Background: Carotid artery stenting is increasingly being selected as the treatment for severe (≥70%) carotid artery stenosis, creating a growing need to prevent potential secondary complications associated with the procedure. In-stent restenosis (ISR) remains an important complication during long-term follow-up after carotid artery stenting. In this clinical case, we have addressed risk factors, pathogenesis, diagnosis, treatment, and monitoring of in-stent restenosis. Case Presentation: We describe the case of a 70-year-old man with severe, symptomatic IRS detected 1.8 years after carotid artery stenting (CAS). Conclusion IRS following carotid artery stenting is a clinically significant complication that may adversely affect cerebral perfusion and increase the risk of recurrent ischemic stroke. Early detection and follow-up with carotid duplex ultrasonography, regular follow-up, and lifestyle modifications, particularly smoking cessation, are essential for prevention of adverse cerebrovascular events.

Background: Branch atheromatous disease (BAD) is believed to be one subtype of ischemic stroke brought on by plaque accumulation that obstructs or stenoses the entrance of penetrating branches. Based on clinical status, risk factors, laboratory results, and radiographic features of infarct and blood vessel morphologies, BAD has been differentiated from large-vessel occlusion and small-vessel disease. BAD-induced stroke has been strongly associated with worse outcomes than lacunar strokes, including high rates of early neurological deterioration (END), recurrent transient ischemic attacks and strokes, and disability. Determining treatment options and each patient’s prognosis depends on early identification of BAD. Case Presentation: A 34-year-old male with a history of recurrent acute ischemic stroke within 7 months, caused by stenosis of the M1 segment of the right middle cerebral artery, was hospitalized twice at the Third Central Hospital of Mongolia. Intravenous Thrombolytic therapy (tPA) was administered during each admission. Conclusion Precise diagnosis of BAD is crucial for planning subsequent treatment and secondary prevention.

Background: Sarcopenia is a multifactorial geriatric syndrome characterized by age-related loss of muscle mass, muscle strength, and physical performance. In recent years, neurotrophic and neuromuscular biomarkers have been investigated as potential diagnostic indicators of sarcopenia; however, evidence regarding their sex-specific differences remains limited. Aim: To evaluate the sex-specific associations of serum BDNF, GDNF, and CAF22 levels with sarcopenia and muscle-related parameters among older adults. Materials and Methods: This analytical cross-sectional study included adults aged 60 years and older. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS 2019) criteria. Serum BDNF, GDNF, and CAF22 levels were measured using ELISA. Group differences were analyzed using independent t-tests, correlations were assessed using Pearson correlation analysis, and diagnostic performance for sarcopenia was evaluated using receiver operating characteristic (ROC) analysis. Multivariable logistic regression analysis was also performed. Results: No statistically significant differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic participants in either the male or female groups (all p>0.05). ROC analysis demonstrated AUC values ranging from 0.540 to 0.542 in males and from 0.508 to 0.530 in females for BDNF, GDNF, and CAF22. Multivariable logistic regression analysis revealed that age (OR=1.12, 95% CI: 1.04–1.21, p=0.003) and lower fat-free mass index (OR=0.78, 95% CI: 0.66–0.91, p=0.001) were significantly associated with sarcopenia, whereas BDNF, GDNF, and CAF22 showed no independent association with sarcopenia. Conclusions 1. No statistically significant sex-specific differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic older adults (all p>0.05). 2. CAF22 levels were weakly negatively correlated with muscle mass and fat-free mass index in males (p<0.05), whereas BDNF levels showed weak positive correlations with handgrip strength and fat-free mass index in females (p<0.05). CAF22 levels also demonstrated a weak positive correlation with age (p<0.05). 3. ROC and multivariable logistic regression analyses indicated limited diagnostic utility of BDNF, GDNF, and CAF22 for sarcopenia (AUC=0.508–0.542), and none of these biomarkers showed an independent association with sarcopenia (all p>0.05). In contrast, older age (OR=1.12, p=0.003) and lower fat-free mass index (OR=0.78, p=0.001) were significantly associated with sarcopenia.

