Subjects comprising the population of this study were recruited from 6 high schools of Khovd province. Total of 104210-12 aged children were participated in this study. Oral health education knowledge of study population was notenough. This range of age is most healthy period of permanent dentition. Therefore for these children giving informationabout healthy foods for teeth, importance of having good oral health behavior by oral health education program is veryeffective to prevent dental caries. It is necessary constitute oral health education program for children which is simple,cheap, and sufficient. Also for this oral health education program for high school children requires active participation ofschool teachers and parents.

Background. A large number of longitudinal studies indicate significantly increased risk of cardiovascular events and death in people with the MetSyn and high plasma levels of triglycerides are an independent risk factor for the development of cardiovascular disease. Apolipoprotein A5 (APOA5) gene, a new member of the APOA1/C3/A4 gene cluster, was identified by comparative sequencing of human and mice DNA by Pennacchio and co-workers in 2001. Since this discovery, variants of ApoA5 gene have been independently assiociated with level of plasma triglyceride in many countries. Human ApoA5 is expressed in the liver then appears in plasma in association with VLDL and HDL and plays a major role in TG catabolism. Variant at ApoA5 gene locus, 1177C>T is located in 3’ UTR which often contains regulatory regions that influence post-transcriptional gene expression. One alteration can be responsible for the altered expression of many genes. Materials and Methods. 152 people with MS for case group and 152 people for control group were selected in this study. MS was diagnosed according to IDF criteria and serum triglyceride levels were determined. DNA from both case and control subjects were extracted from blood samples (200 ml) using “G-spin™ Total DNA Extraction Kit”(iNtRON Biotechnology, Inc). To detect the 1177C>T variation of ApoA5 gene, using High Pure PCR Template Preparation Kits, a forward primer 5’-CTCTGAGCCTCTAGCATGGTTGAGT- 3’ and the mismatch reverse primer 5’-GAGCATTCCCAAATGAGCAC-3’ were used to create the HinfI restriction site. Results. There were 304 total subjects included males 50.3% (153) and female 49.7% (151) in our study. Incident of CC genotype was 71.1% (216), CT genotype was 25% (76) and TT genotype was 3.9%, TAG level was higher in males than females in both groups (p=0.016, ð=0.001) for CC genotype and also, higher with MS in males for CT genotype (p=). But, TAG level was no significant difference among three genotypes in group with MS subjects (male p=0.236, female p=0.881). Conclusion: The TT genotype of the ApoA5 gene 1177C>T polymorphism frequency was 2.9% in control subjects and 4.9% in subjects with MS. However, TG level was not differ in both groups for TT genotype, TAG level in males was higher compared with females (p=0.016 in control, p=0.001 in group with MS).

Introduction. Luteinizing hormone is slowly increasing in menopausal transition phase, it’s maintain to increase till early post menopause phase (Gore et al. 2004). It is related to steroid hormone’s negative feedback and estradiol’s positive feedback (Rossmanith 1995), and in addition, recently years kisspeptin-10 of hypothalamus [1]. LH is dramatically decreasing at the rather late of post menopause phase (Hall et al. 2000, Gill et al 2002). By the year 2030, more than 1.2 billion women in the world will be at least 50 years old. This increasing proportion of the female population will be experiencing the menopausal transition with its accompanying physiology and pathophysiology [2]. Recently researchers more focused to study the comparative analysis of hormones at the menopause phase in different ethnic groups. This kind of study have not implemented in our country yet.Goal.Determination of serum LH level changes in relation to aging. Materials and Methods. In this study were involved 161 healthy Mongolian women aged above 35 years. Subjects were randomly selected and undergone physical examination by geriatrician. People, who are receiving hormone replacement therapy, using in proper use of alcohol, injured and had survey, were excluded from our study. Blood samples were collected in the morning 8.30-10.30 AM, after a night fasting. Blood was separated immediately by centrifugation, then obtained sera were stored at -20 0C until assayed by ELISA kit from United Biotech CoLTD, USA, which sensitivity is 1mlU/ml. Statistical analyses have been performed by statistical software SPSS 17, using ANOVA, Pearson correlation.Results. Average level of LH was 29.95±3.31mIU/ml, 15.87±5.86mIU/ml at the age 35-45, 33.12±7.1mIU/ml at the age 46-55, 15.87±ImU/ml at the age 56-65, 38.15±6.6mIU/ml at the age 66-75, and 56.42±11.1mlIU/ml over 76 age in the all participants, considering by person correlation coefficient, between age and LH are moderate and direct correlation (r=0.264, ð 0.003).Conclusion. Average level of LH was 29.95±3.31mIU/ml in women aged over 35. Considering by person correlation coefficient, between age and LH are moderate and direct correlation (r=0.264, ð 0.003). LH increases with aging till round 70 and decreases after 70 years.

