Background: The most common clinical manifestation of HCV infection, which includes both hepatic and extrahepatic manifestations, is mixed cryoglobulinemia, which is characterized by the precipitation of certain proteins in the blood at temperatures below 37°C (in vitro), aggregation, and deposition in the walls of small and medium-sized vessels, causing vasculitis, which is clinically manifested by a triad of joint pain, fatigue, and rash on the soles of the feet. Cryoglobulinemia is commonly diagnosed in people with HCV infection, with a prevalence ranging from 10% to 70%. Vasculitis that occurs when cryoglobulinemia is detected mainly affects the small vessels of the skin, kidneys, and peripheral nerves, causing complications in other organ systems. Aim : To determine the prevalence of cryoglobulinemia in people with HCV infection, study it in relation to the stage of liver fibrosis, and determine its clinical relevance. Materials and Methods : 200 chronic HCV infected individuals were included in the study according to the inclusion and exclusion criteria. After obtaining informed consent from each participant, a questionnaire was used to collect information, perform physical measurements, and collect peripheral blood samples. Complete blood count and biochemical tests (liver and kidney function) were performed. The degree of liver fibrosis was assessed non-invasively (APRI, FIB4). The glomerular filtration rate was calculated electronically using the MDRD GFR Equation. Skin examination was performed to assess the presence of rash, ulcers, and scarring on the shins and ankles of cryoglobulinemia. To determine cryoglobulinemia, 8 ml of blood was collected in a tube without anticoagulant, and the sample was kept motionless for 1 hour at room temperature until clotting was complete. After centrifugation, the samples were separated and stored in a refrigerator at +4°C for 7 days, and then at room temperature for 30 minutes, the precipitate was detected. Results : A total of 200 people participated in the study, of which 71 were men (35.5%), the average age was 53.39±13.0. Cryoglobulinemia protein precipitates were determined in a total of 148 people, of which 50 were men (33.8%), the average age was 52.95±13.0. Cryoglobulinemia protein precipitates were detected in 89 people, or 60.1% of the study participants. Of the total study participants, 176 (88.0%) had chronic hepatitis C (CHC). Of these, 57 people had CHC with cryoglobulinemia. Comparing laboratory parameters, the mean GGT level in the cryoglobulinemia group was statistically significantly higher than in the non-cryoglobulinemia group (p=0.039). However, when laboratory parameters were grouped by increasing or decreasing, AST and ALT levels were significantly higher in the cryoglobulinemia group, indicating more hepatocellular damage (p<0.000). Increased creatinine levels may be associated with the risk of renal dysfunction. The FIB-4 index and APRI index showed a more severe degree of fibrosis in the cryoglobulinemia group (p<0.005; p<0.000). Univariate logistic regression analysis showed that age was associated with the occurrence of cryoglobulinemia (OR=2.48; 95% CI:1.31–4.70; p=0.005). Platelet count had a statistically significant positive effect in multivariate analysis (OR=14.38; 95% CI:1.26–163.89; p=0.032). Conclusion The prevalence of cryoglobulinemia among HCV-infected patients was 60.1%, and older age and decreased platelet count among infected individuals were associated with the occurrence of cryoglobulinemia.

