Background: Arterial hypertension (AH) is a major cardiovascular risk factor worldwide, with a prevalence of 33.1% in Mongolia according to the 2019 STEPS survey. Hematocrit (HCT) is the primary determinant of blood viscosity and has been associated with hypertension in international studies; however, this association has not been sufficiently investigated in the Mongolian population, providing the rationale for the present study. Aim: To investigate the association between hematocrit levels and arterial hypertension in the Mongolian population. Materials and Methods: From 57,108 records of the 2022–2023 national early detection program organized by the Government of Mongolia, 32,626 participants were selected using proportional stratified random sampling by region. AH was defined per Mongolia’s 2018 Clinical Guidelines for Arterial Hypertension in Adults, with blood pressure measured using an automated sphygmomanometer, as SBP ≥130 mmHg or DBP ≥80 mmHg. Statistical analysis included Mann-Whitney U test, Pearson and Spearman correlation, univariate and multivariate logistic regression, and ROC curve analysis. Result: AH was identified in 58.2% of participants (n=18,988). The median HCT in the AH group (43.60%) was significantly higher than in the normotensive group (42.40%, p<0.001). The correlation between HCT and SBP was r=0.152 (p<0.001), with the strongest association observed in the 18–40 age group (r=0.203). ROC curve analysis identified optimal cut-off values of 47.2% for males and 41.8% for females. Conclusion 1. Hematocrit levels were significantly higher in the hypertensive group compared to the normotensive group and showed a weak positive correlation with both systolic and diastolic blood pressure. 2. Although hematocrit was significantly associated with AH in univariate logistic regression, its independent effect was attenuated in multivariate analysis due to collinearity with hemoglobin. In a separate model with HCT alone adjusted for age, sex, and BMI, the independent association remained statistically significant (aOR=1.260, p<0.001). 3. ROC curve analysis identified sex-specific optimal cut-off values of 47.2% for males and 41.8% for females, highlighting the need to consider sex differences in the Mongolian population. These cut-off values should be regarded as supplementary indicators to be used alongside other cardiovascular risk factors.

Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a major cause of chronic liver disease and is increasingly linked to cardiovascular disease (CVD), the leading cause of mortality globally. Aim: To evaluate individuals participating in early screening using the Hepatic Steatosis Index (HSI) and examine its association with CVD risk levels. Materials and Methods: This population-based retrospective cross-sectional study included 47,542 adults aged 40–70 years who participated in a national screening program between 2023 and 2025. Hepatic steatosis was assessed using the Hepatic Steatosis Index (HSI) and categorized as <30 (no steatosis), 30–36 (indeterminate), and >36 (steatosis). Ten-year CVD risk was estimated using laboratory-based WHO cardiovascular disease risk charts for Central Asia. Associations were evaluated using logistic regression and expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Result: The mean age of participants was 53.18±8.17 years, and 67.1% (31,886) were women. The prevalence of HSI <30, 30–36, and >36 was 8.9% (4,219), 32.1% (15,271), and 59.0% (28,052), respectively. The distribution of low-, moderate-, and high-risk CVD groups was 48.6% (23,115), 41.3% (19,637), and 10.1% (4,790), respectively. The proportion of individuals with high CVD risk was 5.5% in the HSI <30 group and 10.1% in the HSI >36 group. Compared with the reference group, the odds of high CVD risk were increased in the HSI 30–36 group (OR=1.333; 95% CI: 1.152–1.542) and the HSI >36 group (OR=2.401; 95% CI: 2.094–2.753). These associations remained statistically significant after adjustment for age, sex, systolic blood pressure, waist circumference, physical inactivity, and smoking. Conclusion The prevalence of hepatic steatosis in the study population was 59.0%. Individuals with hepatic steatosis had a 1.2-fold higher risk of cardiovascular disease compared with those without steatosis.

