Background: Healthcare workers play a key role in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare settings. Staphylococcus aureus is a major cause of healthcare associated infections, including surgical site infections, ventilator-associated pneumonia, and bloodstream infections.
The anterior nares serve as an important reservoir for this pathogen, facilitating its spread within healthcare environments. In recent years, the rising prevalence of antimicrobial resistance has become a major public health concern, leading to increased morbidity, mortality, and healthcare costs.
Therefore, assessing nasal carriage and antimicrobial resistance patterns among healthcare workers is essential for effective infection prevention and control. Objective: To detect Staphylococcus aureus from nasal swabs of healthcare workers and to determine its antimicrobial susceptibility profile, with a particular focus on resistant strains. Materials and Methods: This descriptive cross-sectional study included 159 healthcare workers from six private hospitals in Songino Khairkhan district. Nasal vestibule swabs were collected and cultured on 5% blood agar and CHROMagar™ MRSA. Bacterial identification was performed using conventional microbiological techniques and API identification systems. Antimicrobial susceptibility testing was conducted using the disk diffusion method and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analysis was performed using SPSS version 24. The study protocol was submitted to and approved by the Research Ethics Subcommittee of “Ach” Medical University on November 11, 2025. Written informed consent was obtained from all participants prior to sample collection. Results: A total of 159 nasal swabs were collected from healthcare workers, from which 58 (36.5%) bacterial strains were isolated. Staphylococcus aureus was the most prevalent pathogen, accounting for 50 (86.2%) of the total isolates, representing an overall carrier rate of 31.4% (50/159) among the participants. Other identified species included Enterococcus spp. (n=5, 8.6%), Streptococcus viridans (n=2, 3.4%), and Klebsiella pneumoniae (n=1, 1.7%). Antimicrobial susceptibility testing revealed that 76% (n=38) of the S. aureus isolates were Methicillin-Resistant S. aureus (MRSA), and 21% (n=10) were Multi-Drug Resistant (MDR). Additionally, Vancomycin-Resistant S. aureus (VRSA) and Vancomycin-Resistant Enterococci (VRE) were each detected at a rate of 0.6% Conclusion Antibiotic-resistant bacteria were identified in 44 (27.7%) of samples collected from healthcare workers, indicating the presence of multidrug resistance.
The detection of methicillin-resistant Staphylococcus aureus (MRSA), along with vancomycin resistant Staphylococcus aureus (VRSA), among healthcare workers indicates a potential risk for the dissemination of highly resistant pathogens.

Background: Ear, nose, and throat (ENT) inflammatory diseases are common conditions that account for a high proportion of healthcare visits. These diseases negatively affect patient’s quality of life, reduce work and learning capacity, and increase healthcare costs. Antibiotics play a crucial role in treatment; however, inappropriate use contributes to the emergence and spread of antimicrobial resistance among pathogenic bacteria. In Mongolia, particularly in Darkhan-Uul Province, data on bacterial pathogens and their antimicrobial susceptibility patterns in ENT infections are limited. Therefore, evaluating the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and antimicrobial resistance is essential for guiding clinical practice and promoting rational antibiotic use. Aim: To assess the bacterial pathogens and their antimicrobial susceptibility patterns in inflammatory diseases of ear, nose and throat. Materials and Methods: The study was conducted at the School of Biomedicine, Mongolian National University of Medical Sciences, in collaboration with the Department of Pharmacology and the “Bid” Hospital of Darkhan-Uul Province. Data from ear, nose, and throat swab examinations of patients suspected of having ENT infections in the outpatient department between January 2024 and February 2025 were extracted from the hospital’s centralized database (n=185). Based on the inclusion and exclusion criteria, information from 145 patients was analyzed. The study was designed as a facility-based, retrospective, cross-sectional observational study and was carried out using SPSS - 26.0. Result: A total of 145 patients aged 1-73 years were included in the study, of whom 48.2% (n=70) were male and 51.7% (n=75) were female. Overall, 145 clinical specimens were collected, including nasal swabs 36 (24.8%), throat swabs 56 (38.6%), and ear swabs 53 (36.6%). Bacteriological examination revealed pathogenic microorganisms in 80.7% (n=117) of the specimens. S.aureus was isolated from 65.5% of nasal swabs, 53.6% of throat swabs, and 67.4% of ear swabs. Among S. aureus isolates from ear swabs, 27.6% (n=8) were identified as methicillin-resistant Staphylococcus aureus (MRSA). Antimicrobial susceptibility testing showed that S. aureus isolates from nasal swabs were resistant to amoxicillin (100%), ampicillin (90.0%), erythromycin (87.5%), and azithromycin (81.8%), while they were susceptible to cefazolin (72.7%), doxycycline (80.0%), and vancomycin (75.0%). S. aureus isolates from throat swabs demonstrated resistance to amoxicillin (100%), ampicillin (100%), chloramphenicol (87.5%), and azithromycin (75.0%), but were susceptible to ciprofloxacin (69.2%) and vancomycin (66.7%). S. aureus isolates from ear swabs were resistant to gentamicin (77.8%), clarithromycin (71.4%), azithromycin (66.7%), and penicillin G (66.7%), while higher susceptibility was observed to nitrofurantoin (87.5%), vancomycin (68.8%), and ciprofloxacin (64.7%). For Streptococcus spp, resistance was observed to erythromycin (84.6%), amoxicillin (76.9%), and chloramphenicol (71.4%), whereas susceptibility was noted to amoxiclav (54.6%), cefazolin (63.2%), and cefotaxime (50.0%). Conclusion 1. Staphylococcus aureus predominated in samples from ear, nose, and throat infections, confirming it as the main causative bacterium of these conditions. 2. The predominantly isolated Staphylococcus aureus showed high resistance to antibiotics from the penicillin, macrolide, and aminoglycoside groups.

