Background: According to the WHO, 1.28 billion people worldwide suffer from hypertension, with the majority living in developing countries. In Mongolia, the prevalence of hypertension remains high, and the STEPS-2019 survey found the disease is common even among younger age groups. Manual/Automated blood pressure measurement methods require specific conditions and carry risks of measurement error. In recent years, the availability of AI-based mobile applications to measure blood pressure and vital signs has increased; however, there is a lack of research in Mongolia evaluating their accuracy in accordance with the ANSI/AAMI/ISO 81060-2:2022 standard, highlighting the necessity for this study. Aim: To compare the results of blood pressure, heart rate, and peripheral oxygen saturation SpO₂ determined by an AI-based application with the results of traditional clinical device measurements. Materials and Methods: We included 120 participants who consented to the study. Measurements were taken 3 times each using both the clinical device and the AI-based application, collecting a total of 360 measurement values. Data were analyzed using Pearson’s correlation coefficient, Paired t-Test, Bland-Altman plots, and Intraclass Correlation Coefficient (ICC). Result: The mean difference between the clinical device and the AI-based smartphone measurements was -2.05 mmHg (p<0.001) for systolic pressure, -2.36 mmHg (p<0.001) for diastolic pressure, -0.30 bpm (p=0.088) for heart rate, and 0.32% (p<0.05) for SpO₂. Pearson’s correlation coefficients were r=0.772 (p<0.001) for systolic pressure, r=0.892 (p<0.001) for diastolic pressure, r=0.978 (p<0.001) for heart rate, and r=0.391 (p<0.001) for SpO₂. Conclusion While AI-based application measurements are capable of determining blood pressure, heart rate, and peripheral oxygen saturation, they are not accurate enough for use in clinical practice.

Background: The cornerstone of medical education in training qualified physicians lies in foundational scientific knowledge, which forms the basis for clinical reasoning and diagnostic-therapeutic decision-making. Anatomy constitutes one of the core foundational subjects within the medical doctor training curriculum and exerts a direct influence on the development of students’ baseline knowledge and the formation of their clinical thinking. This study was conducted to evaluate the anatomy curriculum through assessments by first-year students enrolled in the basic medical education program, with the aim of enhancing instructional quality and improving the structure and organization of the course. Aim: To investigate the satisfaction ratings of first-year students in the basic medical education program regarding the Anatomy-1 course. Material and Methods: The study was carried out using an analytical cross-sectional design during the first semester of the 2025–2026 academic year. Data were collected from a total of 289 first-year students of the basic medical education program at the School of Bio-Medicine of MNUMS (Mongolian National University of Medical Sciences) using a questionnaire comprising 24 items in total—3 demographic questions, 20 general satisfaction questions, and 1 open-ended question—with each item rated on a 5-point Likert scale. Data were processed using SPSS 23.0 software, employing descriptive statistics, two-sample t-tests, ANOVA, Pearson’s correlation, and factor analysis. Results: Of the study participants, 14.2% were male and 85.8% were female, with the cohort distributed across programs as follows: TAM 10.38%, TMS 17.30%, MDS 44.29%, PDS 13.15%, and DSS 14.88%. The overall satisfaction level was 4.59±0.66, falling within the “good” range. The highest rating was attributed to “Faculty members possess strong professional knowledge and skills” (DSS, 4.91±0.37), whereas the lowest rating was assigned to “Students’ knowledge and skills are evaluated objectively and fairly” (PDS, 4.16±0.75). The internal consistency coefficient of the questionnaire yielded α=0.909, indicating excellent reliability. Correlation analysis revealed strong positive associations among instructors’ respect for students’ viewpoints (Q4), instructors’ communication and demeanor (Q5), and professional ethics (Q6) (r=0.787; r=0.755; p<0.01). Factor analysis produced a KMO value of 0.865 and a Bartlett’s test result of p=0.000; accordingly, all 20 items were grouped into two factors—”Faculty Professional Competence” and “Learning Environment and Organization”—which collectively accounted for 58.74% of the total variance. Conclusions 1. The findings indicate that the overall satisfaction of first-year basic medical education students who participated in the study was at a favorable level. 2. Faculty professional competence and the learning environment and organization were identified as factors influencing student satisfaction, explaining 58.74% of the total variance in the results. It was further established that adherence to professional ethics, respect for students’ perspectives, and equitable treatment are contingent upon the instructor’s knowledge and professional expertise.

