Background: According to the World Health Organization (2021), low back pain (LBP) affected approximately 619 million people worldwide in 2020, and the number of cases is projected to increase to 843 million by 2050, mainly due to population growth and aging. A study conducted in the Neurosurgery Department of the National Trauma and Orthopedic Research Center reported that over the past five years, the number of surgeries performed due to spinal disorders, particularly intervertebral disc herniation causing compression of the spinal cord and nerve roots has increased four to fivefold. Furthermore, this condition accounts for the majority of patients seeking treatment abroad. According to the 2023 statistical report of the State Central Hospital, a total of 477 surgeries were performed in the Neurosurgery Department. However, there are relatively few studies that have compared and evaluated pain levels before and after spinal surgery among patients. Therefore, this study was conducted to address this research gap. Aim: To compare and examine the intensity of back pain before and after surgery among patients who have undergone spinal surgery. Materials and Methods: This study employed a cross-sectional design using a quantitative research approach. A total of 123 patients who underwent spinal surgery at the Neurological Clinical Center of the State Central Hospital were randomly selected and included in the study. Pain intensity in patients undergoing spinal surgery was assessed using the Visual Analogue Scale (VAS) developed by Hayes and Patterson et al. A linear pain intensity assessment method was applied, and the study utilized a questionnaire consisting of 13 sociodemographic items. Result: All participants (100%) reported pain prior to surgery. Assessment of pain intensity showed that 1.6% (n=2) had mild pain, 52.8% (n=65) had moderate pain, and 45.5% (n=56) had severe pain. On the third postoperative day, pain assessment indicated improvement, with 51.2% (n=63) reporting no pain and 48.8% (n=60) reporting mild pain. The mean pain intensity score decreased from 4.63±0.53 before surgery to 1.48±0.50 after surgery (p = 0.009). Analysis of factors affecting postoperative pain revealed a significant association with the type of surgical procedure performed (p<0.03). Conclusion Comparison of pain intensity before surgery and on the third postoperative day among patients who underwent spinal surgery demonstrated significant improvement. Preoperative pain intensity varied according to the surgical indication, while postoperative pain was significantly associated with the type of surgical procedure and body mass index (BMI).

Background: Health insurance systems are a core component of social protection, aimed at safeguarding populations from financial risks, ensuring equitable access to health care services, and ultimately achieving universal health coverage. In recent years, Mongolia’s health insurance system has faced significant policy-level challenges related to efficiency, accessibility, and financial sustainability. Therefore, there is a growing need to conduct comparative analyses of internationally successful health insurance models. Aim: To comparatively examine Mongolia’s health insurance system in relation to the health insurance systems of selected countries. Materials and Methods: A comparative document review methodology was employed to analyze the health insurance and health financing systems of Canada, Germany, Japan, the Republic of Korea, and Kyrgyzstan. The analysis was based on policy documents, legal and regulatory frameworks, reports from international organizations, and relevant statistical data. Result: In countries such as Canada, Germany, Japan, and the Republic of Korea, health expenditure as a share of GDP exceeds the global average, while out-of-pocket payments by households remain relatively low. In contrast, Mongolia and Kyrgyzstan exhibit high levels of out-of-pocket expenditure, weaker financial protection, and comparatively lower performance indicators of the health system. Conclusion The findings suggest that increasing health expenditure as a share of GDP toward the global average, improving the management of health insurance funds, and reducing out-of-pocket payments by households are important considerations for enhancing the performance of Mongolia’s health system.

