Background: Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by the accumulation of surfactant within the alveoli, leading to impaired gas exchange and respiratory insufficiency. Although the disease is uncommon, it significantly affects patients’ quality of life and requires specific diagnostic and therapeutic approaches. Whole lung lavage (WLL) is considered the standard treatment; however, it has not been widely implemented in Mongolia. We report the first successful case of WLL performed for PAP in Mongolia. Case Presentation: A 56-year-old male presented with dyspnea. Chest computed tomography demonstrated a bilateral “crazy paving” pattern. Bronchoalveolar lavage fluid was positive for periodic acid–Schiff (PAS) staining, and anti–GM-CSF antibodies were detected, confirming the diagnosis of PAP. WLL was performed under general anesthesia using a double-lumen endotracheal tube with bronchoscopic guidance. One lung was ventilated with 100% oxygen while the contralateral lung was sequentially lavaged with 800–1000 mL of warm (37°C) saline per cycle until the effluent became clear. A total of approximately 20 liters of saline was used. Result: The procedure was completed successfully without complications. Following treatment, the patient showed marked clinical improvement with reduced dyspnea and increased exercise tolerance. Oxygen saturation improved from 88% to 93%, and spirometric parameters (FVC, FEV₁) demonstrated improvement. Chest imaging revealed a reduction in pulmonary opacities. Conclusion This case demonstrates the successful implementation of whole lung lavage (WLL) in Mongolia and highlights its importance in improving the diagnostic and therapeutic capacity for rare pulmonary diseases such as pulmonary alveolar proteinosis. The procedure resulted in significant improvement in clinical, functional, and radiological parameters, consistent with findings from international studies. Early diagnosis of PAP and the adoption of standardized protocols in accordance with international guidelines are essential to optimize treatment outcomes and enhance patients’ quality of life.

Introduction: Following the COVID-19 lockdown, the introduction of powered mopeds and scooters into urban mobility in Mongolia, without basic traffic regulatory frameworks such as vehicle classification, participation rules, age limits for riders, or parking regulations may have contributed to an increased risk of pedestrian injuries. Objective: To examine temporal trends in pedestrian injuries in Mongolia and to assess the impact of the emergence of micro mobility, while accounting for COVID-19 lockdowns, using an interrupted time-series analysis. Methods: We conducted an interrupted time-series analysis using national data on pedestrian injuries in Mongolia from January 2016 to December 2024. Monthly pedestrian injury rates per 10,000 population were calculated and stratified by age groups, regressing it on the number of months after January 2016 (the beginning of the study), after November 2020 (the lockdowns started), after May 2021 (the lockdown lifted and new mode of urban transportation started to release). Results: During the 9-year study period, there were 41,063 pedestrians, of whom 51.5% were male. The monthly rate of overall pedestrian injury started to decrease after the COVID-19 lockdowns possibly due to reduced traffic activity. However, following the lifting of restrictions, the trend started to increase among the age groups under 10 years (1.8%, 95% CI: 0.8–2.8), 10–19 years (1.6%, 95% CI: 0.3–2.9), 50–59 years (0.6%, 95% CI: 0.1–1.2), and 60–69 years (1.3%, 95% CI: 0.4–2.2). Conclusion The increase in pedestrian injuries suggests that the emergence of micromobility may have contributed to higher injury risk for pedestrians in Mongolia. This highlights the urgent need for change in infrastructure and regulations governing micromobility usage to enhance pedestrian safety.

