1. Measurement of multiple cytokines in mouse serum using the flowcytometry
Gansukh Choijilsuren ; Enkhtushig Gavaabaljir ; Anand Altankhuyag ; Munkhjargal Davaajargal ; Nyambayar Dashtsoodol ; Tsogtsaikhan Sandag ; Khongorzul Togoo
Mongolian Medical Sciences 2024;207(1):3-7
		                        		
		                        			Introduction:
		                        			Accurate measurement of multiple cytokines concurrently is essential for comprehensively understanding 
immune responses in various diseases.
 
 
		                        		
		                        			Goal:
		                        			To develop a technological methodology for the simultaneous quantification of multiple cytokines in 
mouse serum using a flowcytometry 
		                        		
		                        			Materials and Methods:
		                        			Utilizing a C57BL/6 mouse model, we induced cytokine production by intraperitoneal injection of 
alpha-galactosylceramide (α-GalCer) and analyzed cytokine levels 24 hours later using a MACSQuant 
analyzer 10 equipped with LEGENDplex™ Mouse Th Panel (13-plex) assay. Means between groups 
were compared using the independent sample t test, and statistically significant differences were 
considered at p ≤ 0.05.
		                        		
		                        			Results:
		                        			Our results demonstrate that the emitted intensity increased proportionally with standard concentration, 
with slightly elevated cytokine staining observed for MCP-1 and IL-10.
The concentration of each cytokine was determined using a regression equation based on the mean 
fluorescence intensity value of the cytokine in each standard. Importantly, we observed significantly 
highest levels of IFN-γ (p<0.05) in α-GalCer-injected mice, indicating successful induction of cytokine 
production, particularly from NKT cells. Notably, our investigation revealed that levels of IFN-b, IL-17A 
and IL-27 in α-GalCer-injected mice increased (p<0.05) those of other cytokines, compared to negative 
controls. The determination of multiple cytokines simultaneously via flowcytometry, facilitated by the 
LEGENDplex assay, holds significant importance in enabling comprehensive comparison of cytokine 
concentrations.
		                        		
		                        			Conclusion
		                        			An experimental methodology for the simultaneous determination of multiple cytokines by flowcytometry 
was successfully developed.
		                        		
		                        		
		                        		
		                        	
2.Comparative study results of serum vitamin D status in trained athletes in Mongolia
Oyu-Erdene Kh ; Bulgan M ; Oyun-Erdene R
Mongolian Medical Sciences 2024;207(1):8-14
		                        		
		                        			Introduction:
		                        			The last decade has seen a dramatic increase in general interest in and research into vitamin D, with 
many athletes now taking vitamin D supplements as part of their everyday dietary regimen. The most 
recognized role of vitamin D is its regulation of calcium homeostasis; there is a strong relationship 
between vitamin D and bone health in non-athletic individuals. Vitamin D is responsible for regulation 
of calcium and phosphate metabolism and maintaining a healthy mineralized skeleton. It is also known 
as an immunomodulatory hormone. Experimental studies have shown that 1,25-dihydroxyvitamin D, 
the active form of vitamin D, exerts immunologic activities on multiple components of the innate and 
adaptive immune system as well as endothelial membrane stability. Studying the level of vitamin D in 
athletes in relation to age group, body mass index, and type of sport is important for reducing the risk of 
injury and infection in athletes and improving performance and success in sports.
		                        		
		                        			Goal:
		                        			To determine the 25-hydroxyvitamin D [25(OH)D] levels in the plasma of the trained athletes and their 
vitamin D status to compare of their sports type.
		                        		
		                        			Materials and Methods:
		                        			
Sample size
Using a cross-sectional design, a total of 71 athletes aged 20-43 from the sports medicine research 
center and the national team was selected by sampling.
Method of the Laboratory analyses
The body mass index and blood plasma level of 25 hydroxy vitamin D of the athletes participating in the 
study were compared by sports type and analyzed using descriptive statistics. Comparison of survey 
data was performed using Pearson’s correlation method.
		                        		
		                        			Results:
		                        			In the study, 71 athletes of the Mongolian national team participated in 5 types of sports. Descriptive 
analysis was performed on the general parameters of the athletes, body mass index, type of sport, level 
of vitamin D in the blood, etc.
An avarege level of vitamin D of the athletes who participated in our study were 22.27±12.9 ng/ml, in the age group of 20-29 years, and compared to the body mass index, it was the highest level in the athletes of normal weight. 
		                        		
