In recent years, not only in our country also in other foreign countries, there is a tendency that the number of newborn with the developmental dysplasia of the hip (DDH) is going to be increased. For our country, there are few research activities or analyses on negative factors for anomaly, and prevalence of developmental dysplasia of the hip or birth defects of hip. In addition, it considers that birth defect is increasing involved with external environment contamination and other unpleasant factors of population and decision-makers. In conclusion, there is a tendency of increasing DDH cases among the newborns and the above risk factors may affect in certain extent. We need to conduct in-depth study on prevalence and risk factor to DDH in Mongolia and develop further on prevention and management of DDH in newborns. Goal To study some risk factors infl uences to DDH in under 5 years old children and develop further on prevention and management of DDH in newborns. Materials and Methods The sampling size of the research is based on the number of under 5 years old children with DDH diagnose or Q18-79 classifi cation, and the number of under 5 years old children with DDH who are under the control of family physicians in central 6 districts (BZD, BGD, SBD, SKHD, KHUD, and CHD), Ulaanbaatar city. In addition, we have selected total 90 mothers with under 5 years old children who were treated, and served by outpatient visit in district clinics for case group. Occupational physicians diagnosed these children and certifi ed that they have DDH. In addition, we have selected total 90 mothers by 1:1 with under 5 years old healthy children with it sex and ages above-mentioned using sampling method for control group. The following programs were used to analyze the data: The study data was entered by Excel spreadsheets. SPSS 11.4 program was used to analyze the data. Result In our research, and 55 or 61.1% of the children are girls and 35 children or 38.9% are boys. First-born children are 57.8% of case group mothers and 52.2% of control group mothers. In consideration for birth type of babies involved in our research, 22.2% of children with developmental dysplasia of the hip and dislocated hip were born by caesarean section, and in statistic probability, most of them are girls (p=0.08.t=2.8). The relevance of birth type has a direct low (Rxy=0.3) bearing on the fetal lie and the wrong fetal lie is the cause of caesarean section. In case group, average birth weight is 317668.5, the limit of weight is 1400-4600 kg while in control group average birth weight is 327853.2, the limit of weight is 1900-4500 kg (p=0.14). 14.5% of the case group children in our research have hereditary disease, 7.8% of that are from female side and 6.7% (p=0.04) are from male side and for control group children with developmental dysplasia of the hip and dislocated hip, 4.4% of them are from female side disease. In the clarifi cation of previous pregnancy of mother with DDH baby now, it says that 18.9% of total mothers have negative genetic and most of them had had an abortion and natural abortion in repeated amount. The negative genetic of mothers previous pregnancy in case and control group is deferent in its statistical probability (p=0.006). 4.4% of mothers with DDH defect had given a birth before with DDH defects also. Case group children were also clarifi ed if they have other birth defects. In the result of the clarifi cation, there are 6 or 6.7% of case group children with other birth defect and 4 of them have cardiac arrhythmia and cardiac ventricle fi stula, 1 with elbowjoint defect, and 1 with ankle joint and heel, for control group, there are 3 children or 3.3% with birth cardiac defects (OR=2.07;0.5-8.5). 74.4% of control group mothers were kept under the control when they were in their 1-3rd month of pregnancy and 25.6% of them were kept under the control when they were in their 4-6th month of pregnancy (p=0.06). Most of the case group mothers or 65.6% and 48.9% of control group mothers had anaemia. Anaemia is different between the case and control group in statistical probability (p=0.024). 51.1% of case group and 32.2% of control group mothers were suffered communicable disease. Communicable disease is different between the case and control group in statistical probability (OR=2.2 (1.201-4.028), p=0.01). 93.5% of case group and 93.1% of control group mothers had suffered from diseases like infl uenza and influenza. 85.6% of case group, 28.9% of control group mothers were with chronic diseases. Mothers chronic diseases is is different between the case and control group in statistical probability (OR=14.58 (6.93-30.67), p=0.005). Conclusion: 1. For DDH had become such factors as heritage, age of mother, pregnancy surveillance time period, birth weight of the baby, pregnancy complications and ailments, mothers virus infection, anemia, chronic diseases, working conditions, use of medications and preparations that infl uence both singularly or jointly. 2. It is possible to prevent those factors and for doing this, it is in need of providing the women of age of possible pregnancy, nursing mothers, and parents with necessary information by the family and midwife gynecologist doctors.