Background: According to the World Health Organization (WHO), arterial hypertension accounts for approximately 58% of the causes of cardiovascular disease (CVD) incidence and mortality. Consistent adherence to antihypertensive medication significantly reduces morbidity and mortality associated with cardiovascular diseases. Evidence from pharmacological treatment outcomes indicates that approximately half of individuals with hypertension do not receive antihypertensive drug therapy. Moreover, the proportion of untreated hypertension is higher among men (55.2%) compared with women (45.6%). However, studies assessing medication adherence among patients with arterial hypertension remain limited, which provided the rationale for conducting this study. Aim: To determine the level of medication adherence among patients with arterial hypertension. Materials and Methods: A cross-sectional study design was employed. General study information was collected using a structured questionnaire, and medication adherence was assessed using the Morisky Medication Adherence Scale-8 (MMAS-8) developed by Dr. Donald Morisky. The scale consists of eight questions. The total adherence score was categorized as follows: 8 points – high adherence; 6–7 points – moderate adherence; and <6 points – low adherence. Ethical approval for the study was obtained from the Research Ethics Committee of the Mongolian National University of Medical Sciences (MNUMS) according to Resolution No. 2023/3-07 of the meeting held on June 16, 2023. Statistical analysis: Statistical analysis of medication adherence was performed using SPSS version 29. A p-value <0.05 was considered statistically significant. Result: A total of 600 patients aged 25–85 years participated in the study. Among them, 14.8% (n=89) were aged 25–45 years, 29.3% (n=176) were aged 46–55 years, 38.7% (n=232) were aged 56–65 years, 15.5% (n=93) were aged 66–75 years, and 1.7% (n=10) were aged 76–85 years. The mean age was 56.35±9.9 years. The mean body weight was 73.95±13.69 kg, mean height 161.21±9.92 cm, and mean body mass index (BMI) 28.37±5.03 kg/m² (28.08 kg/m² in men and 28.53 kg/m² in women). The mean systolic blood pressure was 131.93±17.42 mmHg (135.0 mmHg in men and 130.0 mmHg in women), and the mean diastolic blood pressure was 83.58±13.3 mmHg. Regarding lifestyle factors, 27.3% (n=164) of the participants were smokers and 72.7% (n=436) were non-smokers, while 21.5% (n=129) reported alcohol consumption and 78.5% (n=471) did not consume alcohol. Based on the Morisky Medication Adherence Scale, medication adherence among patients with arterial hypertension was classified as high in 14.8% (n=89), moderate in 7.2% (n=43), and low in 78.0% (n=468). Conclusion Evaluation of medication adherence among patients with arterial hypertension revealed that approximately one in five patients demonstrated inadequate adherence to antihypertensive medication.

Background: Erysipelas is an acute, recurrent infectious disease caused by Group A β-hemolytic streptococcus. Recurrence occurs in 12–29% of patients, and complications in approximately 31%. International studies indicate that age, sex, and skin conditions are key factors influencing complications and recurrence. In Mongolia, the incidence of erysipelas has not steadily declined, and there is a lack of studies investigating clinical and laboratory predictors of complications and recurrence. Aim:: This study aimed to investigate clinical and laboratory predictors of complications and recurrence among erysipelas cases registered in Mongolia. Materials and Methods: A retrospective cross-sectional study design was employed. A total of 165 patients hospitalized with a diagnosis of erysipelas at the National Center for Communicable Diseases between 2020 and 2024 were randomly selected. Data were collected based on the “Clinical Guidelines for Erysipelas.” Statistical analysis was performed using SPSS-26, and ROC curve analysis along with regression models were used to determine risk and predictive factors. A p-value <0.05 was considered statistically significant. Results: The mean age of participants was 50.4±14.2 years; 76.5% were female, and 32.1% were herders. Recurrence was observed in 55.1% of patients (42.8% repeated episodes, 57.2% recurrent cases), and complications occurred in 10.3%. Among patients with complications, lesions were most commonly located on the face (41.2%) and predominantly presented as erythematous-bullous forms (70.6%). The neutrophil-to-lymphocyte ratio was 7.1 (AUC: 0.85, 95% CI: 0.79–0.91, p=0.001), and the systemic inflammatory response index was 3.9 (AUC: 0.93, 95% CI: 0.88–0.98, p=0.001), indicating high levels. Multivariable regression analysis showed that risk factors for complications included age >45 years (aOR=1.8, 95% CI: 1.2–2.7, p=0.004), female sex (aOR=2.8, 95% CI: 1.7–4.6, p=0.001), and occupation (herder) (aOR=2.6, 95% CI: 1.3–5.4, p=0.001). Chronic tonsillitis was significantly associated with recurrence (OR=3.8, 95% CI: 2.5–5.7, p=0.001). Cox regression analysis demonstrated that each additional year of age increased the risk of complications by 2% (HR=1.02, 95% CI: 1.01–1.03, p=0.003), while the presence of chronic tonsillitis increased the risk of recurrence by 7.69 times (HR=7.69, 95% CI: 5.15–11.49, p=0.001). Conclusion Cellular ratio indicators in erysipelas are useful for assessing inflammatory activity and disease progression. Age, sex, occupation, and the presence of chronic tonsillitis significantly influence the risk of complications and recurrence in erysipelas.

