Background: Mycoplasma and Ureaplasma species are considered part of the normal genitourinary microbiota; however, when present in excessive amounts, they may become pathogenic and cause symptoms such as dysuria, vaginal discharge, and lower abdominal pain. Due to the lack of specific clinical manifestations, these infections may remain undiagnosed or be misidentified as other inflammatory conditions. Disseminated infection caused by Mycoplasma and Ureaplasma is rare. Case Presentation: A 27-year-old female presented with progressive pelvic pain and was initially discharged without a definitive diagnosis. The disease subsequently worsened, and laboratory as well as imaging studies revealed a complicated pelvic infection with concurrent pregnancy. Despite surgical intervention and intensive treatment, the patient died due to severe pelvic purulent inflammation, sepsis, septic shock, and multiple organ failure. Multiplex PCR testing was positive for Mycoplasma genitalium (+), Mycoplasma hominis (+), Ureaplasma parvum (+), and Ureaplasma urealyticum (+). The final clinical diagnosis was consistent with the pathological findings. Conclusion Pelvic disease caused by Mycoplasma and Ureaplasma often presents with nonspecific symptoms, making differential diagnosis challenging. In this case, concurrent pregnancy and the use of analgesic medication may have obscured the disease progression. Comprehensive clinical assessment, close observation, appropriate diagnostic testing, and contact tracing with epidemiological investigation are essential in suspected sexually transmitted infections.

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.

Introduction: In Mongolia, data on the etiology and risk factors of cardioembolic stroke (CES) is scarce and few clinical studies have been performed to date. Timely identification and control of cardiovascular risk factors are priority objectives for adequate primary and secondary prevention of CES. Goal: The goal of this study was to describe risk factors for CES in our setting. Results: The case-control study enrolled a total of 525 subjects. CES was detected in 63 (35.7%) out of 176 (33.5%) ischemic stroke patients with a predominance in age group of 60-69 and men (33%). The main risk factor of CES was non-valvular atrial fibrillation (AF). AF especially paroxysmal AF increased the risk of CES by 4.6 times (p=<0.0001, OR 4.6, 95% CI 1.4-44.6). The second main cerebrovascular risk factors were hypertension and dyslipidemia. Conclusion CES accounted for 1/3 of ischemic stroke. The commonest underlying medical conditions were non-valvular atrial fibrillation, hypertension, dyslipidemia, alcohol consumption and obesity. Hence, all patients with hypertension and non-valvular AF should be meticulously screened for prevention of CES.

Hepatitis B (HBV) and C (HCV) are viral infections which can cause acute and chronic hepatitis and are the leading causes for hepatic cirrhosis and cancer, thus creating a significant burden to healthcare systems due to the high morbidity/mortality and costs of treatment. The risk of HBV infection in an unvaccinated person from a single HBV-infected needle stick injury ranges from 6–30. The prevention of HBV infection among HCWs has become a crucial issue. HBV can effectively be prevented by vaccination. A safe and effective HBV vaccine has been available since the 1980s and can prevent acute and chronic infection with an estimated effectivity of 95%. In 2017, the São Paulo Declaration on Hepatitis was launched at the World Hepatitis Summit 2017, calling upon governments to include hepatitis B vaccines for HCWs in national immunization programs. The vaccine is 95% effective in preventing infection and its chronic consequences and has an outstanding record of safety and effectiveness. Data on current hepatitis B vaccine coverage among HCWs in Mongolia is scarce. According to Azzaya et al, the protection level of the subjects was 67.2% >100 mIU/ml, 18.8%, 11-100 mIU/mL and 14.1%, 0-10 mIU/mL based on antibody titer level respectively among the vaccinated HCWs at the 2nd Central hospital. Thus, the HBV vaccination among public and private sector HCWs in Mongolia to inform the health authorities about the HCWs HBV vaccination status along with associated problems and challenges for further improving vaccination strategy among HCWs.

Anomalies of the fetal orbit are caused by chromosomal and non-chromosomal abnormalities. The World Health Organization (WHO) recommended that the evaluation of the fetal growth and development using ultrasound to use their own national standard dimensions for obstetric and neonatal use. Nowadays, most countries have been using the own reference ranges for the fetal orbital dimensions in prenatal diagnosis for their nationality and ethnic group. In Mongolia, the extension of the standard parameters of biophetometer has been used for the fetus with 15-40 weeks of gestation. However, there is no study about fetal orbital dimensions. The purpose of our study was to determine the reference range of fetal orbital distances that can be diagnosed by ultrasound and to evaluate the relationships between the fetal orbital distances and the gestational ages (weeks).The study group included in 781 normal and fertility ages, pregnant women, which are relatively healthy and without any medical complications of pregnancy by prenatal examination of the routine ultrasound and genetic disorder at 16-36 weeks of gestation on a voluntary basis. Statistical analysis, including the linear regression and correlation were performed based on the obtained data.Correlations were observed between fetal orbital distances and the gestational ages. Strong linear relationships were observed between the fetal orbital (OD) (r= 0.81, p< 0.0001), biorbital (BOD) (r= 0.83, p< 0.0001), and inter-orbital (IOD) (r= 0.77, p < 0.0001)distances and the gestational ages (weeks). The fetal orbital distance (OD) was positively correlated with biparietal diameter (BPR) (r=0.77, p<0.0001), and the head circumference (HC) (r=0.83, p<0.0001). Moreover, strong correlations were observed between the biorbital distance (BOD) and the biparietal diameter (BPR) (r=0.804, p<0.0001), and the head circumference (HC) (r=0.86, p<0.0001). In addition, the inter-orbital distance (IOD) was positively correlated with biparietal diameter (BPR) (r=0.74, p<0.0001), and the head circumference (HC) (r=0.79, p<0.0001).The normal size of the orbital distance was slightly higher in Mongolian fetus compared to other countries. However, the inter-orbital distance was similar to other countries; and the bi-orbital distance was smaller in Mongolian fetus. These data may be helpful in the detection of fetal hypotelorism or hypertelorism.

