Background: Diabetes mellitus and disturbances in glucose metabolism are associated with an increased risk of thrombosis through endothelial dysfunction, chronic low-grade inflammation, platelet hyperactivity, and alterations in coagulation factors. Aim: To investigate the association between fasting glucose levels and selected coagulation and platelet parameters. Materials and Methods: This analytical cross-sectional study included 172 participants. According to the exclusion criteria, individuals with previously diagnosed diabetes mellitus, anticoagulant use, or liver disease were excluded. Participants were categorized into two groups according to fasting glucose levels: <5.6 mmol/L and ≥5.6 mmol/L. Activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), fibrinogen, platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) were compared between the two groups. Between-group differences were assessed using the Mann–Whitney U test, and associations between continuous variables were evaluated using Spearman’s correlation analysis. Multivariable linear regression analysis was adjusted for age, sex, and body mass index (BMI). Result: Of the 172 participants, 145 (84.3%) had fasting glucose levels <5.6 mmol/L and 27 (15.7%) had fasting glucose levels ≥5.6 mmol/L. The median aPTT was significantly shorter in participants with elevated fasting glucose than in those with fasting glucose <5.6 mmol/L (25.4 [24.2–26.8] vs. 26.3 [24.9–27.95] seconds; p=0.029). No statistically significant between-group differences were observed in PT, INR, TT, fibrinogen, platelet count, MPV, PDW, or PCT. A weak inverse correlation was observed between fasting glucose and aPTT (ρ=−0.141). In multivariable regression analysis adjusted for age, sex, and BMI, each 1 mmol/L increase in fasting glucose was associated with a 0.242-second decrease in aPTT (B=−0.242; 95% CI, −0.465 to −0.020; p=0.033). Conclusion 1. The median aPTT was significantly shorter in participants with elevated fasting glucose than in those without elevated fasting glucose. 2. Each 1 mmol/L increase in fasting glucose was associated with a 0.242-second decrease in aPTT.

Background: Hematological malignancies are a group of cancers affecting the blood-forming organs and are often associated with long-term treatment and multiple adverse effects, which may negatively influence patients’ quality of life. Therefore, evaluating treatment outcomes should include not only clinical indicators but also the assessment of patients’ quality of life. Aim: To assess the quality of life of patients with hematological malignancies Materials and Methods: An institution-based analytical cross-sectional study was conducted at the Hematology and Bone Marrow Transplantation Center of the First Central Hospital of Mongolia between 2020 and June 2025. A total of 118 adult patients diagnosed with hematological malignancies were included using a non-probability sampling method. Quality of life was assessed using the Hematological Malignancy Patient-Reported Outcome Measure (HM-PRO) and the EORTC QLQ-F17 questionnaires. Statistical analysis was performed using SPSS version 28. Results: The mean age of participants was 52.9 years, with 53% females and 47% males. In terms of diagnosis, 42% had acute leukemia, 42% lymphoma, and 16% multiple myeloma. The internal consistency reliability of the HM-PRO questionnaire was high, with a Cronbach’s Alpha coefficient of 0.96. The mean quality of life score increased from 61.57 before treatment to 90.09 after treatment, showing a statistically significant improvement (p<0.05). This finding indicates that treatment reduced disease-related symptoms and improved patients’ quality of life. Conclusion The quality of life of patients with hematological malignancies significantly improved after treatment. Therefore, assessment of quality of life should be integrated with clinical indicators when evaluating treatment outcomes and planning patient-centered healthcare services.

