Background: Hemophilia is a congenital bleeding disorder caused by a lack of clotting factor in the blood. Hemophilia A, B, and C are caused by congenital deficiencies of clotting factors VIII, IX, and IX which are involved in thrombin generation of intrinsic coagulation pathway. Hemophilia A and B is a recessive X-linked congenital bleeding disorder but hemophilia C is typically inherited in an autosomal recessive, these are rare inherited coagulation disorders. This study was conducted based on the lack of database on the epidemiology, clinical type and severity in hemophilia in Mongolia. Aim: The aim of this study was to investigate the relationship between clotting factor levels and bleeding severity of hemophilia. Materials and Methods: A cross sectional study included a total of 30 patients with hemophilia who were registered from May to October 2025 at the Comprehensive Hemophilia Center, MNUMS. The study was approved by the Research Ethics Committee of MNUMS. Result: In this study 30 patients with hemophilia mean age was 18.4±15.7 years, and 96.7% were male. When categorized by age group, 13.4% (n=4) were under 4 years, 40% (n=12) were 5–13 years, 10% (n=3) were 14–18 years, 33.3% (n=10) were 19–44 years, and 3.3% (n=1) were over 45 years. Of the total cases, 83.3% (n=25) had Hemophilia A and 16.7% (n=5) had Hemophilia B. Of the total case, 80% of cases were classified as severe and 20% as moderate hemophilia. Additionally, 40% of cases had joint complications. Conclusion Joint bleeding was observed in 41.6% of patients with severe hemophilia and in 33.3% of those with moderate hemophilia. Target joint damage was found in 40% of the study population because 86.6% of patients were not able to receive prophylactic factor replacement therapy. Joint damage, joint deformities, reduced range of motion, and deterioration in quality of life were all adverse outcomes related to the early onset of joint bleeding.

Background: Cisplatin is a widely used platinum-based chemotherapeutic agent, but its gonadotoxic effects can damage ovarian tissue, oocytes, and developing follicles and may lead to primary ovarian insufficiency (POI). Adipose-derived stem cells (ADSCs) are being investigated as a potential regenerative treatment because of their paracrine, anti-apoptotic, and tissue-repair effects. Aim: To evaluate the effect of ADSC therapy on estrous cyclicity, body weight, and ovarian follicular morphology in a mouse model of cisplatin-induced POI. Materials and Methods: Thirty 6-week-old female BALB/c mice were included. Six mice received saline as controls, while 24 mice received cisplatin 2 mg/kg intraperitoneally once daily for 10 days to induce POI. After POI induction, cisplatin-exposed animals were continued as an untreated POI group (n=15) or an ADSC-treatment group (n=9). The ADSC group received 1×10⁶ cells suspended in 0.2 mL medium via the tail vein. Body weight and vaginal cytology were monitored daily, and estrous stages were classified as proestrus, estrus, metestrus, and diestrus. Ovaries were collected for histologic evaluation at the end of the study. Result: After cisplatin exposure, mean estrous cycle length increased from 3.97 days in controls to 6.4 days in the POI group (p<0.05). During the post-treatment evaluation, mean cycle length was 5.65 days in untreated POI mice (n=4) and 4.5 days in ADSC-treated mice (n=7), representing a statistically significant improvement after ADSC therapy (p=0.013). Cisplatin caused significant body-weight loss, reaching a mean of 18.0 g on day 6 after completion of cisplatin administration (p<0.01). Histologically, untreated POI ovaries showed follicular atrophy and prominent degenerative changes, whereas ADSC-treated ovaries showed more morphologically preserved primary, secondary, and antral follicles and relatively fewer degenerative changes. Exploratory manual counting in three representative whole-ovary sections per group showed total intact/growing follicle counts of 15.00±2.65 in controls, 6.00±2.00 in POI, and 8.67±2.89 in ADSC-treated ovaries. Conclusion ADSC treatment was associated with partial restoration of estrous cyclicity and ovarian follicular development in a cisplatin-induced POI mouse model. These findings support further investigation of ADSC-based regenerative therapy for chemotherapy-associated ovarian injury.

