Background: Lumbar disc herniation (LDH) is one of the leading causes of lower back pain and disability, significantly impacting public health and socio-economic well-being. International studies have shown that paraspinal muscle size and structure correlate with age, body mass index (BMI), and spinal disorders. However, comprehensive MRI-based research investigating the correlation between LDH and specific morphometric parameters in Mongolia remains limited. Aim: To evaluate lumbar disc herniation using magnetic resonance imaging (MRI) and compare paraspinal muscle volume and subcutaneous fat thickness. Materials and Methods: An observational retrospective study design was conducted between June 2024 and June 2025 at Asraltmed and Orgil hospitals, enrolling 300 cases selected from 2,840 lumbar spine MRI scans based on inclusion and exclusion criteria. Demographic data (age, sex, BMI) were collected alongside MRI metrics. LDH type, size, location, and severity were evaluated using axial, sagittal, and coronal views across T1WI, T2WI, and STIR/T2FS sequences. Paraspinal muscle cross-sectional area (Multifidus, Erector spinae, Psoas) was measured on axial T1WI and T2WI sequences, while subcutaneous fat thickness was measured on sagittal T2WI sequences. LDH parameters were evaluated in relation to paraspinal muscle measurements, subcutaneous fat thickness, and BMI. Disc degeneration was classified using the Pfirrmann grading system, and statistical analysis was performed using IBM SPSS 25.0. Result: The mean age of participants was 45.6±12.3 years. Higher BMI (r=0.41) and increased subcutaneous fat thickness (r=0.46) showed a significant positive correlation with LDH severity (p<0.001). Conversely, paraspinal muscle cross-sectional area (CSA) was negatively correlated with LDH severity (r=0.49, p<0.001). Multivariate regression analysis revealed that age, sex, BMI, subcutaneous fat thickness, and paraspinal muscle CSA were statistically significantly associated with LDH (p<0.01). Subgroup analysis by sex demonstrated similar correlations between paraspinal muscle size, subcutaneous fat thickness, and LDH severity in both male and female groups. Conclusion Lumbar disc herniation severity is associated with increased BMI and subcutaneous fat thickness, as well as decreased paraspinal muscle mass. Normalized muscle parameters reduce sex-related discrepancies and establish an effective MRI-based risk assessment approach.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.