Background: Tuberculosis (TB) remains a major public health concern worldwide and continues to be a leading cause of morbidity and mortality. Delays in diagnosis and care seeking exacerbate disease severity and increase financial burdens on healthcare systems and patients. In Mongolia, comprehensive evidence on diagnostic delays and direct hospitalization costs for TB patients remains limited. Aim: To evaluate the duration of diagnostic delay and estimate direct medical costs incurred during hospitalization among TB patients, as well as to identify associated factors. Materials and Methods: A retrospective cross-sectional study was conducted using medical records of 285 newly diagnosed TB patients hospitalized at the National Center for Communicable Diseases (NCCD) in 2024. Statistical analyses were performed using SPSS version 26 and MS Excel. A p-value of <0.05 was considered statistically significant. Result: The mean age of participants was 42.6±16.0 years, and 56.5% (n=161) were male. Median patient delay was 14 days (IQR: 5–31), median diagnostic delay was 4 days (IQR: 0–14), and mean hospital stay was 21.0±16.0 days. Median direct costs per patient were: diagnostic cost 262.0 thousand MNT (IQR: 187.0–363.0), treatment cost 490.9 thousand MNT (IQR: 234.4–884.1), and total cost 761.7 thousand MNT (IQR: 460.4–1247.6). Multivariate linear regression revealed that patient delay >14 days was significantly associated with higher total costs (=659.333, p=0.004). Conclusion 1. The median patient delay among patients with tuberculosis was 14 days (IQR, 5–31), while the median diagnostic delay was 4 days (IQR, 0–14). Overall, 61.6% of patients experienced patient delay, and 63.5% experienced diagnostic delay. 2. The median total direct medical cost among hospitalized patients was 761.7 thousand Mongolian Tugriks (MNT). A patient delay of more than 14 days was significantly associated with increased total direct medical costs (β=659.333, P=.004).

Background: Erysipelas is an acute, recurrent infectious disease caused by Group A β-hemolytic streptococcus. Recurrence occurs in 12–29% of patients, and complications in approximately 31%. International studies indicate that age, sex, and skin conditions are key factors influencing complications and recurrence. In Mongolia, the incidence of erysipelas has not steadily declined, and there is a lack of studies investigating clinical and laboratory predictors of complications and recurrence. Aim:: This study aimed to investigate clinical and laboratory predictors of complications and recurrence among erysipelas cases registered in Mongolia. Materials and Methods: A retrospective cross-sectional study design was employed. A total of 165 patients hospitalized with a diagnosis of erysipelas at the National Center for Communicable Diseases between 2020 and 2024 were randomly selected. Data were collected based on the “Clinical Guidelines for Erysipelas.” Statistical analysis was performed using SPSS-26, and ROC curve analysis along with regression models were used to determine risk and predictive factors. A p-value <0.05 was considered statistically significant. Results: The mean age of participants was 50.4±14.2 years; 76.5% were female, and 32.1% were herders. Recurrence was observed in 55.1% of patients (42.8% repeated episodes, 57.2% recurrent cases), and complications occurred in 10.3%. Among patients with complications, lesions were most commonly located on the face (41.2%) and predominantly presented as erythematous-bullous forms (70.6%). The neutrophil-to-lymphocyte ratio was 7.1 (AUC: 0.85, 95% CI: 0.79–0.91, p=0.001), and the systemic inflammatory response index was 3.9 (AUC: 0.93, 95% CI: 0.88–0.98, p=0.001), indicating high levels. Multivariable regression analysis showed that risk factors for complications included age >45 years (aOR=1.8, 95% CI: 1.2–2.7, p=0.004), female sex (aOR=2.8, 95% CI: 1.7–4.6, p=0.001), and occupation (herder) (aOR=2.6, 95% CI: 1.3–5.4, p=0.001). Chronic tonsillitis was significantly associated with recurrence (OR=3.8, 95% CI: 2.5–5.7, p=0.001). Cox regression analysis demonstrated that each additional year of age increased the risk of complications by 2% (HR=1.02, 95% CI: 1.01–1.03, p=0.003), while the presence of chronic tonsillitis increased the risk of recurrence by 7.69 times (HR=7.69, 95% CI: 5.15–11.49, p=0.001). Conclusion Cellular ratio indicators in erysipelas are useful for assessing inflammatory activity and disease progression. Age, sex, occupation, and the presence of chronic tonsillitis significantly influence the risk of complications and recurrence in erysipelas.

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.

