Background: Infertility is defined as the inability of couples to conceive despite engaging in regular, unprotected sexual intercourse for over a year. Assisted reproductive technology (ART), particularly in vitro fertilization (IVF), has emerged as the most widely utilized solution for infertility. The cause of infertility, a woman’s ovarian reserve, response, egg and sperm quality, the number and quality of embryos, and various other factors influence the outcome of IVF. Despite significant advancements in ART, predicting IVF outcomes remains challenging, especially when tailoring treatment strategies to individual patient factors. Objective: To investigate the clinical indicators, ovarian reserve markers, and stimulation outcomes influencing the success of IVF treatment in Mongolian women. Material and Method: A prospective study was conducted at the Unimed International Hospital IVF Center between October 2023 and August 2024. Clinical and demographic factors, ovarian reserve markers (FSH, AMH, AFC), and ovarian stimulation outcomes were analyzed in 242 women aged 25 44 years undergoing IVF. Logistic regression analysis was performed to identify risk factors and predictors of clinical pregnancy, with a statistical significance threshold set at p<0.05. Results: Among 208 women who underwent embryo transfer, the clinical pregnancy rate was 36.5%, and biochemical pregnancy was observed in 38.4%. Age was a significant predictor, with older age groups (35-39 years: OR=7.11, p=0.004; 40-44 years: OR=12.65, p=0.004) associated with reduced IVF success. Ovarian reserve markers, including AMH (OR=8.92, p<0.001) and AFC (OR=2.78, p<0.001), were significantly correlated with pregnancy outcomes, whereas FSH was not significant (p=0.518). Higher numbers of pre-ovulatory follicles (POF) (OR=1.03, p=0.040) and high-grade embryos (OR=1.26, p=0.045) increased the likelihood of clinical pregnancy. No significant associations were observed between total gonadotrophin dosage, ovarian sensitivity index, and fertilization rate with pregnancy outcomes. Conclusion Age and ovarian reserve markers (AMH, AFC) are critical predictors of IVF success, while pre ovulatory follicle counts and number of high-grade embryos significantly enhance pregnancy likelihood. These findings emphasize the importance of personalized ART protocols tailored to ovarian reserve and age-related factors to optimize IVF outcomes.

Introduction: While 10 percent of global total population was above the age of 65 in 2022, it tends to rise to 16 percent in 2050. In the case of our country, as of 2021, individuals aged 60 and above comprised 7.7% of the total population, with tendency of an increase to 11.9% by 2030 and 21.1% by 2050. In 2018, a study conducted in Brazil, involving 573 elderly participants, found that 10.3% regularly taking five or more medications. This highlights the necessity of studying polypharmacy among the elderly. Materials and Methods : The study was conducted by analytic crosssectional design. Furthermore, the study was conducted during July 1, 2024, to October 1, 2024, in Ulaanbaatar, covering 6 districts. A total of 12 Family Health Centers (FHCs) were selected, including one from an apartment district and one from a ger district in each area. A random sampling method was used to select 238 elderly individuals aged 55 and above for females and 60 and above for males. From each district, 20 participants were selected, maintaining a gender ratio of 1:1. Statistical analysis was performed using Pearson’s Chi-square test and multiple logistic regression analysis. The study was conducted after obtaining approval from the research ethics committee of “Ach” Medical University. Results: Among the 238 participants in the study, the gender distribution was equal, with 119 females (50%) and 119 males (50%). When analyzing the primary conditions requiring for regular medication by organ system, cardiovascular diseases were the most common, accounting for 89.9% (214) of total cases. A total of 37 elderly patients (15.5%) were found to be on polypharmacy (taking five or more medications). Males (n=10, 21.3%) had a higher prevalence of polypharmacy compared to females (n=4, 18.2%).
