1.Assessment of association between etiology of vitreous hemorrhage and postoperative visual outcome
Munkhsaikhan M ; ; Uranchimeg D ; Baasankhuu J
Mongolian Journal of Health Sciences 2026;91(1):194-198
Background:
The vitreous body is an inelastic, acellular, avascular, transparent matrix that fills the posterior cavity of the eye. The most common causes of spontaneous vitreous hemorrhage are proliferative diabetic retinopathy (32%), retinal tear (30%), branch retinal vein occlusion- BRVO (11%), and posterior vitreous detachment (8%).
Aim:
To analyze causes and visual outcomes of vitreous hemorrhage.
Materials and Methods:
A hospital-based retrospective study of 102 eyes of 102 consecutive patients with VH, which were managed surgically between January 2014 and January 2017, was performed. The main outcome measure was visual acuity at baseline, at 1, 14 and 28 days post operatively and at last follow up.
Result:
Proliferative diabetic retinopathy, branch retinal vein occlusion constituted the etilogoy of vitreous hemorrhage 62 (31%), 77 (38.50%), respectively. After vitrectomy, logMAR visual acuity significantly improved from 1.81±0.60 to 0.50±0.30 (p=0.032).
Conclusion
Branch retinal vein occlusion is a most common cause of vitreous haemorrhage. The poor presenting visual acuity reflects the severity of causes of vitreous haemorrhage in our environment. The visual prognosis of vitreous BRVO is relatively good.
2.Psychiatrists’ Knowledge, Attitudes, and Training Needs Regarding Assessment of HIV and Sexual Risk Behaviors
Uranchimeg M ; Bilguun N ; Nyamtsengel V ; Khishigsuren Z
Mongolian Journal of Health Sciences 2026;94(4):81-86
Background:
Sexual risk behavior is an important issue that requires early identification and assessment because it is associated with sexually transmitted infections, particularly HIV and syphilis, unintended pregnancy, and adverse reproductive, psychosocial, and mental health outcomes. Clients with sexual risk behaviors may also experience fear, anxiety, depression, shame, and stigma. Therefore, psychiatrists have an important role in identifying these risks, providing counseling, and referring clients for further care when needed. However, in routine clinical practice, obtaining a full sexual health history and identifying sexual risk behavior through interview may be limited.
Aim:
This study aimed to assess psychiatrists’ current practice in asking about sexual risk behavior, their basic knowledge of HIV/STIs, attitudes toward clients with sexual risk behavior, and training needs.
Materials and Methods:
A descriptive cross-sectional questionnaire survey was conducted between July and October 2025. The study included 158 psychiatrists working at the National Center for Mental Health, district and local health centers, and private clinics providing mental health services. Data were collected using a questionnaire developed by the research team. The survey included socio-demographic and professional characteristics, practice related to asking about sexual risk behavior, knowledge of HIV/STIs, attitudes toward clients with sexual risk behavior, and institutional training needs. Data were analyzed using Microsoft Excel and SPSS version 23. Descriptive statistics, chi-square tests, non-parametric tests, Spearman correlation, and linear regression models were applied.
Results:
Of the participants, 78.5% were female, and the mean age was 36.8±10.2 years. Psychiatrists asked a mean of 6.2±5.7 out of 22 questions required to identify sexual risk behavior, indicating that only a limited number of relevant questions were routinely covered in clinical practice. General questions such as marital status, age at first sexual intercourse, sexual health-related complaints, and history of sexually transmitted infections were asked more frequently, whereas questions on sex with commercial sex workers, casual and multiple sexual partners in the last 3 months, and sexual orientation were asked less often. Male psychiatrists (p=0.036) and psychiatrists working in private practice (p=0.034) asked significantly more questions. Among the 131 participants eligible for HIV/STI knowledge assessment, 29.8% had adequate knowledge and 70.2% had inadequate knowledge. Misconceptions about mosquito transmission of HIV remained common. The mean attitude score among 131 psychiatrists was 14.3±1.7. Significant differences were observed across age groups (p=0.004), and psychiatrists with 0–10 years of experience had higher attitude scores than those with more than 10 years of experience (p=0.026). A weak but statistically significant negative correlation was found between years of work as a psychiatrist and attitude score toward clients with sexual risk behavior (Spearman r=-0.304, p<0.001; n=131). In addition, 69.0% of participants had previously worked with clients with sexual risk behavior, and 48.1% had provided care to such clients in the last 12 months.
