Background: Cancer incidence and mortality are steadily increasing both globally and in Mongolia. As these rates rise, traditional Mongolian medicine has long utilized herbal formulas for the treatment of gastric and esophageal cancers and precancerous conditions. One such formulation—Hot Natured 3 Herbs (HN3H)—comprises three species from the Ranunculaceae family: Atragene sibirica L., Ranunculus repens L., and Pulsatilla bungeana L.. However, scientific validation of its anti-tumor effects is essential. This study aimed to investigate the effect of HN3H in a tumor-induced animal model. Aim: To identify the biologically active compounds of HN3H and evaluate their effect in an experimentally induced tumor model in animals. Materials and Methods: The three herbs comprising HN3H—Atragene sibirica L., Ranunculus repens L., and Pulsatilla bungeana L.—were collected during their flowering stage (May–June) in Khishig-Undur, Bulgan province, and dried according to official procedures. Extraction was carried out by maceration in 96% ethanol at a 1:10 ratio. The concentrated extract was suspended in water (1:1) and successively fractionated with dichloromethane, ethyl acetate, butanol, chloroform, and n-hexane. The study was approved by the Research Ethics Committee of the Mongolian National University of Medical Sciences (Protocol №2020/03-04). A colorectal cancer model was established by subcutaneous injection of MC-38 cells (Kerafast, USA) into C57BL/6 mice. Immunohistochemistry was performed using CK20, CDX2, Ki67, and p53 antibodies at 1:100 and 1:200 dilutions. Results: The ethanol extract of HN3H contained 2.98±0.04% total phenolics and 2.16±0.05% total flavonoids. Body weight and tumor volume were measured daily with three repetitions. All groups showed a time-dependent increase in body weight. Mice in groups 1A and 1B received ethanol extract at 50 and 100 mg/kg doses; groups 2A and 2B received dichloromethane extract at the same doses. The negative control group was administered 0.5 mg/kg PBS orally, while the positive control group received intraperitoneal injections of 5-fluorouracil (5FU) at 10 mg/kg twice a week. Tumor growth increased in a time-dependent manner across groups. Compared to the negative control, tumor volumes in four treatment groups showed statistically significant reduction (p˂0.05), while no significant difference was observed when compared to the positive control (p=0.08). Histological analysis revealed necrosis in all groups, with variation in extent. Conclusion The ethanol extract of HN3H exhibited moderate levels of phenolic compounds and a high concentration of flavonoids. HN3H extract inhibited tumor progression and activated lymphocyte-predominant inflammation in tumor tissues, indicating potential anti-tumor activity (p˂0.05).

: We report a case of a 1-year-6-month old baby presenting with classic clinical of Prader-Willi syndrome, a rare congenital disorder. Early identification and multidisciplinary management are critical to improving outcomes. Case presentation: Patient U is a 1.5-year old male. Due to his inability to breastfeed for the first day after birth, diagnostic tests were initiated. He was dependent on tube feeding for over two months. At 9 months, the child was able to hold their head up and began sitting independently around 11 months. His eyes are slightly slanted, the bridge of his nose is narrow, the upper lip is thin, and the corners of his mouth are downturned.The skin soft texture. Muscle tone is noted to be weak. The size of the arms and feet is small. Additionally, the neck is of short stature. Cytogenetic Analysis: November 2023. The analysis identified a microdeletion in the 15q11-q13 chromosomal region. He was discharged from the hospital upon demonstrating the ability to suck effectively, achieving consistent weight gain, and having his sucking and swallowing activities adequately controlled. Discussion and Conclusion Prader-Willi syndrome is a genetic disorder resulting from the non-expression of a gene located on chromosome 15 at the 15q11.2–q13 region. The prevalence of corresponding to an approximate global total of 350,000 to 400,000 cases. The sex ratio is equivalent at 1:1. In the initial year of life (0–1 year), affected infants commonly present with muscle weakness, difficulties in feeding, reduced sucking capabilities, absence of crying or vomiting, diminished motor activity, poor muscle strength, and low weight. For individuals aged 1 to 10 years, symptoms encompass increased appetite, obesity, delays in speech and psychomotor development, a long facial structure, narrow forehead, downturned mouth and eyes, small hands and feet, along with other distinctive facial features. In adolescence and adulthood, prevalent symptoms may include behavioral changes, irritability, uncontrolled eating habits, diabetes, and depression. From infancy onward, holistic care may include nutritional interventions (such as tube feeding and specialized diets), strategies for heat retention, enhancement of sucking abilities. Cardiovascular and respiratory monitoring, weight management, physical activity support, health education for families and caregivers, growth hormone therapy, psychological counseling, sex hormone replacement therapy, and assistance with movement, psychomotor skills, cognitive and intellectual development, alongside speech therapy. Timely diagnosis, integrated multidisciplinary care, and proactive family involvement have the potential to markedly enhance the quality of life for affected individuals.

