IntroductionThere are an estimated 246 million people with diabetes mellitus globally and this figure is predictedto rise to 380 million by 2025, with the most rapid growth in developing countries, among the workingage group of the population.Now in Mongolia, the more than half of population live in cities and settlements, following thisurbanization the population`s diet and lifestyle has been changed to more western style and morepeople affected by diabetes mellitus.Diabetic retinopathy is the most common chronic and devastating complication of diabetes whichleads to visual impairment and blindness. Diabetic retinopathy develops in nearly all persons withtype 1 diabetes and in more than 77% those with type 2 who survive over 20 years with disease. Thecurrent estimates of the prevalence of diabetic retinopathy vary in different countries. The WHO hasestimated that diabetic retinopathy is responsible for 4.8% of 37 million cases of blindness throughoutthe world.Significant independent predictors of proliferative diabetic retinopathy determined by multivariableanalysis were fasting plasma glucose level, duration diabetes, plasma cholesterol, systolic bloodpressure and therapeutic regimen.In recent years a number of randomized clinical trials have shown that interventions to improvemetabolic control, careful monitoring and treatment reduce late diabetic complications.GoalTo establish the prevalence, severity and risk factors of diabetic retinopathy type 2 diabetic patientsin Ulaanbaatar.Materials and MethodsThe study conducted by cross sectional study. Randomly selected 235 patients type 2 diabetic patientsfrom Bayanzurh districts of city Ulaanbaatar. Participants provided a detailed medical and personalhistory, underwent an ocular examination including funduscopy. Fasting blood glucose-FBG, totalcholesterols, triglyceride, HDL were determined by methods of laboratory in venous plasma.ResultsThe prevalence of diabetic retinopathy among people with type 2 diabetes was 37.4%. The prevalencenon-proliferative diabetic retinopathy was 17% (40), pre-proliferative diabetic retinopathy was 8.1%(19), and of proliferative diabetic retinopathy was 12.3 %( 29).The mean age of participants with diabetic retinopathy was 57.4 years (range 26-79). The meanage of participants with non-diabetic retinopathy was 53.6 years (range 26-76). The prevalence of diabetic retinopathy did not vary significantly with age. Retinopathy was positively associated with alonger reported duration of diabetes and with higher fractions of blood glucose (p<0.05).Progression of diabetic retinopathy positively associated with high level fasting blood glucose (6.2mmol/l), total cholesterol (4.5 mmol/l), systolic pressure (130 mm Hg) diastolic pressure (90 mm Hg),triglyceride (2.2 mmol.l) and low level HDL (1.1 mmol/l).ConclusionRisk factors for diabetic retinopathy were found to be high level of blood glucose, longer duration ofdiabetes. Diabetes poor control was significantly associated with progression of diabetic retinopathy.

The present study was conducted to assess relationship between drinking water fluoride levels and dental caries among 12 years old school children of 2 districts of Ulaanbaatar city, Mongolia. A cross-sectional analytical study was conducted on 533 school children aged 12 years, selected from 6 schools of 2 districts of Ulaanbaatar city. 533 children were divided into 2 groups according to the fluoride concentration of the waters. The all children were examined oral examination, dental caries was assessed by the DMF-T index. The result of the present study revealed that the caries prevalence in the study population was about 68,9%, and mean DMF-T was 3.05. Water fluoride concentration was highest in Khan-Uul district with 0.622ppm. There was highest prevalence of caries in children who consume water from filtration system in both districts.

There were currently diagnosed by totally 177 cases with HIV in our country. The 82.3% of those were male and 72.9% of them were men sex with man. Sexual minority group especially men who intercourse with male are highly risk to HIV infection. By the study of 2011, which aimedto assess risk to exposure HIV infection among sexual minority group, 56.2% of all participants answered as had depression symptoms and 12.8% of them seen to psychologist and health workers. In addition, 2% of them used by injection of drug for last year, and 60.6% harmfully drank.The study was done by quantitative and qualitative methods and used specific designed questionnaire for sexual minority with HIV infection. Totally 26 consumers participated in our survey. Before the starting of the study, we introduced inform consent to all participants and if they agreed to participate, we coded research cards and collected the information.All participants were answered alcohol drink, and 46.1% of them determined with heavy drinking or harmful consumption by the AUDIT versus 7.8% were alcohol dependence. 65.3% oftotal participants used as smoke, 5 cases used cannabis; one of them has been used within last twelve months. In addition, 23.1% of all participants had anxiety and 15.3% had mild depression symptoms. Of the total 26 cases, 7 cases had suicide thinking related with sexual orientationand 2 cases had suicide thinking related with HIV infection. Those cases answered often feeling hopeless and helpless.In sexual minority group with HIV, alcohol and tobacco consumption was high, drug abuse was low. 15.3-23.1% of all participants had depression and anxiety symptoms. Suicide thinking has been occurred for those cases it means risk to suicide commitment.

