Background: Polymyositis (PM) is a rare idiopathic inflammatory myopathy characterized by symmetric proximal muscle weakness, elevated muscle enzyme levels, dysphagia, and respiratory muscle weakness. Rhabdomyolysis is a potentially life-threatening condition caused by extensive skeletal muscle breakdown, resulting in myoglobinuria and an increased risk of acute kidney injury and multiorgan complications. The coexistence of rhabdomyolysis in patients with polymyositis is uncommon and may complicate both diagnosis and management. Case Presentation: A 65-year-old man was admitted with fever up to 39°C, generalized skin rash, dysphagia, progressive muscle weakness, dyspnea, decreased urine output, and dark tea-colored urine. Physical examination revealed symmetric proximal muscle weakness, with muscle strength graded 3/5 in both upper extremities and 4/5 in both lower extremities. Neck muscle strength was 4/5. Dysphagia and a generalized skin rash were also present. Laboratory investigations showed markedly elevated creatine kinase (CK) at 9,943.1 U/L, alanine aminotransferase (ALT) at 449.1 U/L, aspartate aminotransferase (AST) at 222.1 U/L, lactate dehydrogenase (LDH) at 1,342.9 U/L, and C-reactive protein (CRP) at 70.6 mg/L. Urinalysis showed blood 3+ and protein 2+, while no erythrocytes were detected on urine sediment microscopy. Electromyography demonstrated myopathic changes, and muscle biopsy revealed inflammatory infiltrates and necrotic muscle fibers. Conclusion Comprehensive assessment of clinical manifestations, laboratory findings, autoantibody testing, electrophysiological studies, and muscle biopsy is essential for the diagnosis of polymyositis complicated by rhabdomyolysis. An integrated diagnostic approach facilitates confirmation of the diagnosis, differentiation from clinically similar disorders, and appropriate treatment selection. Early recognition of rhabdomyolysis and other potentially life-threatening complications is crucial for preventing organ damage and improving patient outcomes.

Background: Human papillomavirus (HPV) is the primary cause of cervical cancer, with HPV genotypes 16 and 18 classified as high-risk types. In Mongolia, HPV testing has been increasingly implemented in recent years, alongside updates to the national screening program. These developments highlight the need for additional testing approaches to encourage regular participation in the national screening program, improve diagnostic accuracy, and facilitate timely treatment planning. These considerations provided the rationale for this study. Aim: To detect HPV infection in cervical samples collected by healthcare professionals and vaginal samples self-collected by women, determine the concordance between the test results, and evaluate the feasibility of self-sampling for cervical cancer screening. Materials and Methods: A total of 206 women aged 25–68 years participated in the study. Two types of samples for HPV testing and one sample for PAP smear were collected from the participants. 14 high-risk of HPV genotypes were classified into three groups, and cytological findings were evaluated according to the 2014 Bethesda System. Statistical analyses were performed using SPSS version 30.0. Results: The concordance between the two sampling methods for HPV detection kappa was 0.949. High-risk HPV genotypes were detected in 50 women (35.2%) among the participants with available test results. Cytological abnormalities were identified in 51% of women who tested positive for HPV. Conclusion Self-sampling is a reliable method for HPV detection, demonstrating good concordance with healthcare professional-collected cervical samples. It has considerable potential to increase cervical cancer screening coverage and improve access to screening, particularly in geographically remote areas.

Background: Hepatitis C virus (HCV) is a blood-borne infectious disease that, if left untreated, can lead to chronic infection, liver cirrhosis, and hepatocellular carcinoma. In Mongolia, the prevalence of HCV is relatively high, posing significant public health concerns. In alignment with the global goal to eliminate hepatitis B and C by 2030, this study aimed to investigate the prevalence, genotype distribution, and associated risk factors of HCV infection among the general population in Arkhangai province, Mongolia. Aim: To determine the prevalence of hepatitis C virus infection among the relatively healthy population of Arkhangai Province and to study its genotypes and risk factors. Materials and Methods: A cross-sectional analytical study was conducted using a two-stage sampling method, enrolling 2,304 individuals aged 0–80 years. Participants completed a structured questionnaire, and blood samples were collected for anti-HCV and HBsAg testing using enzyme-linked immunosorbent assay (ELISA) at the central laboratory of the provincial hospital. Serum from anti-HCV positive individuals was preserved at –80°C and transported to Ulaanbaatar for HCV RNA quantification via real-time polymerase chain reaction (RT-PCR) and genotyping through molecular diagnostics. Statistical analyses were conducted using SPSS version 26.0. Results: A total of 2,304 individuals from the provincial center and 8 soums participated in the study, of whom 57.8% were female. The overall HCV seroprevalence was 12.0%, with chronic HCV infection confirmed in 7.16%. Among patients with chronic HCV, genotype 1b was identified in 98.2% of cases. Risk factor analysis revealed statistically significant associations between HCV infection and undergoing cosmetic procedures, receiving injections in non-medical settings, cupping therapy, and sharing shaving equipment. Conclusion This study HCV seroprevalence of 12.0% among the relatively healthy population in Arkhangai province, with genotype 1b detected in 98.2% of chronic HCV cases. The following risk factors were found to be independently associated with HCV infection: undergoing cosmetic procedures (OR: 2.3), cupping therapy (OR: 1.7), receiving nonmedical injections (OR: 2.4), and sharing shaving tools (OR: 1.5) (p<0.001)