: We report a case of a 1-day-old neonate presenting with classic clinical and radiologic features of sacral agenesis, a rare congenital disorder. Early identification and multidisciplinary management are critical to improving outcomes. Case Presentation : A full-term, 1-day-old infant was examined for multiple congenital deformities. Physical f indings included a large head, round eyes, and a shallow chest. The lower limbs were short, internally rotated, and stiff, with minimal mobility at the hip and knee joints. External rotation of the hips was not possible, and both feet were turned inward.
A CT scan of the lumbar spine (without contrast) revealed normal cervical and thoracic vertebrae. However, one thoracic vertebra showed an unclear structure. At the spine’s end, a 2.0 × 1.5 × 1.1 cm spindle shaped mass with a density of +14 to +27 HU was seen under the skin on the right. The pelvis appeared underdeveloped, with an incomplete oblique fracture of the upper right midshaft femur. Upright radiography confirmed underdeveloped pelvic bones. The medial malleolus and tibia appeared symmetrical bilaterally. Epidemiology: Sacral agenesis (caudal regression syndrome) is a rare congenital condition with an estimated incidence of 1 in 100,000 live births. It is more common in infants born to mothers with pregestational diabetes, although it can occur sporadically. Both genetic and environmental factors may contribute.[11] Discussion : Sacral agenesis results from abnormal development of the caudal mesoderm during early embryogenesis, leading to partial or complete absence of the sacrum and sometimes lumbar spine. The severity ranges from isolated sacral agenesis to complete lumbosacral agenesis with associated genitourinary, gastrointestinal, and limb deformities. [8-10].
The current case presented with classic signs: bilateral lower limb deformities, limited joint mobility, underdeveloped pelvis, and a spinal abnormality. The presence of a spindle-shaped subcutaneous mass may represent a lipoma or associated spinal dysraphism. The incomplete femoral fracture may be due to birth trauma in the context of fragile bones or abnormal limb positioning.
Early imaging helps confirm the diagnosis and evaluate associated anomalies. Management typically involves orthopedic, neurologic, and urologic interventions. Long-term care focuses on mobility, continence, and developmental support. [13,14]. Conclusion: This case emphasizes the importance of recognizing sacral agenesis at birth through clinical examination and radiological imaging. Although rare, early diagnosis is vital for implementing supportive care and planning multidisciplinary interventions. Close follow-up is essential to monitor motor development and prevent complications. Ethical Considerations (EHT) : Ethical approval was obtained from the institutional review board. Parental consent was secured for the publication of clinical data and images. All procedures followed ethical standards of clinical care and the Helsinki Declaration. Confidentiality of patient information has been maintained throughout the report. No invasive procedures beyond standard diagnostics were performed. Acknowledgments The authors thank the Neonatology and Radiology Departments of Regional Diagnostic Center of Umnugovi Province for their contributions to the diagnosis and imaging. We also appreciate the cooperation of the child’s family and the medical ethics committee for guidance and approval. Special acknowledgment to the Division of Pediatric Neonatologists for their early intervention planning and support.

