Introduction: The World Health Organization describes poor adherence as the most important cause of uncontrolled blood pressure and estimates that 50–70% of people do not take their antihypertensive medication as prescribed.Goal was to measure non-adherence to antihypertensive therapy in a representative sample of the hypertensive Mongolian population and to define the factors associated with non-adherence in the studied population.Materials and Methods:This descriptive study was a questionnaire-based cross sectional analysis. A simple random sample of 735 hypertensive patients, aged 35-64 years was selected. The questionnaire included sociodemographic characteristics and awareness about hypertension and anti-hypertensive treatment, and factors that encouraged or discouraged the patient’s drug taking behavior. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS), with a 4-item questionnaire. Blood pressure was measured twice by the physicians using aneroid sphygmomanometers and stethoscopes. Results and Discussion: The study sample consisted of 265 men (36.1%) and 470 women (63.9%). The mean age of participants was 53.8 ± 8.7 years. The non adherence to medical treatment found in the our study was 68.3% of hypertensive patients. We found younger age (35-44), low family income, not having a regular doctor towards hypertension control, behaviour not taking drug regularly, monotherapy and lack of patient’s knowledge to be the significantly factors influencing on non-adherence to anti-hypertensive medication among Mongolian hypertensive population. The non adherence to antihypertensive treatment found in the current study was higher than that of 25.9%-55.8% found in the study done in Malaysia, Pakistan and Egypt and lower than what a study in the Bangladesh , India and Brazil (74.2%-90.0%)population.Conclusion: The level of adherence to treatment among the participants in this study seriously needs to be improved through well designed health promotion and education strategies in order to prevent poor treatment outcomes.

There are a lot of influencing factors of facial nerve palsy; experts believe that is most likely caused by a Virus (54%) and Bacterial infections. Noninfectious causes of facial nerve palsy induce tumors (28%) and less commonly influences head trauma (18%). The retrospective analysis of WHO, in 2012. There are some cases of postoperative complication in middle ear surgery is facial nerve palsy and the total recovery outcome of function was not good. From 2013 to 2016 in EMJJ hospital, Mongolia, we enrolled 16 cases with facial nerve damaged in intratympanic canal but we could not recruit some patients with facial palsy over 6 months. Each subject was tested with pure tone test, ABR, Tympanometry. These were performed for the detection of hearing loss after Temporal bone injury. Then we also investigated location of facial nerve damages of patients by MRI and CT before reconstructive surgery. After that surgery, all patients were given corticosteroid treatment (20mg/day) and physical therapy performed such as acupuncture for a week. Study results revealed that 6 cases after 18 days, 2 cases after 30 days, 1 patient after 45 days of reconstructive surgery regained good symmetry. Therefore, we considered that, postoperative treatments like physical therapy with B12, steroid had good benefits for operation result and to shorten the recovery time. There was a patient who had damaged facial nerve in the tympanic segment during Mastoidectomy. In that case, we performed cable nerve grafting using the r.auricularismagnium but we could not recover facial nerve function. Traumatic facial nerve paralysis is the second most common type. We discussed that performing reconstruction surgery within first 3 months after intratemporal facial nerve injury is extremely desirable and more effective. In our opinion, nerve recovery might be not successfully cause of injured myelin sheet of facial nerve during middle ear surgery.

Background: It is stated in the Government Programme of 2016-2020 that public servants, including health care workers, shall be given a gradually increased salary based on their skill, dexterity, workload, and productivity, and such increase started from 2018 as planned. In the health sector of our country, regarding demand and regulation of the programme, the change shall be made that the system for median salary of physicians and overall staff employed at hospitals gets even constructive, and the required human resource for the sector shall be prepared. Thus, inferring from these claims, median salary, real wage, and socioeconomic condition are in critical need for further evaluation. Objective: To examine the current socio-economic condition of health care workers, and to study the influencing factors at play. Methods: In this study, we used quantitative and qualitative methods. In the survey, we involved 655 health care workers from 6 family health centers, 2 district hospitals, 3 health centers (district-based) in Songinokhairkhan, Sukhbaatar, and Baganuur districts; and Provincial hospital, regional diagnosis and health center, 16 soum health centers from Khovd, Uvs, Arkhangai, Bulgan, Khentii, Dornod, Umnugovi, and Dornogovi provinces, along with 3 National specialized health centers and 1 National central hospital. As for data gathering for the qualitative analysis, 30 focus group interviews and 47 key informant interviews were conducted for the purpose of examining socioeconomic condition, real wage sufficiency of health care workers. Results: Average household income of study participants was 1,880,269 tugrik, the real wage was 1,073,065 tugrik, and the overall household is seen to be composed of 2 different sources on average, namely, self-wage and the income coming from family members or supplement of Child Money Programme. It has come to notice that 19.5% of the participants have lower than average living standard, 89.2% have 2 different loans (mortgage, auto loan or mobile application based loans). Material deprivation index is seen to be 2.73, hence deemed as insufficient. In order to increase the real wage of those workers, it shall be taken into consideration that the basic salary is low, and some financial supplements need to be given. Furthermore, the performance based funding system of health sector is seen to be in need of improvement. Conclusion Real wage of the health care workers is, thus, insufficient. The fact that one in every five workers in this sector have lower than average living standard, and the material deprivation index is 2.73 implying that the financial lives of health care workers are immensely fragile.

