Coronary heart disease is a leading cause of mortality in many countries. Acute coronary syndrome is the basis pathophysiology of coronary heart disease. Complication of coronary atherosclerosis composes rupture of plaque and erosion of vulnerable plaque. Endothelial dysfunction is main influence of coronary plaque erosion. But then recently research oxidative stress and reaction of immunocomplex is leading cause of coronary plaque rupture. So the research background will study markers of endothelial dysfunction, oxidative stress, immune reaction in the complication of coronaryatherosclerosis. Aim: Determine the effect of some marker for causing complication of the coronary atherosclerosis. The research has been conducted using case-control study method. In the case group, patients with complication of the coronary atherosclerosis as determined by coronary angiography (stenosis >85%) as in the control group healthy people with carotid artery stenosis (<0.7mm) has been involved. In the study we defined Anti-oxLDL (anti-oxidized low density lipoprotein) using ELISA Kit (Eucardio Lab, USA) and oxLDL (oxidized low density lipoprotein) titer by ELISA Kit (Mercadio, USA), ADMA (Asymmetric dimethylarginine) titer by ELISA kit (Eucardio Lab, USA) reagents in the enzyme binding reaction. Total antioxidant capacity (TAC) was determined by using spectrophotometer method. The average age of people involved in the research is 57.2±9.72 and for the average age is case group 28 (32%) and 50 (68%) for the control group. ADMA titer level for complication of coronary atherosclerosis or case group is (30.1±1.98 ng/ml) which is (13.2±0.57 ng/ml) greater than the control group. It was statistically significant result (p<0.001). Also titer level for case group is oxLDL (72±2.75 mU/l), anti-oxLDL antibody (766±29.8 mU/ml), which is oxLDL (45.1±2.28 mU/l), anti-oxLDL antibody(603±17.74 mU/ml) greater than the control group. It was statistically significant result (p<0.001). But TAC titer level for control group is (116±2.47 nmol/l) which is (108.3±5.43 nmol/l) greater than the case group. It was not statistically significant result (p=0.098). According to the Binary Logistic Regression test the anti-oxLDL (OR=0.992, p<0.001), ADMA (OR=0.681, p<0.001), TAC (OR=1.017, p=0.105), oxLDL (OR=0.900, p<0.001) levels significantly influence the complication of coronary atherosclerosis. Therefore according to the Binary Logistic Regression test the anti-oxLDL level high significantly influence the complication of coronary atherosclerosis. Anti-oxLDL antibody titer are correlated directly with oxLDL (r=0.413, p<0.01), ADMA (r=0.42, p<0.001) levels. However, correlated negative directly with TAC (r=-0.233, p<0.01) level. Markers of endothelial dysfunction (ADMA OR=0.681, p<0.001) and oxidative stress (oxLDL, OR=0.900, p<0.001), (anti-oxLDL antibody, OR=0.992, p<0.001) high influence causing of complication of coronary atherosclerosis.

Introduction: A considerable proportionof adult living donor liver transplantation(LDLT) recipients experience biliarycomplication (BC), but there are few reportsregarding BC based on long-term studies ofa large LDLT population.Methods: The present study examinedBC incidence, from 16 adult and pediatricpatients (14 right liver and 2 left liver graft )between 2011 and 2016 First Central Hospitalof Mongolia.Results: The mean follow-up period was36±1 months. First Central Hospital has DDanastmosis (n=22) double DD (n=2) singlehepaticojejunostomy (n=3). There 3 caseshave biliary stricture after operation. One ofthe 3 cases has biliary laek 2 months laterafter the operation.Conclusion: Close surveillance for BCappears necessary for at least the first 3 yrafter LDLT. In terms of anastomotic stenosisrisk, HJ appears a better choice than DD forright liver grafts involving ducts less than 4mm in diameter.

