Background: In Mongolia, cervical cancer accounted for 11.9% of all cancers diagnosed in women and 7.3% of cancer-related deaths in 2017, ranking as the third most common cancer among women. The American Society for Radiation Oncology (ASTRO) guidelines recommend concurrent chemo-radiotherapy (CCRT) as a standard and effective treatment for patients with FIGO stage IB3–IVA cervical cancer. Accurate assessment of tumor response following CCRT is essential for evaluating treatment efficacy, identifying residual disease, and estimating the risk of recurrence. Magnetic resonance imaging (MRI) is widely used to assess tumor size, local extent, parametric involvement, and post-treatment morphological changes. In contrast, 18F-FDG PET/CT provides both anatomical and functional information and enables quantitative assessment of tumor metabolic activity using the standardized uptake value (SUV). Aim: To estimate the relationship between treatment response to concurrent chemo-radiotherapy and radiological parameters obtained from MRI and 18F-FDG PET/CT in patients with cervical cancer. Materials and Methods: This retrospective study included 35 patients with histo-pathologically confirmed cervical carcinoma who received concurrent chemo-radiotherapy at the Department of Radiation Oncology, National Cancer Center, between 2024 and 2025. Pelvic MRI examinations were performed using a 1.5-T Siemens MRI system to evaluate tumor dimensions and local tumor characteristics before and after treatment. 18F-FDG PET/CT was performed to assess the metabolic activity of the primary tumor, and the maximum SUV was measured. Tumor response following CCRT was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. The relationships between tumor response, changes in tumor size, and pre-treatment SUV were statistically analyzed. Result: A total of 35 patients aged 32–73 years were included in the study, with a mean age of 51.2±12.6 years. The mean baseline longitudinal tumor diameter measured by MRI was 54.3±15.8 mm. Twenty-eight patients (80.0%) had tumors larger than 4 cm, whereas 7 (20.0%) had tumors smaller than 4 cm. According to the FIGO staging system, 22 patients (62.9%) had stage IIIC1 disease, 7 (20.0%) had stage IIIC2, 3 (8.6%) had stage IIIB, 2 (5.7%) had stage IIB, and 1 (2.9%) had stage IVA disease. Histopathologically, 31 patients (88.6%) had squamous cell carcinoma, 3 (8.6%) had adenocarcinoma, and 1 (2.9%) had clear cell carcinoma. Of the 35 patients, 23 (65.7%) had reached the scheduled post-treatment follow-up time and were evaluable for treatment response according to RECIST 1.1, whereas 12 patients (34.3%) had not yet reached the scheduled time for post-treatment assessment. Among the 23 evaluable patients, 15 (65.2%) achieved a complete response (CR), while 8 (34.8%) achieved a partial response (PR). Following CCRT, the longest tumor diameter measured by MRI decreased by a mean of 94.8% in the CR group and 65.3% in the PR group. The reduction in tumor diameter was significantly greater in the CR group than in the PR group (p=0.0016). The mean baseline primary tumor SUVmax on 18F-FDG PET/CT was 16.0±9.8 in the CR group and 24.3±14.5 in the PR group. Although the baseline SUVmax tended to be lower in the CR group, the difference did not reach statistical significance (Mann–Whitney U test, p=0.059). A higher baseline SUVmax tended to be associated with a smaller reduction in tumor diameter following CCRT. Conclusion CCRT resulted in a significant reduction in primary tumor size in patients with cervical cancer. The reduction in tumor size was significantly greater among patients who achieved a complete response than among those who achieved a partial response. Although pre-treatment 18F-FDG PET/CT findings suggest that MRI-based tumor size assessment combined with metabolic information from 18F-FDG PET/CT may provide complementary information for evaluating treatment response following CCRT.