Background: Iron deficiency anemia (IDA) is one of the most common nutritional disorders worldwide, affecting approximately 30% of the global population. Reticulocyte hemoglobin (Ret-He) reflects the amount of hemoglobin in reticulocytes and provides a real-time indicator of iron availability during erythropoiesis. Unlike conventional iron parameters, Ret-He is less affected by inflammation and infection, making it a more sensitive and reliable marker of functional iron status. It enables early detection of iron deficiency from the initial stage of depleted iron stores and is therefore valuable for early diagnosis and treatment monitoring of IDA. However, studies on the clinical application of Ret-He for early diagnosis and follow-up of IDA remain limited in Mongolia, prompting the present study. Aim: To determine reticulocyte hemoglobin (Ret-He) levels in patients with iron deficiency anemia and to compare them across the severity of anemia. Materials and Methods: A total of 100 patients with hypochromic microcytic anemia who presented to the First Central Hospital were included in the study. The relationship between erythrocyte indices, including hemoglobin (HGB) and reticulocyte hemoglobin (Ret-He), was analyzed according to the severity of anemia. Data were analyzed using Stata version 14. Results: The study included 100 participants aged 18–81 years, of whom 8%(n=8) were male and 92%(n=92) were female. The mean age was 52.8±22.6 years in males and 43.7±16.08 years in females. The leading causes of anemia were uterine bleeding (68%), gastrointestinal disorders (18%), malignancies (10%), and other causes (4%). The mean Ret-He level was 16.15±2.66 pg in males and 19.35±2.08 pg in females, indicating a statistically significant sex difference (p<0.05). Red blood cell count, hemoglobin, MCV, MCH, and Ret-He all decreased progressively with increasing severity of anemia, with statistically significant differences between groups (p<0.0001). Hemoglobin levels showed a significant positive correlation with Ret-He (p<0.001). Conclusion In iron deficiency anemia, reticulocyte hemoglobin levels are significantly reduced and correlate strongly and positively with hemoglobin. The progressive decline in Ret-He with increasing severity of anemia reflects impaired iron availability in the bone marrow. Therefore, Ret-He is a clinically valuable biomarker for early detection of iron deficiency, monitoring treatment response, and assessing anemia severity.

Background: Passive smoking among children remains a serious public health concern, particularly because children’s ability to avoid household environmental tobacco smoke exposure is limited when parents smoke. In recent years, increasing scholarly attention has been given to oral mucosal pigmentation as a potential clinical sign of long-term passive smoking in children. However, no previous study has synthesized the available evidence on this topic. Aim: This systematic review and meta-analysis aimed to evaluate the association between passive smoking and oral pigmentation in children. Materials and Methods: A systematic search was conducted in international electronic databases, including PubMed, Scopus, Web of Science, and the Cochrane Library, in accordance with PRISMA guidelines. Observational studies assessing the association between passive smoking and oral pigmentation among children aged ≤18 years were included. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). A random-effects meta-analysis was performed, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Between-study heterogeneity was assessed using the I² statistic, and the certainty of evidence was evaluated using the GRADE approach. Results: Seven studies involving a total of 1,582 participants met the inclusion criteria. The meta-analysis demonstrated that passive smoking was significantly associated with an increased risk of oral pigmentation in children, with a pooled OR of 2.58 (95% CI, 1.35-4.95; p=0.004). Compared with children without exposure to passive smoking, those exposed to environmental tobacco smoke had an absolute risk increase of 17% (95% CI, 6.3%-23.9%). Subgroup analysis by assessment method showed a consistent effect among studies using the Gingival Pigmentation Index (GPI) (OR, 2.12; 95% CI, 1.58-2.84), whereas studies using the Dummett Oral Pigmentation Index (DOPI) showed a wider confidence interval (OR, 3.26; 95% CI, 0.68-15.54). According to the MMAT assessment, the included studies demonstrated adequate participant selection in 100% of cases, appropriate outcome measurement in 76.9%, and adequate control of confounding factors in 46.2%. Owing to the observational nature of the included studies, moderate heterogeneity, and the potential risk of confounding by physiological pigmentation, the certainty of evidence was rated as low according to GRADE. Conclusion Children exposed to environmental tobacco smoke had a significantly higher likelihood of oral mucosal pigmentation than unexposed children. These findings suggest that screening for oral mucosal pigmentation during pediatric oral examinations may serve as a non-invasive marker of passive smoking exposure and may provide visible clinical evidence to support counseling parents on smoking cessation and smoke-free household environments.

Background: Thrombotic alterations play a central role in the pathogenesis of both macrovascular and microvascular complications of diabetes mellitus. D-dimer, a fibrin degradation product generated during fibrinolysis, has emerged as a potential biomarker for predicting chronic diabetic complications and assessing their severity. Aim: To determine D-dimer levels in individuals with type 2 diabetes mellitus (T2DM) and investigate their association with various microvascular complications. Materials and Methods: This cross-sectional study included 215 participants with T2DM. Individuals diagnosed with other forms of diabetes, those receiving anticoagulant therapy, and those with liver disease were excluded according to the predefined exclusion criteria. Participants were categorized into two groups according to their D-dimer levels: ≤0.260 μg/mL and >0.260 μg/mL. The prevalence of diabetic retinopathy, nephropathy, and neuropathy was compared between the groups. Multivariable logistic and linear regression models were adjusted for age, sex, and body mass index (BMI). Results: A total of 215 individuals with T2DM were included in the study. The median D-dimer level was 0.260 μg/mL (interquartile range [IQR]: 0.190–0.460). The prevalence of at least one microvascular complication was significantly higher among participants with D-dimer levels above the median than among those with levels at or below the median (51.4% vs. 37.0%, p=0.034). The prevalence of diabetic nephropathy was 33.6% versus 13.0% (p<0.001), while that of diabetic neuropathy was 20.6% versus 10.2% (p=0.035), respectively, indicating a higher burden of chronic complications in the group with elevated D-dimer levels. Participants with D-dimer levels above the median had 2.23 times higher odds of having at least one diabetic microvascular complication (OR=2.23; 95% CI: 1.19–4.18; p=0.013). Conclusions 1. Elevated D-dimer levels were observed in 21.4% of individuals with type 2 diabetes mellitus included in the study. 2. D-dimer levels above the median (0.260 μg/mL) were associated with a twofold increase in the odds of having diabetic microvascular complications (OR=2.23; 95% CI: 1.19–4.18; p=0.013).