Background: Temporomandibular disorders (TMD) are the most common cause of non-dental orofacial pain and affect about one-third of adults. Population-based data obtained with standardized criteria are scarce in Mongolia, particularly outside the capital. Aim: To determine the prevalence of clinical signs of TMD and of examination-based Diagnostic Criteria for TMD (DC/TMD) diagnoses among residents of western Mongolia, and to compare them by sex and age group. Materials and Methods: This retrospective secondary data analysis utilized research data collected in 2020–2021 across Bayan-Ulgii, Govi-Altai, Zavkhan, Uvs, and Khovd aimags. A total of 520 participants were included in the analysis; participants aged from 16 to 71 years, with females accounting for 72.3%. Ethical approval for the secondary use of data was obtained in 2024. Diagnoses that can be established from the examination alone (IIa, IIIa–IIIc) were assigned. Differences were tested with chi-square and Fisher’s exact tests and logistic regression. The study was approved by the MNUMS Research Ethics Committee (№24/3-06) Results: At least one clinical sign was found in 87.1% of participants; deviation on opening (58.1%) and joint sounds (56.2%) were the most common. Muscle and joint pain on opening were found in 16.7% and 18.3%, and muscle and joint pain on palpation in 8.7% and 8.3%, respectively. An examination-based diagnosis was established in 21.5% (95% CI 18.2–25.3); disc displacement with reduction (14.4%) was the most common and Group III diagnoses were found in 8.3%. Pain on palpation at three or more muscle sites was found in only 3.3%. Compared with men, women more often had joint pain on opening (21.0% vs 11.1%; p=0.009) and muscle and joint pain on palpation, and had 2.5-fold higher odds of a Group III diagnosis (OR 2.50; 95% CI 1.02–6.15). Muscle pain on opening decreased with age (from 26.7% to 10.6%; p=0.036), whereas diagnoses did not differ by age group. Conclusions Most residents of western Mongolia had at least one clinical sign of TMD, mainly deviation on opening and joint sounds, and one in five had an examination-based DC/TMD diagnosis. Painful joint conditions were more common in women. The low prevalence of myofascial pain should be interpreted in light of limited standardization of palpation.