Background: Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by the accumulation of surfactant within the alveoli, leading to impaired gas exchange and respiratory insufficiency. Although the disease is uncommon, it significantly affects patients’ quality of life and requires specific diagnostic and therapeutic approaches. Whole lung lavage (WLL) is considered the standard treatment; however, it has not been widely implemented in Mongolia. We report the first successful case of WLL performed for PAP in Mongolia. Case Presentation: A 56-year-old male presented with dyspnea. Chest computed tomography demonstrated a bilateral “crazy paving” pattern. Bronchoalveolar lavage fluid was positive for periodic acid–Schiff (PAS) staining, and anti–GM-CSF antibodies were detected, confirming the diagnosis of PAP. WLL was performed under general anesthesia using a double-lumen endotracheal tube with bronchoscopic guidance. One lung was ventilated with 100% oxygen while the contralateral lung was sequentially lavaged with 800–1000 mL of warm (37°C) saline per cycle until the effluent became clear. A total of approximately 20 liters of saline was used. Result: The procedure was completed successfully without complications. Following treatment, the patient showed marked clinical improvement with reduced dyspnea and increased exercise tolerance. Oxygen saturation improved from 88% to 93%, and spirometric parameters (FVC, FEV₁) demonstrated improvement. Chest imaging revealed a reduction in pulmonary opacities. Conclusion This case demonstrates the successful implementation of whole lung lavage (WLL) in Mongolia and highlights its importance in improving the diagnostic and therapeutic capacity for rare pulmonary diseases such as pulmonary alveolar proteinosis. The procedure resulted in significant improvement in clinical, functional, and radiological parameters, consistent with findings from international studies. Early diagnosis of PAP and the adoption of standardized protocols in accordance with international guidelines are essential to optimize treatment outcomes and enhance patients’ quality of life.

Background: Sepsis is a life-threatening condition caused by a dysregulated host response to infection, leading to tissue and organ damage. Globally, over 19 million people are affected by sepsis each year, with approximately 6 million deaths, making it the third leading cause of mortality (25%). Identifying factors influencing patient outcomes in sepsis and septic shock is therefore of critical importance. Aim: To investigate the factors associated with outcomes in patients admitted to the Intensive Care Unit (ICU) of the Mongolia-Japan Hospital (MJH) with diagnoses of sepsis and septic shock. Materials and Methods: A retrospective study was conducted on patients admitted to the ICU of MJH with sepsis or septic shock during 2023–2024. We analyzed patient data including pre-existing comorbidities, number of infection foci, presence of multiple organ dysfunction, and initial laboratory parameters to determine associations with patient outcomes. Results: Among 430 patients admitted to the ICU during the study period, 136 (31.6%) were diagnosed with sepsis or septic shock. Of these, 94 patients (69.1%) recovered and 42 (30.8%) died. No significant differences were found between survivor and non-survivor groups in terms of comorbidities, white blood cell count, neutrophils, lymphocytes, mature granulocytes, C-reactive protein, or creatinine levels. However, multiple organ dysfunction (p<0.000), infection foci ≥2 (p<0.001), lactate ≥2 mmol/L (p<0.002), and platelet abnormalities (p<0.014) were significantly associated with mortality. The most common sources of infection were intra-abdominal infections (25.7%), pneumonia (25%), skin and soft tissue infections (22.5%), urinary tract infections (16.1%), abscesses (7.35%), tuberculosis (2.2%), and catheter-related bloodstream or neurologically-origin infections (0.73%). Conclusion Intra-abdominal infections and respiratory tract infections were the most common sources of sepsis among ICU patients. Multiple organ dysfunction, having two or more infection foci, elevated lactate levels (≥2 mmol/L), and platelet abnormalities were found to significantly increase the risk of mortality in patients with sepsis and septic shock.

Background: Spinal muscular atrophy (SMA) is a degenerative neuromuscular disease that causes progressive muscle weakness and atrophy due to the loss of the motor neurons. Approximately 95% of patients with SMA are homozygous for the deletion of SMN1 exon 7. With an incidence of 1/10.000 and a carrier frequency of 1/40 to 1/50, SMA is the most common genetic cause of death in infants. Purpose: To detect homozygous deletion of SMN1 exon 7 and to analyse the SMN1 copy number by molecular genetic analysis. Materials and Methods: In this study, 3 SMA patients with SMN1 gene homozygous deletion and 17 people of their relatives were included. Molecular genetic analysis was performed in the Central Scientific Research Laboratory of the Institute of Medical Sciences. DNA was extracted from peripheral blood, and its purity was assessed by spectrophotometer. Homozygous deletion of SMN1 gene was analyzed with allele-specific PCR, and the SMN1 gene copy number was evaluated by real-time PCR. Results: Among the five participants diagnosed with SMA by clinical symptom and electromyographic test, three cases were found to have homozygous deletion of exon 7 of the SMN1 gene, while two cases did not exhibit such mutation by the allele specific PCR analysis.
The mean age of study participants was 27.76±16.07 (ranging from 8 months to 52 years). Six of the 7 relatives of the first proband had 1 copy number of SMN1 (0.75±0.29) or were carriers of SMA, while one had 3 copy numbers (2.99) or no deletion of SMN1 gene. Additionally, 6 of the 7 individuals of the second proband had 1 copy number of the SMN1 gene (0.72±0.14), and 1 person had 2 copy numbers. All 3 relatives of the third proband had 1 copy number of SMN1 gene (0.96±0.37). Conclusion We consider that determination of SMN1 gene homozygous deletion and carrier testing can be performed by the PCR method locally. Further, it is necessary to implement the molecular genetic testing method into practice and to study the requirements and needs of early detection of SMA in the newborn screening program of Mongolia.

