BACKGROUND: One of the confronted problems of health branch of Mongolia is to confirm pregnancy and delivery to health of mother and baby and to decrease early neonatal mortality and stillbirth. Rate of perinatal mortality becomes real index of health and quality of health care. In the world more than 6 million perinatal mortality and 2.6 million stillbirths occur in 1000 birth every year. In Mongolia last year’s birth increases and perinatal mortality hasn’t been decreased yet. By 2013 perinatal mortality of country and aimag 14.4 per 1000 birth, in eastern and khangai and central regions and Ulaanbaatar (UB) city it is fewer than the above mentioned average, but the western region it is 17.5 or 3.1 î/îî higher than average rate. GOAL: To study current situation of perinatal mortality in western region of Mongolia MATERIAL AND METHODS: On the base of statistical dates of perinatal mortality of Health indicators and dates of health authorities of western region of Mongolia in 2004-2013 we considered indications of stillbirth from 22 weeks of gestation and early neonatal mortality by trend criteria. RESULTS: In the period of last 10 years in the western region of Mongolia totally 94810 mothers gave a birth, perinatal mortality is 2347 or 24.7 per 1000 birth. 57.7% of total perinatal mortality is stillbirth and 42.3% is early neonatal mortality. Among 5 aimags of region in Bayn-Ulgii stillbirth is the highest (77.2%), in Gobi-Altai aimag early neonatal mortality is the highest (70.3%). Dates show that perinatal mortality rate is different among western region’s aimags. Trends of Mongolian western region’s perinatal mortality rate till 2016 years will increase in Zavkhan aimag by 8.6, and in Khovd aimag by 0.9; and in other aimags will decrease. CONCLUSION: Although perinatal mortality decreases in western region of Mongolia, it is always higher than average rate of country. Therefore it is necessary to improve quality of antenatal and prenatal care. By doing this trend of increasing and decreasing will become stable and further it will be decreased.

JUSTIFICATION: According to the World Health Organization (WHO), 6.6 million children under the age of five died in 2012 - more than 750 every hour. Most of these children could survive and thrive with access to simple, affordable interventions. The loss of a child is a tragedy - families suffer and human potential is wasted. WHO is improving child health by helping countries deliver integrated, effective care in a continuum, starting with a healthy pregnancy for the mother, through birth and care up to five years of age. Investing in health systems is important to delivering this essential care [1, 2]. GOAL: To study perinatal mortality, this is the most important reason of infant mortality in Mongolia. MATERIALS AND METHODS: A retrospective cohort study was conducted reviewing data from 2007-2011 using the ICD code P00-P96 [4] listing “certain conditions originating in the perinatal period”. Data was analyzed using Epi-Info 2000 and GIS software. RESULTS: Data from 2007-2011 showed that 3091 neonates died from conditions originating in the perinatal period and of these 58.7% (1814) were males. Furthermore, the results of this study showed that the leading causes of death were “respiratory and cardiovascular disorders during the perinatal period” (ICD code P20-P29). More specifically, the causes were: - Birth asphyxia (P21) - Respiratory distress of newborn (P22) - Congenital pneumonia (P23) CONCLUSION: National average deaths per 1,000 live births in Mongolia are 9.5—with the highest rates reported in Dornogovi, Uvurkhangai, Bayankhongor, Gobi Altai, Uvs, Zavkhan and Khovsgol.

