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: Inflammatory bowel disease (IBD) is a chronic immune-related condition caused by interactions between genetics, immune dysfunction, gut microbiota changes, and environmental factors, often presenting as persistent or recurring diarrhea. Clinically, it commonly presents with chronic diarrhea and other gastrointestinal symptoms. The global prevalence of IBD is increasing, currently affecting approximately 0.5% of the population, with projections suggesting a rise to nearly 1% by 2030. Fecal calprotectin is a neutrophil-derived S100 calcium-binding protein that is elevated in intestinal mucosal inflammation and serves as a reliable noninvasive biomarker of inflammatory activity. Due to its high stability and close association with intestinal inflammatory activity, fecal calprotectin has been established as a dependable, non-invasive marker for identifying intestinal inflammation. In clinical practice, it is extensively used to distinguish IBD from functional gastrointestinal disorders, especially irritable bowel syndrome, among patients presenting with chronic diarrhea. However, its diagnostic utility in Mongolia remains underexplored, and this study aims to determine its sensitivity and specificity in inflammatory bowel disease and compare its diagnostic performance with other inflammatory markers. Aim: To determine the sensitivity and specificity of fecal calprotectin in inflammatory bowel disease and to compare it with other inflammatory markers. Materials and Methods: A total of 109 participants aged 18-87 years with chronic diarrhea, who attended the gastroenterology outpatient clinics of the Mongolia–Japan Hospital and Intermed Hospital between December 2024 and December 2025 and provided informed consent, were enrolled in this study. Data were collected using structured questionnaires, and laboratory investigations included complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and measurement of fecal calprotectin levels from stool samples. Based on fecal calprotectin results, selected participants underwent colonoscopic examination as clinically indicated. Results: Among the 109 participants included in the study, 17.4% were diagnosed with inflammatory bowel disease (IBD), with a mean age of 47.41±15.52 years. Fecal calprotectin levels were significantly higher in the IBD group compared to the control group (p<0.001). Fecal calprotectin demonstrated a weak positive correlation with C-reactive protein (CRP) and leukocyte count (p=0.042, p=0.06), while no significant correlation was observed with erythrocyte sedimentation rate (ESR). At a cutoff value of 250 µg/g, fecal calprotectin showed a sensitivity of 94.4%, specificity of 69.2%, positive predictive value (PPV) of 37.8%, and negative predictive value (NPV) of 98.4%. Receiver operating characteristic (ROC) curve analysis identified an optimal cutoff value of approximately 400 µg/g (AUC=0.919, Youden index=0.724), at which the sensitivity remained 94.4% and specificity increased to 78.0%. In contrast, CRP and ESR demonstrated comparatively lower diagnostic performance, with AUC values of 0.640 and 0.644, respectively. Conclusion This study demonstrates that fecal calprotectin has superior diagnostic performance compared to conventional inflammatory markers in differentiating inflammatory bowel disease (IBD). An optimal cutoff value of approximately 400 µg/g yielded the highest sensitivity and specificity. Therefore, fecal calprotectin may serve as a valuable tool in clinical practice for both screening and diagnostic confirmation.

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.