Polypharmacy was significantly more prevalent among individuals aged 76–84 years, with a rate of 22.4% (p=0.006). Statistically significant differences were observed between polypharmacy and factors such as the type of medications taken for primary diseases (p=0.001), medication dosage (p=0.001), and duration of medication use (p=0.005). Additionally, polypharmacy showed a significant association with comorbid disease-related medication use (p=0.002). Elderly individuals with gastrointestinal and musculoskeletal comorbidities exhibited a higher prevalence of polypharmacy.
Other significant factors associated with polypharmacy included the type of medications used for comorbid conditions (p=0.001), daily medication frequency (p=0.020), and adherence to prescribed medications for comorbid conditions (p=0.017). Multivariate regression analysis identified gender (OR 2.98, 95% CI 1.26-6.97, p=0.007), housing type (OR 0.283, 95% CI 0.117-0.685, p=0.002), medication dosage (OR 4.62, 95% CI 1.97 10.81, p=0.001), and duration of medication use (OR 0.249, 95% CI 0.098-0.631, p=0.003) as statistically significant predicting factors of polypharmacy. Conclusion The use of polypharmacy in the elderly of Ulaanbaatar is 15.5%.

Introduction: According to the World Health Organization (WHO) data from 2022, 19.9 million people were diagnosed with cancer globally, and 9.7 million people died from the disease. In recent years, the incidence of colorectal cancer (CRC) has been rapidly increasing, ranking 4th among all cancers with 18.4 cases and 8.1 deaths per 100,000 population. In Mongolia, 826 new cases of CRC have been registered over the past six years, with an incidence rate of 8.2 cases and a mortality rate of 5.03 per 100,000 population. It is projected that by 2030, the incidence will reach 13.28 cases and the mortality rate will rise to 8.72 per 100,000 population. We aimed to comprehensively examine the risk factors for colorectal cancer among the population of Mongolia, establish a scientific basis for early detection and prevention, and strengthen preventive measures. Materials and Methods: A case-control study was conducted from 2022 to 2024. The study enrolled a total of 305 subjects, including 98 patients with colorectal cancer, 101 patients with colon polyps, and 106 healthy subjects. The risk. questionnaire consisted of 50 questions divided into 10 sections. All statistical analysis was performed with SPSS version 23.0 software (SPSS Inc., Chicago, IL, USA) and P value <0.05 was considered statistically significant. categorical data was represented as numbers and percentages. Pearson’s chi-squared and Fisher’s exact test were used to compare categorical variables. Multivariate logistic regression was used to identify the risk factor associated with recurrence. The study protocol was approved by Ethics Review Committee of Ministry of Health of Mongolia on 17 March 2023 (approval number: 23/012). Results: The average age of the participants was 57.1±12.8 years. Among all study participants, 37.6% (115) were male and 62.4% (188) were female. Comparison of colorectal cancer incidence by age and gender revealed no statistically significant differences (p=0.021; p=0.422). Regular physical exercise was found to have a protective effect against colorectal cancer (p=0.076; OR 0.341 95% Cl 0.118-.0986). The frequency of fruit consumption, 4 to 6 times per week (p=0.008, OR 0.08, 95% Cl 0.01-0.45), frequency of vegetable consumption 4 to 6 times per week (p<0.00; OR 0.07, 95% Cl 0.02-0.19), no dining out (0.007, OR 0.3, 95% Cl 0.18-0.68), and meat consumption (p=0.001) are decreased risk of colorectal cancer. Conclusion The patient's age and the presence of colon polyps are risk factors for colorectal cancer, while regular physical activity and a diet rich in fruits and vegetables are protective factors that help reduce the risk of developing colorectal cancer.