NEED FOR STUDY AND GOAL: There is no data available on pupil’s health with relation to the school environmental condition and organization of educational activities in Mongolia. Therefore, the goal of the study was to assess organization of the educational activities and conduct hygienic assessment of chemical and bacteriological contamination in the school environment.MATERIALS AND METHODS: A total of 1440 children were surveyed in this cross sectional study from the 6 secondary schools of UB city, Uvurhangai and Dornod aimags.Hygiene conditions of school was assessed and organization of educational activities evaluated by class timetable and pupil’s notes of daily regime.RESULT: Timetable of lessons: It was observed that in some cases teachers’ taught to primary pupils Mathematics and Mongolian language for 2 sequential hours, depending on some indexes such as lesson content, capacity and student’s activity. According to timetable of lessons of the secondary schools, pupils have lessons for 32-34 hours in a week. It was revealed that most schools have 2-3 hours more than standard timetable and heavy lessons were taught for 2-3 sequential hours. For the secondary classes, average length of classes was 32-34 hours in a week which indicates 2-3 hours longer timetable. There was no special place for physical training and movement games etc where pupil can do physical exercise, relax and enjoy school life. DAILY REGIME: pupils have been spending most of their time watching TV and listening music and spending few hours to help housework, to read a book and to prepare meal. Urban pupils spent total of 0.5-1 hour for coming to school and going to home but rural pupils spent 20-30 minutes approximately. RESULT OF THE LABORATORY ANALYSIS: The bacteriological analysis of 36 classes in schools showed that before lesson, 94.4% of classes were clean while 5.6% was contaminated in first season of school year. After the lesson, percentage of classes without contamination had been dropped to 88.8% and classes with contamination had been increased to 11.2%. In the 4th season of school year, before lesson 61.6% of classes was clean and 16.6% was contaminated and 22.3% was highly contaminated. Moreover, after the lesson, classes without contamination had been dropped to 27.7% while 72.3% was at high level contamination.CONCLUSION: 1. Time table of lessons and break time management is inadequate in the schools and 32-39.1% of pupils do not follow the daily regime. 2. In the end of day, chemical and bacteriological contamination increased in the classes.

INTRODUSTION: There have been limited research studies done in Mongolia on health status of children in relation to density of children in school classrooms.GOAL: This study aims to evaluate learning ability of children in Mongolia and develop recommendations for next intervention measures.MATERIALS AN METHODS: A total of 1440 children were surveyed in a cross sectional study that included 6 classes from 6 secondary schools of UB city, Uvurhangai and Dornod aimags. The test of letter drawing created by of V.Ya.Anfi mova was used to evaluate the pupil’s learning skills. This test was performed at the fi rst and last classes in each day of which was tested at the beginning (I quarter or September) and end (IV quarter or May) of the academic year.For each tests we accounted the mean of drawing letter, mean of mistake for 500 letter and standard deviation.RESULTS: The results of pupil’s letter drawing tests were compared by quarter for fi rst and last classes in each day. Pupil’s learning ability of class 4 was enough while other classes were not enough (P index 1) on the fi rst and last tests.CONCLUSION: Pupil’s learning ability has been changed by the same way of physiological adaptation process of child.Pupil’s learning ability had been decreased in last tests of each day and on Friday which was revealed by letter drawing test.Pupil’s learning ability of classes between 4 to 9 were not enough on the fi rst term while 4th class was good enough on the forth term (P index 1).

Coronary heart disease is a leading cause of mortality in many countries. Acute coronary syndrome is the basis pathophysiology of coronary heart disease. Complication of coronary atherosclerosis composes rupture of plaque and erosion of vulnerable plaque. Endothelial dysfunction is main influence of coronary plaque erosion. But then recently research oxidative stress and reaction ofimmunocomplex is leading cause of coronary plaque rupture. So the research background will study markers of endothelial dysfunction, oxidative stress, immune reaction in the complication of coronaryatherosclerosis. Aim: Determine the effect of some marker for causing complication of the coronary atherosclerosis.The research has been conducted using case-control study method. In the case group, patients with complication of the coronary atherosclerosis as determined by coronary angiography (stenosis >85%) as in the control group healthy people with carotid artery stenosis (<0.7mm) has been involved. In the study we defined Anti-oxLDL (anti-oxidized low density lipoprotein) using ELISA Kit (Eucardio Lab, USA) and oxLDL (oxidized low density lipoprotein) titer by ELISA Kit (Mercadio, USA), ADMA (Asymmetric dimethylarginine) titer by ELISA kit (Eucardio Lab, USA) reagents in the enzyme binding reaction. Totalantioxidant capacity (TAC) was determined by using spectrophotometer method. The average age of people involved in the research is 57.2±9.72 and for the average age is case group 28 (32%) and 50 (68%) for the control group. ADMA titer level for complication of coronaryatherosclerosis or case group is (30.1±1.98 ng/ml) which is (13.2±0.57 ng/ml) greater than the control group. It was statistically significant result (p<0.001). Also titer level for case group is oxLDL (72±2.75 mU/l), anti-oxLDL antibody (766±29.8 mU/ml), which is oxLDL (45.1±2.28 mU/l), anti-oxLDL antibody(603±17.74 mU/ml) greater than the control group. It was statistically significant result (p<0.001). But TAC titer level for control group is (116±2.47 nmol/l) which is (108.3±5.43 nmol/l) greater thanthe case group. It was not statistically significant result (p=0.098). According to the Binary LogisticRegression test the anti-oxLDL (OR=0.992, p<0.001), ADMA (OR=0.681, p<0.001), TAC (OR=1.017, p=0.105), oxLDL (OR=0.900, p<0.001) levels significantly influence the complication of coronary atherosclerosis. Therefore according to the Binary Logistic Regression test the anti-oxLDL level high significantly influence the complication of coronary atherosclerosis. Anti-oxLDL antibody titer arecorrelated directly with oxLDL (r=0.413, p<0.01), ADMA (r=0.42, p<0.001) levels. However, correlated negative directly with TAC (r=-0.233, p<0.01) level.Markers of endothelial dysfunction (ADMA OR=0.681, p<0.001) and oxidative stress (oxLDL, OR=0.900, p<0.001), (anti-oxLDL antibody, OR=0.992, p<0.001) high influence causing of complication of coronary atherosclerosis.

