Background: Chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) is a major cause of liver cirrhosis and hepatocellular carcinoma worldwide, and is also associated with a wide range of extrahepatic manifestations affecting multiple organ systems. However, comparative studies on the prevalence, risk factors, and clinical associations of these extrahepatic manifestations in Mongolia remain limited. Aim: To comparatively evaluate the risk factors and clinical associations of selected extrahepatic manifestations in patients with chronic HBV and HCV infections. Materials and Methods: This retrospective cohort study included a total of 1.040 participants matched by age and sex. Extrahepatic manifestations were assessed, including hypertension, hyperglycemia, dyslipidemia, and impaired renal function. Results: Extrahepatic manifestations such as hypertension, hyperglycemia, dyslipidemia, and renal dysfunction were significantly more prevalent in the chronic HCV group (p<0.05). In contrast, obesity was more common in the chronic HBV group, particularly among males aged 50-59 years. Increasing age (OR=1.04, 95% CI: 1.02-1.06) and chronic HCV infection (OR=1.65, 95% CI: 1.20-2.26) were associated with a higher risk of extrahepatic manifestations. Liver fibrosis showed similarly high prevalence in both groups (71-72%), with the highest occurrence in the 50-59 age group. A moderate positive correlation was observed between fibrosis stage and renal function impairment (r=0.45). Conclusion Chronic HCV infection is more strongly associated with the presence and risk of extrahepatic manifestations compared to HBV. Age, sex, and metabolic abnormalities are important contributing risk factors. Therefore, regular monitoring of metabolic and renal function, in addition to liver disease, is essential in patients with chronic viral hepatitis to prevent complications.

Background: Zinc is an essential trace element that plays a crucial role in immune function, skin integrity, and inflammatory regulation. Zinc deficiency has been associated with impaired immune response and increased risk of allergic diseases, including atopic dermatitis. Hair mineral analysis provides a reliable method for assessing long-term mineral status. Aim: This study aimed to investigate the association between hair zinc levels and atopic dermatitis among Mongolian children. Materials and Methods: A retrospective observational study was conducted among 1000 children aged 0–18 years. Hair samples were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). Statistical analysis was performed using the chi-square test. Results: The results showed that 79.6% of children had zinc deficiency. Zinc deficiency was highly prevalent in younger age groups, affecting 99.3% of children aged 0–9 years and 93.6% in those aged 10–14 years, while it decreased significantly to 10.2% in those aged 15 years and older. A significant association was found between age group and zinc status (χ²=727.111, p<0.001). Among the participants, 6.3% were diagnosed with atopic dermatitis, and 71.4% of them had zinc deficiency. Conclusion These findings suggest a potential association between zinc deficiency and atopic dermatitis. Early detection and nutritional intervention for zinc deficiency in children may be important for preventing allergic skin diseases.

