Introduction: Hearing loss adversely impacts communication, cognitive function, and quality of life, yet early detection among adults remains inadequate. Despite the availability of portable, cost effective tablet-based audiometric screening tools, national-level prevalence data on adult hearing loss in Mongolia are scarce, and no large-scale screening studies in primary health care settings have been conducted to date. Goal: This study aimed to determine the prevalence of screen-detected hearing loss among adults in Ulaanbaatar, evaluate its association with age and test frequency, and identify associated factors. Material and Methods: A cross-sectional study was conducted at primary health care clinics across nine districts of Ulaanbaatar (2024–2025), enrolling 2,335 adults (≥18 years). Hearing screening was performed using the MAICO easyTone device with DD65 v2A headphones at 500–6000 Hz (30 dB HL at 500 Hz; 20 dB HL at remaining frequencies), with ambient noise monitored per ANSI S3.1-2008. Each ear was classified as Pass or Refer at each frequency. Outcomes included screen-detected hearing loss (SD-HL), speech-frequency hearing loss (SD SFHL, 500–2000 Hz), and high-frequency hearing loss (SD-HFHL, 4000–6000 Hz), each categorized as bilateral or unilateral. Associated factors were assessed by univariable and multivariable logistic regression. Results: SD-HL was identified in 37.2% of participants (bilateral: 31.5%; unilateral: 5.7%), SD-SFHL in 30.6%, and SD-HFHL in 36.3%. Prevalence increased markedly with age, from 29.9% (40–49 years) to 96.6% (≥70 years) (p<0.001). On multivariable logistic regression, male sex was inversely associated with a positive screening result (OR=0.65, 95% CI: 0.42–0.99, p=0.049). Conclusion The findings of this study confirm that the MAICO easyTone tablet-based hearing screening device is a feasible and appropriate tool for the early detection of hearing loss among adults in routine primary health care settings in Ulaanbaatar. The high prevalence of screening-detected hearing loss underscores the urgent need to establish adult hearing screening programs in Mongolia. Future studies should include standard audiometric confirmation in participants with positive screening results to determine the diagnostic validity of this hearing screening approach.

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: Carotid artery stenting is increasingly being selected as the treatment for severe (≥70%) carotid artery stenosis, creating a growing need to prevent potential secondary complications associated with the procedure. In-stent restenosis (ISR) remains an important complication during long-term follow-up after carotid artery stenting. In this clinical case, we have addressed risk factors, pathogenesis, diagnosis, treatment, and monitoring of in-stent restenosis. Case Presentation: We describe the case of a 70-year-old man with severe, symptomatic IRS detected 1.8 years after carotid artery stenting (CAS). Conclusion IRS following carotid artery stenting is a clinically significant complication that may adversely affect cerebral perfusion and increase the risk of recurrent ischemic stroke. Early detection and follow-up with carotid duplex ultrasonography, regular follow-up, and lifestyle modifications, particularly smoking cessation, are essential for prevention of adverse cerebrovascular events.

Background: Branch atheromatous disease (BAD) is believed to be one subtype of ischemic stroke brought on by plaque accumulation that obstructs or stenoses the entrance of penetrating branches. Based on clinical status, risk factors, laboratory results, and radiographic features of infarct and blood vessel morphologies, BAD has been differentiated from large-vessel occlusion and small-vessel disease. BAD-induced stroke has been strongly associated with worse outcomes than lacunar strokes, including high rates of early neurological deterioration (END), recurrent transient ischemic attacks and strokes, and disability. Determining treatment options and each patient’s prognosis depends on early identification of BAD. Case Presentation: A 34-year-old male with a history of recurrent acute ischemic stroke within 7 months, caused by stenosis of the M1 segment of the right middle cerebral artery, was hospitalized twice at the Third Central Hospital of Mongolia. Intravenous Thrombolytic therapy (tPA) was administered during each admission. Conclusion Precise diagnosis of BAD is crucial for planning subsequent treatment and secondary prevention.

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: 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.