The present study was conducted to assess relationship between drinking water fluoride levels and dental caries among 12 years old school children of 2 districts of Ulaanbaatar city, Mongolia.A cross-sectional analytical study was conducted on 533 school children aged 12 years, selected from 6 schools of 2 districts of Ulaanbaatar city. 533 children were divided into 2 groups according to the fluoride concentration of the waters. The all children were examined oral examination, dental caries was assessed by the DMF-T index.The result of the present study revealed that the caries prevalence in the study population was about 68,9%, and mean DMF-T was 3.05. Water fluoride concentration was highest in Khan-Uul district with 0.622ppm.There was highest prevalence of caries in children who consume water from filtration system in both districts.

Background: Last years increased the human and animal cases of anthrax. During 2000-2009 infected 197 livestock of them 73 cattles, 7 horses, 13 goats and 104 sheep and 10 human cases of anthrax at Khentii province. Goal: We are aimed to evaluate human and animal cases of anthrax which registered at Khentii province last 10 years.Materials and methods: Used for registration of veterinary report of 2000-2009, last 10 years report of human cases of CIDNF Khentii province. Analyzed the data, compared and evaluated the result of human and animal anthrax cases. Results: The Khentii province included at zone of middle risk, active foci by classification of anthrax risk foci (Tserendorj and et all, 2006). Totally 1148 livestock infected by anthrax during 2000-2009 in national level and of them 17.1% registered at Khentii province. Infected 10 patient during 2000-2009 occurred 12.7 % than national level. Most of patients 95.2% (16) infected by used the skin, meat with died from anthrax. The 4.8% (1) of all patients infected from soil which work at soil. All patients infected by bubonic form. Last 2007, 2008,2009 disinfected at soil and decreased the detection of cultures or positive results from soil.Conclusion: The high risk of human anthrax depends on most likely from animals and soils. Herders take more risks due to their job specialization. Male workers of working age groups are generally infected by anthrax in particular. Especially assistant workers in agriculture and mining sectors are extra vulnerable in anthrax. The new areas have been infected by the virus of human and animal anthraxes because of increases of animal movement from place to place. The reasons of animal movement are number of people working in commercial and hand operated gold mining, herders movement to another area for looking pasture (otor) and growing number of celebration activities (Batshireet, Norovlin soum in 2007).

