Background: Ear, nose, and throat (ENT) inflammatory diseases are common conditions that account for a high proportion of healthcare visits. These diseases negatively affect patient’s quality of life, reduce work and learning capacity, and increase healthcare costs. Antibiotics play a crucial role in treatment; however, inappropriate use contributes to the emergence and spread of antimicrobial resistance among pathogenic bacteria. In Mongolia, particularly in Darkhan-Uul Province, data on bacterial pathogens and their antimicrobial susceptibility patterns in ENT infections are limited. Therefore, evaluating the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and antimicrobial resistance is essential for guiding clinical practice and promoting rational antibiotic use. Aim: To assess the bacterial pathogens and their antimicrobial susceptibility patterns in inflammatory diseases of ear, nose and throat. Materials and Methods: The study was conducted at the School of Biomedicine, Mongolian National University of Medical Sciences, in collaboration with the Department of Pharmacology and the “Bid” Hospital of Darkhan-Uul Province. Data from ear, nose, and throat swab examinations of patients suspected of having ENT infections in the outpatient department between January 2024 and February 2025 were extracted from the hospital’s centralized database (n=185). Based on the inclusion and exclusion criteria, information from 145 patients was analyzed. The study was designed as a facility-based, retrospective, cross-sectional observational study and was carried out using SPSS - 26.0. Result: A total of 145 patients aged 1-73 years were included in the study, of whom 48.2% (n=70) were male and 51.7% (n=75) were female. Overall, 145 clinical specimens were collected, including nasal swabs 36 (24.8%), throat swabs 56 (38.6%), and ear swabs 53 (36.6%). Bacteriological examination revealed pathogenic microorganisms in 80.7% (n=117) of the specimens. S.aureus was isolated from 65.5% of nasal swabs, 53.6% of throat swabs, and 67.4% of ear swabs. Among S. aureus isolates from ear swabs, 27.6% (n=8) were identified as methicillin-resistant Staphylococcus aureus (MRSA). Antimicrobial susceptibility testing showed that S. aureus isolates from nasal swabs were resistant to amoxicillin (100%), ampicillin (90.0%), erythromycin (87.5%), and azithromycin (81.8%), while they were susceptible to cefazolin (72.7%), doxycycline (80.0%), and vancomycin (75.0%). S. aureus isolates from throat swabs demonstrated resistance to amoxicillin (100%), ampicillin (100%), chloramphenicol (87.5%), and azithromycin (75.0%), but were susceptible to ciprofloxacin (69.2%) and vancomycin (66.7%). S. aureus isolates from ear swabs were resistant to gentamicin (77.8%), clarithromycin (71.4%), azithromycin (66.7%), and penicillin G (66.7%), while higher susceptibility was observed to nitrofurantoin (87.5%), vancomycin (68.8%), and ciprofloxacin (64.7%). For Streptococcus spp, resistance was observed to erythromycin (84.6%), amoxicillin (76.9%), and chloramphenicol (71.4%), whereas susceptibility was noted to amoxiclav (54.6%), cefazolin (63.2%), and cefotaxime (50.0%). Conclusion 1. Staphylococcus aureus predominated in samples from ear, nose, and throat infections, confirming it as the main causative bacterium of these conditions. 2. The predominantly isolated Staphylococcus aureus showed high resistance to antibiotics from the penicillin, macrolide, and aminoglycoside groups.

Background: Health insurance systems are a core component of social protection, aimed at safeguarding populations from financial risks, ensuring equitable access to health care services, and ultimately achieving universal health coverage. In recent years, Mongolia’s health insurance system has faced significant policy-level challenges related to efficiency, accessibility, and financial sustainability. Therefore, there is a growing need to conduct comparative analyses of internationally successful health insurance models. Aim: To comparatively examine Mongolia’s health insurance system in relation to the health insurance systems of selected countries. Materials and Methods: A comparative document review methodology was employed to analyze the health insurance and health financing systems of Canada, Germany, Japan, the Republic of Korea, and Kyrgyzstan. The analysis was based on policy documents, legal and regulatory frameworks, reports from international organizations, and relevant statistical data. Result: In countries such as Canada, Germany, Japan, and the Republic of Korea, health expenditure as a share of GDP exceeds the global average, while out-of-pocket payments by households remain relatively low. In contrast, Mongolia and Kyrgyzstan exhibit high levels of out-of-pocket expenditure, weaker financial protection, and comparatively lower performance indicators of the health system. Conclusion The findings suggest that increasing health expenditure as a share of GDP toward the global average, improving the management of health insurance funds, and reducing out-of-pocket payments by households are important considerations for enhancing the performance of Mongolia’s health system.

