Background: Aetiological mechanisms of demyelinating diseases underlie a very heterogeneous clinical course, ranging from relapsing to progressive, with a longer disease duration leading to physical and cognitive disability. Aim: To identify factors in the development of long-term disability in demyelinating diseases. Materials and Methods: A cross-sectional study was conducted among 64 patients with multiple sclerosis and 33 patients with NMO treated at the Third State Central Hospital. We assessed demographic and clinical data, including the Expanded Disability Status Scale (EDSS). Statistical analysis included descriptive statistics, t-tests, chi-square tests, analysis of variance, correlation, and regression. Result: In MS, relapses (≥1) within 1.0 years of MS onset (OR=5.5, 95% CI 1.11-26.69, p=0.037), optic neuritis (OR=4.3, 95% CI 1.02-21.67, p=0.014), relapse frequency (≥3) (OR=6.6, 95% CI 1.39-31.3, p=0.018), myelitis frequency (≥2) (OR=5.5, 95% CI 1.42-21.67, p=0.014), in NMOSD, time from disease onset to diagnosis (≥3 month) (OR=7.9, 95% CI 1.04-60.7, p=0.046), years of diagnosis (≥3 years) (OR=6.3, 95% CI 1.15-34.12, p=0.034) contributed to disabilty worsening outcomes. Conclusion Disability in demyelinating diseases is affected by many factors.

Background: Simultaneous multiple intracerebral haemorrhages (SMICH) is hemorrhage in different arterial territories and are a rare clinical entity. The primary cause of single ICH is hypertension; however, the causes and risk factors of simultaneous multiple ICH are still unknown. Aim: To clarify the aetiology, risk factors and functional outcome of SMICH compared with solitary intracerebral haemorrhages (ICH). Materials and Methods: A total of 718 consecutive patients with spontaneous ICH admitted to our hospital were prospectively studied. Nine SMICH cases were identified, and 19 risk factors, clinical and neuroimaging variables were compared between SMICH and solitary ICH cases using the unpaired t-test, chi-square test, and multiple logistic regression. Result: 709 (98.75%) patients with ICH and 9 (1.25%) patients with SMICH were enrolled in the study. The age, sex distribution, and other associated risk factors were comparable between the groups (all P>0.05). By SMASH-U classification, arterial hypertension was identified in 6 (66.7%), and it was the most common cause in the SMICH group. Bilateral thalamic or putamenal haemorrhages (33.3% versus 33.3%) were the most common combinations of simultaneous bleedings. Age and NIHSS at admission were associated with 90-day mortality in multivariable analyses (OR 1.018; 95% CI, 1.000-1.036; p=0.044; versus OR 1.080; 95% CI, 1.029-1.135; p=0.002), but GCS was not (OR 0.834; 95% CI, 0.734-0.948; p=0.006). Conclusion Patients with SMICH have risk factors and clinical characteristics similar to those of patients with solitary ICH, but they have a much poorer outcome.

