Background: Azoospermia is the most severe form of male infertility, affecting approximately 1% of all men and 10–15% of infertile men. Previous studies have identified several risk factors, including smoking, alcohol consumption, hormonal disorders, testicular injury, and inflammatory diseases of the male reproductive system. Aim: To investigate selected risk factors associated with azoospermia-related infertility in Mongolian men. Materials and Methods: A case–control study was conducted to identify and estimate risk factors for azoospermia among Mongolian men. The case group included men diagnosed with azoospermia between 2019 and 2021 at the First Central Hospital of Mongolia and the “RMC” National Center for Assisted Reproduction. The control group consisted of men with normal semen parameters according to World Health Organization (WHO) guidelines, with a case-to-control ratio of 1:2. Data were collected using a structured questionnaire, and semen analysis was performed and evaluated in accordance with WHO standards. Result: A total of 180 participants were included, comprising 57 cases with azoospermia and 123 controls with normal semen analysis. The mean age was 35.56 ± 6.95 years (35.80 ± 7.79 in controls and 35.04±4.66 in cases). Socioeconomic and lifestyle factors were not significantly associated with azoospermia risk. However, a history of inflammatory diseases of the male reproductive system increased the risk by 6.4-fold (χ²=22.87, p<0.01). A history of mumps infection was associated with a 2.3-fold increased risk (χ²=6.43, p<0.01). Sexually transmitted infections, particularly gonorrhea, increased the risk by 1.8-fold (p<0.05). Conclusion Among Mongolian men, inflammatory conditions of the male reproductive system, sexually transmitted infections, and a history of mumps are significant risk factors for azoospermia-related infertility, whereas socioeconomic factors appear to have no significant effect.

Background: Studies from other countries have identified multiple contributing factors to renal cell carcinoma (RCC). We conducted this study to investigate the relationship between RCC and certain risk factors among the Mongolian population. Aim: To identify the risk factors for renal cell carcinoma in Mongolian individuals. Material and Methods: This case-control study included 88 patients diagnosed with RCC (confirmed by pathological examination) in the case group. The control group consisted of 88 healthy individuals matched by age and gender. A case-control study design was used. Binary logistic regression analysis was conducted on the questionnaire results from both groups to identify risk factors for RCC through both univariate and multivariate regression analysis. Results: A total of 176 participants were included in the study-88 with RCC and 88 without cancer. Statistically significant associations with RCC were found for hypertension, urinary tract diseases, alcohol consumption, and smoking. Although weight gain appeared to increase the risk for RCC, this was not statistically significant. Conclusion Individuals with hypertension, a history of urinary tract diseases, smokers, and alcohol users are at a higher risk of developing renal cell carcinoma.

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: Azoospermia is the most severe form of male infertility, affecting approximately 1% of male population and 10–15% of infertile men. In azoospermia cases, sperm retrieval from the testis or epididymis through surgical procedures is used for assisted reproductive treatments. When no sperm is retrieved, recent approaches in medicine suggest using immunohistochemical methods to evaluate spermatogenesis in testicular tissue and plan further treatments. Aim: To evaluate spermatogenesis in testicular tissue of azoospermic patients using immunohistochemistry and compare the findings with the clinical outcomes of sperm retrieval procedures. Materials and Methods: This study included 71 azoospermic men who underwent micro-TESE procedures at the IVF center (RMC) between 2019 and 2023. The excised testicular tissues were fixed, processed histologically, and evaluated using Johnson’s score. The presence of spermatozoa in seminiferous tubules was detected by immunohistochemical and immunofluorescence staining, using markers such as TEX101 and LDHC. Results: Johnson’s score was categorized into three groups: poor, moderate, and good spermatogenesis. These were statistically compared with hormonal levels and surgical sperm retrieval outcomes. There were significant differences in Johnson’s scores and serum FSH and LH levels among the three groups (p < 0.005). TEX101 and LDHC proteins were strongly expressed in the good group, weakly in the moderate group, and absent in the poor group. The success rate of sperm retrieval was 100% (17/17) in the good group, 96.29% (26/27) in the moderate group, and only 29.62% (8/27) in the poor group. Conclusion Histological evaluation of spermatogenesis in azoospermic patients can help predict the outcome of surgical sperm retrieval, indicating its clinical value in treatment planning.

