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: Megaloblastic anemia is a hyperchromic macrocytic anemia caused by impaired DNA synthesis and delayed cell division, most commonly resulting from deficiencies of cobalamin and folic acid. Vitamin B12 is obtained from animal-derived foods such as meat, fish, eggs, and dairy products. In the stomach, it is released from dietary proteins by gastric acid and subsequently binds to an intrinsic factor, after which it is absorbed in the distal ileum. Therefore, vitamin B12 deficiency may occur following gastric or intestinal resection surgery. Another common cause of vitamin B12 deficiency is pernicious anemia, which results from autoimmune atrophic gastritis leading to decreased secretion of intrinsic factor. Vitamin B12 deficiency is most frequently observed in individuals over 60 years of age, and its clinical manifestations vary depending on the severity of deficiency. Patients with mild to moderate deficiency commonly present with fatigue, general symptoms of anemia, glossitis, and neurological disturbances. In cases of severe deficiency, profound hematological abnormalities, severe neurological manifestations, and cardiac involvement such as cardiomyopathy may be observed. In this report, we present a clinical case of a 46-year-old male who developed severe vitamin B12 deficiency anemia following total gastrectomy, complicated by anemia-induced mild hypokinesia of the anterior and inferior walls of the heart. Conclusion If vitamin B12 deficiency–related anemia is accurately diagnosed, appropriately treated, prevented, and monitored starting from the primary health care level, it can have a positive impact on patients’ quality of life. Given that this condition may present with diverse clinical manifestations, a multidisciplinary team approach involving specialists in hematology, neurology, psychiatry, gastroenterology, cardiology, and nutrition enables early identification and prevention of potential complications, thereby improving overall clinical outcomes.

Background: Sjögren’s syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, particularly the lacrimal and salivary glands, as a result of genetic and environmental factors, and it is mainly manifested by mucosal dryness. Sjögren’s syndrome is a rare disorder with a prevalence of approximately 6 cases per 1,000 population and shows a marked female predominance. It is most commonly diagnosed between the ages of 40 and 60 years. Anemia is observed in about 70% of patients diagnosed with Sjögren’s syndrome; however, autoimmune hemolytic anemia occurs in only approximately 3% of cases. In this report, we present a rare case of Sjögren’s syndrome that manifested with warm autoimmune hemolytic anemia. Conclusion In cases of autoimmune hemolytic anemia of unknown etiology, it is crucial to investigate the underlying causes leading to hemolysis in order to establish the differential diagnosis and to confirm or exclude the condition. Sjögren’s syndrome typically presents initially with sicca symptoms, with chronic anemia developing during the course of the disease and its treatment. In contrast, in our case, persistent manifestations of autoimmune hemolytic anemia over a prolonged period represented the initial clinical presentation that led to the diagnosis of Sjögren’s syndrome. Immunological markers play a key role in the diagnosis of this syndrome, as they are essential for early detection of Sjögren’s syndrome, timely diagnostic confirmation, monitoring of disease progression, and adjustment of therapeutic dosing.

Introduction: Anemia is still being a population’s challenging issue regardless of high development of countries around the world. According to a study regarding prevalence and etiology of anemia conducted in 187 countries around the world, the anemia rate is 23 176 per 100 000 population. In accordance with the “5th National Nutrition Survey” study conducted in our country in 2017, one of every five women (21.4%), aged 15-49 years, (16.2%) of reproductive age women and (3.0%) of men are anemic. The current study was conducted due to it is still essential to study and identify the etiology of anemia, determine its prevalence, plan appropriate intervention, and organize future preventive measures, depending on the socio economic conditions, location, diet, and customs of the Mongolians. Aim: To determine the prevalence, red blood cell morphology, and severity of anemia among adults. Method: The cross sectional study was conducted during between May 2022 and Sep 2023 and adults aged above 18 years were included. Moreover, we identified anemia cases based on the laboratory test results and determined the anemia severity grade. Statistical analysis was performed by using SPSS software. Result: Overall, (6.7%) of participants were anemic: (9.9%) of women and (2.8%) of men. The distribution by severity was: mild anemia (66.7%), moderate anemia (30%), and severe anemia (3.3%). Among women of reproductive age, prevalence was higher, whereas in men, anemia prevalence increased with age. Regionally, the Central region showed the highest prevalence, while other regions varied. Analysis of anemia by red blood cell morphology showed that normocytic anemia accounted for (51.6%), hypochromic anemia 66%, and mean hemoglobin concentration hypochromic (53.6%). Moderate and severe anemia was more common in women than men. Conclusion Anemia was detected in (6.7%) of the total study population, (9.9%) of females, and (2.8%) of males were anemic. Of those with anemia, (66.7%) had mild anemia, (30%) had moderate anemia, and (3.3%) had severe anemia. Moderate and severe anemia were more common in females than in males.

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.

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.

Background: Anemia is still being a population’s challenging issue regardless of high development of countries around the world. According to a study regarding prevalence and etiology of anemia conducted in 187 countries around the world, the anemia rate is 23 176 per 100 000 population. In accordance with the “5th National Nutrition Survey” study conducted in our country in 2017, one of every five women (21.4%), aged 15-49 years, 16.2% of reproductive age women and 3.0% of men are anemic. The current study was conducted due to it is still essential to study and identify the etiology of anemia, determine its prevalence, plan appropriate intervention, and organize future preventive measures, depending on the socio-economic conditions, location, diet, and customs of the Mongolians. Aim: To identify anemia among the adult population, determine the type and severity of anemia. Materials and Methods: The cross sectional study was conducted during between May 2022 and Sep 2023 and adults aged above 18 years were included. Moreover, we identified anemia cases based on the laboratory test results and determined the anemia severity grade. Statistical analysis was performed by using SPSS software. Results: Among the participants, 6.7% of them, 9.9% of females and 2.8% of males are anemic. Prevalence of mild, moderate and severe anemia is 66.7%, 30% and 3.3%, respectively. While the prevalence of anemia among reproductive age women is higher, the prevalence of anemia increases with age. The anemia prevalence in Ulaanbaatar region, Western region, Khangai mountainous region, Central region and Eastern region is 583 (25.6%); 171 (7.5%); 343 (15.1%); 921 (40.4%); and 261 (11.4%), respectively. By regional location, the prevalence is high in the Central region, with varying prevalence in other regions. Conclusion Anemia was detected in 6.7% of the total study population, 9.9% of females, and 2.8% of males were anemic. Of those with anemia, 66.7% had mild anemia, 30% had moderate anemia, and 3.3% had severe anemia. Moderate and severe anemia were more common in females than in males.

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.