The study is devoted to the morphological characteristics of the maturation of lung tissue structures in the fetal period. Fetal histology of the lungs presents the intrauterine development of lung tissue in four successive stages: pseudoglandular, canalicular, saccular and alveolar, each has specific morphological criteria. The following morphological features are predetermined: the development of alveolar epithelium, the ratio of mesenchyme towards the area in alveolar spaces, the degree of proliferation and location of vessels of the microcirculatory bed towards prealveolar partitions. During the fetal period the alveolar columnar epithelium is flattened and differentiates into alveolocytes type I lung histology with the demonstration of histological preparations of the lungs at different stages of intrauterine development. Keywords: fetal lungs, prealveolar structures, pseudoglandular stage, canalicular stage, alveolar stage, alveolar capillary membrane, immunohistochemical study. 16 and II, the area of the mesenchyme gradually decreases and by the birth of a full-term newborn kid it is present mainly in the thickness between the alveolar septa, microcirculation vessels, initially laying deep in the thickness of the mesenchymal tissue, gradually proliferate, approach the pre-alveolar epithelium, channeling it with the formation of alveolar capillary membranes. Air exchange in the lung tissue is mainly provided with two factors: the presence of second-order alveolocytes capable of producing surfactant, and a sufficient formation of alveolias well. This work summarizes the basics of fetal lung histology with the demonstration of histological preparations of the lungs at different stages of intrauterine development.

Abstract Epilepsy, a neurological disorder characterized by recurrent seizures, affects millions of people worldwide. Significant advancements in both diagnostic and therapeutic approaches have greatly improved outcomes, particularly for individuals with drug-resistant epilepsy. Modern neurostimulation techniques such as Responsive Neurostimulation (RNS), Deep Brain Stimulation (DBS), and Vagus Nerve Stimulation (VNS) have demonstrated effectiveness in reducing seizure frequency in these patients. Additionally, emerging technologies like gene therapy and optogenetics are being explored to better understand the underlying mechanisms of epilepsy and hold promise as future treatment modalities.Traditional imaging techniques often fail to detect subtle epileptogenic zones. However, the introduction of ultra high-field 7T MRI scanners represents a major breakthrough. These advanced scanners use eight transmitters to generate higher-resolution images, reducing signal dropout and enabling the identification of previously undetected lesions. In one study involving 31 patients, 58% had their treatment plans modified based on 7T MRI findings, highlighting its potential to inform surgical decision-making. In terms of pharmacological treatment, newer medications such as sultiame, cannabidiol (CBD), and non-pharmacological approaches like the ketogenic diet have emerged as additional therapeutic options for drug-resistant epilepsy. These developments contribute to more effective, personalized management strategies for epilepsy. In summary, the landscape of epilepsy diagnosis and treatment is rapidly evolving. Innovations in imaging and therapeutic interventions are offering new hope for patients with drug-resistant epilepsy. Ongoing research and clinical trials remain essential to further refine these approaches and improve patient outcomes.

Background: Respiratory viral and bacterial infections are one of the leading causes of hospitalization and death worldwide, particularly affecting children, the elderly, and immune compromised individuals. The detection of causative pathogens is crucial for understanding the epidemiology, prevention, management, and treatment of severe pneumonia. Molecular diagnostic methods provide high sensitivity and speed, enabling the simultaneous detection of viral and bacterial co-infections. Aim: Detection of single and combined viral and bacterial infections in hospitalized children with pneumonia using multiplex PCR. Materials and Methods: We conducted a cross-sectional study design involving 100 hospitalized participants at the National Center for Mothers, Newborns, and Women II. The study utilized questionnaires and laboratory analysis methods. Nasopharyngeal swabs were collected from the participants using a sterile swab and transported in a UTM transport medium (Jiangsu, China). After nucleic acid extraction using the STARMag 96 ProPrepC assay, the samples were analyzed with the Seeprep 32 automated analyzer (Seegene Inc., Korea). Real-time polymerase chain reaction (PCR) analysis was performed using the Allplex™ RV Master Assay and Allplex™ PneumoBacter Assay (Seegene Inc., Korea), with the CFX-96 system (BioRad Inc., USA). Results: The prevalence of viral infections in the study population was as follows: influenza type A 3% (n=3), influenza type B 3% (n=3), total influenza virus 14% (n=14), respiratory syncytial virus 18% (n=18), adenovirus 10% (n=10), rhinovirus 20% (n=20), and SARS-CoV-2 5% (n=5). No bacterial infections, such as B.parapertussis or L.pneumophila, were detected. However, bacterial infections identified included B.pertussis in 1% (n=1), C.pneumoniae in 2% (n=2), H.influenzae in 43% (n=43), M.pneumoniae in 52% (n=52), and S.pneumoniae in 45% (n=45). Of the 100 children in the study, 6% had influenza or influenza-like illness. Among these, 43% had the virus alone, and 14% had a viral co-infection. Bacterial infections were detected individually in 40% of cases, with co-infections in 46% of bacterial cases. Conclusion Metapneumovirus, B.parapertussis, and Legionella pneumophila were not detected in the study participants (0%). Among the viral infections, respiratory syncytial virus (18%, n=18) and rhinovirus (20%, n=20) had the highest prevalence. For bacterial infections, H.influenzae (43%, n=43), M.pneumoniae (52%, n=52), and S.pneumoniae (45%, n=45) were most commonly detected.

