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: Life expectancy in Mongolia has increased by 8.3 years over the past three decades (1995–2025), reaching 72.1 years in 2025 (68.1 years for men and 76.2 years for women; National Statistics Office of Mongolia, 2025). Concurrently, the population aged ≥60 years has increased 2.65-fold since 1990, exceeding 338,000 in 2025. Particularly marked increases have been observed among those aged 60–64 years (241%) and 65–69 years (195%), reflecting the rapid pace of population ageing. These demographic changes are expected to increase the demand for age-appropriate oral healthcare, prosthodontic treatment, and oral rehabilitation services. Aim: To assess oral health status among older adults and examine its association with eating ability. Materials and Methods: An analytical cross-sectional study was conducted among 301 adults aged ≥50 years residing in the Chingeltei, Bayangol, Sukhbaatar, and Khan-Uul districts of Ulaanbaatar, Mongolia. Oral health status was assessed through clinical examination, including tooth loss and denture use, and using the eight-item Oral Health Assessment Tool (OHAT). Based on the OHAT assessment, oral health status was categorized as good or poor. Eating ability was assessed using a standardized questionnaire covering four domains: (1) difficulty biting and chewing hard-textured foods, such as whole pieces of meat and apples, using an ordinal scale; (2) ability to comfortably eat desired foods; (3) restriction of the type or amount of food consumed due to oral health problems; and (4) oral sensitivity to hot, cold, or sweet foods. Associations between categorical variables were assessed using Pearson’s chi-square (χ) test, with statistical significance set at p<0.05. Demographic variables, including age group and sex, were also considered in the analyses. Result: The mean age of the participants was 69.0±7.8 years; 74% were women and 26% were men. Overall, 98.6% had experienced tooth loss, and 23.6% were completely edentulous. The use of removable dentures increased significantly with age (χ=8.83, p=0.032) and was more common among women than men (65.9% vs. 45.9%; χ=8.45, p=0.004). According to the OHAT assessment, 21.0% of participants had poor oral health status, which was significantly associated with educational level (χ=27.69, p<0.001). Among participants with available data on the ability to comfortably eat desired foods (n=240), 27.1% reported being completely unable to do so. This outcome did not differ significantly by age group (p=0.823) or sex (p=0.405). Regarding hard-textured foods such as whole pieces of meat and apples, 50.6% reported being completely unable to bite or chew them, whereas only 11.3% reported being able to consume them without difficulty. The proportion unable to consume hard foods was substantially higher among participants with dietary restrictions than among those without restrictions (82% vs. 22%; χ=74.1, p<0.001). Oral sensitivity was significantly associated with dietary restriction (χ=11.5, p=0.022) and self-rated oral health status (χ=7.7, p=0.021), but was not significantly associated with specific food types, such as meat or citrus fruits (p>0.05). These findings suggest that oral sensitivity is associated with overall dietary restriction rather than selective avoidance of particular foods. Conclusion Oral health problems among older adults are associated with impaired biting and chewing ability and may contribute to dietary restriction. Therefore, nutritional assessment in older adults should extend beyond clinical oral examination to include functional eating ability. A multidisciplinary approach involving dental professionals, geriatricians, and dietitians may provide a more comprehensive assessment of oral health–related nutritional risks in this population.

Background: Likert-scale questionnaire data is widely used to evaluate satisfaction; however, in practical applications, both high classification accuracy and model interpretability are essential requirements. Rule-based machine learning methods provide the opportunity to satisfy both criteria simultaneously. Despite the rapid growth of research using machine learning for classification and prediction in recent years, there is a scarcity of studies employing the C5.0 classification algorithm for Likert-scale satisfaction data, which serves as the rationale for this study. Aim: To implement the C5.0 classification algorithm using a 10-fold cross-validation method to predict two levels of satisfaction (High/Medium) and to evaluate the model’s performance and interpretability. Materials and Methods: he study was conducted at the Department of Physics and Informatics, School of Bio-Medicine, MNUMS, utilizing satisfaction survey data from graduates majoring in Health Information Technology. Data consisting of four Likert-scale variables (V1–V4) were used. The C5.0 model was trained using a parametric grid search and evaluated within a 10-fold cross-validation framework using accuracy and a confusion matrix. Furthermore, IF–THEN rules were extracted from the final rule-based model, and the decision logic was visualized in the form of a flowchart. Results: The results indicated that the rule-based C5.0 model was selected as the optimal model, demonstrating stable performance throughout the cross-validation process. The confusion matrix results showed high precision in identifying the “High” satisfaction class. Among the generated rules, it became evident that variables V4 and V2 have the most significant influence on determining satisfaction levels. Conclusion Utilizing the C5.0 algorithm within a cross-validation framework enables effective and intelligible classification of satisfaction based on Likert data. It was confirmed that the rule-based structure offers distinct advantages for model interpretation and decision-support applications.