Introduction. The acute coronary disease (ACD), broadly encompass the clinical states unstable angina (UA) and acute myocardial infarction (AMI), especially affects adults due to cause the impairment of work ability, associates reducement of life quality and high expenses of medical treatment, and induces leading cause of sever complication and death.Materials and Methods. In this study, 44 ACD patients and 33 healthy subjects enrolled into case and control group, respectively. Relationships of primary and intermediate risk factors between cases and healthy subjects were determined by questionnaire research and clinical examinations. Measurements such as C reactive protein (CRP), cholesterol, triglycerides, low-density lipoprotein (LDH), high-density lipoprotein (HDL), trooping I, and mean platelet volume (MPV) were analyzed by clinical laboratory assays. The SPSS12 statistical software was used for all statistical calculations.Results. Statistical significant differences of hypertension and smoking were observed in ACD patients (UA and AMI) (P<0.01) compared with healthy subjects by independent samples T test. Body mass (BM), waist-to-hip ratio (WHR), body mass index (BMI) were significantly different in patients with UA, but WHR, hip were significantly different in patients with AMI. The levels of biochemical measurements such as cholesterol, triglycerides, and glucose were significantly higher in patients with AMI (р<0.01), whereas glucose concentration was significantly higher in patients with UA (р<0.05). However, a kind of inflammatory markers, CRP was a risk factor in the patients with ACD (UA and AMI), whereas MPV was a risk factor for AMI only. In the ANOVA test, which was confirming analysis on the results of independent samples Ttest, overweight (BM), abdominal obesity (WHR, hip) measurements, parameter of glucose metabolism(glucose) and some inflammatory markers (CRP, MPV) were significantly different between study groups. Relationships by determined Pierson`s correlation, were observed between overweight parameters (BM, BMI) and biomarkers of fatty acid metabolism (cholesterol, LDL, HDL, triglycerides). The BM of overweight parameters and the WHR of abdominal obesity measurements were strongly associated with increased level of glucose.Conclusion. Primary risk factors including hypertension and smoking; parameters of the overweight or abdominal obesity such as BM, WHR, BMI and hip; biochemical measurements as cholesterol, triglycerides and glucose; and some inflammatory biomarkers as well as CRP and MPV were risk factors in the ACD.

Background: Thrombocytopenia is more commonly observed in neonates compared to other age groups, occurring in 1-5% of healthy newborns. However, the incidence of thrombocytopenia is significantly higher (22%-35%) in sick neonates admitted to the Neonatal Intensive Care Unit (NICU), and numerous researchers have noted that severe thrombocytopenia contributes to neonatal mortality. However, the incidence of thrombocytopenia and mortality risk among patients in the NICU in our country has not yet been studied, which provided the rationale for our research. Aim: To investigate and determine the incidence of thrombocytopenia and the risk of mortality in neonates treated in the intensive care unit. Materials and Methods: Data were collected from the medical histories of infants hospitalized in the Neonatal Intensive Care Unit of the National Center for Maternal and Child Health in 2017-2019, and statistical processing was performed using the STATA 16 program. Results: Of all infants in our study, 56.53% (658) were boys and 43.47% (506) were girls. According to the gestational age of newborns, 34.19% (398) were full-term (>37 weeks), 61% (710) were preterm (28-36 weeks), and 4.81% (56) were extremely preterm (<28 weeks). According to birth weight, 33.65% (386) had low birth weight (2500g-1500g), 20.05% (230) had very low birth weight (1500g-1000g), and 8.81% (101) had extremely low birth weight (<1000g). Among the surveyed newborns, 534 (45.88%) had thrombocytopenia, and the number was 51.55% (200/388) in 2017, 46.15% (162/351) in 2018, and 40.47% (172/425) in 2019. The mean platelet count of newborns with thrombocytopenia was 50.21±43.23. Early (age <72 hours) 23.41% (125), late (age ≥72 hours) 76.59% (409), light platelet count (100-150x109/l) 17.42% (93), medium (50) -99x109/l) was 25.28% (135) and severe (<50x109/l) was 57.3% (306). The duration of thrombocytopenia in these infants was 13.68±10.33 days, and 72.65% (388) of them had thrombocytopenia, 27.15% (145) died without thrombocytopenia, and 0.18% (1) had autoimmune thrombocytopenia was under medical supervision and was discharged from the hospital. A total of 20.5% (239) of the neonates included in the study died, and among them, 76.15% (182) had thrombocytopenia, which showed a statistically significant difference when compared between the deceased and surviving groups (p<0.001). To determine whether neonatal thrombocytopenia is a risk factor for mortality, a univariate logistic regression analysis was performed, showing that thrombocytopenia increases the risk of mortality with an OR of 5.19 (p<0.001, 95% CI: 3.75-7.19). A multivariate logistic regression analysis further confirmed this association, with an OR of 2.46 (p<0.001, 95% CI: 1.65-3.68), indicating that neonatal thrombocytopenia significantly increases the risk of mortality. Conclusion Thrombocytopenia is commonly observed in neonates treated in the neonatal intensive care unit. Neonatal thrombocytopenia increases the risk of neonatal mortality.