Background: Pregnancy induces multiple physiological, metabolic, and immunological alterations that increase susceptibility to infections, often necessitating antibiotic therapy. Evaluating the rational use of antibiotics among pregnant women is crucial for optimizing antimicrobial stewardship at the hospital level, improving clinical pharmacy services, and reducing the risk of antimicrobial resistance. Aim: To assess the rational use of antibiotics, including indication, selection, dosage, and treatment duration—among hospitalized pregnant women in the Department of High-Risk Pregnancy and the Department of Preterm Birth at the National Center for Maternal and Child Health. Materials and Methods: A retrospective study was conducted using a specifically designed data collection form to assess antibiotic use among inpatients at the National Center for Maternal and Child Health. Descriptive statistical analyses were performed using SPSS version 29.0. Results: A total of 348 pregnant inpatients were included, with a mean age of 31.6 ± 6.9 years. The mean length of hospital stay was significantly longer in the Department of Preterm Birth (12.5 ± 5.0 days) compared to the Department of High-Risk Pregnancy (5.9 ± 2.0 days; p < 0.001). The indications for antibiotic use were therapeutic in 39.1%, prophylactic in 33.0%, and unspecified in 21.3% of cases. The most frequently prescribed antibiotic regimen was a combination of β-lactams and metronidazole (29%). While the dosing of cefazolin and cefotaxime was largely appropriate, notable dosing discrepancies were observed in the dosing of ampicillin and azithromycin. Based on the U.S. FDA pregnancy risk classification, among a total of 762 antibiotic prescriptions, 87.0% belonged to category B, 8.8% to category C, and 4.2% to category D, with no significant variation across trimesters (p = 0.695). Conclusion The assessment of antibiotic use among hospitalized pregnant women at the National Center for Maternal and Child Health revealed that 39.1% of the prescriptions were therapeutic, 33.0% were prophylactic, and 21.3% lacked a clear indication for use. β-lactam antibiotics were the most commonly used agents, frequently combined with metronidazole. Based on the FDA classification system, 87% of the prescribed antibiotics belonged to category B, 8.8% to category C, and 4.2% to category D. These findings indicate inappropriate antibiotic use and insufficient implementation of antimicrobial susceptibility testing. Therefore, strict adherence to antibiotic stewardship programs and strengthening of clinical pharmacy services are necessary to improve antibiotic use practices.

Introduction: The job satisfaction of family health center nurses, and the factors affecting it, directly affect the stability of the nursing workforce and the quality and performance of their work. This in turn impacts nursing care provided to family clients of all ages. It is important to value nurses’ work, productivity, and job satisfaction with certain periodicity to improve the nursing management system. Aim: To determine the job satisfaction of family health center nurses. Methods: A descriptive cross-sectional design was used for the study. 102 nurses from family health centers participated in the survey. The Nurse's satisfaction instrument (The American Nursing Associations’ "Satisfaction of Nurses ",2021) has 43 items, and 3 subscales (nurses satisfaction, influencing factors for nurses' satisfaction, and possible solutions). The nurse’s satisfaction was rated as poor <0-60, average <61-122, and good <123-180 points. Questions were collected on paper from December 2022 to March 2023. The survey took 15-20 minutes to complete. Results: The job satisfaction of family health center nurses is at a good level (131.98±13.06). Considering the results of the subgroups, the nurse satisfaction group was (mean=32.8±4.06) average, the factors affecting nurse satisfaction were (mean=58.6±8.05) good, and the possible solutions were (mean=40.4±3.04) indicating agreed. There were results that nurses' workload, professional value, salary, and human resources are the most important factors affecting for job satisfaction of nurses. Conclusion According to the research, there is a need for an integrated policy program to improve the job satisfaction of family health center nurses and the factors affecting it.

Background: Nicotine-containing vaporized liquids—composed of propylene glycol, glycerin, water, flavorings, and the thickening agent vitamin E acetate—have been implicated in the development of EVALI. Under conditions of low liquid levels and overheating, these substances release toxic carbonyl compounds (e.g., formaldehyde, acetaldehyde, acrolein). In a 2019 national survey, 3.5% of adolescents aged 13–15 reported cigarette use, and 10% used e-cigarettes. Aim: To study the changes in the behavior, lung, and hippocampal structures of rats due to the effects of electronic cigarettes and their vapor. Materials and Methods: In this study, nineteen 14-day-old SHR rats were exposed to 1 g/mg/day of nicotine and dry hit vapor (control, nicotine and dry hit groups) for four weeks. Behavioral assessments (Open Field Test, Elevated Plus Maze, Conditioned Place Preference), bronchoalveolar lavage (BAL), and histological analysis of lung and hippocampal tissue were conducted. Results: The dry hit vapor group showed significantly reduced body weight (p=0.034), increased anxiety (p=0.006, p=0.025), and avoidance of the smoky chamber. BAL revealed elevated total cells, neutrophils, and macrophages (p=0.01, p=0.04) in both nicotine and dry hit groups. Lung tissue exhibited alveolar septal thickening, inflammation, and emphysema- like changes. Extensive neuronal death was observed in the hippocampus. Conclusion Anxiety-like behavior was observed in both the burn and control groups. Analysis of BAL in the dry hit group revealed inflammation predominantly characterized by macrophage infiltration. Histological examination of lung tissue from both experimental groups demonstrated a reduction in the number of alveoli, accompanied by acute inflammation and thickening of the interalveolar septa. In the hippocampal region, neuronal loss and a reduction in neuronal density were also observed.

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.