Background: Multiple sclerosis (MS) is an autoimmune inflammatory neurodegenerative disease of the central nervous system and a major cause of disability in young adults. MRI is essential for diagnosis and monitoring, while early evaluation of structural brain changes is important. Aim: To evaluate brain volumetric changes using automated MRI analysis in patients with MS. Materials and Methods: This case–control study included 50 MS case patients and 50 controls patients examined between 2020–2023 at the Third State Hospital. T1-MPRAGE images were analyzed using volBrain automated segmentation software. Result: The mean age of MS patients was 45.5±11.8 years. Compared with healthy controls, the MS group showed significantly lower total grey matter volume (p=0.002), cortical grey matter volume (p<0.001), subcortical grey matter volume (p=0.006), and cerebral volume (p=0.02). Significant volume reductions were also observed in the temporal (p=0.006) and occipital (p<0.001) lobes. Deep grey matter structures, including the thalamus (p=0.001), caudate nucleus (p=0.009), putamen (p=0.008), and nucleus accumbens (p<0.001), also showed significantly reduced volumes. Disease duration was negatively correlated with total grey matter volume (r=−0.30, p=0.02), thalamic volume (r=−0.28, p=0.04), and occipital lobe volume (r=−0.43, p=0.002). Disease duration was also significantly associated with spinal cord involvement (p=0.01) and grey matter volume (p=0.04). The number of relapses was negatively correlated with total brain volume (r=−0.28, p=0.046). Conclusion Patients with MS demonstrated decreased grey matter volume, particularly within deep grey matter structures, along with increased abnormal white matter volume, suggesting the coexistence of neurodegeneration and demyelination in MS. Brain volume loss in MS appeared to occur independently of aging. Automated quantitative MRI analysis may provide important diagnostic value in detecting structural brain changes associated with MS.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with cognitive impairment and structural brain alterations. White matter hyperintensities (WMH) detected on magnetic resonance imaging (MRI) serve as critical neuroimaging markers of cerebral small vessel disease. However, research evaluating the WMH burden in the Mongolian population with T2DM using AI-based automated quantitative methods and comparing these findings with a control group remains limited. This research gap provides the rationale and necessity for the current study. Aim: To evaluate and compare the burden of brain white matter hyperintensities (WMH) in adults with type 2 diabetes mellitus (T2DM) versus a control group. Material and Methods: This analytical cross-sectional, retrospective comparative study included participants aged 40 and older who underwent brain MRI at the Mongolia-Japan Hospital of MNUMS between 2019 and 2025. The T2DM group consisted of patients with a confirmed diagnosis, while the control group included individuals without diabetes or prediabetes. After excluding cases with major structural abnormalities, poor image quality, failed automated processing, or incomplete clinical data, 257 out of an initial 283 participants were included in the final analysis (T2DM: 71, Control: 186). 3D T1-weighted MPRAGE and T2-FLAIR MRI sequences were processed using Neurophet AQUA software (version 3.1) to assess total, deep, and periventricular Fazekas scores. Age- and sex-adjusted ordinal logistic regression analysis was performed using SPSS 25.0, with p<0.05 considered statistically significant. Results: A total of 257 participants (T2DM=71, Control=186) were analyzed. There were significant differences between groups in sex distribution (p=0.046) and age categories (p<0.001). The T2DM group exhibited significantly higher total and deep Fazekas scores compared to the control group (total Fazekas: aOR 10.81, 95% CI 5.20-22.49; deep Fazekas: aOR 8.21, 95% CI 4.32-15.60; both p<0.001). Increasing age was associated with higher total (aOR 1.07, 95% CI 1.03-1.11, p=0.001) and deep (aOR 1.04, 95% CI 1.00-1.08, p=0.037) Fazekas scores. Additionally, female sex was associated with higher total (aOR 1.95, 95% CI 1.04–3.63, p=0.036) and deep (aOR 1.95, 95% CI 1.08–3.51, p=0.026) Fazekas score categories. Conclusion Assessment of WMH burden using AI-based automated quantitative MRI processing revealed that T2DM is significantly associated with higher total and deep Fazekas scores. This association remained significant after adjusting for age and sex. These findings suggest that AI-based MRI processing is a suitable method for the objective, quantitative, and standardized assessment of brain WMH burden associated with T2DM.

Background: The human head is an integrated biological structure composed of the brain, cranial bones, facial structures, neuromuscular systems, and sensory organs, all interconnected through coordinated signaling. The relationship between brain development, function, and craniofacial growth is most evident after birth, during which the head increases approximately fourfold in size before adulthood. Brain morphology and volume are associated not only with neurological disorders but also with cognitive and behavioral characteristics. For example, children with holoprosencephaly often present with varying degrees of facial anomalies, while studies have shown that adolescents with malocclusion exhibit higher levels of anxiety, depression, and psychological stress. With the increasing availability of magnetic resonance imaging (MRI), it has become an essential diagnostic tool in clinical practice. MRI is particularly advantageous in pediatric populations due to the absence of ionizing radiation and its superior soft tissue contrast. Recent advances in image processing techniques have enabled comprehensive analysis of both brain structures and craniofacial morphology from a single MRI dataset, forming the basis of this study. Aim: To investigate the relationship between brain tissue volumes and maxillary hypoplasia using MRI-based voxelbased morphometry in children with neurological conditions. Materials and Methods: This study was conducted at the School of Biomedicine, Mongolian National University of Medical Sciences, in collaboration with Chifeng University, as part of the project titled “Investigation of the relationship between craniofacial anomalies and brain disorders using MRI”, funded by the Ministry of Education and Science. Voxel-based morphometry (VBM) analysis was performed on brain MRI scans of children aged 9–11 years. Results: Among the 25 children included in the study, 17 (68%) were male. The youngest average age was observed in the maxillary hypoplasia group (8.4±0.95 years). The signal-to-noise ratio (SNR) of MRI was lowest in the non-temporal epilepsy group (41.1±1.35) and higher in the maxillary hypoplasia group (49.6±8.22). Both epilepsy and maxillary hypoplasia groups demonstrated physiological asymmetry of the cerebral hemispheres, with left parietal lobe dominance (−0.1% and −0.3 cm, respectively). Right frontal lobe dominance (+1.1%) was observed only in the epilepsy group. Conclusion Children aged 9–11 years with maxillary hypoplasia showed a reduction in both gray and white matter volumes of the brain. These findings highlight the importance of early diagnosis of neurodevelopmental disorders affecting odontogenesis and emphasize the need for a multidisciplinary team-based management approach.

