Introduction: Pancreatic cancer in young patients is usually correlated with chronic alcohol consumption and hereditary factor. Chronic pancreatitis, pancreatic trauma, pancreatic cyst, alcoholism, and diabetes mellitus are the most clearly established etiological factors (T.Y Flanders., W.S Foulkes., 1996). The cancer was located to the pancreatic head in 75% to the body in 15-20% and to the tail in 5-10% of cases (A.E Richard., 2005). Goal: Determination of the US signs in pancreatic cancer and establishment standard (control) US diagnostic criteria. Objectives: 1. To reveal direct and indirect US signs of pancreatic cancer. 2. To establish standardized US diagnostic criteria. Materials and Methods: A prospective study was carried out in 35 patients with pancreatic cancer in a 4 years period between 2006-2010 (Shastin Central Hospital, Achtan Clinical Hospital). To each patient has being filled special investigation chart. Diagnosis was confirmed on the result of physical examination, laboratory investigation, abdominal conventional radiography, upper gastrointestinal contrast radiography, CT, MRI, ERCP and biopsy. The results of the measurements were compared with the standardized control evaluation of Mongolian people (Ts.Badamsed.B.Tserendash). Results: Our sample represents US signs in 35 patients with pancreatic cancer. On the basis of our study US sign were divided into two categories: direct and indirect signs. Direct signs: a) irregular shape, b) irregular tumour edge, c) hypodensity, d) tumour size more than 2.1cm, e) different location. Indirect signs: a) CBD distends, b) gallbladder distends, c) intra hepatic bile duct distend, d) pancreatic pseudo cyst, e) near-aortic limp node enlargement, f) splenomegaly. We consider that the upper mentioned US abnormality can be as control standard criteria for the US diagnosis of the pancreatic tumour. According to the study of V.N.Demidov and G.P.Sidorov (1987), the pancreatic cancer is located to head in 50-80%. In our series it was about 45.7%± 8.4. Irregular tumour shape in 60.0%±8.3, tumour hypodensity 80.0%±7.2, irregular tumour edge 68.6%±7.8, tumour clear definition 71.4%±7.6 which are the same with N.M. Mukharllyamov (1987). Conclusions: 1. Were described direct and indirect US diagnostic signs in pancreatic cancer 2. The tumor location, shape, size, edge, consistency, intra and extra hepatic bile duct distend, gallbladder distend, near-aortic limp node enlargement are the basic control criteria for the diagnosis of pancreatic cancer.

IntroductionHypertension is a major public health problem with serious medical and financial consequences. Barriers to successful conventional pharmacological treatment include the side effects, out-of-pocket expenses, patient non-compliance and insufficient dosages. The design of the Stop Hypertension with the Acupuncture Research Program (SHARP) trial balanced rigorous clinical trial methodology with principles of TCM.GoalTo treat arterial hypertension by traditional medicines and acupuncture, and determine its effectiveness.Materials and Methodsthe participants had systolic blood pressure (SBP) 140-179 mmHg and diastolic BP (DBP) 90-109 mmHg in the absence of antihypertensive therapy. Following a screening, the participants were randomly divided to one of the following two groups: individualized acupuncture and standardized acupuncture. Standardized acupuncture used a pre-specified set of points. In the other group, each participant received a “prescription” for individualized acupuncture from an acupuncturist who was masked to treatment assignment, and was subsequently treated by an independent acupuncturist. Acupuncture was performed twice a week for 6 weeks.ResultsThe systolic blood pressure reduced statistically significantly through the 2nd, 4th and 6th weeks against the measurements taken at the onset of the treatment. Before the acupuncture therapy, the systolic blood pressure was 159.52 mmHg (95% CI: 156.52-162.51) and it reduced to 147.62 mmHg (95% CI: 147.62-154.22) in the 6th week. Before the acupuncture therapy the DBP was 98.34 mmHg (95% CI: 96.77-99.91). It reduced to 92.56 mmHg (95% CI: 90.80-94.31) at the 6th week. Conclusions: Acupuncture therapy reduced SBP by the mean of 8.6 mmHg and DBP by the mean of 5.78 mmHg.