Introduction: Safe and accessible WASH services in healthcare facilities are crucial for maintaining high quality care, especially for maternal and newborn health. The WHO-UNICEF JMP on Water Supply, Sanitation, and Hygiene provides reports on progress in water supply, sanitation, and hygiene services at global, regional, and national levels, covering populations, schools, and healthcare facilities. This assessment was conducted to address the insufficient data on the level of hand hygiene services in healthcare facilities, following the methodology of the JMP. Materials and Methods: A cross-sectional study was conducted in 319 healthcare facilities. Availability of hand hygiene services in the study healthcare facilities was assessed using questionnaire of methodology of the JMP. Data were analyzed using SPSS 25.0 software. Relevant parametric and non parametric statistical analysis were conducted. Results: Overall, 72% and 28% of healthcare facilities had basic and limited hand hygiene service respectively. About 18% of private healthcare facilities had limited hand hygiene service compared to 34% of state healthcare facilities. While 20% of urban healthcare facilities had limited hand hygiene service, 56% of rural healthcare facilities do. When examining the level of hand hygiene services by type of medical care, specialty hospitals have 100% basic services. Among primary care facilities, 83% of family health centers provide basic services, while 41% of soum and village health centers meet these standards. Conclusion The basic hand hygiene services in urban healthcare facilities and specialty hospitals were generally sufficient. There need to enhance basic hand hygiene service at the soum and village level. Among the assessed facilities, 81.0% met four out of the five key hand hygiene requirements outlined in the national standard. However, additional budget allocation for maintenance and operational costs for keeping soap and sustaining water running remains crucial to ensure sustained compliance and quality.

Introduction: Cardiovascular disease-related mortality accounts for 34% globally, 23% in the United States, and 22% in Europe, with Asia representing 35% of total deaths as of 2019. In Asia, ischemic heart disease and stroke are the most common causes of cardiovascular diseases (CVD), and the prevalence of these two types of CVD varies significantly across different regions and countries in Asia. Over the last 10 years, the average number of deaths due to cardiovascular diseases has been 5.7 thousand annually, representing 33.7% of total mortality. Cardiovascular diseases account for 11.1% of all illnesses, and as of 2021, the rate has increased by 128 compared to the average of the past 10 years, reaching 936 per 10.000 population. As cardiovascular disease-related mortality is the leading cause of death worldwide, every country has criteria for calculating the 10-year risk of CVD to reduce cardiovascular morbidity and mortality. These criteria are crucial for predicting the risk of stroke and cardiovascular diseases in individuals with or without diabetes. Purpose: To assess the risk of heart disease in people aged 40-74 years without cardiovascular disease. Material and Methods: A total of 394 individuals aged 40-74 were included in the study. Blood samples were taken to determine lipid profiles and fasting glucose levels. Using the World Health Organization's (2019) revised cardiovascular disease risk assessment model (which considers age, systolic blood pressure, smoking, total cholesterol, LDL and BMI), the 10-year risk of developing cardiovascular disease was calculated using both laboratory-based and non-laboratory based risk assessment criteria. Statistical analysis of the study was performed using SPSS 26 software, with a p-value of less than 0.05 considered statistically significant. Ethics: The methodology was approved by the Medical Ethics Sub-Committee of the Ach medical university on the 30th of June, 2023 (Decision #23/02/03) Result: The average age of the adults included in the study was 49.3±14.7 years. Among those aged 40-74 who participated in the CVD risk assessment criteria, the average age was 53.7±9 years, with men having an average age of 54.6±9.3 (117 participants) and women having an average age of 53±8.7 (223 participants). The total cardiovascular risk of the study participants was 54.8% very low, 15.7% low, 13.2% moderate, 8.1% high, and 8.1% very high according to laboratory-based assessment, while the non-laboratory based assessment showed 49% very low, 20.7% low, 16.8% moderate, 7.7% high and 5.9% very high risk).
Among all participants, the prevalence of cardiovascular risk factors was assessed as follows: 26.9% (95% CI: 22.6–31.6%) were smokers, 60.5% (95% CI: 55.4–65.3%) consumed alcohol, 46.4% (95% CI: 42.4–50.2%) had arterial hypertension, 10.4% (95% CI: 0.76–13.9%) had diabetes mellitus, 75% were obese, 78.4% (95% CI: 74.2–81.6%) had central obesity, 24.4% (95% CI: 18.5–31%) had hyperglycemia, 42.6% (95% CI: 35.6–49.9%) had hypercholesterolemia, 19.3% (95% CI: 14–25.5%) had hypertriglyceridemia, and 11.3% (95% CI: 0.71–16.7%) had elevated low-density lipoprotein levels.
