective: We aim to determine D-dimer in КОВИД-19 patients, and patient condition a decrease of D-dimer level after administration of anticoagulant therapy. Case report: We introduce a rare case of КОВИД-19. Laboratory test results and the effect of anticoagulant therapy have been evaluated during the infection. 85 aged women were admitted with a diagnosis other than КОВИД-19. PCR for SARS-Cov-2 was negative on the previous day of admission, and Sars-Cov-2 Ag rapid test was also negative on the admission day. However, the D-dimer test result was much higher with 7120 ng/мл and X-ray and CT revealed a similar pattern to the КОВИД-19 patient. Then anti-Sars-Cov-2 test was positive with 4,08 COI. Based on laboratory test results of D-dimer, LDH, CRP, and CT pattern the patient was diagnosed with post-КОВИД-19 pneumonia, and anticoagulant therapy was initiated additionally to prevent hypercoagulation induced by КОВИД-19. D-dimer test taken before administration of anticoagulant therapy increased more to 10910 ng/мл. 3 days later D-dimer level decreased to 8180ng/мл and the patient’s condition was improved. Conclusion The evaluation of D-dimer of the patients with КОВИД-19 is highly significant. Anticoagulant therapy might be necessary for КОВИД-19 patients with high D-dimer level in serum. Further studies are needed to assess the long-term outcome of the illness and mortality.

Background and Aims: Hepatocellular carcinoma (HCC) is a common cause of cancer related death in Mongolia. Early diagnosis is the very important management to increase successful treatment and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC) tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic biomarker of HCC. Methods: We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP) levels were measured using commercially available enzyme-linked immunosorbent assay kits. The diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and estimated sensitivity and specificity of each biomarker. Results: sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999 (0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6 ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 % with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%). Conclusion Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC. Combination of two markers showed greatest diagnostic accuracy.