Background: Insomnia is one of the most prevalent neurological disorders in the United States, affecting up to half of primary care patients and often necessitating psycho-behavioral interventions. Acupuncture, a key component of traditional Chinese and Mongolian medicine, has been increasingly studied as a treatment for insomnia in recent years. Aim: Evaluating the effectiveness of acupuncture for insomnia Materials and Methods: The study was conducted using a randomized controlled clinical trial design. 148 participants, aged 18-65 years, with a diagnosis of Nonorganic Insomnia (F51.0) according to the ICD-10, and Pittsburgh Sleep Quality Index (PSQI) >7, were divided into the transverse acupuncture, conventional acupuncture, and the control group. The results were analyzed using a Cardiopulmonary Coupling - CPC machine before and after treatment in the 3 groups to assess 1. Total sleep (hours), 2. Deep sleep (hours), 3. Light sleep (hours), 4. REM (hours), 5. Wake time (minutes), 6. Time to first fall asleep (minutes), 7. Sleep rate (%), 8. Number of apneas, and sleep quality was assessed using the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. The research approval was reviewed and granted by the Research Ethics Review Committee of the Mongolian National University of Medical Sciences on January 19, 2024 (Approval No. 24/19/01). Results: The mean age of participants was 51.5±10.8 years, with 79.7% (n=118) being female and 20.3% (n=30) male. In the transverse acupuncture group, post-treatment results demonstrated a 53.8% increase in total sleep time, a 102.8% increase in deep sleep time, a 19.8% increase in light sleep time, a 36.1% increase in REM sleep time, and a 22.1% improvement in sleep normalization rate. The mean differences between pre- and post-treatment scores were statistically significant based on a one-sample t-test. In contrast, no statistically significant improvements were observed in the control group, except for sleep quality. Conclusion Both transverse acupuncture and conventional acupuncture significantly improved sleep quality indicators following treatment.

Background Varicose veins, or chronic venous insufficiency, become visibly noticeable from the second stage when veins start appearing on the surface of the skin. Symptoms include severe itching, pain, swelling, and inflammation. Chronic venous insufficiency is a common condition in countries such as China, South Korea, Japan, Mongolia, and Kazakhstan. Diagnosis of varicose veins relies on blood flow studies, coagulation tests, contrast-enhanced magnetic resonance imaging (MRI), and Doppler ultrasound of the venous system. Patient B, a 43-year-old male, has experienced pain and swelling in the right lower limb vein for the past two years, especially when exposed to heat. Coagulation tests show PT and PT INR within normal range. Doppler ultrasound of the venous system revealed that the perforating vein is dilated to 0.45 cm and has valve insufficiency. In the deep veins, a width of 0.68 cm was measured, while superficial veins ranged between 0.46–0.59 cm. After receiving appropriate treatment from the Department of Fire Acupuncture, the patient’s symptoms have improved.

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.

