Background: Speech audiometry is a widely used standard diagnostic method in the evaluation of hearing and auditory function. It requires word materials that are developed in the native language of the target population and that reflect its phonetic characteristics. Because the phonetic structure, pronunciation, and familiarity of words directly influence speech recognition, it is essential to use language-specific word lists that are phonetically balanced, uniformly distributed, and psychometrically validated to ensure the accuracy and reliability of testing. Therefore, there is a strong need to develop Mongolian bisyllabic word lists that are balanced in both phonetic and psychometric properties, which forms the basis of this study. Aim: To develop psychometrically balanced Mongolian bisyllabic word lists for use in speech audiometry and to evaluate their suitability for determining the Speech Recognition Threshold (SRT). Materials and Methods: Fifty-five commonly used and phonetically balanced Mongolian bisyllabic words were selected and recorded by a professional female speaker. The recordings were presented to 50 normal-hearing participants aged 18–29 years at ten intensity levels ranging from –4 to 14 dB HL in 2-dB steps. Based on participants’ responses, the 50% SRT and the 20–80% slope of the psychometric function for each word were calculated using logistic regression. Chi-square and one-way ANOVA analyses were performed to examine the equivalence between lists. On the basis of these results, two psychometrically balanced half-lists, each containing 25 words, were constructed, and digital level adjustments were applied to ensure uniform intensity. Result: The slopes of the psychometric functions for the two half-lists ranged from 11.2 to 11.6 %/dB. Chi-square and one-way ANOVA analyses showed no statistically significant differences between the two lists in terms of the 50% SRT and psychometric slope derived from logistic regression [χ²(24, N=50) = 2.21, p = 0.99; F(1,48) = 0.00895, p = 0.925]. The mean pure-tone average (PTA) threshold of the 50 normal-hearing participants was 2.23 dB HL with a standard deviation of 4.4 dB. The difference between PTA and SRT was less than 10 dB HL for all participants, which is within the clinically acceptable range. Conclusion The developed Mongolian bisyllabic word lists, consisting of two 25-word sets, are suitable for determining the Speech Recognition Threshold and can be reliably applied in clinical speech audiometry practice.

Background: Cancer is not only a physiological disease but also a complex condition that profoundly affects an individual’s psychological well-being and social relationships. Misconceptions about cancer within the public, including its association with death and the tendency to attribute blame to patients as being “personally responsible,” contribute to the development of social stigma among cancer survivors. This stigma negatively impacts patients’ engagement in treatment and their quality of life, highlighting the need to assess societal attitudes based on survivors’ lived experiences. Aim: To examine the everyday lived experiences of cancer survivors, measure perceived social stigma, and identify psychological challenges as well as sources of support. Materials and Methods: A mixed-methods design was employed. In the quantitative component, the Cancer Stigma Scale (CASS) and the Attitudes Toward Cancer Questionnaire (ATCQ) were translated and their content validity was evaluated by an expert panel using the Content Validity Index (CVI), followed by pilot testing to confirm feasibility (FVI). In the qualitative component, focus group discussions were conducted with cancer survivors, and coping ability was assessed using psychological assessment tools. Result: A total of 207 participants (68% female; mean age 33.82±13.7 years) were included in the quantitative study. Participants experienced a moderate level of cancer-related stigma, with negative attitudes most strongly associated with perceptions of disease severity and individual responsibility. Qualitative findings revealed that physician communication and family support played a decisive role in psychological responses at the time of diagnosis disclosure. Excessive sympathy or social distancing increased psychological distress, whereas normal interpersonal interaction and realistic encouragement were identified as the most effective forms of support. Conclusion To improve psychosocial support for cancer survivors, it is essential to enhance healthcare professionals’ communication skills, promote accurate public understanding of cancer, and strengthen the sustainability of survivor support group activities.