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.

Background: Bone mineral density (BMD) is a key indicator reflecting bone strength and resistance to fracture. It is influenced by multiple factors, including age, sex, genetic background, body composition, nutrition, and physical activity. During young adulthood, peak bone mass is actively formed; therefore, identifying early variations in this period is essential for predicting future skeletal health risks. Accordingly, assessing BMD and evaluating its relationship with physical characteristics among first-year nursing students provides a scientific rationale for this study. Aim: To examine the relationship between bone mineral density and selected physical parameters among students. Materials and Methods: A total of 297 first-year students aged 17-35 years from the School of Nursing, Mongolian National University of Medical Sciences were included. Bone mineral density was assessed by measuring the speed of sound through the radius using an ultrasound bone densitometry device. Handgrip strength was measured using an electronic dynamometer. Physical parameters including age, sex, height, and body weight were measured using standardized procedures, and statistical analysis was performed. The study was approved by the Research Ethics Committee of MNUMS on November 21, 2025 (No. 26/1) and March 28, 2026 (No. 26/03-B02), with no ethical violations identified. Results: According to T-scores, 37.1% (n=110) of participants had normal bone status and 62.9% (n=187) showed reduced bone density. Based on Z-scores, 52.5% (n=159) were normal, while 45.6% (n=138) had decreased values. T-score values were 1.87±0.69 (<20 years), 1.44±0.55 (20–30 years), and 1.10±0.31 (>30 years), while Z-score values were −0.73±1.38, −0.43±1.23, and −0.02±1.27, respectively. ANOVA analysis revealed statistically significant differences among age groups (p<0.01). A positive correlation was observed between T-score and age, whereas no significant correlations were found with other physical parameters. Z-score showed a positive correlation with handgrip strength. Conclusions 1. A high prevalence of reduced bone mineral density was observed among the students, which may be associated with incomplete attainment of peak bone mass in adolescents and young adults. 2. A significant difference in bone mineral density was found between age groups (p<0.01), indicating that age is an important factor influencing bone mineral density.

Background: Systemic lupus erythematosus (SLE) is an unknown systemic autoimmune disease that causes multiple tissue and organ damage. Lupus nephritis (LN) was found to occur in 15-30% of the patients with lupus at the time of initial diagnosis and in 30-50% during disease progression. Accurate diagnosis and active treatment can preserve the kidney function of LN patients and delay the process of kidney fibrosis, thus postponing the occurrence and development of end-stage kidney disease (ESRD). The diagnosis of LN is ideally confirmed by histologic findings in a kidney biopsy. Additionally, serum or urine biomarkers such as serum creatinine, urea, and immune-related molecules, such as anti-double-stranded DNA, anticardiolipin, complement components C3, C4, and anti-C1q antibodies. Aim: The information concerning non-invasive, easy, and accurate biomarkers for diagnosis of lupus nephritis. This study aimed to evaluate the diagnostic significance of cystatin C and complement component 1q antibody for lupus nephritis. Materials and Methods: A study that included 40 patients with systemic lupus erythematosus (SLE) without LN (non-Lupus group), 40 patients with lupus nephritis (Lupus group) was performed in a hospital based cross-sectional study from May 2022 to August 2024. The serum levels of CysC, Anti-C1q, urea, and creatinine were measured, and estimated glomerular filtration rates (eGFRCysC , eGFRcreat , eGFRcomb) were calculated by equations two groups and the CKD-EPI respectively. T-test analysis or Chi-square test was used to compare the differences between the two groups. The receiver operating characteristic (ROC) curve was applied to identify the diagnostic efficiencies of individual or combined multiple indicators. Results: 80 patients were recruited, including 5% men and 95% women with a mean age of 35.15±9.57 years (range 17-56 years). The LN group with a mean age of 35.2±9.44 years, non-LN group with a mean age of 35.1 ±9.38 years. The non-LN group clinical manifestation of 47.5% arthritis, 32.5% hematologic system, 10% interstitial lung disease, 7.5% dermatitis, 2.5% central nervous system. The LN group with SLE disease activity index of 85% severe activity, 2.5% moderate activity, 2.5% mild activity. The non-LN group with SLE disease activity index of 7.5% severe activity, 62.5% moderate activity, 20% mild activity, 10% low activity. Significantly elevated Cystatin C and anti-C1q were observed in the LN groups. Cystatin C, creatinine, urea and antiC1q were increased 60% (n=24), 22.5% (n=9), 32.5% (n=13), and 70% (n=28) respectively (P=0.001). eGFRcreat detected chronic kidney disease (CKD) stage of 63.7% normal, 25% mild, and 11.25% moderate stage. eGFRcyst detected chronic kidney disease (CKD) stage of 47.5% normal, 25% mild, 20% moderate, 7.5% severe stage. Conclusion The separately detected cystatin C(eGFRcyst) and antiC1q were superior to the conventional biomarkers Urea, Creat, and eGFRcreat in the diagnosis of lupus nephritis with SLE.