Introduction: Cardiovascular diseases are one of the leading causes of mortality and morbidity in Mongolia during last 10 years. Accordingly, increasing number of the procedures cardiac open heart surgeries in Mongolia.The aim is to evaluate of the scientific literature related toestimation of expenditure for open heart surgeries.Method: The literature search strategies were developed to identify published studies. The following literature databases were searched and collected individually: MEDLINE PubMed, Google and abstract books in Mongolian libraries.Result: Analyzed the 28 published literatures which made in estimation of expenditures for open heart surgery. The most of the study were generally focused on the expenses of diagnosis and treatments of open heart surgery. Literature showed that for patients not covered by health insurance, valve replacement surgery typically costs from about $80,000 -$200,000 or more with an average, according to an American Heart Association report, of $164,238, not including the doctor fee. A surgeon fee can add $5,000 or more to the final bill. For example, Dartmouth-Hitchcock Medical Center in New Hampshire charges about $86,500, including doctor fee, after a 30% uninsured discount. St. Mary’s Hospital in Wisconsin charges an average of $107,000, but costs can reach $200,000 or more. AndBaptist Memorial Health Care charges about $75,000 -$140,000, not including doctor fee, but cost can go up to more than $200,000 with major complications. In Russia, total 700,000 people take surgery on annual average each year and on which they spend 10 902 500 000$ annually, it has been stated on Bokeriya.L found that 464 637.840 ruble annually on cardiac surgery coronary angioplasty surgery, 792 237 ruble on coronary heart disease surgery and 9 522 ruble on congenital heart defect repairment surgery. Up to per 15 years old children, 24 288 ruble spend on average. Bokeria et all reported that, expenses of medicine through ABC/VEN analysis, 47 types of medicines of A group(13.1% of total medicines) takes 79.62% of total expenses, 71 types of medicines of B group(19.8% of total medicines) takes 15.36% of total expenses, 242 types of medicines of C group(67.1% of total medicines) takes 5.02% of total expenses. Out of this report, N group’s portion of A group medicines takes 0.79% by VENanalysis. Approximate, all inclusive cost for open heart bypass surgery (CABG ) vary between USD 5500 - USD 7800, depending on the facility & city you chose to get the procedure done in India. D.Tsegeenjav and D.Bat-Undral reported the expenses on open heart surgery in Mongolia, as a result showed that health insurance spend 56 422 656 ₮ (appx 39,100,093$) for 156 numbers of procedures. But real cost expenditure was 440 300 000.00₮. It means health insurance spent 12.6% of total expenditure for procedures. Also health insurance expenditure for CABG and one valve replacement per patient were same as 643 272.00₮, but real expenditures for CABG was 2 000 000.00₮, and for one valve replacement surgery per patient was 5 000 000.00 ₮.Conclution: The scientific literatures showed that many studies related in estimation of expenditure for open heart surgery made in international countries such as Russia, USA, UK and India et all. But we didn’t found the study for estimation of expenditures for open heart surgery by using ABC/VEN analysis in Mongolia.References:1. Health indicators of Mongolia 2002-2012. Report of the state implementing agency.2. Цэгээнжав д, Бат-ундрал д. зүрхний нээлттэй мэс заслûн эмчилгээний зардлûн асуудалд, “авьяслаг шастинчууд 2013” эрдэм шинжилгээний хурлûн эмхэтгэл, х3-4Бокерия л. а.самородская и. в.ßрустовский и др., Oпыт применения авс- и ven-анализа в сердечно- сосудистой хирургии фгбу. Бюллетень нЦссх им. а.н. Бакулева рамн, 2012, ¹1, стр http://lekarius. ru/external/paper/26143. The European health report 2009: health and health system. WHO Library Cataloguing in Publication Data.4. Shear A, Scuffham P, Mollon P. The cost of coronary artery disease in the UK. Br. J. Cardiol. 2004. Vol. 11. P 218-223.5. Htt://health.costhelper.com/valve-replacement.html Heart valve replacement costKey words : Open heart surgery, expenditure

BACKGROUND. Annular elastolytic giant cell granuloma (AEGCG) is a rare skin disease, characterized by loss of elastic tissue due to elastophagocytosis by multinucleated giant cells in the upper part of dermis, which clinically presents as multiple annular plaques with raised erythematous border and central atrophy. We report a first case of AEGCG in dermatology practice in Mongolia. Its clinical and histological features, differential diagnosis and treatment modalities are described and discussed in detail.

BackgroundPolycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders affecting women of reproductive age, with a prevalence of about 5%–10% in the general population. PCOS is characterized by menstrual disturbances due to hirsutism, chronic anovulation or oligoovulation, and acne due to excessive androgen production (hyperandrogenemia). The pathogenesis of PCOS is still unexplained. Following the main criteria of diagnosis (Rotterdam Consensus 2003), Dewailly, Welt and Pehlivanov divided the patients with PCOS into 4 phenotype groups: Oligo + HA + PCO, Oligo + HA, HA + PCO, Oligo + PCO. ObjectiveThis aim of the study was to compare gonadotropin levels in serum of reproduction age for comparative healthy women and polycystic ovary syndrome (PCOS).MethodsA cross-sectional study was performed comprising 425 comparative healthy women of reproductive age group 18-35 (<20 n=76, 21-25 n=131, 26-30 n=92, 31-35 n=126). To collect blood sample 4 times of healthy, normal menstrual cycle and body mass index (BMI) of women. To determine FSH, LH hormone in serum by ELISA (Eucardio lab kit used). To evaluate FSH, LH, LH/FSH normal menstrual phase (early follicular phase,late follicular phase, ovulation and mid-luteal phase). PCOS patients divided 2 type (oligo+ha, ha+pco).ResultsThe mean age was group A 26.33±5.28, group B 24.9±4.93, and group C 29.75±4.12, BMI a; 22.35±2.95, b; 28.88±3.85, c; 28.0±3.19. The mean level was FSH a; 4.64±1.65 mIU/ml, b; 12.07±3.85 mIU/ml, c; 5.35±7.20 mIU/ml, LH a; 6.42±3.3 mIU/ml, b; 39.43±15.89 mIU/ml, c; 10.89±2.53 mIU/ml of PCOS. To correlate FSH, LH, LH/FSH level was women was significantly (p<0.05).Conclusion: The increased level of LH, LH/FSH strongly correlates with the clinical degree of amenorrhea and hyperandrogenism.It seems that LH, LH/FSH could be a crucial diagnostic and predictive factor among women with menstrual disorders or presence of polycystic ovaries.

BackgroundSchoolchildren spent most of time in school and the school environment is one of several settings thatcan influence children’s food choices and eating habits. Schools can ensure that the available food andbeverage options are healthy and help young people eat food that meets dietary recommendations forfruits, vegetables, whole grains, and nonfat or low-fat dairy products.GoalTo assess quality of common foods and diet in school environmentsObjectives:1. Define food items and groups in school environment;2. laboratory analysis in sample foods on “School lunch” and around school environmentMaterial and MethodsThirty public and private schools from six districts of city of UB were randomly selected from a list of allschools. Laboratory tests were analyzed total 250 samples from school canteens and within 250 metersdistances around sampled schools.ResultSchoolchildren are exposed to a wide range of unhealthy food and beverages in the school environmentand healthier food and drink’s choices are very limited in these settings. The high availability of differentvarieties of unhealthy food and drinks at affordable prices makes these products the most preferablechoices for children. Overall, 46.5 percent of schoolchildren were served in school canteen and 33.9percent of schoolchildren were served outside of schools including shops and buffet. Main factors of foodchoice were first, like eating (30.2%), food price (27.8%), hungry (16.7%) and food advertisement was6.3% among schoolchildren. Most of common foods (92.5%) were analyzed with high in salt, sugar andlow content of vitamins and minerals around school environment. There was very high sugar content per100 gram products for instance, “Batos” ice-cream 22.75 gr, “Iberry” ice cream 14.05 gr and, “Granat”juice 1364 gr. In addition, fat content is also high in schoolchildren’s common food consumption. Fatcontent tested 31.4gr in chips and 30.6 gr in pie, cake and 26.9 gr in biscuits per 100 gr products.