Introduction: According to the report of World Health Organization and International Society of Hypertension, an estimated 17.5 million people died from cardiovascular diseases in 2005 representing 30% of all global deaths, 1.5 billion people had hypertension and 45% of hypertensive people were unaware of their condition in 2007. In our country, prevalence of hypertension and its risk factors are studied, but prevalence of uncontrolled hypertension that is an important criterion of hypertension control, and its influencing factors is not reported yet. Goal: The aim of our study is to evaluate prevalence of uncontrolled hypertension and to determine its some influencing factors.Materials and Methods: It was population based, cross sectional, prospective study. Participants of the study were selected by randomized method. In the study, 1111 individuals that live in Bayanzurkh and Songinokhairkhan districts of Ulaanbaatar city are participated. The study based on questionnaire and BP measurement which aimed to reveal:• Hypertension unawareness• Untreated• Treated and uncontrolledStatistical analysis was performed by using SPSS 17.0 program.Results: In the study, in total 1111 people aged ≥18 years have been involved. Mean age of all participant was 40.58±16.10 and 63.2% of them were female. We estimated that 38.4% of the population had hypertension and 28.3% of those were unaware their hypertension (unawareness). Among aware population, untreated population percent were 42.1%. We determined that age, sex, education level and visiting to physicians can be risk factors of uncontrolled hypertension.Conclusion: Of the estimated 1111 people with hypertension 28.3% were unaware of their hypertension, 29.5% were aware of their condition but were not being treated, 33.7% were being treated but their hypertension remained uncontrolled and only 8.4% were taking medications that controlled their hypertension. Factors such as young age, male gender, and not measuring BP for the last one year influence negatively on uncontrolled hypertension (p<0.005).

Background According to the report of World Congress of Cardiology in 2007, 1.5 billion people had hypertension and 45% of hypertensive people were unaware of their condition. In our country, some study had provided estimation of risk factors and prevalence of hypertension, but main characteristics presenting the early detection and control of hypertension have not been studied well and information does not exist.The quality of the control, registration and early detection of hypertension will be improved by studying this topic and complications and mortality due to the hypertension could be decreased.GoalThe aim of our study is to evaluate the current situation of the early detection, registration and control of hypertension, and to describe future strategyObjectives:1. To describe the hypertension awareness and risk factors associated with early detection of hypertension2. To evaluate the current situation of registration system of hypertension and to find out the strategies for renewing registration system3. To investigate the rates of the treatment and control of hypertension, and to survey factors associated with the control of hypertensionMaterials and MethodIt was population based, cross sectional, prospective study. Participants of the study were selected by randomized method.In the study, 1103 individuals, 133 physicians and 2 family hospitals located in Bayanzurkh, Songinokhairkhan districts, were surveyed. The study based on questionnaire and BP measurement which aimed to reveal:• Hypertension awareness (%)• Treatment (%)• Control (%)Software program name: Arterial hypertension registration and control Objectives of the program: to evaluate registration of arterial hypertension, to detect earlier, to determine control level of hypertension Users: family hospitals, family doctorsType of morbidity registration: population basedStatistical analysis was performed with SPSS-17 software program. Single- and multi-factorial analysis was explored by using simple and logistic regression and significance.ResultsIn the study, in total, 1103 people aged of ≥18 years living in Bayanzurkh and Songinokharkhan districts of Ulaanbaatar, have been involved. 37% of all participants were male and 63% were female and mean age of all participants was 40.6±16.1. According to our study, 305 individuals of 431 hypertensive participants (70.8%) were aware of their hypertension. This result was different in gender: 58.0% in male, 79.0% in female. Our research team created software program that can integrate all hypertension data to one database. We are planning to determine unawereness; aware and treated; treated and controlled; and uncontrolled levels by using this software and to introduce the program created by us to all primary level physicians in order to use routinely.Conclusions:1. Among hypertensive individuals, awareness of hypertension was 70.8%. Factors such as young age (<35), single people and not measuring BP for the last one year influence negatively on early detection of hypertension (p<0.05).2. Current method of hypertension registration is not proper at the time. Therefore, we concluded that renewing of the arterial hypertension registration database and conversion it into electronic type is convenient to control arterial hypertension and to provide integration.3. Treatment level of arterial hypertension was 39.9%, controlled arterial hypertension among all hypertensive population - 10.2% and among treated population – 25.2%.