Background: Substance use remains a critical public health and social concern, closely linked to increased sexual risk behaviors and a heightened vulnerability to sexually transmitted infections (STIs), particularly HIV and syphilis. International and national evidence suggests that individuals who use drugs often experience impaired judgment during intoxication, leading to unprotected intercourse, casual sexual encounters, and multiple sexual partners. In Mongolia, empirical data regarding sexual risk behaviors within this population remain scarce. Therefore, there is a pressing need to determine the prevalence of sexual risk behaviors and identify the specific factors influencing these patterns among drug users. Materials and Methods: This study employed a cross-sectional analytical design involving 181 participants who use drugs. Data were collected via structured questionnaires. Sexual risk behavior was evaluated using two approaches: as a dichotomous categorical variable and as a cumulative sexual risk score. Statistical analysis was performed using frequency distributions, percentages, means, and standard deviations. The associations between variables were tested using the (chi square test, Pearson correlation analysis, and multiple linear regression models. Results: The findings revealed that 12.2% of participants exhibited high-level sexual risk behaviors, with a mean cumulative risk score of 8.13 ±4.40. Engaging in sexual intercourse while under the influence of alcohol, the frequency of intoxicated sex (reported as "often" or "always"), and a history of casual sexual encounters were significantly associated with sexual risk behaviors. Furthermore, gender, cohabitation status, condom use during the first sexual experience, and the frequency of alcohol-involved sexual encounters were statistically significant predictors of the cumulative risk score. A weak positive correlation was observed between the number of sexual partners in the past year and the cumulative sexual risk score, which remained a significant positive predictor in the linear regression model. Conclusion Sexual risk behavior among people who use drugs is more closely associated with behavioral factors—such as alcohol-influenced sexual activity, casual encounters, lack of condom use during sexual debut, and multiple partnership—than with basic socio-demographic characteristics. Consequently, risk reduction interventions should move beyond general awareness. Efforts must prioritize reducing substance- and alcohol-related sexual risks, promoting consistent condom use, and enhancing the accessibility of STI screening and counseling services tailored to this high-risk group.

Background: Drug use is closely associated with sexually transmitted infections, especially syphilis and HIV, through unsafe sexual practices, multiple partners, and high-risk patterns of substance use. Prisoners with a history of drug use represent a particularly vulnerable subgroup. Aim: This study aimed to determine the prevalence of rapid syphilis test positivity and selected associated factors among incarcerated people who use drugs. Materials and Methods: A cross-sectional analytic study was conducted among 105 prisoners. Data were collected using a structured questionnaire and a finger-prick rapid dual test. Descriptive statistics, chi-square tests, and Fisher exact tests were used, with p<0.05 considered statistically significant. Results: The mean age of participants was 29.1±8.4 years; 78.1% were male. A history of STI was reported by 16.2%, STI-related symptoms during the last 12 months by 19.0%, STI testing during the last 12 months by 39.0%, and STI testing while incarcerated by 45.7%. However, 79.0% had received STI-related education or information. Among 81 participants with valid rapid syphilis test results, 27 were positive, giving a prevalence of 33.3%. Syphilis positivity was significantly higher among those using more than one route of drug administration (41.4% vs 13.0%, p=0.018) and among those with a prior STI history (70.0% vs 26.6%, p=0.011). No significant associations were found with sex, age, education, marital status, cohabitation, income, syringe use, recent STI symptoms, casual sex before arrest, or overall sexual risk behavior. Conclusion These findings suggest that targeted syphilis screening, counseling, and linkage to confirmatory testing and treatment should be strengthened among incarcerated people who use drugs, particularly those with multi-route drug use and a previous STI history.