Background: Liver transplantation has become an effective treatment option worldwide for a wide range of malignant and non-malignant liver diseases. In Mongolia, the high prevalence of single and co-infections with viral hepatitis is a major contributing factor to the development of liver cirrhosis and primary liver cancer. However, data on the indications, clinical characteristics, and outcomes of liver transplantation in the Mongolian population remain limited. Aim: To evaluate the indications and clinical characteristics of patients undergoing liver transplantation and to determine their survival outcomes. Materials and Methods: This single-center, retrospective cohort study included 238 patients who underwent liver transplantation at the National Cancer Center of Mongolia between 2018 and feb 2026. Patients were categorized into two groups according to the indication for transplantation: malignant and non-malignant liver diseases. Demographic and clinical characteristics were compared between the groups. Overall survival was estimated using the Kaplan–Meier method, and differences in survival were assessed using the log-rank test. A p-value <0.05 was considered statistically significant. Result: The mean age of the liver transplant recipients was 49.0 ± 8.4 years. Relatively older male patients were more likely to undergo liver transplantation for malignant liver diseases, whereas younger female patients predominated among those transplanted for non-malignant conditions (p=0.0001). No statistically significant difference in body mass index was observed between the groups (p>0.05). MELD and Child–Pugh (CPT) scores, reflecting the severity and prognosis of liver disease, differed significantly between the two groups. However, no statistically significant difference in survival was observed between the groups at 1-, 3-, or 5- years after liver transplantation (p=0.974). Conclusion Although age, sex, and liver disease severity as assessed by MELD and Child–Pugh scores differed significantly between patients undergoing liver transplantation for malignant and non-malignant indications, no statistically significant difference was observed in survival at 1-, 3-, or 5- years following liver transplantation.

Introduction: Chronic lymphocytic leukemia (CLL) is a hematologic malignancy characterized by the clonal proliferation and accumulation of mature monoclonal B lymphocytes in the peripheral blood. CLL is relatively common in Europe and North America, with an incidence of approximately 4–6 cases per 100,000 population, whereas it is rare in South Asia, with an incidence of approximately 0.11 cases per 100,000 population. During the course of the disease, neoplastic lymphocytes may infiltrate the bone marrow, lymph nodes, liver, spleen, and, less commonly, other organs and tissues. CLL presenting with marked splenomegaly in the absence of lymphadenopathy is uncommon. Therefore, in patients with unexplained splenomegaly, the differential diagnosis should include CLL and other lymphoproliferative disorders. Case Presentation: We report a case of CLL diagnosed on the basis of clinical findings, laboratory investigations, and additional diagnostic evaluation in a patient who presented to a hematology outpatient clinic with splenomegaly. An 81-year-old man presented with a macular rash involving the thighs, lower legs, chest, and both upper extremities, accompanied by dizziness, unsteadiness, nausea, fatigue, and generalized weakness. Physical examination revealed massive splenomegaly with a smooth surface and blunt edge, palpable approximately 25 cm below the left costal margin. Laboratory investigations demonstrated hyperleukocytosis with lymphocytosis, moderate normocytic normochromic anemia, and severe thrombocytopenia. Contrast-enhanced abdominal computed tomography revealed massive splenomegaly, with the spleen measuring 27.9×20.0×7.9 cm. The patient was treated with cyclophosphamide at a dose of 250 mg/m (400 mg administered) in combination with glucocorticoid therapy. Following treatment, leukocytosis, lymphocytosis, and monocytosis improved, and the spleen decreased substantially in size, becoming palpable approximately 4 cm below the umbilicus on physical examination. Conclusion Hematologic malignancies should be considered in the differential diagnosis of patients presenting with unexplained splenomegaly. In this case, a diagnosis of chronic lymphocytic leukemia was established based on bone marrow examination and the overall clinical and laboratory findings. Following treatment with cyclophosphamide and glucocorticoids, peripheral blood abnormalities improved and splenic enlargement decreased substantially, suggesting a favorable therapeutic response.

Background: A child’s physical growth is fundamentally dependent on hormonal regulation, metabolism, and oxygen supply, within which bone mineralization specifically calcium (Ca²⁺) levels acts as a primary factor determining bone mineral density (BMD), muscle function, and hormonal activity. In cardiovascular disease (CVD), multiple physiological processes are disrupted at various levels, including decreased blood circulation and oxygen supply, increased energy expenditure, and reduced absorption of nutrients and micronutrients. In this context, research linking calcium levels in 6–7-year-old children with electrocardiographic (ECG) changes to physical growth has been scarce, which provided the rationale for conducting this study. Aim: To investigate the association between calcium levels and physical growth among 6–7-year-old children with electrocardiographic (ECG) abnormalities detected through early screening. Materials and Methods: This study was conducted using a case-control design. The case group included 143 children aged 6–7 with ECG changes, and the control group included 153 children without ECG changes, totaling 296 voluntary participants. Serum total calcium and albumin levels in both groups were measured using a fully automated biochemical analyzer. Statistical analysis was performed using SPSSv27, applying independent samples t-tests, ANOVA, and correlation analysis to compare means between the two groups. Results: The control group’s serum total calcium was 2.65±0.15 mmol/L, corrected calcium was 2.58±0.13 mmol/L, and the case group’s serum total calcium was 2.64±0.18 mmol/L, corrected calcium was 2.59±0.17 mmol/L, with no statistically significant difference observed between the study groups (p>0.05). When comparing total calcium in case-group children with normal height (2.66±0.20) versus those with stunted growth (2.61±0.13), a statistically significant difference was found (p<0.05). Correlation analysis between total and corrected calcium levels and physical growth indicators across study groups showed no statistically significant association. When height measurements were divided into four quartiles (Q1–Q4) and compared against total and corrected serum calcium, no statistically significant differences were found between the groups. Conclusions Comparison of physical growth and development Z-scores between children with and without ECG abnormalities revealed no statistically significant differences. However, total calcium levels tended to be lower among children with normal growth compared with those with growth retardation in the case group (p < 0.05). No statistically significant differences were observed in serum total or albumin-corrected calcium levels between the study groups (p > 0.05). When height measurements in the study groups were categorized into quartiles, no statistically significant differences in total or albumin-corrected calcium levels were observed between the groups. This suggests that calcium levels alone may not be a decisive determinant of physical growth in children of the same age.

