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: Simulation-based education has become an effective and widely used modern teaching method in health professional education. This approach allows students to apply theoretical knowledge into practice and develop essential skills such as clinical assessment, clinical decision-making, and teamwork in a safe and controlled learning environment. In recent years, international studies have demonstrated that simulation-based training improves students’ clinical skills, confidence, communication abilities, and professional attitudes. However, evidence regarding the effectiveness of simulation-based training remains limited in certain educational settings, particularly in developing countries. Therefore, evaluating the effectiveness of simulation-based training within local educational contexts is necessary. Aim: To evaluate the effectiveness of simulation-based training on students’ knowledge, clinical skills, and professional attitudes. Materials and Methods: This study included 45 third-year medical students from four classes at the Mongolian National University of Medical Sciences using a random sampling method. Participants were divided into two groups according to the training modality: a simulation-based training group (n=20) and a traditional learning control group (n=25). Knowledge was assessed before and after training using an 18-item test covering asthma etiology, pathophysiology, clinical features, diagnosis, and treatment. After the training session, students’ knowledge, clinical skills, and professional attitudes were evaluated using a 21item Likert-scale questionnaire and small-group discussions to identify factors influencing learning outcomes. The reliability of the questionnaire was evaluated using Cronbach’s alpha, which demonstrated high internal consistency (α=0.90). Statistical analysis was performed using SPSS software. Paired samples t-tests were used to compare pre- and post-training knowledge within groups, while independent samples t-tests were used to compare post-training outcomes between groups. Result: After training, mean knowledge scores significantly improved among all participants (pre-training: 9.18±2.33; post-training: 10.47±2.31; p<0.001). In the simulation group, knowledge scores increased from 7.65±2.01 to 9.05±2.46, while in the control group, scores increased from 10.40±1.80 to 11.60±1.41 (p=0.007). Post-training comparisons showed that the simulation group demonstrated higher mean scores in knowledge (36.70±3.73 vs 34.44±4.77) and clinical skills (11.35±1.69 vs 10.92±1.75) than the control group; however, these differences were not statistically significant (p>0.05). Professional attitude scores were significantly higher in the simulation group compared with the control group (43.35±3.60 vs 40.64±4.51, p=0.034). Conclusion Simulation-based training demonstrated positive effects on students’ knowledge and clinical skills and significantly improved professional attitudes. Integrating simulation-based training with traditional teaching methods may serve as an effective educational strategy to enhance the quality of clinical education.

Background: Currently, colorectal cancer (CRC) ranks as the third most common cancer and the second leading cause of cancer-related mortality worldwide. CRC frequently metastasizes to the liver (50%), lungs (10–15%), peritoneum (4%), bones (10.7%–23.7%), brain (0.3%–6%), and spinal cord. Approximately 35% of CRC cases are diagnosed before distant metastasis, 36% upon lymph node involvement, and 23% after distant organ metastasis. Although several studies have established primary tumor models in mice in our country, there are limited studies on experimental lung metastasis models, prompting the need for this research. Aim: To establish and evaluate a lung metastasis model of colorectal cancer in C57BL/6J mice using the MC38 cell line. Materials and Methods: This study was conducted at the Institute of Biomedical Sciences, Mongolian National University of Medical Sciences. Approval was obtained from the Ethics Review Board of the Mongolian National University of Medical Sciences (2023/3-09) and all laboratory safety regulations and protocols were strictly followed. Male C57BL/6J mice bred at the Experimental Animal Center of Mongolian National University of Medical Sciences were used. MC38 murine colorectal carcinoma cells were cultured and injected intravenously (via the tail vein) at a concentration of 0.25×10⁶ cells per mouse (n=12) to induce lung metastasis. Histological analysis was subsequently performed. Results: Histological examination revealed significant alterations in lung tissue architecture, characterized by areas of dense infiltration by pleomorphic, hyperchromatic cells, disrupting the normal alveolar structure. No histological abnormalities were observed in other organs. Conclusion Intravenous injection of MC38 colorectal adenocarcinoma cells into the tail vein of C57BL/6J mice successfully induced lung metastases, characterized by hyperchromatic, pleomorphic cell infiltrates forming glandular structures within the lung parenchyma.

