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: Mongolia, as a country with a high burden of liver disease caused by viral infections, has prioritized reducing the spread of viral hepatitis and sexually transmitted infections (STIs) in line with the WHO strategy for 2022–2030. Orders A/133 (2023) and A/18 (2024) issued by the Ministry of Health mandate that healthcare providers initiate screening of hospitalized patients for hepatitis B and C viruses, syphilis, and HIV infection. Among infectious diseases registered in Mongolia, STIs rank among the leading causes, with more than 40% of reported cases being newly diagnosed syphilis. Hepatitis C virus (HCV) infection and syphilis are transmitted via the parenteral route, can lead to chronic disease, and co-infection represents a serious condition that accelerates liver damage and negatively affects treatment outcomes. Syphilis infection places additional stress on liver function and exacerbates HCV-related inflammation. Aim: This study aimed to investigate how syphilis co-infection affects the biochemical and clinical course of acute hepatitis C virus infection. Materials and Methods: A retrospective, hospital-based cross-sectional study design was used. A total of 74 patients diagnosed with acute hepatitis C virus infection and treated at the National Center for Communicable Diseases between 2025 and 2026 were randomly selected. Data were collected from medical records. Patients were divided into two groups based on syphilis serology results: HCV mono-infection and HCV with syphilis co-infection. Differences between variables in the two groups were analyzed using the T-test, with statistical analysis performed using SPSS version 26. A p-value <0.05 was considered statistically significant. Results: Of the study participants, 17 (23%) had syphilis co-infection. There were no statistically significant differences in age and sex between the groups (p=0.982). In the co-infected group, 23.5% had high RPR titers (indicative of active/new infection). Clinically, general signs of infection and intoxication (35.3%), fatigue (100%), dyspeptic syndrome (100%), and intoxication syndrome (100%) were predominant. Biochemical analysis showed significantly higher levels in the co-infected group compared to the mono-infected group: total bilirubin (192.4 vs 110.5 μmol/L, p<0.01), alkaline phosphatase (245.8 vs 132.1 U/L, p=0.004), and ALT (1240.5 vs 850.2 U/L, p=0.03). Kaplan–Meier analysis demonstrated that the mean time for ALT normalization was longer in the co-infected group (26.4 days) compared to the mono-infected group (20.7 days) (p=0.006), indicating prolonged recovery. Conclusion Syphilis co-infection worsens the clinical course of acute hepatitis C, deepens jaundice and cholestatic syndrome, and prolongs the normalization of biochemical parameters.

Background: Senear-Usher Syndrome, also known as pemphigus erythematosus, is a rare autoimmune blistering skin disease characterized by overlapping clinical, histopathological, and immunological features of both lupus erythematosus and pemphigus foliaceus. Case Presentation: We report the case of a 46-year-old male diagnosed with Senear-Usher Syndrome, who presented to the outpatient clinic of the National Dermatology Center of Mongolia and received inpatient treatment. Diagnosis: The patient exhibited diffuse, thick, pale gray scales and yellowish crusts on the scalp. Multiple brown hyperpigmented macules of various shapes and sizes, vivid erythema, and a few erosions were observed on the nose, cheeks, trunk, and upper and lower extremities. A few pea-sized vesicles containing clear fluid were scattered on the back. Nikolsky's sign was weakly positive, and Besnier-Meshchersky's sign was positive. Histopathology: Histopathological analysis of skin biopsies revealed hyperkeratosis, parakeratosis, and acanthosis in the epidermis. Subcorneal cleft formation with neutrophils within the cleft was noted, along with perivascular infiltration of neutrophils and lymphohistiocytes in the superficial dermis. Treatment: The patient received treatment with hydroxychloroquine, systemic and topical corticosteroids, and symptomatic therapy. Outcome: Following treatment, the patient's general condition improved significantly. The erosions re-epithelialized, and the vesicles resolved, leaving behind brown hyperpigmented macules. The patient is currently under regular follow-up by a dermatologist and a family physician. Conclusion Senear-Usher Syndrome is a rare disease with a high potential for misdiagnosis. Therefore, an accurate diagnosis relies on a comprehensive evaluation of clinical features, histopathological examination, and direct and indirect immunofluorescence studies.

