Background: Pneumonia caused by COVID-19 tends to be more severe in middle-aged and elderly individuals, often leading to decreased pulmonary ventilation function and negatively impacting quality of life post-recovery. However, studies on this topic are limited in Mongolia. Aim: To evaluate pulmonary ventilation function and exercise tolerance in middle-aged and elderly individuals after COVID-19 pneumonia. Materials and Methods: A hospital-based case-control study was conducted from June 2022 to December 2023 at Gurvan Gal United Hospital and the First Central Hospital of Mongolia. The study group included 65 individuals aged 50- 69 who had recovered from COVID-19 pneumonia, while the control group consisted of 65 age-matched individuals who had not contracted the infection. Participants underwent a questionnaire, spirometry, and a 6-minute walk test (6MWT) to assess lung function and exercise tolerance. Results: A total of 123 participants were included in the study. The study group showed a significant reduction in FEV1 (P=0.015). compared to the control group. However, no statistically significant differences were observed in FVC or the 6MWT results between the two groups (P=0.464). Symptoms such as chest pain, cough, fatigue, and insomnia were significantly more common in the study group than in the control group (P<0.0001). Conclusion Individuals aged 50-69 who had COVID-19 pneumonia exhibited prolonged symptoms such as persistent cough, chest pain, nasal congestion, sore throat, fatigue, and sleep disturbances at a significantly higher rate compared to the control group (P<0.0001). Pulmonary ventilation function showed a mild decline, with FEV1% being lower than in the control group (P=0.015). Additionally, pulmonary fibrosis was significantly more prevalent among the post-COVID-19 group compared to the control group (P=0.026).

Background: In December 2019, SARS-CoV-2 spread rapidly worldwide, leading the World Health Organization (WHO) to declare it a pandemic in March 2020. COVID-19 is an infectious disease with symptoms similar to the flu, varying in severity from mild to critical. Post-COVID-19 syndrome refers to the persistence of certain symptoms after recovery from the acute infection. The most common symptoms, such as fatigue, shortness of breath, coughing, and headaches, negatively affect patients’ daily lives. Aim: To investigate the clinical manifestations of post-COVID-19 syndrome concerning the severity of the initial infection. Materials and Methods: A hospital-based cross-sectional study was conducted between 2022 and 2023 at the Pulmonology and Allergy Center of the National Center for Health. In this study, we included participants who came for follow-up one year after being diagnosed with COVID-19. The severity of COVID-19 was categorized according to Living guidance for clinical management of COVID-19 issued by WHO and the COVID-19 diagnostic and treatment guidelines approved by the Minister of Health (A/549). Post-COVID-19 conditions were assessed using the 6-minute walk test, Borg rating of perceived exertion, and Fatigue Severity Scale (FSS). The Chi-square and Mann-Whitney U tests used on SPSS 26.0, with a p-value of <0.05 considered statistically significant. This study was approved by the Research Ethics Committee of the Mongolian National University of Medical Science (2022/03-06). Results: A total of 185 participants were included, comprising 74 men (40%) and 111 women (60%), with a mean age of 57.15±11.29 years. Among them, 90 (48.6%) had severe COVID-19, while 95 (51.4%) had non-severe cases. Clinical symptoms, including cough, dyspnea, fatigue, headache, and myalgia, were statistically different between the non-severe and severe groups. The median FSS score was 45 in the severe group and 38 in the non-severe group, showing a statistically significant difference (p<0.05). The median of 6-minute walking distance was 265 meters in the severe group and 282 meters in the non-severe group (p<0.05). The median Borg score was 2 in the severe group compared to 1 in the non-severe group (p<0.05). Conclusion Individuals who experienced severe COVID-19 exhibited reduced exercise tolerance, increased breathlessness, and more pronounced fatigue than those with non-severe cases.

Background: The numbers of pet ownerships tend to increase worldwide.60 to 65 percent of USA citizens are keeping pets at home and 12-15 percent of them have allergic issues. Another research among the European children who have dog allergy increased up to 15.6 percent in 2006 while it was 8.7 percent in 1992. Also, the allergy symptoms usually come out as bronchial asthma. Methods: This study has conducted by hospital based cross sectional study and retrospective and descriptive study model. For the test (BioIC) to identify allergen-specific IgE in 154 patients, hypersensitive to cat, dog and horse allergy. Results: In our study, a total of 154 participants were involved with 1-63 aged (average age 18.7±14.6). By the result of the BioIC test, cat allergy, dog allergy, horse allergy was 114 (74.02%), 52(33.76%), 47(30.51%) respectively.The mean sensitivity rate for cat allergic children was 12.69AU where it indicates 7.61AU in cat allergic adults (p<0.01). The mean sensitivity rate for horse allergic children was 6.04AU where it indicates 2.27AU in horse allergic adults and 7.65AU in dog allergic children and 4.53AU in adults (p<0.04). Conclusions By the result of the allergen specific IgE test in serum, cat allergy, dog allergy, horse allergy was 114 (74.04%), 52 (33.76%), 47(30.51%) respectively. By the result of the allergen specific IgE test in serum, sensitivity rate of epithelial allergen to cat was strong positive where it indicates medium positive for horse and dog sensitive rate. Children has higher sensitivity rate of epithelial allergen than adults.