Background: Sarcopenia is a multifactorial geriatric syndrome characterized by age-related loss of muscle mass, muscle strength, and physical performance. In recent years, neurotrophic and neuromuscular biomarkers have been investigated as potential diagnostic indicators of sarcopenia; however, evidence regarding their sex-specific differences remains limited. Aim: To evaluate the sex-specific associations of serum BDNF, GDNF, and CAF22 levels with sarcopenia and muscle-related parameters among older adults. Materials and Methods: This analytical cross-sectional study included adults aged 60 years and older. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS 2019) criteria. Serum BDNF, GDNF, and CAF22 levels were measured using ELISA. Group differences were analyzed using independent t-tests, correlations were assessed using Pearson correlation analysis, and diagnostic performance for sarcopenia was evaluated using receiver operating characteristic (ROC) analysis. Multivariable logistic regression analysis was also performed. Results: No statistically significant differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic participants in either the male or female groups (all p>0.05). ROC analysis demonstrated AUC values ranging from 0.540 to 0.542 in males and from 0.508 to 0.530 in females for BDNF, GDNF, and CAF22. Multivariable logistic regression analysis revealed that age (OR=1.12, 95% CI: 1.04–1.21, p=0.003) and lower fat-free mass index (OR=0.78, 95% CI: 0.66–0.91, p=0.001) were significantly associated with sarcopenia, whereas BDNF, GDNF, and CAF22 showed no independent association with sarcopenia. Conclusions 1. No statistically significant sex-specific differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic older adults (all p>0.05). 2. CAF22 levels were weakly negatively correlated with muscle mass and fat-free mass index in males (p<0.05), whereas BDNF levels showed weak positive correlations with handgrip strength and fat-free mass index in females (p<0.05). CAF22 levels also demonstrated a weak positive correlation with age (p<0.05). 3. ROC and multivariable logistic regression analyses indicated limited diagnostic utility of BDNF, GDNF, and CAF22 for sarcopenia (AUC=0.508–0.542), and none of these biomarkers showed an independent association with sarcopenia (all p>0.05). In contrast, older age (OR=1.12, p=0.003) and lower fat-free mass index (OR=0.78, p=0.001) were significantly associated with sarcopenia.

Background: Population health literacy constitutes a comprehensive competency to access, understand, appraise, and apply health information, serving as a foundational prerequisite for disease prevention frameworks. Within primary healthcare settings, nursing counseling plays a pivotal role in fostering healthy behaviors among citizens; however, there remains a critical need to quantitatively evaluate the correlation between these behavioral modifications and health literacy, thereby establishing an evidence-based analysis. Aim: To assess the level of health literacy and healthy lifestyle habits among citizens, and to evaluate their correlation with nursing counseling and support. Materials and Methods: A cross-sectional analytic study was conducted between August and September 2026, enrolling 145 citizens aged 18 and older who received care at the Tsetsekhairkhan Family Health Center of Songinokhairkhan district, Ulaanbaatar city and Telmen Soum Health Center in Zavkhan Province. HL was evaluated using the Mongolian version of the HLS-EU-Q16 questionnaire, and total scores were calculated. Nursing involvement was evaluated via a structured questionnaire. Data analysis was performed using SPSS 21.0, utilizing logistic regression analysis to determine Odds Ratios (OR) and p-values. Results: The mean HLS-EU-Q16 score of the participants (n=145) was 10.4±3.2. Regarding HL level distribution, 42.1% (n=61) were inadequate, 34.5% (n=50) were problematic/limited, and 23.4% (n=34) possessed sufficient health literacy. Participants perceived nursing support as highly influential (58.8%) and moderately influential (29.8%) in adopting healthy habits. Regular recipients of health counseling from nurses demonstrated a 3.79-fold higher likelihood of actively pursuing a healthy lifestyle (OR=3.79, 95% CI: 1.84–7.81, p=0.001) and a 3.05-fold higher likelihood of implementing the counseling into practice (OR=3.05, 95% CI: 1.35–6.88, p=0.0076). Conclusion Although citizens exhibit a limited capacity to independently search for and appraise health information—reflecting an overall inadequate level of HL—nurse-led counseling and support exert a direct, statistically significant positive impact on enhancing healthy behaviors among citizens.