Background: In recent years, due to the rapid development of digital technology and the decline in physical activity, there has been a noticeable decrease in the physical development of children and adolescents, along with an increased risk of non-communicable diseases. Organizations such as the World Health Organization, UNESCO, and the International Olympic Committee recommend integrating regular physical activity into daily life to promote population health. Therapeutic physical exercise is an effective method for restoring bodily functions, increasing muscle strength, and correcting movement impairments, and it serves as an important tool for supporting the physical development and health of school-aged children. Therefore, this study aimed to determine the effects of therapeutic physical exercise on the physical development indicators of children with chronic illnesses and disabilities. Aim: To determine the impact and effectiveness of inclusive participation of students with pathological conditions in physical education classes on their physical development and health indicators. Materials and Methods: Thirty students diagnosed with chronic diseases and enrolled in general education schools participated voluntarily. At the beginning of the study, demographic information was collected, and baseline measurements were taken to assess flexibility, waist and hip circumference, forearm and back muscle strength. Therapeutic exercises tailored to the characteristics of each condition were then implemented according to the FITT principle. After the intervention period, follow-up measurements were conducted. Data were analyzed using descriptive statistics, paired t-test, independent t-test, Pearson correlation, and Cohen’s d in SPSS 25.0 software. Statistical significance was evaluated at the p<0.05 level. Results: After the therapeutic exercise intervention, participants’ flexibility increased by 3.70 cm, right-hand muscle strength by 7.50 kg, left-hand muscle strength by 6.92 kg, and back muscle strength by 17.60 kg, all of which were statistically significant changes (p<0.05). Height increased by 2.36 cm and weight by 1.98 kg. The effect sizes of these indicators ranged from moderate to high. Conclusions 1. The results of this study demonstrate that therapeutic exercise may produce statistically significant positive changes in certain physical fitness parameters among students with pathological conditions, particularly in upper limb and back muscle strength, as well as flexibility. The observed effect sizes ranged from moderate to high, indicating potential practical significance for implementation in practice. 2. In contrast, the changes observed in height and body weight are considered to reflect the indirect effects of therapeutic exercise together with the participants’ natural physiological growth and development. 3. This study suggests that therapeutic exercise may serve as an effective approach for promoting inclusive participation in educational activities among students who are exempted from regular physical education classes, while also supporting the improvement of their physical capacity.

Background: Allergic and atrophic forms of chronic rhinitis are common among the population, characterized by a chronic progressive course with a tendency toward increasing prevalence. Worldwide, allergic rhinitis affects approximately 10–40% of adults and 2–25% of children. According to a study conducted in Mongolia, the prevalence of allergic rhinitis among adults in Ulaanbaatar was reported to be 23.6%, with an increasing trend anticipated in the future. In allergic and atrophic rhinitis, structural alterations occur in the nasal mucosa, including disruption of the normal architecture of the pseudostratified epithelium and ciliated cells, accompanied by changes in goblet cell number and dysfunction of their activity, resulting in a complex pathological process. In otorhinolaryngology practice in Mongolia, there is a relative lack of studies investigating the ultrastructural changes of the nasal mucosa in allergic and atrophic rhinitis. Aim: To compare ultrastructural and histological changes of the nasal mucosa in allergic and atrophic rhinitis. Materials and Methods: Ethical approval was obtained from the Research Ethics Review Committee of the Mongolian National University of Medical Sciences at the meeting held on April 24, 2020 (Protocol No. 2020/З-04). Appropriate ethical permission was also obtained from the EMJJ ENT Hospital. Nasal mucosal tissue samples were collected from surgically resected specimens of patients aged 20–45 years diagnosed with allergic and atrophic rhinitis. The mucosal specimens were processed at the Institute of Biomedical Sciences of the Mongolian National University of Medical Sciences. Samples were fixed and dehydrated according to the protocol, coated with 100 Å gold, and examined using a scanning electron microscope (FEI Quanta FEG 250, USA). In addition, paraffin blocks were prepared, sectioned at 4 μm thickness, stained with Hematoxylin and Eosin, and analyzed histologically. Results: In allergic rhinitis, the pseudostratified epithelium was relatively preserved; however, disorganization of ciliated cells, partial loss of cilia, and goblet cell hyperplasia were observed. In contrast, atrophic rhinitis showed epithelial thinning, near-complete loss of ciliated structures, glandular atrophy, and submucosal fibrosis. Conclusion Allergic rhinitis is associated with relatively mild and predominantly functional mucosal alterations, whereas atrophic rhinitis demonstrates severe structural damage with irreversible impairment of mucosal protective function.