Background: A biological lifespan (ageing) refers to determination of levels of country development, change, and decline in operations of organism system and structure. A biological age indicates a normal state of body, organism structure and functions depending on calendar ageing; and determines the changing of bio-markers5 . In modern theoretical and methodological view traditional medical “wind, bile, phlegm” are “initial elements” and “mind properties” of the human body (Dagvatseren B., 2003). By the theory of traditional medicine the “wind, bile, phlegm” elements are all together been in whole human body and their regulate with function of the human body. The “wind, bile, phlegm” elements are defined by their characters. It may possible correlative measure of “wind, bile, phlegm” and biological ageing. Introduction: In the resent years the occurrences of cardiovascular diseases and related metabolic syndrome have been increased in Mongolia and Asian countries. Mongolians’ mean average of human lifespan is 66.54 years (data of 2008) and Mongolia stays at the medium level of human development. According to the health statistical data of 2008 among total deaths caused by cardiovascular diseases 43.1 percent belongs to hypertension, 30.7 percent – to ischemic heart diseases. Due to epidemiological study 3.2% of adults younger than 44 years, 10.27% of people aged from 45 to 54 years, 36.54% of age group from 55 to 64 years, 34.61% of people aged from 65 to 74 years suffer from ischemic heart diseases (Tsegeenjav D., 2003). Therefore it is required to use healthy life-style to prevent Mongolian people from cardiovascular diseases by matching and combining their reach tradition and custom of live regime, organism peculiarities by regulating their meal, behavior with advanced medicine preventative methods in accordance with urbanization and nomadic cattle-breeding conditions. Aim: The aim of study was investigation of biological ageing status and traditional medical constitutional correlation of Mongolians during ischemic heart disease. MATERIALS AND METHODS. Research was done by the method of Randomized Controlled Trail during 2007-2009 at the Department of Traditional Medicine and Angiography of Shastin Central Hospital, School of Traditional Medicine, HSUM and Medical Research Institute. Research was done due to permission from the Ethical Commission 01/01 of Ministry of Health, Mongolia (2007), and followed international standard of research with the involving of human sources. A total of 240 healthy people - volunteers (control group) and 150 patients with diagnosed ischemic heart diseases (case group) underwent the research. People were aged from 40 to 69 years of age, 57.4% were male and 42.6% were female. Risk factors of the heart coronary disease are studied within the people, who participated in research study and biological ageing is defined for those participants. A biological age was studied in order to determine (B.P.Voitenko, 1991) biomarkers. Investigation of traditional medical body constitutional types was obtained using a self-reported questionnaire, including human habits, speech and emotions. Ischemic heart diseases diagnosed by echocardiography and angiography. Also bio-chemical and lipid regulation indices such as cholesterol, triglyceride, and high, low densities lipoprotein were determined for both groups. RESULT The 5% of examined people have had a primary school education, 31% - high school education, 30% - college education, and 34% higher education out of 390 participants. In case of smoking, the biological age of smokers in 8 years longer than non-smokers, the biological and calendar ageing levels are equal in control group of participants. Difference between biological and calendar ages of alchohol users and non-users are less in 2nd group.Bological age of people, who do regular physical exercises, is 2.5 years longer than calendar age. Biological age of people with genetic heart desease is 2.09-2.22 years shorter, biological age of people with extra weight of body was 2.57-4.37 years shorter than normal people.Traditional medical constitutional types were determined and correlated within biological ageing and ischemic changes of cardiovascular system for each age category. Healthy people’s biological age with “bile-phlegm” constitution is late by the chronological age; “wind-bile” and “phlegm-wind” constitution groups’ biological age are faster than the chronological age. People aged from 50 to 59 show faster biological age than chronological one. Ischemic heart diseases diagnosed in total of 150 examined people. 26.9% of diagnosed participants have had damage of left coronary artery, 31.4% - damage of anterior branch between left coronary artery ventricular (p