		                        			Conclusions
		                        			
1. The level of vitamin D of the athletes who participated in our study was the highest in the age group 
of 20-29 years, 22.27±12.9 ng/ml, and compared to the body mass index, it was the highest level 
in the athletes of normal weight.
When studying the level of vitamin D of the participants in comparison with the type of sport, the 
freestyle wrestlers had a higher level of 34.75±15.13 ng/ml, while the judo wrestlers had a lower 
level of 12.69±5.17 ng/ml.
		                        		
		                        		
		                        		
		                        	
3.The evaluation of the WOI by using ER, PR, Ki67 proliferation index in thin endometrium patients
Narangerel N ; Munkhtsetseg D ; Yanjinsuren D ; Bum Chae Choi
Mongolian Medical Sciences 2024;207(1):15-19
		                        		
		                        			Introduction:
		                        			The endometrium is to receive the embryo and endometrial receptivity predicts successful implantation 
during window of implantation (WOI). During implantation and pregnancy ER,PR,Ki67 significant 
controllers of endometrial decidualization. The PRP is promoting cell proliferation neoangiogenesis and 
anti-inflammatory effects, facilitating successful implantation indicating the safe as well as a potential 
therapeutic response to its application in patients with RIF with thin endometrium.
		                        		
		                        			Goal:
		                        			Our aim was to further elucidate the role of WOI as a diagnostic and prognostic tool to RIF with thin 
endometrium in the fertility field. Also the importance of PRP treatment.
		                        		
		                        			Materials and Methods:
		                        			A prospective study was done of 72 infertile thin endometrium women with history of recurrent implantation failure (RIF). All women underwent hysteroscopy followed by endometrial sampling for histological examination. WOI was studied using the immu-nohistochemicall method of determining Ki67, ER, PR, 6 tissue preparations were excluded due to an unsatisfactory amount of tissue. Therefore, data about tissue specimens from 66 patients were included in statistical analysis. Differences in implantation rate between 2 groups were evaluated using the chi square test. Endometrial thickness was calculated by a repeated measures ANOVA test with greenhouse method. This study received approval from the Ethics 
Committee under the reference number 2021/3-202109 and conducted at the CL fertility clinic.
		                        		
		                        			Results:
		                        			In this study, out of 72 cases, 6 were removed, 42 were synechiae, 24 were polyp. Ki67, ER, PR 
immunohistochemistry expression was found in 66 and endometrial delay was diagnosed 73,6% (Figure 
1). Endometrial thickness was significantly increased with the PRP group. After adjusting the WOI, 
significant increase in implantation 58% and clinic pregnancy 38% (Figure 2).
		                        		
		                        			Conclusion
		                        			Adjusting WOI, receiving PRP treatment in infertile women with thin endometrium significantly associated 
with  implantation rate and pregnancy rate prognostic indicators including  Ki67 proliferation index, 
ER,PR.
		                        		
		                        		
		                        		
		                        	
4.A result of the detection of homozygous deletion of SMN1 gene in the spinal muscular atrophy
Esukhei E ; Khandsuren B ; Erdenetuya D ; Bolormaa D ; Mandakhnar M ; Oyungerel B ; Sarantsetseg S ; Yundendash D ; Nyam-Erdene N ; Batchimeg B ; Altansukh Ts ; Munkhbayar S ; Chimeglkham B
Mongolian Medical Sciences 2024;207(1):20-29
		                        		
		                        			Background:
		                        			Spinal muscular atrophy (SMA) is a degenerative neuromuscular disease that causes progressive 
muscle weakness and atrophy due to the loss of the motor neurons. Approximately 95% of patients 
with SMA are homozygous for the deletion of SMN1 exon 7. With an incidence of 1/10.000 and a carrier 
frequency of 1/40 to 1/50, SMA is the most common genetic cause of death in infants.
		                        		
		                        			Purpose:
		                        			To detect homozygous deletion of SMN1 exon 7 and to analyse the SMN1 copy number by molecular
genetic analysis.
		                        		
		                        			Materials and Methods:
		                        			In this study, 3 SMA patients with SMN1 gene homozygous deletion and 17 people of their relatives were 
included. Molecular genetic analysis was performed in the Central Scientific Research Laboratory of the 
Institute of Medical Sciences. DNA was extracted from peripheral blood, and its purity was assessed by 
spectrophotometer. Homozygous deletion of SMN1 gene was analyzed with allele-specific PCR, and 
the SMN1 gene copy number was evaluated by real-time PCR.
		                        		
