1.Evaluation of the vaginal microenvironment in women of menopausal age
Tsevelmaa E ; Buyan-Ulzii Ch ; Lkham-Erdene G ; Pagmadulam S ; Munkhzul N
Diagnosis 2025;112(1):90-94
Postmenopausal estrogen deficiency can lead to genitourinary syndrome of menopause (GSM), which manifests as vaginal dryness, dyspareunia, and sexual dysfunction, among other clinical symptoms. These complications often result in emotional distress and a decline in overall quality of life (7). Several studies estimate that 25–50% of postmenopausal women experience symptoms such as pain during
intercourse, burning, itching, and dysuria due to vaginal atrophy and inflammation (9). Menopause is commonly diagnosed based on the absence of menstruation and hormone levels (10), but one of the simplest diagnostic methods is the evaluation of the vaginal microenvironment. There is limited
data in Mongolia regarding the vaginal microenvironment of perimenopausal and postmenopausal women and the factors influencing its changes. This gap in knowledge formed the basis of our study.
The aim of this research was to assess the vaginal microenvironment in menopausal women and to analyze its relationship with various influencing factors. We conducted a cross-sectional observational study using a descriptive research design. A total of 110 women aged 45–55 years, presenting with menopausal symptoms at “Santmaral” Women’s Clinic and the Women’s Outpatient Department of Songinokhairkhan Health Center, were selected for the study. Both quantitative and qualitative
research methods were employed, including surveys and physical examinations. Participants completed a 10-minute questionnaire consisting of 8 open-ended and 12 closed-ended questions. The vaginal microenvironment was assessed using special pH test strips applied to vaginal secretions. Data were analyzed using Excel 21 and SPSS 23, comparing the vaginal microenvironment with various influencing factors. The results showed that the average vaginal microenvironment pH among menopausal women was 5.18 ± 0.45 (n=110). In married women, the average pH was 5.1 ± 0.45; among women with a history of pregnancy, it was 4.10 ± 1.58; and among those who had given birth,
it was 2.8 ± 0.98 — indicating an abnormal vaginal microenvironment. Women who were using hormone replacement therapy had an average pH of 5.05 ± 0.45, while those using non-hormonal contraceptive methods had an average pH of 5.3 ± 0.43. These findings were statistically significant
(p = 0.0001****)
2.Insights Into JKMS Submissions and Medical Journal Publications in Korea
Jaehun JUNG ; Yumi JANG ; Munkhzul RADNAABAATAR ; Dae Sun JO ; Jong-Min KIM ; Jin-Hong YOO
Journal of Korean Medical Science 2025;40(1):e76-
We analyzed the publication and submission statuses of Korean medical journals from 2010 to 2024, amidst challenges impacting researchers. Data from 58 domestic journals identified through the 2023 JCR database were used to assess publication status, while data from the Journal of Korean Medical Science (JKMS) were utilized to examine submission status.The proportion of published original articles by domestic authors decreased by 3% in 2024 compared to 2023. Submissions to JKMS also decreased overall, except for slight increases in May and October 2024. In contrast, international submissions to JKMS showed consistent growth, surpassing the 15-year average, reflecting growing global interest. Addressing issues, including medical school admission policies and the lingering effects of coronavirus disease 2019, is vital to ensure a sustainable and thriving medical research environment in Korea.
3.Insights Into JKMS Submissions and Medical Journal Publications in Korea
Jaehun JUNG ; Yumi JANG ; Munkhzul RADNAABAATAR ; Dae Sun JO ; Jong-Min KIM ; Jin-Hong YOO
Journal of Korean Medical Science 2025;40(1):e76-
We analyzed the publication and submission statuses of Korean medical journals from 2010 to 2024, amidst challenges impacting researchers. Data from 58 domestic journals identified through the 2023 JCR database were used to assess publication status, while data from the Journal of Korean Medical Science (JKMS) were utilized to examine submission status.The proportion of published original articles by domestic authors decreased by 3% in 2024 compared to 2023. Submissions to JKMS also decreased overall, except for slight increases in May and October 2024. In contrast, international submissions to JKMS showed consistent growth, surpassing the 15-year average, reflecting growing global interest. Addressing issues, including medical school admission policies and the lingering effects of coronavirus disease 2019, is vital to ensure a sustainable and thriving medical research environment in Korea.
4.Insights Into JKMS Submissions and Medical Journal Publications in Korea
Jaehun JUNG ; Yumi JANG ; Munkhzul RADNAABAATAR ; Dae Sun JO ; Jong-Min KIM ; Jin-Hong YOO
Journal of Korean Medical Science 2025;40(1):e76-
We analyzed the publication and submission statuses of Korean medical journals from 2010 to 2024, amidst challenges impacting researchers. Data from 58 domestic journals identified through the 2023 JCR database were used to assess publication status, while data from the Journal of Korean Medical Science (JKMS) were utilized to examine submission status.The proportion of published original articles by domestic authors decreased by 3% in 2024 compared to 2023. Submissions to JKMS also decreased overall, except for slight increases in May and October 2024. In contrast, international submissions to JKMS showed consistent growth, surpassing the 15-year average, reflecting growing global interest. Addressing issues, including medical school admission policies and the lingering effects of coronavirus disease 2019, is vital to ensure a sustainable and thriving medical research environment in Korea.