Background: Generation Z students, born after 1995, are characterized by their ability to multitask, low tolerance for traditional learning methods, impatience, short attention span, and preference for working independently rather than collaboratively. They are also considered more vulnerable to mental health challenges compared to previous generations. Aim: To assess the level of academic engagement among Generation Z students studying in the School of Nursing. Materials and Methods: This descriptive, cross-sectional quantitative study was conducted from February 1 to April 1, 2025. A total of 420 students majoring in nursing, midwifery, physical therapy, occupational therapy, and traditional medicine nursing at the School of Nursing, Mongolian National University of Medical Sciences, participated in the study. The Student Course Engagement Questionnaire (Handelsman, 2005) was used to evaluate students’ engagement levels. The reliability of the questionnaire was confirmed with a Cronbach’s α of 0.955. Statistical analysis was performed using SPSS version 25, and results were considered statistically significant at p<0.05. Results: Among the 420 participants, 91.9% were female and 8.1% were male. By major, 57.1% studied nursing, 22.6% midwifery, 8.8% physical therapy, and the remainder were from other disciplines. Student engagement was analyzed across three domains: academic involvement, personal responsibility and effort, and learning attitude and motivation. Pearson correlation analysis revealed strong positive correlations between academic involvement and personal responsibility/ effort (r=0.828), learning attitude and motivation (r=0.825), and between responsibility/effort and learning attitude/ motivation (r=0.903) (p<0.01). Age showed a weak positive correlation with year of study (r=0.381), while major and year of study had a weak negative correlation (r= -0.146) (p<0.01). Year of study and learning motivation also showed a weak negative correlation (r=-0.107, p<0.05). Conclusion The learning motivation and class engagement of Generation Z nursing students were found to be strongly correlated with their sense of responsibility, effort, and learning attitude (r=0.82–0.90, p<0.01). Most students demonstrated consistent participation and motivation to learn, showed less interest in traditional teaching approaches, and preferred practical training.

Introduction: In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM. Methods: A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test. Results: The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003). Conclusion The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.

Objective: To compare the nature of pregnancy and deliveryin women with leiomyoma who were treated with uterine artery embolization to the outcomes in women who were treated with abdominal myomectomy. Material and Methods: A prospective, clinical study was conducted in 2010-2013 at “Urguu” Maternity Hospital, Ulaanbaatar. 94 women meeting the criteria were selected for the study. Post-treatment, the patients were reviewed for a period of two years. Uterine artery embolization was performed using polyvinyl alcohol particles (300-500 µm in diameter). Results: The percentage of conception in UAE group was 25.5% and 31.9% in myomectomy group (p=0.494); complication of pregnancy was 50.0% and 57.1% respectively (p=0.729); complication of delivery was 33.3% and 0.0% respectively (p=0.047). 88.9% and 90.0% (p=0.596) had Caesarean delivery. 16 (84.2%) women had uncomplicated and 3 (15.8%) women had complicated delivery due to placenta praevia, placenta acreta and uterine hypotonia. These cases all belonged to UAE group. Conclusion Pregnancy rates in women with leiomyoma who were treated by uterine artery embolization, compared with pregnancies after abdominal myomectomy, were similar.(p=0.494) In this study, there was the rate of Cesarean delivery above 80 percent in both group. There were no differences in newborn weights and Apgar scores.