Conclusion
The practice of asking about sexual risk behavior among psychiatrists remains limited and non-standardized. Differences were observed according to physician sex and type of institution. Continuous workplace-based training and practical guidelines are needed to strengthen psychiatrists’ capacity to identify sexual risk behavior and provide appropriate care.
3.Treatment outcomes of patients diagnosed with mental disorders after discharge from hospitalization during the covid-19 pandemic
Enkhtuvshin R ; Mongoljin A ; Munkh E ; Uranchimeg M ; Yelik M ; Amirlan B ; Yerkyebulan A ; Munkh-Uchral D ; Maidar E ; Amarsaikhan A ; Enkhnaran T ; Оtgonbayar R ; Nasantsengel L ; Khishigsuren Z
Mongolian Medical Sciences 2025;213(3):3-14
Background:
The COVID-19 pandemic has triggered a global mental health crisis. According to WHO
estimates, anxiety and depression rose by 25% in the first year. In the post-COVID era, over
70% of patients experience depression, anxiety, insomnia, PTSD, and OCD, which can persist
for up to 24 months. Hospitalized individuals face heightened risks due to infection severity,
treatment stress, and social isolation. However, studies examining treatment outcomes and
influencing factors remain limited. In Mongolia, mental health issues escalated sharply from
2020 to 2022; WHO data indicate that anxiety and stress were prevalent among healthcare workers and patients. Children and youth were particularly affected, with UNICEF studies
emphasizing the urgent need for intervention. Suicide rates increased from 18.3 per 100,000.
Long-term research on post-COVID mental disorders is scarce, impeding policy formulation.
This study evaluates treatment outcomes in COVID patients and identifies key factors. By
comparing case and control groups at 3 and 12 months, it uncovers differences in symptoms
and treatment responses. The comparative design assesses statistical significance via
P-values and subgroup success rates for CBT and SSRI therapies. Findings will enhance
Mongolia’s mental health services. Larger-scale studies are essential moving forward.
Objective:
To evaluate treatment outcomes for post-COVID mental disorders and identify influencing
factors. To analyze differences in psychological symptoms and treatment between case
(COVID-19 positive) and control groups over 3 and 12 months.
Material and Method:
Retrospective comparative analysis of records from 281 patients (cases n=181, controls
n=100) at a unified hospital from 2020-2022. At 12 months, n=200 (cases n=100, controls
n=100). Patients were categorized by anxiety, depression, insomnia, and stress-related
symptoms, with P-values calculated. Detailed subgroup analysis (n=47 treated patients) was
conducted.
Results:
At 3 months, cases showed higher anxiety (56.4%, P=0.002), depression (41.4%, P<0.001),
and insomnia (58%, P=0.107). At 12 months, differences lessened but anxiety (52%, P=0.023)
and depression (35%, P=0.042) remained significant. COVID-related new symptoms were
elevated in cases (e.g., depression 24.3%, P<0.001). Treatment subgroup success was
95.7% (P<0.001), with duration influencing outcomes (P=0.03).
Conclusion
Post-COVID mental symptoms persist long-term in cases, and extended treatment
durations yield better results. Larger studies are required
4.Risk factors for common mental disorders in hospitalized patients during the covid-19 pandemic
Enkhtuvshin R ; Yerkyebulan M ; Munkh-Uchral D ; Enkhnaran T ; Mongoljin A ; Munkh E ; Uranchimeg M ; Maidar E ; Amarsaikhan A ; Amirlan B ; Otgonbayar R ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):32-38
Background:
The COVID-19 pandemic has profoundly impacted mental health, particularly exacerbating conditions
such as depression, anxiety, insomnia, post-traumatic stress disorder (PTSD), and emotional disorders among hospitalized
patients. This study examined the prevalence of COVID-19-related mental health issues and risk factors in hospitalized
patients affiliated with MNUMS, compared to a control group.