Background: Respiratory and gastrointestinal infectious diseases are the leading causes of morbidity in children. Numerous international studies have demonstrated that handwashing with soap is one of the most effective and cost-efficient methods for preventing these diseases in children. A previous study conducted in Ulaanbaatar found that only 50.1% of general education school students practiced proper handwashing, which is considered insufficient even in areas with relatively adequate facilities. In Mongolia, 56.1% of the 865 schools lack handwashing facilities and soap, and 25% do not meet the WASH standards. Although knowledge about handwashing increased during the COVID-19 pandemic, sustained behavioral change remained limited, highlighting a gap between knowledge and practice and indicating the need for targeted educational interventions. Furthermore, there is limited research comparing the effectiveness of such interventions across different school environments and urban–rural settings, which provides the rationale for this study. Aim: To evaluate the effectiveness of a handwashing educational intervention among primary school students and determine differences in knowledge change across four schools in urban and rural areas. Materials and Methods: A quasi-experimental study design was used from December 2024 to June 2025. A total of 1,353 students from grades 3–5 in four general education schools (two in Ulaanbaatar and two in rural areas) were included in the study. Preand post-intervention handwashing knowledge scores were analyzed using paired t-tests and one-way ANOVA (α=0.05) with STATA 14.0. Ethical approval was obtained from the Ethics Committee of the Mongolian National University of Medical Sciences. Result: The mean handwashing knowledge score increased significantly from 9.68 (±2.64) before the intervention to 10.30 (±2.74) after the intervention, with a mean difference of +0.63 (p<0.001). The differences in improvement between schools were also statistically significant (ANOVA: F(3,1335)=5.90, p=0.0005). The highest improvement was observed in urban School A (+1.49), while the lowest was observed in School B (+0.16). Rural schools C and D showed moderate and relatively consistent improvements (+0.51 and +0.70, respectively). Conclusion School-based handwashing educational interventions effectively improve knowledge among primary school students. However, environmental factors, such as infrastructure and geographic location, significantly influence the effectiveness of the intervention. Therefore, educational interventions should be implemented alongside infrastructure improvements.

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: Research on lactic acid bacteria has confirmed how specific strains possess probiotic properties and impart unique sensory characteristics to food products. The use of probiotic lactic acid bacteria in many food products, thus confers various health benefits to humans when they are frequently consumed in adequate amounts. Aim: To determine the effect of lactic acid bacteria on the growth of tomatoes. Materials and Methods: The lactic acid bacteria were cultured using the Lactobacillus medium from whipping cream and Dandelion (Taraxacum mongolicum) and identified using the MALDI-TOF MS automated microbial identification analyzer. A solution was prepared using Lactobacillus delbrueckii isolated from whipping cream and Lactobacillus gasseri isolated from Dandelion (10^7CFU/ml), and sterilized tomato seeds were watered for 10 days with the solution, while sterilized distilled water was used as a control. The germination rate of the seeds and the root length were measured and recorded every day. Results: The solution of L.delbrueckii bacteria isolated from cream germinated 100% of the seeds, which is 4% higher than the control seeds, while the solution of L.gasseri bacteria isolated from Dandelion germinated 100%, supporting 4% higher than the control seeds. Seedlings irrigated with the L.delbrueckii bacterial solution exhibited an average length of 10.3cm, which was 1.3cm longer than the control (P=0.003), indicating a statistically significant difference. Similarly, those treated with the L.gasseri solution had an average length of 11.5cm, 2.5cm longer than the control (P=0.005), also demonstrating statistical significance. Conclusion The application of the lactic acid bacterial solution significantly enhanced both the germination of tomato seeds and the growth of the plants compared to the control solution.

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.

Diabetes mellitus type 2 (T2DM) is a globally prevalent metabolic disorder associated with macrovascular and microvascular complications. The number of patients diagnosed with T2DM has exceeded 460 million worldwide and continues to rise. Insulin resistance is a primary pathogenic factor contributing to various systemic complications. Glycated hemoglobin (HbA1c) is a critical biomarker for monitoring glucose control in T2DM patients.
This study aimed to compare the mean platelet volume (MPV) between different groups of T2DM patients to assess the impact of disease progression and glycemic control. A total of 152 patients were categorized based on disease duration and glycemic control. The results showed that patients diagnosed for less than one year had a mean MPV of 9.8±1.0 fl, while those diagnosed for more than five years had a mean MPV of 9.0±0.95 fl. Comparative analysis with international studies indicated that MPV is significantly higher in diabetic patients than in non-diabetic individuals. Furthermore, patients with poor glycemic control exhibited a decrease in platelet count, aligning with findings in metabolic disease research.
The study findings suggest that both disease duration and glycemic control status influence platelet volume and count variations. Monitoring MPV can serve as an early indicator of diabetes-related complications. This research underscores the importance of continuous platelet parameter assessment in diabetic patients to predict and manage potential vascular complications effectively.