Background: Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by abnormal proliferation of megakaryocytes in the bone marrow, resulting in persistent thrombocytosis in the peripheral blood and clinical manifestations including thrombotic and hemorrhagic complications. Approximately 90% of patients with ET harbor driver mutations in JAK2, CALR, or MPL, with JAK2V617F being the most frequently detected mutation. The JAK2V617F mutation induces constitutive activation of the JAK–STAT signaling pathway, leading to abnormal megakaryocytic proliferation and increased platelet production. Consequently, patients are predisposed to thrombotic complications; however, qualitative platelet dysfunction may also contribute to an increased risk of bleeding. Among large-vessel thrombotic complications, venous thromboembolism is relatively common, whereas pulmonary artery thromboembolism is an uncommon complication. Moreover, thrombotic risk is generally lower in patients with JAK2-negative ET. Case presentation: In this report, we present a rare case of essential thrombocythemia presenting with respiratory failure secondary to pulmonary artery thromboembolism. Conclusion This case demonstrates that essential thrombocythemia may initially manifest with life-threatening thrombotic complications, including pulmonary thromboembolism, even in the absence of the JAK2 V617F mutation. Accordingly, unexplained thrombocytosis warrants evaluation for an underlying myeloproliferative neoplasm, while early assessment of thrombotic risk is essential for guiding appropriate clinical management and reducing the risk of adverse outcomes.

Background: Obesity, especially central obesity, is a risk factor for non-communicable chronic diseases such as dyslipidemia, type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and metabolic syndrome (MetS). Aim: Study the association between the subcutaneous fat area (SFA) and visceral fat area (VFA) with lipid metabolism parameters in adults with MetS. Materials and Methods: Data from 1511 participants who visited the ‘NURA Mongolia’ Ai Health screening center between September 2023 and February 2024, including general information, DEXA (Dual X-ray Absorptiometry), and biochemical analysis results, were used. Metabolic syndrome (MeS) was assessed based on the harmonizing criteria 2009 (≥3 criteria). VFA and SFA were categorized into four groups using quartiles (Q1-Q4). Statistical analysis was performed using SPSS v26, including T-tests, multiple logistic regression (OR, 95% CI), and ROC (AUC) analysis. Results: The average age of the participants was 30.5±3.9 years, with a BMI of 25.1 kg/m², and 49.5% were male. The group with MetS (n=531) had significantly higher levels of VFA and SFA compared to the group that rated their health as relatively healthy and had no clinical diagnosis (n=979) (control group) (p<0.0001), with males showing higher VFA and females showing higher SFA (p<0.0001). The Q4 group for VFA had a significant association with MetS in males (4.611, 95% CI=2.394–9.591) and females (2.253, 95% CI=1.097-3.912) (p<0.001). Logistic regression analysis showed that increased VFA was more strongly associated with MetS in males (β=0.325, p<0.0001) and females (β=0.338, p<0.003) than BMI. The AUC for predicting MetS was 0.790 (95% CI=0.750-0.831) for VFA and 0.401 (95% CI=0.351-0.451) for SFA, with all results being statistically significant (p<0.001). VFA had a higher predictive value compared to other markers. Conclusion In healthy men with metabolic syndrome, VFA is more prominently defined, while SFA is higher in healthy women. Since VFA is a better predictor of metabolic syndrome than SFA, it increases the risk of diseases such as cardiovascular diseases and type 2 diabetes in men, whereas SFA in women serves as a protective factor.

