Ischemic heart disease (IHD) remains a leading cause of morbidity and mortality worldwide. Metabolic syndrome (MetS), a cluster of interrelated metabolic abnormalities including central obesity, insulin resistance, hypertension, dyslipidemia, and impaired glucose metabolism, has emerged as a major contributor to the development and progression of IHD. The presence of MetS significantly increases cardiovascular risk and worsens clinical outcomes in patients with established coronary artery disease.
We summarize current evidence on the role of metabolic syndrome in ischemic heart disease, with a focus on underlying pathophysiological mechanisms and clinical implications. Key mechanisms linking MetS to IHD include insulin resistance, endothelial dysfunction, chronic low-grade inflammation, oxidative stress, atherogenic dyslipidemia, and pro-thrombotic states, all of which promote atherosclerosis and plaque instability. In addition, emerging biomarkers such as high-sensitivity C-reactive protein (hs-CRP), lipoprotein-associated phospholipase A₂ (Lp-PLA₂), adipokines, and inflammatory cytokines provide further insight into the complex interaction between metabolic disturbances and ischemic heart disease.
Understanding the role of metabolic syndrome in IHD is essential for early risk stratification and targeted prevention strategies. Comprehensive management of metabolic syndrome components may reduce the incidence, severity, and recurrence of ischemic heart disease. This review highlights the importance of an integrated metabolic and cardiovascular approach in the prevention and management of IHD.

Background: Adhesion small bowel obstruction (ASBO) is a common complication following abdominal surgery and can significantly impair postoperative recovery. This condition necessitates the exploration of more effective therapeutic approaches. Aim: The aim of this study was to evaluate the clinical efficacy of Traditional Mongolian Medicine (TMM) combined with acupuncture in the management of postoperative ileus secondary to adhesion-related small bowel obstruction. Case Presentation: We report the case of a 47-year-old female patient who developed postoperative ileus. The therapeutic intervention consisted of a combined regimen of traditional herbal pharmacotherapy and electroacupuncture. The clinical outcomes were assessed based on the resolution of symptoms and the restoration of gastrointestinal function. Result: Following the administration of the integrated treatment, the patient exhibited a marked reduction in abdominal pain. Objective clinical improvement was noted through the successful restoration of intestinal peristalsis and the normalization of flatus and defecation. Conclusion The findings of this case study suggest that Traditional Mongolian Medicine, particularly when integrated with electroacupuncture, may be an effective and viable modality for promoting the recovery of gastrointestinal motility in patients with adhesion-related small bowel obstruction.

Background: Lower respiratory tract infections, specifically pneumonia, are a leading cause of morbidity in children and are predominantly caused by viral and bacterial pathogens. Researchers worldwide have reported that the etiology of pneumonia varies significantly with age, noting an increasing incidence of Mycoplasma pneumoniae pneumonia (MPP) among children over five years of age. In the context of Mongolia, investigating the incidence, clinical presentation, and laboratory and diagnostic imaging characteristics of MPP is essential. Understanding these specific features will facilitate early detection and optimal treatment, preventing potential complications. Furthermore, this research aims to reduce the unnecessary use of antibiotics by ensuring accurate diagnosis, which serves as the primary rationale for this study. Aim: To investigate the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) in relation to laboratory findings and diagnostic imaging changes. Materials and Methods: A retrospective study was conducted at the Pediatric Ward of the National Center for Maternal and Child Health-2 (NCMCH-2). Data were collected using quantitative methods. Information from patient questionnaires, physical examinations, and laboratory test results were coded for analysis. Statistical analysis was performed using Microsoft Excel and SPSS version 30.0. Results: Analysis of the pathogens causing pneumonia across different age groups revealed that mixed viral and bacterial co-infections predominated in younger children. Conversely, bacterial infections became the primary cause as age increased, indicating a significant age-dependent variation in pathogen distribution (p=0.00054). Based on PCR testing, Mycoplasma pneumoniae (MP) was the most frequently detected pathogen, identified in 51.8% (55) of cases. The mean age of children positive for MP was 9.4 ± 4.4 years. Among these cases, only 25% (14) presented as MP monoinfection, while 75% (51) involved co-infections with other bacterial and viral pathogens. Conclusions 1. Mycoplasma pneumoniae was identified as the most prevalent bacterial pathogen (51.8%) among children hospitalized with pneumonia, indicating a high incidence of pneumonia caused by this bacterium during the late months of 2024. 2. Mycoplasma pneumoniae infection primarily affects school-aged children (mean age 9.2 years). Despite presenting with abnormal breath sounds upon auscultation requiring hospitalization, children positive for MP exhibited normal oxygen saturation and normal inflammatory markers in the blood compared to the MP-negative group. This highlight the classic «atypical» nature of the pathogen. Furthermore, clinical manifestations vary across age groups; specifically, upper respiratory symptoms such as rhinorrhea predominate in younger children (likely due to viral co-infection), whereas these symptoms significantly decrease in older children, in whom lower respiratory tract symptoms become dominant.