Background: Multidrug-induced long QT syndrome is a serious heart rhythm disorder where multiple medications prolong the QT interval on an electrocardiogram, increasing the risk of a potentially fatal arrhythmia. Long QT syndrome is characterised by heart rate corrected QT interval prolongation and life-threatening arrhythmias, such as polymorphic ventricular tachycardia, Torsades de pointes leading to syncope and sudden death. Case: 21-year-old woman required resuscitation from an apparent cardiac arrest that had occurred after status epilepticus. The woman was diagnosed with long QT syndrome, cardiac channelopathy. She had a long history of syncope, seizure and palpitations. Family history was non-contributory. Home medications included levetiracetam 500 milligrams orally twice and fluoxetine 20 milligrams orally once a day which the patient reported non-compliance with. Levetiracetam is a widely used anti-epileptic medication secondary to its favorable safety profile. To our knowledge, there are few other case reports documenting torsades de pointes after levetiracetam administration, and specifically our case report will be the first documenting cardiac arrest after multidrug administration. Long QT syndrome is not often included in the differential diagnosis of epileptic and non-epileptic seizures. Early recognition of the syndrome is very important because of prognostic and therapeutic consequences. Conclusion Although no hereditary cause was confirmed, this case represents Torsades de Pointes triggered by multiple medications—including long-term low-dose carbamazepine, fluoxetine, diazepam, and high-dose levetiracetam—on a background of probable Romano–Ward syndrome or predisposition to QT prolongation. The arrhythmia progressed to cardiac arrest, requiring ICD implantation.

: In enterohepatic recycling, foreign chemicals entering the alimentary tract and gut normal micro flora (<b>ShagjJambal., 1989b>) are absorbed into portal venous blood by enterocytes, removed from blood by uptake into hepatocytes, secreted into the bile, and then deposited back into the intestinal lumen where they may be reabsorbed by intestinal wall cells and available for recycling (compartment model modified by <b>Wang and Reuningb>). This process is called enterohepatic circulation or enterohepatic recycling (<b>Rollins and Klaasen, 1979b>). Some studies have attempted to interrupt the enterohepatic recycling of toxicants such as pesticides and heavy metals and 56 carbon tetrachloride (<b>CCl₄b>). Plant Material The plant Gentiana macrophylla pall. Was collected during july 2017 from the forest region Galt sum, Khuvsgul aimakh, Mongolian. The taxonomical identification of the plant was done by Botanical survey of Ganbold E. (ScD) Mongolian university subsidiary of Ulanbator institute, Ulanbator. The study was based on the New medicine medical university bio-model, pharmacology laboratory and laboratory. ELISA-biochemistry laboratory. Animals: Male C57BL/6 (miceweight 18-22g (n=40)) were obtained from the Mongolian national university of Medical sciences animal house. Experimental procuders were conducted in accordance with the regulations of Animal Ethical committee. Myeloperoxidase (<b>MPOb>) activity was measured according to the technique described by <b>Krawisz et al. (1984) b>. Assay for lipid peroxides in animal tissues by thiobarbituric acid Reaction (<b>Yagi, K. and Ohkova.,1979b>). A significant decrease (P<0.005) in the MDA was observed in the <b>Gentiana macrophyllab>(GM) treated group (0.340±0.031)when compared with the control group (0.521±0.023). Conclusion The results of the study show that Gentiana macrophylla is inhibition of lipid peroxidation, protection of liver cell. From the protonation compounds generate polyphenol compound with rich hydroxyl and alkaloid. These compounds help to lipid peroxidation or antioxidation and membrane protection.The results of the study show that Gentiana macrophylla is inhibition off oxidation ferric molecule in vitro reaction and detoxification of reactive oxygen species release from damaged liver cell by CCL₄.

BACKGROUND. Since the implementation of Pre-medical curriculum the first students have successfully finished their courses. However, formative and summative evaluation of the curriculum hasn’t been done. The purpose of this study is to analyze the correlation between satisfaction level and knowledge acquisition of the students. MATERIAL AND METHODS. The study was completed at School of Bio-medicine of MNUMS and Division of Education and Policy. We have studied correlation of grade point average (GPA), integrated final exam score, and general admission test/entrance examination test scores (Chemistry and Biology test scores) of total of 395 students’. RESULTS. A total of 395 students’ 4 types of test scores have been used in this study. Out of 395 students, 68 (17%) male, 327 (83%) female and 317 (80%) medical and 78 (20%) health sciences pre-medical students. Results have shown that, both general admission test score and university pre-medical GPA had a direct, average line correlation. In other words, students who have had a higher general admission test score; have scored higher GPA scores at university. The comparison of GPA with the integrated final exam score has shown a direct, average line correlation, which proves the validity of the GPA.The highest factor among was the teacher methodology skills scoring 4.0. The lowest factor was teaching facilities and student lesson load scoring 3.7. CONCLUSION. The satisfaction level is higher the average. The student GPA, general admission test score, both have a direct or average line correlation.

