Goal: Thoracic surgery usually used for anesthesia double lumen endotracheal tubes, then ventilatedone lung.Methods: The clinical records of the 160 cases patients who had double-lumen endotracheal tubes toplace in National Cancer Center of Mongolia (this structure starts from the inferior part of the larynxin the neck, opposite the 6th cervical vertebra, to the intervertebral disc between Th4-5 vertebrae inthe thorax, where it divides at the carina into the right and left bronchi). Inpatients during one lunganesthesia done 2012- and 2014 were reviewed. All cases were performed high Level thoracic epiduralcatheterization and put double lumen tube for jugularinternal vena. Double-lumen endotracheal tubesare not meant for postoperative ventilation. In addition, because of their significantly larger size andstiffness, they have a higher propensity for trauma after insertion, which may result in postoperativehoarseness or vocal cord lesions.Results: We are reporting 2012- 2014 anesthesia department at National Cancer Center. In our studyinvolved all 160 open thoracic surgery cases with DLT. In study had anesthesia tidal volume7.77+1.07ml/kg, one lung volume 5.87+0.46 ml/kg, the women DLT size 33.43+7.25Fr, deep 27.68+2.47 cm, manDLT size 37.09+7.69cm, deep 28.43+2.6 cm. During anesthesia monitored averageSaO2-95%+1.07,in analyzed arterial blood average SpO2- 92.605 %+5.69 (p<0.032).Conclusion: One lung anesthesia separating two lungs by double lumen tube (DLT) – the advantagesof the method are allowing surgeons to operate safely in collapsed side of lung; there are a few reportsof airway damages. The bronchoscopy procedure is in need to use during the alloperations. Other typesof separation tube are required to be (especially in children) introduced.

Introduction: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Materials and Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 2000 to Jаn 2016 was performed at Shastin Medical Hospital neurosurgery department. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were S. intermedius (n=3), S. aureus (n=3), S. pneumoniae (n=1), Group B streptococcus (n=2), E. coli (n=1), P. aeruginosa (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.

Thoracic surgery usually used for anesthesia double lumen endotracheal tubes, then ventilated one lung in NCC of Mongolia The clinical records of the 160 cases patients who had double-lumen endotracheal tubes to place in NCC of Mongolia. In patients during one lung anesthesia done 2012- 2014 were reviewed. All cases were performed high level thoracic epidural catheterization and put double lumen tube for jugular internal vena We are reporting 2012- 2014 anesthesia department at National Cancer Center of Mongolia. In our study involved all 160 open thoracic surgery cases with DLT. In study had anesthesia tidal volume 7.77+1.07ml/kg, one lung volume5.87+0.46 ml/kg, the Mongolian women DLT size 35.43+2.25Fr, deep 27.68+2.47 cm, Mongolian man DLT size 37.09+4.69cm, deep 28.43+2.6 cm. During anesthesia monitored average SpO2-95%+ 1.07,in analyzed arterial blood average SaO2- 92.65 %+ 5.69. (p<0.032) One lung anesthesia separating two lungs by double lumen tube (DLT) – the advantages of the method are allowing surgeons to operate safely in collapsed side of lung; there are a few reports of airway damages. The bronchoscope procedure is in need to use during the all operations in Mongolia. Other types of separation tube are required to be (especially in children) introduced. In the future lungs, esophagus, mediastinal tumors and heart, spine and vascular surgery need double lumen tube to global standards anesthesia widely available in Mongolia. The thoracic anesthesia use double lumen tube outside the epidural anesthesia decided that it can be combined with postoperative pain control. Correct technique of placing the double lumen tube one lung anesthesia surgical team and the shortness of time and the surgical risk patients with post-surgical complications and reduce mortality is of high importance in Mongolia. In our study is a dominant decided that it was linked to smoking habits