		                        			Results:
		                        			Among the five participants diagnosed with SMA by clinical symptom and electromyographic test, three 
cases were found to have homozygous deletion of exon 7 of the SMN1 gene, while two cases did not 
exhibit such mutation by the allele specific PCR analysis.
The mean age of study participants was 27.76±16.07 (ranging from 8 months to 52 years). 
Six of the 7 relatives of the first proband had 1 copy number of SMN1 (0.75±0.29) or were carriers 
of SMA, while one had 3 copy numbers (2.99) or no deletion of SMN1 gene. Additionally, 6 of the 7 
individuals of the second proband had 1 copy number of the SMN1 gene (0.72±0.14), and 1 person 
had 2 copy numbers. All 3 relatives of the third proband had 1 copy number of SMN1 gene (0.96±0.37). 
		                        		
		                        			Conclusion
		                        			We consider that determination of SMN1 gene homozygous deletion and carrier testing 
can be performed by the PCR method locally. Further, it is necessary to implement the molecular
genetic testing method into practice and to study the requirements and needs of early detection of SMA 
in the newborn screening program of Mongolia. 
		                        		
		                        		
		                        		
		                        	
5.Studying the relationship of air pollutants and pulmonary disease in Yesunbulag sum, population of Gobi-Altai province
Myagmardorj Ch ; Oyun-Erdene O ; Nyandag Ch ; Bataa Ch ; Suvd B
Mongolian Medical Sciences 2024;207(1):30-36
		                        		
		                        			Introduction:
		                        			In 2020, the prevalence of respiratory system diseases in the population of Gobi-Altai province is 
1339.5 cases per 10,000 population, which is 4% (52) more than the average of the provinces and 
20% (223.8) more than the national average. In 2021, the number of deaths due to respiratory system 
diseases was 2.9 per 10,000 population, increasing by 1.1 from 2020 (1.8). Pneumonia-related deaths 
account for 60.7% of all respiratory system-related deaths. As of 2022, there are 7,281 simple stoves, 
248 low-pressure and steam boilers, and 18,207 automobiles in the Gobi-Altai province as sources of 
air pollution. 63.1% of the total coal is consumed by water heating boilers with a capacity of more than 
101 kW, 20.5% by households, and 16.4% by small and medium enterprises.
		                        		
		                        			Goal:
		                        			Determining the relationship between the incidence of pneumonia in the population of Gobi-Altai 
province and the common air pollutants.
		                        		
		                        			Material and Method:
		                        			According to the rotation research model, the common external air pollutants SO₂, NO₂, PM₁₀, 
climate parameters, temperature, pressure, humidity, and population pneumonia measurements 
and registration data of Altai Sum, Gobi-Altai Province in 2020-2021 were analyzed using SPSS-24 
software. statistical processing was calculated for non-parametric parameters.
		                        		
		                        			Result:
		                        			 The annual average value of sulfur dioxide (SO₂ ) measured in 20 minutes in Gobi-Altai province is 
25.2 ± 13.7 μg/m³, the annual average value of nitrogen dioxide (NO₂) measured in 20 minutes is 
36.329±29 μg/m³, and the annual average concentration of PM₁₀ particles is 35.2 ± 28,264 μg/m³, 
which is the standard level of MNS4585:2016. But the 20-minute average concentration of SO₂
 (r=0.81, p=0.005), the average concentration of NO₂  (r=0.089, p=0.008), and the average concentration of PM₁₀  (r=0.089, p=0.002) is directly related to the incidence of pneumonia. It is also inversely correlated with air temperature (r=-142, p=0,000).
		                        		
		                        			Conclusion
		                        			Common outdoor air pollutants in Yesunbulag sum, Gobi-Altai Province are related to 
pneumonia in children aged 0-5 years.
		                        		
