Background: Non-traumatic intracerebral hemorrhage (ICH) represents the most devastating subtype of stroke, charac terized by spontaneous bleeding into the brain parenchyma. This neurological emergency carries a burden of mortality and long-term disability worldwide. Timely identification causal pathways is priority objective for adequate primary and secondary prevention of ICH. Risk factors may differ between ICH subtypes, and stratified approaches to management may be appropriate. Aim: This study is to identify cause and risk factors of ICH. Materials and Methods: A single centre descriptive study was carried out in Stroke Center of the State Third Central Hospital, Mongolia, including 718 consecutive acute patients with ICH during October 2022 to September 2024. Patients were classified using SMASH-U, an etiological based classification system. Results: Out of a total of 718 cases diagnosed with ICH, hypertension caused 75.3%, amyloid angiopathy 12%, undetermined 7%, structural lesions 2.92%, systemic disease 2.37%, medication 0.48% in 718 ICH patients. The mean age of the cases was 57.5 жил, and was the most common in men of the 50-59 age group (p<0.001). The main risk factor in hypertension and amyloid angiopathy groups was arterial hypertension (93.7%), in undetermined group alcohol consumption (48%), in structural group AVM and other vascular causes (23.8%), in systemic group chronic kidney insufficiency (29.4%), in medication group atrial fibrillation (100%), respectively. Conclusion 1. ICH was mostly caused by hypertension, amyloid angiopathy, systemic disease. 2. Arterial hypertension, heart disease, atrial fibrillation, previous stroke, oral anticoagulants, smoking, alcohol consumption, obesity/BMI≥25, liver cirrhosis, chronic kidney insufficiency, AVM and other structural anomalies were the most common risk factors.

Background: The development of accurate and non-invasive diagnostic tools is essential for improving early detection of cancers. Recent studies have shown that serum biomarkers may be useful for early detection of gastric cancer. Aim: We aimed to evaluate the diagnostic accuracy of PGI and PGR biomarkers for detection of the gastric cancer and atrophic gastritis. Materials and Methods: To identify relevant studies, the MEDLINE (PubMed) database was searched using the keywords (((“Gastritis, Atrophic”[Mesh]) OR “Stomach Neoplasms”[Mesh]) AND “Pepsinogen A”[Mesh]) AND “Sensitivity and Specificity”[Mesh]). Based on the inclusion and exclusion criterias, studies were selected according to the PRISMA guidelines. Meta-analysis was performed using Review Manager 5.4.1 and STATA/IC 15.0 (StataCorp LLC, USA, 2017). Results: According to the PRISMA guidelines, we selected a total of 18 studies in this meta-analysis. The meta-analysis results showed that the sensitivity of the PGI for the detection of atrophic gastritis was 58.5% (95% CI, 44.5-71.3), specificity was 90.2% (95% CI, 68.4-97.5), and DOR was 13.0 (95% CI, 2.6-64.6); the sensitivity of the PGR was 69.9% (95% CI, 58.1-79.5), specificity was 80.9% (95% CI, 52.4-94.2), and DOR was 9.8 (95% CI, 2.6-36.9). However, the sensitivity of the PGI biomarkers for detecting gastric cancer was 72.6% (95% CI, 54.7-85.3), specificity was 66.9% (95% CI, 52.5-78.7), DOR was 5.4 (95% CI, 3.1-9.3); PGR sensitivity was 77.8% (95% CI, 64.4-87.4), specificity was 65.0% (95% CI, 53.2-75.1), DOR was 6.6 (95% CI, 3.7-11.7); PGI+PGR sensitivity was 62.3% (95% CI, 51.1-72.2), specificity was 87.6% (95% CI, 78.0-93.3), DOR was 11.6 (95% CI, 6.8-19.8). Conclusion PGI and PGR tests demonstrated high specificity but moderate sensitivity. Although serum pepsinogen cannot replace endoscopy, it is considered to be an additional test and can be used to select high-risk populations.

