Background: Adhesion small bowel obstruction (ASBO) is a common complication following abdominal surgery and can significantly impair postoperative recovery. This condition necessitates the exploration of more effective therapeutic approaches. Aim: The aim of this study was to evaluate the clinical efficacy of Traditional Mongolian Medicine (TMM) combined with acupuncture in the management of postoperative ileus secondary to adhesion-related small bowel obstruction. Case Presentation: We report the case of a 47-year-old female patient who developed postoperative ileus. The therapeutic intervention consisted of a combined regimen of traditional herbal pharmacotherapy and electroacupuncture. The clinical outcomes were assessed based on the resolution of symptoms and the restoration of gastrointestinal function. Result: Following the administration of the integrated treatment, the patient exhibited a marked reduction in abdominal pain. Objective clinical improvement was noted through the successful restoration of intestinal peristalsis and the normalization of flatus and defecation. Conclusion The findings of this case study suggest that Traditional Mongolian Medicine, particularly when integrated with electroacupuncture, may be an effective and viable modality for promoting the recovery of gastrointestinal motility in patients with adhesion-related small bowel obstruction.

Background: Treatment adherence is essential to maintain treatment effectiveness and reduce complications among patients receiving hemodialysis. Patients are required to attend scheduled dialysis sessions, complete the prescribed dialysis duration, take medications as directed, and follow fluid and dietary restrictions. However, adherence may vary across different components of the treatment regimen. Aim: To assess treatment adherence and identify associated reasons and factors among patients receiving hemodialysis. Materials and Methods: We conducted a cross-sectional study a total of 260 patients who are receiving hemodialysis at the ‘Medvic’ Hemodialysis Centers located at the First Central Hospital and the Third Central Hospital. We assessed treatment adherence using the Mongolian version of the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). We evaluated dialysis attendance and duration, medication use, fluid restriction, dietary adherence, and adherence barriers. Differences in ESRD-AQ total scores across demographic and clinical characteristics were analyzed using the independent-samples t-test and one-way analysis of variance (ANOVA). Results: The mean ESRD-AQ total score was 1093.37±99.04. Most participants did not miss (92.3%) or shorten (94.2%) dialysis sessions. In contrast, 57.7% always adhered to fluid restriction and 50.0% always followed dietary recommendations. Although most participants considered treatment recommendations very important, adherence to fluid and dietary restrictions remained comparatively lower. Common barriers included forgetting medication (61.7%), difficulty controlling fluid intake (88.7%), and difficulty avoiding restricted foods (82.5%). ESRD-AQ total scores differed significantly by sex, age group, and employment status (p<0.05). Conclusion Overall adherence to the hemodialysis treatment regimen was relatively good, with high compliance with attendance and full dialysis duration. However, adherence to fluid restriction and dietary recommendations remained poor. Furthermore, patients faced challenges such as difficulty monitoring fluid intake, inability to abstain from restricted foods, and forgetting to take medication. The total treatment adherence score differed significantly by gender, age group, and employment status.

Background: Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by abnormal proliferation of megakaryocytes in the bone marrow, resulting in persistent thrombocytosis in the peripheral blood and clinical manifestations including thrombotic and hemorrhagic complications. Approximately 90% of patients with ET harbor driver mutations in JAK2, CALR, or MPL, with JAK2V617F being the most frequently detected mutation. The JAK2V617F mutation induces constitutive activation of the JAK–STAT signaling pathway, leading to abnormal megakaryocytic proliferation and increased platelet production. Consequently, patients are predisposed to thrombotic complications; however, qualitative platelet dysfunction may also contribute to an increased risk of bleeding. Among large-vessel thrombotic complications, venous thromboembolism is relatively common, whereas pulmonary artery thromboembolism is an uncommon complication. Moreover, thrombotic risk is generally lower in patients with JAK2-negative ET. Case presentation: In this report, we present a rare case of essential thrombocythemia presenting with respiratory failure secondary to pulmonary artery thromboembolism. Conclusion This case demonstrates that essential thrombocythemia may initially manifest with life-threatening thrombotic complications, including pulmonary thromboembolism, even in the absence of the JAK2 V617F mutation. Accordingly, unexplained thrombocytosis warrants evaluation for an underlying myeloproliferative neoplasm, while early assessment of thrombotic risk is essential for guiding appropriate clinical management and reducing the risk of adverse outcomes.