Background: The development of accurate and non-invasive diagnostic tools is essential for improving early detection of cancers. Recent studies have shown that serum biomarkers may be useful for early detection of gastric cancer. Aim: We aimed to evaluate the diagnostic accuracy of PGI and PGR biomarkers for detection of the gastric cancer and atrophic gastritis. Materials and Methods: To identify relevant studies, the MEDLINE (PubMed) database was searched using the keywords (((“Gastritis, Atrophic”[Mesh]) OR “Stomach Neoplasms”[Mesh]) AND “Pepsinogen A”[Mesh]) AND “Sensitivity and Specificity”[Mesh]). Based on the inclusion and exclusion criterias, studies were selected according to the PRISMA guidelines. Meta-analysis was performed using Review Manager 5.4.1 and STATA/IC 15.0 (StataCorp LLC, USA, 2017). Results: According to the PRISMA guidelines, we selected a total of 18 studies in this meta-analysis. The meta-analysis results showed that the sensitivity of the PGI for the detection of atrophic gastritis was 58.5% (95% CI, 44.5-71.3), specificity was 90.2% (95% CI, 68.4-97.5), and DOR was 13.0 (95% CI, 2.6-64.6); the sensitivity of the PGR was 69.9% (95% CI, 58.1-79.5), specificity was 80.9% (95% CI, 52.4-94.2), and DOR was 9.8 (95% CI, 2.6-36.9). However, the sensitivity of the PGI biomarkers for detecting gastric cancer was 72.6% (95% CI, 54.7-85.3), specificity was 66.9% (95% CI, 52.5-78.7), DOR was 5.4 (95% CI, 3.1-9.3); PGR sensitivity was 77.8% (95% CI, 64.4-87.4), specificity was 65.0% (95% CI, 53.2-75.1), DOR was 6.6 (95% CI, 3.7-11.7); PGI+PGR sensitivity was 62.3% (95% CI, 51.1-72.2), specificity was 87.6% (95% CI, 78.0-93.3), DOR was 11.6 (95% CI, 6.8-19.8). Conclusion PGI and PGR tests demonstrated high specificity but moderate sensitivity. Although serum pepsinogen cannot replace endoscopy, it is considered to be an additional test and can be used to select high-risk populations.

Background: In 2022, the World Health Organization (WHO) reported that globally, 2.5 billion (43%) of adults aged 18 and older were overweight, with 890 million (16%) of these individuals classified as living with obesity. Some genes such as the FTO gene are strongly associated with obesity and overweigh. The FTO protein is crucial in regulating food consumption, appetite, energy equilibrium, and expenditure. Aim: The identify single nucleotide polymorphisms rs9939609 and rs17817449 of the FTO gene, which are associated with obesity, and to study their correlation with antropometric measurements and some laboratory test parameters. Materials and Methods: According to the inclusion and exclusion criteria, 50 obese (BMI >30 kg/m²) were included in the case group, and 50 relatively healthy and normal weight (BMI 18.5-24.9 kg/m²) were enrolled in the control group, for a total of 100 people matched for age and gender (1:1). We took physical measurements and collected peripheral blood samples after obtaining informed consent from each participant. Laboratory analyses assessed some parameters of lipid and glucose metabolism. We used the PCR-RFLP technique on two genotype SNPs. A p-value below 0.05 was considered a statistically significant result. Results: In this study, including 100 people aged 23 to 75, the mean age was 46.81±11.54 years, with 60% being female. In terms of antropometric measurements, body mass index, waist circumference, and arterial pressure were markedly elevated in the case group compared to the control group (p<0.001). In laboratory measures, fasting blood glucose, cholesterol, and mean LDL mean levels were statistically significantly higher in the case group compared to the control group. On the other hand, HDL cholesterol levels were lower in the case group compared to the control group. The FTO gene rs9939609 single nucleotide polymorphism was identified in 62% of the total study individuals as TT, 35% as AT, and 3% as AA genotypes. Also, FTO gene rs17817449 single nucleotide polymorphism was identified in 62% of the total study individuals as TT, 33% as AT, and 5% as AA genotypes. Conclusion The rs9939609 AT/AA genotype of the FTO gene elevates the risk of obesity and is associated with increased body weight, waist circumference, and BMI.