Background: Esophageal cancer ranks as the fourth most prevalent malignancy in Mongolia. Among esophageal disorders, gastroesophageal reflux disease (GERD) accounts for 55% of cases, while esophageal motility disorders constitute 40%. Enhancing the diagnosis and management of esophageal disorders, alongside preventative strategies for esophageal cancer, necessitates a comprehensive understanding and widespread clinical application of esophageal functional assessment. However, epidemiological data and classification of esophageal motility disorders remain scarce in Mongolia, highlighting the necessity of this investigation. Aim: to identify specific risk factors associated with ineffective esophageal motility (IEM) Materials and Methods: This study was performed an analytical case-control design and was conducted at Intermed Hospital. A total of 702 HRM test results from patients attending the Gastroenterology and Endoscopy Center’s outpatient department, Intermed hospital Participants diagnosed with IEM based on HRM findings were assigned to the case group, while individuals with esophageal normal motility disorders were designated as the control group at a 1:2 ratio. Results: A total of 612 participants aged 21–80 years were included in this study of whom 57.8% (n=354) were female and 42.2% (n=258) were male, with a mean age of 51.1±12.7 years. The prevalence of IEM demonstrated a statistically significant increase in the 60–69 and ≥70 age groups compared to the control group (p<0.000). Participants diagnosed with IEM exhibited a mean lower esophageal sphincter (LES) pressure of 329.61±246 mmHg and a mean complete liquid bolus transit rate of 46.88±22.7%, both of which were significantly lower than those observed in the control group (p=0.000). Furthermore, the incidence of IEM was found to increase in correlation with the severity of hiatal hernia, as classified by both endoscopic and manometric criteria, demonstrating statistical significance (p=0.000). Conclusion IEM is more prevalent among elderly individuals and increases in incidence with the progression of hiatal hernia size. In cases of IEM, esophageal bolus transit is significantly delayed, and lower esophageal sphincter pressure is diminished. Further studies are warranted to elucidate additional risk factors contributing to ineffective esophageal motility.

Background: Multidrug-induced long QT syndrome is a serious heart rhythm disorder where multiple medications prolong the QT interval on an electrocardiogram, increasing the risk of a potentially fatal arrhythmia. Long QT syndrome is characterised by heart rate corrected QT interval prolongation and life-threatening arrhythmias, such as polymorphic ventricular tachycardia, Torsades de pointes leading to syncope and sudden death. Case: 21-year-old woman required resuscitation from an apparent cardiac arrest that had occurred after status epilepticus. The woman was diagnosed with long QT syndrome, cardiac channelopathy. She had a long history of syncope, seizure and palpitations. Family history was non-contributory. Home medications included levetiracetam 500 milligrams orally twice and fluoxetine 20 milligrams orally once a day which the patient reported non-compliance with. Levetiracetam is a widely used anti-epileptic medication secondary to its favorable safety profile. To our knowledge, there are few other case reports documenting torsades de pointes after levetiracetam administration, and specifically our case report will be the first documenting cardiac arrest after multidrug administration. Long QT syndrome is not often included in the differential diagnosis of epileptic and non-epileptic seizures. Early recognition of the syndrome is very important because of prognostic and therapeutic consequences. Conclusion Although no hereditary cause was confirmed, this case represents Torsades de Pointes triggered by multiple medications—including long-term low-dose carbamazepine, fluoxetine, diazepam, and high-dose levetiracetam—on a background of probable Romano–Ward syndrome or predisposition to QT prolongation. The arrhythmia progressed to cardiac arrest, requiring ICD implantation.

: Pleurotus ostreatus (Jacq) P. Kumm) is the second cultivated and most popular edible mushroom after Agaricus bisporus in the world. The fruiting bodies of these mushrooms have high nutritional value and are beneficial for health. Pleurotus ostreatus are an interesting source of bioactive glucans and other polysaccharides. This study focuses on the isolation and structural characterization of glucans from the fruiting bodies and stems cultivated mushrooms Pleurotus ostreatus. Methods: Physicochemical properties of fruiting bodies and stems cultivated Pleurotus ostreatus in Mongolia, were studied using standard methods. Glucans were extracted and purified using the precipitation method and Sevag reagent, and functional groups were determined by FT-IR. Conclusion The characteristic absorption bands of the water and alkali-soluble fractions were found near 1070, 1044, 869 and 777-769 cm-1. These IR bands are characteristic of fungal (1→3)(1→6)-β-D- glucans, and indicating these fractions are glucan-type polysaccharides