The total cardiovascular risk of the study participants was 54.8% very low, 15.7% low, 13.2% moderate, 8.1% high, and 8.1% very high according to laboratory-based assessment, while the non-laboratory based assessment showed 49% very low, 20.7% low, 16.8% moderate, 7.7% high and 5.9% very high risk.
These distributions showed a statistically significant difference compared to the group without arterial hypertension (p<0.0001). Additionally, comparison of risk between individuals with and without diabetes mellitus using laboratory-based assessment also revealed a statistically significant difference (p<0.0001). The concordance between the two models was 88.8% (95% CI: 83.6–92.9) with a Cohen’s kappa coefficient of κ=0.6, indicating moderate agreement with statistically significant difference (p<0.001). Conclusion 75% of the people surveyed were obese and 78.4% had central obesity, with men at greater risk than women. The cardiovascular risk of having arterial hypertension and diabetes is further increased. The correlation coefficient of the risk estimates showed a strong correlation across gender and age groups. The agreement between the risk estimate models was 88.8%, or a moderate agreement with Cohen's coefficient (k=0.6).

: Eye injuries represent a significant public health concern, being one of the leading causes of low vision and blindness worldwide. Annually, approximately 55 million individuals experience eye injuries, and this condition leads to 19 million people losing their ability to work due to vision impairment. Population-based studies in Asian countries reveal notable prevalence rates, with 4.4% in Singapore and 3.6% in China. Clinical Case: 30 years old man, While he working on a building, He encountered a notable eye injury when cement particles accidentally fell into his eye. Initially, coworkers offered assistance, using available water sources to rinse his eye before he returned home. Medical Intervention: Recognizing the need for professional care due to his persistent symptoms and lack of improvement, Patient B sought treatment at an eye clinic. There, the medical team implemented a comprehensive approach, incorporating both medical and surgical interventions to address the complications arising from his eye injury. This case highlights the importance of prompt and effective treatment for eye injuries, particularly those resulting from chemical exposure. The progression of symptoms in this instance emphasizes the need for greater awareness regarding appropriate initial management and the critical role of professional evaluation when symptoms remain unresolved. Additionally, it serves as a reminder of the potential seriousness associated with injuries that may initially appear minor, especially in environments like construction where chemical exposures are common. A focus on ongoing education and a collaborative approach can prove invaluable in enhancing outcomes for patients facing similar challenges in the future. Novel techniques used in surgery This surgical procedure continues to evolve, contributing to enhanced precision and efficiency in medical procedures. One significant advancement is the single use holy drop system, which prioritizes accuracy in ophthalmic surgeries.
This innovative technique involves the use of a tube that is meticulously measured from the upper eyelid to the lower eyelid of the patient. The tube is subsequently cut into a circular shape based on these measurements, ensuring a customized fit during the surgical procedure.
This approach guarantees that the surgical materials align seamlessly with the anatomical features of the patient’s eye, thereby minimizing trauma and optimizing clinical outcomes.
The circular configuration of the tube is instrumental in maintaining consistent pressure and stability, which contributes to improved healing and a reduction in postoperative complications. Overall, the single use holy drop system represents a notable

The causal link between serum 25(OH)D concentrations and many disorders has not been clearly established, these associations have led to widespread supplementation with vitamin D and increased laboratory testing for 25(OH)D in the general population. The benefit-risk ratio of this increase in vitamin D use is not clear, and the optimal vitamin D intake and the role of testing for 25(OH)D for disease prevention remain uncertain (Marie B.Demay, Anastassion SG Pittas, Daniel B Bikle et al., 2024).
