Introduction: Chronic lymphocytic leukemia (CLL) is a hematologic malignancy characterized by the clonal proliferation and accumulation of mature monoclonal B lymphocytes in the peripheral blood. CLL is relatively common in Europe and North America, with an incidence of approximately 4–6 cases per 100,000 population, whereas it is rare in South Asia, with an incidence of approximately 0.11 cases per 100,000 population. During the course of the disease, neoplastic lymphocytes may infiltrate the bone marrow, lymph nodes, liver, spleen, and, less commonly, other organs and tissues. CLL presenting with marked splenomegaly in the absence of lymphadenopathy is uncommon. Therefore, in patients with unexplained splenomegaly, the differential diagnosis should include CLL and other lymphoproliferative disorders. Case Presentation: We report a case of CLL diagnosed on the basis of clinical findings, laboratory investigations, and additional diagnostic evaluation in a patient who presented to a hematology outpatient clinic with splenomegaly. An 81-year-old man presented with a macular rash involving the thighs, lower legs, chest, and both upper extremities, accompanied by dizziness, unsteadiness, nausea, fatigue, and generalized weakness. Physical examination revealed massive splenomegaly with a smooth surface and blunt edge, palpable approximately 25 cm below the left costal margin. Laboratory investigations demonstrated hyperleukocytosis with lymphocytosis, moderate normocytic normochromic anemia, and severe thrombocytopenia. Contrast-enhanced abdominal computed tomography revealed massive splenomegaly, with the spleen measuring 27.9×20.0×7.9 cm. The patient was treated with cyclophosphamide at a dose of 250 mg/m (400 mg administered) in combination with glucocorticoid therapy. Following treatment, leukocytosis, lymphocytosis, and monocytosis improved, and the spleen decreased substantially in size, becoming palpable approximately 4 cm below the umbilicus on physical examination. Conclusion Hematologic malignancies should be considered in the differential diagnosis of patients presenting with unexplained splenomegaly. In this case, a diagnosis of chronic lymphocytic leukemia was established based on bone marrow examination and the overall clinical and laboratory findings. Following treatment with cyclophosphamide and glucocorticoids, peripheral blood abnormalities improved and splenic enlargement decreased substantially, suggesting a favorable therapeutic response.

Background: Osteoporosis is a systemic skeletal disease characterized by reduced bone mineral density (BMD) and deterioration of bone microarchitecture, resulting in decreased bone strength and an increased risk of fragility fractures. Early assessment of BMD is essential for identifying skeletal abnormalities and supporting clinical decision-making. Dual-energy X-ray absorptiometry (DXA) is a widely used, non-invasive method for evaluating BMD at clinically relevant skeletal sites. Aim: To assess bone mineral density using DXA and describe the corresponding T-score and Z-score measurements in adult patients. Materials and Methods: This descriptive observational study was conducted from June to October 2026 at the Department of Trauma and Orthopedic Surgery, Mongolia–Japan Hospital, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia. Eight patients aged 18 years or older without fractures were included. According to the study records, participants were selected using a random sampling method. Demographic characteristics, height, weight, body mass index (BMI), and DXA measurements were recorded. BMD, bone mineral content (BMC), T-scores, and Z-scores were assessed at the lumbar spine, hip, and forearm. Continuous variables were summarized as means and standard deviations, and categorical variables as frequencies and percentages. Results: A total of eight patients were included, comprising five males (62.5%) and three females (37.5%). The mean age was 52.65±7.95 years, and the mean BMI was 31.59±6.32 kg/m². The mean lumbar spine (L1–L4) T-score was 0.35±1.49, and the mean Z-score was 0.97± .36. The lowest reported mean T-score was observed at the left forearm (−1.29±4.34), followed by the right forearm (−1.25±3.87). Measurements were also recorded at the left and right hip regions. The findings were descriptive and were not intended to establish population-level prevalence. Conclusions The demographic and anthropometric characteristics of the eight patients included in the study were assessed. The mean age was 52.65±7.95 years, and the mean body mass index (BMI) was 31.59±6.32 kg/m². Of the participants, 5 (62.5%) were male and 3 (37.5%) were female. The mean BMI of the participants fell within the obesity category. Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry (DEXA) at the lumbar spine, both hips, and both forearms. The results showed variations in BMD measurements across the different anatomical sites examined. An analysis of the T-scores and Z-scores for each measurement site revealed a mean T-score of 0.35±1.49 and a mean Z-score of 0.97±1.36 at the lumbar spine. At the left hip, the mean T-score was −0.63±1.29 and the mean Z-score was 0.34±1.52, while at the right hip, the mean T-score was −0.63±1.15 and the mean Z-score was 0.31±1.09. The mean T-scores of the forearm were comparatively lower, at −1.29± 4.34 on the left side and −1.25±3.87 on the right side.

