Background: Arterial hypertension (AH) is a major risk factor for cardiovascular morbidity and mortality, with both genetic and environmental factors contributing to its development. The insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene has been investigated as a potential genetic determinant of hypertension; however, evidence in the Mongolian population remains limited. Aim: To determine the distribution of the ACE gene I/D polymorphism and investigate its association with arterial hypertension and cardiovascular risk factors in a Mongolian population. Materials and Methods: A case-control study was conducted between October 2018 and November 2019. A total of 150 participants aged 20–64 years were included, comprising 100 patients with AH and 50 normotensive controls. AH was defined as blood pressure ≥130/80 mmHg or current use of antihypertensive medication. Cardiovascular risk factors were assessed using questionnaires and physical examination. Genomic DNA was extracted from peripheral blood lymphocytes, and the ACE I/D polymorphism in intron 16 was determined using a two-step polymerase chain reaction (PCR). Associations between ACE genotypes and AH were assessed using the chi-square test and multivariable logistic regression. A p value <0.05 was considered statistically significant. Result: Among the 150 participants, 64 (42.7%) were male, and the mean age was 44.2±11.7 years. The frequencies of the II, ID, and DD genotypes were 44.0%, 39.3%, and 16.7%, respectively. No significant difference in genotype distribution was observed between males and females. The frequencies of ID, DD, and II genotypes in the hypertensive and control groups were 39.0% vs. 40.0% (p=0.906), 14.0% vs. 22.0% (p=0.215), and 47.0% vs. 38.0% (p=0.295), respectively. The D-allele frequency was 0.33 in the hypertensive group and 0.42 in the control group, with no statistically significant difference. Participants with AH were older and had significantly higher body mass index, waist circumference, salt intake, alcohol consumption, and blood pressure compared with controls. Conclusion 1. The I allele of the ACE gene was predominant in the studied Mongolian population. 2. Neither the ACE I/D genotype nor the D allele was significantly associated with arterial hypertension. Traditional cardiovascular risk factors, including older age, excess body weight, abdominal obesity, high salt intake, and inappropriate alcohol consumption, showed stronger associations with hypertension in this population.

Background: Polymyositis (PM) is a rare idiopathic inflammatory myopathy characterized by symmetric proximal muscle weakness, elevated muscle enzyme levels, dysphagia, and respiratory muscle weakness. Rhabdomyolysis is a potentially life-threatening condition caused by extensive skeletal muscle breakdown, resulting in myoglobinuria and an increased risk of acute kidney injury and multiorgan complications. The coexistence of rhabdomyolysis in patients with polymyositis is uncommon and may complicate both diagnosis and management. Case Presentation: A 65-year-old man was admitted with fever up to 39°C, generalized skin rash, dysphagia, progressive muscle weakness, dyspnea, decreased urine output, and dark tea-colored urine. Physical examination revealed symmetric proximal muscle weakness, with muscle strength graded 3/5 in both upper extremities and 4/5 in both lower extremities. Neck muscle strength was 4/5. Dysphagia and a generalized skin rash were also present. Laboratory investigations showed markedly elevated creatine kinase (CK) at 9,943.1 U/L, alanine aminotransferase (ALT) at 449.1 U/L, aspartate aminotransferase (AST) at 222.1 U/L, lactate dehydrogenase (LDH) at 1,342.9 U/L, and C-reactive protein (CRP) at 70.6 mg/L. Urinalysis showed blood 3+ and protein 2+, while no erythrocytes were detected on urine sediment microscopy. Electromyography demonstrated myopathic changes, and muscle biopsy revealed inflammatory infiltrates and necrotic muscle fibers. Conclusion Comprehensive assessment of clinical manifestations, laboratory findings, autoantibody testing, electrophysiological studies, and muscle biopsy is essential for the diagnosis of polymyositis complicated by rhabdomyolysis. An integrated diagnostic approach facilitates confirmation of the diagnosis, differentiation from clinically similar disorders, and appropriate treatment selection. Early recognition of rhabdomyolysis and other potentially life-threatening complications is crucial for preventing organ damage and improving patient outcomes.

Background: Sleep is a complex neuropsychological, biological, and physiological process essential to human health. Obstructive Sleep Apnea (OSA) is a highly prevalent disorder worldwide. In Asian countries, 12–40% of the population, and in the United States, 35.8% of the population are estimated to be at high risk for OSA. In Mongolia, however, there is limited research on the prevalence of OSA, which led to the initiation of this study. Aim: To determine the prevalence and risk level of OSA among the Mongolian population. Materials and Methods: A total of 1,405 individuals aged 18 and older from the clinical Mon-Timeline cohort study were assessed using the Berlin Questionnaire (BQ). The BQ evaluates three categories: snoring and witnessed apneas, daytime sleepiness, and high blood pressure and obesity. Individuals who met criteria in any two of the three categories were classified as being at high risk for OSA. Data on educational attainment and lifestyle behaviors were collected using the Food Frequency Questionnaire and the Global Physical Activity Questionnaire. Statistical analysis was performed using Student’s t-test, Pearson’s chi-square test (χ²), and ANOVA. Results: The mean age of participants was 42 ± 14.3 years, and 42.5% were male. A total of 24.3% (n=341) were found to be at high risk for OSA. The risk increased with age: 6.7% in individuals under 30, 28.3% in those aged 30–50, and 39.4% in those over 50. Participants at high risk for OSA tended to be older and more physically inactive. Additionally, 41.7% of all participants reported snoring, and 39.3% of those stated that their snoring disturbed others. Conclusion A significant portion (24.4%) of the Mongolian population is at high risk for OSA. These individuals are more likely to be older and physically inactive. The high prevalence of snoring and associated disturbances suggests a need for increased awareness, early detection, and age-targeted prevention strategies in Mongolia.

