Background: The purpose of this study is to evaluate serum creatinine as a marker of estimated glomerular filtration rate (eGFR) in alcohol use disorder people, and to determine correlation between mean arterial pressure (MAP) and eGFR in chronic kidney disease classification level. Methods: In this study, 118 people were examined 2024. We measured serum creatinine based GFR using the Cockroft Gault formula. Biochemical analysis and serum creatinine were evaluated using a fully automatic analyzer (GOLSITE, China). Statistical results were analyzed SPSS. Result: The mean subject age was 48.6±10.3, BMI 25.3±3.7 and male: female ratio was 5:1. Mean arterial pressure was 104±12.8 mmHg, eGFR 94±28 ml/ min/1.73m2, and mean arterial pressure was significantly correlated with estimated glomerular filtration rate (P<0.05) and no difference between male and female recipients. Mean eGFR was calculated into 4 groups of 10-year intervals, that eGFR was decreased significantly with age groups. For the alcohol dependence stages of the Michigan Test, the mean eGFR was stage 1 is 112 ml/min/1.73m2, stage 2 is 89 ml/min/1.73m2, stage 3 is 97 ml/min/1.73m2 and there is not statistically significant correlation between Michigan test scores and eGFR. Conclusion According to our research, one of the optimal methods for assessing kidney function is the creatinine-based CKD calculation method, and long-term excessive alcohol consumption is a risk factor for CKD, as well as one of the main causes of death due to hypertension and cardiovascular disease.

Background: Complete blood count (CBC) is one of the most widely used clinical tests, offering a high-quality, inexpensive, and routine diagnostic tool for various diseases and for monitoring treatment outcomes. Due to modern technological advancements, blood cells are now measured in greater detail, with 36 parameters being evaluated. The prevalence of diabetes mellitus (DM) is rapidly increasing, not only globally but also in our country. This rise in prevalence leads to numerous adverse consequences, including delayed diagnosis, poor control, an increase in chronic complications, and treatment failure. Hyperglycemia is a predisposing factor for chronic inflammation, and a relatively new inflammatory marker, the neutrophil-to-lymphocyte ratio (NLR), may be useful for assessing diabetes control. In recent years, NLR has been studied as a composite biomarker that more effectively reflects systemic inflammation and is easier to detect compared to other inflammatory markers. An increase in neutrophil count and percentage indicates chronic, low-grade, toxic, and non-specific inflammation, while a decrease in lymphocyte count suggests insufficient immune regulation. Thus, an elevated NLR not only reflects the immune system’s functional state in chronic inflammation, but it is also studied as a reliable and selective marker of systemic inflammation in chronic diseases. NLR is considered more stable than the total leukocyte count, is less affected by physiological and pathological factors, is inexpensive, and can be incorporated into daily clinical practice. Aim: To study the relationship between the neutrophil-to-lymphocyte ratio in a complete blood count and diabetes control and complications Materials and Methods: A cross-sectional study was conducted involving 145 patients with type 2 diabetes mellitus, who were treated at the Endocrine Clinic of the Mongolian-Japanese Hospital, Mongolian National University of Medical Sciences. Data on the neutrophil-to-lymphocyte ratio (NLR), glycated hemoglobin (HbA1c), and diabetic complications, including retinopathy, neuropathy, and foot complications, were collected from the Carte-Hospital Management System. Based on the frequency distribution of the NLR parameter, the values were classified into three groups: low, medium, and high. These groups were subsequently compared with glycemic control and complications using correlation and linear regression analyses, with statistical significance set at p<0.05. Results: The mean age of the study participants (n=145) was 57.3±12.9 years, with 46.8% (n=131) being male. The mean duration of diabetes was 9.6 years (range: 1-31 years), and the mean HbA1c level was 8.6±2.47%. Among the participants, 59.3% (n=86) exhibited poor glycemic control. Regarding complications, 52.3% of participants experienced at least one diabetes-related complication. Of these, 25.2% had one complication, 13.3% had two, and 7.1% had three or more. The most common complications were retinopathy (25.7%), nephropathy (18.6%), and macrovascular complications (11.9%). A statistically significant increase in the mean HbA1c level was observed across groups stratified by NLR levels (p=0.003). Linear correlation analysis revealed a statistically significant positive correlation between HbA1c levels (r=0.194, p=0.001) and the number of chronic diabetes complications (r=0.162, p=0.002). Conclusion The NLR level is positively correlated with both diabetes control and the occurrence of chronic complications. As an inexpensive and easily accessible test, it can be used for daily monitoring and early detection of complications.