Background: As global life expectancy increases, spinal disorders and the need for spinal surgery among elderly individ uals are becoming more prevalent. Postoperative cognitive decline (POCD) is a common complication in this population, adversely affecting functional recovery and quality of life. Despite substantial research, effective preventive strategies for POCD remain limited. Aim: To determine the incidence of POCD and to identify perioperative risk factors associated with its development in elderly patients undergoing spinal surgery. Materials and Methods: A prospective cohort study was conducted at the Second Affiliated Hospital of Inner Mongolia Medical University. Of 200 elderly patients who underwent spinal surgery between, 122 met the inclusion criteria and were enrolled. Preoperative clinical assessments, intraoperative surgical and anesthetic parameters, and postoperative evaluations were systematically collected. Cognitive function was assessed using standardized and validated tools both before and after surgery. Multivariate logistic regression analyses were performed to identify independent predictors of POCD. Results: POCD was observed in a notable proportion of patients postoperatively. Multivariate analysis revealed that prolonged surgical duration (OR=0.989; p=0.005), intraoperative hypotension (OR=0.964; p=0.009), higher intensity of postoperative pain (OR=10.073; p=0.015), and elevated postoperative C-reactive protein levels (OR=1.039; p<0.001) were significantly associated with an increased risk of developing POCD. Conclusion In elderly patients undergoing spinal surgery severe postoperative pain, and systemic inflammatory respons es contribute significantly to the development of POCD. Optimizing perioperative management, including minimizing surgical time, maintaining stable hemodynamics, and controlling postoperative inflammation and pain, may mitigate the risk of cognitive decline.

Background: In recent years, work-life balance has become a pressing issue for healthcare workers in many developing countries around the world. An imbalance between work and personal life leads to psychological stress, health problems, loss of self-confidence, job dissatisfaction, and decreased work productivity due to an inability to concentrate. It also results in a decline in the quality of treatment and services. Furthermore, it increases the risk of medical errors and contributes to both physical and mental burnout, ultimately leading to resignation. Aim: The study analyzed the work-life balance and turnover intentions of employees at family health centers. Materials and Methods: The study was conducted using a cross-sectional model and a quantitative survey method. The work-life balance of employees at Family Health Centers was examined using the work-life balance assessment question naire developed by Hayman (2005), and turnover intentions were assessed using the standard questionnaire developed by Auerbach et al. (2014). The research was carried out in 2024. The study included 123 employees from 22 Family Health Centers located in the Bayangol, Bayanzurkh, Sukhbaatar, Songinokhairkhan, Khan-Uul, and Chingeltei districts of Ulaanbaatar. Results: Of the participants, 95.1% were female, with an average age of 35.2±9.5. Among them, 55.3% were doctors, 29.3% were nurses, 9.8% were health social workers, and 5.7% were other non-medical staff. The income of Family Health Center employees was found to be insufficient; 8.9% had incomes below the minimum subsistence level, and their ability to meet basic household needs was very limited. The results show that participants’ work negatively impacted their personal life (WIPL–23.5), and personal life negatively affected their work (PLIW–15), both of which scored high. Meanwhile, the positive interaction between work and personal life (WPLE–10.7) was low, indicating a disruption in their work-life balance. Working overtime was statistically significant in relation to work-life imbalance (p=0.038). As age and years worked at the current organization increased, the negative impact of work on personal life and personal life on work tended to decrease. Conclusion The work-life balance of Family Health Center employees has been disrupted. The level of work negatively affecting personal life and personal life negatively affecting work is high. 65% of Family Health Center employees are considering leaving their current organization, and 41% are considering leaving the healthcare field.