Background: There is a scarcity of research in Mongolia that assesses essential minerals—crucial for child growth—by analyzing their levels in hair tissue and correlating these findings with age, gender, and growth indicators. This gap serves as the rationale for the present study. Aim: To determine the prevalence of deficient levels (below laboratory reference ranges) of Na, K, Ca, Mg, Zn, P, Fe, Cu, and Se in hair, and to evaluate their associations with growth curves, age, and gender. Materials and Methods: We conducted a retrospective cross-sectional analysis of data from 1,000 children aged 1–18 years who underwent testing at the “Tod-H” Pediatric Growth Clinic between June 2016 and December 2022. The children were categorized into the following age groups: 0–4 (n=138), 5–9 (n=276), 10–14 (n=390), and 15–18 years (n=196). Mineral analysis of hair samples was conducted at the “Medinex” laboratory in South Korea using the ICP-MS method; values falling below the laboratory’s reference range were classified as a “deficiency.” Among the total of 1,000 children, the growth curves of 997 children with recorded height measurements were evaluated and categorized into three groups: ≤3rd percentile (growth retardation, n=154), 3rd–50th percentile (relatively short stature, n=497), and >50th percentile (normal growth, n=346). Three children diagnosed with autism, for whom height measurement was not possible, were excluded from the growth-related analyses. The prevalence of mineral deficiencies is presented as n (%), and comparisons across growth curve groups, age, and sex were performed using the χ² test, with adjustments made via the Benjamini–Hochberg false discovery rate (FDR) procedure. Logistic regression analysis, adjusted for age and sex, was employed to compare the growth-retarded and relatively short-stature groups against the >50th percentile (normal growth) group. Results: An analysis of mineral levels in the hair of all children included in the study revealed deficiencies (levels below the reference range) in the following proportions: zinc (Zn) in 79.6%, phosphorus (P) in 76.6%, selenium (Se) in 73.3%, calcium (Ca) in 19.7%, and magnesium (Mg) in 17.5%. In the group of children with stunted growth, the prevalence of deficiencies was 88.3% for zinc (Zn), 85.7% for phosphorus (P), and 30.5% for calcium (Ca)—rates higher than those observed in the group of children with relatively short stature (3rd–50th percentiles; Zn 77.9%, P 73.8%, Ca 16.5%) and the group with normal growth (>50th percentile; Zn 78.0%, P 76.3%, Ca 19.7%). After applying the FDR correction, the differences among the three growth-curve groups were statistically significant for Zn (q=0.030), P (q=0.030), and Ca (q=0.006). In contrast, the prevalence of selenium (Se) deficiency was identical across all three growth-curve groups (73.4%, 73.4%, 73.4%; q=1.000). The study results indicate that age-related differences are most pronounced regarding deficiencies in zinc, phosphorus, and calcium. The prevalence of zinc (Zn) deficiency was 99.3% for the 0–4 and 5–9 age groups, 93.6% for the 10–14 age group, and 10.2% for the 15–18 age group. For phosphorus (P), the corresponding figures were 93.5%, 92.8%, 90.8%, and 13.8%, while for calcium (Ca), they were 33.3%, 37.0%, 9.5%, and 6.1%, respectively (p<0.001). Furthermore, the prevalence of deficiencies in zinc (Zn) (84.6% vs. 76.0%; q=0.007), iron (Fe) (5.5% vs. 1.7%; q=0.007), and selenium (Se) (77.4% vs. 70.4%; q=0.049) was higher in females than in males. After adjusting for age and sex and applying the False Discovery Rate (FDR) correction, it was determined that none of the mineral deficiencies showed an independent association with stunted growth or relatively short stature. Conclusion Hair mineral analysis revealed that deficiencies in zinc (Zn), phosphorus (P), and selenium (Se) were the most common. In children with growth retardation, deficiencies in zinc (Zn), phosphorus (P), and calcium (Ca) were relatively more prevalent; however, this was associated with age distribution, and factor analysis did not confirm an independent correlation. Conversely, selenium (Se) deficiency did not differ across the growth curve groups.

Background Cancer remains one of the leading causes of death worldwide, with 19.3 million new cases recorded in 2020 and an estimated 28.4 million by 2040. In Mongolia, it ranks second after cardiovascular diseases in terms of mortality. Receiving a cancer diagnosis significantly impacts not only the physical condition of patients but also their psychological and social well-being. Studies indicate that 35–50% of cancer patients experience symptoms of depression, anxiety, and post-traumatic stress. This study aims to determine the stress levels of cancer patients and investigate the relationships between the factors that influence these levels. The Self-Report Questionnaire (SRQ-20), developed by the WHO for primary healthcare physicians, was officially approved and used in this study. In terms of gender distribution, the majority were female (69.8%), while males accounted for 30.2%.
According to the study, in stage I of cancer, 9.5% of patients experienced high stress, 14.3% had moderate stress, and 7.9% reported no stress. In stage II, 9.5% had high stress, 22.2% had moderate stress, and 11.1% had no stress. In stage III, 6.3% experienced high stress, 9.5% had moderate stress, and 3.2% reported no stress. In stage IV, 4.8% experienced high stress, and 1.6% had moderate stress; no patients in this stage reported being stress free.
The highest percentages of moderate stress were observed in stages I and II (14.3% and 22.2%, respectively), possibly due to the strong emotional reaction at the time of initial diagnosis. In contrast, all stress levels declined sharply in stages III and IV, with 6.3% experiencing high stress, 9.5% moderate stress, and 3.2% no stress in stage III. In stage IV, 4.8% had high stress and 1.6% moderate stress, while no patients reported being stress-free.

The global average cancer incidence is 9.3 per 100,000 population, while this figure is 93.7, or 10 times higher, in our country. At the end of the 2023 report, 28,855 people were being monitored and treated for cancer under the supervision of the province's district oncologists. According to the 2022 statistics of the World Health Organization, about 10 million people die from this disease every year in the world. In Mongolia, the incidence and mortality rate of cancer have also increased rapidly in recent years, and as of 2021, it has become the second leading cause of death.
To determine the level of depression in cancer patients and study the relationship between some factors affecting it research methods and scope: The study was conducted using a single-point analytical research design, and data were collected from 95 cancer patients under the care of a family health center between February 10, 2025 and March 20, 2025 using the PHQ 9, 18 Sleep Disorders Questionnaires, and 15 General Information Questionnaires, a total of 42 questionnaires issued by the WHO for primary health care providers. 26.3% (25) of the study participants were male, and 73.7% (70) were female. Of the total study participants, 39 (41.1%) were not depressed, 25 (26.3%) had self-limiting depression, 15 (15.8%) had moderate depression, 3 (3.2%) had moderate to severe depression, and 13 (13.7%) had severe depression. The majority of cancer patients are depressed. Severe depression can make it difficult to perform simple social activities and may even lead to suicide, so psychiatric evaluation, diagnosis, and treatment are necessary.