Introduction: In order to Implement the Mongolian government's 2000 provisions for national health care, on May 28,2004, the Health Minister approved the "Home Care Nursing Service and Rules for Caring and Nursing" according to resolution # 136 and indicated that family clinic nurses should provide home care nursing services [6'71. Interestingly, it is noted that throughout the world, nursing home services have not been limited to family clinic nurses but are being delivered by nurses with diverse areas of specialization.Goal: Purpose of the study is to determine needs for making home nursing services to the population in some province and soum.Objectives:1. To comparatively search needs for providing home nursing services to citizens in the province and soum which were involved to the study.2. To determine nursing type which is required at home3. To develop needs of nurses who make home nursing servicesMaterials and Methods: Conducted studies among the 1109 people from the 520 families in 17 soums of five provinces such as Orkhon, Bulgan, Arkhangai, Khuvsgul and Selenge. We have chosen the clients with anamnesis who are repeatedly served and treated at the hospital for our study and had interviews with them. Questionnaire for citizens consists of 2 basic chapters including 17 questions which determine demographic information and needs of home nursing services. We asked and searched about needs of Home Care Nursing assistances under the 3 basic groups such as General nursing, Treatment nursing and Specialized nursing. After inserting study data into the SPSS-17 program, checked it by appropriate statistical methods (t, x2, fisher exact) and checked if difference between groups and relations has statistical truth.Results: 35.89 percent of clients who got involved to the study answered that they are interested in taking nursing and caring services at home. Also we consider needs for having home nursing at home according to numerical indexes in the provinces involved to the study, clients mostly want to be injected by intramuscular (25.88%), intravenous (31.02%) and IV fluid (30.57%). As we consider specialized nursing assistances at home under the types of needs, health education and assistance for people suffered with hemorrhage and injured people occupy major percent. Clients who got involved to the training, were asked question "With whom do you want to be made nursing assistance at home?" and 75.6% of them answered that they prefer nurses of family clinic.Conclusions:1. It was observed that 35.89% of clients who got involved to the survey, want to receive home nursing assistance and demands for home nursing is being increased with aging.2. Also we conclude that nursing after hemorrhage, nursing for injured patients and nursing for patients with cardiovascular disease occupies higher percent and it shows that percent of cardiovascular diseases and injuries is relatively high and clients' needs to receive nursing assistance at home are faced problems after they were discharged from hospital.3. 75.6% of people who got involved to the study are interested in taking home nursing assistance and we reached to conclusion that it is suitable to train nurses according to it.

Even though the use and production of polychlorinated biphyls (PCBs) and organochlorine (OC) pesticides have been regulated worldwide, in agreement with the Stockholm convention in 2001, they are still posing serious environmental threat both to wildlife and humans. These lipophilic compounds, with high resistance to degradation and long half- lives in humans, have been confirmed to bioaccumulate in fatty tissues of biological specimens such as blood, breast milk, and adipose tissues through dietary intake. The analysis of these tissues reveals the rate of exposure and distribution in the environment.

Background: Spine disorder is the first cause of disability of workers below 45 years and economicalburden costs 20-50 billion us.dol, in European countries. Lumbar disc hernia estimates 40% of 30-50aged population in U.S and in Japan 26/10000. In last 5 years, spine surgeries increased in 4-5 timesdue intervertebral disc hernia, at Shastin State Third Central hospital of Mongolia.Goal: To populate new methods of surgical treatment for compressive lesions of spinal cord, spinalnerve root of cervix, thorax and lumbar spineMaterials and Methods: We did clinical research involving patients who had spine surgery at ourdepartment due “compressive lesion of spinal nerve root and spinal cord”. From, total 217 patients,excluded 9. Excluded cases are: declined from surgery 3, Arnold-Chiari malformation 5, and epiduralabscess 1. We collected data with permission of patient and did statistical analysis by IBM SPSS 17.Results: The surgery for intervertebral disc hernia takes 84.6% (176) of total surgery and 94.9% (167)of lumbar disease. Tumor of spinal cord estimates 9.1% (19) of total case, dominates in lumbar area(57.9%). We used posterior approach mostly, because it is frequently used in lumbar spine. The surgerycontinued 36-750 min (204.6, SD 128.5) ten patients (4.8%) had complications. In this project weused 5 surgical methods totally in solitary or combined. Spondilodesis is the most combined methodamong them. We used Oswestry disability index in Mongolia at first, to count treatment effect. Currentindex evaluated pre and post surgery period. Patient complaint and difficulty of daily life progressivelydecreased after surgery and almost disappeared at third month (p<0.00).Conclusion:1. It is possible to develop international standard surgical treatment of compressive lesions of spinalnerve root, spinal cord of cervix, thorax and lumbar spine in Mongolia.2. We used Oswestry disability index in Mongolia at first, so this questionnaire is simpler and accuratemethod for spine, spinal cord induced disability.3. Twenty seven point nine percent of patients who had surgical treatment has minimal to moderatedisability by Oswestry disability index, so it means we have to process standard of spine surgeryand increase non surgical treatment efficiency.4. Working ability recovers faster when spine surgery has been done.5. These new methods of spine surgery are cost effective than same surgery which will be doneabroad.