Background: Patients with rheumatoid arthritis are at increased risk of developing cardiovascular disease. In Mongolia, the registration of inflammatory diseases is increasing every year, and cardiovascular diseases are the leading cause of death. Aim: We aimed to determine the degree of cardiovascular risk and its correlation in people with rheumatoid arthritis. Materials and Methods: The study was conducted in a cross-sectional study design with 64 patients with rheumatoid arthritis between May and November 2024. Cardiovascular risk was assessed using mSCORE and the World Health Organization (WHO) cardiovascular Risk Table. We received ethical approval to begin the research at the MNUMS meeting on May 17, 2024 (No. 2024/3-05). Results: The average age of the participants was 55.2±9.7 years, and the average duration since being diagnosed with RA was 9.8±8.0 years. Among the participants, 82.8% (n=53) were female, and 17.2% (n=11) were male. The mean WHO risk index was 10.25±11, while the mean mSCORE risk index was 2.9±4 (p=0.001). There was a significant difference in mSCORE scores between the 40-55 and 56-65 age groups (p<0.001). In contrast, the mSCORE risk assessment showed that 15.6% (n=10) had high risk, and 6.3% (n=4) had very high risk. Among the parameters of inflammatory biomarkers, CRP (OR=0.05, r=0.35, 95% CI 0.9-3.2, p=0.004) has a statistically significant difference and positive correlation, and HDL-C (OR=2.3, r=-0.25, 95% CI 2.9- 10.0, p<0.0001) was significantly different and negatively correlated. Conclusion A total of 64 participants participated in our study, and according to the WHO assessment, 17.2% were at high or very high risk of developing cardiovascular disease in the next 10 years, and according to the mSCORE, 21.9% were at high or very high risk of developing cardiovascular disease. Although the degree of disease activity was not significantly associated with cardiovascular risk, the inflammatory biomarker C-reactive protein was statistically significantly different or positively associated with cardiovascular risk assessment.

Background: Gout is a chronic inflammatory joint disease that damages many joints. Monosodium urate-deposition accumulates in the joints and soft tissues due to long-term untreated condition and leading to loss of function, further reducing the quality of life. It is the most common inflammatory joint disease in the world. Hyperuricemia, sedentary lifestyle including diet, obesity, and the use of certain medications are risk factors for gout. A study published in the Asia Pacific Journal of Nutrition in 2018 found that excessive consumption of meat, alcohol, carbonated beverages, and fructose containing drinks increases serum uric acid levels and the risk of gout. Aim: To investigate certain risk factors associated with gout and asymptomatic hyperuricemia among study participants. Materials and Methods: This study was conducted using an analytical cross-sectional design. Data were coded, error- checked, and analyzed using the SPSS 29.0 software. Results: A total of 145 individuals participated in the study, with an average age of 55.0 ± 13.9 years, and 75.2% were male. Based on diagnostic criteria, 29.7% had gout, 35.2% had asymptomatic hyperuricemia, and 35.2% had normal uric acid levels. The consumption of different food products over the past month was analyzed among study groups, and alcohol intake was found to be statistically significant. A univariate regression analysis showed that obesity was associated with hyperuricemia, male sex was associated with gout, and alcohol consumption was a potential risk factor for both hyperuricemia and gout. Conclusion Among the study participants, 29.7% had gout, and 35.2% had asymptomatic hyperuricemia. Obesity, male sex, and alcohol consumption were identified as risk factors contributing to increased serum uric acid levels and gout development.