Background: Hepatitis C virus (HCV) is a blood-borne infectious disease that, if left untreated, can lead to chronic infection, liver cirrhosis, and hepatocellular carcinoma. In Mongolia, the prevalence of HCV is relatively high, posing significant public health concerns. In alignment with the global goal to eliminate hepatitis B and C by 2030, this study aimed to investigate the prevalence, genotype distribution, and associated risk factors of HCV infection among the general population in Arkhangai province, Mongolia. Aim: To determine the prevalence of hepatitis C virus infection among the relatively healthy population of Arkhangai Province and to study its genotypes and risk factors. Materials and Methods: A cross-sectional analytical study was conducted using a two-stage sampling method, enrolling 2,304 individuals aged 0–80 years. Participants completed a structured questionnaire, and blood samples were collected for anti-HCV and HBsAg testing using enzyme-linked immunosorbent assay (ELISA) at the central laboratory of the provincial hospital. Serum from anti-HCV positive individuals was preserved at –80°C and transported to Ulaanbaatar for HCV RNA quantification via real-time polymerase chain reaction (RT-PCR) and genotyping through molecular diagnostics. Statistical analyses were conducted using SPSS version 26.0. Results: A total of 2,304 individuals from the provincial center and 8 soums participated in the study, of whom 57.8% were female. The overall HCV seroprevalence was 12.0%, with chronic HCV infection confirmed in 7.16%. Among patients with chronic HCV, genotype 1b was identified in 98.2% of cases. Risk factor analysis revealed statistically significant associations between HCV infection and undergoing cosmetic procedures, receiving injections in non-medical settings, cupping therapy, and sharing shaving equipment. Conclusion This study HCV seroprevalence of 12.0% among the relatively healthy population in Arkhangai province, with genotype 1b detected in 98.2% of chronic HCV cases. The following risk factors were found to be independently associated with HCV infection: undergoing cosmetic procedures (OR: 2.3), cupping therapy (OR: 1.7), receiving nonmedical injections (OR: 2.4), and sharing shaving tools (OR: 1.5) (p<0.001)

Background: Chronic hepatitis C virus (HCV) infection remains a major global health concern. Approximately 55–85% of individuals with acute HCV infection progress to chronic disease, which is often asymptomatic. Therefore, early diagnosis and treatment are crucial to prevent long-term complications. This provided the rationale for our study to evaluate the clinical characteristics, diagnosis, and treatment outcomes of chronic HCV patients using direct-acting antivirals (DAAs), with comparisons by viral genotype. Aim: To compare the clinical features, diagnosis, and treatment outcomes of chronic hepatitis C according to viral genotypes. Materials and Methods: A total of 1203 chronic HCV patients attending the outpatient department of Arkhangai Provincial General Hospital were included in this prospective and retrospective cohort study. HCV genotyping was performed, and patients received DAA therapy. Clinical manifestations, laboratory findings, HCV RNA levels, and fibrosis scores (APRI and FIB-4) were assessed at baseline, at week 4 of treatment, and at 12 weeks post-treatment. Statistical analysis was conducted using SPSS version 26.0. Results: : Among all patients, 6.7% had liver cirrhosis, and 1.4% had previously received interferon-based therapy. Patients with cirrhosis more frequently reported fatigue, abdominal discomfort, insomnia, right upper quadrant pain and loss of appetite (p<0.001). Virologic response at week 4 was 98.9%, and sustained virologic response at 12 weeks post-treatment was 99.3%. The mean APRI score decreased from 0.71±0.67 to 0.31±0.54, and FIB-4 from 1.61±0.41 to 1.16±0.26 (p<0.001). The most common adverse events were fatigue, headache, and nausea. Conclusion Treatment outcomes were 99.5% in patients with genotype 1b, 100% in genotype 1a, and 75% in genotype 2, with statistically significant differences (p<0.001). Both APRI and FIB-4 scores significantly decreased after treatment, confirming the effectiveness of DAA therapy in improving liver fibrosis (p<0.001).