Introduction: Cases of gastric cancer have been declining worldwide in recent years. However, gastric cancer incidence increased in the last decade in Mongolia. In Mongolia, over 80% of gastric cancer cases are diagnosed during the late stage. Several studies have revealed that serum pepsinogens (PGs) level reflects, indirectly, histological and functional characteristics of the gastric mucosa. Goal: We aimed to evaluate the risk of gastric cancer and its precancerous condition based on serum PGI, PGI/II biomarkers. Materials and Methods: This case-control study enrolled 114 subjects, including patients with gastric cancer (n=36), atrophic gastritis (n=40) and healthy controls (n=138). The questionnaires were obtained to determine risk factors. Serum PGI, PGII, and H. pylori IgG levels were measured by ELISA (Pepsinogen I ELISA; Pepsinogen II ELISA; H.Pylori IgG ELISA; BIOHIT Plc, Helsinki, Finland). PGI to PGII ratio was calculated. Patients were classified into the ABC(D) group according to Miki K approach. Also, we developed new scoring system based on some risk factors and serum PGI, PGI/II ratio. Logistic regressions were performed to evaluate risk and expressed by odds ratio (OR) and 95% confidence intervals (95%CI). Results: Mean age of the subjects was 60±10.9 years. H.Pylori was positive in 67 subjects. The serum PGI and PGI/II ratio levels were significantly decreased in gastric cancer and atrophic gastritis groups compared to the healthy control. According to classification ABC(D), group D (OR 5.04, 95% CI 1.13-22.50) had higher proportion of atrophic gastritis cases, group C (OR 6.19, 95% CI 1.04-36.78) had higher proportion of gastric cancer cases than others. Additionally, we created a risk prediction scoring system with a score ranging from 0 to 7, based on variables age, family history of gastric cancer, prior disease history, PGI and PGI/II ratio levels. For the atrophic gastritis patients, 17 (42.5%) were classified into medium-risk category (OR 4.49, 95% CI 1.38-14.58) and 17 (42.5%) were classified into high-risk category (OR 7.69, 95% CI 2.16-27.43). Whereas, 11 (30.6%) patients with gastric cancer were classified into medium-risk category (OR 4.35, 95% CI 1.13-16.85), 21 (58.3%) were classified into high-risk category (OR 14.25, 95% CI 3.60-56.43). Conclusion The methods based on serum PGI and PGI/II may identify a high risk population of gastric cancer and atrophic gastritis.

Introduction: In a report from the WHO 2013 it states that, 23% of children between the ages of 13 and 17 had suicidal ideation and 9.3% attempted suicide in the last 12 months. According to the research of Bayarmaa V et al, the prevalence of behavioral and emotional disorder among adolescents is between 8.7% & 9.4%. As a result of these researches, it can be concluded that evaluating the mental health of adolescents and learning the risk factors that can affect it has become an urgent matter in Mongolia. Goal: To establish the prevalence, the factors that influence it and the type of signs and symptoms common to this behavioral and emotional disorder in adolescents of the Gobi-Altai province. Material and Method: No ethical errors were reported during the implementation of this study. We used various versions of the Strengths and Difficulties Questionnaire (SDQ) applicable for children, adolescents, parents and teachers and determined exhibition of emotional and behavioral problems by cross-sectional analysis. 2192 adolescents between the ages of 11-18 years old, 1808 parents and caregivers and 102 teachers from the secondary school in Gobi-Altai province were screened from March to December of 2018. Results: In our study, 50.5% (n=1107) of participants were boys, 49.5% (n=1085) were girls and totally 2192 participants were involved. Regarding the survey results, 58.6% of adolescents in Gobi-Altai province were healthy, 36.1% of them had emotional and behavioral problems and 5.2% of them had emotional and behavioral disorders. For the mental health of adolescent, peer bullying (child 1.4 times higher, parents 6.4 times higher), moving house (child 2 times higher), domestic disputes between parents (child 1.6 times higher), loneliness (child 1.4 times high), hormonal change (teacher 7.7 times high, parents 2 times high), obtaining a qualification for a better life (teacher 6.4 times high) are the factors affecting their mental health negativ ely and creating a mental health problem. Conclusion 58.6% of adolescents in Gobi-Altai province were healthy, 36.1% of them had emotional and behavioral problems and 5.2% of them were with emotional and behavioral disorders. Peer bullying, moving house, domestic disputes between parents, loneliness, hormonal change are the factors affecting the mental health of adolescents negatively.