Background: Sexual risk behavior is an important issue that requires early identification and assessment because it is associated with sexually transmitted infections, particularly HIV and syphilis, unintended pregnancy, and adverse reproductive, psychosocial, and mental health outcomes. Clients with sexual risk behaviors may also experience fear, anxiety, depression, shame, and stigma. Therefore, psychiatrists have an important role in identifying these risks, providing counseling, and referring clients for further care when needed. However, in routine clinical practice, obtaining a full sexual health history and identifying sexual risk behavior through interview may be limited. Aim: This study aimed to assess psychiatrists’ current practice in asking about sexual risk behavior, their basic knowledge of HIV/STIs, attitudes toward clients with sexual risk behavior, and training needs. Materials and Methods: A descriptive cross-sectional questionnaire survey was conducted between July and October 2025. The study included 158 psychiatrists working at the National Center for Mental Health, district and local health centers, and private clinics providing mental health services. Data were collected using a questionnaire developed by the research team. The survey included socio-demographic and professional characteristics, practice related to asking about sexual risk behavior, knowledge of HIV/STIs, attitudes toward clients with sexual risk behavior, and institutional training needs. Data were analyzed using Microsoft Excel and SPSS version 23. Descriptive statistics, chi-square tests, non-parametric tests, Spearman correlation, and linear regression models were applied. Results: Of the participants, 78.5% were female, and the mean age was 36.8±10.2 years. Psychiatrists asked a mean of 6.2±5.7 out of 22 questions required to identify sexual risk behavior, indicating that only a limited number of relevant questions were routinely covered in clinical practice. General questions such as marital status, age at first sexual intercourse, sexual health-related complaints, and history of sexually transmitted infections were asked more frequently, whereas questions on sex with commercial sex workers, casual and multiple sexual partners in the last 3 months, and sexual orientation were asked less often. Male psychiatrists (p=0.036) and psychiatrists working in private practice (p=0.034) asked significantly more questions. Among the 131 participants eligible for HIV/STI knowledge assessment, 29.8% had adequate knowledge and 70.2% had inadequate knowledge. Misconceptions about mosquito transmission of HIV remained common. The mean attitude score among 131 psychiatrists was 14.3±1.7. Significant differences were observed across age groups (p=0.004), and psychiatrists with 0–10 years of experience had higher attitude scores than those with more than 10 years of experience (p=0.026). A weak but statistically significant negative correlation was found between years of work as a psychiatrist and attitude score toward clients with sexual risk behavior (Spearman r=-0.304, p<0.001; n=131). In addition, 69.0% of participants had previously worked with clients with sexual risk behavior, and 48.1% had provided care to such clients in the last 12 months. Conclusion The practice of asking about sexual risk behavior among psychiatrists remains limited and non-standardized. Differences were observed according to physician sex and type of institution. Continuous workplace-based training and practical guidelines are needed to strengthen psychiatrists’ capacity to identify sexual risk behavior and provide appropriate care.

Background: Neurosyphilis is a severe manifestation of Treponema pallidum infection that may occur at any stage, particularly in cases of inadequate treatment or follow-up. Case Presentation: We report a case of a 55-year-old male with a prior history of treated syphilis who presented with progressive neuropsychiatric symptoms, including memory impairment, disorganized speech, and behavioral changes. Serial serological testing revealed a rising rapid plasma reagin (RPR) titer from 1:2 to 1:32 over time. Cerebrospinal fluid (CSF) analysis demonstrated elevated protein levels and a positive Treponema pallidum hemagglutination assay (TPHA 1:80), confirming the diagnosis of neurosyphilis despite a negative VDRL test in CSF. The patient was initially treated with ceftriaxone, followed by definitive therapy with intravenous benzylpenicillin for 14 days. Subsequent follow-up showed a gradual decline in RPR titers (1:32 to 1:1) along with clinical improvement. Conclusion This case underscores the importance of adequate post-treatment surveillance and highlights the need to consider neurosyphilis in patients presenting with neuropsychiatric symptoms and rising serological titers, even in the absence of positive CSF VDRL findings.

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%).

Background and Aims: Hepatocellular carcinoma (HCC) is a common cause of cancer related death in Mongolia. Early diagnosis is the very important management to increase successful treatment and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC) tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic biomarker of HCC. Methods: We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP) levels were measured using commercially available enzyme-linked immunosorbent assay kits. The diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and estimated sensitivity and specificity of each biomarker. Results: sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999 (0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6 ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 % with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%). Conclusion Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC. Combination of two markers showed greatest diagnostic accuracy.