A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review, identified and prioritized 14 clinically relevant questions related to the use of vitamin D and 25(OH)D testing to lower the risk of disease. The panel prioritized randomized placebo-controlled trials in general populations (without an established indication for vitamin D treatment or 25[OH]D testing), evaluating the effects of empiric vitamin D administration throughout the lifespan, as well as in select conditions (pregnancy and prediabetes).
The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology was used to assess the certainty of evidence and guide recommendations.The panel suggests empiric vitamin D for those aged 1 to 18 years and adults over 75 years of age, those who are pregnant, and those with high-risk prediabetes. The panel suggests against routine 25(OH)D testing in the absence of established indications.

Background: The World Health Organization has projected that by 2050, the global number of new cancer cases will reach 35 million [1]. In 2024, Mongolia ranks first in cancer mortality worldwide. As of 2024, Mongolia ranks 3rd globally for esophageal cancer with a rate of 19.8% per 100,000 people, and 1st for stomach cancer with a rate of 28.6% per 100,000 people [2]. In recent years, the number of new cases of esophageal and stomach cancers recorded in the population of Mongolia has been steadily increasing compared to other countries. According to statistical data in Mongolia, 8169 new cancer cases were registered in 2024, of which 4755 people died from cancer-related causes [3]. In 2024, 64.4% of cancer patients in Mongolia were diagnosed at a late stage, while only 35.6% were diagnosed at an early stage [4]. Compared to the previous year, early-stage cancer diagnosis increased by 65%, indicating an improvement in cancer detection. This progress is closely related to advancements in diagnostic methods. The development of medical technology, particularly the integration of advanced imaging features such as LCI (Linked Color Imaging) and BLI (Blue Light Imaging) into flexible endoscopy, has brought significant breakthroughs in endoscopic examinations [5]. Since 2023, the General Hospital of Khan-Uul District has been using the FUJINON 6000 model flexible endoscope from Japan, equipped with advanced imaging functions such as LCI (Linked Color Imaging) and BLI (Blue Light Imaging). The evaluation of the effectiveness of these technologies in accurately diagnosing early-stage cancers served as the basis for this study. Objective: The objective is to evaluate the accuracy of early-stage cancer detection using special light modes — LCI (Linked Color Imaging) and BLI (Blue Light Imaging) — among patients who underwent esophageal and gastric endoscopic examinations at the General Hospital of Khan-Uul District." Material and Method: In 2023 and 2024, a total of 4,842 patients underwent flexible endoscopic examinations of the esophagus and stomach at the General Hospital of Khan-Uul District. Among them, 82 patients with mucosal abnormalities or microvascular pattern changes in the esophagus, stomach, or small intestine were selected for retrospective analysis. Biopsies were obtained using advanced imaging technologies, specifically LCI (Linked Color Imaging) and BLI (Blue Light Imaging), to assess the diagnostic value of these modalities in detecting early neoplastic changes. Result: In 2023 and 2024, a total of 4,842 patients underwent flexible endoscopic examination of the esophagus and stomach at the General Hospital of Khan-Uul District. Among them, 82 patients with mucosal abnormalities were selected for further evaluation using LCI (Linked Color Imaging) and BLI (Blue Light Imaging), and biopsy samples were obtained. The findings were as follows:
• 18 cases of esophageal cancer were identified, of which 15 cases (83.3%) were early stage and 3 cases (16.6%) were advanced-stage.
• 26 cases of gastric cancer were detected, with 13 cases (50%) in the early stage and 13 cases (50%) in the advanced stage.
• 1 case of early-stage small intestinal cancer was also newly diagnosed.
All 28 early-stage cancer cases underwent endoscopic mucosal resection (EMR). The advantages of this procedure include minimal patient discomfort, no visible external wounds, low risk of bleeding or complications, and most importantly, organ preservation, which is a major clinical benefit. Conclusion LCI (Linked Color Imaging) and BLI (Blue Light Imaging) demonstrate greater accuracy in detecting mucosal abnormalities compared to conventional WLI (White Light Imaging) in the early diagnosis of esophageal and gastric cancers. Early detection of malignancies significantly improves patients’ quality of life and increases the 5-year survival rate to over 90%.