Background: Medical education has shifted toward integrated, student-centered curricula. Mongolia’s School of Medicine adopted a vertically integrated block model, yet systematic evaluation through student feedback remains limited. Aim: To evaluate the quality of the block curriculum for the “General Medicine” program based on student satisfaction, and to identify factors influencing satisfaction with course content. Materials and Methods: This analytical cross-sectional study was conducted using a questionnaire survey between January 2023 and January 2026. A total of 1,130 students (66.8% of the source population) were selected through stratified random sampling from 1,692 third- to sixth-year medical students enrolled in the Doctor of Medicine program at the School of Medicine, Mongolian National University of Medical Sciences (MNUMS). The mean age of participants was 22.18±1.43 years, of whom 79.7% were female and 20.3% were male. Educational quality was evaluated across three domains: educational content (59 items), learning environment (59 items), and course organization (59 items), using a 5-point Likert scale (5=strongly agree, 4=agree, 3=neutral, 2=disagree, 1=strongly disagree). Internal consistency reliability was assessed using Cronbach’s alpha. Differences between blocks were analyzed using one-way ANOVA and Tukey’s HSD post hoc test. Pearson correlation analysis was used to examine associations among domains, while factors influencing educational content were identified using multivariable linear regression analysis. Statistical significance was established at the 95% confidence level (p<0.05). Results: The questionnaire demonstrated high internal consistency across all seven blocks (Cronbach’s α=0.888–0.937). The overall mean scores were 4.00±0.78 for educational content, 3.91±0.85 for learning environment, and 3.92±0.82 for course organization. Block 6 received the highest ratings across all domains, including educational content (4.15±0.74), learning environment (4.04±0.81), and course organization (4.03±0.81), whereas Block 1A had the lowest mean scores (3.82–3.92). One-way ANOVA revealed statistically significant differences among blocks across all three domains (p≤0.005); however, the effect sizes were very small (Partial η²=0.003–0.006). Tukey’s HSD test showed that Block 6 was rated significantly higher than Block 1A in educational content by 0.226 points (95% CI: 0.103–0.349, p<0.001) and in course organization by 0.206 points (95% CI: 0.078–0.334, p<0.001). Strong positive correlations were observed among educational content, learning environment, and course organization (r=0.747–0.820, p<0.001). Academic year demonstrated weak negative correlations with all three evaluation domains (r=−0.033 to −0.045, p<0.05). Multivariable linear regression analysis indicated that learning environment (β=0.348, p<0.001) and course organization (β=0.487, p<0.001) explained 63.6% of the variance in educational content ratings (R²=0.636, F(2,5894)=5143.82, p<0.001). Conclusion The study findings demonstrated that students generally evaluated the content, learning environment, and organization of the integrated block curriculum positively, with higher ratings observed in senior-level blocks. The strong positive correlations among these dimensions suggest that they are interrelated factors influencing student satisfaction. Furthermore, multivariable linear regression analysis revealed that course organization and the learning environment had the greatest influence on the evaluation of educational content. These findings indicate that improving course scheduling, instructional organization, and the learning environment is essential for enhancing educational quality and students’ perceived value of the curriculum.

Background: Globally, medical education has been shifting from traditional discipline-based models toward student-centered, outcome-based, and integrated curricula. The Mongolian National University of Medical Sciences (MNUMS) has implemented a six-block integrated curriculum; however, evidence on how teaching methodology and assessment practices influence student learning outcomes within this framework remains limited. Aim: To determine the effect of teaching methodology and assessment practices on student learning outcomes in a block-based undergraduate medical curriculum. Materials and Methods: A retrospective study was conducted from January 2023 to January 2026 among 1,130 undergraduate medical students (years 3–6) at the School of Medicine, MNUMS. A stratified random sampling method was applied, representing 66.8% of the target population. Data were collected using a structured 185-item questionnaire based on a 5-point Likert scale. Statistical analyses included descriptive statistics, independent t-tests, one-way ANOVA with Tukey post-hoc tests, and multiple linear regression using SPSS version 26.0. Internal consistency was high (Cronbach’s α=0.90–0.98). Results: The overall mean evaluation score was 4.00±0.73. A decreasing trend in scores was observed with advancing academic years, with final-year students reporting the lowest scores (M≈3.92). Significant inter-year differences were found in Blocks 3 and 4 (p<0.05), suggesting a potential gap during the theory-to-clinical transition. Blocks 5 and 6 showed consistently high and stable scores (M≈4.10–4.15). Teaching methodology and assessment practices were strong predictors of learning outcomes (β=0.289–0.610), with regression models explaining 67–77% of the variance (R²=0.668–0.774). Elevated VIF values indicated multicollinearity among predictors. Conclusion Teaching methodology and assessment practices were found to be decisive determinants of learning outcomes within the integrated block curriculum (R²=0.668–0.774). Although overall student evaluations exceeded the mean threshold, a systematic decline observed across advancing academic years reflects the phenomenon of retrospective critical evaluation, while inter-year discrepancies in Blocks 3 and 4 indicate insufficient curricular coherence during the theory-to-clinical transition. Therefore, it is imperative to further develop the curriculum in a competency-based framework, and to reform both teaching methodology and assessment practices in alignment with clinical competence requirements.