Backround: The university period is a unique phase in students’ lives, often marked by independent living, changes in lifestyle, diet, sleep patterns, increased psychological stress, and the development of unhealthy behaviors. Among students, particularly those studying in the medical field, research on dietary habits and influencing factors is scarce in our country, which serves as the rationale for this study. Aim: The aim of this study is to investigate the dietary habits of medical students and the factors influencing them, including sleep, impulsivity, depression, anxiety, and stress. Materials and Methods: A cross-sectional study was conducted among 358 students from years 1 to 6 across 7 schools of the Mongolian National University of Medical Sciences (MNUMS). Data were collected using internationally standardized and validated questionnaires, including the Three-Factor Eating Questionnaire Revised-18 (TFEQ-R18), the Short UPPS-P Impulsive Behavior Scale-20 (SUPPS-P-20), the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI). Statistical analysis was performed using SPSS 25.0. Results: In terms of eating behavior, uncontrolled eating (UE) and cognitive restraint (CR) were similar between male and female students, while emotional eating (EE) was more prevalent among male students. Students’ eating behaviors were associated with body mass index (BMI). As BMI increased, levels of depression, anxiety, and stress also tended to rise. Sensation-seeking and positive urgency were higher among female students. Overall, 83.5% of students had poor sleep quality, which contributed to increased depression, anxiety, stress, and impulsivity. Psychological burden and impulsivity were independent of the field of study but decreased as students progressed through their academic years, while sleep quality improved. Conclusion The dietary habits of medical students were similar across genders but varied by academic year and field of study. Poor sleep quality, observed in 83.5% of students, was associated with increased depression, anxiety, stress, and impulsivity. Psychological burden and impulsivity were unrelated to the field of study but decreased with advancing academic years, alongside improved sleep quality. As BMI increased, cognitive restraint in eating behaviors decreased.

Background: There are 240 million children with disabilities worldwide, of whom 34 million have hearing and speech impairments; in Mongolia, 1,538 children are affected.¹, ³ Due to barriers in health care, education, employment, social services, and living environments, people with disabilities face limited opportunities to fully participate in social life. In addition to encountering greater obstacles, households with members with disabilities experience poverty levels twice as high as those without.⁴ While studies on children with disabilities in Mongolia have addressed issues related to education, health, and access to social services, little research has been conducted on family quality of life and the factors influencing it. Aim: This study aims to assess the quality of life of families with children who have hearing and speech impairments and to identify factors that influence it. Materials and Methods: The quality of life of families with children who have hearing and speech impairments was assessed using a standardized questionnaire developed by researchers at the University of Kansas, United States, which examines five core domains of family quality of life. A total of 120 parents and caregivers of children aged 0–18 years with hearing and speech impairments were included in the study Results: The mean family quality of life score among families of children with hearing and speech impairments was 3.79±0.61. Among the subdomains, the highest scores were reported for parental role (3.94) and family interactions (3.92), while emotional well-being received the lowest score (3.57). Factors influencing family quality of life included the presence of comorbid disabilities in the child, the caregiver’s self-rated health, stress level, family size, and adequacy of household income. Conclusion The quality of life of families raising children with hearing and speech impairments was found to be generally good. Factors influencing family quality of life included the type of child’s disability, caregiver’s age, health status, stress level, family size, and adequacy of household income.

Background: According to the World Health Organization (WHO), the shortage of human resources in the healthcare sector has shown a growing trend year by year. Notably, there is a significant shortage, inadequate distribution, and high turnover of licensed professionals, influenced by various factors. Aim: This study aimed to examine healthcare workers’ turnover intentions and the influencing factors in referral healthcare organizations in Ulaanbaatar city. Materials and Methods: The study employed a cross-sectional study using quantitative research methods was conducted during 2024–2025. A total of 150 healthcare workers from central hospitals, maternity hospitals, and district health centers participated. The standardized questionnaire developed by Auerbach et al. (2013) was used to assess turnover intention. Data were analyzed using SPSS 26.0 software. Results: Of the participants, 38% were from central hospitals, 33.3% from maternity hospitals, and 28.6% from district health centers. The majority (85.3%) were female. In terms of profession, 44.6% were doctors, 34.6% nurses, and 20.6% comprised paramedics, public health specialists, laboratory physicians, pharmacists, and midwives. Regarding retention, 78% of participants intended to continue working in the healthcare sector until retirement, while 35.3% expressed an intention to leave in the near future. Statistically significant differences in turnover intention were observed by age and profession. Younger employees demonstrated a higher intention to leave, whereas middle-aged employees with longer work experience showed greater stability within the healthcare sector. Additionally, 76% of participants emphasized salary and incentives, 68% workplace atmosphere, and 73.3% opportunities for career advancement as key factors influencing job retention. Conclusion The study revealed that one in five healthcare workers intends to leave the healthcare sector, while one in four is considering leaving their current organization. Turnover intention varied significantly by age and profession.