Background: Hospitalization consumes a large proportion of healthcare financing, and reducing avoidable admissions is critical for optimizing resource use. Objective: To determine the level of hospital admissions due to Ambulatory Care Sensitive Conditions (ACSCs) in Mongolia. Methods: Using the list of 19 ACSC groups defined by Purde et al., a quantitative analysis was conducted on 8.1 million hospital admissions recorded in the National Health Management Information System between 2014 and 2023. The main indicators included admission rates per 1,000 population, average length of stay, and average cost per admission. Results: During the study period, 759,500 avoidable admissions were identified, accounting for 13.2% of non-maternity hospitalizations. The rate of avoidable admissions was 2,375.6 per 10,000 population, with an average length of stay of 7.7 days and an average cost of 116,457.5 MNT per admission. Hypertension (42.8%) and pyelonephritis (25.4%) were the leading causes. Higher risks of avoidable admission were observed among women, the elderly, and those with lower educational attainment. Conclusion Avoidable hospitalizations impose a substantial burden on healthcare resources in Mongolia. Developing a nationally tailored ACSC list with expert consensus and implementing policies to monitor and reduce avoidable admissions are essential steps to support ongoing health sector reforms

Backround: Urolithiasis has been increasing in Mongolia recent years. The prevalence of urolithiasis is different in the countries of the world, and it was 7.54% in China, 8.8% in North America, and 5-10% in Europe as of 2011. In recent years, the prevalence of stones in western European countries is 5-14%, in Canada 12%, in Britain 7-15%. It is a common disease in most parts of the world, but it is rare in countries such as Greenland and Japan. When studying the recurrence of kidney stones, 10-23% after 1 year, 50% after 5-10 years, and 75% after 20 years were studied. In our country, there is an urgent need to study the prevalence and risk factors related to the increasing incidence of urolithiasis. Materials and Methods: We analyzed 35819 cases of urolithiasis diagnosed between 2011 and 2022, and the incidence per 10000 population. In 2020 years, 3625 cases of urolithiasis were reported, and 371 people were included in the study, assuming that a minimum of 360 healthy participants were needed to estimate at a 95% confidence level, an estimated 1% diagnosis. Also, 456 cases with stones were included in the study and statistical processing was done using SPSS 21 software. Results: The average age of the participants was 46.3 ± 17.6, and 19,356 (54.04%) were female. Since 2011, the total incidence of kidney stones has been distributed as a quadratic function and has been increasing annually. In Mongolia, the incidence rate of urolithiasis increased from 4.6 per 10000 population in 2011 to 17.96 in 2022 a 3.9-fold increase from 10 years ago. However, the new cases per 10000 population tripled from 3.72 in 2011 to 11.36 in 2022. Considering future prospects, it will increase to 19.4 per 10,000 population in 2023, 21.7 in 2024, 24.3 in 2025, 27.1 in 2026, and 30 in 2027. Compared to 2017, 10 years ago, it will increase by 3.6 times by 2027(Yt=6.145-1.735 х t+0.18 x t2). According to the correlation of risk factors for stone formation, people living in urban areas (mOR 14.5) have a higher risk of stone formation than people living in rural areas (mOR 1.21) (p 0.0001). When examining stone structure, 64.6% of all cases studied had calcium oxalate stones. Conclusion The incidence of urolithiasis is increasing every year and will continue to increase. People living in cities have a higher risk factor for stone formation.