Background: The craniofacial region is one of the most frequently injured parts of the human body, with mandibular fractures being the most common type of facial skeletal injury. The leading causes of mandibular fractures include traffic accidents, falls, interpersonal violence, and sports-related injuries. In Mongolia, mandibular fractures are prevalent, with a higher incidence among males. However, to date, no national-level analysis of mandibular fractures has been conducted. This study aims to comprehensively examine mandibular fractures in Mongolia by identifying demographic factors and causes of injury. Aim: To determine the incidence and causes of mandibular fractures recorded in Mongolia over the past ten years. Materials and Methods: This study collected data on mandibular fractures recorded in the Health Development Center of Mongolia between 2014 and 2023. Cases were identified using the International Classification of Diseases (ICD-10) code S02.6. Information on patient age, gender, and hospital diagnosis was collected, along with the cause of injury, classified according to ICD-10 codes. Patient age was categorized based on the classification system of the National Statistics Office. Statistical analysis was performed using SPSS 26.00 software, employing the chi-square test for data analysis. Results: During the study period, a total of 2,872 patients were diagnosed with mandibular fractures, with the highest incidence occurring in the 20-40 age group. The average patient age was 31.1±12 years. Males were 5.6 times more likely to sustain mandibular fractures compared to females. The primary causes of injury were interpersonal violence (42%), mechanical trauma (17%), falls (16%), and traffic accidents (15%). Conclusion Between 2014 and 2023, 2,872 cases of mandibular fractures were recorded in Mongolia, with the majority occurring in individuals aged 20-40 years. The leading causes of mandibular fractures were interpersonal violence, mechanical trauma, falls, and traffic accidents. Specialized trauma care services were accessed differently in urban and rural areas.

Introduction: While 10 percent of global total population was above the age of 65 in 2022, it tends to rise to 16 percent in 2050. In the case of our country, as of 2021, individuals aged 60 and above comprised 7.7% of the total population, with tendency of an increase to 11.9% by 2030 and 21.1% by 2050. In 2018, a study conducted in Brazil, involving 573 elderly participants, found that 10.3% regularly taking five or more medications. This highlights the necessity of studying polypharmacy among the elderly. Goal: To identify inappropriate medication use among the elderly Materials and Methods: The study was conducted by analytic cross sectional design. Furthermore, the study was conducted during July 1, 2024, to October 1, 2024, in Ulaanbaatar, covering 6 districts. A total of 12 Family Health Centers (FHCs) were selected, including one from an apartment district and one from a ger district in each area. A random sampling method was used to select 238 elderly individuals aged 55 and above for females and 60 and above for males. From each district, 20 participants were selected, maintaining a gender ratio of 1:1. Statistical analysis was performed using Pearson’s Chisquare test and multiple logistic regression analysis. The study was conducted after obtaining approval from the research ethics committee of “Ach” Medical University. Results: Among the 238 participants in the study, the gender distribution was equal, with 119 females (50%) and 119 males (50%). When analyzing the primary conditions requiring for regular medication by organ system, cardiovascular diseases were the most common, accounting for 89.9% (214) of total cases.
Among the elderly patients included in the study, 68% were found to have inappropriate medication use. Elderly females, aged 85 years and older (n=6, 100%) demonstrated a statistically significant higher prevalence of inappropriate medication use compared to other age groups (p =.023). Among those with inappropriate medication use, 54.9% were females and 45.1% were males, a difference that was also statistically significant (p = .026). Inappropriate medication use was significantly associated with the type of medication used for the primary disease (p = .001), dosage (p = .000), duration of use (p = .000), frequency of daily intake (p =.003), use of medications due to comorbidities (p =.000), and whether the medication was prescribed by a physician (p = .001).According to multivariate logistic regression analysis, age (OR 2.31, 95% CI 1.25–4.29, p = .008), gender (OR 0.574, 95% CI 0.356–0.924, p = .022), education level (OR 2.03, 95% CI 1.21–3.58, p = .008), and pension status (OR 1.03, 95% CI 0.586–1.83, p = .904) were found to be influencing factors for inappropriate medication use. Conclutions 1. Inappropriate medication use among the elderly accounts for 68%.