5.Insights Into JKMS Submissions and Medical Journal Publications in Korea
Jaehun JUNG ; Yumi JANG ; Munkhzul RADNAABAATAR ; Dae Sun JO ; Jong-Min KIM ; Jin-Hong YOO
Journal of Korean Medical Science 2025;40(1):e76-
We analyzed the publication and submission statuses of Korean medical journals from 2010 to 2024, amidst challenges impacting researchers. Data from 58 domestic journals identified through the 2023 JCR database were used to assess publication status, while data from the Journal of Korean Medical Science (JKMS) were utilized to examine submission status.The proportion of published original articles by domestic authors decreased by 3% in 2024 compared to 2023. Submissions to JKMS also decreased overall, except for slight increases in May and October 2024. In contrast, international submissions to JKMS showed consistent growth, surpassing the 15-year average, reflecting growing global interest. Addressing issues, including medical school admission policies and the lingering effects of coronavirus disease 2019, is vital to ensure a sustainable and thriving medical research environment in Korea.
6.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.
7.Chronic kidney disease and serum NT-proBNP level
Sodgerel B ; Anudari I ; Buyandelger J ; Pilmaa Yo ; Gantogtokh D ; Yesukhei E ; Bilguun E ; Nyam-Erdene N ; Yundendash D ; Munkhbayar S ; Bolormaa Do ; Sarangerel Ga ; Munkhzul D ; Batbold B ; Sodnomtsogt L
Mongolian Medical Sciences 2024;210(4):9-17
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%).
8.Clinical Significance of BNP and NT-proBNP in Chronic Kidney Disease
Anudari I ; Buyandelger J ; Munkhzul D ; Sodgerel B
Mongolian Medical Sciences 2024;210(4):53-60
Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney
function over time. As the disease progresses, it leads to an increased risk of cardiovascular
complications, which are the leading cause of morbidity and mortality in CKD patients.
B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic
peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart
failure. Their role in CKD, however, is complex due to the overlapping pathophysiological
mechanisms between cardiac and renal dysfunctions. This literature review aims to explore
the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting
their clinical relevance, the impact of renal function on their levels, and potential therapeutic
implications. The review focuses on studies published in the last decade, examining the
clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP
as biomarkers in CKD patients.
9.Nationwide Target Trial Emulation Evaluating the Clinical Effectiveness of Oral Antivirals for COVID-19 in Korea
Kyungmin HUH ; Youngji JO ; Gi Hwan BAE ; Hyejin JOO ; Munkhzul RADNAABAATAR ; Hyungmin LEE ; Jungyeon KIM ; Dong-Hwi KIM ; Min-Gyu YOO ; Il Uk JO ; Poong Hoon LEE ; Geun Woo LEE ; Hee Sun JUNG ; Jaehun JUNG
Journal of Korean Medical Science 2024;39(42):e272-
Background:
Despite the proven effectiveness of oral antivirals against severe acute respiratory syndrome coronavirus 2 in randomized trials, their clinical reevaluation is vital in the context of widespread immunity and milder prevalent variants. This study aimed to assess the effectiveness of oral antivirals for coronavirus disease 2019 (COVID-19).
Methods:
This retrospective cohort study utilized a target trial emulation framework to analyze patients with COVID-19 aged 60+ from January to December 2022. Data were obtained from the Korea Disease Control and Prevention Agency and Health Insurance Review and Assessment Service. The study involved 957,036 patients treated with nirmatrelvir/ritonavir and 243,360 treated with molnupiravir, each compared with the matched control groups. Primary outcome was progression to critical COVID-19 requiring advanced respiratory support. Secondary outcomes included progression to severe COVID-19, need for supplemental oxygen, and death within 30 days of the onset of COVID-19.Number needed to treat (NNT) derived from the absolute risk reduction.
Results:
Nirmatrelvir/ritonavir was significantly associated with a reduced risk of severe (adjusted odds ratio [aOR], 0.823; 95% confidence interval [CI], 0.803–0.843), critical (aOR, 0.560; 95% CI, 0.503–0.624), and fatal COVID-19 (aOR, 0.694; 95% CI, 0.647–0.744).Similarly, molnupiravir reduced the risk of severe (aOR, 0.895; 95% CI, 0.856–0.937), critical (aOR, 0.672; 95% CI, 0.559–0.807), and fatal cases (aOR, 0.679; 95% CI, 0.592–0.779).NNTs for nirmatrelvir/ritonavir were 203.71 (severe), 1,230.12 (critical), and 691.50 (death);for molnupiravir, they were 352.70 (severe), 1,398.62 (critical), and 862.98 (death). Higher effectiveness was associated with older adults, unvaccinated individuals, and the late pandemic phase.
Conclusion
Nirmatrelvir/ritonavir and molnupiravir are effective in preventing progression to severe disease in elderly adults with COVID-19.
10.Nationwide Trends in Non-COVID-19 Infectious Disease Laboratory Tests in the Era of the COVID-19 Pandemic in Korea
Sun Bean KIM ; Young-Eun KIM ; Taemo BANG ; Minwoo HONG ; Munkhzul RADNAABAATAR ; Kyungmin HUH ; Ki Ho HONG ; Jaehun JUNG
Journal of Korean Medical Science 2023;38(47):e408-
The coronavirus disease 2019 pandemic has brought significant changes to infectious disease management globally. This study explored changes in clinical microbiological testing trends and their implications for infectious disease incidence and medical utilization during the pandemic. We collected nationwide claims for monthly clinical microbiology tests from January 2018 to March 2022 using the National Health Insurance Service database. Seasonal autoregressive integrated moving average models were employed to make predictions for each disease based on the baseline period (January 2018 to January 2020). The results showed a significant decrease in general bacterial and fungal cultures, respiratory infectious diseaserelated, and inflammatory markers, while the representatives of tests for vector-borne diseases, healthcare-associated infections, and chronic viral infections remained stable.The study highlights the potential of clinical microbiological testing trends as an additional surveillance tool and offers implications for future infectious disease management and surveillance strategies in pandemic settings.

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