Background: Systemic sclerosis-related interstitial lung disease (ILD) is a major cause of mortality among patients with systemic sclerosis. During this disease, when the forced vital capacity (FVC) is <50% on spirometry, the prognosis is considered poor. Although early changes in systemic sclerosis-related ILD can be identified by chest computed tomography (CT), evaluating the spirometry test is essential for monitoring further follow-up and assessing treatment outcomes. This study aimed to highlight the importance of considering the role of the spirometry test among patients with systemic sclerosis. Materials and Methods: We conducted this study using a cross-sectional research design based at a single-center hospital. The study included 40 patients diagnosed with systemic sclerosis who were attending the rheumatology outpatient clinic at the Mongolia-Japan Hospital. The inclusion criteria were patients diagnosed with systemic sclerosis who had undergone chest imaging (chest x-ray, chest CT scan) and spirometry tests. Results: In our study, in 62.5% of patients diagnosed with systemic sclerosis, a chest CT scan revealed abnormalities indicative of SSc-ILD. There were statistically significant differences (p<0.05) in certain parameters of spirometry between the two groups (normal chest CT, abnormal chest CT). The group with abnormal chest CT had a higher usage of mycophenolate mofetil (p<0.05). A negative correlation was found between changes on chest CT scan and FVC (r= -.453, p<0.05). However, no statistically significant correlation was observed between FVC and disease duration or comorbidities. Conclusion Using spirometry to assess pulmonary function in patients with systemic sclerosis-related interstitial lung disease may be an appropriate method for evaluating the progression of the disease and detecting complications.

Background: Cardiovascular disease (CVD) is currently the leading cause of morbidity and mortality worldwide. CVD risk increases significantly even in the early stages of chronic kidney disease (CKD) and CVD deaths account for more than half of all known causes of death in patients with end stage renal disease. Cardiovascular risk factors such as hypertension, anemia, hyperphosphatemia, volume overload and uremic toxins usually occur when eGFR is below 60 ml/min/1.73m2, while the subclinical atherosclerosis starts to develop in early stages of CKD. Serum N-terminal pro B type netriuretic peptide (NT-proBNP) is important for predicting subclinical heart failure in patients with CKD. Methods: Plasma NT-proBNP concentrations were measured in 37 patients with CKD (mean age = 54 years, female 48.6%). Renal function was assessed by estimated glomerular filtration rate (eGFR; ml/min/1.73m2) and the subjects were classified into five stages of CKD. Pearson correlation analysis was used to analyze he relationship between renal function and serum NT-proBNP levels. Results: The mean serum NT-proBNP level was in CKD stage I ( <50pg/ml, p<0.0001), CKD stage II (64.86±21.79 pg/ml, p<0.0001), CKD stage III(119.56±158.1pg/ml, p<0.0001), CKD stage IV (5801.8±7213.7 pg/ml, p<0.0001), CKDstage V (6993.1±9029.9 pg/ml l, p<0.0001). Serum NT-proBNP level was inversely correlated significantly with eGFR (r = -0.464, р = 0.004). Conclusion Our findings indicate the circulating levels of NT-proBNP increased with deteriorating kidney function and these values were highest in patients with CKD IV and CKD V stages.

Healthcare is a rapidly growing industry as medical treatments become more sophisticated, more in demand due to increasing incidence of chronic disease and more widely available worldwide. As the amount of healthcare waste continues to increase, there is a need for further research in the field to meet the global demand for proper disposal of healthcare waste. The growing healthcare consumption, driven by various factors, is contributing to the rise in hospital waste, which in turn is putting pressure on current waste management systems.Currently, healthcare institutions manage waste by segregating at the source, safely transporting infectious waste, and disposing of it through incineration, autoclaving, or landfill methods. Both incineration and autoclaving processes have negative environmental and human health impacts. To reduce the amount of healthcare waste generated, it is necessary to train healthcare workers to properly segregate waste according to its type, following established standards.
Governments can take action to improve waste disposal practices, reduce the generation of infectious waste, and ensure that all types of healthcare waste are properly disposed of. This can include:
• Governments should have clear and standardized definitions for both infectious and non infectious healthcare waste, and enhance the regulatory and legal framework to prevent illegal disposal of waste.
• Healthcare institutions should be provided with incentives, financial support, and other measures to reduce hospital waste, with a particular focus on reducing infectious waste in local health institutions.
• Governments should provide research grants to support studies aimed at reducing and managing healthcare waste disposal effectively.
These measures would help improve the overall management and reduction of healthcare waste and ensure a safer and more sustainable approach to waste disposal.