		                        		
		                        		
		                        	
6. Hygienic assessment of soil heavy metal pollution in Ulaanbaatar city
Myagmarjargal N ; Altangerel B ; Enkhnaran N ; Erdenechimeg Kh ; Purevdulam L ; Nyamsuren L
Mongolian Medical Sciences 2024;207(1):37-43
		                        		
		                        			Introduction:
		                        			Total environment 24 % of all estimated global deaths are linked to the environment. As of 2022, 
Ulaanbaatar has a population of 1,691,800, vehicles 435,725, thermal power plants 4, market and 
shopping centers 111, factories 13,465, and 225 gas stations. Also, 1.5 million tons of waste are 
generated annually, 1135.6 tons of coal are used, and environmental pollution is increasing year by 
year.  Therefore, it is necessary to investigate the heavy metal contamination of the soil of Ulaanbaatar 
city and protect the health of the population. 
 
		                        		
		                        			Purpose:
		                        			To determine heavy metals pollution in the soil of Ulaanbaatar city 
		                        		
		                        			Materials and Methods:
		                        			We used descriptive research design in this study. Secondary data from Meteorological and Environmental  Monitoring Department was used. The content of heavy metals such as lead (Pb), mercury (Hg), chromium (Cr), and cadmium (Cd)) in the soil was evaluated in comparison with the maximum permissible amount specified in the MNS 5850:2019 standard. Statistical analyzing was calculated using SPSS-25 software, and p<0.05 was considered statistically significant.
 
 
		                        		
		                        			Results:
		                        			The average concentration of heavy metals in the soil of residential areas of 9 districts of Ulaanbaatar 
city is cadmium 0.43 mg/kg (min=0, max=26.6), mercury 0.22 mg/kg (min=0, max=4), chromium 11.2 
mg/kg ( min=0, max=1609.6), lead is 24.4 mg/kg (min=0, max=257.2). Cadmium concentration in soil 
Bagakhangai (25%), Baganuur (19.7%), Khan-Uul (18.9%), lead concentration in Nalaikh (8.3%), 
Bayanzurkh (5.4%), Chingeltei (3.3), mercury concentration in Baganuur ( 24.7%), Khan-Uul (18.4%), 
and chromium concentration in certain locations of Khan-Uul (4.7%) districts exceeded the standards, 
respectively. The concentration of soil cadmium (21.2%) and lead (7.7%) near the technical market, 
mercury concentration (26.3%) near the market and shopping center, and chromium concentration 
(58.9%) near the central treatment plant exceeded the maximum permissible levels.
		                        		
		                        			Conclusion 
		                        			Cadmium and mercury pollution were mainly detected in the heavy metal pollution of the soil of 
Ulaanbaatar city, and there is heavy metal pollution in certain locations of Baganuur and Khan-Uul 
districts. Heavy metal pollution is caused by activities such as technical markets, auto repair shops, 
markets, shopping centers, and treatment plants. 
		                        		
		                        		
		                        		
		                        	
7. Does air pollution affect liver disease?
Bolor B ; Enkhjargal A ; Burmaajav B
Mongolian Medical Sciences 2024;207(1):52-59
		                        		
		                        			
		                        			Liver disease accounts for approximately 2 million deaths per year worldwide and is responsible for 
4% of all deaths. Acute hepatitis accounts for a smaller amount of mortality, with complications from 
cirrhosis and other chronic liver diseases being the main causes of death. It is mostly brought on 
by nonalcoholic liver disease, alcohol abuse, infections (chronic hepatitis B and C viruses), and air 
pollution.
 In the last 10 years, the number of deaths caused by hepatocellular carcinoma has been continuously 
increasing in Mongolia, and it ranks first in the world in terms of deaths caused by hepatocellular 
carcinoma per 100,000 population, which is 8 times higher than the world average.
 Mongolia is one of the most polluted countries in the world. Globally it is estimated that 9 out of 10 
breathe polluted air and about 7 million deaths are attributed to air pollution. Studies on epidemiology 
have found an association between ambient air pollution and some liver diseases, including cirrhosis, 
liver cancer, and fatty liver disease related to metabolic disorders. This is an issue with global health. 
Exposure to PM2.5 is linked to the development of inflammation, which may be a major risk factor 
in the advancement of non-alcoholic fatty liver disease. According to the literature review, exposure 
to PM is associated with systemic inflammation, a rise in plasma triglycerides, LDL and VLDL, pro
inflammatory cytokines, and insulin resistance.
 Many epidemiological and ecological studies were done in Mongolia on air pollution and health. 
However, it is still not clear how much ambient air pollution can cause cirrhosis and non-alcoholic fatty 
liver disease incidence in Mongolia.
		                        		