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: Diabetes mellitus is a chronic metabolic disorder with an increasing global prevalence. Early detection and risk assessment are essential for preventing disease-related complications. In recent years, machine learning methods have been increasingly investigated for predicting disease status using medical data and supporting clinical decision-making. Aim: This study aimed to develop a predictive model for diabetes status using the Random Forest classification algorithm based on the PIMA Indians Diabetes Database and to evaluate its classification performance. Materials and Methods: The study used the PIMA dataset, comprising 768 observations, eight predictor variables, and one target variable. Zero values in selected measurements that were physiologically implausible were treated as missing values and imputed using the median. The dataset was split into training and test sets at an 80:20 ratio. Hyperparameters of the Random Forest model were optimized using 10-fold cross-validation on the training data. Model performance was evaluated using Accuracy, Sensitivity, Specificity, Balanced Accuracy, Cohen’s Kappa, and the area under the receiver operating characteristic curve (ROC-AUC). Variable importance was also assessed. All statistical analyses and machine learning procedures were performed in the R programming environment. Results: Cross-validation identified mtry=4 as the optimal configuration, achieving an Accuracy of 78.05% and a Cohen’s Kappa of 0.5062. On the test set, the model achieved an Accuracy of 72.55%, Sensitivity of 58.49%, Specificity of 80.00%, Balanced Accuracy of 69.25%, and Cohen’s Kappa of 0.3883. The area under the ROC curve (AUC) was 0.7802, indicating that the model could distinguish between individuals with and without diabetes better than random classification. Variable importance analysis identified blood glucose level as the most influential predictor, followed by body mass index (BMI), age, and number of pregnancies. Conclusion The Random Forest algorithm demonstrated the potential to predict diabetes status using the PIMA dataset; however, its sensitivity on the test set was relatively low. Therefore, the model should be considered a potential tool for preliminary risk assessment and supporting early detection rather than a replacement for clinical diagnosis. Further research is needed to improve sensitivity, compare the model with other machine learning algorithms, and validate its performance using larger and more diverse datasets.

Background: The aging of the world’s population will determine global health trends. According to the 2021 report of the Capital City Health Department, the average life expectancy of the Mongolian population is 71.3 years (male 67.3, female 76.7), the difference between male and female life expectancy is 9.4 years, and elderly people aged 60 and over account for 8.1% of the total population. The report also shows that 6.5% of all outpatient visits are for people aged 60-64, and 9% are for people aged 65 and over, which means that they do not receive adequate health care services. Therefore, it is important to increase the access to and quality of health care services provided to the elderly in order to improve their health and quality of life. Comorbidities that are common among the elderly are one of the pressing issues in the health sector. Aim: We aimed to study the prevalence and risk factors of multi-morbidities among older adults (aged sixty years and over) in urban and rural areas. Materials and Methods: To accomplish our aim, we conducted 156 lifestyle related questionnaires and 18 health related questionnaires among 720 older people in Ulaanbaatar city and rural areas, and created the database. Pearson correlation coefficient was used to determine the relationship between the quantitative influence of factors using single and multi-factor linear (β-coefficient) and binary logistic regression (odds ratio, CI 95%) methods, and p value less than 0.05 was considered statistically significant. The Apriori algorithm in SPSS was used to determine the relationship between multiple chronic diseases in the elderly people. Results: The prevalence of comorbidity was higher in urban areas (48.1%) and rural areas (51.9%), and ageing (urban areas OR: 2.45, 95% CI: 0.9-6.2; rural areas OR: 6.35, 95% CI: 1.47-27.4, P<0.01) was a risk factor of multi-morbidities. Multimorbidity is defined as the presence of 2 or more chronic conditions, and 3, 4, and 5 chronic conditions were co-occurred to older adults with chronic conditions, 28.7% (165). 11 common patterns of relationships in urban areas and 18 common patterns of relationships in rural areas (support (A→B)>3%, confidence (A→B)>30%, lift (A→B)>1) were determined. Conclusion Multimorbidity was different in urban and rural areas, 11 common patterns in urban areas and 18 common patterns in rural areas were determined. It has shown that the prevalence of multimorbidity was different in urban and rural areas.