Background: Vitamins are nutrients essential for human health. They act as coenzymes that help trigger important chemical reactions necessary for energy production. Reference values for vitamins help physicians evaluate the health status of patients and make clinical decisions. The aim of this study was to determine the mean values and reference intervals for some water-soluble vitamins of Mongolian adults. Materials and Methods: Three hundred and forty healthy adults (170 males and 170 females) of 17 to 69 years of age were selected for the study based on CLSI C28-P3 criteria Defining, establishing & Verifying reference interval in the clinical laboratory; Proposed Guidelines. The study was approved by the Resolution No.76 of 2018 of the Medical Ethics Review Committee of the Ministry of Health. Informed consents were taken from the selected individuals. Morning blood samples of the participants were collected under aseptic conditions. Levels of vitamins B₆, B₉, B₁₂ and vitamin C were measured using a high performance liquid chromatography method. The lower- and upper reference limits were defined as the 2.5th and 97.5th percentiles, respectively. The data were analyzed using SPSS and Excel programs. Results: The mean blood level of vitamin C was 11.88 mg/L (95% CI 10.47-13.29) for men and 9.62 mg/L (95% CI 8.11-11.13) for women. The calculated reference interval for males was 1.40-19.40 mg/L and 1.17-18.04 mg/L for females. The mean concentration of vitamin B₁₂ in the blood of males was 938.45 ng/L (95% CI 747.22-1129.68) and that of females was 864.03 ng/L (95% CI 603.81-1124.25). The reference interval for vitamin B₁₂ was 233.03-1597.00 ng/L in men and 132.45-1623.86 ng/L in women. The mean level of vitamin B₉ was 8.47 ng/mL (95% CI 5.64-11.30) for men and 6.91 ng/mL (95% CI 4.89-8.93) for women. The calculated reference interval for this vitamin in males was 1.04-24.74 ng/mL and that in females was 1.04-21.46 ng/mL. As for vitamin B₆, the mean concentration for men was 44.42 ng/mL (95% CI 37.01-51.83) and for women was 34.67 ng/mL (95% CI 29.97-39.39) with the reference intervals of 5.90-79.02 ng/mL for men and 5.27-61.72 ng/mL for women. Conclusion The reference values for vitamins B₆, B₉, B₁₂ and vitamin C of Mongolian adults do not differ significantly from those observed in other populations. The calculated reference intervals can be used in the practice of health laboratories.

Background: Soil pollution in Ulaanbaatar has increased in recent years, causing infectious and non-communicable diseases, both benign and malignant.
Therefore, in order to reduce soil pollution, it is necessary to isolate strains resistant to heavy metals and use these microorganisms capable to degrade or accumulate heavy metals for bioremediation purposes. Methods: Bacterial pure cultures were isolated from soil and water samples and incubated in a Nutrient Broth medium with a lead concentration of 1000 mg/L in a thermostat with a shaker at 37°C. The growth rate was determined at a wavelength of 600 nm using a Spectrophotometer. Results: In total 69 pure cultures were isolated from the soil samples and 65 pure cultures from them were able to grow at the concentration of lead of 1 mmol/L. 4 pure cultures (UBLF1, UBLF3, UBMF2, and SUBZ4) were able tolerate lead concentrations up to 8 mM. These cultures were determined by semi-automatic VITEK®2 analyzers and identified as Bacillus sp. (83%) and UBMF2 identified as Bacillus thuringiensis (93%) respectively. Conclusion The lead content in water samples were found to be acceptable, and isolated pure cultures were not able to withstand the lead concentrations.
Pure culture UBLF3 isolated from the soil capable to reduce lead concentration (500 mg/L) up to 302 mg/L and 230 mg/L in the medium, and pure culture UBMF2 up to 340 mg/L and 279 mg/L respectively