INTRODUCTION:According to the report from 2010, Mongolian water consumption was 550 million cubic meter andapproximately 9.1% of the total Mongolian population obtain their water from inadequate hygiene waterresources - springs and rivers. Due to non-hygiene water usage has caused water-born communicableand non communicable diseases among the population. In the last years there has been issue of pollutionof one of the Mongolia’s more representative river Selenge and its following rivers -Kharaa, Orkhon andit is necessary to evaluate water pollution of these rivers.GOAL:To determine water chemical and biological pollution of Kharaa and Orkhon river and to evaluate waterqualityMaterials and MethodsWe collected water, sediments and macro invertebrates sample from three points of river -upstream,midstream, downstream and for Kharaa river the samples were collected from Tunkhel, Mandal andBayangol soum, fo Orkhon river the sequence was Orkhontuul, Orkhon, Khushaat soum. Samples werecollected June, August, October of 2011, 2013.In water sample, we determined physic-chemical 15 parameters including temperature, pH, total dissolvedsolids, conductivity, smell, color, hardness, sulfate, chloride, nitrate, nitrite, ammonia, dissolved oxygen,biological oxygen demand and mercury using their standard methods. Macro invertebrate samples werecollected to evaluate water quality and we determined mercury in sediments and macroinvertebratesamples to evaluate mercury contamination.RESULT:Physic-chemical results of the water showed that water of Kharaa, Orkhon rivers were classified lowmineralized, soft water and nutrient pollution indicators for ‘slightly polluted’category. For dissolved andbiochemical oxygen, they were belong to the category of ‘pure water’.There were no correlation between 2012 and 2013 results and mercury in water, sediments and macroinvertebrates were qualified standard value.CONCLUSION:According to research results water quality of Kharaa, Orkhon river was good and have less pollution andit is possible to use in household consumption after proper cleaning and disinfection.

INTRODUCTION:Waterborne diseases, especially diarrhea, related to water quality and safety, personal sanitation and hygienehave been still reported very high in developing countries. Globally, there are an estimated 1.4 million casesof hepatitis A every year. The hepatitis A virus is transmitted through ingestion of contaminated food and wateror through direct contact with an infectious person. Hepatitis A is associated with a lack of safe water and poorsanitation [2].Dysentery is bloody diarrhea, i.e. any diarrheal episode in which the loose or watery stools contain visiblered blood. Dysentery is most often caused byShigella species (bacillary dysentery) or Entamoeba histolytica(amoebic dysentery) [3].Kharaa and Orkhon River are tributaries of the Selenge River-basin, in which many mining and other industries,agriculture, and residential areas reside. It has become a one pollutant factor for water of the Kharaa andOrkhon rivers. As a result, water of the Tuul, Kharaa and Orkhon River was reported to be highly contaminated(Mongolian Human Development Report 2010: Water and Development report) [4].GOAL:The aim of the research was to study incidence of gastrointestinal infectious diseases among population ofsoums are located in Selenge River Basin.MATERIALS AND METHODS:Data on health statistics 2009-2013 years of gastrointestinal infectious diseases, including dysentery, diarrhea,hepatitis A virus and others, were collected and analyzed.RESULTS:Incidence of dysentery was registered highly among people who live in Mandal soums in 2009-2013 years. Butincidence of dysentery (per 10 000 population 2.82) among population ofMandal soum lower than the Selengeprovince and National average. Incidence of hepatitis A virus was registered highly among people who livein Orkhon (74.46), Orkhontuul (48.86) soums and it was greater than 1.3-2 times than the Selenge provinceaverage. Incidence of diarrhea was registered highly among people who live in Khushaat soum and it wasgreater than 2.18-3.8 times the than Selenge province averageCONCLUSION:Incidences of diarrhea and hepatitis A virus were registered highly in Orkhon, Orkhotuul and Khushaat soumscompared to other target soums and it was greater than 1.3-3.8 times than the Selenge province average.Especially, these diseases were registered highly among 0-16 aged children.

Introduction: A brain abscess is aserious disease of the central nerve system.We conducted this study to summarize theclinical manifestations and outcomes ofbrain abscesses.Materials and Methods: A retrospectivechart review of pediatric patients diagnosedwith brain abscesses from November 2000 toJаn 2016 was performed at Shastin MedicalHospital neurosurgery department.Results: Twenty-five patients wereincluded in this study. On average, 1.67cases per year were identified and themedian age was 4.3 years. The commonpresenting clinical manifestations were fever(18/25, 72%), seizure (12/25, 48%), alteredmental status (11/25, 44%), and signs ofincreased intracranial pressure (9/25, 36%).A total of 14 (56%) patients had underlyingillnesses, with congenital heart disease(8/25, 32%) as the most common cause.Predisposing factors were identified in 15patients (60%). The common predisposingfactors were otogenic infection (3/25, 12%)and penetrating head trauma (3/25, 12%).Causative organisms were identified in 64%of patients (16/25). The causative agentswere S. intermedius (n=3), S. aureus (n=3),S. pneumoniae (n=1), Group B streptococcus(n=2), E. coli (n=1), P. aeruginosa (n=1),and suspected fungal infection (n=5). Sevenpatients received medical treatment onlywhile the other 18 patients also requiredsurgical intervention. The overall fatality ratewas 16% and 20% of patients had neurologicsequelae. There was no statistical associationbetween outcomes and the factors studied.Conclusion: Although uncommon, a brainabscess is a serious disease. A high level ofsuspicion is very important for early diagnosisand to prevent serious consequences.