Background: Silybum marianum, as well as known milk thistle, has long been recognized for its hepatoprotective effects, primarily attributed to its active flavonolignan complex, silymarin (an extract from water hyacinth fruit). While the pharmacological effects of silymarin have been studied, research on bioactive peptides derived from Silybum marianum remains limited. Aim: To evaluate the toxicity effects of silybum marianum peptides Marerials and Method: This study aimed to evaluate the potential toxicity of Silybum marianum peptide in mice through a 14-day oral administration experiment. Twenty adult male C57BL/6 mice were divided into two groups: the experimental group received 200 mg/kg of Silybum marianum peptide daily, while the control group received an equivalent volume of saline solution. Physiological and biochemical parameters, including body weight, fasting blood glucose levels, liver and spleen wet weights, as well as alanine aminotransferase (ALT) enzyme activity, were assessed to determine potential toxic effects. This exploration aims to shed light on the toxicological effects of silybum marianum peptide in mice, providing insights into its potential benefits and challenges. Results: Results indicated no significant differences between the experimental and control groups in terms of body weight, blood glucose levels, or major organ wet weights. Additionally, ALT enzyme activity remained unaffected, suggesting no detectable liver toxicity. Throughout the study, no abnormal behaviors, physical changes, or mortality were observed in the test subjects. Mice in both the silybum marianum peptide and control groups exhibited shiny and soft fur, normal activity, and regular food consumption. These findings indicate that Silybum marianum peptide exhibits good safety and low biological toxicity under the tested conditions, supporting its potential use as a safe dietary supplement or therapeutic agent. Conclusion At the designated dosage, silybum marianum peptide demonstrated good safety and low biological toxicity.

Background: Gout is a chronic inflammatory joint disease that damages many joints. Monosodium urate-deposition accumulates in the joints and soft tissues due to long-term untreated condition and leading to loss of function, further reducing the quality of life. It is the most common inflammatory joint disease in the world. Hyperuricemia, sedentary lifestyle including diet, obesity, and the use of certain medications are risk factors for gout. A study published in the Asia Pacific Journal of Nutrition in 2018 found that excessive consumption of meat, alcohol, carbonated beverages, and fructose containing drinks increases serum uric acid levels and the risk of gout. Aim: To investigate certain risk factors associated with gout and asymptomatic hyperuricemia among study participants. Materials and Methods: This study was conducted using an analytical cross-sectional design. Data were coded, error- checked, and analyzed using the SPSS 29.0 software. Results: A total of 145 individuals participated in the study, with an average age of 55.0 ± 13.9 years, and 75.2% were male. Based on diagnostic criteria, 29.7% had gout, 35.2% had asymptomatic hyperuricemia, and 35.2% had normal uric acid levels. The consumption of different food products over the past month was analyzed among study groups, and alcohol intake was found to be statistically significant. A univariate regression analysis showed that obesity was associated with hyperuricemia, male sex was associated with gout, and alcohol consumption was a potential risk factor for both hyperuricemia and gout. Conclusion Among the study participants, 29.7% had gout, and 35.2% had asymptomatic hyperuricemia. Obesity, male sex, and alcohol consumption were identified as risk factors contributing to increased serum uric acid levels and gout development.

Background: Esophageal cancer ranks as the fourth most prevalent malignancy in Mongolia. Among esophageal disorders, gastroesophageal reflux disease (GERD) accounts for 55% of cases, while esophageal motility disorders constitute 40%. Enhancing the diagnosis and management of esophageal disorders, alongside preventative strategies for esophageal cancer, necessitates a comprehensive understanding and widespread clinical application of esophageal functional assessment. However, epidemiological data and classification of esophageal motility disorders remain scarce in Mongolia, highlighting the necessity of this investigation. Aim: to identify specific risk factors associated with ineffective esophageal motility (IEM) Materials and Methods: This study was performed an analytical case-control design and was conducted at Intermed Hospital. A total of 702 HRM test results from patients attending the Gastroenterology and Endoscopy Center’s outpatient department, Intermed hospital Participants diagnosed with IEM based on HRM findings were assigned to the case group, while individuals with esophageal normal motility disorders were designated as the control group at a 1:2 ratio. Results: A total of 612 participants aged 21–80 years were included in this study of whom 57.8% (n=354) were female and 42.2% (n=258) were male, with a mean age of 51.1±12.7 years. The prevalence of IEM demonstrated a statistically significant increase in the 60–69 and ≥70 age groups compared to the control group (p<0.000). Participants diagnosed with IEM exhibited a mean lower esophageal sphincter (LES) pressure of 329.61±246 mmHg and a mean complete liquid bolus transit rate of 46.88±22.7%, both of which were significantly lower than those observed in the control group (p=0.000). Furthermore, the incidence of IEM was found to increase in correlation with the severity of hiatal hernia, as classified by both endoscopic and manometric criteria, demonstrating statistical significance (p=0.000). Conclusion IEM is more prevalent among elderly individuals and increases in incidence with the progression of hiatal hernia size. In cases of IEM, esophageal bolus transit is significantly delayed, and lower esophageal sphincter pressure is diminished. Further studies are warranted to elucidate additional risk factors contributing to ineffective esophageal motility.