Background: Pregabalin significantly reduces pain intensity and improves sleep quality and health-related quality of life in patients with neuropathic pain. Since it remains uncertain whether the improvements in sleep quality and quality of life associated with Pregabalin are related to its analgesic properties. Therefore, this study aimed to evaluate whether these clinical outcomes are correlated. Aim: Assessing the Correlation Between patient’s analgesia and sleep quality, health-related quality of life outcomes after pregabalin treatment Materials and Methods: This study was conducted at the Geriatric Hospital of Bayangol District from February, 2026. Patients diagnosed seventy eight with neuropathic pain of any origin who attended the neurology outpatient clinic during the study period were enrolled. Pain intensity, sleep quality, and HRQoL outcomes were evaluated at baseline and at week 8 by means of an 11-point (0-10) numerical rating scale (NRS), the Pittsburgh Sleep Quality Index (PSQI), and the EuroQol EQ-5D-5L score, respectively. The study was designed as an uncontrolled observational analytic study, and statistical analyses were performed using SPSS version 27.0. Result: The mean age of the study participants was 59.5±15.7 years (n=78). Of the participants, 53.8% (n=42) were female and 46.2% (n=36) male. The relationships among pain intensity, sleep quality, and health related quality of life were evaluated using correlation analysis. A strong positive and statistically significant correlation was observed between sleep quality and quality of life (p<0.05), whereas no statistically significant associations were identified among the other variables. Conclusion It was observed that in patients with neuropathic pain, pregabalin reduced pain intensity and that a one-unit improvement in sleep quality was associated with a 0.7-unit increase in quality of life.

Background: In Mongolia, cervical cancer accounted for 11.9% of all cancers diagnosed in women and 7.3% of cancer-related deaths in 2017, ranking as the third most common cancer among women. The American Society for Radiation Oncology (ASTRO) guidelines recommend concurrent chemo-radiotherapy (CCRT) as a standard and effective treatment for patients with FIGO stage IB3–IVA cervical cancer. Accurate assessment of tumor response following CCRT is essential for evaluating treatment efficacy, identifying residual disease, and estimating the risk of recurrence. Magnetic resonance imaging (MRI) is widely used to assess tumor size, local extent, parametric involvement, and post-treatment morphological changes. In contrast, 18F-FDG PET/CT provides both anatomical and functional information and enables quantitative assessment of tumor metabolic activity using the standardized uptake value (SUV). Aim: To estimate the relationship between treatment response to concurrent chemo-radiotherapy and radiological parameters obtained from MRI and 18F-FDG PET/CT in patients with cervical cancer. Materials and Methods: This retrospective study included 35 patients with histo-pathologically confirmed cervical carcinoma who received concurrent chemo-radiotherapy at the Department of Radiation Oncology, National Cancer Center, between 2024 and 2025. Pelvic MRI examinations were performed using a 1.5-T Siemens MRI system to evaluate tumor dimensions and local tumor characteristics before and after treatment. 18F-FDG PET/CT was performed to assess the metabolic activity of the primary tumor, and the maximum SUV was measured. Tumor response following CCRT was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. The relationships between tumor response, changes in tumor size, and pre-treatment SUV were statistically analyzed. Result: A total of 35 patients aged 32–73 years were included in the study, with a mean age of 51.2±12.6 years. The mean baseline longitudinal tumor diameter measured by MRI was 54.3±15.8 mm. Twenty-eight patients (80.0%) had tumors larger than 4 cm, whereas 7 (20.0%) had tumors smaller than 4 cm. According to the FIGO staging system, 22 patients (62.9%) had stage IIIC1 disease, 7 (20.0%) had stage IIIC2, 3 (8.6%) had stage IIIB, 2 (5.7%) had stage IIB, and 1 (2.9%) had stage IVA disease. Histopathologically, 31 patients (88.6%) had squamous cell carcinoma, 3 (8.6%) had adenocarcinoma, and 1 (2.9%) had clear cell carcinoma. Of the 35 patients, 23 (65.7%) had reached the scheduled post-treatment follow-up time and were evaluable for treatment response according to RECIST 1.1, whereas 12 patients (34.3%) had not yet reached the scheduled time for post-treatment assessment. Among the 23 evaluable patients, 15 (65.2%) achieved a complete response (CR), while 8 (34.8%) achieved a partial response (PR). Following CCRT, the longest tumor diameter measured by MRI decreased by a mean of 94.8% in