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: The Anatomy course, which provides general foundational knowledge on the structure of all organ systems of the human body, is a core professional course in the bachelor’s curricula of Pharmacy, Biomedical Science, Hygiene and Epidemiology, Public Health, Occupational Safety and Health, and Nutrition and Dietetics. Student satisfaction is not only an important indicator of the quality of medical education, but also influences graduates’ knowledge, skills, and attitudes; therefore, continuous research in this area is necessary. Aim: To determine the level of satisfaction with the Anatomy curriculum among first-year students in basic health science programs and to identify factors influencing their satisfaction, with the aim of improving the quality of teaching. Materials and Methods: An analytical cross-sectional study was conducted from September 2025 to February 2026 among 182 first-year students enrolled in the following programs at Mongolian National University of Medical Sciences (MNUMS): Biomedical Research, Pharmacy, Health Epidemiology, Public Health, Health Informatics, and Traditional Medicine Therapy. Student satisfaction with the quality of the Anatomy course was assessed using a 24-item questionnaire. Data were analyzed using SPSS version 26, applying descriptive statistics, independent-samples t-test, one-way analysis of variance (ANOVA), Pearson correlation, factor analysis, and multiple regression analysis. A p-value of <0.05 was considered statistically significant. Results: The internal consistency of the satisfaction scale was very high (Cronbach’s α=0.928). The mean overall satisfaction score of the participants was 4.61±0.67. There was no significant difference in overall satisfaction by gender (p > 0.05). Factor analysis identified two main factors influencing the evaluation of teaching quality (KMO=0.894; Bartlett’s test p<0.001), which together explained 52.73% of the total variance. The first factor was “Teachers’ professional competence, communication, attitude, and assessment,” and the second factor was “Course organization, learning environment, and instructional materials.” Correlation analysis showed that better course organization and higher teacher engagement were positively associated with students’ satisfaction (p<0.01). Conclusions 1. Among first-year basic health science students, satisfaction with the Anatomy course was influenced by teachers’ professional competence, ethics, interpersonal communication, and fair, objective assessment. 2. Adherence to professional ethics and maintaining respectful communication with students were found to be closely related to teachers’ knowledge and professional skills.

Background: Currently, the rise of antimicrobial resistance (AMR) has led to reduced therapeutic efficacy in severe infections such as osteomyelitis. Furthermore, broad spectrum synthetic antibiotics disrupt microbiome balance and weaken the host immune system. Therefore, given the need to investigate natural biologically active supplements that inhibit pathogens without adversely affecting the viability of beneficial microorganisms supported by experimental and clinical studies this study was grounded in determining the effects of the Osteo Calcium-5 supplement on pathogenic and beneficial bacteria Aim: To investigate the in vitro effects of the biologically active supplement Osteo Calcium-5 on pathogenic and beneficial bacteria. Objectives: To determine the antibacterial activity of the biologically active supplement Osteo Calcium-5 by measuring the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and the diameter of the inhibition zone. To compare the effects of the Osteo Calcium-5 supplement on the growth of pathogenic and beneficial bacteria, and to evaluate the levels of selective activity and resistance. Materials and Methods: The study was performed using a quantitative research approach with an experimental research design, utilizing two standard pathogenic bacterial strains Staphylococcus aureus ATCC 12600 and methicillin-resistant Staphylococcus aureus (MRSA) ATCC 700699 along with two standard beneficial bacterial strains, Lactobacillus paracasei and Streptococcus thermophilus. The Osteo Calcium-5 supplement was extracted using a solution of 70% ethanol and 0.1% HCl. To determine its antibacterial efficacy, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were assessed in triplicate across a concentration range of 0.78% to 12.5% using the broth microdilution method, and evaluated via the agar well diffusion method based on the inhibition zone diameter. Results: It was established that the extract of the biologically active supplement Osteo Calcium-5 exerts selective effects on the growth of pathogenic versus beneficial bacteria. Specifically, for the pathogenic MRSA strain, the minimum inhibitory concentration (MIC) was 0.78% and the minimum bactericidal concentration (MBC) was 1.56%, whereas for the S.aureus strain, both MIC and MBC values were 1.56%, demonstrating high antibacterial activity with complete inhibition of colony growth at this concentration. In contrast, L.paracasei and S.thermophilus strains grew normally at low concentrations of the supplement, with MIC values ranging from 6.25% to 12.5%, proving to be several fold more resistant than the pathogenic strains. Furthermore, the agar diffusion method showed active inhibition of S.aureus (16.50±0.29mm) and MRSA (15.00-0.58mm) bacterial growth through the formation of inhibition zones, while exhibiting no adverse effects on the growth of the beneficial bacterial strains L.paracasei and S.thermophilus. Conclusions The MIC of the Osteo Calcium-5 supplement was determined to be 0.78% for MRSA and 1.56% for S.aureus, with the MBC for both strains established at 1.56%. Through the agar well method, the supplement actively inhibited the growth of S.aureus (16.50±0.29mm) and MRSA (15.00±0.58mm) by forming inhibition zones, effectively suppressing osteomyelitis inducing pathogens at low concentrations via mechanisms including bacterial cell wall and membrane disruption and virulence neutralization. For the beneficial bacterial strains L.paracasei and S.thermophilus, the MIC values of the supplement extract ranged from 6.25% to 12.5%, allowing normal growth at low concentrations without forming inhibition zones. This indicates a significantly higher resistance to the supplement compared to pathogens, proving its unique capability to selectively inhibit infections without disrupting the balance of the human normal microbiome.