Background: The assessment of patients’ quality of life has emerged as a critical metric in evaluating healthcare services. Internationally, numerous studies have been conducted to assess the QoL of individuals diagnosed with pulmonary embolism through the development of standardized questionnaires and their association with various clinical parameters. Aim: To adapt a standardized questionnaire for assessing the quality of life following a pulmonary embolism and to evaluate the quality of life of affected patients. Materials and Methods: A total of 33 patients diagnosed with pulmonary embolism and hospitalized in the Department of Pulmonology at the Third State Central Hospital in Mongolia between August 2022 and December 2023 were included in the study. An observational cross-sectional study design was used. Inclusion criteria encompassed all patients diagnosed with PE during the study period, while exclusion criteria included individuals with severe comorbidities, those aged over 85 years, and those who declined participation. QoL was assessed using the Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire, which consists of 39 questions categorized into six domains. Higher scores indicate poorer QoL. Data analysis was performed using SPSS version 16. Results: The average age of the participants was 61±15 years, and 18 (54.5%) were female. The median duration of anticoagulant therapy was 170 days (range: 27–2555 days), and the average monthly expenditure on medication was 80,000 MNT (range: 63,000–400,000 MNT). The overall mean QoL score was 69.7±23.2. The median scores for the six domains were as follows: frequency of complaints 1.6 (IQR 1.5-1.9; max 5 score), activities of daily living limitations 1.5 (1.3–1.8; max 3 score), work-related problems 1.7 (1.5–2.0; max 2 score), social limitations 2.0 (2.0–3.0; max 5 score), intensity of complaints 3.0 (3.0–4.0; max 6 score), emotional complaints 2.0 (1.5–2.4; max 6 score). The internal consistency reliability of the questionnaire was assessed, with the symptom frequency category scoring well (α=0.74), while the other categories had excellent reliability (α>0.85). A weak positive correlation was observed between overall QoL scores and age, while a weak negative correlation was identified with body mass index (r=0.14 & r= -0.13, P>0.05). Conclusion The study findings indicate a low QoL among PE patients, emphasizing the necessity for enhancements in post-diagnosis medical care and long-term management strategies to improve patient outcomes.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.

Background: Medical education has undergone significant changes over the past few decades, with a focus on studentcentered learning, problem-based learning, competency-based learning, and outcome-based education. Among these, internal medicine diagnostics plays a crucial role in preparing students for clinical practice. However, there is limited research on the factors influencing student satisfaction in this course. Studies by Harden et al. (1999) and Irby et al. (2010) have emphasized the importance of continuous evaluation and effective teaching methods in medical education. This study aims to assess student satisfaction with the internal medicine diagnostics course within the “Physician” program at the Mongolian National University of Medical Sciences (MNUMS), aligning with these global trends. Aim: The primary objective of this study is to evaluate student satisfaction with the internal medicine diagnostics course in the Physician program. Specific objectives include: Assessing satisfaction with the diagnostics course in the 2nd year of the basic medical education program, evaluating satisfaction with the internal medicine diagnostics course in the 3rd year, exploring the relationship between these two courses. Materials and Methods: This analytical study was conducted from June 2023 to June 2024, involving 1,167 students enrolled in the “Physician” program at MNUMS. Data were collected using a 34-item questionnaire, including:Demographic information (5 questions),General satisfaction (17 questions),Internal medicine diagnostics-specific satisfaction (12 questions). Satisfaction was measured using a 5-point Likert scale (1=strongly disagree, 5=strongly agree). Data were analyzed using SPSS Statistics 26, employing descriptive statistics, ANOVA, T-tests, and regression analysis. Effect sizes were calculated using Cohen’s d and Partial Eta Squared (η²), with statistical significance set at p<0.05. Results: Overall satisfaction: The average satisfaction score was 3.98±0.73. 2nd-year diagnostics course: Highest satisfaction (4.07±0.90), particularly with “course content” (4.07±0.90). 3rd-year internal medicine diagnostics course: Lowest satisfaction (3.97±0.78), especially with “learning environment” (3.90±0.90). Gender and Year Differences: No significant gender-based differences (p>0.05). Satisfaction with the internal medicine diagnostics course decreased as students progressed to higher years (B=-0.172, p=0.016). Course Relationship: A strong positive correlation was found between the two courses (r=0.818, p<0.001), but the effect size was minimal (η²=0.008). Conclusion The above-average student satisfaction reflects the quality of the curriculum content and the effectiveness of teaching methodologies. The decline in satisfaction with internal medicine courses as students progress may be due to course difficulty and resource limitations. The weak correlation between the two subjects suggests the need for further development of integrated learning.