Background: Traditional Mongolian medicine (TMM), which is the main knowledge of medicine of ancient nomads, has produced hundreds of healers, practitioners, doctors, and scientists in the course of 5,000 years of historical development. The methods developed to diagnose, treat, and prevent diseases are used to protect the health of the population even today. Based on the study of medical records and artifacts, it is possible to determine which diseases were prevalent and use archeological finds and records related to the diseases to determine what treatment methods were used. Research goal: To clarify reports, facts, and evidence on spinal disorders and their treatment methods from ancient books written in Tibetan, Manchu, and Mongolian languages on Traditional Mongolian medicine. Methods: The source study method, hermeneutic method, and a method of comparison were used in studying traditional medical books, research literature, and other related materials. Conclusion Research has shown that the structure, function, pathological changes, diagnosis, and treatment methods of the spine have been recorded in many ancient records written in Tibetan, Manchu, and Mongolian languages on Traditional Mongolian medicine. At the same time, since ancient times, Mongolians have been adapting to the transformation of natural phenomena, and drastic changes in climate and developed methods of treating injuries and diseases caused by the characteristics of life, habits, and war, as well as established an independent system of methods for studying and treating the structure of the human body and living a healthy life by accumulating experience passed down from generation to generation. This system was not only based on the knowledge of Mongolian dhom treatment, and Indian and Tibetan medicine, but it was also a complex of knowledge that incorporated the ancient scriptures of Western medicine.

Background: Throughout history, Mongolians experienced struggles of ups and downs, creating a comprehensive teaching, knowledge, and system on the art and science of living and healthy living and passing it on to the next generation. Since the middle of the last century, the use and study of traditional knowledge have decreased, and with it, the use has decreased, and some knowledge has almost been forgotten. In particular, many branches of traditional medicine, including manual techniques, surgical methods, techniques related to surgery, the use of tools, and the skills of pressing, bone setting, and massage have declined in value, and some methods have almost been forgotten. Therefore, we have chosen the topic due to the need of exploring the possibility of solving this issue and enriching the history of traditional medicine by elucidating the ancient historical development of Mongolian bone-setting therapy, of which reports and historical documents in Mongolian medicine are rare. Research goal: To clarify the ancient history of Mongolian bone-setting therapy, establishing its features, usage, and types of methods based on historical evidence.
The following methods were used in the research
Herein: the method of researching original documents and reports, the method of comparison, and the method of probabilistic listing. Conclusion
1. Evidence related to ancient Mongolian bone-setting therapy dates back to the Iron Age and can be traced back to 2000 years ago from the traces of illness and injuries, bone ossification, and signs of healing of the ancient nomads living in Chandman mountain of present day Uvs province, the tribe known as Chandman people.
2. The research shows that it is possible to determine which diseases were prevalent based on the study of related artifacts and scriptures related to Traditional Mongolian medicine, and which methods of treatment were used using archaeological finds and scriptures related to the diseases.

Background: To strengthen access to health care and services to the population, there is a need to strengthen surveillance-information-control systems based on statistical data and risk-based approaches to disease control. Methods: We have used the report of the Polyclinic Eye cabinet 2016-2018 and the reports of illnesses. Results: In 2016-2018, 12271 people served as policlinic eye cabinets, of which 2935 / 23.9% / male% 9336 / 76.1% / women.. The number of cases of blindness and low vision (H54) was higher than in 2018. Most of the patients were older, while the greater the blindness of the cataract. Conclusions Eye-to-eye function is not in the best condition for current illnesses and needs, therefore, it is necessary to establish a eye center for further diagnosis and treatment of eye diseases

Background: Eye diseases constitute one of the common health problems presenting to the general practice clinic and could have significant socioeconomic consequences Objective: The aim of this study was to determine the pattern of different eye diseases among patients attending the Ophthalmic Outpatient Clinic of the Second General Hospital of Mongolia from 2016 to 2018. Methods: This study was carried out on 12271 patients recruited from the ophthalmic outpatient clinic of the Second General Hospital of Mongolia. The study was performed from January 2016 to December 2018. All participants were subjected to fulfilling a demographic data, a detailed ophthalmological history and a complete Ophthalmological Examination. Results and conclusions Cataract are the most common eye disease among the study group followed by the refractive error and glaucoma. The prevalence of blindness and low vision was higher in elder groups and the leading cause of bilateral blindness were glaucoma. To decrease the incidence and prevalence of ocular morbidity, it is necessary to establish an eye center in the community