Background: Employee satisfaction in the healthcare sector has a direct impact not only on the quality of medical services, but also on workforce stability and overall organizational performance. High levels of job satisfaction are associated with improved work performance, whereas low satisfaction often leads to negative outcomes such as stress and burnout. Although studies on job satisfaction have been conducted in Mongolia, research specifically targeting healthcare workers—and identifying the key factors influencing their satisfaction—remains relatively limited. This gap provides the rationale for the present study Aim: The objective of this study is to examine job satisfaction among healthcare workers at primary and referral hospitals and to identify key factors influencing it. Materials and Methods: The study was conducted between 2022 and 2024 among 1,883 physicians, nurses, and other healthcare professionals aged 18–65 years from 11 provinces and Ulaanbaatar city, using a quantitative research approach with a cross-sectional design. Job satisfaction was assessed with a questionnaire comprising six subdomains (supportive leadership, opportunities for human resource development, professional ethics, organizational culture, quality of healthcare services, and workplace safety), rated on a three-point Likert scale. Data analysis was performed using IBM SPSS Statistics version 26.0. Results: The overall level of job satisfaction among participants was 77.6%. Among the subdomains, workplace safety and supportive environment scored the lowest at 71.7%, whereas the quality and safety of healthcare services scored the highest at 83.4%. The findings indicated that holding a managerial position in hospitals in Ulaanbaatar and working as a physician in primary-level hospitals were positively associated with job satisfaction (p < 0.05). Age demonstrated a statistically significant association with job satisfaction, while years of work experience showed a negative correlation, with satisfaction decreasing as tenure increased (r = −0.09, p < 0.001). The findings indicate that improving healthcare workers’ job satisfaction requires strengthening and supporting several organizational dimensions, including supportive leadership, opportunities for human resource development, organizational culture, workplace safety, and a supportive work environment Conclusion Workplace safety and support, opportunities for human resource development, and organizational culture were found to be critical determinants of employee job satisfaction. The findings suggest that job satisfaction can be enhanced by optimizing organizational support, ensuring opportunities for professional growth, and strengthening workplace safety

Introduction: According to the World Health Organization (WHO), more than a million cases of sexually transmitted diseases (STDs) are registered in the world every day. Our country is among the countries with a concentrated spread of HIV infection among the population at risk According to the WHO classification. Although Mongolia is one of the countries with a low prevalence of HIV/AIDS, it is considered to a country with a high risk of STD caused from the location in the middle of the two countries where the HIV infection is spreading as fastest, thus it is important to study. Purpose: The aim is to study the epidemiology of sexually transmitted diseases in the population of Ulaanbaatar. Material and Method: The study was conducted using a single-moment descriptive research design. The following information was obtained from the statistics of the Health Development Center. Including as following:
• Annual indicators of the disease: Statistical data of sexually transmitted diseases between 2017- 2021 (Ulaanbaatar city)
• Annual indicators of the disease: 2017-2021 statistical data on the state of sexually transmitted diseases (city average and provincial average) Result: Considering the prevalence rate of sexually transmitted infections per 10,000 population by age group, as of 2017-2021, the population aged 20-39 had the highest rate of infection with 9.4-154.2 cases, and in 2018, the population aged 30-39 had 146.2 cases was the highest. In terms of the source of infection, 83.1 percent of the total cases in 2017-2021 were sexually transmitted.
Comparing the prevalence of sexually transmitted infections in the population of Ulaanbaatar by location and the number of cases per 10,000 population, as of 2017-2021, Bagakhangai district had more cases in 2017 and 2019, and Sukhbaatar district had 221.4 cases in 2018, which was the highest in the 5-year period, Nalaikh district recorded 64.7 cases in 2020 and 48.4 in 2021, which was the district with the highest number of cases in these years.
In terms of education, people with secondary education or below accounted for 94.1 percent of all cases in the 5-year average.
About the marriage status, 35.9 percent of all cases registered in 2017 were never married, and 53.5 percent were married. As of 2018-2021, there has been no significant increase or decrease in this indicator. Conclusion
1. During 2017-2021, the cases of sexually transmitted infections (syphilis, gonorrhea, trichomoniasis) per 10,000 population was in 2018, the incidence of infection decreased by 2.7 cases, in 2019 it increased by 7 cases, and in 2020 it decreased by 2.2 cases, in 2021, it decreased by 18.3 cases from the previous year, and it is believed that sexually transmitted diseases are expected to decrease in the future.
2. The average rate of syphilis infection (2017-2021) per 10,000 population in Ulaanbaatar was 4.4 cases higher than the average of the provinces, the average of 4.1 cases of gonorrhea infection is likely to increase, and the average of trichomoniasis was 13.4 cases or was equal to average of the provinces and Ulaanbaatar. The problem affecting the incidence of sexually transmitted diseases is related to the level of education of the citizens. 9 out of 10 people have completed secondary education or less.

Background: Treatment of adult tibiofibular fractures, especially severely comminuted fractures, is technically challenging due to the lack of reduction markers and difficulty in restoring the alignment. Fixation of the fibula can facilitate reduction of the tibia fracture and restoration of the lower extremity alignment. Methods: Between 2018-2019 we have operated on 50 patients who have lie on the same plane of tibiafibular fractures. Measures of angulation were obtained from radiographs taken immediately after the surgery, a second time 3 months later, and at 3-month follow-up. The analysis was performed with STATA. Results: Fixating fractures of tibia and fibula at same level were not shown to have complications on the development of nonunion including fibular shortening, hindfoot alignment, slow process of nonunion and unstableness. Conclusions We recommend fibular fixation in all 50 distal fractures when both fractures lie on the same plane and the tibial fracture is relatively stabilized.

Within the spectrum of diagnostic procedures in hepatology, the procurement of a liver specimen plays an important role. The method has been diversifi ed to encompass not only different needle types for cutting and aspiration but also different routes proceeding transvenously or transcutaneously. Over the subsequent 50 years the technique of obtaining liver biopsy samples has been modifi ed regarding the approach, the needle type, and the combination with diagnostic imaging techniques such as ultrasound, computed tomography, angiography and laparoscopy. Histological analyses are capable of establishing the etiology of a chronic or acute liver disease, are determined the inflammatory activity (Grading), degree of fi brosis/cirrhosis (Staging), are relevant for the prognosis of the patient and for indication for cost-intensive as well as potentially side are effect-prone therapies. In general, the accepted mortality rate from liver biopsy is between 0,1% and 0,01%. Among the most feared complications of liver biopsies are hemorrhage, seeding of cancer cells, infections, and injury to the viscera. The increasing number of liver transplant patients within the hepatological spectrum requires regular, safe, and high quality biopsies and their appropriate.