BackgroundDandy described first, about intervertebral disc hernia (1929). Mixter W.J and Barr J.S (1934) investigated that correlation of sciatica and lumbar disc hernia. Discectomy is most confirming surgery among all spine surgery. Asymptomatic lumbar disc hernia revealed in 70% of adult, by MRI. Spine disorder is first cause of disability of workers below 45 yrs, in European countries. International research for predisposing, risk factors of intervertebral disc hernia is widely confirmed, but diagnostic and treatment aspects are not completed.Materials and MethodsWe did computer aided search using key words “disc degeneration, risk factor, discectomy, lumbar disc hernia, spinal instrumentation” in online library: MEDLINE, E pub, PUBMED, HINARI, Mongolmed, years 1970-2011, also domestic research works from Central library of HSUM, Mongolia. We included article, case-control study, systematic review, case study.ConclusionIncidence and disability caused by lumbar disc hernia, requiring surgical treatment is common problem in world. By anatomical region, lumbar disc hernia is the highest. Research work revealed that patients who took surgical treatment different by gender (male:female=2:1), geographical region (US 160/100000, Switzerland 62/100000). At last 20 yrs, dramatically changed theory about predisposing factor of disc hernia. It is changed from mechanical load to genetic role. Disc degeneration disease is basis of disc hernia. Nucleus pulposus, annulus fibrosus losing own structure, containing moleculs, and water under degeneration. The risk factors are frequent heavy lifting, frequent twisting and bending, vibration, sedentary work, driving and overweight. The golden standard surgery of herniated disc of cervical area is anterior cervical discectomy and fusion (ACDF). Posterior screw fixation of lumbar vertebrae is most frequently confirming surgery among the world.

Introduction:Cardiovascular disease morbidity has been continuously increased among the population of Khangai region in the last 10 years - as of year 2010 for instance the rate was 1.5 more in Arkhangai aimag and 1.2 more in Khuvsgul aimag compared to the average rate nationwide. This research study was conducted due to the higher rates listed above in the region and the need to clarify various issues related to the medical care being provided with respect to the illness.Goal:It was deemed necessary to analyze the existing situation of early detection, monitoring and treatment of arterial hypertension among the population of the chosen province and to develop improved methodology.Objectives:1. To study the early detection of arterial hypertension2. To examine whether or not the clients are being given the needed recommendations related to the arterial hypertension monitoring and medicine treatmentMaterials and Methods:Cross sectional, organization based survey with 52 questions was carried out among 87 doctors/professionals of 17 soum and 100 family and aimag's general hospital of Orkhon, Bulgan, Arkhangai, Huvsgul and Selenge aimag. SPSS-17 program and Fisher test was used to generate and develop information.Results:Each soum, inter - soum and provincial doctor is responsible for checking/measuring the arterial pressure of their respective registered number of population by the percentage listed below: Soum doctor-56%, inter-soum doctor-50%, aimag's doctor-46,9% (p=0.19). Body weight and height are being irregularly measured on each chosen level (52.9%-62.5% p=0.67). Similarly the BMI is also being irregularly determined (42, 9% - 54, 5% p=0.07).From all the patients who have an arterial hypertension, 54.3%-55.6% are being monitored by dispensary and 11.1%-14.3% (p=0.53) are being regularly monitored in the chosen medical organizations. Although it is required to repeatedly measure and monitor the arterial pressure depending on its level the result shows that no planned monitoring is being done for the 77.8% of the patients. It is not sufficient for a sound and family doctor to recommend the regular use of antihypertensive the 48.6%, inter- sound doctor 43% and aimer's doctor 29% ( p= 0.40).Conclusions:1. The arterial hypertension - early detection practice is shown to be inadequate at the Chosen health care level (p=0.19).2. For the most clients with the arterial hypertension (59.9% p= 0.40), recommendations on regularly using antihypertensive is not being done - half the clients (54.3% - 55.6%) with the arterial hypertension are not being monitored.

Background: Monocyte / High Density Lipoprotein Ratio (MHR) has become an inflammation marker of atherosclerotic cardiovascular diseases and is a handy and reliable diagnostic marker at a low cost. Objectives: to suggest MHR as a new inflammation marker for ASCVDs by comparing it with other risk factors of cardiovascular disease and assessing the significance in screening Methods: This study conducted during October to December 2019 is a hospital-based cross sectional study, with a total of 396 clients, all 20 to 64 years old, were selected as subjects of the study using a certain criteria. Results: 78.47% of the male subjects and 34.31% of female subjects were diagnosed with dislipidemia, which shows us that males were diagnosed more frequently. The study sample consisted of 274 (72.87%) men and 102 (27.13%) women with mean age of 36.6±8.42 years (range, 20-64 years), 78.47% were male and 34.31% were females. 66.49% of total participants were newly diagnosed with dyslipidemia. An age group of 30 to 40 years old were recorded with the highest cases of dyslipidemia. Monocyte / High Density Lipoprotein Ratio (MHR) were 7.88 and 12.82 in dyslipidemic and non-dyslipidemic subjects, respectively and showed that there is a statistically significant difference(p<0.05). The 10-year ASCVD risk of 113 people aged 40-64 years, which were classified in low risk group (<7.5%) and in high risk group (≥7.5%) were assessed by pooled cohort equation and the results shows that risk percentage were 65.14% and 34.86% and there is statistically significant difference in MHR, which were 10.58±4.80 and 14.07±4. 90 in respective groups. Conclusions Prevalence of dyslipidemia in preventive screening were high in a group of 20-62 years old and the group of those were estimated high The 10-year ASCVD risk, also had relatively higher MHR. Moreover, there is a positive relation between dyslipidemia and MHR. These results show that it is possible to use MHR as a new inflammation marker in ASCVDs for early detection purpose.