Background: Double-lumen tubes (DLTs) are widely used in thoracic surgery to achieve one-lung ventilation. International recommendations suggest tube size selection based on height and sex (39 41 Fr for males ≥160 cm, 35–37 Fr for females ≥150 cm). However, in Mongolian practice, applying these standards often leads to oversized tube use and related complications. Objective: To compare international standards for DLT size selection with body height and sex in Mongolian patients. 10 Methods: A cross-sectional study was conducted among patients who underwent esophagectomy with left-sided DLT placement at the National Cancer Center of Mongolia between 2018 and 2023. Data included age, sex, height, and DLT size. Statistical analysis was performed using chi-square and t-tests, with p < 0.05 considered significant. Results: A total of 211 patients were analyzed (58.8% male, 41.2% female). Among males, 170 cm patients received 37 Fr in 90% of cases (p < 0.001). Among females, 160 cm patients either 35 Fr or 37 Fr (p < 0.001). Tube size also differed significantly by sex (p < 0.001): 68.5% of males received 37 Fr, while 83.9% of females received 35 Fr. Conclusion In Mongolian clinical practice, DLT sizes are generally chosen smaller than those recommended by international standards, based on sex and height. All patients in the study achieved successful one-lung ventilation and favorable surgical conditions, indicating that international standards may not be fully applicable to the Mongolian population. Moreover, the study highlights that while DLT size selection correlates strongly with height in males, the association is weaker in females. Therefore, reliance solely on height and sex may be insufficient, and additional biometric and anatomical parameters should be considered for optimal tube selection

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide, accounting for approximately 1.8 million deaths annually and representing 18% of all cancer deaths¹. According to the GLOBOCAN 2024 report, 2.4 million new cases were registered globally, ranking second after breast cancer². Non-small cell lung cancer (NSCLC) constitutes 85% of lung cancer cases, with adenocarcinoma being the most common subtype³. The objective of this study is to map the prevalence of HER2 activation and mutations in EGFR, EML4-ALK, ROS1, BRAF, and KRAS genes among lung cancer patients in Mongolia, and to evaluate their correlations with clinical and morphological parameters (age, sex, smoking status, stage, and morphology). Aim: To determine the distribution pattern of HER2 activation and EGFR, EML-ALK, ROS1, BRAF, KRAS gene mutations among patients with lung cancer in Mongolia, and to evaluate their associations with clinical and morphological characteristics. Materials and Methods: A retrospective study was conducted using archived materials from lung cancer patients at the Clinical Pathology, Molecular Genetics, and Pathology Laboratories of the National Cancer Center of Mongolia, covering the period from 2019 to June 2025. DNA Extraction from Tumor Tissue: Formalin-fixed paraffin-embedded (FFPE) tissue blocks from patients diagnosed with lung cancer, stored in the pathology department archives, were selected for the study. Sections of 5–10 μm thickness were cut, mounted on glass slides, stained with hematoxylin and eosin (H&E), and reviewed by a pathologist. Areas containing ≥20–30% tumor cells were identified and macro-dissected for analysis. Real-Time PCR Assay for Detection of EGFR/BRAF/KRAS/EML4-ALK/ROS1 Mutations: EGFR mutation detection was performed using the PANAMutyper™ EGFR Mutation Detection Kit (Panagene, Daejeon, South Korea) according to the manufacturer’s instructions. PCR reactions were carried out on a compatible instrument (Roche LightCycler 480, Germany) as recommended by the manufacturer. Statistical analysis was performed using Prisma-10 software. Results: A total of 282 lung cancer cases were included in the study. EGFR mutations were detected in 44% of cases and were absent in 56%. No significant age-related differences were observed (p=0.2636); however, EGFR mutations were significantly more frequent in females (36.6% vs. 19.6%, p=0.0019). No statistically significant differences were found across disease stage, T, N, or M classifications (p>0.05). No association was identified between smoking status and EGFR mutations (p=0.4178). Morphologically, EGFR mutations were significantly more prevalent in adenocarcinoma (54.83%) compared to squamous cell carcinoma (SCC) (31.8%; p=0.002). Of the 282 cases, adenocarcinoma