Introduction: Orthopedic surgery is a highrisk of surgical formation of thromboemboliccomplications.Many researchers are exploringprevent surgical complications.Anticoagulanttreatment is the first choice to preventthromboembolic complications.Artificial jointreplacement surgery has been made in 2008,in National First Central Hospitals (NFCH).Wehave not guideline of anticoagulant treatmentafter surgery and have not principle of choisefollow-drug treatment and unclear testingschedule to monitor anticoagulant treatment,that has become the basis for this study. Westudied by comparing a comparative benefitfor anticoagulant treatment of unfractionatedand low molecular weight heparin results.And studied thromboembolic complications,monitoring test of anticoagulant treatment,fatal bleeding, changes hemostasis ofanticoagulant therapy in both groups. Thesurvey results in practice is doing researchaims to introduce and review the results of thelong-term results.Materials and Methods: Included in thesurvey about 1,400 patients, who had kneeand hip replacement surgery in 2008-2016, inJoint Center of NFCH. All patients are dividedin three group. The first group is control group,do not use anticoagulation treatment, in thesecond group used unfractionated heparin andin the third group used low-molecular-weightheparin.Each group studied comparativewhether thromboembolic complications anddeath caused by thromboembolic, fatalbleeding.Between surgical complication andanticoagulant therapy relationship to investigatethe relationship the correlation is likely trueof 95%. Caused by other thromboemboliccomplications detected cases were removedfrom the study.Results: Control groups has not hospitalmortality, but has 3 cases of sudden death ina after discharge.Hemostasis is longer (INR1,3-1,5) in the second group. There hospitalmortality occurred in 1 (cardiac infarction),and thromboembolic complications 1 (arterialthrombosis in the jugular) in the third group.Low molecular weight heparin are no changeshemostasis, it is strongly dependent (r=0,8).Also in this group there is no fatal bleeding.Conclusions: Orthopedic surgery isnecessary for prevention of thromboemboliccomplications are showing from in controlgroup has sudden death.2 groups have not fatalbleeding when used heparin in normal doses.Other countries researchers conclude lowmolecular-weight-heparin is more effectivethan unfractionated heparin, our study is notvisible correlation reliability.When used lowmolecularweight heparin, hemostasis is notchanged is showing a strong dependence.

Introduction: We performed more than1200 arthroplasty surgeries at National FirstCentral Hospitalfrom 2008, so we haveour surgical technique and experiences.Thepurpose of this study is to assess our surgicalresults and complications after surgery forfemoral neck fracture made in Joint Center,National First Central Hospital, and tocomparingsimilar studies in other countries,and to develop the best optionsurgicaltherapy.Materials and Methods: Between 2008-2015, hip replacement surgery accountedatotal of 168 cases, that was 13.9% allof replacement surgery. A retrospectiveanalysis of patient database based onhospital discharge data and medical recordswas performed. The medical records ofthese patients were reviewed to confirmthe presence of a surgical site infection asdescribed by the Centers for Disease Control(CDC)/NNIS guidelines.Results: Between 2008-2015, in theJoint Center,National First Central Hospital,are seeing increasing number of patientswith hip replacement surgery each year.The cause for hip replacement surgery isaseptic necrosis (42%), at second is femoralneck fractures (22%). Joint Center,NationalFirst Central Hospital currently not providedemergency trauma care center. Therefore,younger patient with femoral neck fracturewas not to happen duringresearch. Olderthan 60 year patients with osteoporosis and,in some cases with nonunion, was doneforhip replacement surgery. The averageage of 75.7 (61-87).Bipolar hip arthroplastywas 14 cases all of 36 patients with femoralneck fracture.9 (5,31%), complications ariseall of hip replacement surgery (168 cases).Including: Infection - 1 (0.59%), sliding - 1(0.59%), dislocation - 2 (1.78%), fracture- 2 (1,18%), nerve injury - 2 (1,18%) andpostoperative mortality - 1 (0.59%).Conclusion: Internal Fixation- for patientage under 60 andgood bone quality. Thatoperation complication is femoral headnecrosis, not healing /nonunion/ delivery ofa lot of research that shows focus. Further,most surgery for femoral neck fracture is hipreplacement that is expected to be widelyavailable.