Background: The first case of COVID-19 was reported in our country on November 11, 2020. As of 2023, a total of 869,385 cases and 2,128 deaths have been recorded nationwide. The World Health Organization (WHO) has recommended that countries use 15 vaccines from 11 manufacturers listed for emergency use. The WHO has advised low-income member states to prioritize vaccinating healthcare workers and other high-risk populations vulnerable to severe illness and death from COVID-19. The main goal of the coronavirus vaccination program is to prevent infection, complications, and death among priority target groups, such as healthcare workers and other populations at high risk of severe illness. The effectiveness of the vaccination is measured by its ability to reduce the risk of illness, hospitalization, and death from COVID-19-related complications among vaccinated individuals. While extensive research is being conducted globally to develop, evaluate, and assess the effectiveness and outcomes of COVID-19 vaccines, there has been limited research focused on these outcomes within our country. This gap highlights the need for and serves as the basis of the present study. Аim: To assess the risk of infection, hospitalization, and associated risk factors among healthcare workers vaccinated against COVID-19, and to examine the factors that influence these risks. Materials and Methods: A This follow-up study was conducted over an 80-week period—at weeks 12, 24, and 48—from February 23, 2021, to December 31, 2022. The study involved healthcare workers from Ulaanbaatar city and the aimags of Bayankhongor, Orkhon, Bulgan, Dundgovi, Darkhan-Uul, and Dornod. The study was conducted over a period of 1.5 years (80 weeks) following the administration of the first two doses of the COVID-19 vaccine. Data were collected from participants at three time points: before vaccination, after the second dose, and after each booster dose. A structured questionnaire comprising 7 sections and 49 questions was used for data collection, and the results were analyzed using SPSS version 26.0. Results: Of the total respondents, 574 (60%) worked in direct contact with infected individuals in the 'red zone,' while 370 (40%) worked in the 'yellow zone.' Additionally, 250 participants (27.1%) were healthcare workers from Ulaanbaatar city, and 674 (72.9%) were from rural areas. In our observational study, the risk of new infections among healthcare workers increased over time, rising from 38.4% at week 24 to 59.6% by week 80. Hospitalizations also increased during the follow-up period: 24 cases (2.6%) were recorded at week 12, 160 (17.3%) at week 24, 202 (21.9%) at week 48, and 204 (22.1%) by week 80. Among frontline workers in rural areas, those in Bayankhongor and Orkhon aimags exhibited a lower risk of infection compared to their counterparts in other aimags. Conclusion In our follow up study, an increase in the duration since primary immunization was associated with a higher risk of new infection among workers, rising from 38.4% at 24 weeks to 59.6% at 80 weeks post-vaccination. Administration of additional (booster) immunizations was associated with a reduced risk of subsequent infection. COVID-19 vaccination was associated with a reduced risk of complications necessitating hospitalization. Employment in rural settings and designated red zones was identified as a risk factor for incident infections, hospitalizations, and reinfections.

Background: Numerous studies have shown that with the advancement of technology such as computers and cell phones, neck and back pain, and carpal tunnel syndrome have become common in daily life. Aim: Estimating the effectiveness of acupoint catgut embedding treatment for chronic neck pain. Materials and Methods: The study used a randomized clinical trial, double-blind, placebo-controlled design with treatment (n=40) and control (n=40) groups. The study included 80 patients with chronic neck pain, and the results were evaluated in the two groups before and after treatment using the “Visual Analogue Scale (VAS), “Neck Disability Index”, and “Quality of Life Questionnaire” (EQ-5D). Results: Acupoint catgut embedding and acupuncture treatment for chronic neck pain increased the neck’s range of motion by 2-5 degrees. Standard acupuncture treatment and acupoint catgut embedding treatment reduce neck pain and improve the neck disability index. Acupoint catgut embedding treatment improves the quality of life of patients with chronic neck pain, especially reducing anxiety and fear scores with statistical significance. Conclusion 1. Standard acupuncture and acupoint catgut embedding treatment are equally effective in relieving chronic neck pain. 2. Acupoint catgut embedding treatment increased the range of motion in the same way as standard acupuncture. 3. Acupoint catgut embedding treatment also reduced the patient’s Neck Disability Index and improved Quality of life.