Goal: To determine schoolchildren’s growth and nutrition situationMaterials and MethodsThe descriptive and cross sectional study was carried out in 4 districts of Ulaanbaatar city (750 schoolchildren from each district) and 2 aimags (889 schoolchildren from Uvurkhangai and 925 from Dornod) of Mongolia. The study was conducted in two steps, Step 1 or beginning of school year covered totally 4760 schoolchildren and in end of school year totally 4108 schoolchildren. Data for the survey was collected by using questionnaire and clinical examintions and antropometric measurements. Weight of schoolchildren was used UNISCALE electrical scales with precision to 100g and height was used standard measurement with precision to 1mm. Schoolchildren’s growth was assessed by method “Sigma” and compared to the survey “Growth means of schoolchildren up to 16 years of Mongolia” (PHI, 2006). The nutritional status of schoolchildren were taken in accordance with the Z score calculated with relation to WHO average population anthropometric reference (WHO, 1995). Also determined current nutrition situation of surveyed schoolchildren by using 24 hours recall method and assessed. Nutrition assessment was used the standard indicators of Technical Committee, WHO [3, 7, 8].ResultsA total of 4760 (46.6% boys and 53.4% girls) school children were present beginning of the school year and 4108 (46.0% boys and 54% girls) of their were end of school year during the visit. Almost 60 of the total school children were from districts of UB beginning and end of school year. Beginning of the school year, 5.1 percent of total surveyed schoolchildren were assessed underweight and 14.1 percent is stunting, 1.7 percent is wasting and end of school year it was 4.7 percent underweight, 13.9 percent stunting and 1.2 percent wasting.71.7 percent of total respondents have breakfast sometimes, 83.2 of them have a lunch only one time per day, and 38.3 percent of total daily energy takes from dinner and have not any difference between age groups. Consumption of food products such as green vegetables, beef liver which are rich with vitamin A is inadequate. Example; among 7-10 years old 184.9 mcg, 11-14 years 247.2 mcg, above 15 years old was 241.6 mcg. Amount minerals such as calcium and phosphorium per day was among 7-10 years old 398.2mg and 756.1мг, 11-14 насанд кальци 277.8-301.5мг, фосфор 688.6-899.5мг, above 15 years old was calcium 366.4-378.3mg, phosphorium 875.3-978.8mg. Dairy consumption was analyzed by urban and rural areas among schoolchildren and it was among urban schoolchildren is more by 16.6-21.4 percent from rural areas.Conclusion:1. The progress made improving gradually the nutritional status of schoolchildren from previous study. The prevalence of underweight, stunting and wasting is “low” level among schoolchildren by WHO. There is statistically significant lower nutritional status among schoolchildren in rural area than in urban.2. Micronutrient deficiency is main reason of undernutrition among schoolchildren. In other words, the vitamins (C, A, D), and minerals (Ca, Fe) which are essential for schoolchildren growth and fiber is insufficient in their food. The consumption of diary is inadequate among schoolchildren of rural area compared to urban.3. Consumption of fruits and vegetables and diary products is inadeguate among total surveyed schoolchildren especially in rural area.

Introduction: We classify peritonitis as end-stage if it lasts for more than 72 hours or more than three days. At this point, the pleural effusion of the posterior abdominal wall, the pleural layer of the gastrointestinal tract, and the dimples of the esophagus are all scattered with pus. During the first operation, it is very difficult to completely cleanse these abscesses. After the operation, pus will collect in the abdomen and abscesses will form, which will require another operation. If this postoperative complication is not diagnosed in time and operated again (relaparotomy), many other complications can occur and the risk of death is high. 48-hour relaparotomy mortality is higher than early surgery (21.8% -76.8%). Necrotic pancreatitis is chronic peritonitis (an abscess of the lower extremities) in which only non-pancreatic adipose tissue, sebum glands, pericardial effusions, pericardial effusions, and kidney adipose tissue become necrotic. Purpose: Endoscopic surveillance for chronic pleurisy with pancreatic necrosis Objectives:
1. Endoscopic monitoring of the postoperative course of pancreatic necrosis.
2. Calculate the results of washing and cleaning using binoculars. Method: Patients with advanced peritoneal inflammation and necrotizing pancreatitis should be selected for reoperation. After removing the dead pancreatic tissue (necrosectomy), all layers of the abdomen are temporarily closed. A 6 mm short tube with surgical rubber is cut into the small pancreas, inserted 2 cm deep into the standard abdomen and sutured to the skin. Or use a silicone tube 4 - 5 cm long. Result: The study was carried out on 56 patients in 2016-2020. The mean age was 50 (89%) for men, 6 (11%) for women, and 47.5 ± 8.6. Conclusion
1. Endoscopic follow-up showed 19 (76%) persistent postoperative peritonitis and re-clearance, and 6 (24%) patients were not diagnosed with persistent peritonitis.
2. 25 (50%) cases of persistent peritonitis after surgery were washed 1-3 times. This method has proven to be a safe and easy procedure and can be used in any urban or rural hospital.