the CR group and 65.3% in the PR group. The reduction in tumor diameter was significantly greater in the CR group than in the PR group (p=0.0016). The mean baseline primary tumor SUVmax on 18F-FDG PET/CT was 16.0±9.8 in the CR group and 24.3±14.5 in the PR group. Although the baseline SUVmax tended to be lower in the CR group, the difference did not reach statistical significance (Mann–Whitney U test, p=0.059). A higher baseline SUVmax tended to be associated with a smaller reduction in tumor diameter following CCRT. Conclusion CCRT resulted in a significant reduction in primary tumor size in patients with cervical cancer. The reduction in tumor size was significantly greater among patients who achieved a complete response than among those who achieved a partial response. Although pre-treatment 18F-FDG PET/CT findings suggest that MRI-based tumor size assessment combined with metabolic information from 18F-FDG PET/CT may provide complementary information for evaluating treatment response following CCRT.

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: Nitric oxide (NO) is a biological messenger molecule that plays a significant role in the pathogenesis of inflammation. It has anti-inflammatory effects under physiological conditions but can act as a pro-inflammatory mediator when produced excessively under abnormal conditions. NO is involved in the pathogenesis of inflammatory diseases affecting the joints, intestines, and lungs. Therefore, compounds that inhibit NO production are considered important for the treatment of inflammatory diseases and are used clinically. The RAW 264.7 mouse macrophage-like cell line is a widely used model for inflammation studies. Lipopolysaccharide (LPS), a component of the outer membrane of Gram-negative bacteria, is used to activate RAW 264.7 cells and create an inflammation model. Glycyrrhiza uralensis, also known as licorice, is a perennial herbaceous plant in the Fabaceae family. It has been widely used in traditional medicine due to its anti-inflammatory, antiviral, and hepatoprotective properties. Recent studies have shown that licorice contains bioactive compounds such as glycyrrhizin, liquiritigenin, and isoliquiritigenin, which play an important role in inhibiting the synthesis of pro-inflammatory cytokines in macrophages induced by LPS. Inula helenium L., also known as elecampane, is a perennial herbaceous plant used as an expectorant, anti-infective, anti-inflammatory, and anti-helminthic agent in various respiratory diseases. Licorice and Inula helenium are included in Mongolian traditional medicine prescriptions, but their anti-inflammatory effects have not been fully determined, which forms the basis for this research. Aim: To study the effect of Glycyrrhiza uralensis and Inula helenium extracts on the production of NO, the end product of inflammation, in RAW 264.7 macrophage cell lines stimulated with lipopolysaccharide. Materials and Methods: The non-toxic dose of the plant extracts was determined in RAW 264.7 mouse macrophage-like cell line cultures using the MTT assay. Nitric oxide production in RAW 264.7 cell line cultures stimulated with lipopolysaccharide was assessed using the Griess method. Statistical analysis of the results was performed using SPSS 25.0 software, with the p-value calculated by one-way ANOVA, and the differences between groups were evaluated. Results: In RAW 264.7 cell cultures, Glycyrrhiza uralensis and Inula helenium extracts were non-toxic and promoted cell growth at doses ranging from 1 to 25 μg/ml, while a dose of 50 μg/ml was toxic and inhibited cell growth (p<0.01). When the combined plant extracts were applied to cells at doses ranging from 1 to 100 μg/ml, they were also non-toxic and enhanced cell growth, while a dose of 500 μg/ml was toxic and inhibited growth (p<0.001). In terms of nitric oxide production, Glycyrrhiza uralensis extract increased NO production in a dose- and time-dependent manner compared to the control or PBS-treated group. However, Inula helenium extract did not show a dose- or time-dependent effect on NO production. In the lipopolysaccharide-induced inflammation model, licorice extract inhibited NO production at a dose of 30 μg/ml after 12 hours, and further reduced NO production in a dose- and time-dependent manner after 48 hours. Conversely, no significant changes were observed in the Inula helenium extract group at a dose of 25 μg/ml after 48 hours, but a reduction in LPS-induced NO production was observed at a dose of 25 μg/ml after 48 hours. Conclusion Glycyrrhiza uralensis extract alone increased NO production in a dose- and time-dependent manner. It also reduced LPS-induced NO production in a dose- and time-dependent manner. In contrast, Inula helenium extract inhibited LPS-induced NO production at a dose of 25 μg/ml after 48 hours.