Background: In Mongolian Traditional Medicine (MTM), the human body constitution is classified according to the doctrine of Khii, Shar, and Badgan, resulting in seven types: three single constitutions Khii, Shar, Badgan, three mixed constitutions Khii-Badgan, Shar-Badgan, Khii-Shar, and one combined constitution in which all three principles coexist. This concept considers not only physical, physiological, mental, and behavioral characteristics but also environmental influences. Childhood obesity has become a major global public health issue. In Mongolia, the prevalence of overweight and obese children aged 5–19 years is projected to reach 19% (approximately 79,648 children) by 2030. However, limited research has examined the relationship between children’s constitutional types and their physical and body composition indicators. Aim: Children (11-17 ages) innate nature of and study of the relationship between physical and body composition. Materials and Methods: A cross-sectional analytical study was conducted among 459 students aged 11–17 years from “Erdmiin Khutuch” Secondary School No. 58, Sukhbaatar District, Ulaanbaatar, selected through random sampling. Constitutional types were determined using the “Mongolian Traditional Medicine Human innate nature Typology” developed by B. Dagvatsereen and U. Batchimeg (2003), based on 19 parameters and 44 indicators through a web-based tool (WEB1). Body composition was measured using a Tanita DC430a analyzer. Statistical analyses were performed using SPSS version 27. Results: Among children aged 11-13 years, the predominant constitutional types were Badgan-Shar, Khii-Badgan, Khii- Shar, Badgan-Khii, and Shar-Khii, with Badgan-Khii being the most common. In those aged 14-17 years, the dominant constitutions shifted to Shar–Khii, Khii–Shar, and Shar–Badgan, with Shar–Khii and Khii–Shar more frequently observed. These patterns may be related to the physiological characteristics of growth during childhood and adolescence. The average height of boys was 158.35±1.13 cm (118-175), while that of girls was 154.94±0.61 cm (116-175), indicating that boys were 3.41 cm taller than girls (p<0.05). The mean waist circumference of boys was 69.66±0.79 cm (60-110), compared to 67.77±0.66 cm (29.50-108) in girls, showing a statistically significant difference of 1.89 cm (p<0.05). The findings demonstrated that girls had higher body fat percentage and fat mass than boys, whereas boys exhibited greater skeletal muscle percentage, skeletal mass, muscle percentage, and muscle mass. These sex differences in fat and muscle composition among children aged 11-17 years may be attributable to hormonal variations associated with pubertal development. Body mass index, waist circumference, body fat percentage, visceral fat level, daily metabolic expenditure, obesity grade, and bone mass showed a weak inverse correlation with the Khii–Shar and Shar–Khii constitutional types. Conclusions 1. Among children aged 11-13 years, Badgan-Shar, Khii-Badgan, Badgan-Khii, and Shar-Khii constitutions were dominant, while in those aged 14-17 years, Shar-Khii, Khii-Shar, and Shar-Badgan types predominated. 2. When comparing children’s physical indicators by sex, boys have greater height and waist circumference than girls. Regarding body composition, girls show higher body fat percentage and fat mass, whereas boys have greater skeletal muscle mass, muscle percentage, and total muscle mass compared to girls. 3. The body mass index, waist circumference, body fat percentage, and degree of obesity showed a weak positive correlation with the Badgan-dan and Badgan-khii constitutional types. In contrast, skeletal muscle mass, muscle weight, body water percentage, and body protein percentage demonstrated a weak positive correlation with the Khii-shar and Shar-khii constitutional types.