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: Background: In recent years, ensuring a safe and healthy working environment for mining employees, improving working conditions, protecting and promoting health, and paying attention to other factors affecting health have become essential requirements. While infectious diseases, noncommunicable (chronic) diseases, nutritional disorders, occupational injuries, and mental health conditions are the main indicators for assessing the health impact on mining workers, there is still a lack of research on noncommunicable diseases among mining sector employees in Mongolia. This gap served as the basis for the present study. Aim: To study the risk factors of noncommunicable diseases among employees of Erdenet Mining Corporation Materials and Methods: A total of 303 employees from 15 divisions of Erdenet Mining Corporation participated in the study. Participants belonging to high-risk groups for noncommunicable diseases were selected using a purposive sampling method. The survey questionnaire was developed based on the WHO STEP wise approach to Surveillance (STEPS) of noncommunicable disease risk factors. Results: Of all participants, 70% were male and 30% were female, with an average age of 46 years. The average total duration of employment was 23 years, of which male employees had worked an average of 19.3 years and female employees 17.3 years at Erdenet Mining Corporation. Among participants, 48.5% had never smoked, while 38.3% were current smokers. When analyzing alcohol consumption by job position, it was found that 85.7% of managers and 66.7% of administrative and decoration workers had high levels of alcohol consumption. Regarding physical activity, 23% of male and 15.2% of female employees reported engaging in active exercise more than three days per week, indicating that male employees were more physically active than females. In terms of dietary habits, 28.3% of males and 17.6% of females did not control their salt intake. As for eating patterns, 53.6% of employees regularly had breakfast, 77.3% regularly had lunch, and 76.6% regularly had dinner at a fixed time. Conclusions 1. Among the employees surveyed, 48.5% had never smoked, while 38.3% were current smokers. Daily smoking was most prevalent among employees aged 35–54 years (74.2%), with the 25–34 age group also showing a relatively high rate of smoking. Regarding alcohol consumption, 38.2% of male employees reported drinking vodka or similar alcoholic beverages. Alcohol consumption was significantly higher among males compared to females, indicating that it is a major risk factor for noncommunicable diseases (p=0.003). 2. In terms of dietary patterns, 53.6% of employees reported regularly having breakfast, 77.3% regularly had lunch, and 76.6% regularly had dinner. Eating habits varied by gender. Concerning physical activity, 23% of male employees and 15.2% of female employees engaged in regular exercise, indicating that male employees were more physically active than females. The study found that lifestyle and behavioral factors such as smoking, alcohol consumption, insufficient physical activity, and poor dietary habits contribute to an increased risk of noncommunicable diseases among employees.

Background: Researchers have identified that occupational exposures related to mining operations-such as dust, noise, and vibration—can increase the risk of developing occupational diseases, including pneumoconiosis, hearing loss, and spinal injuries, as well as noncommunicable conditions such as hypertension and cardiovascular diseases. Work-related stress, living away from family, reliance on portable food services, and shift work systems also contribute to weight gain and negatively affect endocrine function. Aim: To investigate the prevalence of metabolic syndrome and noncommunicable diseases among employees of Erdenet Mining Corporation Materials and methods: A total of 303 employees from 15 divisions of Erdenet Mining Corporation participated in the study. Participants included employees with 10–20 years or more of service; 15% were female, and 75% were technical workers. Employees belonging to high-risk groups for noncommunicable diseases were selected using a purposive sampling method. Results: When analyzing body mass index (BMI) by occupation, overweight or obesity was found among 79.2% of service workers, 65% of electricians, 100% of fuel distributors, 77.8% of decorators, 75.5% of mechanics, 94.7% of specialists, 86.4% of professional workers, 75.7% of operators and engineers, and 88.9% of administrative staff. Central obesity was also analyzed by job position, revealing that 79.2% of service workers, 60% of laboratory staff, 35% of electricians, 64.9% of operators and engineers, and 66.7% of administrative employees had central obesity. Among all participants, 20.7% had a previous history of cardiovascular disease, of whom 71.4% were male and 28.6% were female. The mean blood glucose level among participants was 6.0 mmol/L, with a median of 5.6 mmol/L, a minimum of 3.9 mmol/L, and a maximum of 18.3 mmol/L. The median glucose level was 0.2 mmol/L lower than the national average. No statistically significant difference in blood glucose levels was found between males and females (p = 0.135). By job position, elevated blood glucose levels (prediabetic range) were found in 62.5% of service workers, 40% of laboratory staff, 35% of electricians, 71.4% of managers, and 55.6% of administrative employees. Conclusion The findings indicate an increasing trend in metabolic and cardiovascular risk factors among employees of Erdenet Mining Corporation SOE.