Background: Osteoporotic fractures remain a major concern for public health and the economy. Osteoporosis is a chronic disease characterized by reduced bone density due to genetic, hormonal, mineral, and lifestyle factors. Although often asymptomatic, its primary complication is fractures, which lead to disability and loss of work capacity, impacting individuals, families, and society. In Mongolia, no long-term study has examined bone density changes and fracture risk factors, which forms the basis of this research. Aim: To assess 10-year changes in bone density and identify risk factors for fractures. Materials and Methods: This prospective cohort study was conducted at the Department of Pathophysiology, School of Biomedicine, MNUMS. We have re-enrolled 133 adults from Ulaanbaatar between November 2023 and January 2024, originally part of the ‘Study of some risk and pathophysiological factors of osteoporosis in the Mongolian population’ funded by the Ministry of Health and the Science and Technology Fund of Mongolia. Data collection included questionnaires, anthropometric measurements, bone mineral density assessments using the ‘Sunlight Mini-Omni’ bone sonometer (Beammed, USA) Results: The mean age of participants was 54.4±9.6 years (N=133), with 33.1% (n=44) male and 66.9% (n=89) female. Among the participants, 51.1% had a history of bone fractures, with forearm fractures comprising 10.5% and other types of fractures accounting for 40.7%. The bone fractures was significantly higher among elderly individuals and those diagnosed with osteoporosis (p<0.05). The T-score was significantly lower in the fracture group than in the non-fracture group (p<0.05). Vitamin D deficiency was identified as a significant risk factor for fractures (p<0.05). Conclusion All participants’ bone density has decreased over the decade. Bone fractures are more common in elderly and people with osteoporosis. Inadequate vitamin D intake is a significant risk factor for bone fractures.

Background: The physiology and intellectual traits of individuals are interrelated and should be studied comprehensively. In traditional medicine, the teachings of wind (khi), bile (shar), and phlegm (badgan) are considered an integrated system for maintaining health, preventing diseases, diagnosing, and treating illnesses. Aim: Our research is to study students’ physical indicators, body composition, innate characteristics and the relationship between physique and psychological factors. Materials and Methods: The study was conducted on relatively healthy individuals, did clinical observations and used a cross-sectional study design. (defined as those experiencing internal physiological changes that do not impair their work capacity or active lifestyle) Results: Participants were aged 19-25 years, with an average age of 21.5. Heights ranged from 149 cm to 198 cm, with an average of 165.7 cm. Weights ranged from 37 kg to 111 kg, with an average of 61.55 kg. The Body Mass Index (BMI) varied between 15.3 and 36.3, with an average of 22.36. The majority of participants were female (76.4%), while male participants accounted for 23.6%. Regarding individual constitutional types, the most common were: predominantly bile with wind characteristics (21.2%), predominantly bile with phlegm characteristics (30.8%), predominantly wind with bile characteristics (19.6%). Stress survey results ranged from a minimum score of 0 to a maximum of 50, with an average score of 20.6, indicating slightly below-average psychological well-being. The correlation between physiological traits and psychological survey scores was R=0.323** (p=0.001), showing a weak but positive correlation. This suggests that below-average psychological well-being is only minimally influenced by physiological traits. Conclusion The stress survey results indicated an average score of 20.6, slightly below the normal psychological index. The correlation between constitutional traits and psychological well-being was weak but positive (R=0.323**, p=0.001). This implies that individual constitutional characteristics have a minimal effect on psychological well-being. In the study of intrinsic unique characteristics, it has been found that certain physical constitution metrics of the participants demonstrate both positive and negative correlations with the majority of body types, indicating that individuals exhibit varying physical constitution characteristics. Additionally, there exists a positive but weak correlation between intrinsic unique characteristics and stress levels, warranting further investigation.