Background: Treatment adherence is essential to maintain treatment effectiveness and reduce complications among patients receiving hemodialysis. Patients are required to attend scheduled dialysis sessions, complete the prescribed dialysis duration, take medications as directed, and follow fluid and dietary restrictions. However, adherence may vary across different components of the treatment regimen. Aim: To assess treatment adherence and identify associated reasons and factors among patients receiving hemodialysis. Materials and Methods: We conducted a cross-sectional study a total of 260 patients who are receiving hemodialysis at the ‘Medvic’ Hemodialysis Centers located at the First Central Hospital and the Third Central Hospital. We assessed treatment adherence using the Mongolian version of the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). We evaluated dialysis attendance and duration, medication use, fluid restriction, dietary adherence, and adherence barriers. Differences in ESRD-AQ total scores across demographic and clinical characteristics were analyzed using the independent-samples t-test and one-way analysis of variance (ANOVA). Results: The mean ESRD-AQ total score was 1093.37±99.04. Most participants did not miss (92.3%) or shorten (94.2%) dialysis sessions. In contrast, 57.7% always adhered to fluid restriction and 50.0% always followed dietary recommendations. Although most participants considered treatment recommendations very important, adherence to fluid and dietary restrictions remained comparatively lower. Common barriers included forgetting medication (61.7%), difficulty controlling fluid intake (88.7%), and difficulty avoiding restricted foods (82.5%). ESRD-AQ total scores differed significantly by sex, age group, and employment status (p<0.05). Conclusion Overall adherence to the hemodialysis treatment regimen was relatively good, with high compliance with attendance and full dialysis duration. However, adherence to fluid restriction and dietary recommendations remained poor. Furthermore, patients faced challenges such as difficulty monitoring fluid intake, inability to abstain from restricted foods, and forgetting to take medication. The total treatment adherence score differed significantly by gender, age group, and employment status.

Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide, accounting for approximately 19.8 million deaths in 2022, or 32% of all deaths. Insulin resistance is an important pathophysiological mechanism not only in the development of type 2 diabetes mellitus (T2DM) but also in the development and progression of cardiovascular disease. Evidence remains limited regarding the simultaneous assessment of associations between selected anthropometric measures and insulin resistance in patients with ischemic heart disease (IHD). Aim: To investigate the association between waist-to-height ratio (WHtR) and insulin resistance indices (TG/HDL and HOMA-IR) in patients with chronic ischemic heart disease. Materials and Methods: This hospital-based cross-sectional study included 274 patients aged 40–75 years. Written informed consent was obtained from all participants. Data were collected using a structured questionnaire, anthropometric measurements were performed, and peripheral blood samples were collected. Laboratory measurements included fasting lipid profile, fasting glucose, and fasting insulin levels. WHtR was calculated as waist circumference (cm) divided by height (cm). Insulin resistance was assessed using the TG/HDL ratio, calculated as TG (mmol/L) divided by HDL (mmol/L), and the HOMA-IR index. Metabolic syndrome was defined according to the Joint Interim Statement (JIS-2009) criteria. Results: Among the 274 participants, 209 (76.3%) were male and 65 (23.7%) were female, with a mean age of 61.1±7.9 years. WHtR was significantly and positively correlated with HOMA-IR, with a weak-to-moderate correlation (Spearman’s ρ=0.303, p<0.001). A weak but statistically significant positive correlation was also observed between WHtR and the TG/HDL ratio (ρ=0.136, p=0.039). The discriminative ability of WHtR for insulin resistance was moderate (AUC=0.645, 95% CI: 0.562–0.729; p=0.001). The optimal cutoff value determined using the Youden index was 0.60, with a sensitivity of 63.2% and specificity of 64.2%. Multivariable logistic regression analysis showed that WHtR ≥0.60 was independently associated with insulin resistance. Conclusion WHtR was significantly and positively associated with HOMA-IR and the TG/HDL ratio, and WHtR ≥0.60 was independently associated with insulin resistance.