Background: Asthma management should be individualized, evidence-based, aimed at controlling clinical symptoms, preventing severe exacerbations, and improving quality of life. Studies have shown that inhalation therapy with iodine- bromide saltwater improves lung function in chronic obstructive pulmonary disease (COPD), while radon-containing mineral water inhalation reduces inflammation and oxidative stress in asthma. Several studies have analyzed the composition of the Shargaljuut hot spring, with Oyuntsesteg et al. identifying high levels of Na+-HCO3 - and Na+-SO4. Other studies on mineral water therapies have reported benefits such as thinning bronchial secretions, improving sputum clearance, reducing inflammation and acidity, mitigating oxidative stress, and enhancing quality of life. Aim: To study the effectiveness of combined asthma treatment with inhaled corticosteroids and hot spring inhalation. Materials and Methods: The study included 67 participants diagnosed with asthma who consented to participate and underwent 10 days of combined inhaled corticosteroid therapy and mineral water inhalation at Shargaljuut sanatorium. A total of 57 participants completed the pre- and post-treatment assessments. Treatment result was assessed using Asthma control questionnaire 7, asthma symptom control with Asthma Control Test (ACT), and exercise tolerance by a 6-minute walk test. Chest X-rays were taken for all participants to rule out pneumonia, cancer, or pulmonary fibrosis. Treatment outcomes were evaluated using ACT scores, peripheral blood eosinophil count, total IgE levels in serum, spirometry indices (FEV1, FVC, FEV1/FVC), and the 6-minute walk distance. Results: The average age of participants was 52±12 years, with a predominance of females. The mean asthma control score was 14.2±4.80, indicating poor asthma control. After 10 days of inhaling corticosteroids combined with hot spring inhalation post-treatment quality of life increased by 0.5 points, FEV1 improved by 7.5%, FVC by 4.2%, peripheral blood eosinophil count decreased by 0.3%, and total Ig E levels dropped from 73.3 (22.5; 216) to 73.2 (21.3; 223) u/ml (p=0.000). Conclusion In cases of uncontrolled asthma remission, combining of inhaled corticosteroid therapy with hot spring inhalation at Shargaljuut improved asthma symptoms, quality of life, enhanced lung function, and reduced inflammatory markers (p<0.001).

Background. According to the reports of World Health Organization (WHO), every year over 5 millionpeople died because of violence, accidents and injury, and 600 million disabled. In 2020, 8.4 milliondeath is expected due to exposures of accidents and injury.By the end of 2013, population of Mongolia is 2.930.3 million and has increased by 2.2 percent,comparing to the year before. 68.1% of the total population is living in the urban, and the remaining31.9% is living in the rural. The 46.8% of the total population is residing and living in the capital cityUlaanbaatar, which counts at 1.372.1. million. 80% of residents (residential community) of Ulaanbaatarcity is receiving inpatient care, and 90% is receiving emergency care due to accidents and injury at theNational Traumatology and Orthopedic Research Center (NTORC).A number of clients received emergency care due to accidents and injury at the NTORC is continuallyincreasing for last 5 years. The number of inpatients in 2012 is reduced comparing to a year before.But in 2013, it has increased by 10.9% than in 2012. Also the increase by 10.0% is observed in the last5 year’s average. A major percentage of clients who received care traumatized when used alcoholicbeverages. This exposure is increasing during the holidays. Therefore it demands to find out reasonsof accidents and injury during the holiday celebrations.Goal. To define reasons of accidents and injury for clients who received care during the holiday at theNTORC.Methods. A descriptive case study is conducted based on client’s information which received emergencycare at the NTORC during 5 major holidays in 2012-2014. Selected five holiday celebrations were TheNew Year, Lunar New Year, International Woman’s Day, National Day for Armed Forces and Military(as known Men’s Holiday) and the Naadam (The Summer Festival). A selection of holidays consistedfrom series of days as of pre, post and during holidays when the celebration is for only one-day. Whenthe holiday celebration is for 3 days, all 3 days were chosen. The study described causes of trauma,diagnosis, age, gender and the residential of clients who received the emergency care due accidentsand injury.Results. A number of clients received emergency care during the major holidays, except the LunarNew Year is higher than non-holiday days. Number of clients received emergency care which usedalcoholic beverage is also more during the holidays. Over 60% of exposed is males and majority aged25-34. Causes of injuries during the holiday celebrations were all kinds of falls, interpersonal (domestic)violence’s, and traffic accidents. More exposures of interpersonal (domestic) violence’s during the wellknown Men’s Day holiday has been registered as well as more traffic accidents during the Naadam (TheSummer Festival).