BACKGROUND OF STUDY: According to WHO report estimation, 76.3 million people have been diagnosed with disorder related to alcohol use which has been root cause for over 60 types of disease in the world.1 Smoking causes death to4 million people every year, 11 people every day and 6 every minute. This number is estimated to double reaching 10 million by 2030.2 The study conducted by the ‘World Vision Mongolia’ international organization and the Anti-alcoholism and Drug Association of the Ministry of Justice show 76% of all teenagers has drunk alcohol to some extent. AIMS: To determine alcohol, tobacco and psychoactive drug use by school teenagers of Sukhbaatar district in Ulaanbaatar MATERIAL AND METHODOLOGY: The survey on inquiry of alcohol, tobacco and psychoactive drug use (ASSIST) was conducted among a total of randomly selected 800 (374 boys, 426 girls) students of 8-12th grade from 7 secondary schools of Sukhbaatar district. Statistical data was put into Microsoft office applications (excel, word) and processed by SPSS application with 95% of probability of information and 5.0% of trust level. RESULT OF STUDY: Out of all respondents 32% (256) use tobacco, 43.8% (350)alcoholic drinks, 2.6% (21)cannabis,1.1% (9) cocaine, 1.5% (12) amphetamine, 3%(24)volatile substance, 4.3% (34)sedative and tranquilizer drug, 0.6% (5)hallucinogenic drug, 0.5% (4) opioid, and 0.1% (1) uses other types of drug. Among the survey participants, there are a total of 214 teenagers (in duplicated number) who need short-term action and 2 teenagers who are smoker and need intensive treatment. CONCLUSION: Among total teenagers, the survey participants, 1 in 3 used tobacco, 1 in 2 alcoholic drinks and 1 in 7 used psychoactive drug. Male students smoke twice more than female students and there is no difference in use of alcoholic drink in both sexes. The alcohol and tobacco use among teenagers at the age of 12-18 who participated in the survey showed that they use more when they grow older. 1 in 4 students of all participants belongs to a group with average risk and needs intensive treatment.

Goal: The purpose of this study is to identify issues of current situation of the health information system in the health care facilities of Mongolia.Materials and Methods: A total 362 users as hospital directors, physicians, nurses, statisticians and IT workers of 105 health care facilities at primary, secondary and tertiary level participated in this study. Data collection methods were generated using a combination of questionnaires and in-depth interview of the users. The statistical analysis was carried out using the SPSS. Outcome measures were calculated with 95% confidence intervals (CI).Results: The survey results were shown that a vertical health information flow regulates in the health sector, internal networks set up and H-info 2.0 software as routine data processing and insurance claims are used in the hospitals of Mongolia. Regarding of e-health software as Computerized Physician Order Entry (CPOE), Drug Information System (DIS), Laboratory Information System (LIS) and Radiology Information System (RIS), 82.6% of the health care facilities used only CPOE. There 50% of the existed e-health software is not integrated in the health care facilities. In the data management, 27.0% of the health care facilities that used e-health applications had no backup solution. 45.5% of total users said that the information technology human resource is insufficient. 70.0% of users responded as there did not any continues training program in health information technology. The study was determined lack of functions and difficulty of using the existed software and inadequate software operation and not user-friendliness are the causes of the most of dissatisfactions. Conclusions: A vertical health information flow, internal networks, routine statistic processing set up and mainly CPOE used in the health care facilities. However there is no integration of e-health software and lack of its capacity. It is required modern integrated health information system in the health sector of Mongolia.

INTRODUCTION:Uterine leiomyomas are the common smooth muscle tumors of female genital tract. Usually theirdiagnosis poses no problem. On the other hand leiomyosarcomas are highly malignant tumors.Distinction between the two poses no problem if the leiomyosarcoma shows significant dysplasia,however at times it may become a serious problem to differentiate between leiomyoma and well–differentiated leiomyosarcoma. Under such circumstances the mitotic count per 100 high powerfields considered by many as the most important criterion of distinction.MATERIAL AND METHODS:To investigate the role of mitotic activity in the growth of uterine leiomyomas, the mitotic count per100 high-power fields and the relation of this to the patient’s age (30 to 54 years) were examined intissue sections of leiomyomas from 130 surgically removed leiomyomatous uteri.RESULTS:The mean mitotic count in submucosal uterine leiomyoma was significantly higher (42.3%) than thatof the other location such as intermural and subserosal leiomyoma. We found the highest mitoticcount in a leiomyoma at the late reproductive aged women (46.1%) at early secretory phase. But therewas not a statistical correlation between women’s age and mitotic activity of uterine leiomyoma.CONCLUSION:Increased mitotic activity in leiomyomas under the late reproductive aged women suggests that thegrowth of these tumors is affected by progesterone level