Aim:
To assess the prevalence of mental health disorders such as depression, anxiety, insomnia, and post-traumatic stress
disorder (PTSD), and to identify their associated risk factors.
Materials and Methods:
The study was conducted at hospitals under MNUMS, including the Mongolian-Japanese Hospital,
Central Hospital, and the National Center for Maternal and Child Health. A total of 552 participants (399 case
group, 153 control group) who were hospitalized were included. Depression (PHQ-9≥10), anxiety (GAD-7≥10), insomnia
(ISI≥15), and PTSD (PCL-5≥33) were assessed using standardized scales. Analysis was performed using chi-square tests
and binary logistic regression (crude odds ratio [cOR]/adjusted odds ratio [aOR], 95% confidence interval [CI]), adjusted
for group, age, and sex.
Results:
In the case group, depression (23.1% vs. 13.7%, p=0.015, cOR=1.884 [1.124-3.156]), anxiety (16.8% vs. 11.1%,
p=0.096), and any mental disorder (18.0% vs. 13.7%, p=0.225) were higher, while insomnia was lower (19.5% vs. 30.1%,
p=0.008). PTSD was low overall (1.8% vs. 0.7%, p=0.333). Risk factors included female sex (p<0.001, cOR=0.362 for
depression in males), younger age (p=0.004), unemployment (p=0.017), and prior trauma (p<0.001). COVID-19 symptoms
(difficulty breathing) increased the risk of depression (p<0.001, cOR=2.828 [1.708-4.682]).
Conclusion
Hospitalization for COVID-19 increases the risk of depression and anxiety, modulated by demographic,
clinical, and socioeconomic factors. Targeted interventions for vulnerable groups are essential.
5.Changes in mental health following COVID-19 infection: results of a prospective cohort study in mongolia
Enkhtuvshin R ; Mongoljin A ; Munkh.E ; Uranchimeg M ; Yerkyebulan A ; Munkh-Uchral D ; Enkhnaran T ; Nasantsengel L ; Khishigsuren Z
Mongolian Journal of Health Sciences 2025;90(6):39-44
Background:
COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the
WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first
case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus
affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways
(e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global
studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al.,
BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected
individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National
Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but
long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and
PTSD among COVID-19 patients over 12 months, compared to a control group.
Aim:
To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic
stress disorder (PTSD) among individuals who have had COVID-19
Materials and Methods:
In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited
from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021
and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12
months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases
were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and
multivariable logistic regression (p < 0.05).
Results:
Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12
months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p =
0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19
group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios
confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and
individuals aged 40–59 years were at elevated risk.
Conclusions
1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times
higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control
group.
2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected
after 12 months; this resolution is posited to be associated with the adaptive capacity of the population.
3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.
6.Central serous chorioretinopathy
Temuulen B ; Baasansuren G ; Byambadorj M ; Uranchimeg D
Mongolian Journal of Health Sciences 2025;85(1):257-262
Background:
Central serous chorioretinopathy (CSCR) is described by researchers as a condition that results from fluid
under the retinal pigment epithelium, originating from the choroid of the eye. This disease usually affects the central part
of vision and may resolve on its own over time, though in some cases, it can persist for long periods or recur. In our country, there is a lack of research regarding this condition, which led to the motivation for gathering and reviewing existing
works on this topic.
Aim:
To collect and analyze a review of the studies on central serous chorioretinopathy (CSCR).
Methods:
We reviewed and analyzed literature related to CSCR published in electronic sources such as Thomson Reuters, PubMed-central database, and Google Scholar using literature review methods.
Results:
CSCR is most commonly seen in individuals aged 35-55 years, with a significantly higher prevalence in men
(9.9/100,000) compared to women (1.7/100,000). Researchers found that the prevalence of CSCR is nearly the same
among populations in Europe, Africa, and Asia. CSCR typically affects one eye, but it occurs in both eyes in up to 40%
of cases. Weenink A (2001) studied the family members of 27 patients with bilateral CSCR, finding that 52% of family
members had been diagnosed with CSCR, and 27.5% of them had chronic CSCR in at least one eye. This suggests a
potential genetic predisposition to CSCR. According to researchers, while CSCR can be diagnosed clinically, additional
imaging techniques like fluorescein angiography and optical coherence tomography are frequently used to rule out other
diagnoses and guide treatment.