Background: A 2024 study by the National Statistical Office of Mongolia indicate an incidence rate of 38.8 per 100 000 population, with a total of 8169 new cancer cases diagnosed, of which 16.2% are gastric cancers. Notably, 64.4% of these diagnoses are made at advanced stages.2 Surgical intervention remains one of the most effective treatments for gastric cancer. Early-stage surgery confers a 5-year survival rate of 60-80%, whereas late-stage diagnosis reduces this to 18-50%.5 This study aims to investigate the causes, types, and contributing factors of postgastrectomy anemia in patients undergoing surgery for gastric cancer in Mongolia, where no prior study has been conducted on this topic. Methods: This retrospective study analyzed all patients who underwent gastric cancer surgery at the National Cancer Center of Mongolia from 2022 to 2024. Data on demographics, lifestyle factors, clinical signs of anemia, and comorbidities were collected from medical records and confirmed by direct examination. Results: A total of 788 patients who underwent surgery for gastric cancer were included in the study, of whom 70.5% were male and 29.5% female, aged 22–70 years (mean age 46 years). Among the total cases, 461 patients underwent total gastrectomy, 128 had distal gastrectomy with gastrojejunal anastomosis, 39 underwent partial gastrectomy, 3 had gastrectomy with duodenal anastomosis, 5 underwent gastrectomy with esophagogastric anastomosis, and 6 underwent bypass procedures. Conclusions Postoperative monitoring after gastric surgery was insufficient, and there was a tendency for anemia to progress.

Background: Reference values for a complete blood count (CBC) can vary due to multiple factors, including geographical location, environmental influences, nutrition, genetic characteristics, lifestyle, and the physical-chemical properties of the blood. Mongolia’s high-altitude geography (an average of 1,580 meters above sea level) reduces oxygen supply and activates hematopoiesis through the body’s physiological adaptation mechanisms. As a result, the number of red blood cells, hemoglobin, and hematocrit levels tend to increase, as studied by researchers Ch. Sharav and A. Ulziikhutag. Considering the unique geographical regions of Mongolia (urban, rural, steppe, desert, and high mountain areas), studying the physiological blood parameters of the population and identifying regional differences are crucial for improving diagnostic accuracy and the reliability of clinical assessments, which form the basis for conducting this study. Aim: Select a healthy group from the population that participated in the ‘National Preventive Screening and Early Diagnosis Program’ for preventing and early detecting infectious and non-infectious diseases based on age, gender, and health risks. Establish reference values for comprehensive blood test indicators by geographical location. Materials and Methods: In Mongolia, from 2022 to May 2023, a comprehensive blood analysis was conducted on 7,301 individuals aged 18 and above who participated in the ‘National Preventive Screening and Early Diagnosis Program’ aimed at preventing and early detecting infectious and non-infectious diseases based on age, gender, and health risks. The analysis included red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell count (WBC), and platelet count (PLT) in relation to their geographical location. The study results were calculated using IBM SPSS (20) software. Statistical significance was considered at p<0.05. Results: In our study, 7,301 people aged 18-87 participated, of whom 36.4% (2,644) were male and 63.6% (4,657) were female. The average age was 30.2±0.2 years for men and 35.1±0.1 years for women. Among them, there were 1,764 males and 1,774 females aged 18-30, 603 males and 2,069 females aged 31-45, 199 males and 670 females aged 46-60, and 78 males and 144 females over 61 years old. A total of 26.6% (1,944) of the study participants were from Ulaanbaatar, 12.75% (931) from the western region, 10.12% (739) from the eastern region, 33.18% (2,423) from the Khangai region, and 17.31% (1,264) from the central region. In the Ulaanbaatar region, HGB, HCT, MCV, MCH, and WBC increased with age, while PLT showed a tendency to decrease. Differences in HGB, HCT, MCV, MCH, MCHC, WBC, and PLT indicators were observed between the western, eastern, Khangai, and central regions depending on the area (p<0.05). Conclusion Statistically significant differences in blood parameters were observed across different regions of Mongolia, indicating the necessity of establishing reference values for blood tests that reflect the influences of geographical location, lifestyle, and environmental factors (p<0.05).