Background: Endometriosis is a condition in which cells in the endometrium, layer of tissue normally covers uterine cavity, which grows outside to ovaries and other pelvic organs [1-4]. That may happen chronic pelvic pain, adhesion and pelvic organs dysfunction which leads to infertility later life [1-4]. In worldwide, 19-45 aged women have endometriosis, which is counted for 176 million, from 44% women have ovarian endometrioma [5]. In our country, 56% women received laparoscopic surgery due to ovarian cysts, which is diagnosed endometrioma. In recent years, ovarian endometriosis treated by synthetic progestin, gonadotropin analogues, combined contraceptive pills, intra-uterine device containing with progestin, and non-steroid anti-inflammatory drugs and laparoscopic surgeries [6, 7]. Serum antimullerian hormone (AMH) is key marker to define ovarian reserve, which correlates ovarian number of antral follicle counts [6, 7]. Material and Methods: We studied 129 patients who has diagnosed with ovarian endometrioma, aged 20-46 years, using case-control study design. There are 4 groups with medication and surgeries.
Approval for the study was obtained from the review board and the ethics committee of MNUMS. All the recruited patients provided their informed written consents. Results: When treatment groups were compared, level of AMH before synthetic progestin therapy was 3.48±0.9 and after it 3.41±1.0 (p-0.456), and that was before non-steroid anti-inflammatory drugs 3.68±0.8 and after it 3.11±0.8 ng/ml (p-0.212). Before laparoscopic surgeries for severe endometrioma, average level of AMH was 2.3±1.8ng/ml for synthetic progestin therapy group and it was 1.68±0.2ng/ml (p-0.007) after surgical peeling of endometrioma. For patients of 4th group who had not taking oral synthetic progestin before laparoscopic surgeries average level of AMH was 3.11±1.88 ng/ml before surgery and it became 2.21±0.28 ng/ml (p-0.005). Level of СА-125 marker was before medical therapy for group 1 was 37,9±5,25 IU/ml and after therapy - 20,6±2,03 IU/ml. For group 2 it was 69,9±9,79IU/ml and 35.1±6.76 IU/ml respectively. Average level for group 4 before surgical treatment it was 96.6±36.6 IU/ml, and after surgery became 25.71±2.96 IU/ml, and that for group 3 was before surgery 102±29.1 IU/ml and decreased after surgery to 29.2±4.15 IU/ml.
There are significant reduction of pain in patients who received synthetic progestin (p=0.001) groups. Serum AMH were 3.48±0.9 before treatment and 3.41±1.0 after treatment respectively (p=0.456). Prior treatment of laparoscopic surgery with progestin 3 months, it decreases abdominal lower pain (p=0.001) and dysmenorrhea (p=0.001). Serum AMH level were 3.11±1.8 before surgery and 2.21±0.2 after surgery,respectively, (p=0.005). Conclusion
1. There were little decrease in level of antimullerian hormone and less risk for ovarian reserve when mild endometrioma was treated with synthetic progestin and non-steroid anti-inflammatory drugs in two groups.
When severe and middle degree of endometrioma was treated with laparoscopic surgery there were significant decrease of antimullerian hormone, but it was less in group that had synthetic progestin therapy before surgery and it was more effective that surgical therapy without preparation.
2. Comparison of Serum level of СА-125, marker of ovarian tumor, was decreased less in group of non-steroid anti-inflammatory drugs, and was decreased more or it was more effective.