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer originating from liver cells, classified as a chronic liver disease. This cancer ranks third in the world in terms of mortality rate. The MELD (Model for End-Stage Liver Disease) and Child-Pugh scoring systems are utilized to assess the prognosis of chronic liver diseases. Based on studies suggesting that certain blood test indicators, particularly red cell distribution width (RDW), could be used to predict the prognosis of liver cancer and other cancers, as well as serve as diagnostic markers, this topic was chosen to evaluate the clinical significance of RDW in hepatocellular carcinoma. Aim: The aim is to study some blood test indicators and compare them with the MELD score and Child-Pugh score systems in order to determine the prognosis of chronic liver diseases. Materials and Methods: A retrospective, single-center, cross-sectional study was conducted at Mongolia-Japan Hospital. Among 322 patients diagnosed with HCC, 24 patients were selected for the case group, and 37 patients with liver cirrhosis were included in the control group. Results: According to the research criteria, 61 patients were selected and divided into 3 groups, and statistical analysis was performed. In the detailed blood test, platelet count and WBC count showed statistically significant differences among the 3 groups (p< 0.024). In the biochemical tests, C-reactive protein (CRP) was p< 0.018, total bilirubin p< 0.001, and the mean albumin level p< 0.015, all showing statistically significant differences among the 3 groups. A statistically significant inverse correlation was observed between RDW-CV and the clinical MELD score (r=-0.356). Conclusion Platelet count, RDW, CRP, total bilirubin, and average albumin levels are significantly different across the studied groups. RDW-CV shows a moderate inverse correlation with MELD scores, suggesting its potential as a prognostic marker in chronic liver diseases. Further research with larger sample sizes is recommended to confirm these findings.

Background: Identifying reliable biomarkers for early detection, risk stratification, and prognosis of CVD in the context of CKD is, therefore, of critical importance. Cystatin C has emerged as a potential biomarker capable of reflecting both cardiac injury and renal impairment, particularly in patients with arterial hypertension. This study aimed to evaluate the association between serum cystatin C levels, left ventricular hypertrophy, and chronic kidney disease in individuals with hypertension. Objective: To assess serum cystatin C concentrations in patients with left ventricular hypertrophy and chronic kidney disease secondary to arterial hypertension. Materials and Methods: A case-control analytical study was conducted, enrolling 44 patients aged 45 years or older with both left ventricular hypertrophy and chronic kidney disease due to arterial hypertension alongside a control group of apparently healthy individuals. Serum cystatin C levels were measured using immunoturbidimetric assay. Statistical analysis was performed using SPSS version 25.0. Group comparisons were made using independent-sample t-tests, while multivariate regression and receiver operating characteristic (ROC) analyses were employed to explore associations and the predictive value of cystatin C. Results: The mean serum cystatin C concentration in the case group was 1.6±0.1 mg/L, significantly higher than in the control group (0.88±0.03 mg/L, p<0.05). Similarly, the estimated glomerular filtration rate (eGFR) was markedly reduced in the case group (44.88±6.8 mL/min/1.73 m²) compared to the controls (92.88±3.4 mL/ min/1.73 m², p<0.05). In the case group, a statistically significant inverse correlation was observed between serum cystatin C levels and glomerular filtration rate (GFR), with a regression coefficient of β=−0.028 (p<0.006). Conclusion The elevated serum cystatin C levels (1.6±0.1 mg/L) and decreased eGFR (38.99±12.7 mL/min/1.73 m²) observed in the case group suggest that cystatin C may serve as a potential biomarker for the early diagnosis of left ventricular hypertrophy due to arterial hypertension and chronic kidney disease, as well as for predicting related complications.

Introduction: According to statistics from the World Health Organization, more than 19.2 million population were diagnosed with cancer in 2020, and 9.9 million population died from cancer. Furthermore, Mongolia leads the world in terms of cancer mortality. In Mongolia, 5981 new cancer incidences were registered in 2021, including cervical cancer, which accounts for 5.2 percent. The average incidence rate of cervical cancer is 19.1 cases per 100,000 females, and the mortality rate is 9.6 cases per 100,000 females, which is high in the region. As of 2021, 68,163 females have undergone early screening of cervical cancer. This represents 28.6 percent of eligible women. It can be seen that the rate of early screening of cervical cancer is low. Thus, it is essential to increase the percentage of early screening by providing knowledge regarding cervical cancer in women. Purpose: The study is aimed to screen the women for cervical cancer and make a conclusion among women, living in the 4th khoroo of Bayangol district. Material and method: The study was conducted using an analytical cross sectional design. A total of 100 women aged between 30 and 60 years of the 4th khoroo of Bayangol District were randomly chosen, cervical Pap tests were performed, and STATA13 software was used for statistical analysis. Result:
- Out of a total of 100 females participating in the study, 79% were married, 24.9% had an abortion, 82% do not use contraception, and 17% were post menopausal.
- 80% of the women who participated in the study had a healthy cervical cytology or no tumor cells, while 62% had vaginitis (coccobacillus 71%). Conclusion Cervical pap smear results that are healthy or not precancerous indicate good coverage.