Background: Globally, an estimated 13% of adolescents aged 10–19 are affected by mental disorders. As of 2020, the number of children under the age of 19 in Mongolia was reported to be 1,289,587, reflecting a 0.9% increase compared to 2015. A 2013 study on adolescents found that 60.5% were categorized as mentally healthy, 30.5% exhibited emotional and behavioral difficulties, and 9% were diagnosed with a mental disorder. A study conducted in Govi-Altai Province between 2018 and 2019 reported that 58.6% of adolescents were classified as healthy, 36.1% experienced psychological difficulties, and 5.2% were diagnosed with a mental disorder. Internationally, adolescent mental health has been widely assessed using the Strengths and Difficulties Questionnaire (SDQ), with an increasing number of studies employing artificial intelligence-based predictive models. However, in Mongolia, research utilizing artificial intelligence and machine learning for analyzing large-scale mental health data remains limited. This gap underscores the need for the present study. Aim: Machine learning models were compared to determine adolescent emotional and behavioral problems using the SDQ. Materials and Methods: Data was collected from teenagers, teachers, and parents in Govi-Altai Province, and the databases were created for each group. The teenager database was divided into 10 folds by cross-validation, and the models were developed using machine learning methods and evaluated using their performance measures. The results were mainly analyzed using the Bayes model. Results: The teenagers have emotional and behavioral problems due to emotional and peer interactions, but they are at risk of developing disorders due to hyperactivity and behavioral changes. Conclusion Comparing the model performance results with previous studies, Bayesian model accuracy decreased by 0.03, sensitivity decreased by 0.08, and specificity increased by 0.01. Also, the difference between the performance evaluation metrics of the C50 and Bayesian models is very small, between 0.01 and 0.02. This shows that the performance of the Bayesian method is good when the number of attributes in the database increases. Compared to the results of the knowledge generated by the research, the participants are more likely to develop emotional and behavioral disorders due to their peer relationship indicators, such as other children generally not liking them, getting on better with adults, and due to emotional symptoms such as being unhappy and depressed.

Background: Penile Cancer is a rare and aggressive disease. Related to complex metabolic processes. Objective: This study investigates the effectiveness ­of 18F-FDG PET/CT as a noninvasive method in evaluating penile cancer patients, focusing on the correlation between tissue expression of key tumor markers involved in glucose metabolism and proliferation, and the uptake of 18F-FDG. Methods: Fifty-one patients were selected and underwent 18F-FDG PET/CT-based staging. Semiquantitative analysis wasperformed using the maximum standardized uptake value ­(SUVmax ) and volumetric SUV ­(SUV2SD ). Tissue expressionanalysis of GLUT-1, hexokinase-II, Ki67, p16, and p53 was performed by tissue microarray. PCR evaluated HPV DNA. Results: Warty SCC showed the highest SUV value and significant differences in ­SUVmax (p=0.015). Higher ­SUVmax and SUV2SD values were observed in grade 3 tumors. In typical invasive SCC, grade 3, HPV+, p16-negative, p53-negative,GLUT-1 i-3, and HK-II i-3 tumors showed a higher mean SUV. The Ki-67 value significantly differed for grade 3 tumors (p=0.001) and HK-II i-1 tumors (p=0.036). Ki-67 positivity was also higher in HPV-, p16 i-2, p53 i-3, and GLUT-1 i-3 tumors; none of the differences were statistically significant. Conclusions The study highlights correlations between the uptake of 18F-FDG and the expression of markers associated with glycolytic metabolism in penile cancer. It suggests a potential trend where increased expression of glucose transport markers is linked to higher histological grades and Ki-67 expression. There were no significant differences regarding HPV positivity, demonstrating the complexity of penile cancer molecular biology and need more studies with a higher number of patients.

Objectives: Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults. Methods: This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction. Results: During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96. Conclusions Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.

Functional dyspepsia (FD) is a chronic gastrointestinal disorder without a readily identifiable organic cause, resulting in bothersome upper abdominal symptoms. It is a highly prevalent disorder of which the pathophysiology remains mostly elusive, despite intensive research efforts. However, recent studies have found alterations in the microenvironment of the duodenum in patients with FD. In this review we summarize the duodenal microenvironment in homeostatic conditions and the alterations found in patients with FD, highlighting the similarities and discrepancies between different studies. The most consistent findings, being an impaired duodenal barrier and duodenal immune activation, are reviewed. We discuss the potential triggers for these observed alterations, including psychological comorbidities, luminal alterations and food related triggers. In summary, this review presents the evidence of molecular and cellular changes in patients with FD, with an impaired duodenal barrier and activated mucosal eosinophils and mast cells, challenging the notion that FD is purely functional, and offering different targets for potential future treatments.