Background: Psychosocial work environment predicts a range of health risks including sickness absence, poor self rated health, and depression. Objective: To identify association between psychosocial work environment and health related indicators among health care workers in Mongolia Methods: A cross-sectional study was conducted between January and April, 2023. 655 health care workers from Ulaanbaatar city and 4 aimags were involved. Psychosocial work environment was assessed by the Effort-reward imbalance model. As for the health related indicators, we used the SF-12 questionnaire and sickness absence report. Descriptive and inferential statistical analyses were performed.
The study was approved by Medical Ethics Review Committee on January 18, 2023 (#23/02). Results: 1 in every 2 health care workers experience effort-reward imbalance at work and rated their health as poor. In average, 32.7 percent of the study participants took 16.6 sick days for the last 1 year. The study identified poor physical (44.7±8.6) and mental health functioning (42.1±9.8) among study participants. Physical functioning was lower among nurses whereas mental health functioning was lower among physicians. Conclusion Poor health related indicators among health care workers are associated with adverse psychosocial work environment such as effort-reward imbalance and high effort and low reward

Background: The first case of COVID-19 was reported in our country on November 11, 2020. As of 2023, a total of 869,385 cases and 2,128 deaths have been recorded nationwide. The World Health Organization (WHO) has recommended that countries use 15 vaccines from 11 manufacturers listed for emergency use. The WHO has advised low-income member states to prioritize vaccinating healthcare workers and other high-risk populations vulnerable to severe illness and death from COVID-19. The main goal of the coronavirus vaccination program is to prevent infection, complications, and death among priority target groups, such as healthcare workers and other populations at high risk of severe illness. The effectiveness of the vaccination is measured by its ability to reduce the risk of illness, hospitalization, and death from COVID-19-related complications among vaccinated individuals. While extensive research is being conducted globally to develop, evaluate, and assess the effectiveness and outcomes of COVID-19 vaccines, there has been limited research focused on these outcomes within our country. This gap highlights the need for and serves as the basis of the present study. Аim: To assess the risk of infection, hospitalization, and associated risk factors among healthcare workers vaccinated against COVID-19, and to examine the factors that influence these risks. Materials and Methods: A This follow-up study was conducted over an 80-week period—at weeks 12, 24, and 48—from February 23, 2021, to December 31, 2022. The study involved healthcare workers from Ulaanbaatar city and the aimags of Bayankhongor, Orkhon, Bulgan, Dundgovi, Darkhan-Uul, and Dornod. The study was conducted over a period of 1.5 years (80 weeks) following the administration of the first two doses of the COVID-19 vaccine. Data were collected from participants at three time points: before vaccination, after the second dose, and after each booster dose. A structured questionnaire comprising 7 sections and 49 questions was used for data collection, and the results were analyzed using SPSS version 26.0. Results: Of the total respondents, 574 (60%) worked in direct contact with infected individuals in the 'red zone,' while 370 (40%) worked in the 'yellow zone.' Additionally, 250 participants (27.1%) were healthcare workers from Ulaanbaatar city, and 674 (72.9%) were from rural areas. In our observational study, the risk of new infections among healthcare workers increased over time, rising from 38.4% at week 24 to 59.6% by week 80. Hospitalizations also increased during the follow-up period: 24 cases (2.6%) were recorded at week 12, 160 (17.3%) at week 24, 202 (21.9%) at week 48, and 204 (22.1%) by week 80. Among frontline workers in rural areas, those in Bayankhongor and Orkhon aimags exhibited a lower risk of infection compared to their counterparts in other aimags. Conclusion In our follow up study, an increase in the duration since primary immunization was associated with a higher risk of new infection among workers, rising from 38.4% at 24 weeks to 59.6% at 80 weeks post-vaccination. Administration of additional (booster) immunizations was associated with a reduced risk of subsequent infection. COVID-19 vaccination was associated with a reduced risk of complications necessitating hospitalization. Employment in rural settings and designated red zones was identified as a risk factor for incident infections, hospitalizations, and reinfections.