Background: Cutaneous squamous cell carcinoma (cSCC) accounts for approximately 20% of all malignant skin tumors and is the second most common skin cancer worldwide. Although the prognosis is generally favorable when diagnosed at an early stage, large tumors with invasion into surrounding tissues and metastasis to regional lymph nodes tend to exhibit more aggressive behavior. In particular, reconstruction of large tissue defects following wide excision of skin tumors remains a significant clinical challenge. Case presentation: We present a rare case of cSCC in a 69-year-old male patient, located on the left hip. The lesion measured 13x9 cm, with well-demarcated borders from the surrounding normal skin, prominently elevated above the skin surface, and characterized by a bluish-brown color. The central superior portion of the lesion was depressed and ulcerated with infiltrative features. Histopathological examination confirmed a well-differentiated, keratinizing invasive cutaneous squamous cell carcinoma. Computed tomography revealed a soft tissue density mass at the skin surface of the left lower abdomen, along with enlargement of the left inguinal lymph nodes. Treatment: The patient underwent wide local excision of the tumor along with regional lymph node dissection (lymphadenectomy). The resulting large tissue defect was reconstructed using an anterolateral thigh (ALT) free flap. During surgery, indocyanine green (ICG) angiography was performed to assess flap perfusion, and handheld Doppler was used to evaluate vascular flow. Results: The postoperative course was uneventful. The flap survived successfully with adequate perfusion. Histopathological examination confirmed negative surgical margins, and no metastasis was identified in the lymph nodes. The patient remains in stable condition without any complaints or symptoms and is under regular follow-up by an oncologist. Conclusion This case demonstrates that combining wide excision with free flap reconstruction is an effective approach for managing large cSCC. In addition, the use of indocyanine green (ICG) angiography for intraoperative assessment of vascular perfusion enhances flap viability and contributes to improved surgical outcomes.

Introduction: Oral health is an essential component of children's overall health, growth, nutrition, learning ability, and quality of life. Establishing appropriate toothbrushing habits during early childhood requires both effective oral health education and a supportive school environment. This study aimed to assess oral health knowledge among second-grade primary school students and examine its relationship with dental caries prevalence and the availability of school toothbrushing facilities. Goal: To evaluate oral health knowledge among second-grade students in selected public primary schools in Ulaanbaatar and determine its association with dental caries prevalence, sex, and the school toothbrushing environment. Materials and Methods: A school-based cross-sectional analytical study was conducted in May 2026 among 971 second-grade students from 12 public primary schools in Khan-Uul, Chingeltei, and Bayanzurkh districts of Ulaanbaatar. Schools with and without designated toothbrushing facilities were selected using a 1:2 ratio. Oral health knowledge was assessed using a structured questionnaire consisting of 10 questions covering daily oral hygiene, toothbrushing practices, dietary factors, and preventive care. Dental caries were assessed through clinical oral examinations. Data were analyzed using descriptive statistics, the Chi-square test, and Odds Ratios (ORs) with 95% confidence intervals. The study was conducted with the approval of the Research Ethics Committee of the Mongolian National University of Medical Sciences (MNUMS), under Approval No. 26/03, issued in 2026. Results: Overall, 74.77% of students had dental caries, indicating a high prevalence. No statistically significant difference in caries prevalence was observed between boys and girls. Students attending schools equipped with toothbrushing facilities had a significantly lower prevalence of dental caries than those attending schools without such facilities (OR = 0.57; 95% CI: 0.42 0.76). Regarding oral health knowledge, 59.84% of students demonstrated poor knowledge, 37.88% moderate knowledge, and only 2.88% good knowledge. Students showed relatively good knowledge of cariogenic foods and recommended toothbrush replacement intervals; however, knowledge of proper toothbrushing techniques, appropriate toothbrush selection, and the importance of preventive dental visits remained insufficient. Conclusion Most second-grade students had inadequate oral health knowledge and a high prevalence of dental caries. School toothbrushing facilities were associated with a lower risk of dental caries. Strengthening practical school-based oral health education, establishing standardized toothbrushing facilities, and integrating regular preventive dental examinations into school health programs may contribute to improving children's oral health and reducing dental caries.

Background: Insomnia is one of the most prevalent neurological disorders in the United States, affecting up to half of primary care patients and often necessitating psycho-behavioral interventions. Acupuncture, a key component of traditional Chinese and Mongolian medicine, has been increasingly studied as a treatment for insomnia in recent years. Aim: Evaluating the effectiveness of acupuncture for insomnia Materials and Methods: The study was conducted using a randomized controlled clinical trial design. 148 participants, aged 18-65 years, with a diagnosis of Nonorganic Insomnia (F51.0) according to the ICD-10, and Pittsburgh Sleep Quality Index (PSQI) >7, were divided into the transverse acupuncture, conventional acupuncture, and the control group. The results were analyzed using a Cardiopulmonary Coupling - CPC machine before and after treatment in the 3 groups to assess 1. Total sleep (hours), 2. Deep sleep (hours), 3. Light sleep (hours), 4. REM (hours), 5. Wake time (minutes), 6. Time to first fall asleep (minutes), 7. Sleep rate (%), 8. Number of apneas, and sleep quality was assessed using the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. The research approval was reviewed and granted by the Research Ethics Review Committee of the Mongolian National University of Medical Sciences on January 19, 2024 (Approval No. 24/19/01). Results: The mean age of participants was 51.5±10.8 years, with 79.7% (n=118) being female and 20.3% (n=30) male. In the transverse acupuncture group, post-treatment results demonstrated a 53.8% increase in total sleep time, a 102.8% increase in deep sleep time, a 19.8% increase in light sleep time, a 36.1% increase in REM sleep time, and a 22.1% improvement in sleep normalization rate. The mean differences between pre- and post-treatment scores were statistically significant based on a one-sample t-test. In contrast, no statistically significant improvements were observed in the control group, except for sleep quality. Conclusion Both transverse acupuncture and conventional acupuncture significantly improved sleep quality indicators following treatment.