The result of endovascular surgical treatment of congenital heart disease Background: Over the last 10 years the advances in catheter based interventions for congenital heart disease(CHD) include new procedures, devices and almost 25% of all CHD are now can be treated by endovascular surgery. The purpose of this report was to evaluate the outcome and result of endovascular surgeries for congenital heart disease. Materials and methods: The study included all cases of endovascular surgeries at the National Center for Maternal and Child Health the period of 2014-2019. Results: Total 631 cases had intervention procedures and 377 (59.7%) cases had endovascular surgeries for CHD. 268 patients had patent ductus arteriosus device closure successfully while 57 had pulmonary artery valvuloplasty using balloons. Also 76 patients had device closure of atrial septal defect and 4 patients had device closure of ventricular septal defect using new multifunctional occluder. Another 20 patients had severe coarctation of aorta and had balloon dilatation and stenting as a life saving procedure. Conclusions: Endovascular surgery for CHD is a safe and effective alternative to open heart surgery.

BACKGROUND. Uterine cervical cancer is the fourth leading cause of cancer deaths in women worldwide. In our country, cervical cancer is second most common cancer in women. Uterine cervical smear (Papanicolaou test) remains an effective and widely used method for early detection of precancerous and cancerous lesions. Since 2002, the cervical smear was introduced to the clinical practice of our country. However, there is no study to performed external quality assurance of cervical smear until now. MATERIALS AND METHODS. We selected 20 glass slides of uterine cervical smear, the diagnosis was approved by histopathology. Each chosen slides were evaluated by four cytologists of A, B, C, D hospitals with hidden clinical information, independently. RESULTS. The sensitivity of A, B, C and D hospitals were 87.5%, 93.3%, 93.3%, and 93.3%, respectively. The specificity of A, B, C and D hospitals was 85.7%, 85.7%, 75%, and 66.6%, respectively. The diagnostic concordance of A, B, C and D was 70%, 75%, 50%, and 55%, respectively. The agreement of cytological diagnosis was moderate (kappa = 0.55), moderate (kappa = 0.43), fair (kappa = 0.37), and fair (kappa = 0.33) in A, B, C, and D hospitals, respectively. CONCLUSION: The external quality assurance in cytopathology is needed in Mongolia. The diagnostic concordance method would be applicable in our country to improve diagnostic agreement.

Introduction: Rongalite have many names, the trade name for sodium hydroxymethylsulfinate also sodium formaldehydesulfoxylate. It causes serious side effects to human body and is forbidden to be used as food additives by law. It is still frequently used illegally in rice and flour products. Based on this study, we determination rongalite level in some friut widespread of in our country. The study was done materials used in Lingonberry, Blueberry, Hippophae, Blackcurrant fruits collected in Khuvsgul. To determine rongalite was followed by protocol to sanitation-laboratory of food of the school of social of health in MNUMS used for NC-860 Universal Food Safety Analyzer. The concentration in sample that were measure to 153.88- 213.85 mg/kg of Lingonberry, Blueberry, Hippophae, Blackcurrant fruits weight. Materials and methods : The study was done materials used in a Lingonberry, Blueberry, Hippophae, Blackcurrant fruits collected in Khuvsgul. To determine rongalite was followed by protocol to sanitation-laboratory of food of the school of social of health in MNUMS used for NC-860 Universal Food Safety Analyzer. Weigh accurately 5.0 g of the fruit in a plastic extract bottle, add 20 ml of distilled water, extract for 10 min by centrifugated. Than filtrate into 6 time respectively test tubes through 0.45 μm membrane using remove the color. Rongalite determined in use a disposable test tube, add 1 drop of oxidizing reagent. Amount of rongalite used for NC-860 Universal Food Safety Analyzer. Result and discussion Based on the obtained result, the maximum concentration observed in Blueberry was 213.85 mg/kg, and the minimum concentration observed in Hippophae was 153.88 mg/kg, the concentration observed in Lingonberry was 192.8 mg/kg, the concentration observed in Blackcurrant was 155.29 mg/kg of contained weight respectively. The difference of rongalite concentrations in wheat powder and rice powder was 0.41 mg/kg in China. Identified to the result was higher than other research.