		                        		
		                        		
		                        	
8.Results of the study on pathogens in vaginal smear tests
Mungunshagai A ; Oyun-Erdene R ; Munkhzul N
Mongolian Medical Sciences 2024;208(2):3-7
		                        		
		                        			Introduction:
		                        			 Although bacterial vaginosis prevalence varies across countries and populations, recent systematic 
reviews and meta-analyses indicate that 23–29% of women of reproductive age are infected. Each 
year, 21.2 million (22.9%) women between the ages of 14 and 49 in the United States develop bacterial 
vaginosis. Microenvironments are interconnected with the endocrine, immune, and other organ 
systems and dependent upon external and internal environmental influences. In women between the 
ages of 15 and 44, bacterial vaginosis is the most common vaginal disorder, according to the Centers 
for Disease Control and Prevention. 
In our nation, 93.4% of women who are of reproductive age have vaginalis; the percentage of cases 
with Gardnerella vaginalis alone is 22.6%, and 53.1% have it in combination with other anaerobic 
bacteria, which is a significant percentage. Our research is based on the lack of information about the 
vaginal environment of Mongolian women and factors influencing changes in the microenvironment. 
Our research is based on the lack of information about the vaginal environment of Mongolian women 
and factors influencing changes in the microenvironment. 
		                        		
		                        			Goal:
		                        			The objective is to study how age relates to the development of bacterial and fungal vaginitis through 
the analysis of vaginal swabs. 
		                        		
		                        			Materials and Methods:
		                        			For our study, we selected 100 women aged 20-59 through targeted sampling from clients who 
underwent vaginal smear tests at “Yu Bi Lab” laboratory and “Tsetsuu” diagnostic center in Ulaanbaatar 
in 2023. Vaginal smear analysis was conducted using Nugent’s criteria and Gram staining. Statistical 
analysis was performed by comparing pathogens among the participants based on age using 
Pearson’s correlation method. We obtained permission to conduct research. 
Through the Etugen University Biomedical Ethics Comittee convention held on march 11,2024
		                        		
		                        			Results:
		                        			The study divided 100 women into four age groups to examine the vaginal environment with their age 
and the factors influencing it. The research aimed to understand how bacterial vaginitis and fungal 
vaginitis evolve during reproductive age and menopause. Among the age groups, women aged 20-29 
had an average of 5.59±3.35 epithelial cells (n=32), those aged 30-39 had 6.10±3.29 (n=37), women 
aged 40-49 had 6.70±3.90 (n=17), and women aged 50-59 had the highest number of epithelial cells 
at 9.42±8.19 (n=14), representing 34% of the group.
		                        		
		                        			Conclusion
		                        			
1. Women of reproductive and menopausal age experience changes in the vaginal environment due to 
various factors. This includes a decrease in the ratio of normal microorganisms and lactobacilli, an increase in the number of conditional pathogens, and the development of an alkaline environment 
in the vagina.
2. Bacterial vaginitis predominantly affects younger women, with symptoms often being subtle. In 
contrast, fungal vaginitis is more common among menopausal women. Lower estrogen levels in 
women in this age group cause lactobacilli to break down glycogen less efficiently into lactic acid, 
even though the number of lactobacilli is still normal. This research implies that suppositories and 
estrogen pills may help treat these problems for women between the ages of 40 and 59.
		                        		
		                        		
		                        		
		                        	
9.Results of thyroid hormone levels in women
Bolor B ; Bat-Erdene D ; Oyun-Erdene R
Mongolian Medical Sciences 2024;208(2):8-12
		                        		
		                        			Introduction:
		                        			The average age of the population varies in every country of the world, which depends on the changes 
that occur in the body during aging and many external and internal factors that affect it. Thyroid 
hormones play an important role in ensuring and maintaining normal metabolic function throughout 
life. Our country is located in a mountainous region of the mainland, the amount of iodine in drinking 
water is low, and the amount of iodine taken from food is low, which creates the risk of iodine deficiency 
disorders. Therefore, we aimed to study how the thyroid function changes with age in Mongolian 
people.
		                        		
		                        			Goal:
		                        			A comparative study of thyroid hormone secretion levels in adult women.
		                        		
		                        			Material and Method:
		                        			In our study, 83 women over the age of 20 were selected based on the “Yu Bi Lab” diagnostic center. 
Triiodothyronine (T3), thyroxine (T4), and thyrotropin (TSH) of the women participating in the study 
were determined using the FHU method using the Magiwel ELISA diagnostic kit manufactured by 
United Biotech. 
		                        		