BackgroundOut of total 209550 cases of cardiovascular diseases in 2011, 66,7% were newly registered cases.Cardiovascular diseases are the number one cause of mortality in Mongolia; an estimated 6291 peopledied from CVDs in 2011, representing 36.7% of all deaths. It shows that CVD mortality level is higherthan in other countries.Materials and MethodsOur survey is a cross sectional study. We have investigated 600 people of the age of 20-40 whowere randomly selected from 6 urban districts of Ulaanbaatar city. With a permission #4 issued bythe Medical Ethics Control Committee of the Ministry of Health on 25th March 2011, our survey wascarried out between the 1st of July 2011 and the 1st of January 2012 based on the Functional DiagnosticLaboratory, Department of Physiology and Pathophysiology, School of Biomedicine, Health SciencesUniversity of Mongolia.ResultsThe CAVI was significantly higher (p<0.001) in 30-40 aged adults (6.68, 95% CI 6.58-6.78) than 20-29 aged adults (6.42, 95% CI 6.32-6.52). Also CAVI has a direct correlation with the cholesterol level(p<0.05, R2=0,011). Serum cholesterol, triglycerides and LDL levels were significantly higher (p<0.05)in men than women. Framingham Heart Score was in the normal range in 99.2% of the participantswith 4 cases having the score of 10% or higher representing a risk score.ConclusionsDislipidemia, overweight and obesity in young adults are the main causes of vascular dysfunctionsleading to cardiovascular diseases. Thus, the findings of the study demonstrate that helping youths todevelop healthy lifestyles including healthy eating and physical activities shall play a critical role for theprevention and intervention programs designed for development of healthy behavior and lifestyle fromchildhood, especially for the male population, are vital for fulfillment of this role.

BackgroundHuman-induced climate change will affect the lives of most populations in the next decade and beyond. The impact of meteorological conditions on human health has been reported globally. There is a need to conduct surveys for correlation between climate change and human health.GoalTo study the impact of air temperature on human health in selected aimags and city districts.Materials and MethodsIn order to study how climate change and air quality parameters affect human health we selected Zavhan, Selenge, Dornod, and Umnugobi aimags which represent different climate zones and 2 districts of Ulaanbaatar city during 2009-2011. All data for respiratory system disease J00-J99, circulatory system disease I00-I99, were collected from soum, district’s hospital, and aimag and soum’s Department of health.ResultsDuring the study period, a total number of 8649 incidences of respiratory disease are registered. From them 74.2 percent are influenza and pneumonia (J09-J18), 17.6 percent are other acute lower respiratory infections (J20- J22), and 8.2 percent are asthma (J45-J45.9). For cardiovascular disease 15288 incidences are registered. From them 65.6 percent are hypertensive disease (I10-I15), 23.6 percent are ischemic heart disease, and 10.8 percent are cerebrovascular diseases (I60-I69). The lower the air temperature, higher the incidence of influenza and pneumonia, acute lower respiratory infections, hypertensive, and ischemic heart disease.ConclusionsCold weather is correlated with a higher incidence of respiratory and cardiovascular diseases.

Structure, size of trachea and bronchial tree are well known in modern time. There are hundreds of research about respiratory anatomy havebeen done in developed countries. Our team interested that when and how airway structure to become investigated. In Shinong king’s period (2838 – 2699 BCE) human anatomical feature was described rough and ready and note down in books and other treatises. In Guang – Tae king’s period ( 2698 BCE), the trachea divided into 7 pieces in the thorax cavity described in medical treatise named “Nei King” .Since 8th century BCE when autopsy introduced in India, the morphology started in science as evidence based science. All the theories at the time based on research findings represent that medical science has been developed as a evidence based science since 16thcentury in Mongolia. The late 18 century, period of renaissance technology and science, structures of the respiratory system start investigated in detail. 1889 V.Ewart , There are many scientists attempt to measure size of airway structures, unfortunately the results were quite different that may due to material, method and anatomical feature differences. Thus, future intensive research is needed in order to prosecute out previous docotr’s and scientists studies.