Introduction: Hepatitis C virus (HCV) infection has both hepatic and extrahepatic manifestations, and it is one of the leading cause of liver transplantation. There’s limited research on extrahepatic symptoms of chronic HCV in Mongolia, thus we aimed to investigate the relationship between cryoglobulinemia and it’s related factors. Methods: The study included 200 participants with active HCV, collecting blood samples for various tests (biochemical analysis, kidney function, and cryoglobulinemia detection). The degree of liver fibrosis was assessed using APRI and FIB4 scores, and the study evaluated other health conditions through a questionnaire. Statistical analysis was performed using SPSS-26. Results: Out of 200 participants, 148 checked for cryoglobulin precipitation and 89 (60.1%) were positive. There was a statistically significant age difference between those with and without cryoglobulinemia (54.62 vs. 50.44 years). A higher percentage of participants with cryoglobulinemia had significant liver fibrosis (10.8% vs. 4.7% without). Liver fibrosis scores tended to increase with age, especially in men. Conclusion Liver fibrosis scores above 3.25 are associated with older age, lower platelet counts, elevated AST and ALT levels, and the presence of cryoglobulinemia. FIB4 scores were higher in men with active HCV and cryoglobulinemia.

Introduction: The worldwide prevalence of obesity and its metabolic complications have increased substantially in recent decades. According to the World Health Organization (WHO) indicate that in 2016, over 1.9 billion adults were overweight and, of these, over 650 million were obese. Obesity is a major risk factor for heart disease, type 2 diabetes, steatotic liver, chronic liver disease, stroke, and some cancers. The global prevalence of obesity and its associated comorbidities continue to increase on a pandemic scale. Aim: To determine metabolic changes in overweight and obese adults and their related diseases based on some parameters of anthropometric and laboratory tests. Materials and Methods: This study was conducted with a case-control design in 2023–2024. There were 150 participants in the study, 50 in the control group with normal weight, 50 in the overweight (BMI<29.9kg/m2) case group, and 50 in the obesity (BMI>30kg/m²) case group. Subjects of three groups were matched by age (±1) and sex. We estimated anthropometric parameters and biochemical laboratory analysis including glucose, lipid, ferrum, and liver parameters. CBC All statistical analysis was performed using SPSS 23 software. Categorical variables were described by numbers and percentages, and the numerical variables were characterized by the median (min and max) for the normal distribution, and mean± standard deviation for the non-normal distribution. The statistical tests utilized were the Chi-square, Fisher’s exact, student t-test, and Mann–Whitney tests. Ethical approval for the survey was obtained from the Medical Ethics Committee under the Ministry of Health Of Mongolia in January 2023. Results: The participants' average age was 46.73±11.45, with 60% being women (90) and 40% being men (60). The prevalence of central obesity and fat % were 52.3% and 37.2%, respectively. Between study groups, there were significant differences in fat% (p=0.004), central obesity (p<0.001), FBG (p=0.024), cholesterin (p=0.017), LDL (p=0.018), HDL (p=0.003), ferrum (p=0.010), АЛАТ (p=0.020), and GGT (p<0.001). Conclusion In overweight and obesity groups, the body fat, fasting blood glucose, cholesterol, LDL, and ALT levels are increased. These changes often lead to conditions like type 2 diabetes, arterial hypertension, steatotic liver disease, and liver fibrosis. Therefore, it is important to develop plans for prevention, early detection, public awareness, and intervention programs targeting obesity in the general population.

Introduction: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) has increased significantly over the last three decades worldwide, from 17.6% in 1990 to 23.4% in 2019. The development of this disease depends on many risk factors, including genetics, lifestyle, and environment. The PNPLA3 (patatin-like phospholipase domain-containing protein 3) gene is the most relevant genetic factor influencing the risk of metabolic dysfunction-associated steatotic liver disease. The PNPLA3 rs738409 GG genotype impairs adiponutrin function, accumulating triglyceride in liver cells and forming small fat droplets within the liver. Aim: To determine rs738409 and rs2896019 single nucleotide polymorphisms of the PNPLA3 gene in metabolic dysfunction-associated steatotic liver disease and their correlation with some parameters of anthropometric and laboratory tests. Materials and Methods: This study was conducted with a case-control design in 2023–2024. There were 150 participants in the study, 50 in the control group without MASLD, and 100 in the case group with MASLD. The PNPLA3 (rs738409, rs2896019) gene’s single nucleotide polymorphism was identified by the RFLP-PCR technique. All statistical analysis was performed using SPSS 23 software. Categorical variables were described by numbers and percentages, and the numerical variables were characterized by the median (min and max) for the normal distribution, and mean± standard deviation for the non-normal distribution. The statistical tests utilized were the Chi-square test, Fisher’s exact test, student t-test, and Mann–Whitney test. Ethical approval for the survey was obtained from the Medical Ethics Committee under the Ministry of Health Of Mongolia in January 2023. Results: The participants’ average age was 46.73±11.45, with 60% being women (90) and 40% being men (60). Among all patients, the PNPLA3 gene’s single nucleotide polymorphism rs738409 revealed 44.7% (67) CC, 54.7% (82) GC, and 0.7% (1) GG (OR-CG+GG genotype- 2.9, p=0.003). In addition, as a result of determining the PNPLA3 gene rs2896019 single nucleotide polymorphism, the frequency of the TT genotype was significantly higher in the control group than in the case group (48%, 31%, p = 0.042). Conclusion The frequency of CG/GG genotypes rs738409, and rs2896019 of the PNPLA3 gene is higher in the case group, suggesting that they may be more susceptible to MASLD.