Background: In worldwide, 16.9 million cases of stroke were reported in 2010. It has increased by 68% since 1990. In 2016, there were 5.5 million deaths attributable to cerebrovascular disease worldwide (2.7 million deaths from ischemic stroke and 2.8 million deaths from hemorrhagic stroke). Furthermore, dysphagia is one of the most common complication and occurs 35-78% of patients with stroke. Specifically, dysphagia occurs in 51-100% of the brain stem stroke patients. Moreover, it could be the independent factor to predict mortality. In other words, it directly impacts the quality of life and decreases social activity.
Incidence of cardiovascular disease and stroke have been increasing related to instability of economy, urbanization, bad lifestyle and stress. As a result of that, dysphagia has increased as well and is becoming one of the pressing issue of health care. It results malnutrition and prolonged the hospital stays. Unfortunately, its diagnosis and treatment are still not clearly defined yet.
Many researchers have investigated patients’ treatment outcome using a single treatment. In other word, researchers have studied the comparison of the separate results of electric stimulation and traditional swallowing therapies. In this study, we studied the results of combination therapy of traditional swallowing and muscle stimulation, and we aimed to identify the benefits of the combined therapeutic approach and to propose the effective, non-invasive methods for patients. Objective: We aimed to study treatment outcome and quality of life among stroke patients with dysphagia. Material and Methods: The study was conducted on a hospital-based, cross-sectional method. Study participants were obtained from Affiliated Hospital of Inner Mongolian University for the Nationalities between July 2018 and March 2019. All patients were divided into the three treatment groups. 150 dysphagic patients were evaluated by Swallowing Related Quality of Life (SWL-QOL) Scale before and after the treatment. Results: In total, 150 participants (mean age=59.70±9.55 years) aged between 34-77 were obtained in this study. There were no statistically significant differences between the three groups in age (p=0.609).The data showed statistically significant positive treatment effect for all three groups (p=0.0001).The SWAL-QOL score was 39.25±3.50 in A group, 39.10±3.54 in B group, 42.12±4.55 in C group after the treatment. The SWAL-QOL score shows statistically significant difference, after the treatment (p=0.0001). Conclusions Rehabilitation treatment combined with neuromuscular electrical simulation appears better outcome than nerve or muscular stimulation combined with rehabilitation among stroke patients with dysphagia.

In valve surgery cases among Mongolia, post-arrhythmia is observed that as same as pre-arrhythmia by its kind and prevalence. Which is why post-operation complication, mortality, financial problems are high, also exceeding hospital care. Therefore we aimed to compare pre and post operation arrhythmia in patients who had aortic and mitral valve surgery. In order to compare, we measured pre and post surgery electrocardiogram from total 30 patients with satisfaction. Statistical analyses are completed by SPSS 23 software and the p-value is evaluated as significant when less than 0.05. The average age of patients were 43./±3/. The frequency of pre-surgery arrhythmia were 88.7% hence atrial fibrillation were 62.9%, moreover post-surgery arrhythmia were 80%. There was no statistically significant difference between pre and post surgery arrhythmia (p= 0.9). According to the result, we have concluded that arrhythmia frequency hasn’t been getting lower after valve surgery, consequently needed to improve arrhythmia control, treatment and admit novel methods such as Cox maze IV, and Catheter ablation.

BACKGROUND. Regular blood donation can lead to pre-clinical iron deficiency as well as iron deficiency anemia. With Each donation donors lose 220-250 mg of iron. Early detection of iron deficiency is important for the blood donors and even useful for blood and blood product safety and supply. The research work we studied present Ret-HE to be used to detect the occurrence of iron deficiency eritrony level. Purpose: The aim of this study was to determine Ret-He to have sensitivity and specificity for diagnosing iron deficiency than traditional iron measurements. Materials and methods: We performed a cross sectional and case control study of 156 blood donors who served National Center for Transfusion Medicine. Ret-He, hemoglobin, plasma iron and ferritin were measured using XN2000 Sysmex, and CobasE600 Roche. The statistical analysis was done using One way Anova, Rock curve, Kruskal Wallis test. Results: We examined 64(41.02%) male donors, 92(58.9%) female donors by measurements of Ret-He,hemoglobin, serum, iron and ferritin. Survey participants were 8.33%(n=13) with anemia, 91.67% (n=143) without anemia. In donors with anemia the results were: RBC 4.9*106 u/l, HGB 10.8 g/dl (10;11), serum ferritin 5.2 (4.3; 6.3) mmol, serum iron 4.5 (3.7; 5.8) mmol and Ret-He 25.5 (22; 26) pg. Donors were divided into 3 age groups: group I age was up to 25years, group II was between 26-35 years, group III age criteria was above 35. Group I had serum iron 13.5 (10.; 18.), serum ferritin 41.8 (14; 78), Ret-He 32.2 (30; 33.) RBC 5×106 u/l (4.6;5), HGB14.2g/dl (13.3;14. 2). Group II had serum iron 14.6 (11; 19), serum ferritin 54.1 μg/l (29; 138), Ret-He 32.2pg (31; 33), RBC 5.1×106 u/l(4.7;5.1), HGB14.8 g/dl (13.5;14.8),Group III had serum iron 15.1 umol/l (9; 20), serum ferritin 95.7 μg/l (39; 141), Ret-He 32.7pg (31; 34) , RBC4.9×106 u/l(4.6;4.9), HGB 14.5g/dl(13.8;14.5), respectively. According to a curve (Roc) analysis, AUC of serum iron was 0.0963, serum ferritin 0.909, Ret-He 0.975. The mean Ret-He was 32.3pg (31.3;33.4). The optimal cut off value for the Ret-He was 29,25pg by ROC analysis and are presented along with sensitivity 92.3% and specificity 95.1%. Conclusion: 1. Determining the amount of Ret-He has a better sensitivity and specificity for diagnosing iron deficiency compared to traditional iron measurements. 2. Ret-He has diagnostic indicators that are able to detect the depletion of iron reserves, erythron level. And it need to be used in further clinical practices, as well as doctors should be required to use it for diagnosis and treatment.