Correlation between delay time of surgery of congenital cataract and postoperative visual acuity Introduction: Worldwide, child cataract is 1 to 15 cases per 100,000 children are diagnosed. In the International Classification of Diseases, pediatric cataracts are classified as congenital (Q12) and developmental (H26.0). Congenital cataract occurs in 1–3 out of 10,000 children, and if diagnosed, surgery is required without delay. International researchers report that congenital cataracts require semi-emergency surgery. It is also recommended that children with congenital cataracts be diagnosed after 3 months of age without surgery. Congenital cataracts are recommended for surgery in one eye within 6 weeks and in both eyes within 10 weeks. Early detection of congenital cataracts and emergency surgical treatment are important to improve postoperative visual outcome and quality of life. To investigate the correlation between the surgical delay time and postoperative visual acuity in children diagnosed with congenital cataracts. Material and methods: This study conduct based on the ophthalmic surgery department of the National Center for Maternal and Child Health, performed for a retrospective longitudinal study design. The study examined cases of congenital cataracts in both eyes and retrospectively follow patients who had congenital cataract surgery in 2018-2020 from the onset of symptoms to the postoperative period. The sample size was calculated using open.epi. We sampled participants for non-probabilistic purposes. The study included children 1 year of age and younger or with nystagmus, cataract with nuclear and polar morphology , and bilateral cataracts Statistical analysis was performed using STATA 16.0 software. The risk of delay time to visual acuity was determined by an ordinal regression model. Results: The study included 46 cases of congenital cataracts, under the age of 16. 61 percent of the children were male and 58.7 percent were from rural areas. The postoperative visual acuity of the children in the study was <0.09 in 52.2% (n = 24) and 0.1

Abstract To study adverse drug reactions registered in 2010-2012 in Mongolia. This study has descriptive design. 280 yellow forms for recording adverse drug reaction, which were registered by the Drug assurance department of the Department of Health-Implementing Agency of the Government, were used. Yellow forms were from 2010- 2012. Statistical analysis was performed in SPSS 17.0. More than half of cases (51%) of drug adverse reaction were in people over 41 years old. Psychotropic medications and antibiotics were the most drugs with adverse reaction having 31.1% and 27.1% respectively. The common adverse reactions were dysfunctions of central nervous system (38.6%), skin rashes (22.5%), dysfunctions of digestive system (11.1%), allergic reactions (7.9%) and other symptoms (15.5%). In 4% of cases the symptoms were not described. Countries of production of medications causing drug reactions were Russia in 26.1%, China 13.2%, Моngolia 12.2%, India 11.4%, Indonesia 3.2% and other countries in 15.3%. In 18.6% the country was not recorded. In 18.9%, 16.4% and 9.6% of reactions were from tablets, intramuscular injections and drippings. The forms filled in by the patients in 31% did not have their names, and in 48% there were no records on reasons for taking medicines. Conclusion Psychotropic medications and antibiotics were the most drugs with adverse reaction. The common adverse reactions were dysfunctions of central nervous system, skin rashes and dysfunctions of digestive. Adverse drug reactions were identified insufficiently and forms for recording the adverse reactions were filled incompletely and incorrectly.

