Background: Diabetes mellitus and disturbances in glucose metabolism are associated with an increased risk of thrombosis through endothelial dysfunction, chronic low-grade inflammation, platelet hyperactivity, and alterations in coagulation factors. Aim: To investigate the association between fasting glucose levels and selected coagulation and platelet parameters. Materials and Methods: This analytical cross-sectional study included 172 participants. According to the exclusion criteria, individuals with previously diagnosed diabetes mellitus, anticoagulant use, or liver disease were excluded. Participants were categorized into two groups according to fasting glucose levels: <5.6 mmol/L and ≥5.6 mmol/L. Activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), fibrinogen, platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) were compared between the two groups. Between-group differences were assessed using the Mann–Whitney U test, and associations between continuous variables were evaluated using Spearman’s correlation analysis. Multivariable linear regression analysis was adjusted for age, sex, and body mass index (BMI). Result: Of the 172 participants, 145 (84.3%) had fasting glucose levels <5.6 mmol/L and 27 (15.7%) had fasting glucose levels ≥5.6 mmol/L. The median aPTT was significantly shorter in participants with elevated fasting glucose than in those with fasting glucose <5.6 mmol/L (25.4 [24.2–26.8] vs. 26.3 [24.9–27.95] seconds; p=0.029). No statistically significant between-group differences were observed in PT, INR, TT, fibrinogen, platelet count, MPV, PDW, or PCT. A weak inverse correlation was observed between fasting glucose and aPTT (ρ=−0.141). In multivariable regression analysis adjusted for age, sex, and BMI, each 1 mmol/L increase in fasting glucose was associated with a 0.242-second decrease in aPTT (B=−0.242; 95% CI, −0.465 to −0.020; p=0.033). Conclusion 1. The median aPTT was significantly shorter in participants with elevated fasting glucose than in those without elevated fasting glucose. 2. Each 1 mmol/L increase in fasting glucose was associated with a 0.242-second decrease in aPTT.

Background: Passive smoking among children remains a serious public health concern, particularly because children’s ability to avoid household environmental tobacco smoke exposure is limited when parents smoke. In recent years, increasing scholarly attention has been given to oral mucosal pigmentation as a potential clinical sign of long-term passive smoking in children. However, no previous study has synthesized the available evidence on this topic. Aim: This systematic review and meta-analysis aimed to evaluate the association between passive smoking and oral pigmentation in children. Materials and Methods: A systematic search was conducted in international electronic databases, including PubMed, Scopus, Web of Science, and the Cochrane Library, in accordance with PRISMA guidelines. Observational studies assessing the association between passive smoking and oral pigmentation among children aged ≤18 years were included. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). A random-effects meta-analysis was performed, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Between-study heterogeneity was assessed using the I² statistic, and the certainty of evidence was evaluated using the GRADE approach. Results: Seven studies involving a total of 1,582 participants met the inclusion criteria. The meta-analysis demonstrated that passive smoking was significantly associated with an increased risk of oral pigmentation in children, with a pooled OR of 2.58 (95% CI, 1.35-4.95; p=0.004). Compared with children without exposure to passive smoking, those exposed to environmental tobacco smoke had an absolute risk increase of 17% (95% CI, 6.3%-23.9%). Subgroup analysis by assessment method showed a consistent effect among studies using the Gingival Pigmentation Index (GPI) (OR, 2.12; 95% CI, 1.58-2.84), whereas studies using the Dummett Oral Pigmentation Index (DOPI) showed a wider confidence interval (OR, 3.26; 95% CI, 0.68-15.54). According to the MMAT assessment, the included studies demonstrated adequate participant selection in 100% of cases, appropriate outcome measurement in 76.9%, and adequate control of confounding factors in 46.2%. Owing to the observational nature of the included studies, moderate heterogeneity, and the potential risk of confounding by physiological pigmentation, the certainty of evidence was rated as low according to GRADE. Conclusion Children exposed to environmental tobacco smoke had a significantly higher likelihood of oral mucosal pigmentation than unexposed children. These findings suggest that screening for oral mucosal pigmentation during pediatric oral examinations may serve as a non-invasive marker of passive smoking exposure and may provide visible clinical evidence to support counseling parents on smoking cessation and smoke-free household environments.