BACKGROUND. In our country, the allergic rhinitis spreads through 23,5% of adults and asthma spreads through 20.9% of children. The allergic rhinitis causes rhinosinusitis, rhino polypus, inflammation of respiratory tract, middle ear infection, breath with mouth, insomnia or sleepless and losing of life quality. Therefore it affects badly on children’s focusing and grades. Aim: To detect the specific immunoglobulin E for 3-12 years old children with allergic rhinitis. Goals: 1. To detect the specific immunoglobulin E for 3-12 years old children with allergic rhinitis , to take a skin test from 7-12 years old children 2. to detect the specific immunoglobulin E for 20 children of control group METHODS. We did an otolaryngologic examination and took an anamnesis of “Allergic rhinitis and its impact on asthma” that from the international organization. We detected the specific immunoglobulin E with aeroallergens and 40 types of food allergens for 3-6 years old 20 children with allergic rhinitis and 20 healthy control group children in their peripheral blood by using Agnito BIO Lc, the allergic panel from Taiwan. Did skin test with positive and negative control for 7-12 years old 20 children by 40 types of diagnosing devices that from Allergopharma /from German/, Lofarma /from Italy/ firms. We produced the study results and did statistic information on SPSS 23 program. RESULTS. We did the allergic test in peripheral blood of 3-6 years old children following the standard of allergen-specific IgE and produced the results. 3 of them /19 children/were sensitive for epidermis of dog, cat and horse /15.7%/. All of them were sensitive for ground plants /100%/, 12 of them/63,1%/ were very sensitive/32+/ for mugwort, and 16 /84,2%/of them were sensitive for herbs, 14 /73,6%/ of them were sensitive for other allergens such as resin, candida. And 6 /31,5%/ of them were sensitive for mites. 8 of them were sensitive for food allergens additionally /42,1%/.12 of 17 children who had a skin test were sensitive for mugwort /70,5%/, 9 of them were sensitive for trees/aspen, hus, pinaster/ /52,9%/. There was any sensitiveness for house dust and container dust mite for 7-12 years old 17 children. It shows that there might be immunity for this age. CONCLUSION. The boys with allergic rhinitis were more than girls about 61,1%. It shows that the allergic rhinitis occurs in boys more than girls.3-6 children were sensitive /97,2%/ for ground plantsand sIgE level 7.26±5.18. 7-12 years old 20children were sensitive for herbs and mugwort more /94,1%/.

Introduction: Transurethral resection of the prostate (TURP) has been considered as the gold standard treatment for obstructive voiding dysfunction in men with benign prostatic hyperplasia. This standard treatment has been challenged by consistent data demonstrating the superiority of Holmium enucleation of the prostate (HoLEP). We review summarizes the literature comparing HoLEP to traditional therapies TURP, open prostatectomy (OP) for BPH these are widely used and have long term efficacy data. Patients undergoing HoLEP have significant shortened catheterization times, decreased length of hospital stay, fewer serious postoperative complications, greater reduction in post-operative IPSS, greater improvements in post-operative Qmax and lower rates of repeat endoscopic procedures for recurrent symptoms compared with TURP and OP. Furthermore, HoLEP can be used to resect more than 100 grams tissue and it is equivalent efficacy to open prostatectomy. Conclusion: HoLEP as the new gold standard treatment for surgical BPH therapy further. HoLEP remains its difficult learning curve when compared with traditional transurethral resection.

Introduction: Transurethral resection ofthe prostate (TURP) has been considered asthe gold standard treatment for obstructivevoiding dysfunction in men with benignprostatic hyperplasia. This standard treatmenthas been challenged by consistent datademonstrating the superiority of Holmiumenucleation of the prostate (HoLEP). Wereview summarizes the literature comparingHoLEP to traditional therapies TURP, openprostatectomy (OP) for BPH these are widelyused and have long term efficacy data.Patients undergoing HoLEP have significantshortened catheterization times, decreasedlength of hospital stay, fewer serious postoperativecomplications, greater reduction inpost-operative IPSS, greater improvementsin post-operative Qmax and lower rates ofrepeat endoscopic procedures for recurrentsymptoms compared with TURP and OP.Furthermore, HoLEP can be used to resectmore than 100 grams tissue and it isequivalent efficacy to open prostatectomy.Conclusion: HoLEP as the new goldstandard treatment for surgical BPH therapyfurther. HoLEP remains its difficult learningcurve when compared with traditionaltransurethral resection.