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.

Background: The discovery of insulin over a century ago significantly advanced the treatment of diabetes mellitus (DM). Effective glycemic control in patients on insulin therapy is influenced by a variety of factors. While developed countries have transitioned fully to insulin analogs, abandoning recombinant insulin, Mongolia lacks comprehensive research on how different insulin formulations influence glycemic control. This gap highlights the need for targeted improvements in therapy effectiveness and service quality. Materials and methods: The cross-sectional study was conducted at the Central Hospital of the Mongolian National University of Medical Sciences, including 183 diabetic patients aged 18-65 years. Participants were managed by endocrinologists and participated in a survey consisting of 44 questions alongside physical measurements. Data were 78 analyzed using SPSS version 25, with a significance threshold of p<0.05. Results: The study population had a mean age of 56.7 ± 11.0 years, with 55.2% (n=101) males. The mean duration of diagnosed DM was 12.6 ± 6.33 years, and the mean duration since the initiation of insulin therapy was 6.77 (1-24) years. The mean glycated hemoglobin (HbA1c) was 10.5%, with 87.4% of the participants categorized under poor glycemic control and only 5.5% maintaining optimal levels. Insulin usage was predominantly recombinant (60.7%), with analogue at 32.2%, and mixed regimens at 7.1%. Usage of insulin pens was reported by 43.2% of the participants. The daily insulin dosage ranged from 10 to 71 units, averaging 37.2 ± 13.7 units. Multivariate logistic regression analysis confirmed that inadequate knowledge about insulin therapy is an independent risk factor (OR; 95% CI = 1.48; 1.21 10.32). When adjusting for confounding factors, the average glycated hemoglobin (HbA1c) levels in the group with inadequate knowledge was significantly higher (11.8%) compared to the group with adequate knowledge, where it was significantly lower (10.2%). Conclusion The use of analog insulin among patients with type 2 diabetes undergoing insulin therapy is relatively low (32%), and glycemic control is poor (87%). Therefore, it is necessary to increase the use of analog insulin and improve glycemic control. Inadequate knowledge about insulin therapy negatively affects glycemic control in patients with type 2 diabetes (OR; 95% CI = 1.48; 1.21-10.32). Therefore, it is essential to enhance patients’ knowledge.

Introduction: High workloads among medical professionals can have adverse effects on their performance, the quality and safety of patient care. However, Zoljargal’s 2021 study indicates that existing legal documents frequently offer additional compensation based on factors like skill level and exposure to hazardous conditions, all while lacking a comprehensive assessment of work performance, actual working hours, knowledge, experience, and workload. This research gap underscores the importance of investigating the workload of medical pharmacy professionals. Methods: The research utilized chronometric methods and content analysis. Result In the study, a total of 42 professionals participated. The work efficiency of professionals in the departments of research institutions of levels II and III was studied using the method of chronometry, and they worked for an average of 44.9±3.236 hours over 5 working days, with 12.5-20.4 hours (31.25%-51%) spent on core tasks and 8.2-14.2 hours (20.5%-35.5%) on documentation tasks. Additionally, the workload of professionals in research institutions is highest on Tuesdays and Fridays, with 9.1 hours and 8.7 hours of work, respectively. The employees worked for an average of 35.15 hours and a maximum of 51.62 hours per week, with an average of 45.015±3.236 hours

Background: Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD), emphasizing the need for its early detection and prognosis. Objective: This study aimed to determine the serum NT-proBNP levels in participants with CKD and establish a cut-off value for predicting heart failure. Methods: A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study received approval from the Ethics Committee of the Institute of Medical Sciences (Approval No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology Department of the third state hospital were enrolled based on predefined inclusion and exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence quantitative analyzer. Data were analyzed with SPSS 26.0. Results: The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly between heart failure and non-heart failure groups (p<0.05). Significant differences were also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05). NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%, specificity: 55%). Conclusion Serum NT-proBNP levels are elevated in CKD patients regardless of heart failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).

Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney function over time. As the disease progresses, it leads to an increased risk of cardiovascular complications, which are the leading cause of morbidity and mortality in CKD patients. B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart failure. Their role in CKD, however, is complex due to the overlapping pathophysiological mechanisms between cardiac and renal dysfunctions. This literature review aims to explore the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting their clinical relevance, the impact of renal function on their levels, and potential therapeutic implications. The review focuses on studies published in the last decade, examining the clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP as biomarkers in CKD patients.