Background: A drug related problem is defined by the Pharmaceutical Care Network Europe Association as an an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes. One critical aspect of preventing such errors is proper dose adjustment, which plays a vital role in the diagnosis and treatment of disease. For instance, adjusting the dose of warfarin based on the patient’s INR level is essential. In a 1995 study conducted in England, clinical pharmacists recommended target doses of angiotensin-converting enzyme (ACE) inhibitors for patients with chronic heart failure. As a result, patients experienced a significant reduction in pulmonary and peripheral edema, along with improved exercise test outcomes. At the Mongolian-Japanese Hospital of the Mongolian Medical University of Science and Technology, it is important to analyze dosage-related issues identified by clinical pharmacists and inform healthcare professionals about common dosage selection errors and associated risks. Aim: We analyzed issues related to medication dosage. Materials and Methods: A retrospective study was conducted to examine problem related to dosage detected through prescription monitoring at the Mongolian Japanese Hospital of the Mongolian National University of Health Sciences from 2023 to 2024. Results: Out of a total of 2340 drug-related problem identified across five inpatient wards during this period, 581 (100%) were related to dosage. Clinical pharmacists performed prescription review on approximately 67% of all inpatients, which was consistent between years. However, medication-related problems tended to decrease from 41.1% (n=1499) in 2023 to 22.3% (n=841) in 2024 (p=0.05). The majority of dose-related problems, 75.6% (n=440), were overdoses. Medication-related problems were most common in the surgical department, with 59.5% (n=346) (p=0.001). The most frequent dosage-related errors involved exceeding the daily dose of diclofenac, administering higher- than-recommended doses of ceftriaxone, failing to adjust cefotaxime for renal function, and using inappropriate doses of metronidazole in patients with impaired liver function. The leading cause of these errors was failure to adhere to guideline-recommended dosing, which accounted for 71.3% (n=415) of cases (p=0.001). When dosage-related recommendations were provided to physicians before of treatment, acceptance rates increased by 14% (p=0.001). These interventions resulted in an estimated cost saving of 1.267.219₮ and a reduction of 363 injections. Conclusion Therefore, clinical pharmacist-led prescription review can help reduce the risk of dosage errors, lower associated healthcare costs, and alleviate the burden on medical staff.

Background: Since ancient times, humans have used medicinal plants for medicinal purposes, and they have been recognized as beneficial to health. The basis of the treatment of these plants is phytochemical substances and in modern times, with the development of science and technology, the substances contained in these plants are extracted and medicinal substances and drugs are produced to treat many diseases. There are more than 800 medicinal plants in Mongolia, and their chemical structure and properties are studied in detail, biological activity and main features are discovered, and new medicines are produced. From the Thalictrum squarrosum plant, 25 compounds have been identified, such as triterpenoids with 17 carbon atoms in the cycloartane type ring, saponins, oleic acid glycosides, phytosterols and their glycosides etc., and the structures of 7 new compounds have been determined and the research on phenolic compounds and antioxidant activity has been limited, which is the basis for this research. Aim: Determination of total phenolic content and antioxidant activity of Thalictrum squarrosum. Materials and Methods: Total phenolic compounds were determined spectrophotometrically using Folin-Chicolte color reagent in 1.0 raw material of the Thalictrum squarrosum. Antioxidant activity was determined by DPPH, FRAB and ABTS in sub-extracts of 4 groups. Results: The total phenolic compounds of Thalictrum squarrosum were determined to be 1.9±0.001%. In the study of biological activity of Thalictrum squarrosum plants, the antioxidant activity of 4 groups of sub-extracts was tested by DPPH method, and the IC50 of total alkaloids (pH 9-10) was 201.58±0.1 μg/ml, ethyl acetate sub-extract 94.34±0.66 μg/ml, aqueous extract 824.18±0.08 μg/ml, and butanol sub-extract 128.75±0.58 μg/ml. When tested by ABTS method, the IC50 of total alkaloids (pH 9-10) was 35.83±0.44 μg/ml, ethyl acetate sub-extract 90.45±0.62 μg/ml, aqueous extract 104.19±0.93 μg/ml, dichloromethane sub-extract 156.44±0.48 μg/ml, and butanol sub-extract 170.03±0.61 μg/ml. When tested for antioxidant activity at 800 μg/ml by the FRAB method, the ethyl acetate sub-extract was 8946.16±14.79 μg/ml, the dichloromethane sub-extract was 1670.12±39.28 μg/ml, the butanol sub-extract was 4863.97±25.98 μg/ml, and the total alkaloids (pH 9-10) were 4897.99±58.12 μg/ml. Conclusion The ethyl acetate extract of the plant Thalictrum squarrosum has been found to be highly antioxidant active and total phenolic compound was 1.9±0.001%.