Conclusion
CSCR generally has a favorable prognosis, but recurrences and its effects on visual function indicate the
need for effective management strategies. To maintain long-term visual improvement, it is essential to provide healthcare
services tailored to the patient’s specific conditions and risk factors.
7.Quality Assurance of Gastrointestinal Endoscopy Unit - A Single Center Study
Sarantuya Ts ; Amarjargal B ; Tungalag B ; Khishgee D ; Amarmend T ; Delgertsog T ; Amarjargal E ; Sarantuya G ; Gan-Orshikh L ; Enkhjargal B ; Sarantsatsral D ; Burentungalag A ; Nandintsetseg B ; Tserendolgor Ts ; Sattgul Sh ; Javzanpagma E ; Suvdantsetseg B ; Khashchuluun O ; Ouynkhishig N ; Munkhtuya E ; Uranchimeg M ; Oyuntungalag L ; Myadagmaa B ; Bat-Erdene I ; Batgombo N ; Saranbaatar A
Mongolian Journal of Health Sciences 2025;86(2):165-170
Background:
Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety
and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement
system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional
and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators
specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services.
Aim:
To assess the quality indicators in gastrointestinal endoscopy unit.
Materials and Methods:
A retrospective single-center study was conducted by collecting data from the Intermed hospital’s
electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results
were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research
committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of
four quality indicators measured monthly; b) sample survey data from five categories of quality indicators.
Results :
Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning
score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased
during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was
5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation
quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma
detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes,
Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge
time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate
risk was 0.28% by the TROOPS evaluation during procedural sedation.
Conclusion
The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be
effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.
8.Neuroticism as a risk factor for anxiety, depression, and insomnia during the covid-19 pandemic
Enkhtuvshin R ; Mongoljin A ; Munkhzul E ; Uranchimeg M ; Oyundari G ; Yerkibulan A ; Khishigsuren Z
Diagnosis 2025;115(4):36-42
Background:
The COVID-19 pandemic has profoundly impacted global mental health, exacerbating anxiety, depression, and insomnia, with prevalence rates of 25–30%, 27–32%, and 30–45%, respectively—2–3 times higher than pre-pandemic levels. Neuroticism, a key personality trait from the Big Five model, characterized by heightened negative emotions and stress reactivity, has been linked to increased vulnerability. Meta-analyses show neuroticism triples anxiety risk (OR=3.21; 95% CI: 2.35–4.39) and correlates strongly with insomnia (r=0.46, p<0.001) and depression during the pandemic. In Mongolia, empirical data on neuroticism's role remains limited.
Objective:
This study examines whether neuroticism acts as a risk factor for anxiety, depression, and insomnia among hospitalized patients during COVID-19.
Methods:
A cross-sectional descriptive study enrolled 552 patients (72.3% COVID-19 cases, 27.7% controls) from tertiary hospitals in Mongolia (2024). Participants (mean age 52.8±15.5 years; 60.5% female) completed self-reported questionnaires: Eysenck Personality Inventory (EPI) for neuroticism, PHQ-9 for depression, GAD 7 for anxiety, ISI for insomnia, and PCL 5 for PTSD. Sociodemographics were assessed. Data were analyzed using SPSS 26.0 with chi-square tests (p<0.05 significance). Instruments showed high reliability (Cronbach’s α=0.81–0.89). Ethical approval was obtained from MNUMS Ethics Committee (No. 2024-Psy-17).
Results:
Overall, 79.5% were depression free, 84.8% anxiety-free, and 77.5% insomnia-free. High neuroticism (n=381) was significantly associated with depression (24.4% vs. 11.7%, p<0.001), anxiety (18.6% vs. 7.6%, p<0.001), insomnia (28.3% vs. 9.4%, p<0.001), and any mental disorder (21.3% vs. 7%, p<0.001), but not PTSD (p=0.472). Cholerics (n=200) showed elevated risks (depression 29.5%, insomnia 34.5%, p<0.001), while sanguines/phlegmatics were protective. Verbal expression and trust levels showed no significant associations.