Background: Iron deficiency (ID) and iron deficiency anemia (IDA) are among the most common forms of anemia worldwide. Although the underlying causes of ID may vary depending on a country’s developmental level, lifestyle, and other factors, blood loss remains the principal cause leading to ID and subsequent IDA. In hemophilia, recurrent bleeding due to deficiencies of coagulation factors (FVIII, FIX, FXI) can lead to ID, which may progress to IDA and adversely affect the quality of life in these patients. The absence of studies evaluating the prevalence of ID and IDA among hemophiliac patients in Mongolia provided the impetus for this investigation. Aim: To assess the prevalence of ID and IDA among patients with hemophilia. Materials and Methods: A cross-sectional study was conducted among 45 patients with hemophilia registered at the Hemophilia Comprehensive Center (HCC), Mongolia-Japan Hospital, Mongolian National University of Medical Sciences. All participants underwent laboratory testing, including complete blood count (CBC) and serum ferritin levels—were performed using the SYSMEX XN2000 and COBAS BM6010 analyzers. Data analysis was carried out using SPSS 27.0 and MS Excel 2010. Results: Among the 45 cases, 41 were Hemophilia A and 4 were Hemophilia B. Reduced serum iron levels were found in 33.3% (15), and low ferritin levels were observed in 22.2%. Detailed blood tests revealed microcytic hypochromic changes in 43.9% (18) of Hemophilia A cases and in 100% (4) of Hemophilia B cases. The overall prevalence of ID was 13.3%, while the prevalence of IDA was 22.2%. Among the IDA cases, 90.0% were classified as mild and 10.0% as moderate. Notably, 80.0% of the IDA cases occurred in children under 15 years of age. Conclusion ID and IDA are common among hemophiliac patients. The high prevalence among children under 15 years of age suggests an age-related predisposition, emphasizing the need to improve disease management and to implement preventive measures against anemia in this population.

Background: Hypokalemia is considered when the serum potassium level is less than 3.5 mmol/L. Clinical research indicates that hypokalemia affects 20% of hospitalized patients, and in 24% of these cases, inadequate interventions result in life-threatening complications. At present, there is no research available on the prevalence, management, and outcomes of hypokalemia in hospitalized patients, which justifies the need for this study. Aim: The study aimed to examine the prevalence of hypokalemia and the effectiveness of its management in hospitalized patients within the internal medicine department, in relation to the knowledge of doctors and resident physicians. Materials and Methods: This hospital-based retrospective study included a total of 553 cases of patients hospitalized in the Internal Medicine Department of the Mongolia Japan Hospital between January 2024 and August 2024. Patients with a potassium level of <3.5 mmol/L were diagnosed with hypokalemia, and the effectiveness of potassium replacement therapy was evaluated according to the method of supplementation employed. Results: The prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department was 9.8% (54 cases). Based on the study criteria, 42 cases of hypokalemia were selected for further analysis, and a total of 118 potassium replacements were performed through oral, intravenous, and mixed methods. Following potassium replacement therapy, 37.3% (44) of patients achieved normalized potassium levels, while 62.7% (74) still had persistent hypokalemia. Conclusion According to the study results, the prevalence of hypokalemia among hospitalized patients in the Internal Medicine Department is 9.8%. The method of potassium replacement and the severity of hypokalemia do not impact the normalization of potassium levels, with the critical factor being the proper dosage of supplementation. The knowledge of doctors and resident physicians regarding hypokalemia is insufficient, and there is a need to implement guidelines and protocols for potassium replacement therapy in daily clinical practice.