BACKGROUND: Cardiovascular diseases (CVDs) account for >17 million deaths globally each year and this figure is expected to grow to 23.6 million by 2030. According to the WHO report, one-third of ischemic heart disease is attributable to high cholesterol. There have been some claims that the atherogenic index of plasma (AIP), which is the logarithmic transformation of the just-mentioned ratio (TG/HDL-C), could be used as a significant predictor of atherosclerosis, and CVD as well. Thus, we aimed to study the relationship between AIP and cardiovascular risk factors. METHODS: The cross-sectional hospital based study was conducted including 117 participants aged between 40-72 years old without cardiovascular symptoms were recruited from Second General Hospital. After filled consent form, participants’ habits of smoking, alcohol usage, obesity, arterial hypertension and sedentary lifestyle were assessed through a structured questionnaire and physical examination. By using fully automated open-system analyzer, determinations of total cholesterol, triglycerides, low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) three times and glucose twice were performed simultaneously and then their averages were calculated. At least one abnormal lipid level was considered as “dyslipidemia”. The atherogenic index of plasma (AIP) was calculated as the logarithmically transformed ratio of molar concentrations of TG to HDL-C. Statistical analysis was performed using SPSS 22. RESULTS: Of total 117 participants ranging 40-72 years old, 45.3% were male and 54.7% were female with mean age 53.6±0.79. Regarding cardiovascular risk factors, 63.8% were physically inactive, 32.48% were smokers, 47% were alcohol user, 48% were hypertensive, and 18.26% were diabetic. The mean values plus standard error of lipid components were 195.5±6.09 mg/dL in cholesterol, 181.25±27.36 mg/dL in triglycerides, 60.6±1.39 mg/dL in HDL-C, 138.5±3.74 mg/dL in LDL-C, 6.27±0.26 mmol/L in fasting glucose. The dyslipidemia was detected in 54.7% of total participants and mean level of AIP was 0.33±0.03 (min=-0.52; max=1.51). The mean levels of 10 year and lifetime risk were 6.25±0.63% (min=0.2; max=33.5) and 43±1.53% (min=7.5; max=69), respectively. AIP had weak correlations with gender, smoking, anti-hypertensive drug usage, aspirin usage, 10 year and lifetime risks of CVD, hypertension, fasting glucose, body mass index, and dyslipidemia (0.2

IntroductionStudies on structure and function of reproductive system of experimental animal by developing coldstress model have been getting attractions from researchers. The study on changes of reproductive system of offspring from experimental animal which had cold stress has been done in recent times.GoalCold stress modeling in female experiment rats and, identifying the changes of stages of estrous cycleand reproductive hormone.Materials and MethodsIn order to identify stages of changes of reproductive hormone of experiment female rat which is model of cold stress, 90 Wistar breeding rats weight of 170-178 g were divided into following 6 groups:Non-gravid control group–15, gravid control group–15, non-gravid group for cold stress–15:15:15, gravid group for cold stress–15. Pathologic cold stress was modeled in 15:15:15 rats of non-gravid group for cold stress by putting in fridge everyday between 8 to 11 o’clock for 7:14:21 days and in 15 rats of gravid group for cold stress by putting in fridge (-150) every day between 8 to 11 o’clock for 28 to 30 days (Avcina AP(1989), Melovanov АP(1991)). Time to vaginal opening was determined to use method of Volkova OB in offspring of gravid experiment rats and control group after 2 months. After that selected 15 female offspring were put to sleep with ether and taken blood of 4-5 ml from their hearts and compared the amount of estradiol and progesterone in that blood using rat kits of Ausmausco Pharma with control group.Result Determining hormone level in blood of control group, estradiol is 4.73±0.45ng/l, progesterone is 2, 45±0,50ng/l. After a week pathologic cold stress was modeled in rats, estradiol is determined 3.93±0.70ng/l, progesterone is determined and after 2 weeks, estradiol is 4.0±0.53ng/l, progesterone is 1.97ng/l and after 3 weeks, estradiol is 3,8±0,63ng/l, progesterone is 1,94±0,09ng/l Birth weight of offspring from gravid rats with cold stress, was 1,6g (р=0,001) less than control group.Time to vaginal opening of offspring was 14 days later than control group. Determining hormone of control group offspring, estradiol is 4.53±0.51ng/l, progesterone is 2,39±0,40ng/l. Estradiol is 3.73±0,59.ng/l, progesterone is determined 1.97±0.07ng/l in offspring of gravid experiment rats.Conclusion: 1. When develop cold stress model, gravid rats had miscarriage and preterm delivery and born low birth-weight offspring in 16-22 days of experiment and this reveals that pathologic changes occurred in sexual hormonal regulation of 3 groups of non-gravid rats of experiment because of cold stress. 3. In offspring from gravid rats which had cold stress time of vaginal opening was lengthened and estradiol and progesterone level was decreased in offspring from gravid rats and