Background: Thrombotic alterations play a central role in the pathogenesis of both macrovascular and microvascular complications of diabetes mellitus. D-dimer, a fibrin degradation product generated during fibrinolysis, has emerged as a potential biomarker for predicting chronic diabetic complications and assessing their severity. Aim: To determine D-dimer levels in individuals with type 2 diabetes mellitus (T2DM) and investigate their association with various microvascular complications. Materials and Methods: This cross-sectional study included 215 participants with T2DM. Individuals diagnosed with other forms of diabetes, those receiving anticoagulant therapy, and those with liver disease were excluded according to the predefined exclusion criteria. Participants were categorized into two groups according to their D-dimer levels: ≤0.260 μg/mL and >0.260 μg/mL. The prevalence of diabetic retinopathy, nephropathy, and neuropathy was compared between the groups. Multivariable logistic and linear regression models were adjusted for age, sex, and body mass index (BMI). Results: A total of 215 individuals with T2DM were included in the study. The median D-dimer level was 0.260 μg/mL (interquartile range [IQR]: 0.190–0.460). The prevalence of at least one microvascular complication was significantly higher among participants with D-dimer levels above the median than among those with levels at or below the median (51.4% vs. 37.0%, p=0.034). The prevalence of diabetic nephropathy was 33.6% versus 13.0% (p<0.001), while that of diabetic neuropathy was 20.6% versus 10.2% (p=0.035), respectively, indicating a higher burden of chronic complications in the group with elevated D-dimer levels. Participants with D-dimer levels above the median had 2.23 times higher odds of having at least one diabetic microvascular complication (OR=2.23; 95% CI: 1.19–4.18; p=0.013). Conclusions 1. Elevated D-dimer levels were observed in 21.4% of individuals with type 2 diabetes mellitus included in the study. 2. D-dimer levels above the median (0.260 μg/mL) were associated with a twofold increase in the odds of having diabetic microvascular complications (OR=2.23; 95% CI: 1.19–4.18; p=0.013).

Background: Complete blood count (CBC) is one of the most widely used clinical tests, offering a high-quality, inexpensive, and routine diagnostic tool for various diseases and for monitoring treatment outcomes. Due to modern technological advancements, blood cells are now measured in greater detail, with 36 parameters being evaluated. The prevalence of diabetes mellitus (DM) is rapidly increasing, not only globally but also in our country. This rise in prevalence leads to numerous adverse consequences, including delayed diagnosis, poor control, an increase in chronic complications, and treatment failure. Hyperglycemia is a predisposing factor for chronic inflammation, and a relatively new inflammatory marker, the neutrophil-to-lymphocyte ratio (NLR), may be useful for assessing diabetes control. In recent years, NLR has been studied as a composite biomarker that more effectively reflects systemic inflammation and is easier to detect compared to other inflammatory markers. An increase in neutrophil count and percentage indicates chronic, low-grade, toxic, and non-specific inflammation, while a decrease in lymphocyte count suggests insufficient immune regulation. Thus, an elevated NLR not only reflects the immune system’s functional state in chronic inflammation, but it is also studied as a reliable and selective marker of systemic inflammation in chronic diseases. NLR is considered more stable than the total leukocyte count, is less affected by physiological and pathological factors, is inexpensive, and can be incorporated into daily clinical practice. Aim: To study the relationship between the neutrophil-to-lymphocyte ratio in a complete blood count and diabetes control and complications Materials and Methods: A cross-sectional study was conducted involving 145 patients with type 2 diabetes mellitus, who were treated at the Endocrine Clinic of the Mongolian-Japanese Hospital, Mongolian National University of Medical Sciences. Data on the neutrophil-to-lymphocyte ratio (NLR), glycated hemoglobin (HbA1c), and diabetic complications, including retinopathy, neuropathy, and foot complications, were collected from the Carte-Hospital Management System. Based on the frequency distribution of the NLR parameter, the values were classified into three groups: low, medium, and high. These groups were subsequently compared with glycemic control and complications using correlation and linear regression analyses, with statistical significance set at p<0.05. Results: The mean age of the study participants (n=145) was 57.3±12.9 years, with 46.8% (n=131) being male. The mean duration of diabetes was 9.6 years (range: 1-31 years), and the mean HbA1c level was 8.6±2.47%. Among the participants, 59.3% (n=86) exhibited poor glycemic control. Regarding complications, 52.3% of participants experienced at least one diabetes-related complication. Of these, 25.2% had one complication, 13.3% had two, and 7.1% had three or more. The most common complications were retinopathy (25.7%), nephropathy (18.6%), and macrovascular complications (11.9%). A statistically significant increase in the mean HbA1c level was observed across groups stratified by NLR levels (p=0.003). Linear correlation analysis revealed a statistically significant positive correlation between HbA1c levels (r=0.194, p=0.001) and the number of chronic diabetes complications (r=0.162, p=0.002). Conclusion The NLR level is positively correlated with both diabetes control and the occurrence of chronic complications. As an inexpensive and easily accessible test, it can be used for daily monitoring and early detection of complications.