: The increasing prevalence of noncommunicable diseases (NCDs), driven by factors such as population growth, urbanization, and economic development, presents significant individuals, families, challenges and to healthcare systems. These diseases are often linked to lifestyle choices, poor diet, and physical inactivity. As a result, there is growing interest in finding alternatives to synthetic drugs, particularly those derived from medicinal plants. Medicinal plants are known to contain bioactive compounds that offer therapeutic properties with fewer side effects compared to conventional pharmaceuticals. This study explores the cytoprotective effects of Glycyrrhiza uralensis (licorice) and Inula helenium (elecampane) extracts against oxidative stress induced by hydrogen peroxide (H₂O₂) in RAW 264.7 macrophage-like cells.
The study found that both plant extracts were non-toxic at doses ranging from 1 to 25 µg/mL and promoted cell growth (p<0.01). The results suggest that these extracts support cell survival and exhibit biological activity.
To assess the antioxidant effects, various concentrations of H₂O₂ (10–400 µM) were tested, and 200 µM was found to significantly reduce cell viability. Licorice and elecampane extracts (10 µg/mL and 25 µg/ mL, respectively) enhanced cell viability and reduced oxidative damage. Both extracts significantly reduced cell death compared to the H₂O₂-only group (p<0.01), highlighting their potent antioxidant properties. Conclusion Glycyrrhiza uralensis and Inula helenium extracts demonstrated strong cytoprotective and antioxidant effects, supporting their potential as natural therapeutics for oxidative stress-related conditions.

This clinical review provides a summary of information on antibiotic-food interactions. The effects of medications vary from person to person due to multiple interactions. These include drug-drug interactions and drug-food interactions, which are influenced by everything an individual consumes. While drug-drug interactions are relatively well studied and understood by healthcare professionals such as doctors, nurses, and pharmacists, drugfood interactions are often overlooked, even by medical professionals.
As a result, medications' effects may become stronger, weaker, or completely absent, and in some cases, this may lead to toxicity. Therefore, this review aims to enhance awareness of drug-food interactions among healthcare professionals and the general public to improve treatment outcomes. Food-drug interactions are more noteworthy compared to other interactions. This is because dietary habits are often not recorded in a patient’s medical history and are not always included in consultations with healthcare professionals. However, the risk of adverse effects is the same for both food and medication.
Particularly, solid dosage forms such as tablets, capsules, and pills should be taken with water. If taken with other beverages— such as milk, alcohol, coffee, or fruit juices— they can affect the drug's pharmacokinetics (absorption, metabolism, distribution, and excretion), potentially increasing side effects or suppressing the drug’s effectiveness. Spoiled food, food that has not been stored in a refrigerator, or aged, pickled, fermented, or smoked foods may contain tyramine. Therefore, special caution should be taken to avoid consuming these foods during medication treatment. Tyramine is also found in foods like bananas, avocados, raisins, raspberries, and soy sauce.
When Linezolid is taken with foods high in tyramine, it can cause a sudden and dangerous increase in blood pressure. Thus, it is important to check food labels and ingredients carefully.