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide, accounting for approximately 1.8 million deaths annually and representing 18% of all cancer deaths¹. According to the GLOBOCAN 2024 report, 2.4 million new cases were registered globally, ranking second after breast cancer². Non-small cell lung cancer (NSCLC) constitutes 85% of lung cancer cases, with adenocarcinoma being the most common subtype³. The objective of this study is to map the prevalence of HER2 activation and mutations in EGFR, EML4-ALK, ROS1, BRAF, and KRAS genes among lung cancer patients in Mongolia, and to evaluate their correlations with clinical and morphological parameters (age, sex, smoking status, stage, and morphology). Aim: To determine the distribution pattern of HER2 activation and EGFR, EML-ALK, ROS1, BRAF, KRAS gene mutations among patients with lung cancer in Mongolia, and to evaluate their associations with clinical and morphological characteristics. Materials and Methods: A retrospective study was conducted using archived materials from lung cancer patients at the Clinical Pathology, Molecular Genetics, and Pathology Laboratories of the National Cancer Center of Mongolia, covering the period from 2019 to June 2025. DNA Extraction from Tumor Tissue: Formalin-fixed paraffin-embedded (FFPE) tissue blocks from patients diagnosed with lung cancer, stored in the pathology department archives, were selected for the study. Sections of 5–10 μm thickness were cut, mounted on glass slides, stained with hematoxylin and eosin (H&E), and reviewed by a pathologist. Areas containing ≥20–30% tumor cells were identified and macro-dissected for analysis. Real-Time PCR Assay for Detection of EGFR/BRAF/KRAS/EML4-ALK/ROS1 Mutations: EGFR mutation detection was performed using the PANAMutyper™ EGFR Mutation Detection Kit (Panagene, Daejeon, South Korea) according to the manufacturer’s instructions. PCR reactions were carried out on a compatible instrument (Roche LightCycler 480, Germany) as recommended by the manufacturer. Statistical analysis was performed using Prisma-10 software. Results: A total of 282 lung cancer cases were included in the study. EGFR mutations were detected in 44% of cases and were absent in 56%. No significant age-related differences were observed (p=0.2636); however, EGFR mutations were significantly more frequent in females (36.6% vs. 19.6%, p=0.0019). No statistically significant differences were found across disease stage, T, N, or M classifications (p>0.05). No association was identified between smoking status and EGFR mutations (p=0.4178). Morphologically, EGFR mutations were significantly more prevalent in adenocarcinoma (54.83%) compared to squamous cell carcinoma (SCC) (31.8%; p=0.002). Of the 282 cases, adenocarcinoma accounted for 155 (54.9%) and SCC for 116 (41.1%). Overall, EGFR mutations were positive in 43.97% of cases, with a higher prevalence in adenocarcinoma (24.82%) than in SCC (13.1%). By exon: - Exon 18 mutations were detected in 6% of cases, predominantly in adenocarcinoma (6%, 4.25%). - Exon 19 mutations occurred in 8.15% and are associated with sensitivity to targeted therapy. - Exon 20 mutations were found in 3.19%, with the T790M resistance variant in 1.77%. - Exon 21 mutations were observed in 9.57%, more common in adenocarcinoma (9.57%) than in SCC (3.19%). Survival analysis stratified by stage at diagnosis showed significantly longer median survival in early-stage patients (18.6 months). Kaplan-Meier curve comparison, log-rank test, and hazard ratio calculations confirmed statistically significant differences (p < 0.05), indicating that disease stage is a key prognostic factor. Conclusion The study findings reveal a high prevalence of EGFR mutations among Mongolian patients with lung adenocarcinoma, underscoring the need for widespread implementation of targeted therapy (EGFR-TKIs). In contrast, mutation rates were lower in SCC and other morphological subtypes, highlighting the importance of investigating alternative molecular markers in these subgroups.