In recent years, many researches that is related to waterborne diseases, especially diarrhea and water quality, safety, personal sanitation, hygiene have been conducting in developing country. Kharaa and Orkhon river are tributaries of the Selenge river basin and the many industries,agriculture, mining, provinces, soums are located in the near of Selenge river basin. Also Tuul,Kharaa and Orkhon river water is very polluted (Mongolian human Development Report 2010: Water and Development report).The aim of the research is to study correlation between to Kharaa and Orkhon river’s water pollution level and rate of gastrointestinal infectious diseases of people who live in the near of Selenge river basin.We analysed Kharaa and Orkhon river’s water quality and statistical data of gastrointestinal infectious diseases (such as dysentery, diarrhea, hepatitis A virus and others). Then we conducted correlation analysis between to river water pollution level and rate of intestinal infectious diseases. Kharaa and Orkhon river’s water was determined “less polluted” by physical, chemical andorganic indicators. But total number of bacteria was determined highly and Proteus vulgaris,Citrobacter freundi, Enterobacter agglomerans pathogens were detected in these river’s water. There were significant positive correlations between level of nitrit in river water and incidence of dysentery and diarrhea. (r=0.38, p=0.022; r=0.291, p=0.005).

BACKGROUND. Uterine cervical cancer is the fourth leading cause of cancer deaths in women worldwide. In our country, cervical cancer is second most common cancer in women. Uterine cervical smear (Papanicolaou test) remains an effective and widely used method for early detection of precancerous and cancerous lesions. Since 2002, the cervical smear was introduced to the clinical practice of our country. However, there is no study to performed external quality assurance of cervical smear until now. MATERIALS AND METHODS. We selected 20 glass slides of uterine cervical smear, the diagnosis was approved by histopathology. Each chosen slides were evaluated by four cytologists of A, B, C, D hospitals with hidden clinical information, independently. RESULTS. The sensitivity of A, B, C and D hospitals were 87.5%, 93.3%, 93.3%, and 93.3%, respectively. The specificity of A, B, C and D hospitals was 85.7%, 85.7%, 75%, and 66.6%, respectively. The diagnostic concordance of A, B, C and D was 70%, 75%, 50%, and 55%, respectively. The agreement of cytological diagnosis was moderate (kappa = 0.55), moderate (kappa = 0.43), fair (kappa = 0.37), and fair (kappa = 0.33) in A, B, C, and D hospitals, respectively. CONCLUSION: The external quality assurance in cytopathology is needed in Mongolia. The diagnostic concordance method would be applicable in our country to improve diagnostic agreement.

Introduction: Within the framework of health sector reform, the development of the organization, the responsibility of doctors and medical professionals, and the improvement of ethics, quality and safety of care and services are top priorities. Customer satisfaction is important for the implementation of this operation based on results and quality. The WHO Recommendation states that health professionals have a key role to play in providing information and advice to citizens and their families on how to prevent, mitigate and address air pollution, and how to inform the general public and decision-makers. ADB, the Ministry of Health, and UNICEF report that information and promotional materials on air pollution prevention are scarce and do not provide advice to clients. Therefore, it is the reason for conducting a survey to determine the level of satisfaction of clients receiving child health care. Materials and methods: The survey data were collected using quantitative and qualitative research methods. In this study, totally 1160 guardians of children aged 0-5 participated from Songinokhairkhan and Bayanzurkh district and Bayankhongor aimag center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation and environment of Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. Research methodology discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2). Results: 84.7 percent of the respondents were parents of children aged 0-5 years. Their average age is 34, most of them have higher education, and 43.0 percent of them have a household income of 500,000-1 million MNT. Guardians of children aged 0-5 years in Bayanzurkh District were “dissatisfied” with the Family Health Center’s dressing room, wardrobe, toilet and parking lot. Guardians of children aged 0-5 years in Songinokhairkhan district were “dissatisfied” in the parking lot and toilet of the health organization. Guardians of children aged 0-5 years in Bayankhongor aimag were satisfied with the services, operation and environment of the health organization. Studies have shown that 76.5 percent of the guardians did not receive air pollution risk training. As for difficulties in preventing air pollution, 31.4 percent of the surveyed population answered that they cannot change their living and working environment to prevent air pollution. Conclusion It shows the health care organizations need to improve the hospital environment as well as to provide training how to protect children from air pollution risk for guardians.