Background: A Complete Blood Count (CBC) is essential for early disease detection, diagnosis, treatment, monitoring therapeutic progress, and evaluating a patient’s overall health status. Therefore, establishing reference values for blood tests tailored to the demographic characteristics of a specific population plays a crucial role in improving diagnostic accuracy and treatment outcomes. In our country, there is a lack of studies determining reference values for blood test parameters based on age, gender, body weight, and quality of life, which serves as the basis for conducting this research. Aim: To select a healthy population from those participating in the ‘preventive screening, early detection, and diagnosis of infectious and non-communicable diseases based on age, sex, and health risk factors,’ and to establish the reference range for red blood cells and their additional parameters in relation to body mass index, gender, and age groups. Materials and Methods: A total of 7,301 individuals aged 18 and above who participated in the ‘preventive screening, early detection, and diagnosis of infectious and non-communicable diseases based on age, sex, and health risk factors’ conducted from 2022 to May 2023 in Mongolia were included in the study. The study involved complete blood count (CBC) analysis, including red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). The data were analyzed in relation to age and sex. The statistical analysis was performed using IBM SPSS (version 20), and results with P<0.05 were considered statistically significant. Results: Our study included 7,301 individuals aged 18 to 87, of whom 36.3% (2,644) were male and 63.7% (4,657) were female. The average age was 30.23±0.22 years for males and 35.11±0.15 years for females. Specifically, there were 1,764 males and 1,774 females in the 18-30 age group, 603 males and 2,069 females in the 31-45 age group, 199 males and 670 females in the 46-60 age group, and 78 males and 144 females in the >61 age group. In the 18-30 age group, RBC, HGB, MCV, MCHC, and HCT levels showed statistically significant differences between males and females. In the 31-45 age group, RBC, HGB, MCH, MCHC, and HCT levels also showed statistically significant differences. In the 46-60 age group, RBC, HGB, and HCT showed statistically significant differences, while in the >61 age group, only RBC levels showed statistically significant differences between males and females. When analyzing red blood cells and their associated parameters in relation to BMI, no statistically significant differences were observed between the groups (p>0.05). Conclusion By including the general population in early screening programs, it has become possible to establish reference values for red blood cells and their additional parameters specific to the Mongolian people. Future studies should focus on examining these parameters in relation to geographical location, genetic characteristics, and environmental influences.

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: The Mongolian National drug policy states, “The rational drug rehabilitation is one of the main goals of pharmaceutical care”. Recruitment and prescription medications are important issues for improving rational use of medicines. According to the recommendations of the World Health Organization (WHO), the status of rational use of medicines is assessed through the recipe by 10 criteria. The needs to study on rational drug use in hospitals of Ulaanbaatar and determining standard criteria for the proper use of drugs by recommendation of World Health Organization is the main justified issue of the study. METHODS: In order to study the rational use of medicines, a single moment /descriptive/ research type was used. Recipes for 50 and 50 people who received prescription from pharmacy within 12 hospitals TFCHM, TSCHM, TTCHM, NCCD, NTaORC, NCMH, HCSKhD, HCChD, HCSBD, HCKhUD, HCBZD, HCBGD June 2017 in Ulaanbaatar, it was based on the WHO recommended methodology, a total of 600 clients, 600 recipes and 1249 medicines were selected and submitted to the conclusions. RESULTS: The average number of medicines per minute was 2.08 ± 0.25, 45.2% in International Health Prescription were 42.6% antibiotics. According to a study on a contingency test, 85% did not have prescription signs, 38.8% without diagnostic prescription, 25% did not have physicians, and 48% did not have any medical information. The knowledge about the dose was 68.5% . CONCLUSION The results of the study were compared with the recommendations of the World Health Organization and the proportion of medicines included in the ICS list was lower than the recommendations of the World Health Organization list and the proportion of antibiotic drugs. The study found that 11 different incidents were encountered. Knowledge about medicines dose was 68.5%, compared to World Health Organization recommendations