Background. Low back pain is a frequently encountered symptom. Although 70-80% of the entirepopulation have low back pain complaints in their lives, only 2-4% of them require surgical intervention.’Department of Neurosurgery, Shastin 3rd Central Hospital about 200 patients who undergo back surgery,while 90% of patients who have prolapsed lumbar disc surgery from 2010 to 2012. There are variousstudies indicating that exercise improves pain and disability in chronic low back pain and in those whohave had surgery. The main objectives of the postoperative rehabilitation programmes are to accelerateand maximize function recovery as much as possible, and to prevent further injury by restricting theprogression of degenerative changes. We evaluated the effectiveness of rehabilitation treatments thatare used in our department which is the first time in our country.Goal. To evaluate the effectiveness of rehabilitation after lumbar discectomy.Materials and Method. We examined 83 patients were included the Shastin central hospital, Departmentof neurosurgery and rehabilitation after lumbar discectomy at a single level and operated in the periodfrom May 15, 2013 to September 15, 2014. All patients were evaluated at the beginning and at theend of treatment by Oswestry Disability Index which is a specific functional questionnaire for back pain.Pretreatment values are one month after surgery and posttreatment values three months after surgery.All patients received the intensity specific exercise and back school education programme 3 days aweek for eight weeks.Results. All patients pain intensity are reduced after treatment evaluated by VAS (p<0.000). Functionalability had significantly increased after treatment which is evaluated by Oswestry Disability Index in allpatients (p<0.000). 46 from all patients had minimal disability before treatment and this number wasincreased in to 79 after treatment. The number of moderate and severe disabled patients ability wasincreased after treatment.Conclusion: Back school education and specific exercise programme should be one of the parts oftreatment after lumbar discectomy. After treatment was increased functional ability and early painrelief.

BACKGROUND: Pediatric day surgery shortens the hospital stay, reduces the exposure of nosocomial infections and allows for active parental participation. But pain delays the recovery and it increases the morbidity, including nausea and vomiting, and the maladaptive behavioral changes. This study was conducted to compare the effect of rectally administered paracetamol or diclofenac combined with regional nerve block with the traditional pain control method. METHODS: Two hundred forty one randomly selected pediatric patients were allocated into two groups. The empirical pain relief group (the control group, n = 120) included the patients that received intravenous sulpyrin and/or meperidine postoperatively. The patients in the multimodal preemptive pain relief group (the study group, n = 121) received regional nerve blockade with 0.25% bupivacaine combined with preoperative rectally administered paracetamol 45 mg/kg or diclofenac 1 mg/kg 60 min before surgery for cases that were to undergo lower abdominal surgery. But only paracetamol or diclofenac was rectally administered preoperatively in the other surgical cases. RESULTS: The mean time in the recovery room for the study group was shorter than that for the control group. The postoperative pain was hurts even more in 16.7%, worst in 11.8%, a whole lot in 26.5% and no pain in 27.5% of the control group patients. But the pain was hurts little more only in 11%, a little bit in 10.0% and no pain in 88.9% of the study group patients. The average postoperative VAS score was 0.21 +/- 0.6 in the study group and 8.36 +/- 1.7 in the control group, respectively. Vomiting, nausea and fever were more frequently observed in the control group. CONCLUSIONS: The pain intensity of the children who were treated with rectally administered paracetamol or diclofenac combined with regional nerve block before surgery was significantly decreased as compared to that of the children who were treated with the traditional method.
Acetaminophen ; Ambulatory Surgical Procedures ; Bupivacaine ; Child ; Cross Infection ; Diclofenac ; Dipyrone ; Fever ; Humans ; Isothiocyanates ; Length of Stay ; Meperidine ; Mongolia ; Nausea ; Nerve Block ; Pain Management ; Pain, Postoperative ; Parents ; Recovery Room ; Vomiting