PurposeThe aim of our study is to investigate the relationship between cognitive status, depression level,functional status and quality of life in elderly people living at home and in Batsumber.Methods158 voluntary elderly subjects, older than 60 ages were included in the study. The data was obtained byface to face interviews. The questionnaire covered socio-demographic characteristics, administrationof the standardized Mini mental test (SMMT), Geriatric Depression scale (GDS), Lawton instrumentalactivities of daily living (IADL) scale and World health organization Quality of life instrument-olderadults module (WHOQOL-OLD). Data analysis was performed using SPSS 22 software.ResultsThe living at their own home subjects (77.4%) had a high cognitive level and the living in nursing homesubjects (88.2%) low cognitive level. In both groups appeared in high levels of depression. Therewas a positive correlation between IADL, cognitive status and quality of life (p<0.05) and a negativecorrelation between cognitive status, quality of life and depression status.Conclusion: Our results suggest that elderly are more susceptible to the risk of developing psychiatricproblems especially depression. And this study indicated importance of the relationship betweenfunctional level, cognitive status, depression level and quality of life of elderly people living at homeand in Batsumber.

Aim was to investigate expression of tumor suppressor P53 gene, proliferating Ki-67 protein inordinary and proliferating uterine leiomyomato establish possible usefulness of these two parametersin distinguishing between ordinary leiomyoma and proliferating leiomyoma. Retrospective study of49uterine leiomyoma (25 ordinary leiomyoma, 24 proliferating leiomyoma) technically acceptable foranalysis from years 2010–2013 department of Obstetrics and Gynecology and department of Pathology,Mongolian National University of Medical Science, Ulaanbaatar, Mongolia.MethodAll tissue specimens were obtained from surgically removed tumors. Tissue was fixed in formalinand cut to thickness of 5 mm from paraffin-embedded blocks. All haematoxylineosin slides and allimunohistochemical slides for each case were reviewed by two experienced pathologist.ImmunohistochemistryParaffin-embedded tumor sections were deparaffinized and stained in automated platformDakoCytomationusing monoclonal mouse anti-human Ki-67 antigen (Dako,Glostrup, Denmark), monoclonal mouse anti-humanP53 protein (Dako, Glostrup, Denmark).Immunohistochemicalanalysis of P53 and Ki67 expression was performed. Every nuclei stained brown,regardless of shade intensivity, was considered positive. The interpretation of immunohistochemicalstaining was expressed as number of positive cells in 100 cell count in most active area of the slide.Non-parametric analysis of variance Kruskal-Walistest was performed.P53 expressionExpression of P53 was negative in 24/24 ordinary uterine leiomyoma, 2/10 mitotic activity leiomyoma,11/15 cellular leiomyoma. Expression of P53 in 1–10% of cells showed 3/10(30%) mitotic activeleiomyoma and 1/15(6.6%) cellular leiomyoma. Expression in 10-70% of cells showed 5/10(50) mitoticactivity leiomyoma, 3/15(20%) cellular leiomyoma. A significant difference in expression of P53 wasseen between ordinary and proliferative (mitotic activity and cellular) uterine leiomyoma (p<0.007, Table1).Ki-67 expressionExpression of Ki67 was negative in 20/20 (100%) ordinary leiomyoma, 4/11(36.3%) mitotic activityleiomyoma and 7/18(38.8%) cellular uterine leiomyoma. 1–10% of cells were positive in 4/11 (36.6%)mitotic activity leiomyoma, and 5/18% cellular leiomyoma. Expression was positive in 10-70%of cellsof 3/11(27.2%) mitotic activity leiomyoma and 6/18(33.3%). Statistically significant differences in Ki67expression was found between ordinary leiomyoma and proliferating leiomyoma (p<0.014, Table 2) andbetween LM and LMS (p=0.000, Table 1).Conclusion:The findings of our study in concordance with other study results are helpful information establishingmore diagnostic criteria and parameters for diagnosis in doubtful cases between two entities.Immunoassaying for Ki-67 and P53 are such parameters. The panel of their expression in specific caseeases diagnosis.