Conclusion
Neuroticism significantly heightens risks for anxiety, depression, and insomnia during COVID-19, underscoring the need for targeted psychological interventions. Temperament-informed screening could enhance prevention strategies in crisis settings.
9.Assessment of the biofilm-forming ability of Staphylococcus aureus
Amgalanzaya D ; Batzaya B ; Uranchimeg R ; Badmaarag M ; Sarantuya J ; Munkhdelger Ya
Diagnosis 2025;115(4):43-50
Staphylococcus aureus (S. aureus) is a clinically significant pathogen widely distributed in food production environments. Its ability to form biofilms on food contact surfaces enhances 50 environmental persistence, increases antibiotic resistance 10–1500-fold, and poses serious challenges for food safety and public health. In Mongolia, data on the biofilm-forming ability of S. aureus in meat processing and retail environments are limited. A cross-sectional study was conducted on 437 samples collected from meat supply and retail sites, including raw meat, aprons, counters, trolleys, and workers’ hands. Isolation and confirmation of S. aureus were performed using MNS 6308:2012 and ISO 6888-1:2021 standards, followed by PCR amplification of the species-specific nucA gene (270 bp). Biofilm formation was evaluated using the microtiter plate assay with 0.5% glucose supplemented tryptic soy broth and optical density at 490 nm, and confirmed by scanning electron microscopy (SEM). Statistical analyses were performed using chi-square tests with p< 0.05 considered significant. Of the 437 samples, 14.2% (62/437) were contaminated with S. aureus. Contamination was higher in retail markets (25.9%) than supply sites (9.3%). Among isolates, 40.3% exhibited biofilm-forming ability: 29.0% weak, 9.7% moderate, and 1.6% strong. Biofilm formation did not significantly differ by sampling site or sample type (p>0.05). SEM imaging revealed distinct biofilm architectures with polysaccharide matrices at 80,000× magnification. A considerable proportion of S. aureus isolates from meat processing and retail environments exhibited biofilm forming ability, posing a potential risk for cross-contamination and persistent foodborne transmission. Strengthened hygiene and sanitation measures are essential to control biofilm-associated S. aureus contamination in Mongolia’s meat production and supply chain.
10.Clinical features of ophthalmology in thyroid disease
Oyungerel B ; Erdenezul G ; Misheel B ; Uranchimeg D ; Chimedlkhamsuren G ; Nomin-Erdene M ; Sarantuya J
Innovation 2021;14(2-Ophthalmology):6-10
Background:
TED (thyroid eye disease) is an inflammatory disease of the orbit caused by
autoimmune diseases of the thyroid, which adversely affect the vision, appearance, and quality
of life. Exophthalmos and eyelid retraction are the main features of TED, which can lead to ocular
motility, diplopia, optic neuropathy, and permanent vision loss. The study aims to determine the
most common clinical signs of TED in Mongolians and define whether there is a correlation with
the levels of thyroid autoantibodies.
Methods:
The study involved 102 patients with TED and 81 patients with Graves’ ophthalmopathy.
The clinical features of TED were identified and evaluated by activity score (CAS) and severity of
GO using the European Group of Graves’ Orbitopathy (EUGOGO).
Results:
The mean age of TED patients was 42.6±11.2, which was younger than GD patients
(P=0.012). The current smoker was 24 patients (23.5%) with TED, which is relatively higher than GD
(P=0.0001). The most common ocular signs were eyelid retraction 80 (78.4%), proptosis 77 (75.5%),
diplopia 14 (13.7%) and 4% vision loss. There were no differences in proptosis between the right (18
mm, median) and left eye (17.8 mm, median) (P>0.05). The mean CAS score was 3.09±1.72 and
varied depending on gender and smoking. According to EUGOGO, 62.7% of the patients were
moderately severe. Only 7 % of the patients were in the sight-threatening stage, presenting optic
neuropathy and corneal breakdown. The mean TSI level in patients with TED was 37.95 ± 35.41 IU
/ ml, which was 2.7 times higher than the mean in patients with GD.
Conclusions
Eyelid retraction and exophthalmos are the most common clinical signs of TED.
Early diagnosis of these features can prevent complications of the disease. Determining serum TSI
levels will help in the treatment and monitoring of TED.
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