Introduction: Air pollution has become one of the major problems in socio-economic and health issues in Mongolia. Among the various hazards of particulate matter (PM) pollutants, microorganisms in PM2.5 and PM10 are thought to be responsible for various allergies and for the spread of respiratory diseases. Recent studies have shown that PM2.5 particles can cause chronic heart failure, heart arrhythmias, and strokes, as well as lung damage, cirrhosis, inflammation, cancer, cardiovascular disease, and metabolic disorders. Furthermore, some studies have concluded that PM2.5 particles in the environment are a risk factor for gastrointestinal, liver, colon, and lung cancer as well as it affects the growth and metastasis of various cancer cells caused by other factors. In our country, the health effects of air pollution and the relationship between the pathogenesis of cancer research are scarce. Therefore, the study of the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis) can provide a significant role for cancer treatment, diagnosis, and prevention. Purpose: Determining the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis) in in-vitro Material and Methods: A human liver cancer cell line (HepG2), human gastric cancer cell line (AGS) were obtained from the central scientific research laboratory in the Institute of medical sciences. HepG2, AGS cells were seeded at a concentration of 1*105 cells/mL in a culture flask and cultured in RPMI-1640 medium supplemented with 10% FBS, 1% antibiotic mix (penicillin, streptomycin) in a humidified atmosphere of 5% CO2 at 37 °C. The cytotoxic effect of PM 2.5 in AGS, HepG2 cells were evaluated by MTT, CCK8 assays. AGS, HepG2 cells were incubated in 96 well plates for 24h then treated with different concentrations (0, 5, 10, 25, 50 and 100 μg ) of Bayankhoshuu, Buhiin urguu, and Zaisan samples for 24h, respectively. Results: Concentrations of 10, 25, and 50 μg/ml of samples collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth, while doses of 25, 50 μg/ml of samples collected from Bayankhoshuu in March and December increased HepG2 cell growth. Therefore, concentrations of 25 and 50 μg/ml of samples collected from Bayankhoshuu in March increased AGS cell growth, while concentrations of 25, 100 and μg/ml of samples collected in December increased AGS cell growth. However, no cytotoxic effect was observed in the sample collected from Zaisan in March, whereas the PM2.5 sample enhanced AGS cell growth in dose dependent manner in December.(p <0.05) Conclusion High levels of heavy metals were detected in samples collected in December from Bayankhoshuu, Bukhiin urguu and Zaisan of Ulaanbaatar. Concentration of 25 μg/ml of samples collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth. Concentrations of 25 μg/ml of PM2.5 collected from three regions around Ulaanbaatar increased HepG2 and AGS cell migration.

Research of function of vitamin D on immune system has been studying since the study revealed that vitamin D receptor is expressed on the surface of the immune cells. 1,2-dihydroxyvitamin D3 [1,25(OH)2D], physiologically active form, can be generated through hydroxylation of 25-hydroxyvitamin D3 [25(OH)D], inactive form of vitamin D, in a liver, connecting with specific VDR make biological action. Vitamin D make different biological actions depends on connecting with different immunological cells. Some studies indicated that Vitamin D plays pivotal role in antibacterial innate immune responses through regulating reaction of the main cells as macrophages and dendritic cells. Moreover, calcitriol, the active form of vitamin D, is connected with VDRE, modulates the innate immune response through directly inducing expression of catelicithin and β-defensin as antimicrobial peptides, reducing secretion of IL-1b, IL-6, TNF-a, RANKL, COX-2 as proinflammatory cytokines and increasing production of IL-10, an anti-inflammatory cytokine. Vitamin D plays in proliferation and differentiation of T and B cells and regulates the activities of over 500 genes. Vitamin D differently impacts on per se stages of T cells’ proliferation. Vitamin D indirectly mitigates the differentiation from immature B cells to plasma B cells while it directly impacts on regulation of overloaded production of antibodies in plasma B cells. In conclusion, vitamin D modulates the innate- and adaptive immune response through regulation on activation of APCells, proliferation and differentiation of immune cells, secretion of some antibacterial peptides.

Introduction: Hepatocellular carcinoma(HCC) is the 6th most common cancer inthe world, but the first most commoncause of cancer death in Mongolia. Thereis no universally accepted consensuspractice guidelines for HCC owing to rapiddevelopments in new treatment modalities,the heterogeneous epidemiology and clinicalpresentation of HCC worldwide.Methods and Materials: This study wasconducted in the department of generalsurgery of Second Central Hospital ofMongolia between 2015 and 2016 on a totalof 36 patients with hepatocellular carcinoma.Results: The average of operationtime is a 132.2 min, the hospital stay 18.2days. Postoperative bleeding was 2.7% (1),encephalopathy 5.4% (2), wound infection5.4% (2), and incisional hernia 8.1% (3).There were not bile leak during 30 dayspostoperative day.Conclusion: Postoperative complicationis a comparable to different researcher.There were no death within first month.

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