Introduction: According to the World Health Organization (WHO) in 2020, brain and central nervous system (CNS) cancers account for 2% of all newly diagnosed cancers in the world and 1.5% in Mongolia. Approximately 85-90% of all brain and other CNS tumors were diagnosed primary brain tumor. In 2019, the average 5 year survival probability was 50% for other cancers and 11% for the primary brain tumors. There were 28 patients with primary brain tumor and 33 relatively healthy individuals in our study. Goal: To study the diagnostic value of serum aquaporin-4 and glial fibrous acidic protein in the diagnosis of primary brain cancer Material and Methods: The Department of Neurosurgery at Third central hospital included 28 patients with primary brain cancer and 33 relatively healthy people. The study was conducted under the permission of the Medical Ethics Review Committee of the Ministry of Health on June 19, 2019 №119. Serum aquaporin-4 and glial fibrous acidic protein content was determined by the ELISA kits method using the human aquaporin-4 and glial fibrous acid protein test kit of the Chinese company “Sanlong”. The level is assumed to be true if the p value is less than 0.05. Results Mean age of the all participants was 42.9±16.5, 64% female and 36% male. Serum aquaporin-4 protein levels were 175.71±13.3 pg/ml and serum glial fibrilliary acidic protein levels were 2.682±0.218 ng/ml in patient with primary brain tumor. Serum aquaporin-4 protein and glial fibrilliary acidic protein levels were statistically significant high (p<0.001) in patient with primary brain tumor. Serum aquaporin-4 protein and glial fibrilliary acidic protein level differences were statistically significant (p<0.05) in benign and malignant tumor. There was no statistically significant correlation between serum aquaporin-4 and glial fibrillary acidic protein level and primary brain tumor grade.

Introduction: Valproic acid (VPA) has been used in the treatment of seizures and bipolar disorders. In the present study, we examined how VPA affected PI3K-Akt pathway in response to LPS by using mouse RAW 264.7 macrophage cells. Material and methods: Mouse RAW 264.7 macrophage-like cells cultured and the cell viability checked by MTT and TUNEL assay. In addition, protein expression and protein interaction were detected by immune blotting and immune precipitation, respectively. TLR4 expression on cell surface studied by FACS analysis. Results: The MTT and TUNEL assays demonstrated no significant difference between VPA at 2 mM treated and untreated control cells. VPA attenuated LPS-induced phosphorylation of phosphatidylinositol 3-kinase (PI3K) and Akt, but not nuclear factor (NF)-κB and mitogen activated protein kinases (MAPKs). There was no significant difference in the TLR4 expression on the cell surface between cells treated with or without VPA. VPA inhibited LPS-induced PI3K/Akt signal transduction in a dose dependent manner. Conclusion VPA at 2mM exhibits nontoxic effect in the RAW 264.7 cells. VPA down regulates LPS-induced phosphorylation of Akt via inhibition of PI3K activation.

Introduction: When human body encounters external pathogens primary/innate immunity cells are activated by recognizing them and secondary/adaptive immunity is activated consecutively. Immune cell surface receptors, called Toll-like receptors (TLRs) recognize and bind pathogens. In our previous study, we revealed that there is a synergistic action between TLR9 and IFN-γ signaling in the endothelial cells. Purpose: To determine the role of negative and positive regulatory proteins on the IFN-γ/TLR9 synergistic signaling pathway Materials and Methods: This study was held in the Core Laboratory, Science Technology Center, Mongolian National University of Medical Sciences (MNUMS). In this study, murine endothelial cell (END-D) culture was used. The negative and positive regulator protein expression was detected by Western blotting. Result: Result of immunoblotting assay indicated that CpG DNA enhanced IFN-γ positive regulator protein p38 phosphorylation in the endothelial cells. Treatment by TLR9 ligand CpG DNA and IFN-γ increased p38 activation in 0.5 hour and 1 hour. CpG DNA inhibited IFN-γ negative regulator SOCS1 protein expression in 4 hr and 8 hr. Therefore, TLR9 ligand CpG DNA increased IFN-γ signal transduction in the endothelial cell line. Conclusion TLR9 ligand CpG DNA has decreased IFN-γ negative regulator protein SOCS1 expression. CpG DNA has increased IFN-γ positive regulator protein p38 phosphorylation.

Introduction: Toll like receptors (TLRs) are a class of proteins that key role in the innate immune system. The SOCS1 and SHP2 proteins are negative-feed loop inhibitors of signaling of JAK/STAT and TLRs pathways. Purpose: To determine negative regulator protein activation which is activated through TLR7 ligand/IFN-γ signal transduction in endothelial cells. Methods: We used mouse aortic linear endothelial cell (END-D); protein expressio was detected by western blotting Results: We analyzed a time dependent stimulation effects of negative regulator proteins stimulated by TLR7 ligand/IFN-γ in endothelial cell cultures. Imiquimod of 10 μg/ml treatment of 1 hr was followed by 100 ng/ml IFN-γ stimulation for 1-8hr to analysis of negative regulator SOCS1 and SHP2 protein expression.
In untreated cells, there was low activations of negative regulator SOCS1 and SHP2 proteins. IFN-γ stimulation alone had increased SOCS1 and SHP2 protein expressions, also imiquimod treatment highly elevated SOCS1 and SHP2 expressions. However imiquimod and IFN-γ doubled treatment have decreased activation of negative regulator SOCS1 and SHP2 proteins. These findings suggest SOCS1 and SHP2 proteins are inhibitors in the TLR7 ligand/IFN-γ signaling. Conclusion Negative regulators, SOCS1 and SHP2 strongly suppressed activations of TLR7 ligand/IFN-γ signaling