Background: The annual incidence of pulmonary thromboembolism is reported to be 39–115 cases per 100,000 population, with rates of 60–120/100,000 in Western countries and 10–20/100,000 in Asian countries. In Mongolia, few studies revealed the prevalence of risk factors and clinical manifestations of acute pulmonary embolism. Over the past 30 years, the incidence of risk factors for non-communicable diseases, which are mainly triggered by lifestyle and social parameters, has rose. Moreover, environmental conditions such as cold climate, hypoxia, and blood hyperviscosit may contribute to higher incidences of acute pulmonary embolism in high-altitude regions. This condition is potentially fatal and can become impair quality of life. Aim: We aimed to compare risk factors and clinical characteristics based on age and sex, and to evaluate laboratory findings and diagnostic tests among Mongolian patients diagnosed with acute pulmonary embolism. Materials and Methods: This retrospective research included total 232 patients meeting inclusion criteria. The information was collected from patient histories, including general demographics, risk factors, comorbidities, symptoms, and physical examination findings. Laboratory analyses included complete blood count, coagulation profile, and immunological markers (D-dimer, NT-proBNP, troponin, protein C, homocysteine, and C-reactive protein), as well as selected imaging parameters. We used Wells and Geneva scoring systems to assess probability of acute pulmonary embolism and Pulmonary Embolism Severity Index to determine disease severity. Differences by age and sex were analyzed using independent t-tests for continuous variables and chi-square tests for categorical variables. Results: Among participants with acute pulmonary embolism, the prevalence of tobacco and alcohol use was significantly higher among males (p<0.001). Among comorbidities, arterial hypertension and other pulmonary diseases were more common in males, whereas cardiac diseases were more frequent in females (p=0.028). Participants aged 65 years and older showed higher rates of comorbid conditions and regular medication use (p<0.001). The most common symptoms were dyspnea (90.9%), chest pain (74.2%), cough (70.5%), leg pain (38.9%), hemoptysis (20.7%), and cyanosis (9.3%). According to sPESI scoring, 69.8% (n=162) were at high risk of death within 30 days, with no significant difference by sex. However, mortality risk within 30 days was significantly higher in participants aged 65 years and above (p<0.001). As increasing age, the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were elevated, indicating an acute inflammatory response (p=0.001). Contrast-enhanced CT scans revealed that 95 participants (44.2%) had main pulmonary artery involvement, with no significant sex difference, though involvement of the main pulmonary artery was more frequent in those aged 65 and older. Conclusion Dyspnea, chest pain, and cough were the most common symptoms among patients diagnosed with acute pulmonary embolism. The 30-day mortality risk associated with it was higher among males and increased with advancing age.

Background: In Mongolia, 7,244 new cancer cases were registered in 2023, of which 5.9% (425 cases) were cervical cancer. The prevalence of cervical cancer is 14.5 per 10,000 populations. In Ömnögovi province, 597 cancer cases were recorded in 2023, and 18.5% of them were cervical cancer. The cervical cancer screening coverage in Ömnögovi province was 45.6% in 2023. Aim: To identify the types of human papillomavirus (HPV) among women aged 30 years and above in Dalanzadgad soum. Materials and Methods: A cross-sectional study design was used. We included 100 women aged 30 years and above in Dalanzadgad soum. HPV genotyping was performed using polymerase chain reaction (PCR) among women diagnosed with cervical erosion. A 44-item questionnaire was also administered to assess the risk factors for cervical cancer. Results: HPV was detected in 41% of participants, while 59% tested negative. Among the participants, 25 had one genotype, 13 had two genotypes, and 3 had three genotypes. Among the 41 women who tested positive, 49% had high-risk genotypes. A total of 20 HPV genotypes were identified, including 16 high-risk and 4 low-risk types. Of the HPV-positive women, 65.9% were married, and 58.5% had only one lifetime sexual partner. In addition, 78% of participants reported never having undergone cervical cytology screening prior to this study. Conclusion In Dalanzadgad soum, 2 out of every 5 women are at risk of HPV infection, and among those infected, 1 out of 2 carry a high-risk HPV genotype.