Background: Spinal Muscular Atrophy (SMA), an autosomal recessive disorder characterized by lower motor neuron loss, leads to progressive muscle weakness and atrophy. With a neonatal incidence ranging from 1:6000 to 1:11000, individuals affected by SMA face challenges in locomotor function. The advent of newborn screening tests, early diagnostic techniques, and the introduction of gene therapy have, however, shown promise in enabling the acquisition of these motor skills. Objective: This review article seeks to shed a light on current understandings of the epidemiology, clinical presentations, diagnostic methods, and treatments for spinal muscular atrophy, highlighting cutting edge approaches within the discipline. Methods: A thorough search was conducted on PubMed, Cochrane, National Institutes of Health, and Web of Science databases for recent research articles concerning SMA’s incidence, prevalence, clinical manifestations, early detection, genetic testing and contemporary gene therapy. Results: The prevalence of SMA stands at 1-2 cases per 100,000 population, with an incidence of approximately 8 cases per 100,000 live births. Pre-1995 studies exhibited varying prevalence rates due to using non molecular-biological methods, small localized populations, diagnostic errors, and regional characteristics. Diagnosis involving Multiplex ligation-dependent probe amplification (MLPA), quantitative polymerase chain reaction (qPCR), or next-generation sequencing (NGS) analysis to confirm SMN1 and SMN2 gene status aids in identifying carriers and SMA subtypes. Countries implementing newborn screening programs have demonstrated early SMA detection in asymptomatic newborns, contributing to reduced mortality and disability rates. Currently, several types of gene therapy are being used in the treatment of SMA. Conclusion The epidemiology of SMA varies between countries and regions. It is fully possible to confirm the disease, identify carriers and subtypes. The inclusion of SMA in newborn early detection programs is crucial for reducing infant mortality and disability, and several gene therapies have received approval from relevant authorities for SMA treatment. In Mongolia, it is possible to introduce tests to confirm the disease and determine carriers and subtypes.

Background: During the historical development of traditional medicine, many books and manuscripts have been written in Mongolian medicine. The main textbook of traditional medicine states that: “The size of a bone consists of 23 bone species, 28 spinal joints, 24 ribs, 32 teeth, and 360 pieces of bone.”
However, modern medicine estimates that the human body has 206 bones. Therefore, this topic was chosen to study the source material of traditional medicine, including the structure of the human body, and the number of bones in the modern medical anatomy textbook. Purpose: Details of the number of bones in the human body in the “Four Medical Tantras” (རྒྱུད་བཞི) of traditional medicine and its commentary, as well as compare with the number of bones in the basic textbook of anatomy of modern medicine. Objectives: In order to successfully implement the research objectives, the following objectives will be implemented. These include:
1. Sampling and analyzing number of bones from traditional medicine;
2. Sampling and analyzing bone numbers from modern medical textbooks;
3. Compare the names and numbers of bones in traditional medicine and modern medicine Results: The number, classification and features of human bones were analyzed from the main scriptures of traditional medicine such as “Explanatory Tantra”, of the “Four Medical Tantras” and the “Legs bshad gser gyi thur ma” by Blo-bzang-chos-grags. In addition, the number of bones in the human body was sampled from modern medical textbooks and prepared for comparison. The number and characteristics of bones in the human body were compared by traditional medicine and modern medicine and made a conclusion.
This study reveals that the foundations for the integrated development of traditional medicine were laid long ago in Mongolian medicine. In addition, to highlight the book “Four Medical Tantras”, which is the basis of the textbook on the structure of the human body and the research work of scientists and scholars, which is considered in Mongolian mamba datsan’s contribution to the science of human anatomy. The importance of this research is to change the extremes of Western medicine and traditional medicine and increase opportunities to use its introduction and development into training and clinical practice. Conclusion
1. The main creature of body structure in traditional medicine is the “Four Medical Tantras” which generally assumes that the numbers of bones are 360 but does not specify it in detail. During the research, we identified 357 bone names to identify each bone. The names and locations of the three bones were not clearly marked in the medical sources.
2. The numbers of bones are 206 in modern medical textbooks. We recalculated 151 bones based on traditional medical sources without duplication of that.
3. Compared to traditional medicine and modern medicine, the number of bones and are higher than 154 bone names in traditional medicine because we included the number of teeth, small bones in the ears and small bones in the fingers and toes. Some cartilage was also counted as bones.