BACKGROUNDProstate cancer is the most frequent malignancy among men nowadays.METHODSImmunohistochemical expression of prostate-specific antigen (PSA) was retrospectively investigated in 10 patients admitted with clinical suspicion of the prostate cancer. Slides were collected from archived biopsiesandthey were stained for PSA.The final reaction product was evaluated as negative (0), weak/moderate positive (1), and intense positive (2).RESULTSGlandular prostate carcinoma was found in 40% (n=4) and undifferentiated carcinoma in 60% (n=6). The immunoreaction for PSA was intense positive in 30% (n=3), weak/moderate positive in 50% (n=5) and negative in 20% (n=2) of total cases.CONCLUSIONSWe concludethat PSA immunoreaction is helpful for the differential diagnosis based on our results.

IntroductionThe aimag health statistics of 2009 shows that the cancer morbidity is 24.94 per 10000 populations,which is 1.6 times and the cancer mortality is 21.48 per 1000, 1.8 times higher than the national average respectively. Therefore, this research was carried out to study the KAP on breast and cervical cancers among the women of Sukhbaatar aimag for planning and implementation of actions meeting their needs.MethodologyIn total 570 women from Bayandelger, Dariganga, Ongon, Munhkhaan and Erdenetsagaan soums and 2 baghs of the aimag centre were involved in the study by random sampling.ResultsIn the study involved 570 women of 6 soums of Sukhbaatar aimag. The average age of the women is 33 1.0. Women with university education are 21.4%, with complete secondary education 44.3%, with incomplete secondary education 3.3%, with primary education 7.7%, and uneducated was 1.1%. Herding women composed 22.8% of the participants. The knowledge related to the age of the participants demonstrate higher level of knowledge on cancer among 35-44 year old women. By thereasons of involvement in the breast screening, 68% have not been examined in last 5 years, 10% have visited voluntarily and the rest participated as it was organised by their employees or by chance. The average score of the knowledge on cervical cancer was 7.8 or 30%. The women themselves assessed their knowledge on cervical cancer as poor. The responses given by respondents in the study of the signs of the cancer also demonstrate low level of knowledge. Also the women’s knowledge on early detection of the cancer is insufficient. The knowledge, attitude and practicce of local women concerning breast/cervical cancer, the factors affecting the screening, current needs and the level of health education were defined by this study and the findings of the study show that it is necessary to focus on improving the KAP of the target population on preventive acctivities and participation in screening and enhancement of related trainings.Conclusions:1. The knowledge of the women on breast and cervical cancers is generally low.2. The sources of information on the causes of breast and cervical cancers are scarce.1. The insufficient KAP towards screening and poor preventive behavior negatively affect early diagnosing of breast/cervical cancer.

IntroductionThe detection of adverse drug reactions has become increasingly significant because of introduction of a large number of potent toxic chemicals as drugs in the last two or three decades. Adverse drug reaction (ADR) monitoring and reporting activity is in its infancy in Mongolia. The important reason is lack of awareness and lack of interest of healthcare professionals in ADR reporting and documentation.GoalTo evaluate implementation and trends of health care professionals toward adverse drug reaction reporting at first, second and tertiary level hospitals.Materials and MethodA prospective study was carried out in first and second level hospitals of Khentii, Dundgovi, GoviAltai, Selenge and Uvurkhangai provinces, Sukhbaatar, Songinokhairkhan district hospital and First maternaty hospital. From tertiary level hospitals were selected First national hospital, Third national hospital, National center of oncolgy, National center of traumatolgy. The questionnaire survey involved total of 175 doctors and pharmacists.ResultsThe study result have shown that most of health care profeesionals (76 – 80%) of first and tertiary level hospitals have known about legal bases and theie duties for the ADR reporting than health care professionals (69%) of secondary level hospitals. And, pharmacists more activily involve in ADR reporting than doctors. The main reasons of healthcare professionals ADR underreporting were lack of time to report, lack of awarness about ADR and not knowing importance of ADR repoting. The implementetion extent of ADR reporting was in tertiary level hospital better than in secondary level hospitals. Lacking of clinical pharmacists and clinical pharmacologists and unproper activitity of Drug therapeutic committee in secondary level hospitals were the reason of poor implementing and underreporting of ADR.ConclusionThe study result has shown that there is needed to encourage doctors to the adverse drug reporting activity and implementation of drug safety should be strengthen in each level of health care system.