BackgroundEarly detection of minor strokes and their treatment that aim to prevent from complications into severe strokes is a process of secondary prevention. There is a need to extensively use image diagnostics (CT, MRI) because signs are obscure, at times without focal neurological sign but can have special mental or psychological syndromes. The start of minor stroke studies in Mongolia will enable further deepening of these studies in future and give an impetus to identification of theoreticaland practical aspects together with further improvement of diagnostics, treatment and prevention of minor strokes.GoalTo develop and introduce the diagnostic criteria of ischemic and hemorrhagic minor strokes in accordance to the concepts of minor strokes and to treat minor stokes in order to prevent complications into severe strokes.Materials and MethodCurrently there are no globally accepted diagnostic criteria for minor stroke. We support the 1981 WHO criteria of minor strokes as strokes neurological signs of which disappear in relatively short period of time. There is a general notion that it should mean all light forms of stroke other than severe strokes. In cases of neurological signs of a minor stroke, complete recovery and elimination of the symptoms take up to 3 weeks. Most scholars tend to consider ischemic lacunar strokes (arising from occlusion of arteriole vessels deep in the brain and with size of 0.5-20 mm) as minor strokes. We maintained the concept that characteristic features of these strokes are their limited focal areas and the following neurological symptoms: pure motor, pure sensory, light ataxia, etc. We also duly considered a suggestion (D. German, L. G. Koshchug et al, 2008 ) to define minor hemorrhagic strokes as strokes with diameter less than 2 cm and blood volume less than 5 cm3.We identified 60 patients with minor strokes, involved in monitoring using special research template (with a term of at least 1.5years) and involved in pathogenesis treatment. In the treatment, we maintained a principle of differential diagnosis of ischemic stroke symptoms. Specifically, we differentiated the following: signs related to an atherotromb, cardio-embolic, lacunar, hemodynamic, hemorheologic pathogenesis. To verify the diagnoses, we used MRT and CT image tests. We executed paraclinic tests in order to identify risk factors: Doppler-duplex-sonography, brain angiography, blood lipid fraction, ECG, EchoCG, heart Holter, blood hemorheology test, and identified the most affecting factors (hereditary factors, excess weight, smoking etc).Results: Our study identified the following clinical forms: lacunar stroke, non-lacunar minor stroke, and hemorrhagic minor stroke. Among the minor strokes, the lacunar stroke dominates (48%), the nonlacunar stroke is the next (27.7%), and the hemorrhagic was found to be the least common 25%. From among a host of risk factors, arterial hypertension is dominant (86%) either alone or in combination with such other diseases as diabetes, atherosclerosis etc. Diabetes occurrence was 5 cases (8,3%) which is fewer than in some foreign studies.The clinic of minor stroke also varies. The strength and expression of their symptoms compared with those of severe strokes are unique in the following:- Relatively lighter and recover faster as a result of treatment even in acute forms,- Some are without specific clinical signs (“silent stroke”).- Some minor strokes have micro focal signs, for example, “pure motor”, pure sensory, ataxia etc, in other words, the signs are limited.- In cases of lacunar strokes, predominantly deep brain arterioles are damaged.- Whereas in non-lacun strokes, embolic, ateroma, thrombotic mechanisms are predominant suchas distal branches of big artery. - In cases of hemorrhagic minor strokes, arteriopathy distortions occur not only in depth of brain but also in any small lobar vessels of brain.- Focal lesions have some variations by their pathological locations and minor stroke signs.In non-lacunar strokes (25%), the focal damages predominantly occur in branches of large intra/extra cranial arteries. In cases of lacunars strokes, the focal lesion is not in branches of large intracranial vessels, but is predominantly in basal ganglia, deep white matter, thalamus, pons and in area of deep penetrating arterial vessels. However, focal infarcts in cerebella may occur in any form of minor strokes.ConclusionAccording our study there were identified 3 subtypes of minor stroke. The finding is that lacunars and hemorrhagic minor strokes are more likely to give grounds to severe strokes. From this, it can be concluded that there are specific factors in the population of Mongolia to affect the genesis of minor strokes, namely, arterial hypertension which is directly related with these forms of minor strokes. We appropriate the WHO criteria of minor stroke that is neurological signs of a minor stroke, complete recovery and elimination of the symptoms take up to 3 weeks. In treatment of minor stroke, we suggest that minor strokes should be treating by pathogenetic therapy. Namely, antihypertensive therapy for lacunar infarction, anti-aggregation therapy for nonlacunar infarction and haemostatic and antihypertensive therapy for hemorrhagic minor stroke.