Background : Activities of Daily Living (ADL) refer to the essential self-care tasks necessary for independent living. A 2021 study conducted in France by researchers Axelle Kostenobel and Wierle Knoop found that the loss of independent functioning is a syndrome of physiological decline, with 60% of post-surgical patients experiencing a reduction in their independence. In Mongolia, there is limited research on the ability of post-surgical patients to perform daily activities independently. Therefore, this study was conducted to address this gap. Aim: The objective of this study is to assess the level of independence among patients admitted to the Surgical Department of the Mongolian-Japanese Hospital and to analyze the interrelationships between different functional abilities. Materials and Methods: This study was conducted as a cross-sectional quantitative study involving 185 patients who underwent surgery at the Surgical Department of the Mongolian-Japanese Hospital, affiliated with the Mongolian National University of Medical Sciences. The patients’ independence levels were evaluated postoperatively using the standard six-question ADL assessment questionnaire developed by Katz et al. (1963). The collected data were analyzed using SPSS 25.0, with normality distributions assessed. Since the data did not follow a normal distribution, Spearman’s rank-order correlation coefficient was used to determine the strength of associations between variables. Results: Among the study participants, 50.8% (n=94) were male, and 49.2% (n=91) were female. The average age was 47.9±14.56 years, and the mean hospital stay was 2.7±1.6 days. The assessment of independence levels revealed that: • 11.9% (n=22) were completely dependent, • 21.1% (n=39) had impaired independence, and • 67% (n=124) maintained normal or good independence. The mean hospital stay for patients with normal or good independence was 2.51±1.42 days, while it was 2.79±1.73 days for those with impaired independence and 3.6±2.03 days for fully dependent patients. There was a weak positive correlation between independence level and length of hospital stay (r=0.159, p=0.03). Strong direct correlations were observed between: • Eating ability and dressing ability (r=0.671, p=0.001), bathing ability (r=0.568, p=0.001), mobility (r=0.571, p=0.001), toileting ability (r=0.588, p=0.001), and continence control (r=0.609, p=0.001). • Dressing ability and bathing ability (r=0.766, p=0.001), mobility (r=0.723, p=0.001), toileting ability (r=0.788, p=0.001), and continence control (r=0.736, p=0.001). • Bathing ability and mobility (r=0.789, p=0.001), toileting ability (r=0.715, p=0.001), and continence control (r=0.644, p=0.001). • Mobility and toileting ability (r=0.822, p=0.001) and continence control (r=0.770, p=0.001). • Toileting ability and continence control (r=0.909, p=0.001). Conclusion One-third of the patients admitted to the surgical department experienced a decline in independence or complete dependence postoperatively, which was weakly correlated with a longer hospital stay. The various functional abilities that determine independence were strongly interrelated.

Background: The craniofacial region is one of the most frequently injured parts of the human body, with mandibular fractures being the most common type of facial skeletal injury. The leading causes of mandibular fractures include traffic accidents, falls, interpersonal violence, and sports-related injuries. In Mongolia, mandibular fractures are prevalent, with a higher incidence among males. However, to date, no national-level analysis of mandibular fractures has been conducted. This study aims to comprehensively examine mandibular fractures in Mongolia by identifying demographic factors and causes of injury. Aim: To determine the incidence and causes of mandibular fractures recorded in Mongolia over the past ten years. Materials and Methods: This study collected data on mandibular fractures recorded in the Health Development Center of Mongolia between 2014 and 2023. Cases were identified using the International Classification of Diseases (ICD-10) code S02.6. Information on patient age, gender, and hospital diagnosis was collected, along with the cause of injury, classified according to ICD-10 codes. Patient age was categorized based on the classification system of the National Statistics Office. Statistical analysis was performed using SPSS 26.00 software, employing the chi-square test for data analysis. Results: During the study period, a total of 2,872 patients were diagnosed with mandibular fractures, with the highest incidence occurring in the 20-40 age group. The average patient age was 31.1±12 years. Males were 5.6 times more likely to sustain mandibular fractures compared to females. The primary causes of injury were interpersonal violence (42%), mechanical trauma (17%), falls (16%), and traffic accidents (15%). Conclusion Between 2014 and 2023, 2,872 cases of mandibular fractures were recorded in Mongolia, with the majority occurring in individuals aged 20-40 years. The leading causes of mandibular fractures were interpersonal violence, mechanical trauma, falls, and traffic accidents. Specialized trauma care services were accessed differently in urban and rural areas.