Background: A 2024 study by the National Statistical Office of Mongolia indicate an incidence rate of 38.8 per 100 000 population, with a total of 8169 new cancer cases diagnosed, of which 16.2% are gastric cancers. Notably, 64.4% of these diagnoses are made at advanced stages.2 Surgical intervention remains one of the most effective treatments for gastric cancer. Early-stage surgery confers a 5-year survival rate of 60-80%, whereas late-stage diagnosis reduces this to 18-50%.5 This study aims to investigate the causes, types, and contributing factors of postgastrectomy anemia in patients undergoing surgery for gastric cancer in Mongolia, where no prior study has been conducted on this topic. Methods: This retrospective study analyzed all patients who underwent gastric cancer surgery at the National Cancer Center of Mongolia from 2022 to 2024. Data on demographics, lifestyle factors, clinical signs of anemia, and comorbidities were collected from medical records and confirmed by direct examination. Results: A total of 788 patients who underwent surgery for gastric cancer were included in the study, of whom 70.5% were male and 29.5% female, aged 22–70 years (mean age 46 years). Among the total cases, 461 patients underwent total gastrectomy, 128 had distal gastrectomy with gastrojejunal anastomosis, 39 underwent partial gastrectomy, 3 had gastrectomy with duodenal anastomosis, 5 underwent gastrectomy with esophagogastric anastomosis, and 6 underwent bypass procedures. Conclusions Postoperative monitoring after gastric surgery was insufficient, and there was a tendency for anemia to progress.

: BACKGROUND: The Mongolian National drug policy states, “The rational drug rehabilitation is one of the main goals of pharmaceutical care”. Recruitment and prescription medications are important issues for improving rational use of medicines. According to the recommendations of the World Health Organization (WHO), the status of rational use of medicines is assessed through the recipe by 10 criteria. The needs to study on rational drug use in hospitals of Ulaanbaatar and determining standard criteria for the proper use of drugs by recommendation of World Health Organization is the main justified issue of the study. METHODS: In order to study the rational use of medicines, a single moment /descriptive/ research type was used. Recipes for 50 and 50 people who received prescription from pharmacy within 12 hospitals TFCHM, TSCHM, TTCHM, NCCD, NTaORC, NCMH, HCSKhD, HCChD, HCSBD, HCKhUD, HCBZD, HCBGD June 2017 in Ulaanbaatar, it was based on the WHO recommended methodology, a total of 600 clients, 600 recipes and 1249 medicines were selected and submitted to the conclusions. RESULTS: The average number of medicines per minute was 2.08 ± 0.25, 45.2% in International Health Prescription were 42.6% antibiotics. According to a study on a contingency test, 85% did not have prescription signs, 38.8% without diagnostic prescription, 25% did not have physicians, and 48% did not have any medical information. The knowledge about the dose was 68.5% . CONCLUSION The results of the study were compared with the recommendations of the World Health Organization and the proportion of medicines included in the ICS list was lower than the recommendations of the World Health Organization list and the proportion of antibiotic drugs. The study found that 11 different incidents were encountered. Knowledge about medicines dose was 68.5%, compared to World Health Organization recommendations

Background: One of the main goals of pharmaceutical care is the developing proper drug use and high lighted “The Government of Mongolia is aiming to provide health organizations and veterinary clinic by highly effective, safe, quality assured and selectable drugs with continuous, uniform and accessible”.
World Health Organization (WHO) recommended that there are 5 standard to assess pharmaceutical care services. In Mongolia, people unused drugs with prescription and doctor direction. Background of this survey is to define appropriate use of drug in Ulaanbaatar citizen according to the WHO criteria and to determine the necessary parameters for the proper use of drugs in the future. Discussion: The survey was based on the WHO recommendation and selection of pharmacies nearby the hospitals which we selected each 50 and 50 citizen’s prescription from total 12 hospital of Ulaanbaatar city, a total of 600 recipes and questionnaire on specific drug information and knowledge of clients. Result: Average counseling was 1.02 minutes, duration of dispense was 35.3 seconds, 85% of drug % from written on prescription and 61.6% of customers knowledge about drug. Conclusion
1. It doesn’t meet the requirements of pharmaceutical assistance because of the citizen’s drug knowledge is insufficient and pharmacist’s counseling time is not enough.
2. Customer’s knowledge about drug name, dose, and method of usage is 62% and it is insufficient.