accounted for 155 (54.9%) and SCC for 116 (41.1%). Overall, EGFR mutations were positive in 43.97% of cases, with a higher prevalence in adenocarcinoma (24.82%) than in SCC (13.1%). By exon: - Exon 18 mutations were detected in 6% of cases, predominantly in adenocarcinoma (6%, 4.25%). - Exon 19 mutations occurred in 8.15% and are associated with sensitivity to targeted therapy. - Exon 20 mutations were found in 3.19%, with the T790M resistance variant in 1.77%. - Exon 21 mutations were observed in 9.57%, more common in adenocarcinoma (9.57%) than in SCC (3.19%). Survival analysis stratified by stage at diagnosis showed significantly longer median survival in early-stage patients (18.6 months). Kaplan-Meier curve comparison, log-rank test, and hazard ratio calculations confirmed statistically significant differences (p < 0.05), indicating that disease stage is a key prognostic factor. Conclusion The study findings reveal a high prevalence of EGFR mutations among Mongolian patients with lung adenocarcinoma, underscoring the need for widespread implementation of targeted therapy (EGFR-TKIs). In contrast, mutation rates were lower in SCC and other morphological subtypes, highlighting the importance of investigating alternative molecular markers in these subgroups.

Background: Globally, gastric cancer accounts for 1,089,000 new cases and 769,000 deaths annually, ranking fifth in overall cancer incidence and third in cancer-related mortality. The aim to determine HER2 expression in patients with gastric cancer and to evaluate its correlation with clinical and immunological biomarkers, as well as the need for further laboratory diagnostics. Aim: To determine HER2 expression in patients with gastric cancer and to evaluate its association with clinical and immunological biomarkers, as well as the potential need for further laboratory diagnostics. Materials and Methods: A retrospective study was conducted using archived materials from patients with gastric cancer at the Clinical Pathology, Molecular Genetics, and Pathology Laboratories of the National Cancer Center of Mongolia, covering the period from 2019 to June 2025. HER2 protein expression in tumor tissue was assessed using immunohistochemistry (IHC), and chromogenic in situ hybridization (CISH-HER2) was employed to confirm gene amplification. Statistical analysis was performed using the Prisma-10 software. Results: In our study, among 210 cases of gastric cancer evaluated by IHC for HER2, 46 (21.9%) were HER2-positive and 164 (78.1%) were HER2-negative. When comparing patients with gastric cancer stratified into HER2 1+ (negative) and HER2 3+ (positive) groups, no statistically significant differences (p < 0.05) were observed in age, sex, tumor location (surgically resected tissue), morphology, or disease stage. However, a higher proportion of males was noted in the HER2 3+ group (80.9%), though this did not reach statistical significance (p = 0.0879). Significant associations were found with tumor markers. Elevated serum CA-72-4 (>5 ng/mL) was more frequent in the HER2 3+ group (58.8%; p = 0.0069). In contrast, elevated CA-19-9 (>35 U/mL) was more common in the HER2 1+ group (93.5%; p = 0.0117), and elevated CEA (>6.9 U/mL) was also predominant in the HER2 1+ group (90.6%; p = 0.002). These findings suggest that HER2 3+ status predominates in cases with elevated CA-72-4, which may influence diagnostic strategies and HER2-targeted therapies (e.g., trastuzumab). Conversely, elevated CA-19-9 and CEA were more associated with HER2 1+ status, indicating a need for further detailed investigation of these markers in relation to HER2 expression. In patients evaluated by CISH for HER2 expression, stratification into HER2-positive and HER2-negative groups revealed no statistically significant differences (p < 0.05) in age, sex, tumor location, morphology, stage, or serum tumor markers (CA-72-4, CA-19-9, CEA). This suggests that HER2 status (positive/negative) may be independent of these variables. Although HER2 positivity was higher in poorly differentiated tumors (48% vs. 30.6% negative; p=0.1414) and in stage IV disease (50% vs. 39.3% negative; p=0.2607), these differences were not statistically significant. Elevated serum markers (CA-72-4, CA-19-9, CEA) were observed but showed no significant correlation with HER2 status. Conclusion Determining the molecular profile of gastric cancer patients can significantly contribute to refining clinical diagnosis, developing treatment strategies, enhancing therapeutic outcomes, and improving patients’ quality of life.