Middle aortic coarctation (MAC), a variantof middle aortic syndrome, is a rare entity withonly ~200 cases described in the literature.It classically presents with early onset andrefractory hypertension, abdominal angina,and lower extremity claudication(1).A 30 years-old woman, Her systolic bloodpressure measures 180-200mm Hg and diastolicpressures measure 70mm Hg in both arms,lower extremity pressures are approximately70mm Hg. Her bilateral femoral pulses andpedal pulses are nonpalpable, but present onDoppler exam and CT-Angiography.We prepared diagnostic of CT-Angiographyand Aortography before operation. Wesuccessful operated abdominal aorticcoarctation by “Silver graft” Aortoaortic bypasson the middle aortic, left nephrectomy.She was discharged home on postoperativeday 7. Post operation is good. We werecontrolled CT-Angiography.

Purpose; To control acupuncture of essential hypertension. Method;The design of the SHARP trial balanced rigorous clinical trial methodology with principles of TCM. Eligible participants had systolic blood pressure 140-179 mm Hg and diastolic blood pressure 90-109 mm Hg in the absence of antihypertensive therapy. Acupuncture was delivered twice a week for 6 weeks.Follow –up visits were every 2 weeks. Result;At weeks 2, 4 and 6 ;both pre-acupuncture and post- acupuncture blood pressure were measured. Those time pre- acupuncture blood pressure decline than post –acupuncture(p<0.0001) . Conclusion;Acupuncture treatment had a significant negative influence reduction blood pressure.

Background: Infertility is defined as the inability of couples to conceive despite engaging in regular, unprotected sexual intercourse for over a year. Assisted reproductive technology (ART), particularly in vitro fertilization (IVF), has emerged as the most widely utilized solution for infertility. The cause of infertility, a woman's ovarian reserve, response, egg and sperm quality, the number and quality of embryos, and various other factors influence the outcome of IVF. Despite significant advancements in ART, predicting IVF outcomes remains challenging, especially when tailoring treatment strategies to individual patient factors. Aim: To investigate the clinical indicators, ovarian reserve markers, and stimulation outcomes influencing the success of IVF treatment in Mongolian women. Materials and Methods: A prospective study was conducted at the Unimed International Hospital IVF Center between October 2023 and August 2024. Clinical and demographic factors, ovarian reserve markers (FSH, AMH, AFC), and ovarian stimulation outcomes were analyzed in 242 women aged 25-44 years undergoing IVF. Logistic regression analysis was performed to identify risk factors and predictors of clinical pregnancy, with a statistical significance threshold set at p<0.05. Results: Among 208 women who underwent embryo transfer, the clinical pregnancy rate was 36.5%, and biochemical pregnancy was observed in 38.4%. Age was a significant predictor, with older age groups (35-39 years: OR=7.11, p=0.004; 40-44 years: OR=12.65, p=0.004) associated with reduced IVF success. Ovarian reserve markers, including AMH (OR=2.49, p<0.001) and AFC (OR=1.56, p<0.001), were significantly correlated with pregnancy outcomes, whereas FSH was not significant (p=0.518). Higher numbers of pre-ovulatory follicles (POF) (OR=1.03, p=0.040) and high-grade embryos (OR=1.26, p=0.045) increased the likelihood of clinical pregnancy. No significant associations were observed between total gonadotrophin dosage, ovarian sensitivity index, and fertilization rate with pregnancy outcomes. Conclusion Age and ovarian reserve markers (AMH, AFC) are critical predictors of IVF success, while pre-ovulatory follicle counts and number of high-grade embryos significantly enhance pregnancy likelihood. These findings emphasize the importance of personalized ART protocols tailored to ovarian reserve and age-related factors to optimize IVF outcomes.