Introduction: Antimicrobial Resistance (AMR) has emerged as a significant public health and economic issue worldwide, affecting both developed and developing countries. Our research has been motivated by the increasing prevalence of carbapenem-resistant P. aeruginosa, A.baumannii, and K. pneumonia in recent years. Goal: To determine antibiotic susceptibility of the pathogens isolated from wound infection and to detect its multidrug resistance. Material and Method: Samples were collected from patients with wound infections. Pathogens were identified by using the traditional culture methods and the API system with serotypes determined phenotypically. Antibiotic susceptibility was assessed using the disk diffusion method and the MIC to analyse antibiotic resistance. Results: In the study, among 11,221 recorded cases of wound infections in 2023, bacterial pathogens were detected and identified at the species level in 10,339 cases (92.1%).
For identification results showed that A. baummannii were detected from 138 cases (1.3%), 216 cases (2.08%) of Ps. aeruginosa, 5 cases (0.04%) of B. cepacia, 1,383 cases (13.4%) of Enterobacteriaceae, 205 cases (2.0%) of Enterococcus spp., 8,329 cases (80.5%) of Staphylococcus spp., and 63 cases (0.6%) of Streptococcus spp.
Antibiotic susceptibility of these bacteria was assessed and determined multidrug resistance. We found the followings: For A. baumannii were resistant with MDR in 68 cases (49.3%), MRSA in 4,243 cases (51.1%), MDRSta. aureus in 1,805 cases (29.4%), VRE in 34 cases (16.5%), ESBL in 4.6%, KPC in 26 cases (11.1%), FRNF in 24 cases (11.6%), and CRPA in 13 cases (6.3%). Conclusion
1. Of all wound infections reported in 2023 in 92.1% there were detected pathogenic bacteria, of which S.aureus were in 80.5% and E. coli was in 13.4%
2. 60.7% of the pathogenic bacteria detected in wound infections were multidrug-resistant, with MRSA accounting for 51.1% and MDR A.baumannii accounting for 49.3%, indicating high antimicrobial resistance(AMR).

BACKGROUND Bovine colostrums is the milk secreted by cows during the first few days after parturition. It contains many essential nutrients and bioactive components, including growth factors, immunoglobulins, lactoperoxidase, lactoferrin and cytokines ets. Lactoferrin has been reported for its multifunctional properties such as antifungal, antibacterial, antiviral antioxidant and anticancer activities. The aims of this study focused on the isolation and purification of lactoferrin from Mongolian bovine colostrums. Lactoferrin purified using HiTrap DEAE an ion exchange chromatography. Lactoferrin purification efficiency was about 60.5%. The single band of purified lactoferrin has been observed in SDS-PAGE electrophoresis. METHODS Bovine colostrum was collected at a cow farm in the Darkhan province of Mongolia. At first the cream was separated by centrifugation (10000 xg 20 min at 4oC). In order to separate the whey, the samples were precipitated with 1mol/l to pH 4.6 and centrifuged at 10000 g 20 min again. The samples of whey were stored at -18oC to the analysis. Lactoferrin was purified by HiTrap DEAE an ion exchange chromatography using 0.005 M phosphate buffer (pH 7.7) and linear gradient NaCl from 0.25M, 0.5M, 1M. During chromatography, protein in the eluents was monitored by ultraviolet absorbation at 280 nm with the instrument. Purity test done by using polyacrylamide gel electrophoresis under denaturated condition (SDS-PAGE) method by Laemmli (1970). For HPLC determination of the lactoferrin by Shimadzu Nexera X2 HPLC system with UV/ VIS detector were used. Detection was carried out at the wavelength 280 nm. Separation was performed on a chromatographic column Protein R C18 ,2.2 x 150 mm, 5 μm particle size. Linear gradient and flow rate 0.2 ml/min were used. Mobile phase a consisted of water / acetonitrile/ trifluoroacetic acid ( 95:5:0.1). The column temperature was set at 40oC and injection volume was 10 μl. Data were collected and evaluated by software Lab Solution. An external standard method for quantification analytes was used. RESULTS Purified lactoferrin in the present study had a good concentration and purification efficiency was about 60.5 %. Protein fraction from 1M NaCl gradient delivers sharp and clean peak to HPLC chromatogram that fits intensity and retention time of standard bovine lactoferrin. Ammount of lactoferrin in bovine colostrums was 0.6 mg/ml and it`s molecular weight 80 kDa as a standard sample. The retention time of lactoferrin fraction which is purified by SDS-PAGE gel electrophoresis. The peak of fraction same compared to the standard lactoferrin 5.8 minutes by HPLC analysis. CONCLUSION Ion exchange chromatography shows reliable and easy isolation of lactoferrin from Mongol bovine colostrum.