Background: The most common clinical manifestation of HCV infection, which includes both hepatic and extrahepatic manifestations, is mixed cryoglobulinemia, which is characterized by the precipitation of certain proteins in the blood at temperatures below 37°C (in vitro), aggregation, and deposition in the walls of small and medium-sized vessels, causing vasculitis, which is clinically manifested by a triad of joint pain, fatigue, and rash on the soles of the feet. Cryoglobulinemia is commonly diagnosed in people with HCV infection, with a prevalence ranging from 10% to 70%. Vasculitis that occurs when cryoglobulinemia is detected mainly affects the small vessels of the skin, kidneys, and peripheral nerves, causing complications in other organ systems. Aim : To determine the prevalence of cryoglobulinemia in people with HCV infection, study it in relation to the stage of liver fibrosis, and determine its clinical relevance. Materials and Methods : 200 chronic HCV infected individuals were included in the study according to the inclusion and exclusion criteria. After obtaining informed consent from each participant, a questionnaire was used to collect information, perform physical measurements, and collect peripheral blood samples. Complete blood count and biochemical tests (liver and kidney function) were performed. The degree of liver fibrosis was assessed non-invasively (APRI, FIB4). The glomerular filtration rate was calculated electronically using the MDRD GFR Equation. Skin examination was performed to assess the presence of rash, ulcers, and scarring on the shins and ankles of cryoglobulinemia. To determine cryoglobulinemia, 8 ml of blood was collected in a tube without anticoagulant, and the sample was kept motionless for 1 hour at room temperature until clotting was complete. After centrifugation, the samples were separated and stored in a refrigerator at +4°C for 7 days, and then at room temperature for 30 minutes, the precipitate was detected. Results : A total of 200 people participated in the study, of which 71 were men (35.5%), the average age was 53.39±13.0. Cryoglobulinemia protein precipitates were determined in a total of 148 people, of which 50 were men (33.8%), the average age was 52.95±13.0. Cryoglobulinemia protein precipitates were detected in 89 people, or 60.1% of the study participants. Of the total study participants, 176 (88.0%) had chronic hepatitis C (CHC). Of these, 57 people had CHC with cryoglobulinemia. Comparing laboratory parameters, the mean GGT level in the cryoglobulinemia group was statistically significantly higher than in the non-cryoglobulinemia group (p=0.039). However, when laboratory parameters were grouped by increasing or decreasing, AST and ALT levels were significantly higher in the cryoglobulinemia group, indicating more hepatocellular damage (p<0.000). Increased creatinine levels may be associated with the risk of renal dysfunction. The FIB-4 index and APRI index showed a more severe degree of fibrosis in the cryoglobulinemia group (p<0.005; p<0.000). Univariate logistic regression analysis showed that age was associated with the occurrence of cryoglobulinemia (OR=2.48; 95% CI:1.31–4.70; p=0.005). Platelet count had a statistically significant positive effect in multivariate analysis (OR=14.38; 95% CI:1.26–163.89; p=0.032). Conclusion The prevalence of cryoglobulinemia among HCV-infected patients was 60.1%, and older age and decreased platelet count among infected individuals were associated with the occurrence of cryoglobulinemia.

Background: Employee satisfaction in the healthcare sector has a direct impact not only on the quality of medical services, but also on workforce stability and overall organizational performance. High levels of job satisfaction are associated with improved work performance, whereas low satisfaction often leads to negative outcomes such as stress and burnout. Although studies on job satisfaction have been conducted in Mongolia, research specifically targeting healthcare workers—and identifying the key factors influencing their satisfaction—remains relatively limited. This gap provides the rationale for the present study Aim: The objective of this study is to examine job satisfaction among healthcare workers at primary and referral hospitals and to identify key factors influencing it. Materials and Methods: The study was conducted between 2022 and 2024 among 1,883 physicians, nurses, and other healthcare professionals aged 18–65 years from 11 provinces and Ulaanbaatar city, using a quantitative research approach with a cross-sectional design. Job satisfaction was assessed with a questionnaire comprising six subdomains (supportive leadership, opportunities for human resource development, professional ethics, organizational culture, quality of healthcare services, and workplace safety), rated on a three-point Likert scale. Data analysis was performed using IBM SPSS Statistics version 26.0. Results: The overall level of job satisfaction among participants was 77.6%. Among the subdomains, workplace safety and supportive environment scored the lowest at 71.7%, whereas the quality and safety of healthcare services scored the highest at 83.4%. The findings indicated that holding a managerial position in hospitals in Ulaanbaatar and working as a physician in primary-level hospitals were positively associated with job satisfaction (p < 0.05). Age demonstrated a statistically significant association with job satisfaction, while years of work experience showed a negative correlation, with satisfaction decreasing as tenure increased (r = −0.09, p < 0.001). The findings indicate that improving healthcare workers’ job satisfaction requires strengthening and supporting several organizational dimensions, including supportive leadership, opportunities for human resource development, organizational culture, workplace safety, and a supportive work environment Conclusion Workplace safety and support, opportunities for human resource development, and organizational culture were found to be critical determinants of employee job satisfaction. The findings suggest that job satisfaction can be enhanced by optimizing organizational support, ensuring opportunities for professional growth, and strengthening workplace safety