Background: Cardiovascular diseases (CVDs) is a third leading cause of non-communicable diseases and a leading cause of mortality in Mongolia. Among these, acute myocardial infarction (AMI), a complication of coronary artery disease (CAD), is a leading cause of cardiovascular mortality. In patients with AMI, both epicardial artery blood flow, observed through coronary angiography, and coronary microcirculatory dysfunction (CMD) play critical roles in the disease’s pathophysiology. Recent advancements have introduced artificial intelligence (AI)-based softwares which are capable of analyzing coronary blood flow from coronary angiography images. The AI based softwares can assess not only epicardial blood flow but also CMD in recent studies. In this review, we discussed the role of CMD in pathophysiology of AMI, diagnostic approaches, the application of AI-based technologies, their clinical significance, and future directions. Aim: This review aims to explore the pathophysiological relationship of coronary microcirculatory dysfunction (CMD) in the context of acute myocardial infarction (AMI), diagnostic methodologies, the application of artificial intelligence (AI)-based technologies, and their clinical significance. Hypotheses: 1. AI-based software allows for highly accurate assessment of coronary microcirculation during AMI. 2. CMD during AMI is associated with structural and functional changes in the heart. 3. CMD during AMI is related to disease prognosis and patient outcomes. Methodology:: This narrative review was compiled using a systematic and logical approach, based on publicly available recent clinical and biomedical research literature addressing the above hypotheses. Conclusion In recent years, AI-based image processing software has been developed to analyze angiographic images obtained during percutaneous coronary intervention (PCI) and treatment procedures. These tools show significant promise for early detection and improved diagnosis of CMD during AMI, as well as for better assessment of short- and long-term patient risk.

BACKGROUND: Tuberculosis (TB) and indoor air pollution (IAP) are equally critical public health issues in the developing world. Mongolia is experiencing the double burden of TB and IAP due to solid fuel combustion. However, no study has assessed the relationship between household solid fuel use and TB in Mongolia. The present study aimed to assess the association between household solid fuel use and TB based on data from the Mongolian National Tuberculosis Prevalence Survey (MNTP Survey). METHOD: The MNTP Survey was a nationally representative population-based cross-sectional survey targeting households in Mongolia from 2014 to 2015, with the aim of evaluating the prevalence of TB. The survey adopted a multistage cluster sampling design in accordance with the World Health Organization prevalence survey guidelines. Clusters with at least 500 residents were selected by random sampling. A sample size of 98 clusters with 54,100 participants was estimated to be required for the survey, and 41,450 participants were included in the final analysis of the present study. A structured questionnaire was used to collect information on environmental and individual factors related to TB. Physical examination, chest X-ray, and sputum examinations were also performed to diagnose TB. RESULTS: The use of solid fuels for heating (adjusted odds ratio (aOR): 1.5; 95% confidence interval (CI): 1.1-2.1), male gender (aOR: 2.2; 95% CI: 1.6-3.2), divorced or widowed (aOR: 2.6; 95% CI: 1.7-3.8), daily smoker (aOR: 1.8; 95% CI: 1.3-2.5), contact with an active TB case (aOR: 1.7; 95% CI: 1.2-2.3), being underweight (aOR: 3.7; 95% CI: 2.4-5.7), and previous history of TB (aOR: 4.3; 95% CI: 3.0-6.1) were significantly associated with bacteriologically confirmed TB after adjusting for confounding variables. CONCLUSION The use of solid fuels for heating was significantly associated with active TB in Mongolian adults. Increased public awareness is needed on the use of household solid fuels, a source of IAP.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Air Pollution, Indoor/adverse effects* ; Cooking ; Cross-Sectional Studies ; Female ; Heating/adverse effects* ; Humans ; Male ; Middle Aged ; Mongolia/epidemiology* ; Prevalence ; Tuberculosis/epidemiology* ; Young Adult