Background: Globally, gastric cancer accounts for 1,089,000 new cases and 769,000 deaths annually, ranking fifth in overall cancer incidence and third in cancer-related mortality. The aim to determine HER2 expression in patients with gastric cancer and to evaluate its correlation with clinical and immunological biomarkers, as well as the need for further laboratory diagnostics. Aim: To determine HER2 expression in patients with gastric cancer and to evaluate its association with clinical and immunological biomarkers, as well as the potential need for further laboratory diagnostics. Materials and Methods: A retrospective study was conducted using archived materials from patients with gastric cancer at the Clinical Pathology, Molecular Genetics, and Pathology Laboratories of the National Cancer Center of Mongolia, covering the period from 2019 to June 2025. HER2 protein expression in tumor tissue was assessed using immunohistochemistry (IHC), and chromogenic in situ hybridization (CISH-HER2) was employed to confirm gene amplification. Statistical analysis was performed using the Prisma-10 software. Results: In our study, among 210 cases of gastric cancer evaluated by IHC for HER2, 46 (21.9%) were HER2-positive and 164 (78.1%) were HER2-negative. When comparing patients with gastric cancer stratified into HER2 1+ (negative) and HER2 3+ (positive) groups, no statistically significant differences (p < 0.05) were observed in age, sex, tumor location (surgically resected tissue), morphology, or disease stage. However, a higher proportion of males was noted in the HER2 3+ group (80.9%), though this did not reach statistical significance (p = 0.0879). Significant associations were found with tumor markers. Elevated serum CA-72-4 (>5 ng/mL) was more frequent in the HER2 3+ group (58.8%; p = 0.0069). In contrast, elevated CA-19-9 (>35 U/mL) was more common in the HER2 1+ group (93.5%; p = 0.0117), and elevated CEA (>6.9 U/mL) was also predominant in the HER2 1+ group (90.6%; p = 0.002). These findings suggest that HER2 3+ status predominates in cases with elevated CA-72-4, which may influence diagnostic strategies and HER2-targeted therapies (e.g., trastuzumab). Conversely, elevated CA-19-9 and CEA were more associated with HER2 1+ status, indicating a need for further detailed investigation of these markers in relation to HER2 expression. In patients evaluated by CISH for HER2 expression, stratification into HER2-positive and HER2-negative groups revealed no statistically significant differences (p < 0.05) in age, sex, tumor location, morphology, stage, or serum tumor markers (CA-72-4, CA-19-9, CEA). This suggests that HER2 status (positive/negative) may be independent of these variables. Although HER2 positivity was higher in poorly differentiated tumors (48% vs. 30.6% negative; p=0.1414) and in stage IV disease (50% vs. 39.3% negative; p=0.2607), these differences were not statistically significant. Elevated serum markers (CA-72-4, CA-19-9, CEA) were observed but showed no significant correlation with HER2 status. Conclusion Determining the molecular profile of gastric cancer patients can significantly contribute to refining clinical diagnosis, developing treatment strategies, enhancing therapeutic outcomes, and improving patients’ quality of life.

Background: Meniere's disease is a condition caused by disturbances in the auditory and vestibular systems. It is characterized by symptoms such as dizziness, nausea, vomiting, and tinnitus. In the United States, the prevalence of Meniere's disease has been found to be 84 cases per 100,000 women and 56 cases per 100,000 men. Regionally, it is more common in less populated areas, and research has confirmed that the prevalence increases with higher household income. Aim: To evaluate the effectiveness of traditional medicine treatments and therapies for Meniere's disease. Results: The patient is a 43-year-old male, with symptoms of dizziness, vomiting, and tinnitus. Since 2023, he has sought care at the Central Hospital of Mongolian Medicine, where he received traditional medicine treatments including herbal therapy and other traditional therapies on three occasions. As a result, the frequency of dizziness has decreased and other clinical symptoms have improved. Conclusion Traditional medicine treatments have been shown to be effective in managing Meniere's disease by extending the interval between relapses, improving quality of life, and significantly reducing clinical symptoms.