Background: Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD), emphasizing the need for its early detection and prognosis. Objective: This study aimed to determine the serum NT-proBNP levels in participants with CKD and establish a cut-off value for predicting heart failure. Methods: A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study received approval from the Ethics Committee of the Institute of Medical Sciences (Approval No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology Department of the third state hospital were enrolled based on predefined inclusion and exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence quantitative analyzer. Data were analyzed with SPSS 26.0. Results: The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly between heart failure and non-heart failure groups (p<0.05). Significant differences were also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05). NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%, specificity: 55%). Conclusion Serum NT-proBNP levels are elevated in CKD patients regardless of heart failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).

Introduction: Cases of gastric cancer have been declining worldwide in recent years. However, gastric cancer incidence increased in the last decade in Mongolia. In Mongolia, over 80% of gastric cancer cases are diagnosed during the late stage. Several studies have revealed that serum pepsinogens (PGs) level reflects, indirectly, histological and functional characteristics of the gastric mucosa. Goal: We aimed to evaluate the risk of gastric cancer and its precancerous condition based on serum PGI, PGI/II biomarkers. Materials and Methods: This case-control study enrolled 114 subjects, including patients with gastric cancer (n=36), atrophic gastritis (n=40) and healthy controls (n=138). The questionnaires were obtained to determine risk factors. Serum PGI, PGII, and H. pylori IgG levels were measured by ELISA (Pepsinogen I ELISA; Pepsinogen II ELISA; H.Pylori IgG ELISA; BIOHIT Plc, Helsinki, Finland). PGI to PGII ratio was calculated. Patients were classified into the ABC(D) group according to Miki K approach. Also, we developed new scoring system based on some risk factors and serum PGI, PGI/II ratio. Logistic regressions were performed to evaluate risk and expressed by odds ratio (OR) and 95% confidence intervals (95%CI). Results: Mean age of the subjects was 60±10.9 years. H.Pylori was positive in 67 subjects. The serum PGI and PGI/II ratio levels were significantly decreased in gastric cancer and atrophic gastritis groups compared to the healthy control. According to classification ABC(D), group D (OR 5.04, 95% CI 1.13-22.50) had higher proportion of atrophic gastritis cases, group C (OR 6.19, 95% CI 1.04-36.78) had higher proportion of gastric cancer cases than others. Additionally, we created a risk prediction scoring system with a score ranging from 0 to 7, based on variables age, family history of gastric cancer, prior disease history, PGI and PGI/II ratio levels. For the atrophic gastritis patients, 17 (42.5%) were classified into medium-risk category (OR 4.49, 95% CI 1.38-14.58) and 17 (42.5%) were classified into high-risk category (OR 7.69, 95% CI 2.16-27.43). Whereas, 11 (30.6%) patients with gastric cancer were classified into medium-risk category (OR 4.35, 95% CI 1.13-16.85), 21 (58.3%) were classified into high-risk category (OR 14.25, 95% CI 3.60-56.43). Conclusion The methods based on serum PGI and PGI/II may identify a high risk population of gastric cancer and atrophic gastritis.