Introduction: Foodborne diseases are a major public health concern worldwide. The report, which estimates the burden of foodborne diseases – states that each year as many as 600 million, or almost 1 in 10 people in the world, fall ill after consuming contaminated food. Of these, 420 000 people die, including 125 000 children under the age of 5 years. The 20.3% of diarrhea and 27.5% of die caused by contaminated foods are diarrheagenic Escherichia coli (DEC). Aim: To identify of DEC and determine their antibiotic resistance from ready-to-eat salads Material and Methods: A total of 40 bagged salad mix samples were collected from food markets in Ulaanbaatar, Mongolia. Escherichia coli (E.coli) strains were determined on the basis of MNS 6308:2012 standard and confirmed by polymerase chain reaction (PCR) in samples. DEC was identified using multiplex PCR. Bacterial susceptibility to antimicrobial agents determined by the Kirby Bauer disk diffusion method. Results: Our results showed the presence of E. coli in 19 samples (47.5%). DEC isolates identified by multiplex PCR were defined as follows: the presence of eae and bfp for EPEC, the presence of lt for ETEC, the presence of ipaH for EIEC, the presence of stx1 and stx2 for EHEC, the presence of aap and aggR for EAEC, and the presence of daaE for DAEC. The multiplex PCR assays detected EHEC 6 (31.6%), EPEC 5 (26.3%), EIEC 1 (5.3%). EAEC and ETEC were not detected in samples. The E.coli isolates were 73.7% resistant to chloramphenicol as the first choice of treatment of diarrhea and high resistance (68.4-94.7%) to the cephalosporins. In our country, cephalosporins are widely used in medical practice for the treatment of infectious diseases. Conclusion In this study, about half of ready-to-eat salads are contaminated with E. coli. The three types (EHEC, EPEC, EIEC) of DEC pathotypes were identified in the ready-to-eat salads and high prevalent of antimicrobial resistance. Future research is required to track the contamination sources and develop appropriate steps that should be taken by industry and retailers to reduce microbial contamination in ready-to-eat salads.

BACKGROUND. Previous retrospective study from our team showed that RDW significantly increased in chronic heart failure (CHF). OBJECTIVE. The aim of the study was to compare the value of RDW-CV with NT-pro BNP and evaluate sensitivity and specificity of RDW for diagnose of heart failure. MATEREALS AND METHOD. Here, we analyzed 20 patients who were suffering from heart failure and were treated in the department of Cardiology, First Clinical Hospital between in June 2017. All patients in the study group were underwent a complete blood count, immunoassay for NT-proBNP. The ejection fraction was analyzed by ECHO cardiograpy. RESULTS. 85.0% of patients were male and remained was female. RBC and RDW was significantly differentially measured in between CHF groups (р= 0.028 p=0.0001). In control groups without heart failure NT-proBNP was estimated up to 100 pg/ml, whereas it was definitelly increased in patient with CHF (р=0.0001). There was strong correlation between RDW and NT-proBNP (r =0.846, p=0.0001). sensitivity and specificity of RDW was 89%, and 74.3 % respectively in CHF. CONCLUSION. According to the our results there was direct correlation between RDW-CV and heart failure (p=0.035). RDW-CV migh be cost effective and routine laboratoty marker to evaulate CHF.

A child’s career aspirations are based on a number of external factors such as ethnicity, gender, age, income, family influence and socioeconomic status. These factors are interrelated and given varying degrees of importance culturally, for example, in the UK, white British parents tend to have high aspirations for their daughters whereas, in Pakistani and Bangladeshi families, daughters are expected to marry, not excel in their education or career. High school students of secondary education in terms of gender, 34432 studentsenrolled in high school who are studying in 46.47% of men and women are 53.52% of the high school, there are changes in the gender disparity. This study is conducted due to Millennium Development Goal 3 is to eliminate gender disparity in education by 2015. This study was conducted among General Education School students of Ulaanbaatar city in 2015. Three hundred twenty four school students participated in this study. The cross sectional study was conducted with 294 high school students.Thirty high school students participated in focus group interview. This study was used qualitative and quantities design.Of the respondents, 47.6% were male and 52.4% female. 79.3% of high school students have chosen a career and 20.7% of high school students have not chosen yet. We are evaluated in career choice with a focus on a gender issue. P = 0.0001 whether there are statistically significant and career choice have different in men and women gender.In this study, 20.7 percent of high school students do not choose career due to a lack of information,do not give the professional advice from the school for them. Thus, schools need to introduce if possible considering the foreign experience, lesson of career choice is reflected in the school curriculum.

There is a little information about weight excess of school materials in Ulaanbaatar, Mongolia. The aim of this study was to study of the weight of backback and the ergonomic effects of backpack carriage on school students in Ulaanbaatar. This cross-sectional study was performed in the city of Ulaanbaatar in 2015. Two hundred fourteen school students participated in study. Nordic Musculoskeletal Questionnaire was used, asking about complaints of neck, shoulders, upper and lower back. Length and weight of the children were determined. Backpacks were weighed and the relative weight of the backpack was calculated.In this study, first and second grades students carried proportionately heavier backpacks than older students and more than 10% of their weight. Musculoskeletal complaints were reported by about 79% of school students. The (relative) weight of backpacks was not related to complaints of neck, shoulders, upper and lower back.