Background: Between 2017 and 2021, the prevalence of obesity among children aged 2-19 years reached 19.7%, affecting approximately 14.7 million children, with rates of 12.7% among those aged 2-5 years and 22.2% among those aged 6-11 years. Globally, dental caries is among the most common non-communicable diseases, often leading to pain, infection, tooth loss, and reduced quality of life. In Mongolia, the prevalence of overweight and obesity among children and adolescents has increased markedly since 2010, beginning at an early age. In 2018, one in six children under five years and one in eight adolescents were overweight. Aim: This study aimed to assess selected non-communicable disease risk factors among children and adolescents. Materials and Methods: A cross-sectional study was conducted in Ulaanbaatar, Mongolia, using Family Health Centers across all nine districts. A total of 622 children aged 6–17 years were included. Anthropometric measurements (weight, height, and waist circumference) were obtained, and body mass index (BMI) was calculated. Oral health examinations were performed to determine the Decayed, Missing, and Filled Teeth (DMFT) index. Nutritional status was classified based on age and sex-specific growth charts into normal weight, overweight, and obesity categories. Results: Among the participants, 10.29% (n=64) were overweight and 9.97% (n=62) were obese. Overweight was more prevalent among girls, whereas obesity was relatively higher among boys (p<0.001). Regarding dental caries, 37.6% (n=234) of participants had no caries (DMFT=0), 48.1% (n=299) had mild caries (DMFT=1-2), and 14.3% had moderate to severe caries (DMFT≥3). The overall prevalence of dental caries was 62.38%, with significant variation by age group: highest in children aged 6-9 years (69.9%) and lowest in those aged 15-17 years (46.1%) (p<0.001). No statistically significant association was found between BMI categories and dental caries status. Although normal weight predominated in the DMFT=0 and DMFT=1-2 groups, logistic regression adjusted for age and sex showed no significant relationship between BMI and dental caries. However, children aged 6-9 years had a significantly higher likelihood of having dental caries compared to those aged 15-17 years (OR=0.39, 95% CI: 0.24-0.63, p<0.001). Conclusions 1. Among the risk factors for non-communicable diseases (NCDs), overweight and obesity were highly prevalent among children, with one in every five children classified as overweight or obese. The prevalence among male children was approximately two times higher than that among female children (p<0.001). 2. The prevalence of dental caries among the study participants was 90.7%, with a mean caries intensity of 6.4, indicating high level of severity. Age-group analysis demonstrated that children aged 6–10 years exhibited the highest prevalence and severity of dental caries, with a prevalence of 93.5% and a mean caries intensity of 7.3.

Background: In Mongolia, the prevalence of non-communicable diseases and their intermediate risk factors has continuously increased in recent years. From results of early detection and prevalence studies of non-communicable diseases in Mongolia, studies linking intermediate risk factors to insulin resistance are scarce. Aim: To identify the prevalence of insulin resistance among the population and study its connection with intermediate risk factors of non-communicable diseases. Materials and Methods: This study was approved by the MNUMS Ethics Committee on February 23, 2024 (2024/3- 02), and was conducted based on the data of participants who took part in the “Population-based Preventive and Early Detection Screening of Infectious and Non-Infectious Diseases” organized by the Mongolian government from 2022 to 2023. Insulin resistance was identified using the triglyceride-glucose index (TyG), calculated by the formula Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) / 2]. “Ln” refers to the natural logarithm, based on Euler’s number, approximately 2.71828. TyG levels were classified into low risk (<8.5), medium risk (8.5-9.0), and high risk (>9.0). Defined intermediate risk factors for non-communicable diseases according to stages of hypertension and diabetes. Results: The mean age of participants was 44.3±15.2 years, with 39.2% (n=49,270) male and 41.4% (n=49,749) residing in urban areas. Among the participants, 59.1% had overweight or obesity, 23.6% had diabetes or impaired fasting glucose, 61.4% had hypertension, and 19.7% had elevated triglycerides. Analyzing by levels of insulin resistance risk, 62.8% of the population had low risk, 22.5% medium risk, and 14.7% high risk. Comparing systolic blood pressure across levels of insulin resistance risk showed that even without central obesity or diabetes, as the level of insulin resistance increased, the level of systolic blood pressure also increased (low risk group: 117.0±11.7, medium risk group: 121.1±10.9, high risk group: 123.5±16.2 mmHg). Regression analysis of the risk of hypertension by insulin resistance risk level showed that the risk increased with higher levels of insulin resistance (medium risk group OR=1.35, p<0.0001; high risk group OR=1.63, p<0.0001). Conclusion 22.5% of the population is at medium risk and 14.7% at high risk of insulin resistance. The increase in hypertension risk with higher insulin resistance levels is statistically significant, independent of central obesity and diabetes stages.