		                        			Results:
		                        			81 women over 20 years of age participated in our study, the average age was 44.45±14.17, and the 
participants were divided into 5 groups with 10 age intervals. 20-29 years 18% (n=15) average age 
24.6±2.64, 30-39 years 22% (n=18) average age 33.6± 3.12, 40-49 years 16% (n=13) average age 
45.15±1.67, 50-59 years 25% (n=20) average age 54.15±2.99, 60-69 years 19% (n=15) average age 
63.73± 3.05, were.
		                        		
		                        			Conclusion
		                        			
1. When comparing T3 and T4 hormones by age group, T3 hormone is higher in the 30-39 age group 
at 5.05 ng/ml. The T4 hormone gradually decreases with age.
 
2. Thyroiodin hormone increased with age. The relationship between the age of the participants 
and TSH hormone was directly related to statistical age when calculated by Pearson’s correlation 
coefficient (p=0.01).
		                        		
		                        		
		                        		
		                        	
10.Results of study on the cognitive and behavioral changes of amyotrophic lateral sclerosis
Mandakhnar Myadagsuren ; Byambasuren Dagvajantsan ; Chimeglkham Bazrai
Mongolian Medical Sciences 2024;208(2):13-20
		                        		
		                        			Background:
		                        			Cognitive and behavioral changes in ALS are recognized as an integral feature of the disease. 
Moreover, recent studies have also highlighted prominent changes in language and social cognition. 
The Edinburgh Cognitive and Behavioral ALS Screen (ECAS) is designed to detect the specific profile 
of cognition and behavior changes in ALS and to differentiate it from other disorders. It is evident 
that the test is specific and sensitive for ALS related cognition and behavioral changes and has been 
adapted and used for many languages to avoid the fallacy of cultural differences. However cognitive 
and behavioral changes of Mongolian ALS patients have not been studied. 
		                        		
		                        			Purpose:
		                        			Our aim is to assess the behavior and cognitive characteristics of patients with ALS using the Mongolian 
version of the ECAS.
		                        		
		                        			Materials and Methods:
		                        			The study was conducted by cohort design and questionnaire method.  Using the ECAS-Mon, a 15—
 20 min screen, containing an ALS-Specific score (ALS-SS) and an ALS Non-specific score (N-ALS
SS), cognitive and behavioral changes of ALS were studied in 30 ALS patients (none with evident 
dementia), 7 carers and 60 healthy controls. The results were processed using the SPSS (USA, 
version 25.0) program. Descriptive tests were done as appropriate. According to Abrahams et al., all 
cut-off scores were determined by subtracting two standard deviations from the mean score. Non
parametric Spearman's correlation was used to estimate correlations between age, education and 
the test parameters.The differences in categorical variables were analysed by Pearson's x2 test, the 
differences between quantitative variables were analysed by the Manny-Whitney U test. Whent the p 
value was less than 0.05, the statistical significance was considered. The internal reliability of the test 
was determined by Cronbach's alpha.
		                        		
		                        			Results:
		                        			Healthy controls’s (30 males, 30 females) mean age was 59.8 ± 14.4 and mean years of education 
was 12.5 ± 3.5. Patients’s mean age was 59.8 ± 11.0 and mean years of education was 11.4 ± 3.7. 
Data from healthy controls produced cut-off points of 86.8 for ALS-SS; 28.6 for N-ALS-SS; and 97/136 
for ECAS total. Patients’s points were 53.7 for ALS-SS, 16.8 for N-ALS-SS, and 74/136 for ECAS 
total. The reliability of ECAS-Mon test was 0.91. The most prevalent deficit of cognition occurred in language functions followed by memory and fluency.  Patients performed more poorly than controls, 
with significance levels at p < 0.001 for all domains of cognitive function. The dominant behavioral 
changes were apathy or inertia (39%), loss of sympathy or empathy (38%) and hyperorality and 
altered food preferences (31%) in ALS patients.
		                        		
		                        			Conclusion
		                        			Mongolian ALS patients have decreased cognitive performances, specially memory performance 
compared to healthy control. The ECAS-Mon questionnaire can be used to detect ALS related 
cognitive and behavioral changes in Mongolian patients. 
		                        		
		                        		
		                        		
		                        	
            
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