Introduction : Water is a vital resource for human existence and is essential for daily food processing, preparation, washing, hygiene, and sanitation. Furthermore, providing the population with safe drinking water is one of the pressing problems of the world and some regions.
In recent years, population density and the scale of commercial and industrial activities, as well as clean and dirty water consumption were increased in the capital city. As a result of these, ground and surface water resources are becoming scarce and polluted.
Therefore, assessment of daily drinking and residential water consumption of Ulaanbaatar should be determined to use drinking water properly in daily life and water loss. This study assessed the actual amount of households’ daily water consumption. Goal: The purpose of this study is to determine the daily consumption of drinking water for households in ger areas and apartments in Ulaanbaatar. Materials and Method: This study covers 30 households in ger areas and 15 apartment households, in Ulaanbaatar. Household members performed 6-10 types of measurements every day, within 7 days. As a result of these measurements, actual consumption of water quantity used for drinking and household purposes was calculated. Statistical analysis was done by SPSS Version 21 to calculate the true probability of difference between parameters. Result: 67.9% of the households in the ger areas were 4-5 family members. The average daily household consumption of drinking and domestic water were 68.3 ± 3.57 L (95% 61.3-75.3), the minimum consumption was 12 L, and the maximum was 227 L. Average of the household water consumption water was 97.6-108.9 liters during the weekends, and water consumption was statistically higher than weekdays (p=0.001; p=0.01).
The water consumption of residential households with 3 family members accounted for the majority (30.8%) in this study. The average daily consumption of drinking and domestic water was 297.67±19.7 liters. There was no statistically significant difference (p=0.96) in week. The average daily water consumption including drinking and residential was 270.3-335.97 L.
The total daily drinking and residential water consumption per person was 15.57 L for households in ger areas and 90 L for apartment households. Calculating the daily water consumption of households in ger areas, 60.3% of it is used for laundry, washing dishes, food preparation, washing face and hands, and clothes, 31% for drinking, and 8.7% for outdoor water use. While apartment households, approximately 94.1%, were used for household and 5.9% for drinking purposes. Research ethics approval : This study was discussed at the meeting of the Academic Council of the National Center for Public Health. In addition, this study was carried out according to the methods and methods discussed and approved at the meeting of the Medical Ethics Control Committee of the Ministry of Health (Resolution No. 08). Conclusion The total daily consumption of drinking and residential water per person were 15.57 litres for the households in the ger areas and 90 litres for the apartment households. It implies that it does not exceed the WHO recommendations

Introduction : Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder that occurs during childhood development, which presents with signs of reduced attention and hyperactivity [1]. Necessary nutrients, such as trace minerals, including manganese, iron, zinc, iodine, selenium, copper, and chromium, are associated with changes in neuronal function that can lead to adverse effects on behavior and learning [2]. In addition to these, social, emotional, behavioral problems, and cognitive impairments such as executive dysfunctions are common in ADHD [3]. Goal: To evaluate the hair elements and intelligence quotient in children with ADHD. Materials and Methods: This is a cross-sectional comparative study conducted at elementary schools of Ulaanbaatar city. All in all 60 children of both genders aged between 7-12 years old were included in the study. Children were divided into two groups as children with ADHD group and a control group. Each group had 30 children. For assessment of emotional Intelligence EQ-i:YV - Emotional Quotient Inventory: Youth Version (Bar-On & Parker, 2000; it ad. Sannio Fancello, & Cianchetti, 2012) was used. Scalp hair samples were randomly collected from approximately ten sites around both sides of posterior parietal eminences and external occipital protuberance. Samples were then packed at room temperature and submitted for laboratory analysis. The study was approved by the Research Ethics Committee of Mongolian National University of Medical Sciences (Reg. No. 2018/Д-10). Results: The IQ of children with ADHD group were 85.03±16.86 p<.0001 and the IQ of control group =108.9±21.22, p<.0001. We identified hair minerals such as Mg, Zn, Pb, Se, Mn. We have then compared to each group and normal ranges of ages. ADHD group and the control group had Pb concentration that was slightly higher and inversely Mg concentration was slightly lower (r=-0.502, p=.005). Concentration of Pb, IQ were directly opposite (r=-0.38, p=.03). Conclusion
1. IQ was lower in the ADHD group compared to control group 85.03±16.86 p<.0001, monitored group 108.9±21.22, p<.0001.
2. The group with ADHD had lower Mg, Zn, and higher Pb, Se, Mn (p<.0001). The IQ decreased when there was increased Pb and decreased Mg.

Introduction: A considerable proportionof adult living donor liver transplantation(LDLT) recipients experience biliarycomplication (BC), but there are few reportsregarding BC based on long-term studies ofa large LDLT population.Methods: The present study examinedBC incidence, from 16 adult and pediatricpatients (14 right liver and 2 left liver graft )between 2011 and 2016 First Central Hospitalof Mongolia.Results: The mean follow-up period was36±1 months. First Central Hospital has DDanastmosis (n=22) double DD (n=2) singlehepaticojejunostomy (n=3). There 3 caseshave biliary stricture after operation. One ofthe 3 cases has biliary laek 2 months laterafter the operation.Conclusion: Close surveillance for BCappears necessary for at least the first 3 yrafter LDLT. In terms of anastomotic stenosisrisk, HJ appears a better choice than DD forright liver grafts involving ducts less than 4mm in diameter.