Introduction: Antimicrobial Resistance (AMR) has emerged as a significant public health and economic issue worldwide, affecting both developed and developing countries. Our research has been motivated by the increasing prevalence of carbapenem-resistant P. aeruginosa, A.baumannii, and K. pneumonia in recent years. Goal: To determine antibiotic susceptibility of the pathogens isolated from wound infection and to detect its multidrug resistance. Material and Method: Samples were collected from patients with wound infections. Pathogens were identified by using the traditional culture methods and the API system with serotypes determined phenotypically. Antibiotic susceptibility was assessed using the disk diffusion method and the MIC to analyse antibiotic resistance. Results: In the study, among 11,221 recorded cases of wound infections in 2023, bacterial pathogens were detected and identified at the species level in 10,339 cases (92.1%).
For identification results showed that A. baummannii were detected from 138 cases (1.3%), 216 cases (2.08%) of Ps. aeruginosa, 5 cases (0.04%) of B. cepacia, 1,383 cases (13.4%) of Enterobacteriaceae, 205 cases (2.0%) of Enterococcus spp., 8,329 cases (80.5%) of Staphylococcus spp., and 63 cases (0.6%) of Streptococcus spp.
Antibiotic susceptibility of these bacteria was assessed and determined multidrug resistance. We found the followings: For A. baumannii were resistant with MDR in 68 cases (49.3%), MRSA in 4,243 cases (51.1%), MDRSta. aureus in 1,805 cases (29.4%), VRE in 34 cases (16.5%), ESBL in 4.6%, KPC in 26 cases (11.1%), FRNF in 24 cases (11.6%), and CRPA in 13 cases (6.3%). Conclusion
1. Of all wound infections reported in 2023 in 92.1% there were detected pathogenic bacteria, of which S.aureus were in 80.5% and E. coli was in 13.4%
2. 60.7% of the pathogenic bacteria detected in wound infections were multidrug-resistant, with MRSA accounting for 51.1% and MDR A.baumannii accounting for 49.3%, indicating high antimicrobial resistance(AMR).

Background: The shapes of the eye and upper eyelid are distinctive facial landmarks. The palpebral fissure is composed of the free edges of upper and lower eyelids the lateral and medial canthus. Many researchers confirmed that the morphometric characteristics of the palpebral fissure, canthal distance and exophthalmometirc value (EV) vary according to race, ethnicity, age and sex and normative values which may serve as a reference in the index population. Knowledge of normal dimensions, the existence of asymmetry of the palpebral fissure is of value in several clinical specialties including ophthalmology, plastic and reconstructive surgery and traumatology, where it plays a part in the patient evaluation, management and outcomes. Methods: This cross-sectional study was conducted in the Ophthalmological Department, Third State Central Hospital between January 2022 and August 2022. We included participants who are above 18 years, no history of congenital or traumatic craniofacial deformities, any orbital fractures, tumors and surgeries. All measured values that represent eyelid shape and EV were calculated by mean and standard deviation for statistical analysis. Results: A total of 103 participants aged 19-86 were included in the study, of which 44 (42.7%) were male and 59 (57.3%) were female. The distance between the lateral and medial canthus ranged from 20 to 35 mm, and the mean of the right and left side was 28.30+3.23 mm and 28.05+2.99 mm, respectively (p=0.561). The palpebral fissure height ranged from 5 to 13 mm, and the mean of the right and left side was 8.85+1.65 mm and 8.80+1.65 mm, respectively (p=0.816). The mean distance between the lateral canthi were 90.39+5.57 (range: 80-105 mm), whereas the mean distance between the medial canthi were 63.75+4.25 (range: 53-73 mm). The orbital height varied between 27-43 mm (33.73+3.72) and 26-44 mm (33.78+3.73) on the right and left sides, while the orbital width varied between 26-47 mm (36.75+4.53) and 27-45 mm (36.72+4.42) on the right and left sides, respectively. When measuring the exophthalmometric value (EV), the axial position of the eyeball, with the Hertel’s exophthalmometer, it ranged from 8 to 20 mm on both sides (mean value 13.68+3.01 and 13.71+3.00 on the right and left sides, respectively), and there was no statistically significant difference in symmetry (p=0.94). Conclusion The results are determined different from the findings of Chinese, Korean, Afro-American and Caucasian population based studies. Thus further evaluation is required to represent the normative value of Mongolian index population, that is highly beneficial for clinical assessment, diagnosis and management.