Background: Obesity and metabolic disorders are significant contributors to hypertension and cardiovascular disease (CVD). While body mass index (BMI) and waist circumference are known to be associated with systolic blood pressure (SBP), the interplay between adiposity, glucose levels, triglycerides, and SBP is not fully understood. This study aims to investigate the relationships between BMI, waist circumference, glucose, triglycerides, and SBP in a large population-based cohort. Methods: A cross-sectional analysis was conducted on [insert total number] participants with complete data on BMI, waist circumference, blood pressure, glucose, and triglycerides. Descriptive statistics, ANOVA, Pearson correlations, mediation analysis, and multiple regression were used to explore the associations between variables. The moderation effect of glucose on the BMI-SBP relationship was examined using an interaction term in the regression model. Results: The mean age of the study population was 44.3 ± 15.2 years. The mean BMI was 26.7 ± 4.9 kg/m², and 22.7% of participants were classified as obese. Central obesity, measured by waist circumference, was prevalent in 55.9% of the population. BMI, waist circumference, glucose, and triglycerides were significantly associated with SBP (p < 0.0001). Mediation analysis showed that waist circumference partially mediated the effect of BMI on SBP. The interaction term for BMI and glucose was significant (β = 0.32, p < 0.05), indicating that glucose levels moderated the relationship between BMI and SBP, with higher glucose levels amplifying the hypertensive effect of BMI. Conclusion This study highlights the complex interplay between BMI, waist circumference, glucose, triglycerides, and SBP. Waist circumference partially mediates the effect of BMI on SBP, and glucose levels moderate this relationship, amplifying the impact of obesity on blood pressure.

BACKGROUND. To evaluate educational environment, it is important to use confidential and accepted tool. Dundee Ready Education Environment Measure (DREEM) (3) is a globally accepted and widely used tool to measure the education environment. Regular assessment of educational environment to evaluate teachers’ teaching method, students’ perception and their outcome and making the necessary adjustment to it is one of the factors affecting students’ knowledge, clinical practice and their motivation (4). In the MNUMS program, educational environmental assessment is one of the most important parts and we are unaware of any report of research work. Therefore, the researchers decide to carry this study. AIM OF THE STUDY. This study aimed to evaluate the educational environment in Nursing school of MNUMS using globally accepted DREEM Questionnaire. MATERIALS AND METHODS. This cross-sectional analytic study was carried out in Faculty of Nursing in Darkhan, Dornogobi and Gobi-Altai aimag out of 9 branch school of MNUMS during the academic year 2015-2016 and 2016-2017. DREEM questionnaire was used to collect data from 306 nursing students. RESULT. Most of the participants were female accounted around 89.9% (275) and male were 10.1% (31). By age, age of 17-19 were 25.5%(78), 20-22 were 52.0% (159), 23-25 were 15.0%(46), >26 were 7.5% (23). The mean item score was highest in Dornogobi school of 3.8 and lowest in Nursing school of 3.6. 4th year students’ 68.6% (210) agreed to “more on positive side” for their academic self perception and 22.5% (69) agreed “moving in right direction” for their academic self perception. All domains were statistically significant specially the perception of curriculum (0.854**) and perception of learning (0.803**) have high correlation. On the other hand, perception of educational atmosphere (0.444**) and perception of teachers have moderate correlation. The reliability of questionnaire was confirmed by Cronbach alpha and it is counted as reliable if it is more than 0.7. The perception of curriculum was relatively low in 2nd year students but higher in 3rd year students. The perception of educational atmosphere was relatively low in 4th year students but higher in 1st year students. CONCLUSION. The nursing school program is in same level. Students are satisfied with their academic self perception and perception of teachers. The result showed that 68.2% (209) of students consider positive aspect of educational environment (p<0.001). Students of all 4 school of MNUMS with same level of nursing school program are satisfied with their knowledge, clinical skills and educational atmosphere among the students. Dornogobi school students’ 65% assessed perception of teacher as “model instruction”.