Introduction: According to the World Health Organization (WHO) data from 2022, 19.9 million people were diagnosed with cancer globally, and 9.7 million people died from the disease. In recent years, the incidence of colorectal cancer (CRC) has been rapidly increasing, ranking 4th among all cancers with 18.4 cases and 8.1 deaths per 100,000 population. In Mongolia, 826 new cases of CRC have been registered over the past six years, with an incidence rate of 8.2 cases and a mortality rate of 5.03 per 100,000 population. It is projected that by 2030, the incidence will reach 13.28 cases and the mortality rate will rise to 8.72 per 100,000 population. We aimed to comprehensively examine the risk factors for colorectal cancer among the population of Mongolia, establish a scientific basis for early detection and prevention, and strengthen preventive measures. Materials and Methods: A case-control study was conducted from 2022 to 2024. The study enrolled a total of 305 subjects, including 98 patients with colorectal cancer, 101 patients with colon polyps, and 106 healthy subjects. The risk. questionnaire consisted of 50 questions divided into 10 sections. All statistical analysis was performed with SPSS version 23.0 software (SPSS Inc., Chicago, IL, USA) and P value <0.05 was considered statistically significant. categorical data was represented as numbers and percentages. Pearson’s chi-squared and Fisher’s exact test were used to compare categorical variables. Multivariate logistic regression was used to identify the risk factor associated with recurrence. The study protocol was approved by Ethics Review Committee of Ministry of Health of Mongolia on 17 March 2023 (approval number: 23/012). Results: The average age of the participants was 57.1±12.8 years. Among all study participants, 37.6% (115) were male and 62.4% (188) were female. Comparison of colorectal cancer incidence by age and gender revealed no statistically significant differences (p=0.021; p=0.422). Regular physical exercise was found to have a protective effect against colorectal cancer (p=0.076; OR 0.341 95% Cl 0.118-.0986). The frequency of fruit consumption, 4 to 6 times per week (p=0.008, OR 0.08, 95% Cl 0.01-0.45), frequency of vegetable consumption 4 to 6 times per week (p<0.00; OR 0.07, 95% Cl 0.02-0.19), no dining out (0.007, OR 0.3, 95% Cl 0.18-0.68), and meat consumption (p=0.001) are decreased risk of colorectal cancer. Conclusion The patient's age and the presence of colon polyps are risk factors for colorectal cancer, while regular physical activity and a diet rich in fruits and vegetables are protective factors that help reduce the risk of developing colorectal cancer.

Introduction: Vaccination is a cost-effective intervention to prevent major illnesses that contribute to child mortality in the country. Increase in parental knowledge abour vaccination will lead to increase in vaccination rates of children. The main aim of our study was to assess the knowledge, attitudes and perceptions of vaccination. People’s knowledge about immunization and their attitudes toward them are likely influence uptake. Goal: The main purpose of the study is to evaluate the knowledge and attitude of the population towards measles and to clarify their satisfaction and understanding of the measles immunization program. Materials and Methods: We conducted cross-sectional study, involved participants from 3 aimags and 6 districts covered voluntarily. Total participants were 509. We used to online model and with the participant’s self-answer closed questionnaire. Results: 76% of the respondents were female and 24% were male. 64.1% of respondents who have children of 0 to 5 years of age, had little or bad knowledge towards immunization schedules against measles. Overall, the general attitude towards vaccines was positive, but the knowledge about significance of vaccines was weak. Further, district and province family doctors need to pay particular attention to increasing awareness and knowledge on importance of vaccines among families with young children. It is necessary to conduct extensive, long-term research and training among population to evaluate their knowledge and attitude towards measles, its vaccine and prevention, and to identify causes of lack of knowledge. Conclusion Our study shows the importance of good physician–patient communication in improving knowledge attitude and practice of parents towards their children’s vaccination.