Background: Milk and dairy products are important sources of protein, vitamins (B2, B12), and minerals (calcium, zinc), playing a key role in maintaining normal body weight, bone structure, and overall health. However, in Mongolia, regular milk consumption among school-aged children is inadequate, and scientific evidence on its association with growth, micronutrient status, and bone health is limited. Objective : To determine the relationship between weekly milk consumption and children’s physical growth, bone softening, and serum levels of vitamin D and selected minerals. Material and Methods: A cross-sectional study was conducted in December 2024 among 453 students aged 7–12 years from six general education schools in Ulaanbaatar. Participants were classified into three groups based on weekly milk consumption: (1) non-consumers, (2) consumers at school or home, and (3) consumers at both school and home. Anthropometric measurements were obtained, and BMI z-scores were calculated using WHO growth reference standards. Blood samples were analyzed for vitamin D, calcium, magnesium, and zinc, and bone mineral density was measured. Data were analyzed using SPSS 26, applying independent t-tests, chi-square tests, and ANOVA, with p<0.05 considered statistically significant. Results: Children consuming milk regularly at both school and home had higher mean height (139 ± 8 cm) compared to non-consumers (136 ± 17 cm), though differences were not statistically significant (p=0.33). BMI was more often in the normal range among dual-site consumers (56.4%) compared to non-consumers (43.4%) (p<0.05). Vitamin D deficiency was less prevalent among dual-site consumers (47%) than in other groups (p<0.05). Magnesium (0.86±0.07 mmol/L) and zinc (18.74±2.48 μmol/L) levels were significantly higher in this group (p<0.05). Bone softening prevalence was lower among dual-site consumers (47.8%) compared to non-consumers (58.3%) (p=0.026). No significant associations were found between milk consumption and red blood cell indices. Conclusion Regular milk consumption is associated with improved BMI status, higher serum magnesium and zinc levels, and lower prevalence of bone softening among school-aged children in Ulaanbaatar. These findings support the potential role of school milk programs in enhancing child nutrition and bone health in Mongolia.

Introduction: Smoking causes hardening of the arteries (atherosclerosis) and blockage of small arteries, which is a direct cause of morbidity and mortality from stroke and heart attack. This study was conducted to determine the risk of atherosclerosis-related diseases in male smokers. Goal: To determine the relationship between carotid artery stenosis in men and certain risk factors (age, smoking, blood pressure, and blood biochemical parameters). Material and Method: The study was conducted in a hospital-based case-control study design. It involved 140 men aged 40-60, smokers (n=70) in the case group, and non-smokers (n=70) in the control group. Result: When considering the average values of blood biochemical test parameters by age group, HDL levels were 1.50±0.33 mmol/l in the smoking group aged 40-49 and 1.30±0.29 mmol/l in the 50-60 age group (p<0.016), while in the non-smoking group (1.51±0.33, 1.37±0.34, p<0.05), which statistically significantly decreased with age. The mean blood triglyceride level was 1.36±0.54 mmol/L in men who smoked ≤10 cigarettes per day (n=36) and 1.75±0.77 mmol/L in men who smoked ≥10 cigarettes per day (n=34), which was statistically significant (p<0.006). When considering the parameters of atherosclerosis by age group, the average IMT in smokers was 0.59±0.09 mm in the 40-49 age group and 0.70±0.19 mm in the 50-60 age group (p<0.001), while in non-smokers it was (0.57±0.08 mm, 0.61±0.13 mm, p<0.004), indicating that the thickness of the vascular wall increased with age in both groups with statistical significance. Conclusion Carotid artery atherosclerosis is strongly age-related, and long-term smoking accelerates the process of atherosclerosis. Blood LDL levels decrease with age, especially in smokers, and they decrease more than in nonsmokers. People who smoke ≥10 cigarettes per day have higher blood LDL levels.