Introduction : Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder that occurs during childhood development, which presents with signs of reduced attention and hyperactivity [1]. Necessary nutrients, such as trace minerals, including manganese, iron, zinc, iodine, selenium, copper, and chromium, are associated with changes in neuronal function that can lead to adverse effects on behavior and learning [2]. In addition to these, social, emotional, behavioral problems, and cognitive impairments such as executive dysfunctions are common in ADHD [3]. Goal: To evaluate the hair elements and intelligence quotient in children with ADHD. Materials and Methods: This is a cross-sectional comparative study conducted at elementary schools of Ulaanbaatar city. All in all 60 children of both genders aged between 7-12 years old were included in the study. Children were divided into two groups as children with ADHD group and a control group. Each group had 30 children. For assessment of emotional Intelligence EQ-i:YV - Emotional Quotient Inventory: Youth Version (Bar-On & Parker, 2000; it ad. Sannio Fancello, & Cianchetti, 2012) was used. Scalp hair samples were randomly collected from approximately ten sites around both sides of posterior parietal eminences and external occipital protuberance. Samples were then packed at room temperature and submitted for laboratory analysis. The study was approved by the Research Ethics Committee of Mongolian National University of Medical Sciences (Reg. No. 2018/Д-10). Results: The IQ of children with ADHD group were 85.03±16.86 p<.0001 and the IQ of control group =108.9±21.22, p<.0001. We identified hair minerals such as Mg, Zn, Pb, Se, Mn. We have then compared to each group and normal ranges of ages. ADHD group and the control group had Pb concentration that was slightly higher and inversely Mg concentration was slightly lower (r=-0.502, p=.005). Concentration of Pb, IQ were directly opposite (r=-0.38, p=.03). Conclusion
1. IQ was lower in the ADHD group compared to control group 85.03±16.86 p<.0001, monitored group 108.9±21.22, p<.0001.
2. The group with ADHD had lower Mg, Zn, and higher Pb, Se, Mn (p<.0001). The IQ decreased when there was increased Pb and decreased Mg.

Introduction : Water is a vital resource for human existence and is essential for daily food processing, preparation, washing, hygiene, and sanitation. Furthermore, providing the population with safe drinking water is one of the pressing problems of the world and some regions.
In recent years, population density and the scale of commercial and industrial activities, as well as clean and dirty water consumption were increased in the capital city. As a result of these, ground and surface water resources are becoming scarce and polluted.
Therefore, assessment of daily drinking and residential water consumption of Ulaanbaatar should be determined to use drinking water properly in daily life and water loss. This study assessed the actual amount of households’ daily water consumption. Goal: The purpose of this study is to determine the daily consumption of drinking water for households in ger areas and apartments in Ulaanbaatar. Materials and Method: This study covers 30 households in ger areas and 15 apartment households, in Ulaanbaatar. Household members performed 6-10 types of measurements every day, within 7 days. As a result of these measurements, actual consumption of water quantity used for drinking and household purposes was calculated. Statistical analysis was done by SPSS Version 21 to calculate the true probability of difference between parameters. Result: 67.9% of the households in the ger areas were 4-5 family members. The average daily household consumption of drinking and domestic water were 68.3 ± 3.57 L (95% 61.3-75.3), the minimum consumption was 12 L, and the maximum was 227 L. Average of the household water consumption water was 97.6-108.9 liters during the weekends, and water consumption was statistically higher than weekdays (p=0.001; p=0.01).
The water consumption of residential households with 3 family members accounted for the majority (30.8%) in this study. The average daily consumption of drinking and domestic water was 297.67±19.7 liters. There was no statistically significant difference (p=0.96) in week. The average daily water consumption including drinking and residential was 270.3-335.97 L.
The total daily drinking and residential water consumption per person was 15.57 L for households in ger areas and 90 L for apartment households. Calculating the daily water consumption of households in ger areas, 60.3% of it is used for laundry, washing dishes, food preparation, washing face and hands, and clothes, 31% for drinking, and 8.7% for outdoor water use. While apartment households, approximately 94.1%, were used for household and 5.9% for drinking purposes. Research ethics approval : This study was discussed at the meeting of the Academic Council of the National Center for Public Health. In addition, this study was carried out according to the methods and methods discussed and approved at the meeting of the Medical Ethics Control Committee of the Ministry of Health (Resolution No. 08). Conclusion The total daily consumption of drinking and residential water per person were 15.57 litres for the households in the ger areas and 90 litres for the apartment households. It implies that it does not exceed the WHO recommendations