Uterine leiomyomas are common (20-50%) in women of reproductive age. It is a benign tumor and it ranks second place among genital organ disorders in women.To date, abdominal laparotomy and laparoscopic surgical treatment (myomectomy and hysterectomy) are widely used to manage symptomatic leiomyomas.Although, hysterectomy is considered to be a radical method to manage uterine leiomyomas, women who have had hysterectomy are left totally infertile and they also are at risk to develop post-surgical and post-anesthetic complications. The advantage of myomectomy is to preserve women’s fertility and menstrual function but, the probability of recurrence of leiomyoma is 15-30% [1, 2]. Furthermore, depending on the location, size and number of fibroids, duration of surgery lingers, volume of blood loss is high and the risk to develop post surgical adhesions are high too.In recent, more than a decade period, effective and minimally invasive new, non-surgical methods to manage uterine leiomyomas have been introduced in many countries around the world. These methods have short recovery period and are advantageous to women to preserve their reproductive organ and fertility. They include: uterine artery embolization, uterine artery occlusion via transvaginal route and MRI– guided focused ultrasound surgery of uterine fibroids. Antiprogesterone-low-dose mifepristone for uterine leiomyomas are being introduced as well.In our country, managing leiomyomas surgically is still occupying high rate among surgical treatments. Further, to prevent and reduce complications of surgical treatment and to preserve organ, it is essential and imperative to introduce some of the above- mentioned contemporary non-surgical methods.

INTRODUCTION:Uterine leiomyoma occurs with broad range of 20-50% among reproductive aged women. It takessecond place of all women’s genital diseases that cause abnormal menstrual bleeding. Leiomyomadependent surgical frequency such as hysterectomy is around up to 80, 6%. Lately uterine fibroidembolization treatment is highly effective, less painful, and more rapid recovery, most importantlykeeping organ while maintaining the reproductivity, is successfully entered in practice. We successfullyperformed 40 cases first time in Mongolia and 8 of them conceived naturally after treatment.GOAL:To determine if arterial embolization in women with uterine fibroids (leiomyomata) is an effectivemethod to keep their reproductive organ intact.OBJECTIVES:• To study pregnancy cases in women who had uterine fibroid embolization• To monitor and determine the features of course of pregnancy and childbirth.• To evaluate uterine fibroids.MATERIALS AND METHODS:The study was conducted in 2009-2012. A total of forty women between 23-50 years of age,diagnosed with symptomatic uterine fibroid that received embolization treatment of dominatingarterial blood vessel feeding the uterine fibroids were involved in the study. Eight of the forty womenwho conceived naturally were selected for the study. The study focused on monitoring the course oftheir pregnancy and delivery and its outcome.RESULTS:Among 40 women who underwent bilateral uterine artery embolization, 31 (75.5%) were seeking tobecome pregnant, and 8 of the 31 (25, 8%) became pregnant, four having been nulliparous. Onepatient had two pregnancies. All 8 pregnancies were spontaneous. The mean time from embolizationto conception was 12±3, 5 months (range, 6-27 months). Three medical terminations occurred. Theother 5 pregnancies went to term; one pregnancy had to be terminated pre-term due to placentapraevia. 60% experienced threatened abortion and 1 case with advanced age mother complicatedwith mild preeclampsia. 62,5% of the women’s pregnancy ended with childbirth, of which one woman(20%) had vaginal delivery and the remaining four pregnancies (80%) ended with C-section. On anaverage, post-treated uterine fibroids decreased in volume by 94% in comparison to pre-treateduterine fibroids in the patients who became pregnant. All of the neonates were healthy with Apgarscores greater than8. The mean weight of the neonates was 3,189± 200 g (range, 2,100–3,800 g). One neonate waspreterm due to placenta praevia (2,100 g).CONCLUSION:1. Of the forty women that received arterial embolization treatment with uterine fibroid, thirty one(75, 5%) women desired to keep their uterine for further reproduction, of which eight women (25,8% of the patients) between the ages of 23-42 years (mean age=35) conceived naturally. Arterialembolization to treat women with uterine fibroids is an effective method for women who wish to keeptheir reproductive organ intact to conceive and reproduce.2. 60 percent of the women who conceived experienced threatened abortion and 20 percent of thewomen’s pregnancy had to be terminated pre-term due to placenta praevia. 62,5 percent of thewomen’s pregnancy ended with childbirth, of which one woman (20%) had vaginal delivery and theremaining four pregnancies (80%) ended with C-section.3. On an average, post-treated uterine fibroids decreased in volume by 94% in comparison to pretreateduterine fibroids.