This study examines the association between the neutrophil-to-lymphocyte ratio (NLR) and glycemic control in patients with type 2 diabetes mellitus (T2DM). A cross-sectional analysis was conducted on 109 randomly selected T2DM patients, stratified into three groups based on HbA1c levels: good control (14%, HbA1c <7%), moderate control (16%, HbA1c 7–8%), and poor control (70%, HbA1c >8%). Demographic and hematological parameters were analyzed, with NLR calculated from complete blood count data.
Results demonstrated a significant increase in NLR with deteriorating glycemic control (good: 1.8±0.8; moderate: 1.9±0.8; poor: 2.3±1.2; p=0.015). No significant age or gender differences were observed among groups. Patients with longer diabetes duration (>5 years) exhibited higher HbA1c and NLR levels, suggesting a link between chronic hyperglycemia and inflammation. The findings support NLR as a low-cost, accessible inflammatory marker for T2DM progression.
This study highlights NLR’s potential as a clinical biomarker for monitoring glycemic control and systemic inflammation in T2DM. Future research should investigate NLR’s predictive value for diabetes-related complications.

Background: Gliomas are common primary brain tumors of glial origin in adults with a poor prognosis. Tumor-related inflammatory cytokines such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and aquaporin-4 (AQP-4) water channel protein have been reported to be expressed in gliomas Aim: This study aimed to determine their serum levels in patients with primary brain tumors compared to healthy controls and to evaluate their potential diagnostic value. Materials and Methods: Serum AQP-4 levels were measured by ELISA in 28 patients with primary brain tumors (PBT) and 26 healthy controls. IL-6 and TNF-α were assessed by flow cytometry in 59 PBT patients and 52 controls. Results: Among the primary brain tumor cases, 45.61% were meningiomas, 26.32% anaplastic astrocytomas, 8.77% glioblastomas, and 12.28% other tumors (including chondroma, ependymoma, schwannoma, craniopharyngioma). Serum IL-6, TNF-α, and AQP-4 levels were significantly higher in the PBT group compared with healthy controls. Conclusion Elevated serum levels of AQP-4, IL-6, and TNF-α in patients with primary brain tumors suggest that these biomarkers molecules could represent valuable non-invasive biomarkers for the early detection of PBT.

Background: Since August 2021 in Mongolia, the rapid spread of the SARS-CoV-2 Delta variant among the population coincided with the reopening of all levels of educational institutions, including universities, general education schools, and kindergartens, for in-person learning. Aim: To examine the impact of the measures implemented when school was reopened with in-person learning on COVID-19 morbidity among school children, to assess the overall infection situation in children, and to determine whether any school-based outbreak clusters occurred during the Delta variant surge. Materials and Methods: This study used national data from confirmed COVID-19 cases recorded in the electronic surveillance system between January 1, 2021, and February 28, 2022, including all cases and those among children aged 0-17 years. The 7-day moving average of the proportion of cases among children was calculated, representing the average proportion of pediatric cases during the preceding seven days. Additionally, the study compared the incidence and relative risk (RR) of COVID-19 among children aged 0-17 years at the time of school reopening on September 1, 2021, with those observed during previous outbreaks caused by the SARS-CoV-2 Wuhan, Alpha, and Omicron variants. As vaccination was available only for adolescents aged 12-17 years, the analysis was stratified by three age groups: 0-4, 5-11, and 12-17 years. Results: Throughout the study period, the proportion of COVID-19 cases among children aged 0–17 years nationwide ranged from 0.73% to 5.93% across outbreaks caused by the four SARS-CoV-2 variants (min 0.73%; max 8.57%). The 14-day confirmed case rate per 10,000 population was highest during the Delta (107.57) and Omicron (113.56) variant outbreaks. When comparing age groups, children aged 5–11 years were used as the reference group. During outbreaks, the relative risk for the 12–17-year group was lowest during the wild-type virus wave (RR=0.47) and highest during the Delta wave (RR=0.78). Conclusion During COVID-19 outbreaks, the proportion of pediatric cases (0-17 years) among total cases ranged from 0.73% to 5.93%, consistent with findings from studies conducted in other countries. Overall, infection rates were higher among the 0-4 and 12-17 age groups, with the highest rates among 0-4-year-olds during the Delta variant outbreak. No clustered outbreaks involving six or more cases were reported in school settings. Future studies should focus on assessing the transmission dynamics of respiratory infections among children in both household and school settings, especially during influenza and influenza-like illness outbreaks, to generate evidence for preventive measures against respiratory pathogen transmission.