Background: Infectious keratitis is a disease caused by inflammation, infection, and other ocular damage to the outer and other deep layers of corneal epithelium. It is a major cause of monocular blindness and visual disability worldwide regardless of age and gender. Therefore, we aimed to determine the clinical features and risk factors of infectious keratitis among Mongolians and to identify the causative microorganism and compared them with the treatment results. Methods: We collected the data of 149 patients who diagnosed as infectious keratitis at the Ophthalmology Department of the First State Central Hospital in 2017-2020 and using a case series model of descriptive study. Statistical analysis was calculated using Stata14 software. Results: The majority of patients in our study were male, with a male-to-female ratio is 2.1:1. The cause of infectious keratitis were categorized and eye injury-induced keratitis accounted for the highest percentage of 38.3% (n=57), with the majority being men 73.7% (n=42) (p=0.028). As for the type of treatment, antibacterial drugs 103 (69.1%) and evisceration 27(45%) predominate. Conclusion Our study shows that the majority of infectious keratitis in Mongolia is due to trauma in male patients. Forty-five percent of all surgeries involve evisceration surgery, which reduces the client's quality of life.

Introduction: Over 800,000 people in the world contract HCC each year and approximately 700,000 die from the disease. HCC is the 6th most common cancer in the world. HCC is the 3rd leading cause of cancer deaths in the world. 2/3 of liver cancer deaths are caused by hepatitis. In the U.S, HCV infection is the more common cause of HCC, while in Asia and Africa, HBV is more common. Mongolia ranks first in the world in mortality from liver cancer, indicating the need for early detection and treatment of cirrhosis. Sysmex Corporation has introduced for HISCL series analyser, a new cirrhosis marker M2BPGi of non-invasive, blood-testing. In 2016, the test was introduced at Medipas Hospital in Orkhon province. It is possible to study the advantages and significance of the marker for use in clinical practice. Materials and methods: From a total of 385 patients who underwent M2BPGi marker testing in 2016-2017Medipas hospital laboratory, data from a total of 283 patients tested for hepatitis B and C virus and M2BRGi markers were selected. A comparison of age, sex, and test parameters of a total of HCVab and HBsAg positive 172 patients tested for Total bilirubin, GPT, GOT, GGT, AFP and M2BPGi. HCV Ab, HBsAg, AFP, M2BPGi markers were analyzed by SysmexHISCL-5000 fully automated immunological analyzer, Liver function tests were performed with a fully automatic biochemical analyzer JEOL Biomajesty BM6010/C. Results: Of the M2BPGi marker tested 283 patients 94 (33%) were infected with the C virus, 78 (28%) were with the B virus,11 (4%) were co-infected with B and C viruses, 100 (35%) no any viral infection. Of the 172 patients diagnosed with hepatitis B and C virus infection, 97 (56%) were male, 75 (44%) were female. In terms of age, 72% of the population is over 45 years old.
Of the 172 patients, 115 (67%) had M2BPGi marker abnormal or > 1.0 COI. Of the M2BPGi marker abnormal patients, 47 (41%) were infected with the B virus and 68 (59%) with the C virus. In terms of age, 27.7% of hepatitis B patients and 10.3% of hepatitis C patients were under 45 years of age, 72.3% of hepatitis B patients and 89.7% of hepatitis C virus patients were over 45 years of age.
Hepatitis B and C viruses are slightly more common in men than in women. The majority of patients infected with the hepatitis virus over the age of 45. The majority of patients with hepatitis virus have abnormal liver function. Increased M2BPGi markers in people under the age of 45 with hepatitis B virus infection are relatively higher for hepatitis B virus infection than for C virus infection. Conclusions The M2BPGi marker was abnormal in 67% of hepatitis virus infected patients. It has been observed that the probability of an increase in M2BPGi marker is slightly higher in hepatitis C virus infection than in hepatitis B virus infection.