Background: According to the study conducted by International Diabetes Federation, total of 127,1 million pregnant women were participated in the study and 21,7million (16,8%) of them were diagnosed as Gestational diabetes mellitus.³ Maternal physical structure, figure and correlation between maternal anthropometrics and fetal measurements influence directly to fetal status, process of labor and termination of birth. During the period between 1950-1960, it was described for the very first time that gestational diabetes mellitus can lead to infant overweight.⁴ Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels after 24 weeks thus the risk to develop Diabetes mellitus type 2 increases. The average infant at right after birth weighs approximately 3200-3500 grams but sometimes infants with more than average weight are born. If infant weighs 4000-5000 grams and more than this, it is defined as overweighed. The infant’s weight depends on several factors. However, hereditary factors and blood glucose levels are the main cause of infant’s overweight. According to study conducted by Koyanagi et al, 2003, maternal obesity, diabetes mellitus type 2, post term pregnancy, subsequent pregnancy, maternal and paternal height and weight, maternal older age and previous history of giving birth to overweight infant can lead to infant being born overweight.⁷ Methods: The study is made by using cross sectional method of analytic study and total of 200 pregnant women from Khan-Uul, Bayangol, Chingeltey and Bayanzurkh districts who were attending the first admission of pregnancy follow-ups. According to WHO recommendation, we made diagnosis based on results of glucose tolerance test (blood glucose measurement 2 hours after giving 75 grams of sugar orally). The body mass index is calculated by using body weight and height as BMI. In full term birth, infant weighs less than 3999 grams is normal and more than 4000 grams is termed as overweight infant Results: Infant weight depends on maternal age and it is statistically significant (р<0.025). Pre pregnancy weight and BMI are affecting the increasing level of blood glucose by statistically significant (р<0.005) (table 3). In addition, maternal age (0.012) and Glucose tolerance test (blood glucose level after 2 hours) (0.002) have direct correlation to infant weight and it is statistically significant respectively.
96 of total (48.0%) pregnant women gave vaginal birth, 104 (52,0 %) of them have undergone caesarean section. It seems, that as fetus weight rises, frequency of caesarean section increases (table 5). Moreover, fetal weight depends on gestational physical activities rather than frequency of pregnancy and gestational weight gain (р<0.002). Conclusion Women who gave birth to overweighed infant have higher fasting blood glucose and glucose tolerance test (glucose level after 2 hours) results and higher index than mean BMI. In other words, gestational diabetes mellitus is one of the risk factors which leads to infant’s overweight.

The Rapid Assessment of Avoidable Blindness (RAAB) has been developed as a simple and rapidsurvey methodology that can provide data on the prevalence and main causes of blindness.AimTo assess the prevalence and main causes of avoidable blindness and visual impairment in peopleaged 50 and above in Mongolia.MethodsThe RAAB uses a standard methodology which is documented in the RAAB Instruction Manual (HansLimburg, International Centre for Eye Health, London School of Hygiene and Tropical Medicine).Assuming an estimated prevalence of blindness in persons aged 50+ of 2.14% and a non-complianceof 5%, with a variation to 25% around the estimate of 2.14% at 95% probability, the required samplesize was calculated at 4,040: 101 clusters of size 40. Visual acuity (VA) was measured with a Snellentumbling E chart, using optotype size 18 (60) on one side and size 60 (200) on the other side. Thelens status of all participants was assessed by both torch and distant direct ophthalmoscopy, by anophthalmologist in a shaded or dark environment. The data were analyzed using RAAB Version 4.02(ICEH, London) for pre-defined reports relating to both crude and age and gender adjusted results.ResultsThe survey included 4,040 people aged 50 years and older, of whom 4,029 were actually examined.The coverage was 99.7%. 7 persons (0.2%) were absent and 4 (0.1%) refused to participate in thestudy. The prevalence of bilateral blindness with available correction in the better eye is 2.2 % (95% CI,1.7 - 2.7%); 2.4% in males and 2.2% in females. The prevalence of bilateral severe visual impairment(SVI) is 2.1% and bilateral moderate visual impairment (MVI) is 10.8%. The prevalence of functionallow vision, requiring low vision services, is 4.5%. In people aged 50+, untreated cataract is the mostcommon cause of bilateral blindness with 38.9%, followed by glaucoma (20.0%), non-trachomatouscorneal opacity (13.3%), and other posterior segment disease (7.8%).Conclusion: Untreated cataract and uncorrected refractive errors are the major causes of avoidableblindness and low vision in Mongolia, respectively. Priority should be given to cataract surgery,followed by the development of optical services and PHC and PEC services, as these are the mostcost-effective interventions. These three interventions will address about three thirds (67.8%) of thecauses of blindness and have most impact.