Background: Breastfeeding is the ideal food source for all newborns globally. Proper feeding of infants and young children promotes optimal growth and development, especially in the critical window from birth to 2 years of age. Exclusive breastfeeding for 6 months and continued breastfeeding for the first 2 years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. Objective: To assess the indicators of infant feeding practices among 0- 23 months old children. Materials and Methods: The NNS V was implemented in 21 aimags (provinces) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [1]. The infant and young child feeding indicators assessed in the NNS V were based on the mother’s or caretaker’s report of breastfeeding and consumption of foods and fluids by the child during the day or night prior to being interviewed. Results: 83.7% of children under 2 years started breastfeeding within 1 hour of birth and though almost all children were ever breastfed (97.9%), a slightly higher percentage of girls were ever breastfed overall and within 1 hour of birth. Children 0-5 months were categorized according to whether they were exclusively breastfed or predominantly breastfed, with the former only allowing vitamins, mineral supplements, and medicine and the latter also including plain water and non-milk liquids. Among children 0-5 months of age, 58.3% were exclusively breastfed and 65.3% were predominantly breastfed, having received other liquids or foods in addition to breast milk. The prevalence of exclusive breastfeeding was lowest in the 4th wealth index quintile (46.5%) and wealthiest quintile (54.0%) households. Conclusions Exclusive breastfeeding and early initiation of breastfeeding practices are unacceptably low in Mongolia; 20% of newborns are not breastfed within 1 hour of birth and more than 40% of infants under 6 months of age are not exclusively breastfed and therefore, not receiving optimum nutritional and immunity benefits from breast milk. Strengthening IYCF counselling in all regions and wealth quintiles to support women to practice optimal breastfeeding, along with counselling and awareness of timely and adequate complementary feeding for children under 2 years of age, should be a top priority for public health and as it is a key strategy to reduce malnutrition in children.

Background : Overweight and obesity are conditions of over nutrition resulting from consumption of more calories than the body requires leading to excess body fat accumulation. The prevalence of both overweight and obesity is increasing globally in all age groups in high, middle, and low-income countries and is largely attributed to the “nutrition transition” with a shift from traditional diets to readily available and inexpensive, low-nutrient unhealthy foods high in energy [1].
The move away from traditional to “junk” foods often occurs at the same time as the move of populations away from daily physical activity and increase in sedentary activities such as time spent in front of a phone, computer, or television, furthering increasing the risk of becoming overweight. People who are overweight or obese are at higher risk for serious health problems including hypertension, heart disease, stroke, diabetes, some cancers, and osteoarthritis. The increase in overweight and obesity is accompanied by a dramatic increase in prevalence of above mentioned chronic conditions in the worldwide. While the long-term repercussions of overweight and obesity are severe, they are largely preventable and treatable through healthy diets and healthy lifestyle behaviors [2]. Materials and Methods: The fifth National nutrition survey (NNSV) was implemented in 21 provinces (aimags) in 4 socio-economic regions (Central, Eastern, Khangai, and Western) and the capital city of Ulaanbaatar. Given the regional differences in dietary patterns and nutrition status, target populations were stratified into 5 strata based on 4 regions and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. In total, 1750 school children data on demographic and dietary information collected by interview methods and anthropometric measurement results were used in this study. Ethical considerations: The survey protocol was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted by order of director of Scientific committee of PHI on 28th June, 2016. Ethical approval for conducting the NNS V was obtained from the Medical Ethics Committee under the Ministry of Health of Mongolia on July 7, 2016. Participation in the survey was voluntary, oral and written informed consent were obtained from adult caregivers of each children. Results: Consumption of unhealthy or junk (high-calorie, low-nutrient) foods in the past week was nearly universal (99.0%) among school children 6-11 years of age. Over half of children (51.4%) consumed junk foods at least once per week and 45.7% consumed junk foods a few times a week. Consumption of sugar-sweetened beverages was high with 80.9% of children consuming these at least once in the past week. Overall consumption of fried foods was lower than consumption of junk foods or sugar-sweetened beverages with 22.7% of children not consuming any fried foods in the past week and only 8.5% of children consuming fried foods a few times per week. Consumption of sweet foods was high with nearly all children having consumed sweet foods in the past week, 45.9% of children 6-11 years having consumed sweet foods a few times per week.
The prevalence of overweight (BMI > +1 SD) was 22.2% and prevalence of obesity (BMI > +2 SD) was 6.4%. Overweight prevalence was higher in boys (26.6%) compared to girls (17.8%) and in urban (23.9%) compared to rural (17.6%) areas with the highest prevalence in Ulaanbaatar (25.6%) compared to other regions. Children 6 years old (26.1%) and 7 years old (25.6%) had a higher prevalence of overweight than older children. Conclusion
1. Consumption of unhealthy foods and drinks is common to 6-11 year olds group, with almost all children (99.2%) consuming any type of unhealthy foods and drinks at least once per week, in particular, 8 out of 10 children were found consuming sugary drinks and/or deep fried food.
2. The consumption of unhealthy foods was not differing by child’s sex, there were revealed significant differences between living area and regions. Proportion of the school children 6-11 years of age was relatively higher in Ulaanbaatar city and urban settings.
3. The prevalence of overweight and obesity in school children aged 6-11years sharply increased from 2010 NNS IV level and reached 22.2% and 6.4%, respectively. Among children with obesity consumption of any unhealthy foods and sugary drinks were 1.4–1.9 times higher than nonobese children, respectively.