The microbiologist, who aged 44 man has work with glander DNA extraction between January and March at 2022, was developed sumptoms with fever, headache, muscle pain, weakness, cut throat, cough at 4 March, 2022. On March 7, he had tested Covid-19 and the result was negative. He was given 1gr tefazoline by eight-time interval for two days. Despite completing the therapy, episodes of fever and headache increased. A medical evaluation, which included MRI test was no disorder was developed. On March 12, painful with leg and developed muscle pain. He continued to difficulty to walk and cough, fever and weakness. On March 13, he has admitted hospital with diagnoses pneumonia.
He had continued sign with pneumonia in both lung, fever, infiltration with right leg, cough, headache, and glandule node in hospital. By PCR test, glander DNA was detected in sputum in National Center for Zoonotic Diseases laboratory. He recovered 20 days in hospital.
He has 12 days incubation period and infection route was by worked with glander strain and it was pneumonia form with laboratory-acquired human glanders.
Human glander case is rare in Mongolia. Three human glander cases had registered in 1966, 1972, 1977 among prison’s horse herder in Mongolia.

Purpose: Researchers suggest that the prevalence of infertility varies between developing and developed countries, with differences in infertility care, socioeconomic status, lifestyle, and reproductive disorders such as pelvic inflammatory disease and sexually transmitted infections being the main risk factors. The research project aims is to define risk factors for female fertility in the Mongolian population. Methods: This study was conducted between 2016-2018 using a cross-sectional survey of analytical research. Participants were randomly selected from Ulaanbaatar and the Central, Western, Eastern, and Khangai provinces according to Mongolia’s regional geographic model. The contents of a questionnaire were comprised of 5 units with 95 questions including socio-economic, geographical, lifestyle, health education, reproductive health indicators, sexual behavior. General physical characteristics were measured according to the standard. Results: The prevalence of the female fertility rate in the Mongolian population is 7.4%. Female participants were classified into 2 groups, namely infertile and fertile, and we developed a case-control study. Among the socio-economic factors influencing infertility, primary education aOR: 1.6 (95% CI 0.98-2.66), monthly household income lower than the average aOR: 1.1 (95% CI 0.77- 1.66), living in rural areas OR: 2.3 ( 95% CI 1.46-3.68) were crucial risk factors. As for reproductive and general health indicators, STIs aOR: 1.8 (95% CI 0.98-3.50), especially gonorrhea OR: 2.8 (95% CI 1.14-6.91), and thyroid disorders OR: 1.7 (95% CI 1.03). -2.97), grade 3 obesity OR: 3.8 (95% CI 1.05-13.95) are estimated risk factors for infertility. Conclusions Of all potential socio-economic factors, residence status, education and financial situation are significant for female infertility meanwhile reproductive health indicators include sexually transmitted infections, thyroid disease, and obesity.

Objective: This study examines the job satisfaction of Mongolian hospital nurses by comparing their status and workload of Mongolian nurses with Japanese nurses’ one.Settings and participants/Methods: Survey data were collected from randomly selected 200 nurses (100 were Mongolians and the other 100 were Japanese) who agreed to participate in the survey. Data were collected through a self-administered survey questionnaire. Survey items were age, the duration of work experience, work position, health condition, accumulated fatigue, stress level, and whether having family members who need child care or nursing care. Collected data were analyzed by t-test and Wilcoxon Rank Sum test.Results: The average age of Mongolian nurses was significantly lower than that of Japanese nurses. Consequently, the average work experience of Mongolian nurses was less than that of Japanese nurses. More Japanese than Mongolian nurses had family members in need of care. Job satisfaction and status were significantly higher among Japanese than Mongolian nurses. However, Japanese nurses have family members who need child care or nursing care at a higher rate than Mongolian nurses. Job satisfaction of Japanese nurses about their work and job status was significantly higher than Mongolian nurses’ one. However, the opposite result was found in the job satisfaction about their workload. The influence of the relationships among nurses on the job satisfaction was significantly greater in Mongolian nurses than in Japanese nurses. Job satisfaction of Japanese nurses about their salaries was significantly higher than Mongolian nurses’ one.Conclusion: In order to raise nurses’ job satisfaction in Mongolia, it is necessary to raise their “occupational status” and salary of nurses.